No abstract

In an attempt to formulate a standardised approach to the diagnosis and management of patients with the double-crush syndrome, we reviewed 65 surgical cases (39 men and 26 women) with cervical myeloradiculopathy associated with entrapment neuropathy in the arm by examining the clinical features, results of nerve conduction velocity studies and distribution of the vertebral levels of compression. Fifty-three patients (average age, 43 years) presented with a carpal tunnel syndrome at the wrist and cervical lesions (41 with spondylosis and 12 with ossi®ed posterior longitudinal ligament), while 12 had a cubital tunnel syndrome at the elbow with cervical lesions (eight with spondylosis and four with ossi®cation of the posterior longitudinal ligament). In the former group, the lesions were found mostly at C5 ± 6 and C6 ± 7 levels, while in the latter group involvement of C6 ± 7 was frequently observed. Two patients in each group required additional cervical decompression after carpal or cubital tunnel release. A retrospective review of our patients suggested that it is reasonable to pursue an accurate diagnosis followed by treatment based on individual neurological and electrophysiological ®ndings, but taking into consideration the signi®cant level of physical impairment associated with cord compromise, we believe that it may be reasonable to perform a cervical decompression rather than peripheral nerve release in such cases. Our ®ndings suggest that one should be aware of a double-crush during examination of patients complaining of neck and hand problems.

The DCP trend might be useful for assessing treatment outcomes after TACE in patients with recurrent HCC.

No abstract

We evaluated the brain lesions of patients with chronic alcoholism (n = 34) in comparison with age-and sex-matched controls (n = 40) by MR imaging. Tl-weighted sagittal and axial images and T2weighted axial images were obtained with a 0.5 T superconducting MR unit. Various brain measurements were then performed, and the presence of regions of abnormal signal intensity was also compared between the two groups. The brain measurements revealed signi ficant cerebral atrophy (characterized by lateral and 3rd ventricular dilatation, and widening of the interhemispheric fissure) as well as significant cerebellar atrophy (represented by 4th ventricular dilatation) in the alcoholic group. These changes were more promi nent in patients in their fifties and sixties than in those aged in the thirties and forties. Focal hypointense lesions were observed in 20.6% of the alcoholics and in 5% of the controls (p<0.01), while focal hyperintense lesions were observed in 61.8% of the alcoholics and in 20% of the controls (p< 0.001). The severity of these MR findings correlated well with the age of the patients. These observa tions suggest that alcohol is an important promotor of brain aging.