The three-dimensional nature of scoliosis, coupled with changes due to natural history or treatment, is often difficult to quantify and visualise. A difference map was developed to compare the sequential surface topography of subjects over their treatment period. Three-dimensional surface maps representing patients' trunk surfaces were captured with a laser scanner. Patient surface maps from two clinic visits were matched using a manual best-fit technique that accounted for growth and positioning. The surfaces were subtracted, generating a colour-coded three-dimensional difference map displaying the surface changes. The difference maps were compared with known clinical measures, indicating good agreement (78% specific) with the clinical parameters in detecting change. Full agreement or agreement with the clinical parameters occurred in the surgical, brace and no treatment groups: 76%, 80% and 85%, respectively. A difference index (average of the absolute value of differences on a point-by-point basis) was calculated from the difference map, enabling quantification of change. The difference index, with zero being a perfect match, averaged 5 +/- 1 for repeated measures 7 +/- 2 for subjects deemed to have no change, 9 +/- 2 for subjects with slight change, and 14 +/- 2 for subjects with significant change. The difference map showed the extent and location of changes and is a useful tool for assessing surface topography changes.

From 1976-1979 127 patients were treated with a tutoplast dura sling operation. Either an open or a closed sling was used. Between one and four and one half years later 117 patients were re-examined and 65 patients had urodynamic tests. The late results of tutoplast dura sling operations are good and compare favorably to the upper data indicated in the literature. The best results are obtained in cases of prolapse. The closed sling has higher success rates but also higher complication rates than the open sling. Primary operations have better results than operations for recurrence. A severe stress incontinence should be subjected to specific primary treatment.

No abstract

Bezoar-induced small bowel obstruction is a rare entity, but it should be highly suspected in those with prior abdominal or bariatric surgery. The cornerstone of treatment for intestinal bezoars has been surgical exploration to relieve the obstruction. We present a patient with obstructive jejunal phytobezoar formation that was relieved via an endoscopic approach rather than a surgical modality.