BACKGROUND & AIMS: BACKGROUND:Posterior reversible encephalopathy syndrome may occur frequently and be underrecognized in children and young adults admitted to a pediatric critical care unit. METHODS:Patients <21 years of age with the diagnosis of posterior reversible encephalopathy syndrome were reviewed in this retrospective cohort study conducted over a 30-month period. RESULTS:There were 2588 admissions to pediatric critical care unit, 226 neurology service consultations, and 10 patients diagnosed with posterior reversible encephalopathy syndrome (incidence of 1 in 259 pediatric critical care unit admissions, 0.4%). The majority of posterior reversible encephalopathy syndrome patients (9/10) presented with generalized tonic and or clonic seizures. Apart from hypertension and cytotoxic medication use, anemia, a previously unreported risk factor, was found in all 10 (100%) patients with posterior reversible encephalopathy syndrome. One-year follow up available in eight patients showed no residual neurological deficits attributable to posterior reversible encephalopathy syndrome with significant resolution of white matter signal abnormalities on neuroimaging. CONCLUSION:Our case cohort includes an estimation of incidence of posterior reversible encephalopathy syndrome in children and young adults with 1-year follow-up and anemia as a potential previously unreported risk factor.

背景与目标：

BACKGROUND & AIMS: :Separation of the vitreous and posterior hyaloid membrane (PHM) or posterior vitreous detachment (PVD) typically occurs between the ages of 45 and 65 years in the general population, but may occur earlier in myopic or otherwise predisposed individuals. Age-related synergetic changes occurring within the cortical and central gel must be distinguished from the PHM, which envelopes it. This study reports on the correlation between 'true' PVD seen clinically by the physician using dynamic examination, high-power slit-lamp biomicroscopy, and oblique illumination with some of its histological, immunohistochemical, and ultrastructural features post-mortem. The presence of the Weiss ring does not necessarily indicate total clean separation of PHM, nor does its absence confirm that the PHM remains attached, since it may be destroyed during the process of separation. Immediately prior to PVD with the vitreous gel attached, the PHM must, by definition, form part of the inner limiting membrane. The detached PHM frequently exhibits basement membrane (BM) and its indigenous laminocytes stain focally for GFAP and type IV collagen. The PHM is distinct from and much thicker than the BM of Müller cells alone and the factors that initiate or limit separation of the PHM require greater study, particularly the role of laminocyte proliferation and migration.

背景与目标： : 在一般人群中，玻璃体和后玻璃体膜 (PHM) 或玻璃体后脱离 (PVD) 的分离通常发生在45至65岁之间，但在近视或其他易患个体中可能更早发生。皮质和中央凝胶内发生的与年龄有关的协同变化必须与包裹它的PHM区分开。这项研究报告了医师使用动态检查，大功率裂隙灯生物显微镜和斜视照明及其某些组织学，免疫组织化学和死后超微结构特征在临床上所见的 “真实” PVD之间的相关性。Weiss环的存在不一定表示PHM的完全干净分离，也不一定表明PHM的缺失仍然存在，因为它可能在分离过程中被破坏。在附着玻璃体凝胶的PVD之前，根据定义，PHM必须形成内部限制膜的一部分。分离的PHM经常表现出基底膜 (BM)，其本地层细胞染色局部为GFAP和IV型胶原蛋白。PHM与单独的m ü ller细胞的BM不同且厚得多，启动或限制PHM分离的因素需要更多的研究，尤其是层细胞增殖和迁移的作用。

BACKGROUND & AIMS: :The rat auditory cortex is divided anatomically into several areas, but little is known about the functional differences in information processing between these areas. To determine the filter properties of rat posterior auditory field (PAF) neurons, we compared neurophysiological responses to simple tones, frequency modulated (FM) sweeps, and amplitude modulated noise and tones with responses of primary auditory cortex (A1) neurons. PAF neurons have excitatory receptive fields that are on average 65% broader than A1 neurons. The broader receptive fields of PAF neurons result in responses to narrow and broadband inputs that are stronger than A1. In contrast to A1, we found little evidence for an orderly topographic gradient in PAF based on frequency. These neurons exhibit latencies that are twice as long as A1. In response to modulated tones and noise, PAF neurons adapt to repeated stimuli at significantly slower rates. Unlike A1, neurons in PAF rarely exhibit facilitation to rapidly repeated sounds. Neurons in PAF do not exhibit strong selectivity for rate or direction of narrowband one octave FM sweeps. These results indicate that PAF, like nonprimary visual fields, processes sensory information on larger spectral and longer temporal scales than primary cortex.

背景与目标： : 大鼠听觉皮层在解剖学上分为几个区域，但对这些区域之间信息处理的功能差异知之甚少。为了确定大鼠后听觉场 (PAF) 神经元的过滤特性，我们比较了对简单音调，调频 (FM) 扫描以及调幅噪声和音调与初级听觉皮层 (A1) 神经元反应的神经生理反应。PAF神经元具有平均比A1神经元宽65% 的兴奋性感受野。PAF神经元的较宽的感受野导致对比a1强的窄和宽带输入的响应。与A1相反，我们几乎没有证据表明PAF中基于频率的有序地形梯度。这些神经元表现出的潜伏期是a1的两倍。响应调制的音调和噪声，PAF神经元以明显较慢的速度适应重复刺激。与A1不同，PAF中的神经元很少对快速重复的声音表现出促进作用。PAF中的神经元对窄带一个倍频FM扫描的速率或方向没有很强的选择性。这些结果表明，与非主要视野一样，PAF在比主要皮层更大的光谱和更长的时间尺度上处理感觉信息。

BACKGROUND & AIMS: :To investigate if the surface modification of intraocular lens (IOL) is efficient in the prevention of posterior capsular opacification (PCO), the acrylic surface of intraocular lens (Acrysof) was polymerized with polyethylene glycol (PEG-IOL). The human lens epithelial cells (1 x 10(4) cells/mL) were inoculated on PEG grafted or unmodified acrylic lenses for the control. The adherent cells on each IOL surface were trypsinized and counted. The every PEG-IOL was implanted in 20 New Zealand rabbits after removal of crystalline lens. The formations of PCO were checked serially through retroilluminated digital photography, and the severity scores were calculated using POCOman. The cell adherence patterns on each IOL were examined by scanning electron microscopy. As a result, the mean number of adherent cells of PEG-IOL (3.2+/-1.1 x 10(3)) tended to be smaller than that of the acrylic controls (3.6+/-1.9 x 10(3)) without a statistical significance (p=0.73). However, the mean severity of PCO formation in PEG-IOL was significantly lower than that in the control during the third to sixth weeks after surgery. Scanning electron microscopy revealed that the more patch-like cells were found firmly attached to the IOL surface in control than in the PEG-IOL. Conclusively, PEG polymerization to the acrylic IOL would possibly lessen the formation of PCO after cataract removal.

背景与目标： : 为了研究人工晶状体 (IOL) 的表面改性是否能有效预防后囊混浊 (PCO)，人工晶状体 (Acrysof) 的丙烯酸表面与聚乙二醇 (PEG-IOL) 聚合。将人晶状体上皮细胞 (1x10(4) 细胞/mL) 接种在PEG移植或未修饰的丙烯酸镜片上，以进行对照。对每个IOL表面的贴壁细胞进行胰蛋白酶处理并计数。去除晶状体后，将每只PEG-IOL植入20只新西兰兔子中。通过逆光数码摄影连续检查PCO的形成，并使用pocomanan计算严重程度评分。通过扫描电子显微镜检查每个IOL上的细胞粘附模式。结果，PEG-IOL的贴壁细胞的平均数目 (3.2 +/-1.1 × 10(3)) 趋向于小于丙烯酸对照的数目 (3.6 +/-1.9 × 10(3))，没有统计学意义 (p = 0.73)。然而，在术后第三至第六周，PEG-IOL中PCO形成的平均严重程度显着低于对照组。扫描电子显微镜显示，与PEG-IOL相比，对照中发现更多的斑块状细胞牢固地附着在IOL表面。最终，聚乙二醇聚合到丙烯酸IOL可能会减少白内障摘除后PCO的形成。

BACKGROUND & AIMS: :Extranodal presentation in non-Hodgkin's lymphoma (NHL) is uncommon, and the mandible is very rarely involved. Primary NHL of the mandible, for the most part, has intermediate or high malignancy and has a much greater incidence of local recurrence compared with other sites of involvement. A 48-year-old Japanese man with NHL of the mandible received radiotherapy, followed by high-dose chemotherapy supported with peripheral blood stem cell transplantation (PBSCT). High-dose cyclophosphamide, Adriamycin, and vincristine were used for pretransplant conditioning. He achieved complete remission and has survived in continuous complete remission for more than 72 months to date. Marrow-ablative chemotherapy facilitated by PBSCT is thought to be useful as part of the primary therapy for patients with NHL who have poorer prognoses.

背景与目标： : 非霍奇金淋巴瘤 (NHL) 的结外表现并不常见，下颌骨很少涉及。与其他受累部位相比，下颌骨的原发性NHL大部分具有中等或高度恶性，并且局部复发的发生率更高。一名48岁的日本下颌骨NHL男子接受了放疗，随后接受了大剂量化疗，并伴有外周血干细胞移植 (PBSCT)。大剂量环磷酰胺，阿霉素和长春新碱用于移植前调理。迄今为止，他获得了完全缓解，并且在连续完全缓解中存活了72个月以上。PBSCT促进的骨髓消融化疗被认为是对预后较差的NHL患者的主要治疗的一部分。

BACKGROUND & AIMS: BACKGROUND:Idiopathic chronic anal fissure is believed to be a consequence of a traumatic acute anodermal tear followed by recurrent inflammation and poor healing due to relative tissue ischaemia secondary to internal sphincter spasm. This pilot trial compared the efficacy of a novel manufactured ano-coccygeal support attached to a standard toilet seat (Colorec) to the standard procedure of lateral internal sphincterotomy (LIS) for chronic anal fissure. METHODS:Fifty-three patients with confirmed chronic anal fissures were enrolled and assigned, based on their preference, to the test group and the control group. Each patient was reviewed after therapy, and follow-up was scheduled at 4, 6 and 8 weeks and at 6 months. RESULTS:The fissure healing rate was 100% in both groups. There were no statistically significant differences between the test group (n = 30, median age 42 years; range 20-71 years) and the control group (n = 22, median age 38 years; range 23-60 years) with regards to resolution of rectal bleeding at defaecation after 4 weeks (86.6 vs. 72.7%, p = 0.698), and by week 6, bleeding had resolved in 100% of patients in both groups. There was no statistically significant difference between the test group and the control group with regards to pain scores at 4, 6 and 8 weeks (4.30 ± 0.79, 2.03 ± 0.80, 0.43 ± 0.50 vs. 3.50 ± 0.74, 1.68 ± 0.56, 0.50 ± 0.51, p = 0.054) and to time until complete healing of fissures (5.60 ± 1.52 weeks vs. 5.91 ± 1.57 weeks, p = 0.479). After continuous use of the ano-coccygeal support over 6 months, no patients in the test group had recurrent fissures. No complications were observed during the trial. CONCLUSIONS:Results of both methods were comparable and demonstrated that the ano-coccygeal support is at least as effective as LIS, without any short-term complications. Larger and randomised trials on the use of ano-coccygeal support for chronic anal fissures are awaited.

背景与目标：

BACKGROUND & AIMS: We studied the roles of Notch, Delta, and Serrate in vertebrate epithelial appendage morphogenesis using feather as a model and found the following. (1) C-Notch-1, C-Delta-1, and C-Serrate-1 are not expressed at the early placode stage and are therefore not involved in the determination of bud versus interbud compartments. (2) From symmetric short buds to asymmetric long buds, C-Delta-1 and C-Serrate-1 are expressed in the posterior bud mesenchyme in a nested fashion, while C-Notch-1 is expressed as a stripe perpendicular to the anterior-posterior (A-P) axis and positioned posterior to the midpoint. (3) Epithelial-mesenchymal recombination with rotation led to the disappearance of these genes followed by their reappearance with new positions appearing to predict their new morphological orientation. (4) Conditions leading to branched buds (e.g., recombination of later buds) show polarized staining patterns before branching occurs. (5) Conditions leading to symmetrical round buds (e.g., treated with the protein kinase A agonist forskolin) suppress expression of all three genes. These results lead us to hypothesize that Notch, Delta, and Serrate are involved in establishing the A-P asymmetry of feather buds.

背景与目标： 我们以羽毛为模型研究了Notch，Delta和Serrate在脊椎动物上皮附件形态发生中的作用，发现以下内容。(1) C-Notch-1，C-Delta-1和C-Serrate-1在早期阶段不表达，因此不参与芽间隔室的确定。(2) 从对称的短芽到不对称的长芽，C-Delta-1和C-Serrate-1以嵌套方式在后芽间充质中表达，而C-Notch-1表示为垂直于前后 (a-P) 轴并位于后的条纹中点。(3) 旋转使上皮-间充质重组导致这些基因消失，然后以新的位置重新出现，以预测其新的形态方向。(4) 导致分支芽的条件 (例如，后期芽的重组) 在分支发生之前显示出极化染色模式。(5) 导致对称圆芽的条件 (例如，用蛋白激酶A激动剂forskolin处理) 抑制所有三个基因的表达。这些结果使我们假设缺口，三角洲和锯齿参与建立羽毛芽的A-P不对称性。

BACKGROUND & AIMS: We report the case of a 5-year-old girl with an enlarging suboccipital mass, a posttraumatic intraosseous arachnoid cyst. Diagnostic work-up revealed that the lesion consisted of an intradiploic arachnoid cyst and an extra-axial occipital pouch that communicated by way of an osseous and dural defect. Surgical repair was undertaken with good results. A search of the current literature has shown only seven previous reports of leptomeningeal cysts situated at the occipital bones, most of them the result of an antecedent skull fracture. A pathogenetic hypothesis is presented comparing the growth of arachnoid intraosseous cysts and the development of meningocencephaloceles.

背景与目标： 我们报告了一个5岁女孩的情况，该女孩的枕下肿块扩大，创伤性骨内蛛网膜囊肿。诊断性检查显示，病变由一个内蛛网膜囊肿和一个通过骨和硬脑膜缺损连通的轴外枕袋组成。进行了手术修复，效果良好。对当前文献的搜索显示，以前只有七个关于枕骨处的软脑膜囊肿的报道，其中大多数是先前颅骨骨折的结果。提出了一种致病假说，比较了蛛网膜骨内囊肿的生长和脑膜脑膜的发展。

BACKGROUND & AIMS: :The aim of the study was to analyze the long-term outcome (>20 years) after treatment of posterior fossa medulloblastoma (MB) in childhood. We analyzed data from patients treated for posterior fossa MB between 1974 (introduction of the first international treatment protocol in Norway) and 1987 (when use of radiotherapy was abandoned in children under 4 years of age). Out of 47 children, 24 survived >20 years. At the time of analysis, 16 patients (median age 41 years, range 32-52) were alive (median follow-up 34 years, range 30-42), while 8 patients died 22-41 years (median 31 years) after primary treatment: one late death (after 22 years) was due to tumor recurrence whilst other 7 deaths (after 23 to 41 years) were related to the detrimental effects of the treatment (secondary tumors, stroke, severe epilepsy and depression). Observed 20- and 30-year survival rates were 51% and 44%, respectively. Despite successful treatment of MB in childhood and satisfactory tumor control during the first 20 years following primary treatment, our data indicates that even long-term survivors may die from tumor recurrence. However, the main factors causing late mortality and morbidity in long-term survivors seem to be the complications related to radiotherapy given in childhood.

背景与目标： : 该研究的目的是分析儿童期后颅窝髓母细胞瘤 (MB) 治疗后的长期结果 (>20年)。我们分析了接受后颅窝MB 1974年 (在挪威引入了第一个国际治疗方案) 和1987 (在4岁以下儿童中放弃放疗时) 治疗的患者的数据。在47名儿童中，有24名存活了20年以上。在分析时，16例患者 (中位年龄41岁，范围32-52) 存活 (中位随访34年，范围30-42)，而8例患者在初次治疗后死亡22-41年 (中位31年): 1例晚期死亡 (22年后) 是由于肿瘤复发，而其他7例死亡 (23至41年后) 与治疗的有害影响 (继发性肿瘤，中风，严重癫痫和抑郁症) 有关。观察到的20年和30年生存率分别为51% 和44%。尽管在儿童时期成功治疗了MB，并且在初次治疗后的前20年中肿瘤控制令人满意，但我们的数据表明，即使是长期幸存者也可能死于肿瘤复发。然而，导致长期幸存者晚期死亡率和发病率的主要因素似乎是与儿童时期放疗有关的并发症。

BACKGROUND & AIMS: OBJECTIVE:The characteristics of typical posterior canal-benign paroxysmal positional vertigo-canalolithiasis (P-BPPV-Can) are well known. We found 10 patients with a new variant of P-BPPV-Can: Reverse (Rev)-P-BPPV-Can. The characteristics and pathophysiology of Rev-P-BPPV-Can are discussed. METHODS:For 4 years and 9 months, 10 patients with Rev-P-BPPV-Can (9 women and 1 man; mean age: 73 years) visited our clinic. Within the same period, 268 patients with unilateral typical P-BPPV-Can were treated. During the Dix-Hallpike and Epley maneuvers, nystagmus was recorded using an infrared charge-coupled device camera mounted on a pair of spectacles. RESULTS:The patients exhibited entirely opposite direction of nystagmus from typical P-BPPV-Can in both the Dix-Hallpike head position and upright sitting position. The patients had typical characteristics of nystagmus due to canalolithiasis, such as latency, duration of <1 min, linear-torsional nystagmus, and fatigability. Rev-P-BPPV-Can appeared after the Epley maneuver for typical P-BPPV-Can; in other patients, Rev-P-BPPV-Can changed to typical P-BPPV-Can. The affected sides of Rev-P-BPPV-Can were decided by those of typical P-BPPV-Can. CONCLUSION:Canalolithiasis in the non-ampullary distal portion of the posterior semicircular canal may be a potential pathophysiology of Rev-P-BPPV-Can. The Epley maneuver has little effect for treating Rev-P-BPPV-Can, but spontaneous transition to typical P-BPPV-Can or spontaneous recovery is expected.

背景与目标：

BACKGROUND & AIMS: UNLABELLED:It is unclear whether using artificial cages increases fusion rates compared with use of bone chips alone in posterior lumbar interbody fusion for patients with lumbar spondylolisthesis. We hypothesized artificial cages for posterior lumbar interbody fusion would provide better clinical and radiographic outcomes than bone chips alone. We assumed solid fusion would provide good clinical outcomes. We clinically and radiographically followed 34 patients with spondylolisthesis having posterior lumbar interbody fusion with mixed autogenous and allogeneic bone chips alone and 42 patients having posterior lumbar interbody fusion with implantation of artificial cages packed with morselized bone graft. Patients with the artificial cage had better functional improvement in the Oswestry disability index than those with bone chips alone, whereas pain score, patient satisfaction, and fusion rate were similar in the two groups. Postoperative disc height ratio, slip ratio, and segmental lordosis all decreased at final followup in the patients with bone chips alone but remained unchanged in the artificial cage group. The functional outcome correlated with radiographic fusion status. We conclude artificial cages provide better functional outcomes and radiographic improvement than bone chips alone in posterior lumbar interbody fusion for lumbar spondylolisthesis, although both techniques achieved comparable fusion rates. LEVEL OF EVIDENCE:Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

背景与目标：

BACKGROUND & AIMS: PURPOSE:To evaluate the reparability of the posterior horn of the medial meniscus with root ligament tear by measuring the actual pullout failure strength of a simple vertical suture of an arthroscopic subtotal meniscectomized posterior horn of the medial meniscus. METHODS:From November 2009 to May 2010, nine posterior horns of the medial meniscus specimens were collected from arthroscopic subtotal meniscectomy performed as a treatment for root ligament rupture of the posterior horn of the medial meniscus. Simple vertical sutures were performed on the specimens, and pullout failure load was tested with a biaxial servohydraulic testing machine (Model 8874; Instron Corp., Norwood, MA, USA). The degree of degeneration, extrusion, and medial displacement of the medial meniscus were evaluated with magnetic resonance imaging (MRI). The Kellgren-Lawrence classification was used in standing plain radiography, and mechanical alignment was measured using orthoroentgenography. Tear morphology was classified into ligament proper type or meniscoligamentous junctional type according to the site of the torn root ligament of the posterior horn of the medial meniscus during arthroscopy. RESULTS:The mean pullout failure strength of the posterior horn of the medial meniscus was 71.6 ± 23.2 N (range, 41.4-107.7 N). The degree of degeneration of the posterior horn of the medial meniscus on MRI showed statistically significant correlation with pullout failure strength and Kellgren-Lawrence classification. Pullout failure strength showed correlation with mechanical alignment and Kellgren-Lawrence classification (P < 0.05). CONCLUSIONS:The measurement of pullout failure strength of the posterior horn of the medial meniscus with root ligament tear showed a degree of repairability. The degree of degeneration of the posterior horn of the medial meniscus on MRI showed a significant correlation with the pullout failure strength. The pullout failure strength was also not only correlated with the degree of degeneration of the posterior horn of the medial meniscus, but also with mechanical alignment and Kellgren-Lawrence classification, which represent bony degenerative change.

背景与目标：

BACKGROUND & AIMS: :The connections between nuclei of the septum-diagonal band complex and the clusters of histaminergic neurons in the posterior hypothalamic region were studied with a dual-labeling procedure in which anterograde neuroanatomical tracing with Phaseolus vulgaris-leucoagglutinin was combined with immunohistochemistry of histidine decarboxylase. Phaseolus vulgaris-leucoagglutinin was injected in the medial and lateral septal nuclei, and in various parts of the nuclei of the diagonal band of Broca. The fibers arising from the medial and lateral septal nuclei traverse the vertical limb of the diagonal band and, in part, join the medial forebrain bundle in the preoptic area. Other fibers descend diffusely through the lateral hypothalamus to the posterior hypothalamus, or course in a bundle of fibers ensheathing the fornix. The nuclei of the diagonal band project via the medial forebrain bundle and the diffuse pathway to the posterior hypothalamic region. All the nuclei of the septum-diagonal band complex, with the exception of the medial and lateral parts of the nucleus of the horizontal limb of the diagonal band, project to clusters of histaminergic neurons. These projections exhibit the following arrangement: along the axis lateral septal nucleus-medial septal nucleus-vertical limb of the diagonal band-medial part of the horizontal limb of the diagonal band, the septohypothalamic fibers decrease in density and distribute to fewer clusters of histaminergic neurons. Varicosities on the labeled fibers are formed in close proximity to the cell bodies and dendrites of the histaminergic neurons.

背景与目标： : 通过双重标记程序研究了隔-对角带复合体的核与下丘脑后部组胺能神经元簇之间的联系，其中将菜豆-白细胞凝集素的顺行神经解剖示踪与组氨酸脱羧酶的免疫组织化学相结合。将菜豆-白细胞凝集素注入内侧和外侧间隔核以及Broca对角线带核的各个部分。由内侧和外侧中隔核产生的纤维横穿对角线带的垂直肢体，并部分连接视前区的内侧前脑束。其他纤维通过下丘脑外侧扩散到下丘脑后部，或以一束纤维的方式延伸到穹窿。对角带的核通过内侧前脑束和弥散途径投射到下丘脑后部区域。隔膜-对角线带复合体的所有核，除了对角线带水平肢核的内侧和外侧部分外，都投射到组胺能神经元簇。这些投影表现出以下排列: 沿着轴外侧间隔核-内侧间隔核-对角线带的垂直肢体-对角线带的水平肢体的内侧部分，下丘脑隔膜纤维的密度降低并分布到更少的组胺能神经元簇。标记纤维上的静脉曲张形成于组胺能神经元的细胞体和树突附近。

BACKGROUND & AIMS: :The aim of this study was to demonstrate the incidence of absence of the posterior root of the first cervical nerve, and the relation between the accessory nerve and the posterior root of the first cervical nerve in Turkish population. Dissections of the accessory nerve and the posterior root of the first cervical nerve were performed in 49 specimens from 27 formalin fixed cadavers (25 male and 2 female). The type of the connections between the accessory nerve and the posterior root of the first cervical nerve was classified into four types. Type III was the most common type in present study (30.6%). There was a connection between the accessory nerve and the posterior root of the first cervical nerve in this type. The connections demonstrated in this study are important in the etiology and surgical treatment of the spasmodic torticollis.

背景与目标： : 这项研究的目的是证明土耳其人群中第一颈神经后根缺失的发生率，以及副神经与第一颈神经后根之间的关系。在来自27例福尔马林固定尸体 (25例男性和2例女性) 的49个标本中进行了副神经和第一颈神经的后根解剖。副神经与第一颈神经后根之间的连接类型分为四种类型。III型是目前研究中最常见的类型 (30.6%)。在这种类型中，副神经和第一颈神经的后根之间存在连接。在这项研究中证明的联系在痉挛性斜颈的病因和手术治疗中很重要。

BACKGROUND & AIMS: :We report a case of compression fracture of anterior margin of medial tibial plateau and medial femoral condyle combined with the posterior cruciate ligament and posterolateral corner disruption. A thirty-seven-year old male had undergone the left knee injury 6 months before. The physical examination revealed positive posterior drawer test and tibial dial test, which evidenced the posterior cruciate ligament and posterolateral corner insufficiency. The plain lateral knee radiographs showed a marginal fracture of the anteromedial tibial plateau and a dimpling on the adjacent part of the medial femoral condyle. On arthroscopy, there were no gross tear of the cruciates, but the posterolateral capsule disclosed stigmata of stretching injury with multiple petechiae and scarring. The compression fracture on the anteromedial side and the stretching injury on the posterolateral side altogether support the mechanism of hyperextension pivoting on the anteromedial side of the knee joint. A small bony lesion around the knee joint should be inspected rigorously with an assumed mechanism of injury for it may herald major ligamentous injury.

背景与目标： : 我们报告了一例胫骨内侧平台前缘和股骨内侧con合并后交叉韧带和后外侧角断裂的压缩性骨折。一名37岁的男性在6个月前遭受了左膝受伤。体格检查显示后抽屉试验和胫骨表盘试验阳性，证明后交叉韧带和后外侧角功能不全。膝关节外侧x线平片显示胫骨前内侧平台的边缘骨折和股骨内侧con的相邻部分凹陷。在关节镜检查中，十字形没有明显的撕裂，但后外侧囊显示出有多处瘀点和疤痕的拉伸损伤的柱头。前内侧的压缩性骨折和后外侧的拉伸损伤共同支持了膝关节前内侧过度伸展枢转的机制。应严格检查膝关节周围的小骨病变，并假定其损伤机制，因为它可能预示着严重的韧带损伤。