Computer-Aided 3D Analysis of Anatomy and Radiographic Parameters of the Distal Radius

ABSTRACT Introduction This study applied mathematical modeling to examine the anatomy of the distal radius; to define the radiographic parameters in a 3D imaging modality; and to report their normal ranges in the uninjured radius. Materials and Methods A series of 50 cone-beam computed tomography (CBCT) scans of uninjured radii were analyzed using computer-aided image processing. The radius shape model was used to determine the optimal location for measuring the longitudinal axis. With the axis determined, the volar tilt and radial inclination angles and the areas of the articular facets and their reference points were analyzed. Results The optimal location for determining the longitudinal axis was between 28.8?mm and 53.3?mm proximally from the articular surface. The mean radial inclination angle was 21.8°. The mean volar tilt angle via the most distal tips of the volar and dorsal rims was 13.0°; along the lunate and scaphoid facets it was 9.1° and 11.2°, respectively. The scaphoid facet was larger than the lunate facet and 25% of it was convex. Conclusions Computer-aided CBCT image processing offers an advanced tool to record 3D geometry and the radiographic parameters of the osseous structures of the wrist. Analysis of the distal radius? anatomy showed that the longitudinal axis was affected by its measurement location and subsequently also affected the determination of the angular parameters. We also report the variation of the volar tilt along the articular surface and the shapes and sizes of the articular facets. This article is protected by copyright. All rights reserved.Peer reviewe

The clinical significance of magnetic resonance imaging of the hand : an analysis of 318 hand and wrist images referred by hand surgeons

Magnetic resonance imaging (MRI) is a common diagnostic tool in hand surgery. However, there is limited knowledge on the kind of findings that are relevant in treatment planning. We analysed the findings and utility of arm, wrist, metacarpal, and finger MRIs taken in a tertiary hand surgery clinic of 318 consecutive images from 316 patients referred by a hand surgeon or hand surgeon resident. Ganglions (28%), findings on the extensor carpi ulnaris tendon (18%) and on the triangular fibrocartilage (18%) were the most common findings and increased with patient age; the clinical significance of these findings was minimal. The correlation between the clinical scaphoid shift test or the fovea sign test and MRI was also non-significant. Despite findings on MRI, the diagnosis remained unsolved in 76 (24%) cases. However, MRI had a role in reassuring the patient, and in 70% of the cases, further follow-up was unnecessary. This study demonstrates that the indications for wrist and hand MRI must be considered thoroughly and interpretation of the MRI report requires knowledge.Peer reviewe

Radiographic measurements of the normal distal radius: reliability of computer-aided CT versus physicians’ radiograph interpretation

We examined the reliability of a computer-aided cone-beam CT analysis of radiographic parameters of 50 normal distal radii and compared it with interobserver agreement of measurements made by three groups of physicians on two-dimensional plain radiographs. The intra-rater reliability of the computer-aided analysis was evaluated on 33 wrists imaged twice by cone-beam CT. The longitudinal axis, anterior tilt, radial inclination and ulnar variance were measured. The reliability of computer-aided analysis was excellent (intraclass correlation coefficient (ICC) 0.94-0.96) while the interobserver agreement of two-dimensional radiograph interpretation was good (ulnar variance, ICC 0.80-0.84) to poor (anterior tilt and radial inclination, ICC 0.20-0.42). We conclude that computer-aided cone-beam CT analysis was a reliable tool for radiographic parameter determination, whereas physicians demonstrated substantial variability especially in interpreting the angular parameters.Peer reviewe

Usability issues in the operating room - Towards contextual design guidelines for medical device design

Most usability assessments of medical devices describe the problems of individual devices in detail, but few account for the real context of use or provide designers with actionable guidelines for improvement. To fill this gap, this paper reports the results of a case study on the usability of operating room technologies and documents the creation of contextual design guidelines for operating room device design. We spent 64 h in a gynecological operating unit conducting interviews with staff and observing device use during surgery. With qualitative analysis methods and based on existing usability principles, we created 21 design guidelines for the operating room context. The new guidelines highlight interactions between multiple devices, staff members, as well as other contextual factors. While the guidelines require further validation, they can potentially support the creation of more safe, ergonomic, and intuitive medical devices.Peer reviewe

Three Megapixel Ultrasonic Microscope Imaging

Peer reviewe

Enchondromas of the Hand : Curettage With Autogenous Bone vs. Bioactive Glass S53P4 for Void Augmentation

Background/Aim Enchondroma is the most common primary bone tumour of the hand. When surgery is indicated, curettage with or without void augmentation has been described. However, only few comparative studies exist. The aim of this study was to compare the outcomes of hand enchondromas treated with autologous bone graft (AG) and bioactive glass S53P4 (BAG). Patients and Methods: A retrospective comparative analysis was conducted among patients surgically treated for hand enchondromas at a tertiary referral centre during a 17-year period. Results: A total of 190 patients (116 AG vs. 74 BAG) with 205 enchondromas were included. No statistically significant differences in outcome measures were observed. A reoperation was performed in five patients in the autologous bone-graft group; one patient presented a rare malignant transformation from enchondroma to chondrosarcoma after the primary operation. No reoperations were performed in the BAG group. Conclusion: Although AG is the gold standard for filling bony cavities, bone-graft retrieval can cause complications and postoperative pain. Our results suggest that S53P4 BAG is a safe and effective bone-graft material alternative for filling of enchondroma-evacuated cavities.Peer reviewe

Epidermal UV-A absorbance and whole-leaf flavonoid composition in pea respond more to solar blue light than to solar UV radiation

Plants synthesize phenolic compounds in response to certain environmental signals or stresses. One large group of phenolics, flavonoids, is considered particularly responsive to ultraviolet (UV) radiation. However, here we demonstrate that solar blue light stimulates flavonoid biosynthesis in the absence of UV-A and UV-B radiation. We grew pea plants (Pisum sativum cv. Meteor) outdoors, in Finland during the summer, under five types of filters differing in their spectral transmittance. These filters were used to (1) attenuate UV-B; (2) attenuate UV-B and UV-A We studied the relative importance of the UV and blue wavebands of sunlight for the phenolics in leaves of pea (Pisum sativum cv. Meteor) plants grown outdoors. We report a large reduction in epidermal flavonoids and a change in the flavonoid composition in leaf extracts when solar blue light was attenuated. Under the conditions of our experiment, these effects of blue light attenuation were much larger than those caused by attenuation of UV radiation.Peer reviewe

Detecting Distal Radius Fractures Using a Segmentation-Based Deep Learning Model

Deep learning algorithms can be used to classify medical images. In distal radius fracture treatment, fracture detection and radiographic assessment of fracture displacement are critical steps. The aim of this study was to use pixel-level annotations of fractures to develop a deep learning model for precise distal radius fracture detection. We randomly divided 3785 consecutive emergency wrist radiograph examinations from six hospitals to a training set (3399 examinations) and test set (386 examinations). The training set was used to develop the deep learning model and the test set to assess its validity. The consensus of three hand surgeons was used as the gold standard for the test set. The area under the ROC curve was 0.97 (CI 0.95-0.98) and 0.95 (CI 0.92-0.98) for examinations without a cast. Fractures were identified with higher accuracy in the postero-anterior radiographs than in the lateral radiographs. Our deep learning model performed well in our multi-hospital and multi-radiograph system manufacturer settings. Thus, segmentation-based deep learning models may provide additional benefit. Further research is needed with algorithm comparison and external validation.Peer reviewe

Antibacterial Bioactive Glass, S53P4, for Chronic Bone Infections - A Multinational Study

Correction: Volume: 971 Pages: 115-116 DOI: 10.1007/5584_2017_13 Published: 2017 WOS:000446017300010Osteomyelitis is an infectious process in bone that occasionally leads to bone destruction. Traditionally, the surgical treatment procedure is performed in combination with systemic and local antibiotics as a two-stage procedure that uses autograft or allograft bone for filling of the cavitary defect. Bioactive glass (BAG-S53P4) is a bone substitute with proven antibacterial and bone bonding properties. One hundred and sixteen patients who had verified chronic osteomyelitis was treated using BAG-S53P4 as part of the treatment. Most of the patients had previously undergone numerous procedures, sometimes for decades. A register of patient data obtained from 11 centers from Finland, Italy, the Netherlands, Germany, Azerbaijan and Poland was set-up and continuously maintained at Helsinki University Central Hospital. The location of the osteomyelitis was mainly in the tibia followed by the femur and then the calcaneus. The median age of the patients was 48 years (15-87). The patients were either treated according to a one-stage procedure without local antibiotics (85 %) or by a two-stage procedure using antibiotic beads in the first procedure (15 %). The minimum follow-up was 1 year (12-95 months, median 31). The cure rate was 104/116, the total success rate 90 % and most of the patients showed a rapid recovery. The study shows that (BAG-S53P4) can be used in a one-stage procedure in treatment of osteomyelitis with excellent results.Peer reviewe

Musiikki, minä ja kulttuuri sosionomi (AMK) -koulutuksessa : Peers-projekti ammatti-identiteetin kehittymisen taustalla

Tutkimme opinnäytetyössämme Peers-projektin vaikutusta ammatti-identiteetin kehittymiselle. Opinnäytetyömme pohjautuu sveitsiläis-suomalaiseen Peers-projektiin (2015-2016), jonka koimme yhtenä vaikuttavimmista opintokokonaisuuksista sosionomi-opinnoissamme. Projektin aikana musiikin sekä kulttuurin merkitys itsetuntemukselle ja ammatti-identiteetin kehittymiselle syveni. Tarkastelemme opinnäytetyössämme sosionomi-koulutuksen tavoitteita ja työelämätaitoja, joiden avulla sosionomi pystyy tekemään vaikuttavaa auttamistyötä. Tämän lisäksi käsittelemme tietoperustassa musiikkia, kulttuuria ja minän rakennetta. Valitsimme edellä mainitut aiheet, koska koimme ne Peers-projektiin pohjautuvan tutkimuksemme kannalta merkityksellisiksi. Tutkimme teorialähtöisesti kyseisiin aiheisiin liittyviä kokemuksiamme ja niiden merkitystä ammatti-identiteetin kehittymiselle. Tavoitteenamme on, että opinnäytetyöstämme löytyy aineksia sosiaalialan opintojen sisältöjen kehittämiseen. Laurean Learning by Developing -toimintamallissa korostetaan kumppanuutta, autenttisuutta, tutkimuksellisuutta, luovuutta ja kokemuksellisuutta. Kansainvälinen projekti tuki tämän toimintamallin toteutumista sekä toi oppimiseen tarvittavan moniulotteisuuden ja reflektiivisyyden. Tutkimuksemme on laadullinen tutkimus, jossa aineistona ovat Peers-projektiin osallistuneiden opiskelijoiden muistot, valokuvat ja raportit. Tutkimus on fenomenologis-hermeneuttinen, koska kohteena ovat kokemustemme merkitykset ja niiden tulkinta. Tutkimusmenetelminä olivat teemoittelu ja sisällönanalyysi. Aineistonkäsittelytapamme oli narratiivinen. Tutkimuksemme mukaan musiikki- ja kulttuurikokemukset vaikuttavat vahvasti tunteisiin, tunnetietoisuuteen, itsetuntemukseen sekä identiteettiin. Nämä puolestaan vaikuttavat ammatti-identiteetin kehittymiseen. Kansainvälistyvässä maailmassa koemme kulttuurivaihto-opinnot arvokkaana osana sosionomi-opintojamme, ja pidämme niiden kehittämistä hyvin tärkeänä.In this thesis we studied the impact of the Peers-project for professional identity. The thesis is based on Swiss-Finn Peers-project (2015-2016) from which we analysed the connections between creativity, self-esteem and music. The Peers-project was particularly impressive due to its deep impact on our professional identity and hence was chosen as the subject. The groundwork of our thesis lied in Bachelor of Social Services Education, music, culture and the structure of self-image. We constructed the research from our experiences based on theory and their meaning for development of professional identity. We hoped to find new aspects to develop social service studies. Laurea University of Applied Sciences’ Learning by Developing (LbD) model highlights; partnership, authenticity, experiential nature, creativity and research oriented approach. An international project supported the aims of LbD by helping us to understand the multidimensionality and reflectivity better. The research design is qualitative and the research material was from our Peers-project including memories and reports. The data analysis executed was hermeneutic phenomenological because our experiences and their meanings were the object of the research. The research method was based on themes content analysis and the treatment material was the narrative. According to our findings music and cultural experiences strongly affect feelings, awareness of feelings, self-perception and identity. These further affects developing the professional identity. In a global world we feel that cultural exchange studies are a valuable part of our Bachelor of Social Services Education and we find the development of our studies very important