scholarly journals Association of Lunate Morphology With Carpal Instability in Scapholunate Ligament Injury

Hand ◽  
2017 ◽  
Vol 13 (4) ◽  
pp. 418-422 ◽  
Author(s):  
Eric Quan Pang ◽  
Nathan Douglass ◽  
Robin N. Kamal
Keyword(s):  
Retrospective Chart Review ◽  
Plain Film ◽  
Ligament Injury ◽  
Type I ◽  
Type Ii ◽  
Scapholunate Ligament ◽  
Ligament Injuries ◽  
Scapholunate Instability ◽  
Significant Difference ◽  
Chi Square Analysis

Background: We examined the relationship between lunate morphology (type 1 without a medial facet; type II with a medial facet) and dorsal intercalated segmental instability (DISI) in patients with scapholunate ligament injuries. We tested the primary null hypothesis that there is no relationship between lunate morphology and development of DISI. Secondary analysis compared the agreement of classifying lunate morphology based on the presence of a medial lunate facet, capitate-to-triquetrum (CT) distance, and magnetic resonance imaging (MRI). Methods: We performed a retrospective chart review of patients with known scapholunate ligament injuries from 2001 to 2016. Posterior-anterior radiographs and MRI, when available, were evaluated. CT distances were measured as a secondary classification method. DISI and scapholunate instability were determined as radiolunate angle >15° and scapholunate angle >60°, respectively. Differences between groups were determined using chi-square analysis with significance set at P < .05. Agreement between plain radiographs, MRI, and CT distance was calculated using the kappa statistic. Results: Our search found 58 of 417 patients who met inclusion criteria; 41 of 58 had type II and 17 of 58 had type I lunates. There was no significant difference between groups in regard to DISI or scapholunate instability. Subanalysis using MRI alone or correcting any discrepancy between plain film and MRI classification, using MRI as the standard, found no difference between groups in regard to DISI or scapholunate instability. Conclusions: In patients with scapholunate ligament injuries, there are no differences in the development of DISI or scapholunate instability between patients with type I and type II lunates.

scholarly journals Analysis of sagittal profile and radiographic parameters in symptomatic thoracolumbar disc herniation patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ang Gao ◽  
Yongqiang Wang ◽  
Miao Yu ◽  
Xiaoguang Liu
Keyword(s):  
Disc Herniation ◽  
Thoracic Spine ◽  
Normal Population ◽  
Sagittal Profile ◽  
Sacral Slope ◽  
Type I ◽  
Type Ii ◽  
Radiographic Parameters ◽  
Significant Difference ◽  
Thoracolumbar Region

Abstract Background Few studies describe thoracolumbar disc herniation (TLDH) as an isolated category, it is frequently classified as the lower thoracic spine or upper lumbar spine. Thus, less is known about the morphology and aetiology of TLDH compared to lumbar disc herniation (LDH). The aim of study is to investigate sagittal alignment in TLDH and analyze sagittal profile with radiographic parameters. Methods Data from 70 patients diagnosed with TLDH were retrospectively reviewed. The thoracic-lumbar alignment was depicted by description of curvatures (the apex of lumbar curvature, the apex of thoracic curvature, and inflexion point of the two curvatures) and radiographic parameters from complete standing long-cassette spine radiographs. The rank sum test was utilised to compare radiographic parameter values in each subtype. Results We found two subtypes differentiated by the apex of thoracic kyphotic curves. The sagittal profile was similar to that of the normal population in type I, presenting the apex of the thoracic kyphotic curve located in the middle thoracic spine. The well aligned thoracic-lumbar curve was disrupted in type II, presenting the apex of the thoracic kyphotic curve located in the thoracolumbar region in type II patients. Thirty-six patients were classified as type I, and 34 patients were classified as type II. The mean sagittal vertical axis, T1 pelvic angle and L1 pelvic angle were 27.9 ± 24.8°, 8.2 ± 7.3° and 6.2 ± 4.9°, respectively. There was significant difference (p < 0.001) of thoracolumbar angle between type I (14.9 ± 7.9°) and type II patients (29.1 ± 13.7°). Conclusions We presented two distinctive sagittal profiles in TLDH patients, and a regional kyphotic deformity with a balanced spine was validated in both subtypes. In type I patients, disc degeneration was accelerated by regional kyphosis in the thoracolumbar junction and eventually caused disc herniation. In type II patients, excessive mechanical stress was directly loaded at the top of the curve (thoracolumbar apex region) rather than being diverted by an arc as in a normal population or type I patients. Mismatch between shape and sacral slope value was observed, and better agreement was found in Type II patients.

RA05.04: MANAGEMENT & OUTCOMES OF ANASTOMOTIC LEAKS FOLLOWING ESOPHAGECTOMY: A PROSPECTIVE 10-YEAR SINGLE-SITE EXPERIENCE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 28-28
Author(s):  
Joel Lambert ◽  
Sanya Caratella ◽  
Eloise Lawrence ◽  
Bilal Alkhaffaf
Keyword(s):  
Minimally Invasive ◽  
Anastomotic Leak ◽  
Surgical Intervention ◽  
Type I ◽  
Oral Contrast ◽  
Open Approach ◽  
Type Ii ◽  
Anastomotic Leaks ◽  
Type Iii ◽  
Significant Difference

Abstract Background Anastomotic leak after esophagectomy is associated with high levels of morbidity and may impact negatively on oncological outcomes. The aim of this single centre study was to describe our experience in managing these complications Methods From 2007–2017 data was reviewed retrospectively from our prospectively maintained electronic database. All patients underwent either 2 or 3 phase esophagectomy for cancer of the oesophagus or esophago-gastric junction. All histological sub-types and stage of cancer were included in the analysis. Anastomotic leaks were classified according to the Esophagectomy Complications Consensus Group (ECCG) guidelines; type I—conservative management, type II—non-surgical intervention, type III—surgical intervention. Results 224 esophagectomies were included in our analysis (104 (46%) minimally invasive, 120 (54%) open approach). The incidence of all anastomotic leaks was 10% (23/224). Surgical approach did not influence the incidence of anastomotic leak (minimally invasive 10 (43%), open approach 13(57%), P = 0.76). Five patients (22%) had a type I leak, 9 patients (39%) type II and 9 (39%) had a type III leak. There was an increase in the number of leaks managed non-surgically over the last 5 years compared to those in the first five years of our dataset (2012–2017: 11/23 (48%) vs 2007–2012: 4/23 (17%) P = 0.08). The median time for leak diagnosis was 8 days. Most leaks were diagnosed with oral contrast CT 19 (83%). Median hospital stay after anastomotic leak was 58.5 days. Type III leaks were associated with an increased length of stay (median 84 days) compared to type I&II leaks (median (38.5 days) (P = 0.002 95% CI 18.19- 74.41). There was no significant difference in 30-day mortality between type I&II (0 patients) and type III leaks (1 patient) P = 0.260. Conclusion Low mortality rates with anastomotic leak can be achieved. In centres with experienced radiological and endoscopic skills, most anastomotic leaks can be managed non-surgically. Disclosure All authors have declared no conflicts of interest.

Close Reduction Percutaneous Pinning (CRPP) versus Open Reduction Internal Fixation (ORIF) for Pediatric Supracondylar Humerus Fractures Gartland Type II and III: A Systematic Review and Meta-analysis

2021 ◽  
Vol 71 (4) ◽  
pp. 187-193
Author(s):  
Putu Astawa ◽  
Made Agus Maharjana ◽  
Surya Adisthanaya ◽  
Made Winatra Satya Putra ◽  
Agus Suarjaya Putra ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Cosmetic Outcome ◽  
Type I ◽  
Type Ii ◽  
Supracondylar Humerus Fractures ◽  
Significant Difference ◽  
Humerus Fractures

Introduction: Displaced supracondylar fracture in children is a challenging injury that may result in impaired functional and cosmetic outcome if not well-treated. Utilization of Closed Reduction and Percutaneus Pinning (CRPP) increased for this pathology, some authors believe ORIF results better anatomical reduction and lower rate of loss of reduction. Study aims to compare CRPP and ORIF for pediatric supracondylar humerus fracture. Method: Systematic review was conducted based on PRISMA guideline. Inclusion criteria were age <18 years old, comparing CRPP and ORIF for Supracondylar Humerus Fractures Gartland Type II, II.Studies of one surgical technique, Gartland type I, case reports were excluded. For meta-analysis, 6 studies were included and fixed effect model used to pool the result. In each study, mean difference (MD) with 95% confidence interval (CI) was calculated for dichotomous outcomes using Review Manager. Result: Total of 252 patients aged 0-15 years old were included. CRPP more often performed than ORIF. Satisfactory outcomes measured by Flynn’s criteria were achieved in 87.74% in CRPP and 86.73% in ORIF patient group, indicating significant difference (Heterogeneity, I2 = 23%; WMD, 1.26; 0.58 to 2.73; P =0.56). Conclusion: Current systematic review and meta-analysis suggest that for displaced supracondylar humerus fractures, ORIF offers a comparable functional and cosmetic outcome compared to CRPP.

Should All Cases of High-Grade Serous Ovarian, Tubal, and Primary Peritoneal Carcinomas Be Reclassified as Tubo-Ovarian Serous Carcinoma?

2015 ◽  
Vol 25 (7) ◽  
pp. 1201-1207 ◽  
Author(s):  
Esther Louise Moss ◽  
Tim Evans ◽  
Philippa Pearmain ◽  
Sarah Askew ◽  
Kavita Singh ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clear Cell ◽  
Stage Iii ◽  
Serous Carcinoma ◽  
Low Grade ◽  
Type I ◽  
High Grade ◽  
Type Ii ◽  
Ovarian Serous Carcinoma ◽  
Significant Difference

IntroductionThe dualistic theory of ovarian carcinogenesis proposes that epithelial “ovarian” cancer is not one entity with several histological subtypes but a collection of different diseases arising from cells of different origin, some of which may not originate in the ovarian surface epithelium.MethodsAll cases referred to the Pan-Birmingham Gynaecological Cancer Centre with an ovarian, tubal, or primary peritoneal cancer between April 2006 and April 2012 were identified from the West Midlands Cancer Registry. Tumors were classified into type I (low-grade endometrioid, clear cell, mucinous, and low-grade serous) and type II (high-grade serous, high-grade endometrioid, carcinosarcoma, and undifferentiated) cancers.ResultsOvarian (83.5%), tubal (4.3%), or primary peritoneal carcinoma (12.2%) were diagnosed in a total of 583 woman. The ovarian tumors were type I in 134 cases (27.5%), type II in 325 cases (66.7%), and contained elements of both type I and type II tumors in 28 cases (5.7%). Most tubal and primary peritoneal cases, however, were type II tumors: 24 (96.0%) and 64 (90.1%), respectively. Only 16 (5.8%) of the ovarian high-grade serous carcinomas were stage I at diagnosis, whereas 240 (86.6%) were stage III+. Overall survival varied between the subtypes when matched for stage. Stage III low-grade serous and high-grade serous carcinomas had a significantly better survival compared to clear cell and mucinous cases,P= 0.0134. There was no significant difference in overall survival between the high-grade serous ovarian, tubal, or peritoneal carcinomas when matched for stage (stage III,P= 0.3758; stage IV,P= 0.4820).ConclusionsType II tumors are more common than type I and account for most tubal and peritoneal cancers. High-grade serous carcinomas, whether classified as ovarian/tubal/peritoneal, seem to behave as one disease entity with no significant difference in survival outcomes, therefore supporting the proposition of a separate classification of “tubo-ovarian serous carcinoma”.

scholarly journals Analyzing the Influence of Modic Changes on Patients with Lower Back Pain Undergoing Conservative Treatment

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Yufeng Chen ◽  
Huilin Yang ◽  
Lianfang Zhang ◽  
Yue Wang ◽  
Jun Zou
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Modic Changes ◽  
Nonsurgical Treatment ◽  
Type I ◽  
Type Ii ◽  
Lower Back ◽  
Significant Difference ◽  
Modic Type ◽  
Vas Scores

Objective. This study aimed to investigate if the presence of Modic changes (MCs) was correlated with lower back pain (LBP) and LBP-related disability in patients who underwent nonsurgical treatment. Methods. In this study, 129 patients who experienced consecutive LBP and underwent lumbar spine magnetic resonance imaging in our institute were divided into three groups according to the presence or type of MCs. The Oswestry Disability Index (ODI) and visual analog scale (VAS) were used to assess the outcomes of the treatment. Results. Based on the achieved results, there was no significant difference between three groups before treatment (P>0.05). Three months after undergoing nonsurgical treatment, the rates of improved ODI and VAS scores were statistically significantly different (P=0.014,  0.023). After an additional 3 months of treatment, in patients with Modic type I changes, the symptoms significantly improved in comparison with those 3 months prior (P=0.037,  0.026), while that improvement did not occur in patients with Modic type II changes (P>0.05). Conclusions. The existence of MCs affects the outcomes of nonsurgical treatment in patients with LBP. However, symptoms can be improved after an additional round of treatment for Modic type I changes, while this is not confirmed for Modic type II changes.

scholarly journals Significant Differences in the Prevalence of Elevated HbA1c Levels for Type I and Type II Diabetics Attending the Parirenyatwa Diabetic Clinic in Harare, Zimbabwe

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kurai Z. Chako ◽  
Heather Phillipo ◽  
Erisi Mafuratidze ◽  
Danai Tavonga Zhou
Keyword(s):  
Public Health ◽  
Glycemic Control ◽  
Public Health Facility ◽  
Poor Glycemic Control ◽  
Type I ◽  
Type Ii ◽  
Cross Sectional ◽  
Significant Difference ◽  
Type Ii Diabetics ◽  
Hba1c Levels

Diabetics have chronically elevated glucose levels. High levels of glucose result in nonenzymatic formation of glycosylated haemoglobin (HbA1c). Therefore, elevated HbA1c is a good indicator of poorly controlled diabetes. We used the standard HbA1c method to determine glycemic control in diabetics attending a public health facility in Harare, Zimbabwe. Our study sought to assess the prevalence of elevated HbA1c amongst treated diabetics and compare the HbA1c levels by type of diabetes. The cross-sectional study was carried out at one of the main public health centres in Zimbabwe: the Parirenyatwa Group of Hospitals in Harare. Type I and type II diabetics were recruited and had their blood HbA1c levels measured. The standard one tailed proportion z test was used to test the hypothesis at 5% significance level. Combined prevalence of type I and type II diabetics with elevated HbA1c was 27%. There was no significant difference in levels of HbA1c by age and sex. Over half (54%) of Type I diabetics had elevated HbA1c, suggesting poor glycemic control. In contrast only 24% of the Type II diabetics studied had elevated HbA1c. The difference in proportion of Type I and Type II diabetics with elevated HbA1c suggestive of poor glycemic control was significant (P=0.0067).

scholarly journals Diastolic dysfunction in cases with Type II diabetes mellitus.

2019 ◽  
Vol 26 (12) ◽  
pp. 2040-2043
Author(s):  
Munir Ahmed ◽  
Abdul Hayee ◽  
Shahla Afsheen Memon ◽  
Ismail Salim Memon ◽  
Abdul Qayoom Memon
Keyword(s):  
Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Type Ii Diabetes ◽  
Female Gender ◽  
Type Ii Diabetes Mellitus ◽  
P Value ◽  
Type I ◽  
Type Ii ◽  
Cross Sectional ◽  
Significant Difference

Objectives: To determine the frequency of diastolic dysfunction in patients presenting with type II Diabetes Mellitus. Study Design: Cross sectional study. Setting: Sheikh Zayed Hospital, Rahim Yar Khan. Period: From 01-01-2017 to 30-06-2017. Material & Methods: In this study the cases were selected via non probability consecutive sampling of both male and female gender with age more than 40 years having type II DM of at least more than 2 years were included. The cases suffering from type I DM, gestational DM and those with HTN, end stage kidney and liver failure were excluded. Trans thoracic echocardiography was done to label diastolic dysfunction and was labelled as yes when the E/A ratio was <0.8. The data was analysed using chi square test and p value less than 0.05 was taken as significant. Results: In this study, 100 cases of type II DM were included with mean age of 51.31±7.89 years at presentation. There were 61% males and 39% females. Diastolic dysfunction was observed in 53% of the cases. There was no significant difference in terms of gender where it affected 56.41% of females with p= 0.92. Diastolic dysfunction was more in cases that had duration of DM more than 3 years affecting 48 (70.58%) cases with p= 0.001 and it was also significantly high in cases that had BMI more than 30 where it was seen in 40 (70.17%) of cases with p= 0.001. Conclusion: Diastolic dysfunction seen in half of the cases suffering from type II DM and it is significantly high in cases that had duration of DM more than 3 years and BMI more than 30.

scholarly journals Which kind of classification is more suitable for Herlyn–Werner–Wunderlich syndrome

2021 ◽  
Author(s):  
Heng Wei ◽  
Wei Li
Keyword(s):  
Adolescent Girls ◽  
Clinical Work ◽  
Vaginal Wall ◽  
Cystic Mass ◽  
Type I ◽  
Type Ii ◽  
Classification Methods ◽  
Life Changes ◽  
Significant Difference ◽  
Medical University

Abstract Background: To analyze the clinical characteristics of patients with Herlyn–Werner–Wunderlich syndrome (HWWs) in two classification methods.Methods: 87 HWWs patients syndrome admitted to the Shengjing hospital of China Medical University between April 2003 to June 2020 were retrospectively reviewed. Results: Type II of average age at time of diagnosis (25.11±8.96) was significantly longer than the other two types(13.06±2.55; 13.06±2.55). The menarche and the interval between menarche and time of diagnosis was significant difference between types I and II. The average age at time of diagnosis, the menarche and the interval between menarche and time of diagnosis was significant difference between classification I and II. Cystic mass in vaginal wall was a significant difference between type I and II. Endometriosis of type I and II was a more common than type III. Sex life was a significant difference between type I and II. Mediastinum of uterus of type II was a more common than type I and III. The time of diagnosis, menarche, interval between menarche and time of diagnosis, cystic mass in vaginal wall, abnormal vaginal discharge, sex life, changes of urination and defecation and mediastinum of uterus were significant difference between classification 1 and classification 2. The site of olique septum vaginalis was significant difference in two classification methods. The absence of kidney in HWWs type was significant difference in two classification methods. Conclusion: Type I HWWs should be suspected in cases involving adolescent girls presenting with cyclical pelvic pain, change of urination and defecation. Two classification can be easy to treat in clinical work.

scholarly journals Antioxidant Gene Expression in Vocal Hindbrain of a Teleost Fish

2018 ◽  
Author(s):  
Clara Liao ◽  
Ni Y. Feng ◽  
Andrew H. Bass
Keyword(s):  
Oxidative Stress ◽  
Breeding Season ◽  
Motor Neurons ◽  
Sound Production ◽  
Cellular Respiration ◽  
Type I ◽  
Type Ii ◽  
Antioxidant Genes ◽  
Long Duration ◽  
Significant Difference

ABSTRACTPlainfin midshipman fish (Porichthys notatus) have a remarkable capacity to generate long duration advertisement calls known as hums, each of which may last for close to two hours and be repeated throughout a night of courtship activity during the breeding season. The midshipman’s striking sound production capabilities provide a unique opportunity to investigate the mechanisms that motor neurons require for withstanding high-endurance activity. The temporal properties of midshipman vocal behaviors are largely controlled by a hindbrain central pattern generator that includes vocal motor neurons (VMN) that directly determine the activity pattern of target sonic muscles and, in turn, a sound’s pulse repetition rate, duration and pattern of amplitude modulation. Of the two adult midshipman male reproductive phenotypes -- types I and II-- only type I males acoustically court females with hums from nests that they build and guard, while type II males do not produce courtship hums but instead sneak or satellite spawn to steal fertilizations from type I males. A prior study using next generation RNA sequencing showed increased expression of a number of cellular respiration and antioxidant genes in the VMN of type I males during the breeding season, suggesting they help to combat potentially high levels of oxidative stress linked to this extreme behavior. This led to the question of whether the expression of these genes in the VMN would vary between actively humming versus non-humming states as well as between male morphs. Here, we tested the hypothesis that to combat oxidative stress, the VMN of reproductively active type I males would exhibit higher mRNA transcript levels for two superoxide dismutases (sod1,sod2) compared to the VMN of type II males and females that do not hum and in general both of which have a more limited vocal repertoire than type I males. The results showed no significant difference insod1transcript expression across reproductive morphs in the VMN and the surrounding hindbrain, and no difference ofsod2across the two male morphs and females in the SH. However, we observed a surprising, significantly lower expression ofsod2transcripts in the VMN of type I males as compared to type II males. We also found no significant difference insod1andsod2expression between actively humming and non-humming type I males in both the VMN and surrounding hindbrain. These findings overall lead us to conclude that increased transcription ofsod1andsod2is not necessary for combatting oxidative stress from the demands of the midshipman high-endurance vocalizations, but warrant future studies to assess protein levels, enzyme activity levels, as well as the expression of other antioxidant genes. These results also eliminate one of the proposed mechanisms that male midshipman use to combat potentially high levels of oxidative stress incurred by motor neurons driving long duration vocalization and provide more insight into how motor neurons are adapted to the performance of extreme behaviors.

scholarly journals The severity of developmental dysplasia of the hip does not correlate with the abnormality in pelvic incidence

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Rongshan Cheng ◽  
Muyin Huang ◽  
Willem Alexander Kernkamp ◽  
Huiwu Li ◽  
Zhenan Zhu ◽  
...  
Keyword(s):  
Pelvic Incidence ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Type I ◽  
Type Ii ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Dysplasia Of The Hip

Abstract Background The purpose of this study was to investigate the association between the severity of Developmental dysplasia of the hip (DDH) and the abnormality in pelvic incidence (PI). Methods This was a retrospective study analyzing 53 DDH patients and 53 non-DDH age-matched controls. Computed tomography images were used to construct three-dimensional pelvic model. The Crowe classification was used to classify the severity of DDH. The midpoint of the femoral head centers and sacral endplates were projected to the sagittal plane of the pelvis. The PI was defined as the angle between a line perpendicular to the sacral plate at its midpoint and a line connecting this point to the axis of the femoral heads. Independent sample t-tests were used to compare the differences between the PI of DDH group and the non-DDH controls group. Kendall’s coefficient of concordance was used to determine the correlation between the severity of DDH and PI. Results Patients with DDH had a significantly (p = 0.041) higher PI than the non-DDH controls (DDH 47.6 ± 8.2°, normal 44.2 ± 8.8°). Crowe type I patients had a significantly (p = 0.038) higher PI (48.2 ± 7.6°) than the non-DDH controls. No significant difference between the PI in Crowe type II or III patients and the PI in non-DDH controls were found (Crowe type II, 50.2 ± 9.6°, p = 0.073; Crowe type III, 43.8 ± 7.2°, p = 0.930). No correlation was found between the severity of DDH and the PI (r = 0.091, p = 0.222). Conclusions No correlation was found between the severity of DDH and the PI. The study confirmed that the PI in DDH (Crowe type I) group was higher than that of the non-DDH control group, while the PI does not correlate with the severity of DDH.

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