Progressive shoulder arthropathy.
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Aged↗
Biomedical subjects
K M Cheung
Publications and source records attributed to K M Cheung.
Computed tomographic osteometry of Asian lumbar pedicles.
STUDY DESIGN: The lumbar pedicles of 100 adult Chinese patients were studied with computed tomography to provide data on their dimensions and angular alignment. Data obtained were compared with published measurements of spines from white patients to determine similarities and differences between the lumbar spines. SUMMARY OF BACKGROUND DATA: The age range of the patients was 18 to 60 years. There were 63 men and 37 women. There was no demonstrable sex difference for dimensions or angular alignment of the pedicles. METHODS: The method of scanning and measurement was standardized. Levels considered abnormal by the radiologist were excluded from the study, and a single observer was used to avoid inter-observer errors. The data obtained were statistically analyzed using Student's t test to determine differences between men and women and left and right sides. Age differences were analyzed using the F statistic test. The pedicle inclination angle (transverse angle) and the pedicle dimensions were compared with published data of whites. RESULTS: The pedicles of Asians, when compared with those of whites, showed a similar pattern of changes with vertebral level. However, Asian pedicles had a larger pedicle inclination angle (transverse angle) from L1 to L4 (L1 = 16 degrees, L2 = 16 degrees, L3 = 19 degrees, L4 = 23 degrees), whereas L5 (29 degrees) was similar to many series of whites. CONCLUSIONS: There are differences between the lumbar pedicles of Asians and whites. Such differences need to be considered when posterior pedicle screw fixation of the spine is performed.
Adult↗
Computed tomographic osteometry of the Asian lumbar spine.
The computed tomography (CT) scans of 100 adult Chinese patients 18-60 years of age were studied to provide osteometric data on the Asian lumbar spine. The study population was composed of 63 men and 37 women. A total of 29 parameters were measured from each vertebral level. All the data were statistically analyzed for differences between men and women and left and right sides for paired structures. The data then were compared with data for white individuals where available. The results show that for Asians there is a significant sex difference (p < 0.001) for vertebral body and disk dimensions but not for the posterior elements or spinal canal. Compared with white individuals, Asians have a smaller vertebral body and a different spinal canal shape, with the lower part of the canal in relation to the vertebral body being narrowest. Such findings are of significance to the radiologist, to the surgeon, and in the design of instruments and implants for the Asian lumbar spine.
Adolescent↗
Pyogenic vertebral osteomyelitis: treatment by anterior spinal debridement and fusion.
Forty-three patients with pathologically proven vertebral osteomyelitis were studied between 1957 and 1990. Thirty-nine underwent anterior debridement and fusion, and four underwent anterior debridement only. The indications for surgery were uncertain diagnosis, persistent pain, failed conservative treatment with uncontrolled sepsis, and neurological involvement. Thirty patients were followed-up for an average period of 5 years, with a minimum of 2 years and the longest for 15 years. All their symptoms improved after surgery; only one patient subsequently deteriorated due to multiple level recurrence. All patients with neurological deficit improved. Bony fusion occurred in 93% of cases (average time to fusion, 6.8 months), and 90% of the patients were able to return to their original work 4-20 months after surgery. We feel that anterior debridement and spinal fusion allow for reliable microbiological and histological diagnosis, and rapid relief of symptoms and return to work. Primary bone grafting is successful despite the presence of infection.
Adolescent↗
Congenital absence of portal vein presenting as hepatopulmonary syndrome.
A 9-year-old girl presented with cyanosis and decreased exercise tolerance. Chest X-ray, lung function and echocardiogram were normal. Contrasted echocardiogram showed intrapulmonary right to left shunt and computerized tomography of the thorax showed dilated pulmonary vasculature. There was no arteriovenous malformation. Computerized tomography of the abdomen revealed absence of the intrahepatic portion of the portal vein. The superior mesenteric and splenic veins joined as a common trunk, bypassed the liver and drained into the right atrium. We concluded that the patient had hepatopulmonary syndrome secondary to absence of the portal vein. This is the first report of hepatopulmonary syndrome in a female paediatric patient with a congenital absence of the portal vein. As all portal blood entered directly into systemic circulation, the condition was equivalent to congenital portosystemic shunt. Cases of congenital portosystemic shunt complicated by hepatopulmonary syndrome were also reviewed.
Child↗