SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Surface lesions involving the bones of the hand are uncommon. This pictorial review illustrates the spectrum of conditions including benign primary bone tumours, malignant primary bone tumours and non-neoplastic disorders. The review focuses on the radiographic appearances of these lesions and other techniques such as CT and MR imaging that may suggest a specific diagnosis.
Radiograms with direct enlargement of the image were performed by means of X-ray apparatus "PEIC" designed by the firm "Svetlana", Leningrad. The status of the hand bones was studied in persons with posttraumatic bone regeneration, as well as angioarchitectonics of organs in experimental animals. In radiograms with direct enlargement some details characterising the process of ageing in the hand bones are observed more distinctly than in routine radiograms. The investigators succeeded in obtaining age changes in the structure of spongy substance and of cortical layer of phalanxes. The apparatus "PEIC" presents new possibilities for vital investigation of bone ostructures in experimental and clinical work, as well as to examine preparations of organs and their histological sections.
Total lengths of the 19 diaphyseal hand bones were measured from standardized radiographs of healthy American whites as young adults (ca. 21 years) and again at ca. 55 years of age. The four hand-bone rows exhibit distinctive length changes: Distal and middle phalanges continue to increase significantly in length, proximal phalanges constitute a transition zone of little change, and metacarpals uniformly decrease in length. Clear-cut sex differences are noteworthy: Males change more (lose more in some bone rows, gain more in others) than females. Progressive elongation was greatest in the distal phalanges where apposition around the distal aspect ("tufting") is not constrained by a joint or epiphysis. Loss of bone length in the metacarpals by subchondral resorption is consistent with documented reductions in activity levels and grip strength with age, as well as diminished joint spaces which alter loading of the joints.
Explore the source record for details and available documents.
This paper reports the results of a series of univariate and bivariate statistical genetic analyses that were performed on a sample of nuclear and more complex pedigrees (N = 567 individuals) of an ethnically homogenous White population. Our major objectives were: (1) To quantitatively evaluate the extent and pattern of the putative genetic effects on plasma level variation and covariation of the intact parathyroid hormone (PTH) and 25-hydroxyvitamin D [25(OH)D]; (2) To evaluate the extent of the possible genetic covariation between each of the two calciotropic hormones and two important bone mass traits, namely radiographic hands bone mineral density (BMD) and cortical index (CI). Variance component analysis, as implemented in the statistical package FISHER unambigously demonstrated that in addition to age, genetic factors contribute significantly to interindividual variation of both calciotropic hormones (37.5% for PTH and 53.3% for 25(OH)D). Complex segregation analysis strongly suggested the involvement of major gene effects into the determination of 25(OH)D levels, but was not clear cut with respect to PTH. Significant correlations between circulating levels of study hormones were found (-0.146, P < 0.05 in men and -0.194, P < 0.01 in women). However, no genetic correlation was revealed between PTH and 25(OH)D plasma concentrations. Bivariate analyses showed that familial cross correlations between PTH and BMD and CI measured at the bones of the hand were consistently statistically significant, suggesting moderate, but detectable pleiotropic genetic effects. The corresponding genetic correlations were -0.461 +/- 0.153 and -0.223 +/- 0.113, respectively. Circulating levels of 25(OH)D showed neither phenotypic nor genetic correlation with any of the BMD or CI variation.
Although metastases to bones from solid tumors are very common, involvement of small bones of the hands and feet is extremely rare. One half of the cases reported in literature resulted from a primary tumor in the lung. Four cases seen over the last four years with metastases to bones of the hand and one case with metastases to foot bones are discussed. None of these patients had a lung primary tumor. Three of the four patients who had metastases to hand bones had the disease on the right side.
Metacarpophalangeal pattern (MCPP) analysis is an application of an anthropometric technique that provides a quantitative assessment of the amount and direction of abnormality in the hand skeleton. MCPP analysis was undertaken on 15 individuals (9 males, 6 females) with Noonan syndrome ranging in age from 0.1 to 36 years with a mean age at 11.6 years. The overall average Z score for the MCPP variables was -2.1 and the range was -2.5 (for metacarpal two) and -1.5 (for middle phalanx 5). The average hand pattern variability index, a measure of hand bone length relationships, was abnormal. A Pearsonian correlation analysis was used to assess similarity between the mean pattern and each of the 15 individual patterns. Nine (60%) of the fifteen individuals with Noonan syndrome had significant positive correlations (P < 0.05), indicating homogeneity or similarity in the hand patterns. A stepwise discriminant analysis was performed on Z score data from the individual hand bone measurements on the 15 subjects with Noonan syndrome and 41 healthy controls (24 females, 17 males; mean age = 13.1 years with age range of 9.6 to 18 years). This analysis produced a discriminant function with two MCPP variables (metacarpal 1 and middle phalanx 3) entering into the function and producing a correct classification rate of 93%. The two MCPP variables contributed to the overall difference between individuals with Noonan syndrome and the normative sample. The hand pattern variability index was outside of the normal range, indicating an abnormal MCPP with multivariate analysis. The MCPP analysis may be useful as a tool for diagnosis in screening subjects for Noonan syndrome.
Autogenous bone grafting of hand fractures often occurs within the milieu of a complex wound. Risks of infection and/or stiffness increase with injury severity, contamination, and the time interval between injury and successful wound closure or coverage. A clean wound is paramount for successful tissue repair, reconstruction, and closure. Skeletal restoration is an integral component of composite wound management. Fracture stabilization enhances pain control, protects soft tissue repairs and reconstruction, inhibits infection, and facilitates bone graft consolidation and functional recovery. Mini plate fixation provides the sustained stability necessary for hand fractures with bone loss to heal. Bone grafting is an essential element of skeletal restitution for defects due to comminution or actual loss. Cancellous bone grafts heal more rapidly and are more resistant to infection than cortical bone grafts and may be preferable for partial or smaller intercalary defects. Cortical or corticocancellous grafts augment stability and may be especially useful for larger segmental diaphyseal defects and articular bone loss requiring arthrodesis.
Changes in microbiological parameters during the production of fine poultry salami was monitored in a private poultry-processing plant in Kosice within a period of six months. This product consists of meat paste or mechanically deboned poultry meat (MDPM), which is produced with the help of a Protecon MPB 30 E deboning machine, pork trimmings, water (in the form of crushed ice), salt, spices, and garlic paste. The main raw food material (hand-boned meat and skin from poultry carcasses intended for mechanical deboning), MDPM immediately after production, salted MDPM after its 24-hour-storage and ripening in the chiller, pork trimmings added to MDPM at an amount of 25%, prepared salami emulsion, and the final product (fine poultry salami) were examined for the presence of pathogenic and potentially pathogenic microorganisms. The total plate count, the counts of indicatory microorganisms (Coliforms and Enterococci), Staphylococci, psychrotrophic, proteolytic and lipolytic bacteria were also determined according to the Slovak government regulations. The results of the quantitative microbiological examination are shown in Figs. 1 and 2. It follows from them that the microbial load of poultry skin is considerably higher than that of hand-boned meat. During the deboning process an increase in all microbial parameters (on average by 1-3 radices) was noticed as compared with the raw food material (defrosted poultry carcasses before the mechanical deboning). MDPM contained 10(4)-10(7) CFU/g; the count of coliforms ranged between 10(3) and 10(6)/g; the count of proteolytic and lipolytic bacteria between 10(4) and 10(6)/g; the count of Staphylococci and Enterococci between 10(2) and 10(4)/g. Staphylococcus aureus was discovered in about 50% samples of MDPM in an average concentration of 10(2)/g. In addition to the groups of bacteria listed above, a wide range of potentially pathogenic microorganisms belonging to the family Enterobacteriaceae, especially those of the genus Proteus, Escherichia coli, Citrobacter and Providencia, was also found in MDPM. In four cases Salmonella enteritidis was also detected in the samples of both the skin of chicken carcasses and the MDPM. The nitrate salting mixture added at a concentration of 2% did not significantly reduce the counts of bacteria present in the MDPM. The prepared salami emulsion was very high in all groups of microorganisms, which was also caused by the addition of pork trimmings. This component seems to be a very important source of microbial contamination, showing the following average bacterial counts: total plate count 4.8 x 10(6)/g, the count of psychrotrophic bacteria 1.0 x 10(6)/g, the count of coliforms 7.0 x 10(5)/g, the count of Enterococci 9.2 x 10(3)/g, the count of Staphylococci 3.0 x 10(4)/g, the count of proteolytic microorganisms 2.7 x 10(5)/g, and the count of lipolytic microorganisms 4.2 x 10(5)/g. However, heat treatment of the final product reliably and almost completely devitalized all the bacteria found in the salami emulsion before heat processing. No pathogenic or potentially pathogenic bacteria were detected in any sample of fine poultry salami. Quite a high number of bacteria in the salami emulsion was reduced by heat treatment to a final average value of 10(2)/g.
Eighteen cases are reported of solitary chondroma of the long bones of the hand treated by curettage and packing with autoplastic grafts of spongy bone. The preferred localisation was in the three ulnar rays and in the metaphyseal zones in the neighborhood of the growth cartilage. In the younger patients the site was more often in the diaphysis; in the older patients, almost exclusively meta-epiphyseal. The diagnosis is usually made fortuitously as a result of a pathological fracture (61 per cent of the cases investigated). The results, assessed at an average of two and a half years after operation, were consistently excellent. They demonstrate that, in practice, any variety of this condition can be successfully treated by this method.
OBJECTIVE: To investigate the safety and efficacy of a conservative orbital decompression using sharp-curette bony decompression and intraconal fat debulking through a transconjunctival incision in patients with thyroid-related orbitopathy and mild to moderate proptosis. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS AND METHODS: Data from all patients undergoing minimal orbital decompression at the Jules Stein Eye Institute, Los Angeles, Calif, over a period of 4(1/4) years were collected and analyzed. Data included visual acuity, exophthalmometry measurements, intraocular pressure, complete slitlamp examination results, ocular ductions, new-onset primary or downgaze diplopia, and patient satisfaction. Conservative decompression was performed through a transconjunctival incision using a manual curette and by removing cortical bone from the zygomatic marrow space on the anterior rim of the inferior orbital fissure; intraconal fat was bluntly dissected and excised or suctioned with a Frasier tip aspirator. MAIN OUTCOME MEASURES: Patient perception of pressure pain and ocular discomfort, proptosis, visual acuity, intraocular pressure, postoperative complications, and new-onset primary or downgaze diplopia. RESULTS: Eighty minimally invasive orbital decompression surgeries were performed in 48 patients (6 male, 42 female). Six surgeries (4 patients) were performed for prominent globes with relative proptosis and no thyroid-related orbitopathy (non-Graves proptosis). All patients had improvement in congestive orbitopathy and pressure pain associated with thyroid-related orbitopathy. Exophthalmos decreased by a mean +/- SD of 2.4 +/- 2.6 mm from 22.7 +/- 2.5 mm (range, 17-29 mm) to 20.3 +/- 2.3 mm (range, 14-25 mm) (P<.001 [95% confidence interval, 1.8-3.0]). Mean visual acuity improved after surgery (P = .02). One patient (2.1%) developed postoperative primary or downgaze diplopia; he underwent successful eye muscle surgery at a later stage. No complications were associated with orbital decompression. CONCLUSIONS: Minimally invasive orbital decompression surgery with intraconal fat debulking in this group of patients was effective in proptosis reduction; improvement in subjective pressure pain and high patient satisfaction were noticed. Surgery was associated with a low rate (2.1%) of new-onset primary or downgaze diplopia. Proptosis reduction using a graded approach accounting for 4 mm of retrodisplacement was achieved.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We report on 37 patients with traumatic cysts and pseudoarthroses of the scaphoid, who were treated with Ender's scaphoid plate. Owing to technical errors there was no osseous healing in 4 cases (10.8%). The main advantage of this method is the brief immobilization period.
Explore the source record for details and available documents.