-
The American Journal of Sports Medicine Mar 2022Injuries of the acromioclavicular joint (ACJ) are common shoulder injuries that often lead to pain and dysfunction of the affected shoulder. Regardless of operative or...
BACKGROUND
Injuries of the acromioclavicular joint (ACJ) are common shoulder injuries that often lead to pain and dysfunction of the affected shoulder. Regardless of operative or nonoperative treatment, a relatively large number of patients remain symptomatic and experience pain. However, the specific source of persistent pain in the ACJ remains ambiguous.
PURPOSE
To investigate the presence of sensory nerve fibers or pain-generating neurotransmitters within the intra-articular disk of the ACJ to determine its potential role as an independent pain generator in ACJ disorders.
STUDY DESIGN
Descriptive laboratory study.
METHODS
Twelve paired ACJs from 6 fresh human cadavers (mean age, 56 years; range, 41-82 years) were harvested and freed from surrounding soft tissues, leaving only the ACJ capsule intact. The specimens were placed in 4.5% formaldehyde fixative for a minimum of 48 hours. Coronal plane sections were obtained and demineralized in EDTA for a week, embedded in paraffin for 12 hours, and dehydrated overnight. With a rotation microtome, 2-μm sections were cut and stained with hematoxylin and eosin to investigate tissue architecture and confirm the presence of a fibrocartilaginous intra-articular disk. The sections were immunohistochemically stained with antisera against S100, neuropeptide Y (NPY), and substance P (SP) to detect for neural tissue. Additionally, a nerve fiber count per 10 high-power fields representing an area of 0.2 mm was conducted for S100 stains. All sections were examined for the presence of positive immunoreactivity to S100, NPY, and SP.
RESULTS
The presence of a fibrocartilaginous intra-articular disk could be observed in all 12 examined ACJs. In all specimens, an immunoreactivity to S100, NPY, and SP could be observed within the superior peripheral region of the intra-articular disk. High-power field nerve counts of the S100 stains revealed a mean ± SD of 7.9 ± 2.28 nerves per 10 high-power fields (range, 4-12).
CONCLUSION
The documented immunoreactivity to S100, NPY, and SP indicates the presence of somatic and autonomic nerve fibers within the intra-articular disk of the ACJ.
CLINICAL RELEVANCE
Confirming the presence of nerve fibers within the intra-articular disk of the ACJ suggests that the disk itself could be an independent source of pain after injury and thus a possible explanation for recalcitrant pain after treatment.
Topics: Acromioclavicular Joint; Humans; Joint Capsule; Joint Dislocations; Joints; Middle Aged; Pain
PubMed: 35099332
DOI: 10.1177/03635465211070276 -
Indian Journal of Ophthalmology Mar 2023: "Congenital cavitary optic disk anomalies" is a term used to include optic disk pit (ODP), optic disk coloboma, and morning glory disk anomaly (MGDA). Imaging the...
BACKGROUND AND PURPOSE
: "Congenital cavitary optic disk anomalies" is a term used to include optic disk pit (ODP), optic disk coloboma, and morning glory disk anomaly (MGDA). Imaging the radial peripapillary capillary (RPC) network in congenital optic disk anomalies with optical coherence tomography-angiography (OCTA) can shed light on its pathogenesis. This video describes the OCTA findings of optic nerve head and RPC network using the angio-disk mode in five cases of congenital cavitary optic disk anomalies.
SYNOPSIS
The video presents characteristic RPC network alterations in two eyes of ODP, one eye of optic disk coloboma, and two eyes of noncontractile MGDA.
HIGHLIGHTS
OCTA in ODP and coloboma shows absence of RPC microvascular network and a region of capillary dropout. This finding is in contrast to MGDA, where the microvascular network is dense. OCTA is an effective imaging modality to study vascular plexus and RPC and their alteration in congenital disk anomalies, which could provide information about the structural differences among them.
VIDEO LINK
https://youtu.be/TyZOzpG4X4U.
Topics: Humans; Optic Disk; Coloboma; Eye Abnormalities
PubMed: 36872758
DOI: 10.4103/IJO.IJO_2743_22 -
Journal of Binocular Vision and Ocular... 2022Fusional potential in patients experiencing binocular torsional diplopia may be challenging for the clinician to assess, particularly when accompanied by vertical and...
INTRODUCTION
Fusional potential in patients experiencing binocular torsional diplopia may be challenging for the clinician to assess, particularly when accompanied by vertical and horizontal diplopia.
OBJECTIVE
To demonstrate a clinical test that may help predict if binocular fusion can be achieved once cyclotorsion is alleviated.
DESIGN
Video recording demonstrating how to perform the white disk test and retrospective chart review of patients tested with the white disk test.
RESULTS
Twelve patients with binocular torsional diplopia were included. All subjects had excyclotorsion, 11 (91.7%) had combined vertical and horizontal strabismus and 1 patient (8.3%) had vertical strabismus. Eleven patients (91.7%) were able to achieve single binocular vision with the white disk test and 1 patient (8.3%) demonstrated brittle fusion. The white disk test successfully predicted postoperative fusion in 10 of 11 patients (90.9%). Eight patients (66.7%) demonstrated improved stereopsis after surgery.
CONCLUSION
The white disk test was found to be very useful in predicting fusional potential in patients that experience binocular torsional diplopia.
Topics: Humans; Diplopia; Retrospective Studies; Strabismus; Vision, Binocular; Depth Perception
PubMed: 35994693
DOI: No ID Found -
Life (Basel, Switzerland) Jun 2022(1) Background: This study aimed to perform a literature review related to disk displacement (DD) in class II malocclusion or cervical vertebrae position alterations and... (Review)
Review
Temporomandibular Joint Disk Displacements in Class II Malocclusion and Cervical Spine Alterations: Systematic Review and Report of a Hypodivergent Case with MRI Bone and Soft Tissue Changes.
(1) Background: This study aimed to perform a literature review related to disk displacement (DD) in class II malocclusion or cervical vertebrae position alterations and to report a hypodivergent case with cervical pain and right anterolateral DD with reduction, left anterolateral DD with reduction, and left joint effusion. (2) Methods: A structured electronic search was conducted between March 2022 and April 2022, without time limits, following PRISMA guidelines, in the following databases: PubMed, Scopus, Embase and Cochrane; the terms "disc displacement", "disk displacement", "temporomandibular joint", "class II malocclusion" and "cervical vertebrae" are searched. (3) Results: the following thirteen publications are included in this review: two prospective studies and eleven cross-sectional studies; for evaluating disk position, eight included publications used magnetic resonance imaging (MRI), whilst six studies used lateral cephalogram to determine craniofacial morphology and relationships between the cranial base, vertical skeletal pattern, maxilla and mandible. (4) Conclusions: although the literature still shows contradictory opinions, a relationship between temporomandibular disorders and cervical posture has been shown in the presented case as well as in the literature review.
PubMed: 35743939
DOI: 10.3390/life12060908 -
Journal of Infection in Developing... Nov 2022The broth microdilution (BMD) method recommended for the detection of colistin resistance is labor-intensive, time-consuming, and difficult to apply in routine...
INTRODUCTION
The broth microdilution (BMD) method recommended for the detection of colistin resistance is labor-intensive, time-consuming, and difficult to apply in routine laboratories. Thus, various methods, such as disk elution, commercial microdilution, and rapid polymyxin-NP tests have been developed for the detection of colistin resistance. In this study, a total of 102 multi-resistant Gram-negative bacteria isolated from blood cultures were evaluated by four different methods for the detection of colistin resistance, and compared with the reference method.
METHODOLOGY
For the detection of the compatibility of these methods with the reference method, categorical and essential agreements, very major, major, and minor error rates were determined. Colistin-tigecycline and colistin-meropenem combinations were investigated in colistin-resistant isolates.
RESULTS
Of the isolates, 15 (15%) [K. pneumoniae (n = 12), A. baumannii (n = 2), E. coli (n = 1)] were resistant to colistin with reference BMD method. MIC50 and MIC90 values of all isolates were ≤ 0.25 μg/mL and 16 μg/mL, respectively. The categorical agreement rates were 100% for commercial microdilution, disk elution, and RPNP test. The essential agreement rates of commercial microdilution, disk elution, and broth macrodilution were 78.4%, 86.3%, and 100%, respectively. Although there were no major errors in these methods, the macrodilution (12%) and commercial microdilution (20.6%) methods showed the most minor errors. Colistin-meropenem combination showed a 100% synergistic effect, but the colistin-tigecycline combination showed an 80% synergistic effect and 20% indifference effect.
CONCLUSIONS
Disk elution and RPNP tests are suitable for routine use because they are the most efficient, easiest, low-cost, and good performance tests in detecting colistin resistance.
Topics: Colistin; Blood Culture; Tigecycline; Meropenem; Escherichia coli; Gram-Negative Bacteria; Klebsiella pneumoniae
PubMed: 36449647
DOI: 10.3855/jidc.16480 -
BioNanoScience 2022Interest is growing in nanopores as real-time, low-cost, label-free virus size sensors. To optimize their performance, we evaluate how external electric field and ion...
Interest is growing in nanopores as real-time, low-cost, label-free virus size sensors. To optimize their performance, we evaluate how external electric field and ion concentrations and pore wall charges influence currents and object (disk) radius-current relationship using simulations. The physics was described using the Poisson-Nernst-Planck and Navier-Stokes equations. In a charged cylindrical nanopore with a charged disk, elevated external electric field produces higher (and polarity independent) ion concentrations and greater ion current (largely migratory). Elevated external ion concentrations also lead to higher concentrations (mainly away from the pore wall), greater axial electric field especially in the disk-pore wall space, and finally larger current. At low concentrations, current is disk radius independent. The current rises as concentrations increase. Interestingly, the rise is greater for larger disks (except when the pore is blocked mechanically). Smaller cross-sectional area for current flow or volume exclusion of electrolyte by object thus cannot be universally accepted as explanations of current blockage. Ion current rises when pore wall charge density increases, but its direction is independent of charge sign. Current-disk radius relationship is also independent of pore wall charge sign. If the pore wall and disk charges have the same sign, larger current with bigger disk is due to higher counter-ion accumulation in the object-pore wall space. However, if their signs are opposite, it is largely due to elevated axial electric field in the object-pore wall space. Finally in uncharged nanopores, current diminishes when disk radius increases making them better sensors of virus size.
PubMed: 35607652
DOI: 10.1007/s12668-022-00990-2 -
Indian Journal of Ophthalmology Dec 2022The current study was aimed at assessment of optic disk by disk damage likelihood scale (DDLS) staging using slit-lamp biomicroscopy and optical coherence tomography... (Observational Study)
Observational Study
PURPOSE
The current study was aimed at assessment of optic disk by disk damage likelihood scale (DDLS) staging using slit-lamp biomicroscopy and optical coherence tomography (OCT) in diagnosing primary open-angle glaucoma (POAG) patients.
METHODS
This was a cross-sectional observational study of 106 POAG patients, which was conducted from April 2017 to April 2018. All patients underwent slit-lamp fundoscopy with a +78 D lens and high-definition (HD)-OCT, and the vertical cup disk ratios (VCDRs) were recorded. Disk size and neuroretinal rim assessment were done, and the disk was then staged using the recent version, which stages the optic nerve head (ONH) from 1 to 10 as read from the DDLS nomogram table. DDLS scores >5 indicate glaucomatous damage. Pearson coefficient was used to correlate the DDLS staging by slit-lamp biomicroscopy with best-corrected visual acuity (BCVA), intraocular pressure (IOP), disk size, and VCDR and VCDR, mean deviation, and DDLS staging by HD-OCT.
RESULTS
The mean age of the patients was 59.54 ± 6.61 years. The male: female ratio was 2:1. The mean IOP was 16.04 ± 1.97 mmHg, and BCVA was 0.72 ± 0.13 LogMAR units. The mean VCDR on 78 D slit-lamp biomicroscopy was 0.76 ± 0.09 (standard deviation [SD]) (range 0.1-0.77), whereas on HD-OCT, the mean VCDR was 0.81 ± 0.09 (SD) (range 0.07-0.81). The mean deviation on visual field testing in decibels was -14.43 ± 3.31 (SD). The correlation coefficient between DDLS staging by slit-lamp biomicroscopy and DDLS staging by HD-OCT parameters was r = 0.96.
CONCLUSION
There is a positive correlation between the DDLS system of optic disk evaluation on slit-lamp biomicroscopy and most of the HD-OCT evaluation parameters.
Topics: Humans; Female; Male; Middle Aged; Aged; Optic Disk; Tomography, Optical Coherence; Cross-Sectional Studies; Glaucoma, Open-Angle; Slit Lamp Microscopy
PubMed: 36453304
DOI: 10.4103/ijo.IJO_1113_22 -
Acta Neurochirurgica. Supplement 2023Introductionː Cervical disk arthroplasty is a potential alternative procedure to anterior cervical decompression and fusion for the treatment of cervical disk disease....
Introductionː Cervical disk arthroplasty is a potential alternative procedure to anterior cervical decompression and fusion for the treatment of cervical disk disease. The aim of the study was to perform a systematic literature review on long-term clinical and radiological outcomes after Bryan cervical disk arthroplasty.Material and Methodsː A systematic literature review was performed according to PRISMA guidelines via PubMed and Embase, Scopus, and the Cochrane Library database by using the following keywords: "Bryan prosthesis"; "cervical disk arthroplasty"; "outcomes"; and "long-term follow-up." Eight articles with at least 10 years of follow-up were considered for eligibility.Resultsː In total, 481 patients were enrolled in the studies. Because of the occurrence of multiple treated levels, 588 arthroplasties were performed, divided as follows: 12 C3/4 cervical disk arthroplasties (2.01%), 63 C4/5 (10.71%), 325 C5/6 (55.27%), and 188 C6/7 (31.97%). The mean preoperative cervical lordosis was 13.6 ± 9.3°, whereas the last follow-up value was 12.8 ± 8.7°. In the last follow-up, the mean segmental range of motion was 8.2 ± 3.3°.Discussion: Recent studies have suggested that cervical disk arthroplasty should be safely performed in healthy young patients with disk degeneration who may need future revision surgery. The results suggest that this procedure preserves native cervical spinal biomechanics at long-term follow-up with acceptable adjacent segments disease and periprosthetic ossifications.Conclusionsː Cervical disk arthroplasty has good long-term device survival, motility, adjacent segment degeneration, and clinical outcomes. Therefore, it represents a valid alternative for the treatment of cervical spine degenerative pathologies, especially in young patients.
Topics: Animals; Humans; Arthroplasty; Biomechanical Phenomena; Databases, Factual; Intervertebral Disc Degeneration; Intervertebral Disc Displacement
PubMed: 38153488
DOI: 10.1007/978-3-031-36084-8_49 -
Oral Surgery, Oral Medicine, Oral... Nov 2019The aim of this study was to correlate the morphometric measurements of the temporomandibular joint, including condylar size, joint space, and articular eminence size,...
OBJECTIVE
The aim of this study was to correlate the morphometric measurements of the temporomandibular joint, including condylar size, joint space, and articular eminence size, with gender, disk position, and condylar position by using magnetic resonance imaging.
STUDY DESIGN
Overall, 93 patients were evaluated (31.2% males and 68.8% females; age 18-81 years; mean age 41 years). Condylar size (D1), joint space (D2), and eminence size (D3) were measured. Correlations with gender, disk position, and condylar position were calculated.
RESULTS
A statistically significant correlation was found between D2 and gender, with the joint space being significantly larger in the male group (P = .05). There were correlations between D2 and the position of the disk and the position of the condyle (P ≤ .05).
CONCLUSIONS
The results indicate a correlation between male gender and larger joint space. In addition, we found that the joint space size influences the articular disk and condyle position, which can cause disk displacement.
Topics: Adult; Algorithms; Female; Humans; Joint Dislocations; Magnetic Resonance Imaging; Male; Mandibular Condyle; Risk Factors; Sex Factors; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 31447325
DOI: 10.1016/j.oooo.2019.07.011 -
Current Opinion in Ophthalmology Nov 2022The purpose of this review is to provide an overview of the ophthalmic findings associated with peripapillary hyperreflective ovoid mass-like structures (PHOMS) in both... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to provide an overview of the ophthalmic findings associated with peripapillary hyperreflective ovoid mass-like structures (PHOMS) in both adult and pediatric patients.
RECENT FINDINGS
PHOMS have recently been identified in a number of different ophthalmic disease entities ranging from nonpathologic to pathologic, including but not limited to anatomic abnormalities (tilting in myopia), optic nerve head drusen, optic disc edema from inflammation (optic neuritis, white dot syndromes), vascular insults (ischemic optic neuropathy, retinal vascular occlusion), and papilledema. The mechanism underlying the formation of PHOMS has not been fully elucidated although it has been hypothesized that PHOMS occur secondary to axoplasmic stasis from crowding at the optic nerve head.
SUMMARY
Although the clinical significance of the presence of PHOMS remains unclear, PHOMS are associated with several disease processes. Understanding the mechanism behind their formation and their impact on optic nerve head structure and visual function may be relevant in patients with optic nerve head pathology. The presence of PHOMS may also correlate with disease severity and duration. Future studies to evaluate whether the formation of PHOMS may be useful as an early indicator of disease or a prognostic tool are warranted.
Topics: Adult; Child; Humans; Optic Disk; Optic Disk Drusen; Optic Neuritis; Papilledema; Tomography, Optical Coherence
PubMed: 36094020
DOI: 10.1097/ICU.0000000000000897