No abstract available.
Ankle* ; Foot* ; Humans ; Outpatients*

No abstract available.
DNA*

One of the common cause of the acquired adult flat foot is posterior tibial tendon insufficiency whose etiology and development is different from that of congenital flat foot, and various methods, such as synovectomy, tendon transfer, calcaneal osteotomy and arthrodesis, can be used to treat the symptoms. The sliding calcaneal osteotomy has been recently introduced by Mark Myerson. The basic concept beneath this treatment is that by displacing distal part medially after a calcaneal osteotomy, the valgus strain in hindfoot can be relieved to place the joint back to the normal position. In order to find out the effect of the sliding calcaneal soteotomy on the flat foot, we measured the changes in the strain in the upper medial spring ligament complex underneath the talonavicular joint after the operation. Four right hand four left fresh frozen cadaver foot specimens, which included the distal half of the tibia were utilized. The spring ligament was isolated with its origin at the sustentaculum tali and insertion on the navicular. At the medial calcaneus the soft tissues were periostially dissected and a small incision was made over the lateral calcaneus for the purpose of visualization. For each specimen a calibrated open liquid metal strain gauge was secured at the origin and insertion of the ligament with superglue and the gauge was sutured along the length of the superomedial portion of the spring ligament complex allowing for the gauge to slide freely. A tibial rod was driven into the intramedullary canal and the foot was always placed in the neutral plantigrade position in the test fig such that the rod was vertical at all times. A initial strain measurement was obtained with only the weight of the platform (19.6N) on the tibia. Weights were added in 7 increments to a total 472 Newton and strains were recorded. Three trials were conducted. The specimens were then removed from the rig and an oblique osteotomy were conducted. A repeated measures analysis of variance showed a significant (p < 0.001) reduction in strain following the osteotomy. To conclude, the direct measurements support the concept that a calcaneal osteotomy provides an alteration which is favorable to unloading the medial arch.
Adult ; Arthrodesis ; Cadaver ; Calcaneus ; Flatfoot ; Foot ; Hand ; Humans ; Joints ; Ligaments ; Osteotomy ; Posterior Tibial Tendon Dysfunction ; Tendon Transfer ; Tibia ; Weights and Measures

Generalized perforating granuloma annulare is a rare variant of granuloma. annulare, which was first described by Duncan et al 1) in 1973. A 21-year-old female had hundreds of 3 to 5mm papules over the whole body, which were mainly distributed in the extremities and trunk since three months ago. Individual papules developed a central umbilication with a peripheral collarette of scale. Histopathologic examination showed an epidermal perforation and transepidermal elimination of necrobiotic material. The epidermal perforation communicated with areas of necrobiotic collagen surrounded by palisading granulorna in the dermis. We treated her with oral prednisolone and dapsone, but there was no clinical improvement.
Collagen ; Dapsone ; Dermis ; Extremities ; Female ; Granuloma Annulare* ; Granuloma* ; Humans ; Prednisolone ; Young Adult

No abstract available.
Child* ; Epilepsy* ; Humans

No abstract available.
Epilepsy*

No abstract available.
Choledochal Cyst*

No abstract available.
Spinal Muscular Atrophies of Childhood*

No abstract available.
Anticonvulsants* ; Carnitine* ; Liver*

PURPOSE: Norepinephrine has modulatory effects on neuronal excitability and, in some cases, has a proconvulsant effect. Intraperitoneal imipramine treatment increases norepinephrine level, and to a lesser extent, dopamine and serotonin in brain dialysate from rats. We sought to determine the effects of imipramine on pilocarpine-induced seizures in the immature rats. METHODS: Right and left cortical and hippocampal electrodes were placed in 10~15 day old Sprague-Dawley rats. The following day 3-hour video EEG recordings were obtained to monitor electrographic seizures and status epilepticus induced by intraperitoneal injection of high dose(200mg/kg : HD) and low dose (75mg/kg : LD) pilocarpine. A first group of rats received HD pilocarpine alone(n=25), or pretreatment with 0.5(n=6). 1(n=6), 2(n=6), 5(n=6), or 10(n=11)mg/kg of imipramine. A second group of rats received LD pilocarpine alone(n=6) or pretreatment with 2mg/kg of imipramine (n=6). Data were analyzed using the Fisher exact test. RESULTS: Treatment with HD pilocarpine alone resulted in electrographic seizures in 76%(n=19) and status epilepticus in 44%(n=11). In the HD pilocarpine group, status epilepticus was seen in 100% of rats pretreated 1, 2, and 5mg/kg imipramine. 90.9% of the rats pretreated with 10mg/kg of imipramine developed seizures and 36.4% developed status epilepticus. Imipramine at 0.5, 1,2, and 5mg/kg increased the incidence of seizures and status epilepticus in the HD pilocarpine group, but the incidence was statistically significant only for status epilepticus(p<0.05). The latency for the occurrence of first status epilepticus was 12.3+/-1.3 min in the HD pilocarpine alone group, and it was 21+/-3.8 min and 25.3+/-5.7 min in the group pretreated with 5 and 10mg/kg imipramine, respectively(p<0.02). Treatment with LD pilocarpine alone resulted in seizures in 50% and status epilepticus in 16.7%. In the LD pilocarpine group with imipramine 2mg/kg pretreatment, 83.3% had seizures and status epilepticus. Imipramine at 2mg/kg increased the incidence of seizures and status epilepticus in the LD pilocarpine group, but the increase was statistically significant only for status epilepticus(p<0.05). CONCLUSION: Imipramine exhibits a proconvulsant effect at low doses and an anticonvulsant effect at high doses in the pilocarpine seizure model in immature rats. There may be a dose-dependent effect on monoaminergic receptors which results in increased neuronal excitability.
Animals ; Brain ; Dopamine ; Electrodes ; Electroencephalography ; Imipramine* ; Incidence ; Injections, Intraperitoneal ; Neurons ; Norepinephrine ; Pilocarpine ; Rats* ; Rats, Sprague-Dawley ; Seizures* ; Serotonin ; Status Epilepticus