Rotational occlusion of the vertebral artery at the atlantoaxial joint: is it truly physiological?

We present a patient with vertebrobasilar insufficiency, with vertigo and horizontal nystagmus, induced by turning the head to the right. Angiography demonstrated transient occlusion of the left vertebral artery at the atlantoaxial joint during rotation of the head. The pathogenesis and angiographic findings are discussed.     

双枚和三枚细加压螺纹钉内固定治疗股骨颈骨折的疗效比较

近年来我院采用手法复位的同时用双枚或三枚细加压螺纹钉内固定治疗股骨颈骨折,效果良好,现对比分析报告如下。1 临床资料 1991年1月-2000年1月,共收治新鲜股骨颈骨折患者480例,采用内固定治疗者388例,其中采用X线闭路电视下手法整复双枚或三枚细加压螺纹钉内固定者282例。为缩小年龄跨度,便于比较疗效,年龄小于45岁和大于75岁31例未收集。因死亡而不能继续随访者21例,死亡均发生于术后半年以上,与骨折或手术无直接关系。因其他原因而失访者16例。其余214例资料较完整,其中男86例,女128例。有5例伴同侧的Colles骨折,3例同侧肱骨外科颈骨折,其他无严重并发症。所有伤侧髋关节手术前无明显关节炎改变。加压螺纹钉规     

前路减压Z-plate内固定治疗胸腰段爆裂性骨折伴不全性截瘫

目的 探讨胸腰段爆裂性骨折伴不全瘫前路减压内固定优越性以及Z-plate系统的优点。方法 采用前路减压Z-plate内固定治疗胸腰段爆裂性骨折伴不全瘫25例。结果 全部病例均获随访，随访时间6～24个月，平均17个月。按Frankel分级评定有1～3级恢复，随访期间无后凸加重及内固定松动，植骨融合。结论 前路减压Z-plate内固定是治疗胸腰段爆裂性骨折的较好方法。     

Array compression for MRI with large coil arrays.

Arrays with large numbers of independent coil elements are becoming increasingly available as they provide increased signal-to-noise ratios (SNRs) and improved parallel imaging performance. Processing of data from a large set of independent receive channels is, however, associated with an increased memory and computational load in reconstruction. This work addresses this problem by introducing coil array compression. The method allows one to reduce the number of datasets from independent channels by combining all or partial sets in the time domain prior to image reconstruction. It is demonstrated that array compression can be very effective depending on the size of the region of interest (ROI). Based on 2D in vivo data obtained with a 32-element phased-array coil in the heart, it is shown that the number of channels can be compressed to as few as four with only 0.3% SNR loss in an ROI encompassing the heart. With twofold parallel imaging, only a 2% loss in SNR occurred using the same compression factor.     

肱骨干骨折内固定的选择及应注意的问题

目的正确选择肱骨干骨折手术内固定.方法对107例肱骨干骨折分别进行交锁髓内钉(34例)、加压钢板(29例)、Y型钢板(38例)、螺钉(6例)等内固定,并随访比较分析. 结果所有病例均得到随访,平均随访6.3个月.交锁髓内钉、螺钉内固定组全部愈合;加压钢板内固定组愈合26例,伴桡神经损伤2例;Y型钢板内固定组全部愈合,伴肘关节僵硬2例. 结论根据肱骨干骨折的部位和类型选用适当的内固定方法,骨折愈合良好,可有效的减少并发症的发生.     

Dislocation of an upper third molar into the maxillary sinus after a severe trauma: a case report

Abstract – Dental injuries are common following facial trauma. This article presents a rare injury: the dislocation of a third molar into the maxillary sinus after complex mandibular and maxillary tuberosity fractures. The possible mechanism and clinical treatment are discussed.     

Gd-DTPA-enhanced MR in thoracic disc herniations

Summary The Gd-DTPA-enhanced magnetic resonance findings in two patients with herniated thoracic intervertebral discs are reported. The first patient was a 56-year-old woman with a small subligamentous T6-7 disc herniation, slightly lateralized to the right. The second patient was a 51-year-old man with a central and right posterolateral disc herniation, including a large calcified fragment, at the T8-9 level. The nonenhanced MR examination revealed the presence of an extradural mass lesion in both patients, impinging upon the dural sac and compressing and displacing the spinal cord posteriorly. The lesion was slightly hypointense on both T1- and T2-weighted spin echo sequences. Following intravenous injection of Gd-DTPA in a dosage of 0.1 mmol/kg body weight, enhancement of the posterior longitudinal ligament was noted and triangular areas of contrast uptake were seen to occur in the epidural space above and below the herniated disc. At surgery, they were found to correspond to dilated and congested epidural veins.     

Intramedullary pilocytic astrocytomas — a clinical and morphological study after combined surgical and photon or neutron therapy

Ten patients suffering from intramedullary pilocytic astrocytomas (WHO-classification: astrocytoma grade I) were investigated catamnesticly. Combined surgery and radiotherapy was performed. Seven patients received neutron irradiation postoperatively. In four cases the neurological symptoms were improved after follow-up periods ranging from 33 to 89 months. The three other patients died after 6 to 21 months. The autopsy findings of a 14 year old child are presented. Our results are compared with reports in the literature. In addition, long-term problems of the spinal column are discussed. It seems that the combined surgical and neutron therapy improves the prognosis of pencil gliomas.     

鼻眶筛骨折手术治疗的临床评价

目的　探讨鼻眶筛骨折的手术入路、骨折复位与坚固内固定及合并眼球内陷的处理方法。方法　对 17例鼻眶筛骨折患者进行回顾性研究 ,根据CT结果与Fedor骨折分型分为三型 ,其中Ⅰ型 1例 ,Ⅱ型 7例 ,Ⅲ型 9例 ;13例选用鼻根正中入路 ,3例鼻旁入路 ,7例需同时附加眶下切口。 8例合并眼球内陷者采用眼球赤道后方碘仿纱条填塞与植骨矫正法。结果　①本组病例平均内眦宽度和内眦宽度 /外眦宽度比例从 ( 35± 7)mm、( 37± 8) %恢复到 ( 32± 4 )mm、( 35± 7) %比较正常水平 ;②面部外形全部恢复到正常或接近正常 ;③ 8例眼球内陷患者术后 6例恢复到基本正常 ,2例术后仍有轻度凹陷 ,5例复视术后全部消失。结论　鼻根正中入路附加眶下切口可充分显露骨折片 ,结合坚固内固定技术可使骨折片解剖复位 ;内眦韧带复位固定是本手术关键所在 ,重建正常眶内容积和眶内容物准确复位 ,以解决眼球内陷和眼球运动受限问题