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Biomedical subjects

William Ryan

Publications and source records attributed to William Ryan.

5 recordsLinked to original sources

Tooth movement in the elderly: a case report.

Orthodontic appliances can take advantage of favourable growth in adolescents to achieve treatment goals. However in the elderly where growth potential is modest, tooth movement is still highly feasible and is a useful adjunct to multidisciplinary treatment. Orthodontic treatment of the elderly normally involves limited objectives with goals customised to the patients concerns and functional needs. This case report demonstrates that orthodontic treatment of the elderly is possible and can improve the function and aesthetics of the dentition and thus increase their quality of life.

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SCAR R&D Symposium 2003: comparing the efficacy of 5-MP CRT versus 3-MP LCD in the evaluation of interstitial lung disease.

The efficacy of two medical-grade, self-calibrating, gray scale displays were compared with regard to impact on sensitivity and specificity for the detection of interstitial lung disease (ILD) on computed radiographs (CR). The displays were a 5-megapixel (MP) cathode ray tube (CRT) device and a 3-MP liquid crystal display (LCD). A sample consisting of 230 anteroposterior (AP), posteroanterior (PA), and lateral views of the chest with CT-proven findings characteristic for ILD as well as 80 normal images were compared. This double-blinded trial produced a sample sufficient to detect if the sensitivity of the LCD was 10% or more reduced (one-sided) from the "gold standard" CRT display. Both displays were calibrated to the DICOM gray scale standard and the coefficient of variation of the luminance function varied less than 2% during the study. Five board-certified radiologists specializing in thoracic radiology interpreted the sample on both displays and the intraobserver Az (area under the ROC curve) showed no significant correlation to the display used. In addition, an interobserver kappa analysis showed that the relative disagreement between any observer pair remained relatively constant between displays, and thus was display invariant. This study demonstrated there is no significant change in observer performance sensitivity on 5-MP CRT versus 3-MP LCD displays for CR examinations demonstrating ILD of the chest.

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Folie a deux in bipolar affective disorder: a case report.

BACKGROUND: The syndrome of folie a deux is uncommon and often described in the context of schizophrenia. We report a case of induced delusional disorder associated with bipolar affective disorder (BAD). CASE REPORT: We present a case of monozygotic twins in their late 60s with an unusually close relation with one another and relative isolation from other people. Both twins have been diagnosed as suffering from BAD and relapsed into mania with psychotic symptoms. During their hospital stay they exhibited features consistent with folie a deux. Separation caused disappearance of the phenomenon whilst the affective disorder persisted. CONCLUSION: This case highlights the unusual and rare phenomenon of folie a deux occurring in the context of BAD. It also suggests current difficulty in defining folie a deux as an entity according to current diagnostic criteria.

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Relationship of the common peroneal nerve and its branches to the head and neck of the fibula.

The common peroneal nerve (CPN) lies on the neck of the fibula, which forms the floor of the so-called 'fibular tunnel.' The tunnel entrance is a musculo-aponeurotic arch derived from the soleus and peroneus longus muscles and it is here that the CPN is commonly compressed in cases of peroneal nerve palsy. This study aims to define the relationship of the CPN and its branches to the apex of the head of the fibula and to the tunnel, with special regard to possible sites of entrapment. The distances from the apex of the fibula to the opening of the fibular tunnel, the CPN bifurcation, and the exit point of the deep peroneal nerve (DPN) from the tunnel, were measured in 30 legs to ascertain possible sites of entrapment. The angle that the CPN subtended with the long axis of the fibula was measured to gauge the range of positions of the CPN at the neck of the fibula. An unyielding musculo-aponeurotic fibular arch at the entrance to the fibular tunnel was confirmed in all specimens. The DPN exited through a crescentic opening in the anterior intermuscular septum in all cases and no DPN branches were found in the lateral compartment in any specimen. The mean (+/-SD) distance from the apex of the head of the fibula to the opening of the fibular tunnel was 3.2 +/- 1.0 cm, to the CPN bifurcation was 3.8 +/- 0.9 cm, and to the DPN exit point was 7.0 +/- 1.5 cm. The mean angle subtended anteriorly from the long axis of the fibula by the CPN was 18.9 +/- 9.0 degrees. We recommend further study of the mean distances and reference angle in relation to fibular landmarks, for use in possible minimally invasive surgical procedures to decompress the fibular tunnel.

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Treatment outcome in individuals with chronic pain: is the Pain Stages of Change Questionnaire (PSOCQ) a useful tool?

The efficacy of psychological treatments emphasising a self-management approach to chronic pain has been demonstrated by substantial empirical research. Nevertheless, high drop-out and relapse rates and low or unsuccessful engagement in self-management pain rehabilitation programs have prompted the suggestion that people vary in their readiness to adopt a self-management approach to their pain. The Pain Stages of Change Questionnaire (PSOCQ) was developed to assess a patient's readiness to adopt a self-management approach to their chronic pain. Preliminary evidence has supported the PSOCQ's psychometric properties. The current study was designed to further examine the psychometric properties of the PSOCQ, including its reliability, factorial structure and predictive validity. A total of 107 patients with an average age of 36.2 years (SD=10.63) attending a multi-disciplinary pain management program completed the PSOCQ, the Pain Self-Efficacy Questionnaire (PSEQ) and the West Haven-Yale Multidimensional Pain Inventory (WHYMPI) pre-admission and at discharge from the program. Initial data analysis found inadequate internal consistencies of the precontemplation and action scales of the PSOCQ and a high correlation (r=0.66, P<0.01) between the action and maintenance scales. Principal component analysis supported a two-factor structure: 'Contemplation' and 'Engagement'. Subsequent analyses revealed that the PSEQ was a better predictor of treatment outcome than the PSOCQ scales. Discussion centres upon the utility of the PSOCQ in a clinical pain setting in light of the above findings, and a need for further research.

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