Association between subtalar articular surface typing and flat foot deformity: which type is more likely to cause flat foot deformity

Abstract Background Previous studies have shown a wide range of anatomical classifications of the subtalar joint (STJ) in the population and this is related to the different force line structures of the foot. Different subtalar articular surface morphology may affect the occurrence and development of flat foot deformity, and there are fewer studies in this area. The main objective of our study was to determine the association of different subtalar articular surface with the occurrence and severity of flat foot deformity. Methods We analyzed the imaging data of 289 cases of STJ. The articular surface area, Gissane’s angle and Bohler’s angle of subtalar articular surface of different types were counted. The occurrence and severity of flat foot deformity in different subtalar articular surface were judged by measuring the Meary angle of foot. Results We classified 289 cases of subtalar articular surface into five types according to the morphology. According to Meary angle, the flat foot deformity of Type I and Type IV are significantly severer than Type II (P < 0.05). Type II (7.65 ± 1.38 cm2) was significantly smaller than Type I (8.40 ± 1.79 cm2) in the total joint facet area(P < 0.05). Type III (9.15 ± 1.92 cm2) was smaller than Type I (8.40 ± 1.79 cm2), II (7.65 ± 1.38 cm2) and IV (7.81 ± 1.74 cm2) (P < 0.05). Type II (28.81 ± 7.44∘) was significantly smaller than Type I (30.80 ± 4.61 degrees), and IV (32.25 ± 5.02 degrees) in the Bohler’s angle (P < 0.05). Type II (128.49 ± 6.74 degrees) was smaller than Type I (131.58 ± 7.32 degrees), and IV (131.94 ± 5.80 degrees) in the Gissane’s angle (P < 0.05). Conclusions After being compared and analyzed the measurement of morphological parameters, joint facet area and fusion of subtalar articular surface were closely related to the severity of flat foot deformity and Type I and IV were more likely to develop severer flat foot deformity. Level of evidence Level III, retrospective comparative study.

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Association Between Subtalar Articular Surface Typing and Flat Foot Deformity: Which Type is More Likely to Cause Flat Foot Deformity

10.21203/rs.3.rs-762843/v1 ◽

2021 ◽

Author(s):

Lei Zhang ◽

Xiaoyao Peng ◽

Siyuan He ◽

Xin Zhou ◽

Gang Yi ◽

...

Keyword(s):

Articular Surface ◽

Type I ◽

Type Ii ◽

Foot Deformity ◽

Imaging Data ◽

Level Of Evidence ◽

Flat Foot ◽

Wide Range ◽

Retrospective Comparative Study ◽

Böhler’S Angle

Abstract Background Previous studies have shown a wide range of anatomical classifications of the subtalar joint (STJ) in the population and this is related to the different force line structures of the foot. Different subtalar articular surface morphology may affect the occurrence and development of flat foot deformity, and there are fewer studies in this area. The main objective of our study was to determine the association of different subtalar articular surface with the occurrence and severity of flat foot deformity. Methods We analyzed the imaging data of 289 cases of STJ. The articular surface area, Gissane's angle and Bohler's angle of subtalar articular surface of different types were counted. The occurrence and severity of flat foot deformity in different subtalar articular surface were judged by measuring the Meary angle of foot. Results We classified 289 cases of subtalar articular surface into five types according to the morphology. According to Meary angle, the flat foot deformity of Type Ⅰ and Type Ⅳ are significantly severer than Type Ⅱ (P < 0.05). Type II (7.65 ± 1.38 cm2) was significantly smaller than Type I (8.40 ± 1.79 cm2) in the total joint facet area(P < 0.05). Type III (9.15 ± 1.92 cm2) was smaller than Type I (8.40 ± 1.79 cm2), II(7.65 ± 1.38 cm2) and Ⅳ(7.81 ± 1.74 cm2 ) (P < 0.05).Type II (28.81 ± 7.44∘) was significantly smaller than Type I (30.80 ± 4.61 degrees), and IV (32.25 ± 5.02 degrees) in the Bohler’s angle (P < 0.05). Type II (128.49 ± 6.74 degrees) was smaller than Type I (131.58 ± 7.32 degrees), and IV (131.94 ± 5.80 degrees) in the Gissane’s angle (P < 0.05). Conclusions After being compared and analyzed the measurement of morphological parameters, joint facet area and fusion of subtalar articular surface were closely related to the severity of flat foot deformity and Type I and IV were more likely to develop severer flat foot deformity. Level of evidence: Level III, retrospective comparative study.

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Distal Tibiofibular Syndesmotic Widening in Progressive Collapsing Foot Deformity

Foot & Ankle International ◽

10.1177/1071100720982907 ◽

2021 ◽

pp. 107110072098290

Author(s):

Elijah Auch ◽

Nacime Salomao Barbachan Mansur ◽

Thiago Alexandre Alves ◽

Christopher Cychosz ◽

Francois Lintz ◽

...

Keyword(s):

Case Control Study ◽

Mean Difference ◽

Foot And Ankle ◽

Spearman Correlation ◽

Foot Deformity ◽

Weak Correlation ◽

Level Of Evidence ◽

Valgus Instability ◽

Retrospective Comparative Study ◽

Control Study

Background: Lateral overload in progressive collapsing foot deformity (PCFD) takes place as hindfoot valgus, peritalar subluxation, and valgus instability of the ankle increase. Fibular strain due to chronic lateral impingement may lead to distraction forces over the distal tibiofibular syndesmosis (DTFS). This study aimed to assess and correlate the severity of the foot and ankle offset (FAO) as a marker of progressive PCFD with the amount of DTFS widening and to compare it to controls. Methods: In this case-control study, 62 symptomatic patients with PCFD and 29 controls who underwent standing weightbearing computed tomography (WBCT) examination were included. Two fellowship-trained blinded orthopedic foot and ankle surgeons performed FAO (%) and DTFS area measurements (mm2). DTFS was assessed semiautomatically on axial-plane WBCT images, 1 cm proximal to the apex of the tibial plafond. Values were compared between patients with PCFD and controls, and Spearman correlation between FAO and DTFS area measurements was assessed. P values of less than .05 were considered significant. Results: Patients with PCFD demonstrated significantly increased FAO and DTFS measurements in comparison to controls. A mean difference of 6.9% ( P < .001) in FAO and 10.4 mm2 ( P = .026) in DTFS was observed. A significant but weak correlation was identified between the variables, with a Þ of 0.22 ( P = .03). A partition predictive model demonstrated that DTFS area measurements were highest when FAO values were between 7% and 9.3%, with mean (SD) values of 92.7 (22.4) mm2. Conclusion: To our knowledge, this was the first study to assess syndesmotic widening in patients with PCFD. We found patients with PCFD to demonstrate increased DTFS area measurements compared to controls, with a mean difference of approximately 10 mm2. A significantly weak positive correlation was found between FAO and DTFS area measurements, with the highest syndesmotic widening occurring when FAO values were between 7% and 9.3%. Our study findings suggest that chronic lateral impingement in patients with PCFD can result in a negative biomechanical impact on syndesmotic alignment, with increased DTFS stress and subsequent widening. Level of Evidence: Level III, retrospective comparative study.

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Cancer Biology and Prevention in Diabetes

Cells ◽

10.3390/cells9061380 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1380 ◽

Cited By ~ 1

Author(s):

Swayam Prakash Srivastava ◽

Julie E. Goodwin

Keyword(s):

Type Ii Diabetes ◽

Cancer Biology ◽

Cancer Metastasis ◽

Type I Diabetes ◽

Type I ◽

Type Ii ◽

Mesenchymal Transition ◽

Wide Range ◽

Risk Of Cancer

The available evidence suggests a complex relationship between diabetes and cancer. Epidemiological data suggest a positive correlation, however, in certain types of cancer, a more complex picture emerges, such as in some site-specific cancers being specific to type I diabetes but not to type II diabetes. Reports share common and differential mechanisms which affect the relationship between diabetes and cancer. We discuss the use of antidiabetic drugs in a wide range of cancer therapy and cancer therapeutics in the development of hyperglycemia, especially antineoplastic drugs which often induce hyperglycemia by targeting insulin/IGF-1 signaling. Similarly, dipeptidyl peptidase 4 (DPP-4), a well-known target in type II diabetes mellitus, has differential effects on cancer types. Past studies suggest a protective role of DPP-4 inhibitors, but recent studies show that DPP-4 inhibition induces cancer metastasis. Moreover, molecular pathological mechanisms of cancer in diabetes are currently largely unclear. The cancer-causing mechanisms in diabetes have been shown to be complex, including excessive ROS-formation, destruction of essential biomolecules, chronic inflammation, and impaired healing phenomena, collectively leading to carcinogenesis in diabetic conditions. Diabetes-associated epithelial-to-mesenchymal transition (EMT) and endothelial-to-mesenchymal transition (EndMT) contribute to cancer-associated fibroblast (CAF) formation in tumors, allowing the epithelium and endothelium to enable tumor cell extravasation. In this review, we discuss the risk of cancer associated with anti-diabetic therapies, including DPP-4 inhibitors and SGLT2 inhibitors, and the role of catechol-o-methyltransferase (COMT), AMPK, and cell-specific glucocorticoid receptors in cancer biology. We explore possible mechanistic links between diabetes and cancer biology and discuss new therapeutic approaches.

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Rate constants rather than biochemical mechanism determine behaviour of genetic clocks

Journal of The Royal Society Interface ◽

10.1098/rsif.2008.0046.focus ◽

2008 ◽

Vol 5 (suppl_1) ◽

Cited By ~ 21

Author(s):

Emery Conrad ◽

Avraham E Mayo ◽

Alexander J Ninfa ◽

Daniel B Forger

Keyword(s):

Transcription Regulation ◽

Negative Feedback ◽

Rate Constants ◽

The Other ◽

Type I ◽

Type Ii ◽

Biochemical Mechanism ◽

Wide Range ◽

Negative Feedbacks ◽

Positive And Negative Feedbacks

Many biological systems contain both positive and negative feedbacks. These are often classified as resonators or integrators. Resonators respond preferentially to oscillating signals of a particular frequency. Integrators, on the other hand, accumulate a response to signals. Computational neuroscientists often refer to neurons showing integrator properties as type I neurons and those showing resonator properties as type II neurons. Guantes & Poyatos have shown that type I or type II behaviour can be seen in genetic clocks. They argue that when negative feedback occurs through transcription regulation and post-translationally, genetic clocks act as integrators and resonators, respectively. Here we show that either behaviour can be seen with either design and in a wide range of genetic clocks. This highlights the importance of parameters rather than biochemical mechanism in determining the system behaviour.

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Signal transduction and TGF-β superfamily receptors

Biochemistry and Cell Biology ◽

10.1139/o96-033 ◽

1996 ◽

Vol 74 (3) ◽

pp. 299-314 ◽

Cited By ~ 22

Author(s):

Steven M. Kolodziejczyk ◽

Brian K. Hall

Keyword(s):

Signal Transduction ◽

G Protein ◽

Intracellular Signaling ◽

Specific Cell ◽

Type I ◽

Type Ii ◽

Type Iii ◽

Wide Range ◽

Transduction Mechanisms ◽

Kinase Cascade

The TGF-β superfamily includes a large number of related growth and differentiation factors expressed in virtually all phyla. Superfamily members bind to specific cell surface receptors that activate signal transduction mechanisms to elicit their effects. Candidate receptors fall into two primary groups, termed type I and type II receptors. Both types are serine/threonine kinases. Upon activation by the appropriate ligand, type I and type II receptors physically interact to form hetero-oligomers and subsequently activate intracellular signaling cascades, ultimately regulating gene transcription and expression. In addition, TGF-β binds to a third receptor class, type III, a membrane-anchored proteoglycan lacking the kinase activity typical of signal transducing molecules. Type III receptors appear to regulate ligand availability to type I and type II receptors. Although a number of transduction mechanisms may be available to TGF-β superfamily members, evidence gathered through the use of specific kinase and G-protein inhibitors and through assays measuring activation and levels of signaling intermediates suggests that at least one signaling pathway interacts with Ras and Raf proteins via a G-protein intermediate. Raf begins the cytoplasmic kinase cascade that leads to gene regulation. The myriad responses regulated by TGF-β superfamily members makes the understanding of signal transduction mechanisms utilized by these proteins of great interest to a wide range of biological disciplines.Key words: TGF-β superfamily, serine/threonine kinase receptors, G-proteins, Ras, cytoplasmic kinase cascade.

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Recent Developments in the Synthesis of Pyrido[1,2-a]benzimidazoles

Synthesis ◽

10.1055/s-0036-1589533 ◽

2018 ◽

Vol 50 (11) ◽

pp. 2131-2149 ◽

Cited By ~ 7

Author(s):

Kamal Kapoor ◽

Parthasarathi Das ◽

Rajni Khajuria ◽

Sk. Rasheed ◽

Chhavi Khajuria

Keyword(s):

Transition Metal ◽

Medicinal Chemistry ◽

Type I ◽

Type Ii ◽

Aromatic Rings ◽

Metal Free ◽

Wide Range ◽

Recent Developments ◽

Metal Catalyzed ◽

Synthetic Approaches

Pyrido[1,2-a]benzimidazole is one of the most important azaheterocyclic compounds consisting of three fused aromatic rings. Molecules containing this core have displayed a wide range of applications in the field of medicinal chemistry. The synthesis of pyrido[1,2-a]benzimidazole and its derivatives has attracted organic chemists because of its tremendous utility in interdisciplinary branches of chemistry. In this context, this review discusses the main advances in the synthesis of pyrido[1,2-a]benzimidazoles via metal-mediated and metal-free reactions from 2000 to 2016.1 Introduction2 Synthetic Approaches to Pyrido[1,2-a]benzimidazoles2.1 Type I: Transition-Metal-Catalyzed Methods2.2 Type II: Metal-Free Approaches3 Conclusion

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Arthroscopic Assisted Reduction and Internal Fixation of Tibial Plateau Fractures

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.248 ◽

2019 ◽

Vol 7 (7) ◽

pp. 1133-1137 ◽

Cited By ~ 2

Author(s):

Sherif Hamdy Mohamed Zawam ◽

Ahmed Mahmoud Gad

Keyword(s):

Internal Fixation ◽

Tibial Plateau ◽

Articular Surface ◽

Knee Injuries ◽

Tibial Plateau Fractures ◽

Type I ◽

Type Ii ◽

University Hospitals ◽

Type Iii ◽

Schatzker Type

BACKGROUND: Tibial plateau fractures present an important entity in orthopaedic fractures. Arthroscopic-assisted reduction and internal fixation is a good alternative to ORIF as it has the advantage of direct visualisation of the articular surface of the plateau, direct assessment of the reduction of the articular surface, and managing any associated intra-articular pathology. AIM: Our study aim is to determine the results of arthroscopic assisted reduction and internal fixation of tibial plateau fractures. METHODS: This study involved 25 patients with tibial plateau fractures presenting to the emergency department of Cairo University Hospitals between the periods of November 2016 and May 2017. The patients were followed up for an average of 14 months (11-18 months). According to Schatzker’s classification, five patients had type I, eleven had type II, and nine patients had type III fractures. RESULTS: The average time to full union in Schatzker type I was 9.1 weeks, in type II was 10.2 weeks, and in type III it was 9.4. The mean clinical Rasmussen score among the 25 patients was 26 (range, 24-30). A group of 19 patients (76%) had excellent results, (4 type I, 8 types II, and 7 types III) 6 patients (24 %) had good results (1 type I, 3 types II, 2 types III). Radiologic results were excellent in (14 cases) 56.0% and good results (11 cases) 44%. CONCLUSION: Arthroscopic assisted reduction and fixation of tibial plateau fractures have the advantages of checking the adequacy of reduction, avoiding the need for detachment of the meniscus, and allowing for accurate diagnosis and management of associated knee injuries. Therefore, we recommend that arthroscopic assisted reduction and fixation of tibial plateau fractures should be used more often.

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Biosynthesis of Polyketides in Streptomyces

Microorganisms ◽

10.3390/microorganisms7050124 ◽

2019 ◽

Vol 7 (5) ◽

pp. 124 ◽

Cited By ~ 12

Author(s):

Chandra Risdian ◽

Tjandrawati Mozef ◽

Joachim Wink

Keyword(s):

Secondary Metabolites ◽

Structure And Function ◽

Polyketide Synthases ◽

Type I ◽

Type Ii ◽

Filamentous Form ◽

Gram Positive Bacteria ◽

Wide Range ◽

Different Types ◽

And Function

Polyketides are a large group of secondary metabolites that have notable variety in their structure and function. Polyketides exhibit a wide range of bioactivities such as antibacterial, antifungal, anticancer, antiviral, immune-suppressing, anti-cholesterol, and anti-inflammatory activity. Naturally, they are found in bacteria, fungi, plants, protists, insects, mollusks, and sponges. Streptomyces is a genus of Gram-positive bacteria that has a filamentous form like fungi. This genus is best known as one of the polyketides producers. Some examples of polyketides produced by Streptomyces are rapamycin, oleandomycin, actinorhodin, daunorubicin, and caprazamycin. Biosynthesis of polyketides involves a group of enzyme activities called polyketide synthases (PKSs). There are three types of PKSs (type I, type II, and type III) in Streptomyces responsible for producing polyketides. This paper focuses on the biosynthesis of polyketides in Streptomyces with three structurally-different types of PKSs.

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Comparison of clinical outcomes of three-corner arthrodesis and bicolumnar arthrodesis for advanced wrist osteoarthritis

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193420905484 ◽

2020 ◽

Vol 45 (7) ◽

pp. 679-686 ◽

Cited By ~ 1

Author(s):

Marc Olivier Gauci ◽

Thomas Waitzenegger ◽

Pierre-Emmanuel Chammas ◽

Bertrand Coulet ◽

Cyril Lazerges ◽

...

Keyword(s):

Clinical Outcomes ◽

Revision Surgery ◽

Functional Outcomes ◽

Type I ◽

Type Ii ◽

Level Of Evidence ◽

Wrist Motion

We retrospectively compared results of 27 wrists with bicolumnar arthrodesis with mean follow-up of 67 months to 28 wrists with three-corner arthrodesis adding triquetral excision with mean follow-up of 74 months in 54 patients (55 wrists). Minimal follow-up was 2 years for all patients. Capitolunate nonunion occurred in three wrists with bicolumnar arthrodesis and six wrists with three-corner arthrodesis, and radiolunate arthritis developed in four wrists with three-corner arthrodesis. Among patients with bicolumnar arthrodesis, hamatolunate arthritis occurred in seven wrists, all with a Viegas type II lunate; and pisotriquetral arthritis occurred in three wrists. At mean 5 years after surgery, 45 wrists had not needed revision surgery, and both groups had similar revision rates. The wrists with three-corner arthrodesis and bicolumnar arthrodesis had similar functional outcomes, and range of wrist motion was not significantly different between the two groups. We concluded that bicolumnar arthrodesis results in greater longevity than three-corner arthrodesis for a type I lunate. We do not recommend bicolumnar arthrodesis for type II lunate. We also concluded that three-corner arthrodesis has a greater incidence of radiolunate arthritis and capitolunate nonunion. Level of evidence: III

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Association Between Middle Facet Subluxation and Foot and Ankle Offset in Progressive Collapsing Foot Deformity

Foot & Ankle International ◽

10.1177/10711007211040820 ◽

2021 ◽

pp. 107110072110408

Author(s):

Nacime Salomão Barbachan Mansur ◽

Matthieu Lalevee ◽

Connor Maly ◽

Kevin Dibbern ◽

Hee Young Lee ◽

...

Keyword(s):

Multivariate Regression ◽

Prediction Models ◽

Intraclass Correlation ◽

Multivariate Regression Analysis ◽

Foot And Ankle ◽

Foot Deformity ◽

Level Of Evidence ◽

Potential Association ◽

Reliable Marker ◽

Retrospective Comparative Study

Background: Subtalar middle facet (MF) subluxation was recognized as a reliable marker for progressive collapsing foot deformity (PCFD) diagnosis. Foot and Ankle Offset (FAO) is an established measurement, predictive of malalignment severity. The objective of this study was to assess the potential association between MF subluxation and FAO in PCFD patients. Methods: 56 individuals with flexible PCFD (74 feet) were assessed. Two blinded foot and ankle surgeons calculated MF uncoverage, MF incongruence, and FAO. Agreement was quantified using intraclass correlation coefficient (ICC). A multivariate regression analysis and partition prediction models were applied to assess relationship between values. Results: All ICCs were >0.80. MF subluxation and FAO were found to be correlated ( rs = 0.56; P < .0001). Changes in the MF subluxation were noticeably explained by FAO and BMI ( R2 = 0.33). MF incongruence was not correlated with the assessed variables ( P = .10). In this cohort, an MF subluxation of 27.5% was a threshold for increased FAO (FAO of 3.4%±2.4% when below; FAO of 8.0% ±3.5% when above). Conclusion: We found a correlation between MF subluxation and FAO. An MF subluxation of 27.5% was found to be a threshold for higher FAO, which corresponded to a greater malalignment. These data may help surgeons optimize treatment decisions in PCFD patients. Level of Evidence: Level III, retrospective comparative study.

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