[Relationship between radiographic parameters and clinical outcomes of elderly patients with distal radius fractures].

OBJECTIVE: To analyze the relationship between radiographic parameters and clinical outcomes of patients with distal radius fractures in elderly patients following conservative treatment, and find the important radiographic parameters with distal radius fractures in elderly patients. METHODS: From May 2012 to May 2015, a retrospective analysis was performed of 45 elderly patients with distal radius fractures treated by conservative treatment, which including 17 males and 28 females with an average age of 64.49 years old from 60 to 89 years old. The imaging parameters were measured and the clinical efficacy was evaluated. The imaging parameters on the standard wrist joint X-ray picture were measured including metacarpal angle, the radius height, the ulna variation, the ulnar angle, and so on. The clinical effect of wrist joint was evaluated by Dienst score standard. Multiple factor linear regression was used to analyze the relationship between the image parameters and the clinical efficacy. RESULTS: All patients were followed up for 12 to 24 months with an average of 17.6 months. All fractures of the distal radius were healed. According to the Dienst evaluation, at the final follow-up the result was excellent in 27 cases, good in 10 cases, fair in 6 cases and poor in 2 cases. There was a significant correlation between the height of the radius, the angle of the palmar and the variation of the ulna and the function of the wrist joint in the imaging parameters. When the radius height more than 8.12 mm, the palmar angle more than -1.64 degree and the ulna variant less than 4.05 mm, the result of Dienst function was better. CONCLUSIONS: The imaging parameters such as the radius height, the palmar angle and the ulna variation are related to the recovery of the clinical efficacy of the distal radius fractures in the elderly. The most important parameter is the radius height, which reminds the surgeon to pay special attention to the reduction of the radius fracture in the elderly.

Stereoscopic Display of the Peripheral Nerves at the Elbow Region Based on MR Diffusion Tensor Imaging with Multiple Post-Processing Methods.

BACKGROUND: Peripheral nerves at the elbow region are prone to entrapment neuropathies and injuries. To make accurate assessment, clinicians need stereoscopic display of the nerves to observe them at all angles. OBJECTIVES: To obtain a stereoscopic display of the peripheral nerves at the elbow region based on magnetic resonance (MR) diffusion tensor imaging (DTI) data using three post-processing methods of volume rendering (VR), maximum intensity projection (MIP), and fiber tractography, and to evaluate the difference and correlation between them. SUBJECTS AND METHODS: Twenty-four elbows of 12 healthy young volunteers were assessed by 20 encoding diffusion direction MR DTI scans. Images belonging to a single direction (anterior-posterior direction, perpendicular to the nerve) were subjected to VR and MIP reconstruction. All raw DTI data were transferred to the Siemens MR workstation for fiber tractography post-processing. Imaging qualities of fiber tractography and VR/MIP were evaluated by two observers independently based on a custom evaluation scale. RESULTS: Stereoscopic displays of the nerves were obtained in all 24 elbows by VR, MIP, and fiber tractography post-processing methods. The VR/MIP post-processing methods were easier to perform compared to fiber tractography. There was no significant difference among the scores of fiber tracking and VR/MIP reconstruction for single direction. The imaging quality scores of fiber tractography and VR/MIP were significantly correlated based on intraclass correlation coefficient (ICC) analysis (ICC ranged 0.709 - 0.901), which suggested that the scores based on fiber tractography and VR/MIP for the same sample were consistent. Inter- and intraobserver agreements were good to excellent. CONCLUSION: Stereoscopic displays of the peripheral nerves at the elbow region can be achieved by using VR, MIP, and fiber tracking post-processing methods based on raw DTI images. VR and MIP reconstruction could be used as preview tools before fiber tracking to determine whether the raw images are satisfactory.

An intractable case of suspected psoriatic arthritis combined with Dupuytren's disease.

Some cases of psoriatic arthritis (PsA) cannot be explicitly diagnosed, especially when the skin and nail lesions present years after the joint disease or are absent. Autoimmunity may also play a role in the development of Dupuytren's disease. However, the simultaneous presence of PsA and Dupuytren's disease is very rare. We present a patient displaying arthritis in multiple small joints, with bone erosions and bony fusions in all four extremities, combined with Dupuytren's disease. Because of the atypical clinical manifestation, the diagnosis perplexed doctors for decades. Without formal treatment, the disease followed a natural course over time. Reviewing the patient's data, a potential diagnosis of PsA, combined with Dupuytren's disease, was eventually made. After surgery, contractures of palmar and plantar fascia as well the thumb web were released, and the hallux valgus was corrected.

Three-dimensional display of peripheral nerves in the wrist region based on MR diffusion tensor imaging and maximum intensity projection post-processing.

OBJECTIVES: To achieve 3-dimensional (3D) display of peripheral nerves in the wrist region by using maximum intensity projection (MIP) post-processing methods to reconstruct raw images acquired by a diffusion tensor imaging (DTI) scan, and to explore its clinical applications. METHODS: We performed DTI scans in 6 (DTI6) and 25 (DTI25) diffusion directions on 20 wrists of 10 healthy young volunteers, 6 wrists of 5 patients with carpal tunnel syndrome, 6 wrists of 6 patients with nerve lacerations, and one patient with neurofibroma. The MIP post-processing methods employed 2 types of DTI raw images: (1) single-direction and (2) T2-weighted trace. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the median and ulnar nerves were measured at multiple testing sites. Two radiologists used custom evaluation scales to assess the 3D nerve imaging quality independently. RESULTS: In both DTI6 and DTI25, nerves in the wrist region could be displayed clearly by the 2 MIP post-processing methods. The FA and ADC values were not significantly different between DTI6 and DTI25, except for the FA values of the ulnar nerves at the level of pisiform bone (p=0.03). As to the imaging quality of each MIP post-processing method, there were no significant differences between DTI6 and DTI25 (p>0.05). The imaging quality of single-direction MIP post-processing was better than that from T2-weighted traces (p<0.05) because of the higher nerve signal intensity. CONCLUSIONS: Three-dimensional displays of peripheral nerves in the wrist region can be achieved by MIP post-processing for single-direction images and T2-weighted trace images for both DTI6 and DTI25. The FA and ADC values of the median nerves can be accurately measured by using DTI6 data. Adopting 6-direction DTI scan and MIP post-processing is an efficient method for evaluating peripheral nerves.

Copolymer coatings consisting of 2-methacryloyloxyethyl phosphorylcholine and 3-methacryloxypropyl trimethoxysilane via ATRP to improve cellulose biocompatibility.

AB diblock copolymers comprised of poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) and poly(3-methacryloxypropyl trimethoxysilane) (PMTSi) segments, which are used for biocompatible coatings, were investigated. Block copolymers with various compositions were synthesized by atomic transfer radical polymerization (ATRP). The obtained copolymers were dissolved in an ethanol solution, and dynamic light scattering showed that all block copolymers were capable of existing as micelles. After a convenient "one-step" reaction, the cellulose membranes could be covalently modified by these copolymers with stable chemical bonds (C-O-Si and Si-O-Si). Block copolymers with different PMPC chain length were applied to surface modification to find the most suitable copolymer. The functional MPC density can be controlled by adjusting the ratio of the two monomers (MPC and MTSi), which also affect surface properties, including the surface contact angle, surface morphology, and number of functional PC groups. The low-fouling properties were measured by protein adsorption, platelet adhesion and activation, and cell adhesion. Protein adsorption of bovine serum albumin (BSA), fibrinogen, and human plasma were also tested and a moderate monomer composite was attained. The protein adsorption behavior on the novel interfaces depends both on MPC density and PMPC chain length. Platelet adhesion and activation were reduced on all the modified surfaces. The adhesion of Human Embryonic Kidney 293 (293T) cells on the coated surfaces also decreased.