Case reports - The sequelae of late diagnosis in tuberculous flexor tenosynovitis of the hand–a report of 2 cases

No Abstract available.     

Radiographic evaluation of the acromion in impingement syndrome: comparison with arthroscopic findings in 147 shoulders

We analyzed standardized scapulolateral and anteroposterior view radiographs in 147 patients with impingement syndrome to detect a subacromial osteophyte or spur, which should be of value in those patients who require surgical treatment. Standard anteroposterior view radiographs with a fixed tube angulation, 0 and 30 degrees, were compared to anteroposterior view radiographs with individual tube angulation (the radiograph beam was tilted caudally, depending on the slope of the acromion). In all patients, we identified an acromion bony overhang on the anteroposterior view radiographs with individual tube angulation having an average thickness of 5 mm, which correlated well with the intraoperative findings at arthroscopic acromioplasty. In only 35% of the patients did we detect a subacromial osteophyte or spur on radiographs with a fixed tube at 0 degrees angulation and in 92%, we found a false impression of a spur on the 30-degree views because of overexposure. We conclude that, anteroposterior view radiographs with an individual caudally-tilted X-ray beam, depending on the acromion slope, can show the whole spur and/ or size of the osteophyte, on the anterior margin of the acromion.     

Accuracy of complex lower-limb deformity correction with external fixation: a comparison of the Taylor Spatial Frame with the Ilizarov ring fixator

Purpose Circular external fixators have several advantages over other surgical options in the treatment of limb length discrepancy and axial deformity. The innovative Taylor Spatial Frame (TSF) combines a rigid hexapod fixation system with the support of a web-based software program, and thus offers the possibility of simultaneous corrections of multidirectional deformities. Whilst there is still some scepticism of many Ilizarov device users about the advantages of the TSF, the purpose of the study was to perform a comparison between the TSF and the Ilizarov ring fixator (IRF) with regard to the accuracy of deformity correction in the lower limb. Methods Two hundred and eight consecutive deformity corrections in 155 patients were retrospectively evaluated. There were 79 cases treated with the IRF and 129 cases treated with the TSF. The mean age of the patients at the time of surgery was 13.2 years (range; 2–49 years). Standing anteroposterior and lateral radiographs were evaluated preoperatively and immediately after removal of the frames. The final result was compared to the preoperatively defined aim of the deformity correction. According to the treated count of dimensions, we differentiated four types of deformity corrections. The results were graded into four groups based on the persisting axial deviation after removal of the frame. Results The aim of the deformity correction was achieved in a total of 90.7% in the TSF group, compared to 55.7% in the IRF group. On the basis of the count of dimensions, the TSF achieved obviously higher percentages of excellent results (one dimension: TSF 100%; IRF 79.3%; two dimensions: TSF 91.8%; IRF 48.6%; three dimensions: TSF 91.1%; IRF 28.6%; four dimensions: TSF 66.7%; IRF 0%). In addition, the degree of the persisting deformity increased with the number of planes of the deformity correction. Conclusions The TSF allowed for much higher precision in deformity correction compared to the IRF. In two-, three- and four-dimensional deformity corrections in particular, the TSF showed clear advantages. This may derive from the TSF-specific combination of a hexapod fixator with the support of an Internet-based software program, enabling precise simultaneous multiplanar deformity corrections.     

A role for proneural genes in the maturation of cortical progenitor cells

We showed previously that the proneural genes Neurogenin1 (Ngn1) and Ngn2 are required to specify the phenotypes of early- and not late-born neurons in the neocortex, acting in part through repression of Mash1, a third cortically expressed proneural gene. The precise timing of Ngn1/2 specification activity was unexpected given these genes are expressed throughout cortical development, prompting us to search for a later function. Here we reveal that Ngn2 and Mash1 are expressed in a dynamic fashion, acquiring a cell cycle-biased, nonoverlapping distribution, with preferential expression in prospective basal progenitors, during mid corticogenesis. We also identified a new function for Ngn2 during this latter period, demonstrating that it is required to regulate the transit of cortical progenitors from the ventricular zone (VZ) to the subventricular zone. Notably, Ngn2 regulates progenitor maturation at least in part through repression of Mash1 as misexpression of Mash1 strongly enhanced progenitor cell exit from the VZ. Significantly, the ability of Mash1 to promote progenitor cell maturation occurred independently of its ability to respecify cortical cells and is thus a novel function for Mash1. Taken together, these data support a model whereby Ngn2 and Mash1 function together to regulate the zonal distribution of progenitors in the developing neocortex.