Analysis of Radiographic Relationship between Distal Radius, Ulna, and Lunate

Background Wrist anatomy variability is associated with differing susceptibility to pathology. For example, a flat radial inclination is associated with Kienbock's disease. Lunate facet inclination (LFI) also exhibits variability. Its relationship with other wrist features is poorly documented. Purposes We tested the hypothesis that high LFI is associated with increased uncovering of the lunate, negative ulnar variance (UV), and type 2 lunates to balance forces across wrists. Methods In total, 50 bilateral and 100 unilateral wrist posteroanterior radiographs were reviewed. Lunate type, lunate uncovering index (LUI), lunate tilting angle (LTA), UV, and sigmoid notch angle (SNA) were measured, and correlation with LFI was assessed on 150 right wrist radiographs followed by an assessment of differences based on lunate morphology. Symmetry of 50 bilateral wrists was assessed. Results There was no correlation of LFI with lunate morphology, LUI, and LTA. There was a low correlation of LFI with SNA and UV. There was an inverse relationship between UV and SNA. Wrists with type 2 lunates had more oblique sigmoid notches and higher LTA in comparison to wrists with type 1 lunates. Side-to-side comparison revealed strong correlation except for LUI, which exhibited moderate correlation. Conclusions There is no correlation between LFI, LUI, and lunate morphology. Type 2 lunates are associated with higher LTA and more oblique SNA. Wrists were symmetrical. Clinical Relevance Factors other than lunate morphology are essential in balancing forces across wrists. A better understanding of soft tissue and other factors will improve the understanding of wrist biomechanics and pathology. Contralateral wrist radiographs can guide reconstructive surgery.

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Anatomical Wrist Patterns on Plain Radiographs

Current Rheumatology Reviews ◽

10.2174/1573397113666170417124711 ◽

2019 ◽

Vol 15 (2) ◽

pp. 168-171 ◽

Cited By ~ 2

Author(s):

Aviv Kramer ◽

Raviv Allon ◽

Alon Wolf ◽

Tal Kalimian ◽

Idit Lavi ◽

...

Keyword(s):

Significant Relationship ◽

Classification System ◽

Quality Evaluation ◽

Normal Database ◽

Radiocarpal Joint ◽

Wrist Anatomy ◽

Wrist Biomechanics ◽

Midcarpal Joint

Background: Interpreting the structure in the wrist is complicated by the existence of multiple joints as well as variability in bone shapes and anatomical patterns. Previous studies have evaluated lunate and capitate shape in an attempt to understand functional anatomical patterns. Objective: The purpose of this study was to describe anatomical shapes and wrist patterns in normal wrist radiographs. We hypothesized that there is a significant relationship in the midcarpal joint with at least one consistent pattern of wrist anatomy. Methods: Seventy plain posteroanterior (PA) and lateral wrist radiographs were evaluated. These radiographs were part of a previously established normal database, had all been read by a radiologist as normal, and had undergone further examination by 2 hand surgeons for quality. Evaluation included: lunate and capitate shape (type 1 and 2 lunate shape according to the classification system by Viegas et al.), ulnar variance, radial inclination and height, and volar tilt. Results: A significant association was found between lunate and capitate shape using a dichotomal classification system for both lunate and capitate shapes (p=0.003). Type 1 wrists were defined as lunate type1and a spherical distal capitate. Type 2 wrists had a lunate type 2 and a flat distal capitate. No statistically significant associations were detected between these wrist types and measurements of the radiocarpal joint. Conclusion: There was a significant relationship between the bone shapes within the midcarpal joint. These were not related to radiocarpal anatomical shape. Further study is necessary to better describe the two types of wrist patterns that were defined and to understand their influence on wrist biomechanics and pathology.

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Abstract 555: The Universal Clinical Classification of Acute Myocardial Infarction is a Better Predictor of Long Term Outcomes than ST Segment Classification

Circulation ◽

10.1161/circ.118.suppl_18.s_579-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Manuel A Gonzalez ◽

Dana Eilen ◽

Rana A Marzouq ◽

Saed Awadallah ◽

Hiren R Patel ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Inverse Relationship ◽

Long Term Outcomes ◽

St Segment ◽

Vascular Beds

Introduction: The universal classification (UC) of AMI aims to facilitate cross-study analysis, yet the long-term outcomes using UC are largely unknown. Hypothesis: We tested the hypothesis that the long-term outcome of patients with AMI is better predicted by UC than ST segment classification. Methods: We conducted a prospective study of 348 consecutive patients with AMI with mean follow-up of 30.6 months. The primary outcome was the major adverse cardiovascular events (MACE) [composite of all causes of mortality, recurrent AMI, and stroke]. Multivariate and survival analysis of MACE was performed. Results: The study population was STEMI=168, NSTEMI=180, Type 1=278, Type 2=55, Type 3=5, Type 4a=2, Type 4b=5, and Type 5=3. During follow-up 80 patients died, 31 had an AMI, and 7 had a stroke. UC correlates with the ST segment classification (p<0.005). MACE free survival was different for Type 1 and Type 2 (p=0.043), but not for STEMI and NSTEMI. There was a positive association between MACE and the quartile of peak Troponin, number of cardiovascular risk factors, and number of vascular beds affected, and an inverse relationship with the utilization of discharge cardiovascular protective medications (all p≤0.01). No such inverse relationship existed for Type 2. Conclusions: UC of AMI is a better long-term predictor of MACE. The quartile of peak Troponin levels, cardiovascular risk factors, and number of vascular beds affected are independent predictors of MACE, while cardiac medications protect against MACE, except in Type 2 patients.

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Neurofibroma of the hard palate

BMJ Case Reports ◽

10.1136/bcr-2020-239887 ◽

2021 ◽

Vol 14 (4) ◽

pp. e239887

Author(s):

Bethany Cartwright ◽

Kenneth Corsar

Keyword(s):

Soft Tissue ◽

Hard Palate ◽

Soft Tissue Mass ◽

Treatment Options ◽

Neurofibromatosis Type ◽

Incisional Biopsy ◽

Tissue Mass ◽

Benign Tumours

Neurofibromas are defined as benign tumours arising from peripheral nerve sheaths. Few intraoral palatal cases have been reported. Neurofibromas can occur as part of neurofibromatosis, type 1 (NF1) or type 2 (NF2). A 41-year-old patient presented with a slowly enlarging soft tissue mass on the hard palate. An incisional biopsy was performed, which confirmed the diagnosis of a neurofibroma associated with NF1. It should be considered that there is a chance of malignant transformation. Here, we discuss the clinical features, types, diagnosis, histopathology and treatment options.

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Inverse relationship between type 1 diabetes mellitus and migraine. Data from the Nord-Trøndelag Health Surveys 1995–1997 and 2006–2008

Cephalalgia ◽

10.1177/0333102417690488 ◽

2017 ◽

Vol 38 (3) ◽

pp. 417-426 ◽

Cited By ~ 7

Author(s):

Knut Hagen ◽

Bjørn Olav Åsvold ◽

Kristian Midthjell ◽

Lars Jacob Stovner ◽

John-Anker Zwart ◽

...

Keyword(s):

Diabetes Mellitus ◽

Inverse Relationship ◽

Population Based ◽

Classical Type ◽

Cross Sectional ◽

Population Based Study ◽

The Third ◽

Type 1 Dm

Aims The aim of this cross-sectional population-based study was to investigate the associations between migraine and type 1 and type 2 diabetes mellitus (DM). Methods We used data from the second (1995–1997) and third survey (2006–2008) in the Nord-Trøndelag Health Study. Analyses were made for the 26,121 participants (30–97 years of age, median 58.3 years) with known headache and DM status in both surveys, and for the 39,584 participants in the third survey (20–97 years, median 54.1 years). The diagnosis of migraine was given to those who fulfilled the questionnaire-based migraine diagnosis in the second and/or third survey. Associations were assessed using multiple logistic regression, estimating prevalence odds ratio (OR) with 95% confidence intervals (CIs). Results In the multivariate analysis of the 26,121 participants in both surveys, adjusting for age, gender, years of education, and smoking, classical type 1 DM (n = 81) was associated with a lower prevalence of any headache (OR = 0.55, 95% CI 0.34–0.88),and migraine (OR = 0.47, 95% CI 0.26–0.96) compared to those without DM (n = 24,779). Correspondingly, the merged group of classical type 1 DM and latent autoimmune diabetes of adults (LADA) (n = 153) were less likely to have migraine (OR = 0.53, 95% CI 0.31–0.91). Similarly, an inverse relationship between type 1 DM and migraine was found in analyses of 39,584 participants in the third survey. No clear association was found between headache and type 2 DM. Conclusions In this cross-sectional population-based study of mainly middle-aged participants, type 1 DM was inversely associated with headache, in particular migraine.

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CLASSIFICATION AND TREATMENT OF HAMATE FRACTURES

Hand Surgery ◽

10.1142/s0218810405002747 ◽

2005 ◽

Vol 10 (02n03) ◽

pp. 151-157 ◽

Cited By ~ 42

Author(s):

Kenichi Hirano ◽

Goro Inoue

Keyword(s):

Soft Tissue ◽

Closed Reduction ◽

Open Reduction ◽

Functional Results ◽

Non Union ◽

Cast Immobilisation ◽

Classification And Treatment

Twenty-nine patients with hamate fractures were treated. The two main types of hamate fractures are hook fractures (type 1) and body fractures (type 2). We sub-divided type 2 fractures according to the fracture line into coronal, type 2a and transverse, type 2b. There were 15 type 1, 11 type 2a and three type 2b fractures. For type 1, nine were treated with excision, one with open reduction and internal fixation (ORIF) and five with cast immobilisation, in which two resulted in non-union followed by excision. For type 2, five type 2a cases were treated with ORIF and the others with closed reduction and pinning. Most of the patients had satisfactory results at the seventh month follow-up. However, those with associated neurovascular and musculotendinous injuries were likely to have unfavourable results. On the basis of study findings, it appears that functional results are influenced mainly by the associated soft tissue damage.

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Inverse Relationship Between Organ-Specific Autoantibodies and Systemic Immune Mediators in Type 1 Diabetes and Type 2 Diabetes: Action LADA 11

Diabetes Care ◽

10.2337/dc16-0293 ◽

2016 ◽

Vol 39 (11) ◽

pp. 1932-1939 ◽

Cited By ~ 20

Author(s):

Nanette C. Schloot ◽

Minh N. Pham ◽

Mohammed I. Hawa ◽

Paolo Pozzilli ◽

Werner A. Scherbaum ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Inverse Relationship ◽

Immune Mediators ◽

Organ Specific

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Necrotizing Fasciitis Associated withStaphylococcus lugdunensis

Case Reports in Infectious Diseases ◽

10.1155/2012/453685 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Tony Hung ◽

Soroush Zaghi ◽

Jonathan Yousefzadeh ◽

Matthew Leibowitz

Keyword(s):

Soft Tissue ◽

Necrotizing Fasciitis ◽

Staphylococcal Infection ◽

Tissue Destruction ◽

First Case ◽

Life Threatening ◽

Group A ◽

Group B

Necrotizing fasciitis is a life-threatening soft tissue infection that results in rapid local tissue destruction. Type 1 necrotizing fasciitis is characterized by polymicrobial, synergistic infections that are caused by non-Group Astreptococci, aerobic and anaerobic organisms. Type 2 necrotizing fasciitis involves Group AStreptococcus(GAS) with or without a coexisting staphylococcal infection. Here we provide the first report of necrotizing fasciitis jointly associated with the microbes Group BStreptococcusandStaphylococcus lugdunensis.S. lugdunensisis a commensal human skin bacterium known to cause often painful and prolonged skin and soft tissue infections. To our knowledge, however, this is the first case ofStaph. lugdunensis-associated necrotizing fasciitis to be reported in the literature.

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Corallite increase and mural pores in Lichenaria (Tabulata, Ordovician)

Journal of Paleontology ◽

10.1666/06-114.1 ◽

2008 ◽

Vol 82 (2) ◽

pp. 377-390 ◽

Cited By ~ 9

Author(s):

Robert J. Elias ◽

Dong-Jin Lee ◽

Sung-Kyu Woo

Keyword(s):

Soft Tissue ◽

Phylogenetic Relationships ◽

Wall Structure ◽

Pore Types ◽

Type 3 ◽

Tabulate Corals ◽

Colony Integration

Lichenaria may be a representative of the most primitive stock of tabulate corals. The degree of paleobiologic complexity discovered in L. globularis and L. grandis is therefore surprising. Six types of corallite increase are recognized. All are lateral, which is the predominant mode in tabulates. Most types, however, are unique or are comparable to those in few other Ordovician taxa. Only Type 1 (L. globularis), yielding a single offset with a simple basal mural pore, is typical of tabulates. In Type 2 (L. globularis), one parent produces two offsets simultaneously, whereas in Type 3 (L. globularis), two offsets arise from separate parents at nearly the same time and join via a connective mural pore. Types 4 (L. globularis, L. grandis), 5 (L. grandis), and 6 (L. globularis, L. grandis), respectively, involve one, two, and two to four corallites in addition to the parent, which join via a connective mural pore at the site of offsetting.Several features of L. globularis and L. grandis point to unexpectedly high levels of colony integration. Continuously fused common walls lacking back-to-back epithecae suggest soft tissue continuity among polyps above the corallum. Connective mural pores indicate temporary fusion of polyps. Coordinated behavior of polyps is suggested by the development of conjoined offsets from two parents during Type 3 increase, and by fusion during Types 4 to 6 increase. Attempts at certain types of increase sometimes failed to yield offsets, suggesting expendability of incipient buds, perhaps reflecting subjugation of individuals for the good of the colony.In light of this study, genera that have previously been included in Lichenariidae and Lichenariida require reassessment and their phylogenetic relationships should be reconsidered. Unfortunately, this is hindered because fundamental characters such as corallite increase and wall structure remain inadequately known in most early tabulates.

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