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[en] Percutaneous vertebroplasty has gained widespread popularity and demonstrated clinical efficacy in the treatment of spinal osteoporotic compression fractures and pathologic osteolytic lesions. Despite its rapid pain relief and safety, this minimally invasive intervention has exhibited some rare complications over the past decade. In this case study, we describe a patient with an uncommon complication of polymethylmethacrylate (PMMA) cement pulmonary embolism following fluoroscopy-guided percutaneous vertebroplasty for treatment of pain associated with an osteoporotic vertebral fracture. We present this case to highlight that vertebroplasty is not risk-free and that knowledge of such potentially severe complication is necessary for prevention and optimal operative outcomes
[en] The objective of the present study was to compare the effect of electroacupuncture (EA) and carprofen (CP) on postoperative incisional pain using the plantar incision (PI) model in rats. A 1-cm longitudinal incision was made through skin, fascia and muscles of a hind paw of male Wistar rats and the development of mechanical and thermal hypersensitivity was determined over 4 days using the von Frey and Hargreaves methods, respectively. Based on the experimental treatments received on the third postoperative day, the animals were divided into the following groups: PI+CP (CP, 2 mg/kg, po); PI+EAST36 (100-Hz EA applied bilaterally at the Zusanli point (ST36)); PI+EANP (EA applied to a non-acupoint region); PI+IMMO (immobilization only); PI (vehicle). In the von Frey test, the PI+EAST36 group had higher withdrawal force thresholds in response to mechanical stimuli than the PI, PI+IMMO and PI+EANP groups at several times studied. Furthermore, the PI+EAST36 group showed paw withdrawal thresholds in response to mechanical stimuli that were similar to those of the PI+CP group. In the Hargreaves test, all groups had latencies higher than those observed with PI. The PI+EAST36 group was similar to the PI+IMMO, PI+EANP and PI+CP groups. We conclude that 100-Hz EA at the ST36 point, but not at non-acupoints, can reduce mechanical nociception in the rat model of incisional pain, and its effectiveness is comparable to that of carprofen
[en] Ultrasonography (USG) is a safe, easily available, and cost-effective modality, which has the additional advantage of being real time for imaging and image-guided interventions of the musculoskeletal system. Musculoskeletal interventions are gaining popularity in sports and rehabilitation for rapid healing of muscle and tendon injuries in professional athletes, healing of chronic tendinopathies, aspiration of joint effusions, periarticular bursae and ganglia, and perineural injections in acute and chronic pain syndromes. This article aims to provide an overview of the spectrum of musculoskeletal interventions that can be done under USG guidance both for diagnostic and therapeutic purposes
[en] Thirty-nine patients (forty-four joints) who had been diagnosed as having meniscus perforation of the temporomandibular joint by inferior joint space arthrography and had been treated by surgical procedures were evaluated retrospectively. Information of clinical findings, arthrotomographic findings and surgical findings was collected on a standardized form and evaluated. The results were as follows: 1. On the 34 patients of 38 joints which were surgically confirmed perforation of meniscus or its attachments of the temporomandibular joint, there were 29 females and 5 males (5.8:1). The average age was 36 years (range 17 to 70). 2. The common clinical findings of group that had meniscus displacement without reduction and with perforation were pain on the affected joint and limitation of mouth opening. In the group showing meniscus displacement with reduction and with perforation the common clinical findings were pain and clicking on the affected joint. 3. 32 joints (84.2%) were arthrotomographically anterior meniscus displacement without reduction and with perforation, 6 joints (15.8%) showed anterior meniscus displacement with reduction and with perforation. 4. Joints categorized arthrotomographically as having meniscus displacement without reduction and with perforation were less likely to have full translation of the condyle in comparison with the normal or meniscus displacement with reduction and with perforation groups (p<0.05) 5. The arthrographic findings of 44 joints having meniscus perforation were compared with surgical findings, there were 6 false positive findings of meniscus perforation, the reliability of arthrographic findings of meniscus perforation was a 86.4% correlation with surgical findings. 6. On the site of perforations of 38 joints which were surgically confirmed perforation of meniscus or its attachments, twenty-three of perforations (60.5%) were in location at the junction of the meniscus and posterior attachment, fourteen (36.9%) were located at the posterior attachment and one (2.6%) was at the meniscus itself.
[en] The author analyzed a total of 127 cases of ultrasonography studied for evaluation of the causes of right upper quadrant pain during ten months from Feb.1 to Nov. 30 1981, at the department of radiology, Busan national university and St. Benedict hospital. The results were as follows: 1. ultrasonographic findings of the total of 127 cases are normal in 41(32.3%) cases, and abnormal in 86(67.6%) cases. 2. Clinical diagnosis of normal ultrasonographic cases is unknown in 15(36.6%) cases, hepatitis in 10(24.3%) cases, pancreatitis in 6(14.6%) case,enterocolitis in 5(12.1%) cases, acute gastritis in 3(7.5%), acute pyelonephritis in 1(2.4%) case, and clonorchiasis in 1(2.4%) case. 3. Pathological diagnosis of 50 cases out of 86 cases of abnormal ultrasonography is GB stone in 36(72.0%) cases, pancreatic cancer in 5(10.0%) cases, hepatoma in 3(6.0%) cases, CBD stone in 4(8.0%) cases, pancreatic pseudocyst in 1(12.9%) case and liver abscess in 1(2.0%) case. 4. Diagnostic accuracy of ultrasonography of GB stone was 91.7%, false positive 2.8% and false negative 6.6%. 5. Ultrasonography has the advantage of noninvasiveness and easy performance, but the diagnostic accuracy of ultrasonography alone was low. Ultrasonography is considered as a good screening and complementary method for evaluation of right upper quadrant pain
[en] The antrolith is a rare disease in the maxillary sinus. We experienced a 67-year-old female whose chief complaint was an intermittent dull pain of clinical, radiological and histological findings, we diagnosed it as antrolith in the left maxillary sinus and obtained results as follows: 1. Three radiopaque substances in the left maxillary sinus were revealed as 'Antroliths'. 2. These antroliths were movable in the left maxillary antrum and combined with maxillary sinusitis. 3. We supposed it internal origin of nidus in this case.
[en] 117 consecutive herniograms were reviewed for patients who had symptoms suggestive of hernia but with no evidence or inconclusive findings on physical examination. The traditional approach has been to explore patients with suspected occult hernias. The aim of this study was to assess the impact of herniography in minimizing needless groin exploration and to evaluate its safety. Thirty-three herniograms were positive and showed unilateral and bilateral inguinal hernias. There were no false positive examinations and two false negative examinations. No complications were present. Patients with positive herniograms were explored, and operative findings correlated well with herniographic findings. Twenty-four patients were referred to other specialities. Follow-up in clinic and telephone interviews showed symptomatic improvement in the majority of patients. Herniography is useful in evaluating obscure groin pain and occult hernias. It is a safe procedure and more cost effective than a negative exploration or diagnostic laparoscopy.
[en] In the great majority of cases with the lower back pain, the lumbar herniated disc is one of the common causes. The plain radiographs of preoperative and postoperative periods and relationship with clinical symptom were studied in 76 cases which were surgically verified as lumbar herniated disc at Baik Hospital. The following results were obtained: 1. Males were affected more frequently than females with the ratio of 1.6 to 1. In male it is most common in the 3rd decade of life and in female in the 4th decade. 2. In preoperative plain radiograph, 16.9% of 76 cases revealed no specific abnormality. The most common positive finding was the straightening of the lumbar curvature (56.6%). Other common positive findings was a relative narrowing of the intervertebral disc space (46.1%) 3. The greatest incidence of preoperative intervertebral disc space was between 0.8 cm and 1 cm (48.8% of case) and next 1.1cm - 1.3cm (37.8%) 4. Among 82 lesions of herniated lumbar disc, the greater incidence of location was L4-L5 disc space (86.6%) 5. The overall mean of lumbosacral angle in preoperative plain radiography was 29.8 .deg in male and 29.5 .deg in female. The greatest incidence of lumbosacral angle was between 31 .deg and 40 .deg (31.6% of cases) and next 21 .deg-30 .deg (30.3%) 6. Study of postoperative (after 1 month-1 year) radiograph and it's relationship to postoperative clinical symptom.