scholarly journals Biomechanical Impact of FHL Tendon Harvest on Forefoot and Great Toe Push-off Strength and Its Correlation to Knot of Henry Crossover Variation

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0003
Author(s):  
Timothy Charlton ◽  
Danielle Thomas ◽  
David Thordarson ◽  
Melodie Metzger ◽  
Trevor Nelson
Keyword(s):  
Repeated Measures ◽  
Plantar Flexion ◽  
Tissue Bank ◽  
Flexor Hallucis Longus ◽  
Type I ◽  
Type Ii ◽  
Great Toe ◽  
Type Iv ◽  
Loading Patterns ◽  
Type V

Category: Midfoot/Forefoot Introduction/Purpose: The flexor hallucis longus (FHL) tendon is commonly used for tendon transfers in reconstructive Achilles tendon procedures. A subset of patients who undergo this procedure complain of first great toe weakness and loss of push off strength after FHL tendon transfer. Despite the frequency of this procedure, there is currently little information available to surgeons to help understand this potential complication. Therefore, the objective of this biomechanical cadaveric study was to quantify plantar flexion strength after FHL harvest and correlate it to variations in anatomy to determine if distinct tendon crossover patterns at the Knot of Henry are more likely to lead to forefoot weakness. Methods: Cadaveric specimens were procured from an approved tissue bank. The proximal end of the tibia was potted and secured to the Mechanical Testing System. A pressure mapping system was used to measure plantar force though the great toe and lesser toes. The Achilles, FHL, and flexor digitorum longus (FDL) tendons were attached to linear actuators for load application. Pressure under the toes was measured with the Achilles alone, Achilles with FHL, Achilles with FDL, and Achilles with both FHL and FDL. The resultant loading patterns were recorded in the greater and lesser toes and compared between the different states. After biomechanical testing, all specimens were carefully dissected and the tendinous slips between the FHL and FDL were documented and classified based on a previously determined system (Types I-V, LaRue; Edama) Functional and anatomical relationship between the classification type and loading patterns were statistically analyzed using repeated measures ANOVA. Results: 23 specimens (13M / 10F) with a mean age of 71 years (range: 54-90) were used in this study. 61% were anatomically classified as type I, followed by type II (26%), IV (9%), and type V (4%), and type III (0%). Simulated FHL harvest in type I specimens resulted in a 29% decrease in great toe flexion pressure and an 21% decrease in total forefoot flexion pressure, p<0.05. In type II feet, FHL harvest led to a greater reduction in flexion pressure in the great toe (34%) and forefoot (25%), p<0.05. Type IV specimens also had a decrease in flexion pressure in both the great toe (21%) and forefoot (15%), p<0.05. Type V specimens trended similar to type I specimens. Conclusion: This study is the first to quantify loss of great toe and lesser toe flexion pressure after FHL harvest. In addition, it is the first to correlate these losses to variations in anatomic crossover patterns at the Knot of Henry. Specimens classified as type II had the greatest reduction in flexion pressure, followed by type I and type IV. This information is clinically important for preoperative discussions about post-surgical expectations and surgical planning.

scholarly journals Distribution of Virulence Genes Among Methicillin-resistant Staphylococcus Aureus of Clinical and Environmental Origin

2020 ◽  
Author(s):  
Deepshikha Bhowmik ◽  
Shiela Chetri ◽  
Bhaskar Jyoti Das ◽  
Debadatta Dhar Chanda ◽  
Amitabha Bhattacharjee
Keyword(s):  
Staphylococcus Aureus ◽  
Multidrug Resistance ◽  
Virulence Genes ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Virulence Gene ◽  
Type I ◽  
Type Ii ◽  
Methicillin Resistant ◽  
Type Iv ◽  
Type V

Abstract Objective: This study was designed to discover the dissemination of virulence genes in Methicillin-resistant Staphylococcus aureus from clinical and environmental settings. Results: The virulence gene such as sea (n=54), seb (n=21), eta (n=27), etb (n=2), cna (n=24), ica (n=2) and tst (n=30) was revealed from this study. Different SCCmec types such as type I, type II, type III, type IV, type V, type VI, type VII, type VIII and type XII were detected among sixty three MRSA isolates where SCCmec type II having ST1551 and type V with ST2416 were found to be associated with multidrug resistance and were highly prevalent in the study area.

Syntheses of Post-Iboga Alkaloids

Synthesis ◽  
2019 ◽  
Vol 51 (14) ◽  
pp. 2737-2758 ◽  
Author(s):  
Hyeonggeun Lim ◽  
Sikwang Seong ◽  
Sunkyu Han
Keyword(s):  
Secondary Metabolites ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Type Iv ◽  
Synthetic Studies ◽  
Type V

Post-iboga alkaloids are secondary metabolites that are biosynthetically derived from iboga-type alkaloids via rearrangements of the indole and/or isoquinuclidine moieties. Herein, we categorize post-iboga alkaloids into five types based on the biosynthetic mode of transformation of the iboga scaffold. We then describe reported syntheses of post-iboga alkaloids, including our laboratory’s recent contributions, based on our own categorization.1 Introduction1.1 Iboga and Post-Iboga Alkaloids1.2 Classification of Post-Iboga Alkaloids1.2.1 Introduction to Type I Post-Iboga Alkaloids1.2.2 Introduction to Type II Post-Iboga Alkaloids1.2.3 Introduction to Type III Post-Iboga Alkaloids1.2.4 Introduction to Type IV Post-Iboga Alkaloids1.2.5 Introduction to Type V Post-Iboga Alkaloids2 Syntheses of Post-Iboga Alkaloids2.1 Syntheses of Type I Post-Iboga Alkaloids2.1.1 Syntheses of Monomeric Type I Post-Iboga Alkaloids2.1.2 Syntheses of Dimeric Type I Post-Iboga Alkaloids2.2 Syntheses of Type II Post-Iboga Alkaloids2.3 Synthetic Studies Toward Type III Post-Iboga Alkaloids2.4 Syntheses of Type IV Post-Iboga Alkaloids2.5 Synthesis of Type V Post-Iboga Alkaloids3 Conclusion and Outlook

scholarly journals Study On The Application of Preoperative Three-Dimensional CT Angiography of Perigastric Arteries In Laparoscopic Radical Gastrectomy

2022 ◽  
Author(s):  
Peng Liu ◽  
Wenbin Yu ◽  
Meng Wei ◽  
Danping Sun ◽  
Xin Zhong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Three Dimensional ◽  
Classification Model ◽  
Type I ◽  
Radical Gastrectomy ◽  
Type Ii ◽  
Type Iii ◽  
Type Iv ◽  
Type V

Abstract Objection: To investigate the clinical value and significance of preoperative three-dimensional computerized tomography angiography (CTA) in laparoscopic radical gastrectomy for gastric cancer.Methods: The clinical data were analyzed retrospectively from 214 gastric cancer patients. We grouped according to whether to perform CTA. The gastric peripheral artery was classified according to CTA images of patients in the CTA group, and we compared and analyzed the difference of the data between the two groups.Results: The celiac trunk was classified according to Adachi classification: Type I (118/125, 94.4%),Type II (3/125, 2.4%),Type III (0/125, 0%),Type IV (1/125, 0.8%),Type V (2/125, 1.6%),Type VI (1/125, 0.8%).Hepatic artery classification was performed according to Hiatt classification standard:Type I (102/125, 81.6％),Type II (9/125, 7.2%),Type III (6/125, 4.8%),Type IV (2/125, 1.6%),Type V (3/125, 2.4%),Type VI (0, 0%),Others (3/125, 2.4%).And this study combined vascular anatomy and clinical surgical risk to establish a new splenic artery classification model. It was found that the operation time and estimated blood loss in the CTA group were significantly lower than those in the non-CTA group. In addition, the blood loss in the CTA group combined with ICG (Indocyanine Green) labeled fluorescence laparoscopy was significantly less than that in the group without ICG labeled. Conclusion: Preoperative CTA can objectively evaluate the vascular course and variation of patients, and then avoid the risk of operation, especially in combination with ICG labeled fluorescence laparoscopy, can further improve the quality of operation.

scholarly journals Clinopyroxene phenocrysts from the Księginki nephelinite (SW Poland)

2015 ◽  
Vol 1 (1-2) ◽  
pp. 1-15
Author(s):  
Marcin Goleń ◽  
Jacek Puziewicz ◽  
Magdalena Matusiak-Małek ◽  
Theodoros Ntaflos
Keyword(s):  
Chemical Composition ◽  
Source Rock ◽  
Significant Influence ◽  
Fractional Crystallisation ◽  
Type I ◽  
Type Ii ◽  
Linear Variation ◽  
Type Iv ◽  
Sw Poland ◽  
Type V

Abstract The Eocene nephelinite from Księginki quarry (SW Poland) contains five types of clinopyroxene phenocrysts varying by texture and chemical composition. Type I phenocrysts are formed of Mg-rich (mg# = 0.93–0.88) homogenous cores, patchy mantle and zoned rims. Abundant type II is less magnesian (mg# = 0.65–0.88) and consists of spongy or spongy-patchy core surrounded by zoned rims, whilst in type III (mg# = 0.69–0.84), the cores are massive but patchy. The mg# of cores of type IV phenocrysts is slightly lower than that of type I (0.79–0.89), but its cores are either massive or patchy. Type V is very scarce and consist of relatively Mg-poor (mg# = 0.75–0.77) core enveloped by nonpatchy, sometimes zoned mantle and zoned outer rim. Chemical composition of type I and type IV cores suggests that they are xenocrysts introduced into the nephelinite from disintegrated peridotite and clinopyroxenitic xenoliths, respectively. Type V is also of xenocrystic nature, but its source rock was significantly more evolved than mantlederived ones. Types II and III are possibly cognates from the host nephelinite or a melt related to the nephelinite. All the types of phenocrysts suffered from disequilibrium with the nephelinitic (or proto-nephelinitic) melt or dissolution during adiabatic uplift. Linear variation in chemical composition of phenocrysts of Księginki nephelinite suggests its evolution because of fractional crystallisation, without significant influence of other differentiation processes.

scholarly journals Association of external nose deformity in individuals with nasal septal deviation

2019 ◽  
Vol 5 (5) ◽  
pp. 1372
Author(s):  
Ravi Kishore Hubballi ◽  
Shruthi Manohar Koujalagi
Keyword(s):  
Nasal Septum ◽  
Type I ◽  
Type Ii ◽  
Medical Sciences ◽  
Deviated Nasal Septum ◽  
Type Iv ◽  
External Nose ◽  
Facial Midline ◽  
Nose Deformity ◽  
Type V

<p class="abstract"><strong>Background:</strong> Deviated nasal septum presents a challenge as often functional problems as well as aesthetic deformities must be addressed. Deviated nasal septum can be a result of varying pathologies and etiologies. Classifying the nasal deviation enables the surgeon to choose the appropriate operative intervention. This study is intended to know the association of external nose deformity in patients with deviated nasal septum.</p><p class="abstract"><strong>Methods:</strong> 100 patients were attending to the Department of ENT, Vijayanagara Institute of Medical Sciences, Ballari with deviated nasal septum, septal dislocation, septal spur and external nose deformity. Deviated nasal septum was classified as per the classification proposed by Mladina. External nose deformity was classified into 5 types proposed by Yong Jo Jang’s classification depending on the orientation of 2 horizontal units (bony pyramid and cartilaginous subunits) with respect to facial midline.  </p><p class="abstract"><strong>Results:</strong> Out of 100 patients with deviated nasal septum, external nose deformity was present in 61% of the patients. Significant association was present between the deviated nasal septum and external nose deformity (p=0.01).</p><p><strong>Conclusions:</strong> Type II (33%) deviated nasal septum was most common followed by Type VII (31%). Among the external nose deformity, Type I was most common followed by Type V. Type II deviated nasal septum was associated most commonly with Type V external nose deformity, Type VII deviated nasal septum with Type I external nose deformity and Type IV deviated nasal septum with Type I/II external nose deformity in equal frequency.</p>

scholarly journals Root canal morphology of South Asian Indian maxillary molar teeth

2015 ◽  
Vol 09 (01) ◽  
pp. 133-144 ◽  
Author(s):  
Shishir Singh ◽  
Mansing Pawar
Keyword(s):  
South Asian ◽  
Root Canal ◽  
Type I ◽  
Type Ii ◽  
Third Molars ◽  
Type Iv ◽  
Maxillary Molars ◽  
Root Canal Morphology ◽  
Type V ◽  
South Asian Indian

ABSTRACT Objective: The objective was to study the root canal morphology of South Asian Indian Maxillary molars using a tooth clearing technique. Materials and Methods: Hundred teeth each comprising of first, second, and third molars collected from different dental schools and clinics in India were subjected to standard dye penetration, decalcification and clearing procedure before being studied. Results: The first molar mesiobuccal roots exhibited 69% Type I, 24% Type II, 4% Type IV, 2% Type V, and 1% exhibited a Vertuccis Type VIII canal anatomy. In the group with three separate roots the second molar mesiobuccal roots in exhibited 80.6% Type I, 15.3% Type II, 2.7% Type IV, and 1.4% Type V canal anatomy while the third molars mesiobuccal roots exhibited 57.4% Type I, 32% Type II, 2.1% Type III, 8.5% Type IV, 1% had a Type V canal anatomy in the similar group. Conclusion: A varied root canal anatomy was seen in the mesiobuccal root canal of the maxillary molars.

A Review and Proposed Classification System for the No-Option Patient With Chronic Limb-Threatening Ischemia

2020 ◽  
pp. 152660282096391
Author(s):  
Tanner I. Kim ◽  
Shant S. Vartanian ◽  
Peter A. Schneider
Keyword(s):  
Treatment Strategies ◽  
Major Amputation ◽  
Occlusive Disease ◽  
Tissue Loss ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Type Iv ◽  
Foot Anatomy ◽  
Type V

A growing, but poorly defined subset of patients with chronic limb-threatening ischemia (CLTI) have “no option” for revascularization. One notable subgroup includes patients with severe ischemia and advanced pedal artery occlusive disease, termed “desert foot,” who are at high risk for major amputation due to a lack of conventional revascularization options. Although new therapies are being developed for no-option patients with desert foot anatomy, this subgroup and the broader group of no-option patients are not well defined, limiting the ability to evaluate outcomes. Based on a systematic review, a classification of the no-option CLTI patient was constructed for use in clinical practice and studies. Several no-option conditions were identified, including type I—severe and pedal occlusive disease (desert foot anatomy) for which there is no accepted method of repair; type II—lack of suitable venous conduit for bypass in the setting of an acceptable target for bypass; type III—extensive tissue loss with exposure of vital structures that renders salvage impossible; type IV—advanced medical comorbidities for which available revascularization options would pose a prohibitive risk; and type V—presence of a nonfunctional limb. While type I and type II patients may have no option for revascularization, type III and type V patients have wounds, infection, comorbidities, or functional status that may leave them with few options for revascularization. As treatment strategies continue to evolve and novel methods of revascularization are developed, the ability to identify no-option patients in a standardized fashion will aid in treatment selection and assessment of outcomes.

scholarly journals Nasal Septal Deviation and Incidental Paranasal Sinus Opacification: A Role of Computed Tomography

2021 ◽  
Vol 28 (1) ◽  
pp. 50-56
Author(s):  
Soo Young Choi ◽  
So Young Jeon ◽  
Hwa Sung Rim ◽  
Sung Wan Kim ◽  
Jin-Young Min
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Septal Deviation ◽  
Type I ◽  
Type Ii ◽  
Nasal Septal Deviation ◽  
Type Iv ◽  
Significant Difference ◽  
Ct Evaluation ◽  
Type V

Background and Objectives: The purpose of this study was to investigate the prevalence of incidental paranasal sinus (PNS) opacification in nasal septal deviation (NSD) using computed tomography (CT) and to identify contributing factors.Subjects and Method: We analyzed 216 patients who underwent septoplasty for the correction of NSD and who underwent preoperative PNS CT. We assessed the prevalence of incidental PNS opacification in these patients and determined the type of NSD according to Mladina classification. We also evaluated whether the direction of NSD affected the presence of PNS opacification on CT, and whether the presence of PNS opacification was associated with other rhinologic symptoms.Results: Of 216 patients with NSD, 86 showed opacified PNS on CT. According to Mladina classification, NSD patients were classified as type I (24.1%), type II (36.1%), type III (20.8%), type IV (5.6%), type V (9.7%), type VI (2.3%), or type VII (1.4%). Patients with type II NSD showed a significantly higher incidence of PNS opacification compared with other types of NSD (p=0.001). However, the direction of NSD did not significantly influence the presence of incidental PNS opacification. Furthermore, regardless of the presence of PNS opacification, there was no significant difference in rhinologic symptoms such as olfactory dysfunction, among others.Conclusion: We found that incidental PNS opacification on CT was common in NSD patients, especially in patients with type II NSD. Thus, we suggest that CT evaluation of patients with NSD may be helpful for assessing comorbid PNS pathologies as well as objectively identifying nasal septal deformities.

Alkali sulfates with aphthitalite-like structures from fumaroles of the Tolbachik volcano, Kamchatka, Russia. III. Solid solutions and exsolutions

2021 ◽  
Vol 59 (4) ◽  
pp. 713-727
Author(s):  
Nadezhda V. Shchipalkina ◽  
Igor V. Pekov ◽  
Sergey N. Britvin ◽  
Natalia N. Koshlyakova ◽  
Evgeny G. Sidorov
Keyword(s):  
Crystal Structures ◽  
Parent Phase ◽  
Structure Type ◽  
Cation Ordering ◽  
Type I ◽  
Type Ii ◽  
Hexagonal Close Packed ◽  
Type Iv ◽  
Tolbachik Volcano ◽  
Type V

ABSTRACT Six different exsolution types are found in crystals of aphthitalite-group alkali sulfates from exhalations of the active Arsenatnaya fumarole, Tolbachik volcano, Kamchatka, Russia. The coexisting minerals in these exsolutions are metathénardite, ideally Na2SO4 (P63/mmc), and vanthoffite, Na6Mg(SO4)4 (P21/c) (Type I); metathénardite and belomarinaite, KNaSO4 (P3m1) (Type II); thénardite, Na2SO4 (Fddd), and aphthitalite, K3Na(SO4)2 (Pm1) (Type III); aphthitalite and arcanite, K2SO4 (Pnma) (Type IV); metathénardite and natroaphthitalite, KNa3(SO4)2 (Pm1) (Type V); and two chemical varieties of metathénardite (Type VI). The exsolution processes occur in crystals belonging to the high-temperature, hexagonal Na2SO4(I) (= metathénardite, P63/mmc) structure type with different K:Na ratios formed at temperatures higher than 500 °C. The similarity and hexagonal close-packed nature of the crystal structures of the coexisting phases, all representatives of aphthitalite-like structure types, cause the coherent conjugation of domains during diffusion and cation ordering in the parent phase. The breakdown of solid solution can be facilitated by the mosaic character of crystals of a parent phase (incoherent grain boundaries) and the presence of coherent twin boundaries. The heating of samples with exsolution Types II and V up to 700 °C over 24 h shows that diffusion of K and Na through the domain borders does not result in the complete disorder of these cations and the extinction of domains with different crystal structures.

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