Magnetic Resonance Enteroclysis

MR enteroclysis (MRE) is an emerging technique for the evaluation of small intestinal diseases. Administration of an iso-osmotic water solution through a nasojejunal catheter can guarantee adequate luminal distention, and in combination with ultrafast sequences, such as single shot TSE, true FISP, HASTE and 3D FLASH, results in excellent anatomic demonstration of the small intestine. MR fluoroscopy can be performed during MRE examination to monitor the filling process and might be useful in studying low-grade stenosis or motility related disorders. MRE is a very promising technique for the detection and characterization of involved small bowel segments in patients with Crohn's disease while its diagnostic performance in disclosing lumen narrowing and extramural manifestations and complications of the disease is outstanding. Initial experience shows that MRE is very efficient in the diagnosis of small bowel tumors and can be used in the evaluation of small bowel obstruction.     

Primary ilio-psoas abscess extending to the thigh in a neonate: US, CT and MR findings

Psoas abscess in children, and especially in neonates, is an uncommon condition which is difficult to diagnose clinically. The US, CT and MR findings of a psoas abscess in a neonate, which extended to the thigh, are reported. Imaging was helpful in revealing the abnormality, in demonstrating its extension and in determining its nature. The child was treated conservatively and the abscess resolved, leaving atrophy of the psoas muscle. Received: 24 June 1997 Accepted: 9 January 1998     

Impact of a standardized patient simulation on undergraduate nursing student knowledge and perceived competency of the care of a patient diagnosed with schizophrenia

Background

Undergraduate nursing students may not have the opportunity to assess and intervene with a patient diagnosed with schizophrenia during their clinical rotation. Provision of a standardized patient simulation experience affords students this opportunity in a safe setting without risk to the patient or student.

Strategy Use on the Ruff Figural Fluency Test☆

Although the popularity of including figural fluency tests in cognitive and neuropsychological test batteries has increased in recent years, the spontaneous use of strategies on these measures remains poorly understood. This study addressed three questions pertaining to strategy use on the Ruff Figural Fluency Test (RFFT): (i) how common is strategy use, (ii) what information does strategy use convey, and (iii) can examinees learn to use strategies. Findings revealed that nearly seven out of 10 healthy college students used a strategy at least once while taking the RFFT. The number of strategies used and the number of figures produced using a strategy had modest correlations with select executive function measures (D-KEFS Tower Test, Sorting, and Letter & Category Verbal Fluency) in hypothesized directions. When strategies were demonstrated for subjects who did not spontaneously use them, those subjects were able to subsequently use strategies. These findings suggest that although common, failure to spontaneously use a strategy is not unusual. Further, strategy use may reflect a cognitive asset, particularly regarding planning, reasoning, and cognitive flexibility.     

A novel repair method for the treatment of acute Achilles tendon rupture with minimally invasive approach using button implant: A biomechanical study

BackgroundMinimally invasive Q3 repair has been proposed for acute Achilles tendon rupture with low rate of complications. However there are still controversies about optimal technique. In this study we aimed to describe Endobutton-assisted modified Bunnell configuration as a new Achilles tendon repair technique and evaluate its biomechanical properties comparing with native tendon and Krackow technique.Methods27 ovine Achilles tendons were obtained and randomly placed into 3 groups with 9 specimens ineach. The Achilles tendons were repaired with Endobutton-assisted modified Bunnell technique in group 1, Krackow suture technique in group 2 and group 3 was defined as the control group including native tendons. Unidirectional tensile loading to failure was performed at 25 mm/min. Biomechanicalproperties such as peak force to failure (N), stress at peak (MPa), elongation at failure, and Young'smodulus (GPa) was measured for each group. All groups were compared with each other using one-wayANOVA followed by the Tukey HSD multiple comparison test (a = 0.05).ResultsThe average peak force (N) to failure of group 1 and group 2 and control group was 415.6 ± 57.6, 268.1 ± 65.2 and 704.5 ± 85.8, respectively. There was no statistically significant difference between native tendon and group 1 for the amount elongation at failure (p > 0.05).ConclusionsRegarding the results, we concluded that Endobutton-assisted modified Bunnell technique provides stronger fixation than conventional techniques. It may allow early range of motion and can be easily applied in minimally invasive and percutaneous methods particularly for cases with poor quality tendon at the distal part of rupture.Level of evidenceLevel II, Biomechanical research study.     

Relationship of Bone Mineralization Density Distribution (BMDD) in Cortical and Cancellous Bone Within the Iliac Crest of Healthy Premenopausal Women

Bone mineralization density distribution (BMDD) is an important determinant of bone mechanical properties. The most available skeletal site for access to the BMDD is the iliac crest. Compared to cancellous bone much less information on BMDD is available for cortical bone. Hence, we analyzed complete transiliac crest bone biopsy samples from premenopausal women (n = 73) aged 25–48 years, clinically classified as healthy, by quantitative backscattered electron imaging for cortical (Ct.) and cancellous (Cn.) BMDD. The Ct.BMDD was characterized by the arithmetic mean of the BMDD of the cortical plates. We found correlations between Ct. and Cn. BMDD variables with correlation coefficients r between 0.42 and 0.73 (all p < 0.001). Additionally to this synchronous behavior of cortical and cancellous compartments, we found that the heterogeneity of mineralization densities (Ct.Ca_Width), as well as the cortical porosity (Ct.Po) was larger for a lower average degree of mineralization (Ct.Ca_Mean). Moreover, Ct.Po correlated negatively with the percentage of highly mineralized bone areas (Ct.Ca_High) and positively with the percentage of lowly mineralized bone areas (Ct.Ca_Low). In conclusion, the correlation of cortical with cancellous BMDD in the iliac crest of the study cohort suggests coordinated regulation of bone turnover between both bone compartments. Only in a few cases, there was a difference in the degree of mineralization of >1wt % between both cortices suggesting a possible modeling situation. This normative dataset of healthy premenopausal women will provide a reference standard by which disease- and treatment-specific effects can be assessed at the level of cortical bone BMDD.