Distal Hook Research Articles

Magnetic Resonance Imaging and Sonographic Features before and after Surgery in Carpal Tunnel Syndrome: Association with Clinical Findings.

The interest in ultrasonography (US) and magnetic resonance imaging (MRI) assessment of the patients with carpal tunnel syndrome (CTS) is growing. This paper aimed to find the correlation of postoperative changes in these modalities' parameters with clinical outcomes. Boston CTS questionnaire-symptom severity (BQ-SS), Boston CTS questionnaire-functional status (BQ-FS), and visual analog scale (VAS) questionnaires (for pain, paresthesia, and grip weakness assessment) were used to evaluate clinical outcomes. Various imaging parameters of the median nerve and carpal tunnel were evaluated using US and MRI at two levels of the hook of the hamate (distal) and the pisiform (proximal) once preoperatively and then 3 months postoperatively. Corresponding US and MRI parameter measures were compared, and correlational analysis was performed between alteration of imaging findings and changes in clinical parameters postoperatively. Patients' functional status (BQ-FS score) was positively correlated with the nerve width both in US and MRI at the proximal level (r = 0.457 and r = 0.453, respectively) and also with the MRI nerve circumference at the distal level (r = -0.482). Correlation between paresthesia and the nerve width was notable in MRI at the distal hook of the hamate level (r = -0.403). Grip weakness VAS score was correlated with the nerve width-to-height ratio (WHR) in US at the distal level (r = 0.432). Changes in US and MRI parameters of the median nerve width, circumference, and WHR were associated with clinical changes in patients with CTS after surgery.

Urocleidoides spp. (Monogenea: Dactylogyridae) from the gills of Parodon nasus (Characiformes: Parodontidae) from a Brazilian stream with descriptions of two new species.

Urocleidoides spp. are reported from the gills of 20 specimens of Parodon nasus (standard length 8.512 cm), from the Indiana stream, Tiet River, Upper Paran River basin, municipality of Botucatu, So Paulo State, Brazil. Urocleoidoides tenuis and two new species were found. Urocleidoides indianensis n. sp. differs from its congeners mainly by the morphology of the vaginal sclerite that is robust, sickle-shaped, and forked at the distal end; and by the bulbous-shaped accessory piece of the male copulatory complex. Urocleidoides parodoni n. sp. resembles U. tenuis by presenting male copulatory organ with approximately 7 counterclockwise rings, but differs by the morphology of the accessory piece (lobate with a small hook-like projection versus pincer-shaped), vaginal sclerite (thumb-like subterminal projection vs. presence of a distal hook), vaginal tube (conspicuously sclerotized vs. slightly sclerotized), shape of the ventral bar (bowed vs. wide V-shaped), ventral and dorsal anchors (robust base and short shaft vs. considerably less robust base and long shaft), and hooks (slender shank with a weakly sclerotized subunit at base vs. dilated shank). Sequences of the partial 28S rDNA gene of the dactylogyrids found in this study are provided. Phylogenetic analyses showed Urocledoides spp. from Parodontidae clustering together with strong support values. This study increases the number of valid Urocleidoides species to 39, and the number of species described from parodontid hosts to four.

Pudendal Nerve Block by Low-Frequency (≤1 kHz) Biphasic Electrical Stimulation

To test the hypothesis that poststimulation block of nerve conduction can be achieved by low-frequency (≤1kHz) biphasic stimulation (LFBS). A tripolar cuff electrode was placed around the pudendal nerve in cats to deliver LFBS (1kHz, 500Hz, and 100Hz). Two bipolar hook electrodes were placed central and distal to the cuff electrode to induce external urethral sphincter (EUS) contractions. A catheter was inserted into the urethra to record EUS contraction pressure. Pudendal nerve block by LFBS was confirmed by the failure of the central hook electrode stimulation to induce EUS contractions, while the distal hook electrode stimulation still induced contractions. Pudendal nerve conduction was completely blocked by LFBS at different frequencies (1kHz, 500Hz, and 100Hz) after terminating LFBS. The post-LFBS block induced at the minimal stimulation intensity and duration was fully reversible within the same time period (10-15 min on average) for the three frequencies. However, the stimulation duration to induce block significantly (p < 0.05) increased from 23 ± 8sec to 95 ± 14 sec when frequency increased from 100Hz to 1kHz. This study discovered that LFBS (≤1kHz), like high-frequency (≥5kHz) biphasic stimulation (HFBS), can induce poststimulation block. The result provides support for the theory that biphasic stimulation waveforms block axonal conduction by changing intracellular and extracellular ion concentrations. The post-LFBS block provides the opportunity to develop new neuromodulation devices for clinical applications where initial nerve firing is acceptable.

Mesioangulation of mandibular second molars: A case report

This case report describes a simple alternative for treatment of mesioangulation of mandibular second molars. An 11-year-old girl was diagnosed with unilateral posterior crossbite, moderate incisor crowding and mesioangulation of the right mandibular second molar. The ectopic second molar was uprighted using a modified lingual arch with a distal hook and elastic chains. Orthodontic traction began after appliance installation and was activated once per month using 120 g of force. After six months, the right mandibular second molar was in an upright position. Orthodontic treatment continued with teeth levelling and alignment until acceptable occlusal and aesthetic results were achieved. Adequate stability was observed one year after debonding. The modified mandibular lingual arch with a distal hook is a simple and effective alternative to manage mesioangulation of mandibular second molars with minimum adverse effects and stable outcomes.

Oecanthus rohiniae sp. nov. (Gryllidae: Oecanthinae): A new chirping tree cricket of the rileyi species group from Mexico

A new species ofOecanthusis described from Mexico.Oecanthus rohiniaesp. nov.occurs in central Mexico in the understory of tropical deciduous forest and is currently known only from Mexico. This new species has the coloring, antennal markings, slightly widened tegmina, and calling song that are found in therileyispecies group. Although morphologically very similar toOecanthus fultoni, the shapes of the distal hooks on the male copulatory blades differ between the two species. There are also differences in the song pulse patterns and chirp rate response to temperature. This new species has been given the common name Cri-Cri tree cricket. Video and song recordings are available online.

Sand spit dynamics in a large tidal‐range environment: Insight from multiple LiDAR, UAV and hydrodynamic measurements on multiple spit hook development, breaching, reconstruction, and shoreline changes

AbstractSand spits with distal hooks have been well documented from coasts with low to moderate tidal ranges, unlike high tidal‐range environments. Datasets from 15 LiDAR and 3 UAV surveys between 2009 and 2019 on the Agon spit in Normandy (France), a setting with one of the largest tidal ranges in the world (mean spring tidal range: 11 m), combined with in‐situ hydrodynamic records between 2013 and 2017, highlight a three‐stage pattern of spit hook evolution. Stage 1 (2009–2013) commenced with the onshore migration and attachment of a swash bar, followed by persistent spit accretion updrift of the bar and erosion downdrift because of the slow speed of bar migration in this large tidal‐range environment. In stage 2 (2013–2016), three overwash events and a 220 m‐wide breach culminating in the total destruction of the spit during winter 2015–2016 involved the landward mobilization of thousands of cubic metres of sand. These events occurred during short durations (a few hours) when spring high tides coincided with relatively energetic waves, underscoring the importance of storms in rapid spit morphological change. Strong spring tidal currents maintained the breach. Stage 3 (2016–2019) has involved new hook construction through welding of a swash bar and spit longshore extension, highlighting the resilience of the spit over the 10‐year period, and involving a positive sediment balance of 244 000 m3. The three stages bring out, by virtue of the temporal density of LiDAR and UAV data used, a high detail of spit evolution relative to earlier studies in this macrotidal setting. The large tidal range strongly modulates the role of waves and wave‐generated longshore currents, the main process drivers of spit evolution, by favouring long periods of inertia in the course of the spring–neap tidal cycle, but also brief episodes of significant morphological change when storm waves coincide with spring high tides. © 2020 John Wiley &amp; Sons, Ltd.

Design and evaluation of the crimping of a hooked self-expandable caval valve stent for the treatment of tricuspid regurgitation

To design a hooked self-expandable caval valve stent and determine the best crimping scenario for its percutaneous implantation in the Superior and Inferior Vena Cava (SVC & IVC) for the treatment of tricuspid regurgitation (TR). A hooked, Nitinol based stent design was modeled using SOLIDWORKS and finite element analysis (FEA) was carried out using ABAQUS. The Nitinol material used in this study was modeled in ABAQUS as superelastic-plastic. Two cases were simulated. In case A, the stent model was crimped to 18 F by compressing the stent main body and then: (i) bending both the proximal and distal hooks; (ii) straightening the proximal hooks and bending the distal hooks. In case B, the stent model was crimped to 18 F by: (i) bending the proximal and distal hooks and then compressing the stent main body; (ii) straightening the proximal hooks and bending the distal hooks and then compressing the stent main body. The maximum strain after crimping was used to evaluate the best crimping scenario. Hook straightening produced strains of 10.7% and 10.96% as opposed to 12.6% and 13.0% produced by hook bending. From comparison of results of both cases simulated, it was found that straightening the hooks gave lower strain and thus was the best crimping procedure. The analysis performed in this paper may help understand the critical issue of crimpability of the new stent design. The best crimping scenario can be found based on finite element modeling and simulation. Identifying the best crimping way will also help the design team to optimize the delivery system that will eventually be used to deploy this caval valve stent.

A new commensal ostracod Asterositus ohtsukai n. g., n. sp. (Paradoxostomatidae) on the sea star Sclerasterias euplecta (Fisher) (Asteriidae) and its feeding habits.

A new commensal ostracod Asterositus ohtsukai n. g., n. sp. (Podocopida: Cytheroidea: Paradoxostomatidae) is described. This new taxon occurs on the ambulacral grooves and wreath of pedicellariae around superomarginal spines of the sea star Sclerasterias euplecta (Fisher) (Asteroidea: Forcipulatida: Asteriidae). Although the family Paradoxostomatidae Brady & Norman, 1889 contains four ectoparasitic or commensal genera, the association with asteroideans has never hitherto been reported. Morphological observations suggested that A. ohtsukai n. g., n. sp. is closely associated with the host sea star as it typically has distal hooks on the antenna and fifth to seventh limbs, and specialised mandibula and maxillula structures that are considered adaptations to a commensal life-style. In addition, this study discussed the feeding habits of A. ohtsukai n. g., n. sp. based on comparison with previous works. The extremely reduced palp and endites of maxillula of A. ohtsukai n. g., n. sp. imply that they have unique feeding habits that are not based on the feeding function of maxillula. From morphological comparisons with siphonostomatoid copepods, we suggest that A. ohtsukai n. g., n. sp. may feed on the body of host sea star by injuring them with styliform needle-like mandibular coxa and sucking the tissues, body fluid, or mucus with the suctorial disc on the oral cone.

The Effect of Distal Hooks in Thoracolumbar Fusion Using a Pedicle Screw in Elderly Patients

The Effect of Distal Hooks in Thoracolumbar Fusion Using a Pedicle Screw in Elderly Patients

Three new species of the genus Ripipteryx from Colombia (Orthoptera, Ripipterygidae).

Three new species of Ripipteryx Newman (Orthoptera: Tridactyloidea: Ripipterygidae) are described from Colombia; namely Ripipteryx diegoi sp. n. (Forceps Group) and Ripipteryx guacharoensis sp. n. (Marginipennis Group) from Parque Nacional Natural Cueva de los Guacharos in Huila, and Ripipteryx gorgonaensis sp. n. (Crassicornis Group) from Parque Nacional Natural Gorgona in Cauca. Ripipteryx diegoi sp. n. is characterized by the antennae black with white spots on flagellomeres 3–7, male subgenital plate with median ridge forming a bilobed setose process, epiproct produced laterally near its base and phallic complex with virga thickened distally and not reaching beyond the membrane. Ripipteryx guacharoensis sp. n. is characterized by the antennae thick with white spots present dorsally on flagellomeres 1–4 and 8, epiproct narrow and triangular, uncus reduced and lacking a distal hook, phallic complex with a concave ventral plate and a dorsal elevation in the middle extended to the virga, and the virga itself with two small projections basally. Ripipteryx gorgonaensis sp. n. is characterized by the epiproct with a lateral notch, antennae with a white dorsal spot on flagellomere 1 and flagellomeres 4–7 entirely white. The antennal color pattern of Ripipteryx gorgonaensis sp. n. strongly resembles that of Ripipteryx atra but differs from the latter in the absence of any significant morphological modification of the flagellomeres.

Évaluation d’une modification de la technique d’arthrodèse totale du poignet rhumatoïde selon Mannerfelt. À propos de 19 cas

We studied a technical modification of Mannerfelt's total wrist fusion technique in a series of 19 wrists. A fully intramedullary technique without dorsal carpal fixation was used to protect the extensor tendons. Two intramedullary Rush pins without dorsal staples were used during the arthrodesis procedure. Nineteen rheumatoid arthritis wrists (2 bilateral cases) were reviewed with a mean follow-up of 4.9 years (range 2–10 years). Clinical outcomes were assessed using the VAS pain scale, DASH-score and wrist strength measurements. Wrist fusion was assessed on AP and lateral X-rays of the wrist. The position of the carpal Rush pin entry points and distal hook orientation were also assessed. Pain was 8.9 preoperatively and 1.1 at the last follow-up with 95% patients satisfied. Mean DASH-score was 46.9 points. The pinch strength was 79% and the grip strength was 68% of the contralateral wrist. Carpal height, carpal anterior subluxation and ulnar deviation were stable at the last follow-up. All of the wrists were in straight position and no extensor tendon ruptures were noted. Fusion was complete in all cases within 6 to 12 weeks, except in one case. The technical modification proposed in the current study —intraosseous fixation only— appears to be a good alternative to Mannerfelt's original technique. Every case treated with this modified technique had good functional results and none required pin removal.

Locking Compression Plate Distal Ulna Hook Plate as Alternative Fixation for Fifth Metatarsal Base Fracture

Intramedullary screw fixation has been the most common treatment for fifth metatarsal base fractures. However, screw application will not achieve accurate reduction in fractures with small fragments, osteoporotic bone, or Lawrence zone 1 fractures. Because of the similar anatomic architecture between the distal ulna and the fifth metatarsal base, the purpose of the present study was to assess the results of a locking compression plate distal ulna hook plate in stabilizing displaced zone 1 or 2 fifth metatarsal base fractures. A total of 19 patients with Lawrence zone 1 (n = 12) or 2 (n = 7) fractures of the fifth metatarsal base were treated surgically with a locking compression plate distal ulna hook plate. The patients were evaluated clinically and radiographically, and the functional outcomes were graded using the American Orthopaedic Foot and Ankle Society midfoot scoring system. Radiographic bony union was obtained in all patients, at an average of 7.4 weeks. The mean American Orthopaedic Foot and Ankle Society midfoot score improved from 26 (range 0 to 45) points preoperatively to 94 (range 72 to 100) points at the final follow-up visit. Three patients developed post-traumatic cubometatarsal arthrosis, and 1 patient developed sural nerve neurapraxia. In our experience, the distal ulna hook plate achieved a high rate of bony consolidation and anatomically suitable fixation in zone 1 or 2 fifth metatarsal base fractures. We suggest that the locking compression plate distal ulna hook plate should be considered as an alternative treatment of multifragmentary, osteoporotic, and tuberosity avulsion (zone 1) fifth metatarsal base fractures.

Intra Pulmonary Migration of a Kirschner Wire After Glenohumeral Fixation

A 79-year-old asymptomatic woman underwent arthrodesiswith a double K-wire insertion for a posttraumatic invet-erate right glenohumeral dislocation. After removal of thefirst K-wire, chest X-ray showed intrathoracic migration ofthe foreign body, and the CT scan confirmed the pulmonarypenetration of the device within the right upper lobe withintraparenchymal surrounding hematoma (Fig. 1).Although the vital parameters were substantially within therange, the patient underwent urgent surgery. A combinedapproach was attempted: the K-wire was mobilized fromthe glenoid cavity to resect the distal hook and, at the sametime, a right lateral thoracotomy was performed to removesafely the device deeply slipped into the lung and suture theparenchyma (Fig. 2). The postoperative course wasuneventful, and the patient was discharged on the eighthpostoperative day.Improper uses or positioning of K-wires are widelydescribed in the literature and may expose patients toinsidious but potentially life-threatening complications [1];therefore, regular radiological follow-up may be advisablein patients with foreign body at risk of dislodgement intovital structures.

Seven new species and one new species record of Sabatieria (Nematoda: Comesomatidae) from the continental slope of New Zealand.

Sabatieria is the most abundant nematode genus on the upper continental slope of New Zealand but no Sabatieria species have yet been recorded/described from the region's deep-sea habitats. The present study describes seven new and one known species of this genus from the continental margin of New Zealand. S. bitumen Botelho et al. 2007 was originally described from the South Atlantic Ocean, and is recorded from the first time in the Pacific Ocean. Sabatieria challengerensis sp. n. is characterised by a combination of short cephalic setae, large fovea amphidialis with 3 turns, short arcuate spicules without distal hook, and short tail with cylindrical proximal portion and blunt, rounded distal portion. Sabatieria parapraedatrix sp. n. is characterised by having a slender body, cuticle with striations resulting from fusion of every second lateral row of dots,fovea amphidialis with 2.0-2.5 turns, spicules with distal hook, and short conico-cylindrical tail. Sabatieria bubulba sp. n. is characterised by the presence of a large muscular pharyngeal bulb, secretory-excretory system with large ventral gland at level of intestine and with cuticularised pore opening. Sabatieria exculta sp. n. is characterised by having a slender body, cuticle with faint annulations resulting from fusion of every second or third lateral row of dots, short cephalic setae, a large ventral gland, and long, narrow gubernacular apophyses. Sabatieria balbutiens sp. n. is characterised by having a dorsally-directed mouth opening and assymetrical mouth cavity and spicules with small distal hook. Sabatieria pumila sp. n. is characterised by the combination of short body length, short cephalic setae, spicules with distal hook and short distal lamella, and 8-9 precloacal supplements. Sabatieria bathycopia sp. n. is characterised by having a stout body, short cephalic setae, curved gubernaculum, and spicules with swollen, lightly cuticularised distal tip.

Three new species of the carnivorous snail genus Perrottetia Kobelt, 1905 from Thailand (Pulmonata, Streptaxidae)

Three new species of the streptaxid snail genus Perrottetia are described from north and northeastern Thailand, Perrottetia aquilonaria sp. n., Perrottetia dermapyrrhosa sp. n. and Perrottetia phuphamanensis sp. n. Each species is endemic to a single or a few limestone mountain ranges. The species are characterized by the morphology of their genital organs, as well as by shell characters. Perrottetia aquilonaria sp. n. has a club shaped distal penis and large penial hooks are present and penial papillae cover almost the entire penial hook portion; adjacent areas possess low reticulated folds. Perrottetia dermapyrrhosa sp. n. has a long genital atrium and the penial sheath is about two-thirds of the penis length. Penial hooks are long, scattered and sunken into deep ovate hollows; vaginal hooks are present. Perrottetia phuphamanensis sp. n. has a rounded and protruded shell periphery. The aperture is subcircular, peristome is thick and the second parietal lamella is adjacent to the first parietal lamella; a basal lamella is the smaller than in the other Thai species.

Gonopodial Structures Revisited: Variation in Genital Morphology Within and Across Four Populations of the Western Mosquitofish (Gambusia affinis) in Texas

Abstract We report on gonopodial structures in the western mosquitofish (Gambusia affinis) including forked distal hooks and presence-absence of the elbow and gap. In addition, we present information on gonopodial variation across the Trinity, San Jacinto, and Brazos river drainages in Texas.

LCP distal ulna hook plate as alternative fixation for fifth metatarsal base fracture

Intramedullary screw fixation is the most common treatment for fifth metatarsal base fractures. Screw application does not achieve accurate reduction in fracture with small fragments, osteoporotic bone, or Lawrence zone 1 fractures, however. On the basis of similar anatomical architectures between the distal ulna and the fifth metatarsal base, the purpose of this study was to assess the results of a locking compression plate (LCP) distal ulna hook plate in stabilizing displaced zone 1 or 2 fifth metatarsal base fractures. Nineteen patients with Lawrence zone 1 (n=12) or 2 (n=7) fractures of the fifth metatarsal base were treated surgically with an LCP distal ulna hook plate. The patients were evaluated clinically and radiographically, and functional outcomes were graded by using the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scoring system. Radiographic bony union was obtained in all patients, at an average of 7.4weeks. The mean AOFAS midfoot score improved from 26 (range, 0-45) preoperatively to 94 (range, 72-100) points at the final follow-up. There were three patients with post-traumatic cubometatarsal arthrosis and one patient with sural nerve neuropraxia. In our experience, the distal ulna hook plate achieves a high rate of bony consolidation and anatomically suitable fixation in zone 1 or 2 fifth metatarsal base fractures. We also suggest that the LCP distal ulna hook plate should be considered as an alternative treatment in multifragmentary, osteoporotic, and tuberosity avulsion (zone 1) fifth metatarsal base fractures.

Concomitant high-energy fractures of the distal radius and hook of hamate

Concomitant high-energy fractures of the distal radius and hook of hamate

Two new free-living marine nematode species of Xyalidae (Monhysterida) from the Yellow Sea, China

Two new species of free-living marine nematodes Paramonohystera eurycephalus sp. nov. and Steineria sinica sp. nov. from the Yellow Sea, China are described. Paramonohystera eurycephalus sp. nov. is characterized by relatively wide head diameter (33 μm in width), large cup-shaped buccal cavity; presence of numerous long cervical setae; amphidial fovea 18–20 μm in diameter; spicules slender, arcuate, 3.1–3.2 anal body diameter; gubernaculum tubular with a distal hook; five to six minute precloacal supplements. Steineria sinica sp. nov. is characterized by eight groups of three subcephalic setae at almost same level as cephalic setae; eight groups of two long cervical setae situated between subcephalic setae and amphidial fovea; amphidial fovea round, 35% of corresponding body diameter, about one head diameter from anterior end; spicules slender, cephalate proximally and taper distally; gubernaculum pipe-shaped with dorsocaudal apophysis; tail conico-cylindrical with three long terminal setae.

Transacromial erosion of a locked subacromial hook plate: Case report and review of literature

Consensus on the technique for surgical reduction of highgrade acromioclavicular (AC) joint separations (Tossy III, Rockwood III-V) has remained elusive and controversial for several decades. It has been estimated that 50 to 70 procedures have been described to treat AC joint separations. These range from transarticular Kirschner wires with cerclage to coracoclavicular (CC) screw fixation to a variety of CC cerclage techniques with or without AC wire stabilization and capsule reconstruction. Beginning in the 1980s, reports emerged in the German-language literature of AC plates that were used independently or in combination with AC or CC ligament repair or reconstruction. The Rahmanzadeh plate used a ball-and-socket design in an effort to improve AC mobility. The Wolter plate had a ‘‘C’’-shaped crook, which was positioned inferior to the acromion. The tip of the crook was placed into a hole in the acromion, which was predisposed to widening and made the procedure technically challenging. The Balser plate had a distal hook, which was also positioned beneath the acromion. It most resembles the recently introduced AO AC hook plate, which has become increasingly popular during the last decade. We report a case of hook plate erosion through the acromion. To our knowledge, this is the first description of this complication.