Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.25.1 (proteasome)
 28,817 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

PIP joints, MCP joints and wrists of 80 patients with rheumatoid arthritis were operated on with late synovectomy. The rate of recurrence of local synovitis was about 5%, which contrasted favourably with a considerably higher rate of progression of bony erosions. The loss of range of movement was small to moderate. Pain was alleviated in most cases. The possibility of forecasting the results by preoperative parameters was limited. It was concluded that the main indication for late synovectomy of the hand was alleviation of pain. The prophylactic effect on joint destruction seemed to be both slight and unpredictable.
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PMID:Late synovectomy of the hand in rheumatoid arthritis. 98 95

Eighty-two patients subjected to late synovectomy of the hand were followed up. Late synovectomy was defined as an operation performed after at least 3 years' duration of local synovitis in the type of joint operated on. The minimum follow-up period was 24 months for the fingers joints (IP + PIP and MCP) and 18 months for the dorsal aspect of the wrist (W). The multifocal swelling of joints, preoperatively, was symmetrical in 89% of the patients. The X-ray changes, however, were symmetrical in only 22%, 27%, and 68% for IP + PIP, MCP, and W, respectively. These findings may preclude the use of controlled studies on early synovectomy using the non-operated hand as a control in a long-term assessment of X-ray progression. The rate of X-ray progression during the observation period was 60% for IP + PIP joints. The corresponding figures for MCP and W were 64% and 39%, respectively. Absence of bony lesions prior to synovectomy was favourable sign.
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PMID:X-ray changes in connection with late synovectomy of the hand in rheumatoid arthritis. 113 14

The major goal of this investigation was to collect statistically-based anthropometry describing the kinematics of the human hand and to model this anthropometry as a function of external hand measurements, so that it may be predicted noninvasively. Joint centres were anatomically estimated as the centre of curvature of the head of the bone proximal to the given joint. Joint centres determined using Reuleaux's method for PIP and DIP were within 1.4 mm of this anatomical estimate. Models using bone length as the independent variable explain more than 97% of the variability in the anatomically estimated joint centre position along the mid-line of the bone. Models for estimating the lengths of the kinematic segments using external hand length as the independent variable account for between 49 and 99% of the variability in segment length. Models for estimating the axial location of the finger MCP and thumb CMC joints with respect to the distal wrist crease using external hand length as the independent variable account for between 82 and 96% of the variability in these locations. Models for estimating the radio-ulnar location of the finger MCP and thumb CMC joints with respect to the long axis of the third metacarpal using external hand breadth as the independent variable account for between 30 and 74% of the variability in these locations.
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PMID:Anthropometric data for describing the kinematics of the human hand. 157 36

A kinematic model has been developed for simulation and prediction of the prehensile capabilities of the human hand. The kinematic skeleton of the hand is characterized by ideal joints and simple segments. Finger-joint angulation is characterized by yaw (abduction-adduction), pitch (flexion-extension) and roll (axial rotation) angles. The model is based on an algorithm that determines contact between two ellipsoids, which are used to approximate the geometry of the cutaneous surface of the hand segments. The model predicts the hand posture (joint angles) for power grasp of ellipsoidal objects by 'wrapping' the fingers around the object. Algorithms for two grip types are included: (1) a transverse volar grasp, which has the thumb abducted for added power; and (2) a diagonal volar grasp, which has the thumb adducted for an element of precision. Coefficients for estimating anthropometric parameters from hand length and breadth are incorporated in the model. Graphics procedures are included for visual display of the model. In an effort to validate the predictive capabilities of the model, joint angles were measured on six subjects grasping circular cylinders of various diameters and these measured joint angles were compared with angles predicted by the model. Sensitivity of the model to the various input parameters was also determined. On an average, the model predicted joint flexion angles that were 5.3% or 2.8 degrees +/- 12.2 degrees larger than the measured angles. Good agreement was found for the MCP and PIP joints, but results for DIP were more variable because of its dependence on the predictions for the proximal joints.
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PMID:A kinematic model of the human hand to evaluate its prehensile capabilities. 173 91

In summary, patients with multiple hereditary exostosis often inherit hand involvement but rarely show hand deformity. The principal area of involvement appears to be around the MCP joint but the PIP joint is the most common area of deformity. Metacarpal shortening usually does not cause functional problems and need not be treated. Angular deformity, though rare, does cause problems and needs surgical treatment. Unfortunately, there is no evidence that prevention of deformity is possible by early excision of osteochondromas. Treatment, therefore, requires both osteochondroma excision and closing-wedge corrective osteotomy.
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PMID:Hand involvement in multiple hereditary exostosis. 226 78

It would appear to us that the patients with rheumatoid arthritis (RA), in whom articular bone lesions were confined to the wrist and/or carpal joints in X-ray films, may follow a milder disease activity than do the patients with the hand and finger joint lesions. To clarify it, the present study was performed retrospectively. RA patients showing stage II or more lesions in the wrists and/or carpal joints but no lesions over stage II in any hand and finger joint (MCP, IP and PIP) radiologically after 5 years or more duration were regarded as the carpal type (C type). The clinical and laboratory data were compared between 44 patients of the C type RA and 44 patients of other type RA, matched in the sex, age and disease duration. Significant differences were observed in the following parameters between the 2 groups; the functional class, Lansbury's activity index, number of the affected joints, ESR, CRP and hemoglobin values, and ADL scores. That is, Hb values and ADL scores were higher, but the others were lower, in the C type RA group than in other type RA group. The positive percentage and titer of rheumatoid factor were not significantly different between the 2 groups. It was concluded that C type RA patients are milder in the activity and fewer in the number of affected joints than other type RA patients. Furthermore it was suggested that C type RA patients may have milder clinical course and better prognosis than other type RA patients.
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PMID:[Evaluation of disease activity by hand X-ray findings in rheumatoid arthritis]. 277 54

The radiographic diagnosis of rheumatoid arthritis can be suggested long before bone and joint destruction. Soft tissue swelling at the ulnar styloid is classical, but soft tissue swelling also occurs at the PIP and MCP joints. Joint space widening, loss of the lateral fat planes of the wrist, and radial carpal narrowing can all be seen prior to bony change. The earliest bony change is loss of the cortical white line on the radial aspect of the fourth and fifth metacarpal heads.
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PMID:Early changes of rheumatoid arthritis in the hand and wrist. 305 Oct 92

Although MCP joint dislocations are much less common than PIP dislocations, they present a unique set of problems. MCP dislocations usually require open reduction. The obstructions to reduction include the volar plate, interposed ligaments, and the finger-trap effect of intrinsics and flexor tendons. The key to management of such injuries is proper identification of the dislocation type, use of open reduction where necessary, and an aggressive postinjury rehabilitation program. Complications of these injuries do occur, and they must be identified and managed properly.
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PMID:Metacarpophalangeal dislocations. 327 78

Although any fracture of the proximal phalanx can potentially disrupt finger MCP and/or PIP motion, appropriate consideration based on sound principles of biomechanics and biology of healing will delineate the options available. Applying the risk/benefit associated with any particular mode of treatment is more challenging. Perhaps the most difficult thing is to anticipate and recognize failure of a treatment mode sufficiently early and then to act concisely to rectify the situation. The physician and patient must recognize what goal is realistic for each patient's injury. This encompasses the patient factors as outlined, as well as a clear awareness in the surgeon's mind of his or her technical limitations and expertise. Final function and range of motion of the MCP and PIP joints will depend not only on bony union in good position, but on restoration of the gliding function of the flexor and extensor tendons that are contiguous to the fracture site.
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PMID:Troublesome shaft fractures of the proximal phalanx. Early treatment to avoid late problems at the metacarpophalangeal and proximal phalangeal joints. 334 86

Fifteen patients with classical rheumatoid arthritis were evaluated prospectively on 3 occasions to determine if any additional data could be obtained by joint scintigraphy which was not found by physical examination. Clinical and scan examinations were performed simultaneously and the scans were interpreted qualitatively by a radiologist without knowledge of the clinical findings. Simultaneous evaluations of 86 shoulder, elbow, knee, ankle, 84 wrist, 420 MCP and PIP, and 430 MTP joints were recorded. Concordance was noted in 67% of the evaluations and this was significant for the MCP, PIP, elbow, shoulder, knee, MTP, ankle, but not wrist joints. In 10% of instances the clinical examination was positive when the joint scan was negative. On average, the scan was positive 23% of the time (range 5-44%), when the clinical findings were normal. However, most of these scan abnormalities were due to minimal radionuclide uptake. The scan was most useful in the detection of MTP and ankle abnormalities which had been scored clinically negative, suggesting that greater attention be devoted to the clinical examination of the RA foot by the rheumatologist.
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PMID:A prospective study comparing the clinical examination of peripheral joints with radionuclide scintigraphy in patients with rheumatoid arthritis. 359 61


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