Changes In Angulation Research Articles

Long-term changes in hyoid bone position and craniocervical posture in complete denture wearers.

Changes in hyoid position in relation to changes in mandibular inclination and craniocervical posture were studied by roentgen cephalometrics in a sample of 24 long-term complete denture wearers over a 15-year period. The measurements were made on lateral occlusion films obtained with the subjects in the sitting position and with the head oriented according to its natural balance. The changes in mandibular inclination ranged from -5.5 degrees to 8.6 degrees, with a mean of zero. The cervical column became significantly more forward inclined (mean, 5 degrees), and the craniocervical angulation became on an average 5 degrees larger. Correlation analyses indicated that the hyoid position was influenced by two postural systems: the changes in mandibular inclination and the changes in cervical and craniocervical posture. The vertical changes in hyoid position in relation to the upper face largely followed the patterns of increase or decrease in mandibular inclination, whereas the horizontal changes mainly followed the changes in cervical inclination and craniocervical angulation.

Technique to match mantle and para-aortic fields

A technique is described to match the mantle and para-aortic fields used in treatment of Hodgkin's disease, when the patient is treated alternately in supine and prone position. The approach is based on referencing the field edges to a point close to the vertebral column, where uncontrolled motion is minimal and where accurate matching is particularly important. Fiducial surface points are established in the simulation process to accomplish this objective. Dose distributions have been measured to study the combined effect of divergence differences, changes in body angulation and setup errors. Even with the most careful technique, the use of small cord blocks of 50% transmission is an advisable precaution for the posterior fields.

Proximal Femoral Osteotomy

A trigonometric analysis of the effect of a proximal femoral osteotomy, either dome or cuneiform, on leg length was done to aid the preoperative planning for this surgery. Change in leg length may be determined for a dome osteotomy by multiplying the length of the head-neck segment by the difference between the cosines of the preoperative and postoperative neck-shaft angles as measured from the vertical. A series of determinations are tabulated for a variety of head-neck lengths and angulation changes. When a cuneiform osteotomy is being done, the effect of the wedge can be determined and should be considered. Also to be considered are a tendency for spontaneous correction and growth stimulation from the osteotomy.

Evaluation of ataxia by measuring changes in angulation of shoulders while stepping.

Evaluation of ataxia by measuring changes in angulation of shoulders while stepping.

Peripheral Vestibular Disorders and Changes in Angulation of Shoulders while Stepping

A polarized light goniometer (abbreviated as Polgon) and a microcomputer were applied for the calculation of the real values of changes in shoulder angulation during stepping movement in normal subjects and patients with peripheral vestibular disorders.Characteristic results were obtained from patients with Meniere's disease, showing larger means and variations as compared with those of normal subjects. The shoulder of the same side with affected ear usually showed larger values than those of another shoulder.Those patients with sudden deafness accompanying vestibular disorder presented larger means and normal standard deviations. The results obtained from two patients with vestibular neuronitis were almost normal. Five subjects with other vestibular disorders showed larger means only when stepping with the eyes closed.

Measurement of Changes in Angulation of Shoulders during Stepping Movements

A polarized light goniometer (abbreviated as Polgon) was applied for the analysis of the stepping movement in normal adults and patients with peripheral vestibular disorders.In normal subjects the most stable pattern of shoulder angulation was obtained with 1.0 to 1.4 steps per second. The calculated changes of angulation of shoulders while stepping at the speed of 1.2 steps per second with the eyes open were 7.8±3.9deg. (right shoulder) and 7.7±4.3deg. (left shoulder), while those with the eyes closed were 11.5±5.0deg. (right shoulder) and 11.3±5.4deg. (left shoulder).The patients with peripheral vestibular disorders showed larger patterns of shoulder angulation with accompanying body rotation or asymmetric movements between the right and left shoulders.The results suggest that the Polgon is a useful tool for the analysis of vertigo and ataxia.

Irradiation dose to the lens of the eye during CT of the head.

The irradiation dose to the lens of the eye during CT scanning has been measured in 16 patients. The dose is greatly influenced by changes in gantry angulation, the position of the patient, the thickness and number of slices, KV, and milliamperage. The total lens dose has been measured to be higher than previously reported. Repeated CT scans imply the risk of irradiation cataract, especially in infants and children.

Tibial osteotomy for osteoarthritis of the knee. A five to ten-year follow-up study.

Of the 141 osteoarthritic knees treated by tibial osteotomy at the Kotka Central Hospital from 1969 to 1974, 103 (ninety-two with a varus deformity and eleven with normal alignment) were followed for at least five years, the average follow-up being 6.9 years. In eighty-six knees (83.5 per cent) the result was good or fair. In the ninety-two knees with a varus deformity, the best results were achieved when the postoperative femorotibial angle was 167 to 175 degrees. In the eleven knees with normal preoperative alignment, the osteotomy was designed to shift the load to the compartment in which there was less osteoarthritis involvement. In nine of these eleven knees there was an average change in angulation (varus or valgus) of 5.3 degrees (range, 3 to 9 degrees) and the result was good or fair. All osteotomies united without reoperation. The incidence of delayed union was 3.6 per cent when the osteotomy was proximal and 14 per cent when it was distal to the tibial tubercle. The elimination of the tethering effect of the fibula by osteotomy or release of the proximal tibiofibular joint did not prevent the recurrence of varus deformity. At an average of 3.4 years after the osteotomy, deterioration was demonstrable in twenty-six knees in which the initial result had been good. This is a higher incidence of deterioration than in previously published series. In sixteen of the 103 knees, a total arthroplasty subsequently was performed because of a poor result, at an average of 7.6 years after the osteotomy.

Bender Gestalt Signs as Indicants of Conceptual Impulsivity

Sixty children were individually administered the Matching Familiar Figures Test and the Bender Gestalt Test. The mean age of the subjects was 10 years, 11 months. A significant relationship was found between errors on the Bender Gestalt test and impulsivity. More specifically, increased or decreased loops (figure four or six), change in angulation, loops for circles and circles for dots or dots for circles were all significantly related to children's impulsivity.

Angular Measurements in Orthopantomography

There are many situations in clinical dental practice when it is of importance to determine the inclination of a certain tooth in relation to neighbouring teeth. This is especially true con­ sidering orthodontics and oral surgery. The degree of inclination of an impacted tooth may be significant in selection of the ideal thera­ peutic alternative, orthodontic or surgical.

The growth of the cranial vault in the albino rat

The growth of the interparietal bone and the frontal bone from 14 to 60 days of age was studied in the midsagittal, or para-median sagittal, plane by a combination of roentgenocephalometry and vital staining. The roentgenocephalometric study dealt with growth changes in length and shape of the bones, changes in shape of the cranial vault and changes in angulation between neighbouring bones. The interparietal bone increased in length only between 30 and 60 days, while the frontal bone increased in length during the whole period, although with decreasing velocity. The two bones also changed in shape with age. The cranial vault became flatter and more angulated with increasing age, obviously due to changes in angulation between the bones of the vault. The lack of growth in length of the interparietal bone between 14 and 30 days as found in the roentgenocephalometric part of the study was explained with the results from the alizarin study, which showed that this bone until 30 days had slight resorption on its posterior end and slight apposition on its anterior end. Furthermore, the results from the alizarin study confirm general principles of growth of bones in the cerebral skull, described in previously published studies. A reconstruction of the growth of the bones in the cranial vault is presented from the results of this study and studies previously mentioned. This reconstruction shows how the original bones are situated in relation to the final ones. The problems of drift of bones and the interaction between movements of bones in relation to their former position and movements in space are discussed.

Changes in arch form and dimensions of cleft patients

The photocopy method of cast analysis permits a better understanding of the dimensional changes occurring during various stages of arch development. The statistical evaluation of the measurements described, and the changes in arch dimension as a result of growth and surgery gave us a better understanding of cleft patients. We found a wide variation in initial arch form among the groups and a variable pattern of arch development from birth to age 5. Surgical closure of the lip had a significant effect upon reduction of the alveolar and palatal cleft and upon maxillary segmental relationships and positioning. The reduction of the palatal cleft after lip surgery was attributed to segmental repositioning, downward growth and change in angulation of the palatal shelves, and mesial growth of the palatal shelves of the lesser segment. A significant pattern of anteroposterior and lateral dimension retardation was noted immediately after surgical treatment. This lag appears to have diminished in most subjects after the age of 4 years. Maxillary width was affected more than length, and even though the cleft group had a reduced width as compared to the normal group at 5 years, a significant increase in this width was noted among the cleft subjects from year to year, suggesting that the type of surgery performed did not cause a major or persistent growth disturbance. In all CLP subjects at 5 years of age, the length measurements were similar to those of normal subjects. A constant change was observed in the relationship between the greater and the lesser segments during various stages of arch development. In the majority of patients in whom there was an overlap of the greater segment over the lesser segment, both before and after lip surgery, and even up to the age of 2 years, the segmental relationships began to change prior to the age of 3 years and assumed and end-to-end relationship after the eruption of the deciduous dentition. A study of cross-bite in the deciduous dentition in the CLP patients revealed that twelve subjects (40 per cent of the patients) did not have a cross-bite, seven subjects (23 per cent) had a cross-bite limited to the canine, eight subjects (26 per cent) had a complete buccal cross-bite, one had an anterior cross-bite, and two patients had an anterior and buccal cross-bite. These findings suggest that it may not be necessary to treat the arch in early infancy with a holding or an expansion appliance, since it appears that the arch and the segmental relationship will undergo favorable change with growth and with eruption of the deciduous dentition, provided that growth is not retarded by surgical intervention and scar tissue. It has been our opinion that the segments were able to assume a more favorable position because they were not locked in within the region of the alveolar cleft by any type of surgical intervention. Mandibular length and width were significantly smaller in the CP group than in the CLP and normal groups. This appears to suggest a definite tendency toward mandibular hypoplasia in CP subjects.

Manejo Conservador vrs Quirúrgico con placa volar en pacientes mayores con fractura distal de radio

Las fracturas de la región distal de radio constituyen lesiones que se atienden con mayor frecuencia en los servicio de urgencias.(1) El tratamiento conservador era el de elección hasta hace algunos años. Sin embargo se ha visto una tendencia progresiva al tratamiento quirúrgico, debido a los importantes trastornos funcionales que acompañaban a los métodos ortopédicos (2).Objetivo: Se comparo la evolución en pacientes mayores de 50 años con fractura extraarticular distal de radio, manejados con tratamiento conservador vrs. tratamiento quirúrgico con placa volar; atendidos en la Consulta Externa de Ortopedia y Traumatología del Hospital Escuela, desde de Junio del 2009 a Junio del 2010.Métodos: Estudio descriptivo longitudinal, con muestra de 27 pacientes mayores de cincuenta años. Parte de los pacientes fueron manejados con tratamiento conservador, debido a un prolongado tiempo de evolución transcurrido desde el momento de la fractura; y a la vez se estudiaron los pacientes que fueron manejados quirúrgicamente con placa volar; con evaluaciones a los dos y tres meses postratamiento. Se analizaron hallazgos radiológicos, complicaciones, y funcionalidad relacionadas con ambos manejos.Resultados: La mayoría no presentaron alteraciones en la altura y angulación radial en ambos manejos, la perdida de rango articular normal fue la complicación mas reportada, los pacientes manejados con placa volar realizaron sus actividades cotidianas con menor dificultad la las 12 semanas.Conclusión: Los pacientes con manejo quirúrgico presentan menor alteración de parámetros radiológicos, y obtienen mejor grado funcional a las 8 semanas postratamiento debido la movilización precoz y fijación rígida de la fractura.Palabras Claves: Fractura extra articular distal de radio; manejo conservador; manejo quirúrgico; complicaciones; funcionalidad.DOI: http://dx.doi.org/10.5377/rmpm.v13i3.622 Revista de los Postgrados de Medicina UNAH Vol. 13 N° 3 Agosto-Octubre 2010

The growth of the cranial base in the albino rat revealed by roentgenocephalometry*

Growth in length of the single bones in the cranial base, changes in angulation between these bones and changes in shape of the cranial base have been studied in the rat by serial roentgenocephalometry between 14 and 60 days.All the bones studied showed increase in length during the whole period. However, differences in both absolute and relative increase were found. Sex differences were as a rule of significance from 21 days of age. This phenomenon was explained as a difference in time of maturation between males and females.The cranial base became more dorsally concave with increasing age. This was found to be due to changes in angulation between the basisphenoid bone, the basioccipital bone and the cribriform plate of the ethmoid bone.The development of the rat skull from a clinorhynchal to an orthocranial type was found to be due to a combination of the changes in the cranial base and a high degree of stability of the angle between the cribriform plate and the nasal bone.Furthermore a marked stability of the relative position of the sphenooccipital synchon‐drosis during growth was found. This area corresponds to the position of the hypophysis.

Bone Growth after Spine Fusion

It was concluded from these cases that when a spine fusion is unquestionably solid and fairly massive, there is little increase in length of the fused area. The small increase that most of the cases we studied showed could be accounted for by magnification and other technical factors, but it is impossible to rule out a small amount of growth. The slight decrease in the kyphos in two of our cases suggests some bending of the fusion mass. No definite pseudarthroses could be seen on the roentgenograms but the presence of one or more pseudarthroses could not be ruled out. Microscopic and transient pseudarthroses are considered by us to be the most likely mechanism by which any real increase in length or any true change in angulation occurs. In our experimental studies9, microscopic losses of bone continuity in transepiphyseal bone grafts in the distal femora of young rabbits were demonstrated. These defects were of such a nature that they could not be demonstrated by standard clinical or roentgenographic methods. In our opinion, the end-result study of Hallock and his associates is valuable in that it indicates, from the practical, clinical point of view, what will happen to the average patient after spine fusion in early childhood. However, their data and the observations of the other authors previously mentioned convey an inaccurate and perhaps unintentional impression that considerable growth occurs in a solidly fused spine segment. It would be unfortunate, we believe, to allow this impression to persist since surgeons not familiar with all that is known about growth of the spine after spine fusion might be falsely encouraged on the basis of published data to perform longer and more massive spine fusions in young children. Our study suggests that a long, massive, and completely solid fusion in early childhood will impair spine growth to a significant degree. We believe that growth of a fused segment of the spine can occur only at the ends of the segment or at the site of gross or microscopic defects in the fusion plate. Pseudarthroses in spine fusions in children are much more frequent, in our opinion, than is generally suspected because of the tension forces exerted by the growing epiphyseal cartilages, as well as the usual stresses caused by motion. These pseudarthroses or stress fractures may be microscopic or grossly visible; they may occur spontaneously at any time and heal spontaneously. The more massive the fusion plate, the less chance there will be that it will break down under the stress of growth and motion. Finally, we believe that the laws that govern bone growth in general apply to the bone of spine fusions. There is in our opinion no such thing as interstitial growth of bone.

A quantitative study of the prenatal changes in angulation of the spinal nerves.

A quantitative study of the prenatal changes in angulation of the spinal nerves.