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Biomedical subjects

J S Shapiro

Publications and source records attributed to J S Shapiro.

14 recordsLinked to original sources
PubMed1996

The wrist in rheumatoid arthritis.

In the rheumatoid wrist, cartilage loss, synovial expansion with erosive disease and ligamentous laxity, result in loss of carpal height and stability and development in varying amounts of ulnar/palmar translocation and supination of the carpus on the distal forearm. This results in a painful wrist which influences deformity development distally. The aims of surgery are relief of pain and adequate stability while retaining as much motion as possible consistent with the degree of destruction present. A variety of procedures from soft-tissue reconstruction to total arthrodesis are available to achieve these aims.

Arthritis, Rheumatoid↗
PubMed1992

Relationship of squamosal suture to asterion in pongids (Pan): relevance to early hominid brain evolution.

Based on 244 measurements of the relationship of the squamosal suture to the landmark asterion in 49 chimpanzee skulls, it is shown that in the normal lateral view the squamosal suture is very rarely inferior to asterion. In hominid crania, the squamosal suture is always well superior to asterion. Even in Pan, that part of the squamosal suture most homologous with the remnant found on the Hadar AL 162-28 Australopithecus afarensis hominid cranial fragment is very rarely inferior to asterion. Such variability suggests that Falk's (Nature 313:45-47, 1985) orientation of the Hadar specimen is incorrect; she places asterion superior to the position of the squamosal suture if projected endocranially. The implication for the brain endocast is that, however the fragment is oriented, the posterior aspect of the intraparietal (IP) sulcus is in a very posterior position relative to any chimpanzee brain. The distance from the posterior aspect of IP to occipital pole is twice as great in chimpanzee brain casts than on the Hadar AL 162-28 endocast, even though the chimpanzee brain casts are smaller in overall size. This suggests that brain reorganization, at least as exemplified as a reduction in primary visual striate cortex (area 17 of Brodmann), occurred early in hominid evolution, prior to any major brain expansion.

Animals↗
PubMed1987

Breast cancer presenting as periostitis.

A previously healthy 69-year-old woman presented with progressive and unremitting distal leg pain that was confirmed by biopsy to be periostitis. Ten months after the onset of symptoms, carcinoma of the breast was diagnosed. Surgical removal of the neoplasm was followed by complete relief of leg pain within 24 hours. Hypertrophic osteoarthropathy must be considered in adult patients presenting with unexplained joint or distal extremity symptoms, and a vigilant search for underlying malignancy should be undertaken.

Aged↗
PubMed1987

Power staple fixation in hand and wrist surgery: new applications of an old fixation device.

After laboratory testing power driven staples were used in metaphyseal type bone 39 times from December 1983 through April 1985 in 33 patients with hand or wrist problems. Applications included arthrodeses, nonunions, and osteotomy fixation. Diagnoses included rheumatoid and degenerative arthritis, scaphoid, and interphalangeal nonunions. There were no infections, and only one staple has broken. There has been little evidence of loosening or inflammation. Shattering of bone has not occurred; osteoporotic bone appears to be ideal tissue in which to use this fixation.

Hand↗
PubMed1982

Wrist involvement in rheumatoid swan-neck deformity.

Two observations have led to the consideration of another possible factor in the etiology of rheumatoid swan-neck deformity. Distraction of the rheumatoid wrist with correctable carpal collapse and reversible swan-neck deformities resulted in easier initiation of proximal interphalangeal joint flexion, not found in hands with boutonniere deformity or lack of deformity. Review of x-rays of rheumatoid patients with swan-neck deformity indicates that most have evidence of carpal collapse. With carpal collapse and proximal migration of the carpal-hand unit, long or extrinsic motor systems are no longer working at physiological length or optimal efficiency. An imbalance is created, resulting, in effect, in an "extrinsic-minus" phenomena and swan-neck finger deformity.

Adult↗
PubMed1978

Benign intracranial hypertension.

Although antecedent factors are occasionally implication, most cases of benign intracranial hypertension are idiopathic and occur in young adult women who otherwise appear healthy. The natural course is usually one of spontaneous recovery, although medical intervention may accelerate improvement. Computerized tomographic scanning is the procedure of choice for excluding more ominous conditions, such as brain tumors. The most serious complication of this syndrome is visual loss and in these patients the disease is not "benign."

Adult↗
PubMedDate not supplied

Sarcoidosis: current concepts and case reports.

Sarcoidosis is a systemic granulomatous disease of unknown etiology associated with various immune alterations and biochemical changes. This article reports recent advances in the conceptualization of the immune dysfunction with emphasis on helper T-cell overactivity in the lungs. Because 90 percent of patients with sarcoidosis have intrathoracic disease, the mode of presentation, radiographic findings, clinical course, and treatment of pulmonary involvement are discussed. Case reports are used to demonstrate the typical course of the disease and generally favorable outcome of the vast majority of patients seen in the non-referral setting. A rare case of neurosarcoidosis with neuroendocrine features is presented.

Adult↗