Familial hyperextensible proximal interphalangeal joints

Summary Hyperextensibility of the proximal interphalangeal joints was noted in 3 males and 6 females in 3 generations of a Japanese family. The proposita, a 14-year-old girl, had hyperextensible proximal interphalangeal joints of the 2nd, 3rd, 4th, and 5th fingers giving swan-neck appearance during the extension. She was asymptomatic and had no other features of skin involvement. Her father, younger sister, grandmother, two aunts, and three cousins on the father's side had hyperextensible proximal interphalangeal joints. No instance of male to male transmission was present. The condition was thus inherited as an autosomal or X-linked dominant trait.     

李仲愚杵针刺激大鼠"足三里”穴区对中枢单胺类神经递质含量的影响

为探讨李仲愚杵针针刺镇痛效应的中枢作用机制,了橇针对正常大鼠及腹腔注射对氯苯丙氨酸大鼠的不同脑区单胺类递质水平的影响,并与是针作比较。结果显示：杵与电针一样,在刺激大鼠“足三里”穴区后,能明显提高间脑和端脑５－羟色胺与５－羟醋酸吲哚的含量,同时也可使间脑去甲肾上腺素含量明显下降,杵针对端脑的ＮＥ以及两脑区多巴胺的影响未见明显的影响。腹腔注射ＰＣＰＡ后大,大鼠脑内Ｔ－ＨＴ、５－ＨＩＡＡ含量均明显下降     

A comparison of gait initiation and termination methods for obtaining plantar foot pressures

The midgait protocol is the most commonly used method to collect pressure platform data. Spatial limitations, however, frequently render this technique unsuitable. Alternative gait protocols have focused on gait initiation procedures in obtaining data. The current study investigated whether a commonly cited two-step gait initiation protocol, or a two-step gait termination protocol produced pressure data more representative of the criterion, midgait method. A pressure platform was used to collect data for 25 asymptomatic subjects using the midgait, two-step gait initiation and two-step gait termination walking protocols. The contact duration, percentage contact duration, peak pressure, peak force, pressure–time integral and force–time integral were calculated for seven sites within the foot. Multivariate analysis of variance with repeated measures identified significant protocol by site interactions for all variables except the force-time integral. The gait initiation protocol, although having minimal effect on peak pressures beneath the forefoot, markedly altered the relative timing parameters of the foot. In contrast, the gait termination protocol had minimal effect on temporal parameters, but resulted in a reduction in pressures beneath the forefoot. Abbreviated gait protocols are often employed in plantar pressure studies. This study suggests that the choice between a gait initiation and termination protocol is largely dependent on the gait parameter of interest.     

The role of PGE2 in the sensitization of mechanoreceptors in normal and inflamed ankle joints of the rat

Summary The role of PGE₂ in the sensitization of highthreshold tarsal joint mechanoreceptors (putative nociceptors) has been investigated in 11 arthritic and 16 normal rats. Injections of a low dose of Freund's complete adjuvant at multiple sites into the tissues surrounding the ankle joint induced a chronic unilateral monoarthritis in the injected limb. Measurements of both spontaneous activity and responses of tarsal joint mechanoreceptors to repeated graded mechanical stimuli were made. All of the mechanoreceptors examined had afferent fibres with conduction velocities in the C or A- range. Using this new model of joint inflammation we have shown that lysine acetylsalicylate reduces the mechanical sensitivity of these joint mechanoreceptors and reduces the spontaneous activity in afferent nerve fibres. Prostaglandin E₂ is unable to restore either the spontaneous activity in the afferent axon or the mechanical sensitivity of tarsal joint mechanoreceptors after lysine acetylsalicylate in the arthritic rat. Similarly, PGE₂ does not sensitize or excite tarsal joint mechanoreceptors in the normal rat. In the normal rat, however, PGE₂ potentiates the excitatory action of bradykinin and enhances the sensitizing effect of bradykinin on the responses of joint mechanoreceptors to mechanical stimulation when both substances are injected simultaneously. These results indicate that PGE₂ is not important in the sensitization of these joint mechanoreceptors in this model of chronic joint inflammation but that in other circumstances PGE₂ may be able to contribute to a sensitization of joint mechanoreceptors by enhancing the action of bradykinin.     

螺旋CT多平面重建及三维重建在关节损伤中的应用价值

目的：探讨螺旋CT多平面重建(MPR)及三维重建(3D)在关节损伤中的应用价值。方法：选择57例典型关节外伤病人，分析螺旋CT轴位表现及进行MPR和3D后的表现，并将三者进行对照。结果：轴位CT对显示关节骨与软组织由细小病变较好，但对水平面内关节面的改变可能估计不足。MPR和3D有助于弥补轴位CT的不足，较全面评价关节内外的损伤改变，显示多发粉碎性骨折的三维空间关系。结论：螺旋CT轴位图像结合MPR及3D，更加全面、直观地显示关节损伤性改变，对于临床选择治疗方法有重要意义。     

Treatment of painful heels with acupuncture in 32 cases

Points Fengfu (GV 16), Fengchi (GB 20) and Anmian were selected as main acupoints to treat painful heels and the total effective rate of 96.9% was got. The technique of lifting needle was the key to the therapy. Author: Ye Ming-zhu(1947-), male, associated chiefphysician Translator: Chen Han-ping     

Foot pressure and radiographic outcome measures of lateral column lengthening for pes planovalgus deformity

The purpose of this study was to establish and characterize the relationship between foot pressure analysis and radiographic measurements in children that underwent a lateral column lengthening procedure for pes planovalgus (PPV). Eight children (13 feet) with PPV that had failed non-operative treatment underwent a lateral column lengthening procedure. Pre-operative and post-operative standing AP and lateral radiographs and foot pressure data were obtained. The relationships between the radiographic and foot pressure measurements were investigated. The findings from this study demonstrated strong relationships between these parameters. The relationships seen in this study indicate that the addition of foot pressure analysis provides objective documentation of the improvement in foot pressure distribution following a lateral column lengthening. Also, there is a direct, positive relationship between the key radiographic and foot pressure measurements.     

Mannosidosis: an unusual cause of a deforming arthropathy

We report on a case of a deforming arthropathy in a young man with a lysosomal storage disorder. A 31-year-old man with a known diagnosis of mannosidosis presented with a painful swollen right elbow. Radiographs of his right elbow showed a disorganised joint with multiple fragments resembling the appearances of a neuropathic joint. This case provides further evidence that a deforming arthropathy may occur as part of the spectrum of skeletal abnormalities seen in mannosidosis. Received: 17 November 1999 Revision requested: 13 December 1999 Revision received: 6 March 2000 Accepted: 9 March 2000     

Association of posterior tibial tendon abnormalities with abnormal signal intensity in the sinus tarsi on MR imaging

Objective. To evaluate the association of abnormal signal intensity within the sinus tarsi with abnormalities of the posterior tibial tendon (PTT) on MR imaging. Design and patients. Sinus tarsi abnormalities were identified on 30 ankle MR examinations in 29 patients. The PTT and anterior talofibular ligament were retrospectively analyzed for abnormalities in these same patients. Results and conclusions. Tears of the anterior talofibular ligament were found in 13 of 30 (43%) ankles. PTT abnormalities (complete tear, partial tear or dislocation) were seen in 14 of 30 (47%) studies, and were distributed relatively equally between those patients with and without lateral ligament tears. Our results provide evidence of an association between abnormalities of the PTT and the sinus tarsi. The finding of abnormal signal intensity within the sinus tarsi on MR imaging should alert the radiologist to potential abnormalities of the PTT. Received: 17 March 2000 Accepted: 17 May 2000     

踝足矫形器矫治脑瘫患儿尖足初步疗效分析

目的对痉挛型脑瘫患儿踝足矫形器配戴前后的尖足改善情况进行量化评定。方法对24例痉挛型脑瘫患儿(48足)配戴矫形器6个月后进行疗效评定。结果48只尖足均得到了明显改善,其中显效25%,好转64.6%,无变化10.4%,与配戴踝足矫形器前比较差异有显著意义(P<0.01)。在尖足改善的同时,患儿的站立和步行能力均得到了提高。结论踝足矫形器在纠正脑瘫患儿尖足、提高下肢运动功能方面有积极的作用。