scholarly journals Pes Cavovarus in Charcot-Marie-Tooth Compared to the Idiopathic Cavovarus Foot: A Preliminary Weightbearing CT Analysis

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0010
Author(s):  
Alessio Bernasconi ◽  
Lucy Cooper ◽  
Shirley Lyle ◽  
Shelain Patel ◽  
Nicholas Cullen ◽  
...  
Keyword(s):  
Pearson Correlation ◽  
Three Dimensional ◽  
Varus Deformity ◽  
Neutral Position ◽  
Hindfoot Alignment ◽  
Mean Values ◽  
Charcot Marie Tooth ◽  
Charcot Marie Tooth Disease ◽  
Bonferroni Test ◽  
The Mean

Category: Ankle, Hindfoot Introduction/Purpose: Charcot-Marie-Tooth disease (CMT) is an inherited sensory motor peripheral neuropathy progressively leading to cavovarus deformity of the foot. Conversely, the idiopathic cavovarus foot represents a non-neurological condition, with a spectrum from subtle to markedly deformed. Our aim was to investigate morphological differences between CMT pes cavovarus (CMT-PC), idiopathic pes cavovarus (I-PC) and normally aligned feet using three-dimensional (3D) cone beam weightbearing computed tomography (WBCT) measurements. We hypothesised that the hindfoot alignment was significantly different between the three groups. Methods: Retrospectively, we compared 17 CMT-PC (15 patients) with 24 I-PC and 24 clinically normally aligned feet. Patients were comparable by age, sex and body mass index. All WBCTs were performed during routine investigation. Exclusion criteria included previous ipsilateral foot/ankle surgery and inability to heel weightbear. Three measurements were made by one orthopaedic surgeon: foot and ankle offset (FAO), a three-dimensional calculation describing the relationship between the centre of gravity of the tripod of the foot and the centre of the ankle; calcaneal offset (CO), measuring the distance between a theoretically neutral position of the calcaneus and its true position; and hindfoot angle (HA), an estimative of coronal angular hindfoot alignment. These measurements were all repeated twice for intraobsever reliability calculation (Pearson correlation). The mean values were compared using one-way ANOVA (values normally distributed after Shapiro-Wilk test) with the Bonferroni test. Results: Intraobserver reliability was excellent for all the three measurements (r=0.98 for FAO, CO and HA). Mean FAO value ± standard deviation in CMT-PC group (-14.1% ± 7.2) and in I-PC group (-9.6% ± 5.2) both differed from normal feet (1.6% ± 3.3) (p< .001). Of note, a difference was found between mean FAO in CMT-PC and I-PC feet (p .025). Furthermore, the mean CO (- 23.6 mm ± 11.3 in CMT-PC, -16.7 mm ± 8.2 in I-PC and 3.1 mm ± 6 in normal feet) and the mean HA (-44.9° ± 21.7 in CMT-PC; - 30.3° ± 16.9 in I-PC; 5.1° ± 10.1 in normal feet) significantly differed in three groups (p< .001) and specifically between CMT-PC and I-PC feet (p .032 and p .02 for CO and HA, respectively). Conclusion: This study confirms our hypothesis. Hindfoot alignment in patients diagnosed with CMT cavovarus and idiopathic cavovarus feet significantly differed between them and from normal controls, with a more accentuated varus deformity in CMT patients. This probably reflects the presence of a known neuromuscular imbalance driving the deformity over time in CMT feet. We therefore propose using a reliable method of quantifying heel varus and seeking a potential neurological diagnosis in the more severe.

scholarly journals TL 18092 - Hindfoot alignment of adult acquired flatfoot deformity

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 76S
Author(s):  
Alexandre Leme Godoy-Santos ◽  
Cesar Cesar Netto ◽  
Lauren Roberts ◽  
Francois Lintz ◽  
Lew C Schon ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Cone Beam Ct ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Hindfoot Alignment ◽  
Mean Values ◽  
Alignment Angle ◽  
Adult Acquired Flatfoot Deformity ◽  
The Mean ◽  
Calcaneal Tuberosity

Introduction: Clinical assessment of hindfoot alignment (HA) in adult acquired flatfoot deformity (AAFD) can be challenging, and the weightbearing (WB) cone beam CT (CBCT) may potentially better demonstrate this three-dimensional (3D) deformity. Objective: To compare clinical and WB CBCT assessments of HA in patients with AAFD. Methods: In this prospective study, we included 12 men and 8 women (mean age: 52.2 years, range: 20-88) with flexible AAFD. All subjects also underwent WB CBCT and clinical assessment of hindfoot alignment. Three fellowship-trained foot and ankle surgeons performed six hindfoot alignment measurements on the CT images. Intra- and Inter-observer reliabilities were calculated using Intraclass correlation (ICC). Measurements were compared by paired T-tests, and p-values less than .05 were considered significant. Results: The mean of clinically measured hindfoot valgus was 15.2 (95% confidence interval [CI]: 11.5 - 18.8) degrees. It was significantly different from the mean values of all WB CBCT measurements: Clinical Hindfoot Alignment Angle, 9.9 (CI: 8.9 - 11.1) degrees; Achilles tendon/Calcaneal Tuberosity Angle, 3.2 (CI: 1.3 - 5.0) degrees); Tibial axis/Calcaneal Tuberosity Angle, 6.1 (CI: 4.3 - 7.8) degrees; Tibial axis/Subtalar Joint Angle, 7.0 (CI: 5.3 - 8.8) degrees, and Hindfoot Alignment Angle, 22.8 (CI: 20.4 - 25.3) degrees. We found overall substantial to almost perfect intra- (ICC range: 0.87-0.97) and interobserver agreement (ICC range: 0.51-0.88) for all WB CBCT measurements. Conclusion: Using 3D WB CBCT can help characterize the valgus hindfoot alignment in patients with AAFD. The different CT measurements were reliable and repeatable, significantly differing from the clinical evaluation of hindfoot valgus alignment.

scholarly journals Lateral Antebrachial Cutaneous Nerve as a Donor Source for Digital Nerve Grafting: A Concept Revisited

2017 ◽  
Vol 11 (1) ◽  
pp. 1041-1048 ◽  
Author(s):  
Mehmet Bekir Unal ◽  
Kemal Gokkus ◽  
Evrim Sirin ◽  
Eren Cansü
Keyword(s):  
Pearson Correlation ◽  
Mean Value ◽  
Cutaneous Nerve ◽  
Digital Nerve ◽  
Mean Values ◽  
Nerve Grafts ◽  
The Mean ◽  
The Difference ◽  
Mean Time

Objective: The main objective of this study is to evaluate the availability of lateral antebrachial cutaneous nerve (LACN) autograft for acute or delayed repair of segmented digital nerve injuries. Patients and Methods: 13 digital nerve defects of 11 patients; treated with interposition of LACN graft that harvested from ipsilateral extremity were included in the study. Mean follow up period was 35, 7 months. The mean time from injury to grafting is 53, 3 days. The results of the mean 2PDT and SWMT values of injured /uninjured finger at the end of follow up period were evaluated with Paired T test. The correlation between the defect length and the difference of 2PDT, SWMT values between the uninjured and injured finger at the end of follow up period; were evaluated with Pearson - correlation analysis. Results: The mean value of our 2PDT and SWMT results are ~5,923, ~3, 52, respectively in which can be interpreted between the normal and diminished light touch. The defect length and difference percentage of SWMT values is positively and significantly correlated statistically. Mean length of interposed nerve grafts was 18.5 mm. The age of the patient and the mean values of 2PDT and SWMT with the difference % of 2PDT and % of SWMT are not statistically correlated. Conclusion: Based on results regarding sensory regaining at recipient side and negligible sensory deficit at harvesting side, we suggest that lateral antebrachial cutaneous nerve might be a valuable graft option for digital nerve defects.

scholarly journals pH of exudate test in the physiological quality of crambe seeds

2016 ◽  
Vol 46 (6) ◽  
pp. 1014-1018 ◽  
Author(s):  
Charline Zaratin Alves ◽  
Lennis Afraire Rodrigues ◽  
Carlos Henrique Queiroz Rego ◽  
Josué Bispo da Silva
Keyword(s):  
Pearson Correlation ◽  
Raw Material ◽  
Mean Values ◽  
Tukey Test ◽  
Physiological Quality ◽  
The Subject ◽  
The Mean ◽  
C 30

ABSTRACT: Crambe is a rapeseed with high oil content and can be used as a winter cover or as a source of raw material for the production of biodiesel, however espite the growing interest in the culture, research on the subject is still incipient, especially concerning the seed production and analysis technology. The purpose of this study is to evaluate the physiological quality of crambe seeds, 'FMS Brilhante' cultivar, by testing the pH of exudate. Five seed lots were submitted to the determination of water content and the tests of germination and vigor (first count, emergence and tetrazolium). In the conduction of pH exudate test, temperatures (25 and 30oC), and periods of seed imbibition in water (15, 30 and 45 minutes) were tested. The experiment was conducted in a completely randomized manner, with four replicates, and the mean values were compared by the Tukey test at 5% probability; Pearson correlation between the pH of the exudate and initial tests was also made. Testing the pH of exudate is promising for separating lots of crambe seeds and the following combinations of 25°C/30 minutes or 30°C/45 minutes can be used.

scholarly journals The correlation between the three-dimensional radiolucency area around the crown of impacted maxillary canines and dentigerous cysts

2020 ◽  
Vol 49 (4) ◽  
pp. 20190402
Author(s):  
Junliang Chen ◽  
Dongmei Lv ◽  
MingXia Li ◽  
Wei Zhao ◽  
Yun He
Keyword(s):  
Cone Beam Ct ◽  
Dentigerous Cyst ◽  
Three Dimensional ◽  
Cone Beam ◽  
Hard Tissue ◽  
Mean Values ◽  
Dentigerous Cysts ◽  
Impacted Canine ◽  
The Mean ◽  
Surgical Operations

This study aimed to reveal the correlation between the radiolucency area around the crown of impacted maxillary canines and dentigerous cysts using cone beam CT (CBCT). CBCT data were obtained from patients with impacted maxillary canines. Three points of five areas (tooth cusp area and buccal, lingual, mesial and distal areas of the crown) were randomly selected, and the distance between the point and the surrounding hard tissue was measured respectively. The mean values were recorded as the radiolucency area. These results were compared with the occurrence of dentigerous cysts during surgery. 58 patients with 76 impacted maxillary canines were included. 14 of the 76 impacted canines were accompanied by cysts (18.42%). With the increase in the thickness of the radiolucency area, the incidence of cysts was significantly increased (p < 0.05). No cysts were found in the compacted canines with 0–1 mm thickness of the radiolucency area. The highest incidence (71.43%) was observed in canines with 3–4 mm thickness of the radiolucency area. This study found that the thickness of the radiolucency area around the crown of the maxillary impacted canine was closely related to the occurrence of dentigerous cysts. CBCT can be used to estimate the occurrence possibility of dentigerous cyst and guide surgical operations.

Segmental Femoral Ostectomy for the Reconstruction of Femoropatellar Joint in Dogs with Grade IV Medial Patellar Luxation

2020 ◽  
Vol 33 (04) ◽  
pp. 287-293
Author(s):  
Yukari Nagahiro ◽  
Sawako Murakami ◽  
Keiji Kamijo ◽  
Masakazu Shimada ◽  
Nobuo Kanno ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Muscle Length ◽  
Varus Deformity ◽  
Treatment Method ◽  
Quadriceps Muscle ◽  
Radiographic Findings ◽  
Femoral Length ◽  
Surgical Methods ◽  
The Mean ◽  
Resected Femoral

Abstract Objective The aim of this study was to describe a new surgical method of segmental femoral ostectomy for the reconstruction of the femoropatellar joint (FPJ) in dogs with medial patellar luxation (MPL) grade IV. Study Design The medical records of six dogs that underwent segmental femoral ostectomy to reconstruct the FPJ for MPL grade IV were retrospectively reviewed. The data included breed, age, body weight, comorbidities, history of orthopaedic abnormalities, pre- and postoperative radiographic findings, morphological indicators measured on three-dimensional computed tomographic multiplanar reconstruction images, surgical methods and postoperative complications. Outcomes Eleven hindlimbs with MPL grade IV in six dogs underwent segmental femoral ostectomy to reconstruct the FPJ with the four basic surgical procedures. Six stifle joints with femoral varus deformity were treated by closing wedge ostectomy and segmental ostectomy, while five stifle joints were treated by segmental ostectomy alone. The mean resected femoral length was 11.7 mm. The mean resected femoral length relative to the preoperative femoral length was 14.3%. The stability and congruity of the FPJ was markedly improved, with an increased range of motion in all dogs compared with their preoperative status. Conclusion Segmental femoral ostectomy was a useful treatment method for MPL grade IV with shortened quadriceps muscle length relative to the femoral length. Reconstruction of the FPJ is important for recovery of limb function.

Biomechanical effects of sensorimotor orthoses in adults with Charcot–Marie–Tooth disease

2015 ◽  
Vol 40 (4) ◽  
pp. 436-446 ◽  
Author(s):  
Caleb Wegener ◽  
Katrin Wegener ◽  
Richard Smith ◽  
Karl-Heinz Schott ◽  
Joshua Burns
Keyword(s):  
Lower Limb ◽  
Repeated Measures ◽  
Three Dimensional ◽  
Walking Ability ◽  
Charcot Marie Tooth ◽  
Charcot Marie Tooth Disease ◽  
Inherited Neuropathy ◽  
Custom Made ◽  
Patient Reported ◽  
Tooth Disease

Background: Charcot–Marie–Tooth disease is an inherited neuropathy causing progressive weakness, foot deformity and difficulty walking. Clinical anecdotes suggest orthoses designed on the ‘sensorimotor’ paradigm are beneficial for improving gait in Charcot–Marie–Tooth disease. Objectives: Investigate the effect of sensorimotor orthoses on in-shoe and lower limb biomechanics in adults with Charcot–Marie–Tooth disease. Study design: Randomised, repeated-measures, exploratory study. Methods: Eight males and two females with Charcot–Marie–Tooth disease aged 31–68 years fitted with pedorthic shoes and custom-made sensorimotor orthoses were randomly tested at baseline and after 4 weeks of adaptation. In-shoe three-dimensional multi-segment foot and lower limb kinematics and kinetics were collected as were plantar pressures, electromyography and self-reported comfort, stability, cushioning and preference. Results: Compared to the shoe only condition, sensorimotor orthoses increased midfoot eversion and plantarflexion, increased ankle eversion and produced small but significant changes at the knee and hip indicating increased internal rotation. The orthoses increased medial ground reaction forces and increased pressure at the heel, midfoot and toes. There were minimal effects on electromyography. The sensorimotor orthoses were rated higher for comfort, cushioning, stability and preference. Conclusion: Sensorimotor orthoses produced changes in kinematic, kinetic and pressure variables in adults with Charcot–Marie–Tooth disease and were regarded as more comfortable, cushioned and stable during walking. Clinical relevance In this study, the walking ability of patients with Charcot–Marie–Tooth disease improved with the use of foot orthoses designed according to the sensorimotor paradigm. However, the mechanism of action appears to be primarily mechanical in origin. Randomised controlled trials are necessary to evaluate the long-term patient-reported outcomes of sensorimotor orthoses.

scholarly journals Vectors of subsurface stormflow in a layered hillslope during runoff initiation

2006 ◽  
Vol 10 (3) ◽  
pp. 309-320 ◽  
Author(s):  
M. Retter ◽  
P. Kienzler ◽  
P. F. Germann
Keyword(s):  
Three Dimensional ◽  
Volume Flux ◽  
Wetting Front ◽  
Experimental Assessment ◽  
Mean Values ◽  
Top Soil ◽  
Wave Guides ◽  
The Mean ◽  
Vector Approach

Abstract. The focus is the experimental assessment of in-situ flow vectors in a hillslope soil. We selected a 100 m2 trenched hillslope study site. During prescribed sprinkling an obliquely installed TDR wave-guide provides for the velocity of the wetting front in its direction. A triplet of wave-guides mounted along the sides of an hypothetical tetrahedron, with its peak pointing down, produces a three-dimensional vector of the wetting front. The method is based on the passing of wetting fronts. We analysed 34 vectors along the hillslope at distributed locations and at soil depths from 11 cm (representing top soil) to 40 cm (close to bedrock interface). The mean values resulted as follows vx=16.1 mm min-1, vy=-0.2 mm min-1, and vz=11.9 mm min-1. The velocity vectors of the wetting fronts were generally gravity dominated and downslope orientated. Downslope direction (x-axis) dominated close to bedrock, whereas no preference between vertical and downslope direction was found in vectors close to the surface. The velocities along the contours (y-axis) varied widely. The Kruskal-Wallis tests indicated that the different upslope sprinkling areas had no influence on the orientation of the vectors. Vectors of volume flux density were also calculated for each triplet. The lateral velocities of the vector approach are compared with subsurface stromflow collected at the downhill end of the slope. Velocities were 25-140 times slower than lateral saturated tracer movements on top of the bedrock. Beside other points, we conclude that this method is restricted to non-complex substrate (skeleton or portion of big stones).

scholarly journals Evaluation of three-dimensional acromiohumeral distance in the standing position and comparison with its conventional measuring methods

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuki Yoshida ◽  
Noboru Matsumura ◽  
Yoshitake Yamada ◽  
Minoru Yamada ◽  
Yoichi Yokoyama ◽  
...  
Keyword(s):  
Supine Position ◽  
Humeral Head ◽  
Three Dimensional ◽  
Standing Position ◽  
Ct Scanner ◽  
Mean Values ◽  
Measuring Methods ◽  
The Mean ◽  
Acromiohumeral Distance ◽  
2D And 3D

Abstract Background Narrowing of the acromiohumeral distance (AHD) implies a rotator cuff tear. However, conventional AHD measurements using two-dimensional (2D) imaging or with the patient in the supine position might differ from that while standing during daily activity. This study aimed to evaluate the three-dimensional (3D) actual distance between the acromion and humeral head in the standing position and compare the AHD values with those obtained using conventional measuring methods. Methods Computed tomography (CT) images of 166 shoulders from 83 healthy volunteers (31 male and 52 female; mean age 40.1 ± 5.8 years; age range, 30–49 years) were prospectively acquired in the supine and standing positions using conventional and upright CT scanners, respectively. The minimum distance between the acromion and humeral head on the 3D surface models was considered as the 3D AHD. We measured the 2D AHD on anteroposterior digitally reconstructed radiographs. The AHD values were compared between the supine and standing positions and between the 2D and 3D measurements. Results The mean values of 2D AHD were 8.8 ± 1.3 mm (range, 5.9–15.4 mm) in the standing position and 8.1 ± 1.2 mm (range, 5.3–14.3 mm) in the supine position. The mean values of 3D AHD were 7.3 ± 1.4 mm (range, 4.7–14.0 mm) in the standing position and 6.6 ± 1.2 mm (range, 4.4–13.7 mm) in the supine position. The values of 3D AHD were significantly lower than those of 2D AHDs in both the standing and supine positions (P < 0.001). The values of 2D and 3D AHDs were significantly lower in the supine position than in the standing position (P < 0.001). Conclusions This study evaluated the 3D AHD of normal shoulders in the standing position using an upright CT scanner. The present results indicated that assessments in the supine position can underestimate the value of the AHD compared with those made in the standing position and that assessments using 2D analysis can overestimate the value.

scholarly journals Radiographic Measurements on Hindfoot Alignment View in 1,128 Asymptomatic Subjects

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0016
Author(s):  
Jun Young Choi ◽  
Jin Soo Suh
Keyword(s):  
Flat Foot ◽  
Adult Type ◽  
Hindfoot Alignment ◽  
Mean Values ◽  
Radiographic Measurements ◽  
Alignment Angle ◽  
The Mean ◽  
Asymptomatic Subjects ◽  
The Relationship ◽  
Female Subjects

Category: Hindfoot Introduction/Purpose: The primary aim of this study was to calculate the mean values of three most frequently measured parameters for hindfoot alignment determination in asymptomatic subjects - hindfoot alignment angle (HAA), hindfoot alignment ratio (HAR), and hindfoot moment arm (HMA). The secondary aim was to determine the relationship between HAR and HAA or HMA using statistical methods. Methods: From January 2014 to June 2019, a total of 1128 asymptomatic subjects were enrolled in this study. With the hindfoot alignment view by Saltzman and el-Khoury, HAA, HAR, and HMA were measured to evaluate the degree of hindfoot varus or valgus deviation. All subjects were divided into subgroups according to sex and age (<45 years old vs >=45 years old). Simple linear regression was performed to draw out the regression formula between HAR and HAA or HMA. Results: The mean HAA, HAR, and HMA for all subjects were -4.07+-3.48o, 0.21+-0.15, and -6.12+-5.22 mm, respectively. By comparing subgroups, female subjects >=45 years old showed the largest valgus deviation (-7.08+-6.34o, P=0.001). To predict HAR using HAA or HMA, the regression formulas were ‘HAR= 0.366 + 0.039 × HAA’ and ‘HAR= 0.361 + 0.025 × HMA.’ Conclusion: Under HAA, HAR, and HMA evaluation, the hindfoot alignment for asymptomatic subjects was valgus deviation. Furthermore, the degree of valgus deviation was the largest in female subjects aged 45 years or older. This can be explained as the progression of adult type flat foot deformity with aging.

scholarly journals Synovial Tissue Sublining CD68 Expression Is a Biomarker of Therapeutic Response in Rheumatoid Arthritis Clinical Trials: Consistency Across Centers

2009 ◽  
Vol 36 (8) ◽  
pp. 1800-1802 ◽  
Author(s):  
BARRY BRESNIHAN ◽  
ELIZA PONTIFEX ◽  
ROGIER M. THURLINGS ◽  
MARJOLEIN VINKENOOG ◽  
HANI EL-GABALAWY ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Early Stage ◽  
Medical Center ◽  
Biological Effects ◽  
Pearson Correlation ◽  
University Hospital ◽  
Mean Values ◽  
The Mean

Objective.To determine whether the correlation between the mean change in disease activity and the mean change in synovial sublining (sl) CD68 expression could be demonstrated across different academic centers.Methods.Synovial biopsies obtained at arthroscopy from patients with rheumatoid arthritis before and 160 days after rituximab therapy were selected and coded. Paired sections were processed independently at Amsterdam Medical Center (AMC) and at St. Vincent’s University Hospital (SVUH), Dublin. Digital image analysis (DIA) was employed at both centers to quantify sublining CD68 expression.Results.After analysis of CD68sl expression at centers in 2 different countries, high levels of intracenter and intercenter agreement were observed. For the pooled sections stained at AMC, the correlation between 2 investigators was R = 0.942, p = 0.000, and for sections stained at SVUH, R = 0.899, p = 0.001. Similarly, the intracenter correlations for ΔCD68sl expression after treatment were R = 0.998, p = 0.000, for sections stained at AMC and R = 0.880, p = 0.000, for sections stained at SVUH. The intercenter correlation for the pooled scores of sections stained at AMC was R = 0.85, p = 0.000, and for the sections stained at SVUH, R = 0.62, p = 0.001. The consistent correlation between ΔDAS (Disease Activity Score) and ΔCD68sl expression across different studies (Pearson correlation = 0.895, p < 0.001) was confirmed. The standardized response mean values for ΔCD68sl, calculated from analyses at both AMC and SVUH, were consistently 0.5 or greater, indicating a moderate to high potential to detect change.Conclusion.The correlation between mean ΔDAS and mean ΔCD68sl expression was confirmed across 2 centers. Examination of serial biopsy samples can be used reliably to screen for interesting biological effects at the site of inflammation at an early stage of drug development.

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