MR Arthrography of Shoulder

The glenohumeral joint boasts the greatest range of motion of any peripheral joint in the body, but not without cost; it is also the most frequently dislocated joint in the body. Stability of this articulation is limited for two major reasons. The articulating surface of the glenoid is significantly smaller than that of the humeral head, and the joint capsule is redundant and provides little support. This unit presents a basic MR arthrography protocol for evaluation of glenohumeral joint instability.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145405/1/cpmia2202.pd

Rotator Cuff Disease

Shoulder pain is a common clinical presentation. Though the spectrum of disorders affecting the shoulder is quite diverse, emphasis is often placed on abnormalities of the rotator cuff and glenohumeral joint instability. The rotator cuff plays an important role in both the function and stability of the shoulder. Moreover, its pathology, with early and accurate diagnosis, is amenable to treatment, which can markedly affect patient outcome. This unit presents an MR imaging protocol for evaluation of the glenohumeral joint. Though specific emphasis is placed on the rotator cuff, it can also be used for global assessment of the shoulder.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145303/1/cpmia2201.pd

Modelled rainfall response to strong El Nino sea surface temperature anomalies in the tropical Pacific

© 2015 American Meteorological Society.El Niño-Southern Oscillation strongly influences the interannual variability of rainfall over the Pacific, shifting the position and orientation of the South Pacific convergence zone (SPCZ) and intertropical convergence zone (ITCZ). In 1982/83 and 1997/98, very strong El Niño events occurred, during which time the SPCZ and ITCZ merged into a single zonal convergence zone (szCZ) extending across the Pacific at approximately 58S. The sea surface temperature anomalies (SSTAs) reached very large values and peaked farther east compared to other El Niño events. Previous work shows that tropical Pacific precipitation responds nonlinearly to changing the amplitude of the El Niño SSTA even if the structure of the SSTA remains unchanged, but large canonical El Niño SSTAs cannot reproduce the szCZ precipitation pattern. This study conducts idealized, SST-forced experiments, starting with a large-amplitude canonical El Niño SSTA and gradually adding a residual pattern until the full (1982/83) and (1997/98) mean SST is reproduced. Differences between the canonical and strong El Niño SSTA patterns are crucial in generating an szCZ event. Three elements influence the precipitation pattern: (i) the local meridional SST maxima influences the ITCZ position and western Pacific precipitation, (ii) the total zonal SST maximum influences the SPCZ position, and (iii) the equatorial Pacific SST influences the total amount of precipitation. In these experiments, the meridional SST gradient increases as the SSTAs approach szCZ conditions. Additionally, the precipitation changes evident in szCZ years are primarily driven by changes in the atmospheric circulation, rather than thermodynamic changes. The addition of a global warming SST pattern increases the precipitation along the equator and shifts the ITCZ farther equatorward

The non-linear impact of El Nino, La Nina and the Southern Oscillation on seasonal and regional Australian precipitation

The relationship between El Niño-Southern Oscillation (ENSO) indices and precipitation (P) in some parts of Australia has previously been shown to be non-linear on annual and seasonal time scales. Here we examine the relationship between P and the Southern Oscillation Index (SOI) at all Australian locations and in all seasons. We show that in many Australian regions, there is more-than-expected P during strong La Niña years (SOI>13), but less-than-expected drying during strong El Niño years (SOI<-13). Statistically significant non-linearities are found over northern NT, QLD and parts of WA during SON, and parts of QLD, NSW, and VIC during DJF, when regressing P against June-December SOI. During the MAM immediately preceding a June-December ENSO year, and during JJA, the rainfall-SOI relationship is linear over most of the country. Systematic eastward shifts in P patterns can explain non-linearities over northern Australia, but do not explain non-linearities southward of approximately 20°S. The seasonal P distribution is decomposed into FP, the fraction of days on which P falls, and PD, the amount of rain per day on days when P is non-zero. Both FP and PD display a non-linear relationship with SOI similar to the P-SOI relationship, although the relative influence of each term on P is spatially and seasonally dependent

Quantitative magnetic resonance imaging of meniscal pathology ex vivo

OBJECTIVE To determine the ability of conventional spin echo (SE) T2 and ultrashort echo time (UTE) T2* relaxation times to characterize pathology in cadaveric meniscus samples. MATERIALS AND METHODS From 10 human donors, 54 triangular (radially cut) meniscus samples were harvested. Meniscal pathology was classified as normal (n = 17), intrasubstance degenerated (n = 33), or torn (n = 4) using a modified arthroscopic grading system. Using a 3-T MR system, SE T2 and UTE T2* values of the menisci were determined, followed by histopathology. Effect of meniscal pathology on relaxation times and histology scores were determined, along with correlation between relaxation times and histology scores. RESULTS Mean ± standard deviation UTE T2* values for normal, degenerated, and torn menisci were 3.6 ± 1.3 ms, 7.4 ± 2.5 ms, and 9.8 ± 5.7 ms, respectively, being significantly higher in degenerated (p  0.14). In terms of histology, we found significant group-wise differences (each p < 0.05) in fiber organization and inner-tip surface integrity sub-scores, as well as the total score. Finally, we found a significant weak correlation between UTE T2* and histology total score (p = 0.007, R$_{s}$$^{2}$ = 0.19), unlike the correlation between SE T2 and histology (p = 0.09, R$_{s}$$^{2}$ = 0.05). CONCLUSION UTE T2* values were found to distinguish normal from both degenerated and torn menisci and correlated significantly with histopathology

A randomised clinical trial of a comprehensive exercise program for chronic whiplash: trial protocol

Background: Whiplash is the most common injury following a motor vehicle accident. Approximately 60% of people suffer persistent pain and disability six months post injury. Two forms of exercise; specific motor relearning exercises and graded activity, have been found to be effective treatments for this condition. Although the effect sizes for these exercise programs, individually, are modest, pilot data suggest much larger effects on pain and disability are achieved when these two treatments are combined. The aim of this study is to investigate the effectiveness and cost-effectiveness of this comprehensive exercise approach for chronic whiplash

The role of the South Pacific in modulating Tropical Pacific variability

Tropical Pacific variability (TPV) heavily influences global climate, but much is still unknown about its drivers. We examine the impact of South Pacific variability on the modes of TPV: the El Niño-Southern Oscillation (ENSO) and the Interdecadal Pacific Oscillation (IPO). We conduct idealised coupled experiments in which we suppress temperature and salinity variability at all oceanic levels in the South Pacific. This reduces decadal variability in the equatorial Pacific by ~30% and distorts the spatial pattern of the IPO. There is little change to overall interannual variability, however there is a decrease in the magnitude of the largest 5% of both El Niño and La Niña sea-surface temperature (SST) anomalies. Possible reasons for this include: (i) reduced decadal variability means that interannual SST variability is superposed onto a ‘flatter’ background signal, (ii) suppressing South Pacific variability leads to the alteration of coupled processes linking the South and equatorial Pacific. A small but significant mean state change arising from the imposed suppression may also contribute to the weakened extreme ENSO SST anomalies. The magnitude of both extreme El Niño and La Niña SST anomalies are reduced, and the associated spatial patterns of change of upper ocean heat content and wind stress anomalies are markedly different for both types of events

EM-mosaic detects mosaic point mutations that contribute to congenital heart disease.

BackgroundThe contribution of somatic mosaicism, or genetic mutations arising after oocyte fertilization, to congenital heart disease (CHD) is not well understood. Further, the relationship between mosaicism in blood and cardiovascular tissue has not been determined.MethodsWe developed a new computational method, EM-mosaic (Expectation-Maximization-based detection of mosaicism), to analyze mosaicism in exome sequences derived primarily from blood DNA of 2530 CHD proband-parent trios. To optimize this method, we measured mosaic detection power as a function of sequencing depth. In parallel, we analyzed our cohort using MosaicHunter, a Bayesian genotyping algorithm-based mosaic detection tool, and compared the two methods. The accuracy of these mosaic variant detection algorithms was assessed using an independent resequencing method. We then applied both methods to detect mosaicism in cardiac tissue-derived exome sequences of 66 participants for which matched blood and heart tissue was available.ResultsEM-mosaic detected 326 mosaic mutations in blood and/or cardiac tissue DNA. Of the 309 detected in blood DNA, 85/97 (88%) tested were independently confirmed, while 7/17 (41%) candidates of 17 detected in cardiac tissue were confirmed. MosaicHunter detected an additional 64 mosaics, of which 23/46 (50%) among 58 candidates from blood and 4/6 (67%) of 6 candidates from cardiac tissue confirmed. Twenty-five mosaic variants altered CHD-risk genes, affecting 1% of our cohort. Of these 25, 22/22 candidates tested were confirmed. Variants predicted as damaging had higher variant allele fraction than benign variants, suggesting a role in CHD. The estimated true frequency of mosaic variants above 10% mosaicism was 0.14/person in blood and 0.21/person in cardiac tissue. Analysis of 66 individuals with matched cardiac tissue available revealed both tissue-specific and shared mosaicism, with shared mosaics generally having higher allele fraction.ConclusionsWe estimate that ~ 1% of CHD probands have a mosaic variant detectable in blood that could contribute to cardiac malformations, particularly those damaging variants with relatively higher allele fraction. Although blood is a readily available DNA source, cardiac tissues analyzed contributed ~ 5% of somatic mosaic variants identified, indicating the value of tissue mosaicism analyses