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Our purpose is to compare ultrasound and fluoroscopic-guided approaches to the glenohumeral joint at the rotator cuff interval for magnetic resonance (MR) arthrography of the shoulder. Forty consecutive patients were prospectively studied. 20 patients underwent ultrasound-guided and 20 patients underwent fluoroscopic guided injection. Successful rate of ultrasound guidance is 95%. No significant difference in pain score and duration of injection between two methods (P>.05). Ultrasound-guided rotator cuff interval injection of the glenohumeral joint for MR arthrography is comparable with fluoroscopic-guided injection. Ultrasound is the preferred method as there is no ionizing radiation., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Our purpose was to determine the relationship between tibiofemoral translation on magnetic resonance imaging and clinical instability of the knee following anterior cruciate ligament (ACL) injury. Within 66 patients (43 males, 23 females, mean age 30.25 years), 15 of 19 patients (80%) with an intact ACL had a demonstrable normal screw home movement, while 24 of 47 patients (51%) with an ACL tear had absence of the screw home movement. Patients with clinical instability had greater tibial translation and excursion at the lateral compartment (P=.0001). Following ACL injury, there is demonstrable absence of the normal screw-home movement with anterior tibial translation and excursion related to presence of clinical instability., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Study Objectives: To characterize the long-term pulmonary function and health status in a prospectively identified cohort of patients who survived the severe acute respiratory syndrome (SARS)., Design: Prospective follow-up cohort study., Setting: University-affiliated hospital., Patients: Ninety-four patients who recovered from SARS were assessed at a uniform time point of 1 year after hospital discharge., Measurements: The study included the measurement of static and dynamic lung volumes, the determination of the diffusing capacity of the lung for carbon monoxide (D(LCO)), and a health status evaluation using the St. George Respiratory Questionnaire (SGRQ)., Results: Eleven patients (12%) had mild impairment of FVC, 20 (21%) had mild impairment of FEV1, 5 (5%) had mild impairment of the FEV1/FVC ratio, and 17 (18%) had mild impairment of the D(LCO). There was one patient (1%) who had moderate impairment of FVC, one patient (1%) who had moderate impairment of the FEV1/FVC ratio, and three patients (3%) who had moderate impairment of the D(LCO). No pulmonary function abnormalities were detected in 59 patients (63%). Mean scores were significantly higher (ie, worse) than the population norms in the activity (p < 0.001), impacts (p < 0.001), and total (p < 0.001) domains of the SGRQ., Conclusions: One year after recovery from SARS, persistent pulmonary function impairment was found in about one third of patients. The health status of SARS survivors was also significantly worse compared with the healthy population. The main determinants of morbidity in recovered SARS patients need to be further defined.

A 16-year-old girl who suffered from untreated tuberculosis spondylitis since childhood presented with marked Potts kyphotic deformity in adolescence. She had increasing shortness of breath and was admitted for investigation of right pleural effusion. On radiological examination, she was found to have extensive paraspinal abscesses, with the largest collection trapped within the kyphotic angulation in the thoracic region. The latter could only be appreciated with magnetic resonance (MR) imaging and had been overlooked in the initial computed tomography (CT).

Objectives: To prospectively study all patients with COPD and spontaneous pneumothorax (SP) who underwent thoracoscopic talc poudrage (TP) under local anesthesia to determine its efficacy and safety in recurrence prevention., Methods: Data on clinical measurements, complications, duration of chest tube drainage, length of hospital stay, and outcome were collected., Results: Forty-one patients (38 men and 3 women) with a mean (+/- SD) age of 70.7 +/- 7.2 years were treated. All patients had COPD, with a mean FEV(1) of 41 +/- 14% predicted. The majority of SPs measured 20 to 50% in size, and 34% were recurrent. Three grams of talc were insufflated into the pleural cavity without complications. Thirteen patients (32%) complained of pain, 5 (12%) developed fever, 27 (66%) had subcutaneous emphysema, and 7 (17%) had prolonged air leaks. Postoperative chest tube drainage and hospital stay were 4 and 5 days, respectively. Success was 95% after a median follow-up of 35 months. Four patients with FEV(1) of < 40% predicted died within 30 days of the procedure, yielding a mortality rate of 10%. FEV(1) (in liters), FEV(1) (in % predicted), and ischemic heart disease were risk factors that influenced early mortality., Conclusion: Thoracoscopic TP is effective for pneumothorax prevention and can be performed with acceptable mortality in patients with advanced COPD.

The burrowing responses of a common tropical bivalve, the short-neck clam Ruditapes philippinarum, to cadmium (Cd)-spiked sediment, variations of sediment grain size and natural sediments collected from 15 locations in Hong Kong's inshore waters were investigated through a series of laboratory tests. Results showed that the burrowing response exhibited a negative relationship with an increase in Cd concentration in the spiked sediments. The level of Cd was also found to be directly proportional to the percent mortality of the clam. However, there was no significant difference (p > 0.05) in the time elapsed for the clam to burrow into sediments with different grain size composition. The elapsed time for 50% of the test clams to burrow into the sediment (ET50) over a period of 48 h was calculated for the sediment samples collected from the 15 locations. Results of ANOVA showed significant difference (p < 0.05) among the sediment samples. Tukey's multiple comparison test revealed two groups of sediments: group 1 containing 3 sediment samples collected from Victoria Harbour and group 2 containing 12 samples obtained from other coastal areas of Hong Kong. The ET50 value for group 1 sediments was found to be greater than 2,880 min whilst the ET50 for group 2 sediments had a mean of 173.9 min. Agglomerative classification of the sediment samples, based on metal content (As, Cd, Cr, Cu, Ni, Pb, Zn), also showed two similar groups, suggesting that the ET50 values were correlated with the metal level of the sediment samples. Group 1 sediments collected from Victoria Harbour had greater concentrations of Cd, Cr, Cu, Ni and Zn as compared to that in group 2. The present study demonstrated that high metal content in the sediment tends to inhibit the burrowing responses of the clam and that there is potential to develop the burrowing responses of R philippinarum as a sublethal sediment toxicity test.