Decomposition of leg movements during overground walking in individuals with traumatic brain injury.

OBJECTIVE: Walking requires precise coordination of bilateral lower extremity motions at all joints. This ability can be affected by traumatic brain injury (TBI). The study investigated inter-joint coordination of lower extremities during overground walking after TBI. METHODS: Ten individuals with post-injury ataxia, postural stability and gait abnormalities, as well as 10 sex- and age-matched control subjects were involved in the study. Participants walked at self-selected speed in three experimental conditions: normal walking without any additional task; walking with a narrow base of support, and walking while holding a cup full of water. Inter-joint coordination was analysed as the percentage of gait cycle during which the leg movement was decomposed with 0% indicating simultaneous motion of the two joints (i.e. hip-knee, knee-ankle, and hip-ankle) through the entire gait cycle or 100% indicating motion of only one joint. Decomposition was calculated for each pair of joints and for the left and right leg separately. RESULTS: Participants with TBI showed greater decomposition indices and poorer inter-joint coordination respectively than control individuals for all joint pairs (p < 0.01). Walking with the narrower base of support or with a cup, increased movement decomposition in the TBI group, but not in the control group. CONCLUSION: The results revealed post-injury gait impairment that manifests as decomposition of multi-joint motions of the lower extremities during overground walking.

CT demonstration of empyema necessitatis.

Empyema necessitatis is a collection of fluid that has, by direct extension from the pleural cavity, penetrated the thoracic wall to form a mass in the extrapleural soft tissues of the chest wall. This is a rare condition and usually is associated with tuberculous effusion but may be associated with malignancy, blastomycosis, actinomycosis, and may even follow thoracentesis.

Adenocarcinoma of the urachus with vesicoenteric fistula.

A case of mucoid adenocarcinoma of the urachus demonstrated by ultrasonography, cystography, and computerized tomography is presented. The inhomogeneous, echogenic mass was confluent with the anterior--superior aspect of the bladder but was also associated with a fistula between the bladder and small intestine, a finding not previously reported.

HIDA scanning and ultrasonography in the expeditious diagnosis of acute cholecystitis.

Radionuclide hepatobiliary imaging (HIDA scanning), a pathophysiologic modality, has become the diagnostic method of choice for suspected acute cholecystitis. The diagnosis is made quickly with this technic, which is simple, safe, and accurate. It is in widespread use and will soon be available for small community hospitals as well as large metropolitan and university centers. Ultrasound, though an excellent anatomic modality for diagnosing cholelithiasis, does not demonstrate the status of the cystic duct, information essential to the diagnosis of acute cholecystitis.

Natural history of pulmonary thromboemboli in dogs. Serial radiographic observation of clots labeled with powered tantalum.

Powdered tantalum was blown onto the surface of blood clots from 10 dogs. After autologous, tantalum-labeled clots were injected into a systemic vein in each dog, the dogs were sacrificed at varying times over a 5-week period. Microscopic sections showed the tantalum remained attached to the intraluminal clots throughout this period. No appreciable dispersion of label into extravascular parenchyma was observed. Serial roentgenograms demonstrated (a) initially, the labeled clots in the pulmonary arterial tree, (b) lysis of the clots, as indicated by progressive decrease in the breadth of the tantalum labels, (c) peripheral movement of the labeled clots, and (d) eventual fragmentation of the labels.