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BACKGROUND: The intraarticular portion of the long head of the biceps tendon is often widened in shoulders with cuff tears. It is unclear whether this is a local phenomen or is caused by muscle hypertrophy. METHODS: We investigated morphological changes of the biceps brachii in 14 embalmed shoulders: 7 with intact rotator cuff and 7 with rotator cuff tears. We measured the cross-sectional area (CSA) of the tendon of the long head of the biceps (LHB) at 9 levels between the glenoid origin and the musculotendinous junction. The muscle volume and the muscle fiber length of the long and short heads of the biceps were measured to calculate the physiological CSA (PCSA) by dividing the volume by the fiber length. RESULTS: The CSA of the LHB tendon at the entrance to the bicipital groove was greater in cuff tear shoulders than in normal shoulders. The PCSA of the biceps was similar in normal and cuff tear shoulders. INTERPRETATION: Hypertrophy of the LHB tendon appears to be a localized morphological change near the entrance to the bicipital groove. [ABSTRACT FROM AUTHOR]

BACKGROUND: Elongation of the shoulder capsule is often noticed on arthrograms or during surgery in shoulders of patients who have experienced recurrent anterior dislocations. HYPOTHESIS: We can quantify the elongation of the capsule in shoulders with recurrent anterior dislocations by using magnetic resonance arthrography. STUDY DESIGN: Retrospective review of prospectively collected data. METHODS: Twelve patients with unilateral recurrent anterior shoulder dislocations were enrolled in this study. Magnetic resonance images in the axial and coronal oblique planes were obtained from both shoulders (involved and uninvolved sides) after 10 ml of gadolinium/saline solution was injected into the glenohumeral joint. The length of the anteroinferior, inferior, and posteroinferior portions of the capsule was measured by using image analyzing software and normalized to the humeral head diameter. RESULTS: The anteroinferior capsule was significantly elongated in the involved shoulder at 4 mm (16% elongation) and 10 mm (19% elongation) superior to the inferior margin of the glenoid. The inferior capsule was also significantly elongated in the involved side both at the center (12% elongation) and at 4 mm anterior to the center of the glenoid (29% elongation). The posteroinferior capsule did not show any significant elongation. CONCLUSIONS: The anteroinferior and inferior portions of the shoulder capsule are elongated an average of 19% in shoulders with recurrent anterior dislocation. [ABSTRACT FROM AUTHOR]

Background: Glenohumeral dislocations often recur, probably because a Bankart lesion does not heal sufficiently during the period of immobilization. Using magnetic resonance imaging, we assessed the position of the Bankart lesion, with the arm in internal and external rotation, in shoulders that had had a dislocation.Methods: Coaptation of a Bankart lesion was examined with use of magnetic resonance imaging, with the arm held at the side of the trunk and positioned first in internal rotation (mean, 29 degrees) and then in external rotation (mean, 35 degrees), in nineteen shoulders. Six shoulders (six patients) had had an initial anterior dislocation, and thirteen shoulders (twelve patients) had had recurrent anterior dislocation. Fast-spin-echo T2-weighted axial images were made when the dislocation had occurred less than two weeks earlier, and spin-echo T1-weighted axial images after intra-articular injection of gadolinium-diethylenetriamine pentaacetic acid were made when the dislocation had occurred more than two weeks earlier. Separation and displacement of the anteroinferior portion of the labrum from the glenoid rim were measured on the axial images, and coaptation of the anterior part of the capsule to the glenoid neck was assessed by measurement of the detached area, opening angle, and detached length.Results: Separation and displacement of the labrum were both significantly less (p = 0.0047 and p = 0.0017, respectively) when the arm was in external rotation than when it was in internal rotation. The detached area and the opening angle of the anteroinferior portion of the capsule were both significantly smaller (p = 0.0003 and p < 0.0001, respectively), and the detached length was significantly shorter (p < 0.0001) with the arm in external rotation.Conclusion: Immobilization of the arm in external rotation better approximates the Bankart lesion to the glenoid neck than does the conventional position of internal rotation. [ABSTRACT FROM AUTHOR]

Blind children, particularly congenitally blind children, find it difficult to understand their surroundings. Spatial awareness requires the ability to recognize shapes, to perceive locations and directions in space, and to match one space with another space (like a map). To help congenitally blind children acquire spatial awareness, we developed a computerassisted instruction (CAI) system. This system consists of a personal computer, an image-capture board, and a camera with three charge couple devices. There are four tasks - object selection (circle, triangle and square), object location, a tic-tac-toe game, and Hukuwarai (arranging face parts). The last two tasks are included so that blind children may enjoy performing them. A blind, user is asked to arrange blocks of different shapes according to vocal commands presented by the system. When the user completes the arrangement task, the camera captures a picture of the block layout. The system analyzes the shape and location of each block by image processing and outputs the result as speech expressing whether the arrangement is correct or not, and any correction, if necessary. The system achieves a rapid response, of less than two seconds and has a simple interface requiring only mouse clicking. By repeating tasks using auditory corrections instead of getting help from sighted persons, the user acquires spatial awareness independently. We conducted experiments with five subjects, including three congenitally blind students, and two sighted children who were blindfolded. All of the subjects were interested in the system and the tasks, especially those involving games. We hope that the proposed system will help blind children gain spatial awareness. [ABSTRACT FROM AUTHOR]

Herpes simplex virus (HSV) was detected by a polymerase chain reaction (PCR) in 47 (4.7%) out of 1,000 saliva samples from the outpatients of an oral and maxillofacial surgery department compared with 27 (2.7%) by conventional virus isolation. There were 20 PCR-positive, culture-negative cases but no culture-positive, PCR-negative cases. Patients younger than 10 years or older than 60 years secreted HSV more frequently than the others. Those with inflammatory diseases showed higher positivity for HSV than those with malignancy, trauma or other complaints. All 27 virus isolates were typed as HSV type 1 and none were resistant to acyclovir, arabinofuranosyl-adenine, iododeoxyuridine or phosphonoacetic acid. [ABSTRACT FROM AUTHOR]