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Inflammatory, Hypersensitivity and Immune Lung Diseases, including Parasitic Diseases.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Patients may have pulmonary vascular disease without interstitial lung disease. D-penicillamine and cyclophosphamide may help with interstitial lung disease and nifedipine may help with vasculitis. Gastro-intestinal tract: oesophagus - loss of peristalsis, dilatation, sometimes with narrowing or shortening (see also p. 16.4 and Illus. OES-SCLERODERMA.): stomach - decreased peristalsis, hiatus hernia, 'wide open cardia' (distinguishing the oesophageal change from achalasia).: small intestine - decreased peristalsis and pseudodiverticula.: colon - decreased peristalsis, dilatation, localised narrowing. (GI tract complications are shown in Illus. SCLERODERMA, Pts. 4, 7b, 8d, 15a-d, & 17 to 19.)Heart and kidneys: decreased contraction of myocardium, progressive renal failure.Phalanges: absorbtion of tufts of distal phalanges esp. of fingers, calcinosis, etc.- Illus. SCLERODERMA, Pts. 14b, 15e-f & 20-24.Teeth: widening of periodontal spaces.Lymph nodes: sometimes enlarged mediastinal nodes may be found - see refs.
The Musculoskeletal System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
The large bone located above the knee in the leg is the femur. The tibia is the largest bone below the knee, located in front of the fibula. The ankle bones or tarsals, the foot bones or metatarsals (literally, "after the tarsals"), and the toe bones or phalanges (singular: phalanx) complete the lower extremity. The upper extremity is composed of the collar bone or clavicle, which articulates with the wingbone or scapula, the long bone of the upper arm known as the humerus, the radius and ulna below the elbow and joining the wrist bone or carpais, the bones of the hand or metacarpals, and the phalanges of the fingers.
Hands
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Fracture management represents a compromise of sorts between fracture healing and mobility. ORIF with plates/screws provides (close to) rigid fixation and permits early mobilisation, but the surgical trauma will lead to adhesions and stiffness. Closed non-rigid fixation with K-wires is associated with less trauma and adhesions, but often requires splintage for a period that encourages stiffness. Thus, the choice between ORIF and K-wire fixation is not so clear-cut. See ‘Unacceptable phalangeal fractures’.
Surgical treatment of macrodactyly of the foot in children
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Lu Chen, Wei Huang, Wei Chen, Xiaofei Tian
If the affected toe was at least twice the length of the toe on the contralateral side, the distal phalanx was amputated; if it was less than twice this length, phalangeal shortening by wedge osteotomy or interphalangeal joint arthrodesis was performed. If both the width and height of the affected phalanges were increased, longitudinal osteotomy of the phalanx was carried out. Ray resection was performed in the following cases: (1) involvement of the metatarsal; (2) gross overgrowth of the forefoot; (3) accompanying syndactyly; (4) the order of the affected toes (more third and fourth rays were resected because the third and fourth toes were shorter than the first and second toes, anatomically); (5) the desire of the patients and parents (older patients had a stronger desire for ray resection). If the first metatarsal and phalanx were involved, osteotomy was preferred, rather than resection of the first ray, as the first toe contributes substantially to weight-bearing and normal gait. Soft tissue debulking was an integral part of the treatment and was performed in all cases.
Long-term outcomes after phalangeal distraction lengthening in patients with constriction band syndrome
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Kousuke Iba, Kenichi Takashima, Megumi Hanaka, Atsushi Teramoto, Makoto Emori, Akira Saito, Hikaru Hayakawa, Toshihiko Yamashita
Bone lengthening procedures were performed from December 2009 to June 2010 at our hospital for five proximal phalanges in two boys with shortened digits associated with congenital constriction band syndrome. The phalanges consisted of one index finger, one middle finger, two ring fingers, and one little finger. Associated anomalies in the contralateral hand and the right foot were observed in 1 patient. Neither of the patients had any generalized abnormalities, syndrome or other congenital anomalies of the limbs. The patients underwent distraction lengthening procedures for the phalanges at age of 53 and 41 months, respectively. Pre-operative problems included impairment of pinch and grasp function due to their short fingers. The post-operative follow-up period was 126 and 124 months, respectively.
Evidence-based medicine, the number ‘three’ and its multiples in urological clinical rules
Published in Scandinavian Journal of Urology, 2021
Georges Mjaess, Fouad Aoun, Simone Albisinni, Michel Vanhaeverbeek, Thierry Roumeguère
Therefore, many of the presented clinical rules are time-related (hours, days, weeks, or months). This can remind us of the ancient Babylonian numbering system. Babylonians based their counts on the sexagesimal (also known as base 60 or sexagenary) which is a numeral system with 60 (12 × 5) as its base. This system has given its origins to the modern time units (e.g. 1 h = 60 mins = 60 × 60 secs). Babylonians also used the ‘three’ phalanges of each finger (except for the thumb) to count, making a total of twelve per hand. This might explain the origin of this ‘temporal bias’ unconsciously impacting our clinical opinion. Furthermore, the number three has a religious and cultural significance in many societies: the holy trinity in Christianity, the three daily prayers in Judaism, the triple Bodhi in Buddhism, etc. This concept has soaked to many life domains such as sports (triathlon), physics (the number of dimensions humans can perceive), and politics (the ‘third’-world countries). We think that medicine in general, and not only urology, is also another life domain impressed by this ‘number three’ vestige.