A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture

PURPOSE: To compare the clinical results between the extensile lateral approach and sinus tarsi approach in the open reduction of the Sanders type II calcaneal fracture. MATERIALS AND METHODS: From July 2002 to Februry 2007, thirty two patients having thirty three calcaneal fractures of Sanders type II were managed with open reduction and internal fixation using the extensile lateral approach or sinus tarsi approach. The mean age of 19 patients using extensile lateral approach was 43.3 years. The mean age of 13 patients using sinus tarsi approach was 46.3 years. Clinical outcome, radiographic parameters, and postoperative complications were compared between both groups. RESULTS: There was no difference between two groups associated with patients demographs. The mean AOFAS score and VAS between both groups were not different (p=0.716, p=0.774). The mean Bohler's angle and Gissane's angle between both groups were not different (p=0.343, p=0.357). Two cases of sural nerve injury, one malunion, and one deep infection were occurred in the group of extensile lateral approach. However, patients using sinus tarsi approach had no postoperative complications. CONCLUSION: The clinical results of sinus tarsi approach may be comparable with those of extensile lateral approach, with the advantages of reduced risk of postoperative complications.

Change of Kyphotic Angle in Posterior Pedicle Screw Fixation for Thoracic and Lumbar Burst Fractures: Comparison Study by the Screw Fixation Level

PURPOSE: To evaluate the relationship between the level of screw fixation and the stability of the segment of endplate fracture after posterior pedicle screw instrumentation for thoracic and lumbar burst fractures. MATERIALS AND METHODS: The 41 patients of burst fractures who had been operated with pedicle screw instrumentation were retrospectively evaluated. The patients were divided into two groups by the levels of screw fixation. One group was treated with screws fixed by one-level to the direction of fractured endplate (One-level group, 16 cases). The other group was treated with screws fixed by two-level to the direction of endplate fracture (Two-level group, 25 cases). The two groups were compared by the radiographic changes of kyphotic angle between the day of surgery and 6 months after surgery. RESULTS: At the 6 months, one-level group showed the change of kyphotic angle of 17.5+/-2.4 degrees, which was different from two-level group of 5.2+/-0.8 degrees (p=0.000). CONCLUSION: In posterior pedicle screws fixation for thoracic and lumbar burst fractures, 2 vertebrae to the direction of the endplate fracture should be included to prevent the postoperative kyphotic change.

Ankle Arthrodesis in Very Unstable Charcot Arthropathy using Autogenous Fibular Strut Bone Graft (A Case Report) / 대한족부족관절학회지

Charcot arthropathy of the foot and ankle is characterized by a combination of sensory, motor and autonomic peripheral neuropathy leading to gross swelling, bony destruction and finally severe bony deformity with joint instability. We report a case of very unstable Charcot arthropathy in ankle joint managed with ankle arthrodesis using fibular strut bone grafting technique.

Short-term Results of Medial Displacement Calcaneal Osteotomy for Flexible Flatfoot / 대한족부족관절학회지

PURPOSE: To evaluate the short-term results of medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot deformity. MATERIALS AND METHODS: Twenty four patients (25 feet) who had undergone medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot between July 2004 and May 2007 were included. The mean age was 43.6 years (16~78 years). The mean follow-up was 26 months (14~50 months). Clinical outcomes were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Six radiographic parameters were measured from weightbearing radiographs to assess the difference between preoperative and postoperative radiographs. RESULTS: The mean AOFAS score improved from 57.9 points preoperatively to 89.2 points at latest follow-up (p=0.000). The mean VAS improved from 62 points preoperatively to 23 points at latest follow-up (p=0.000). The mean talonavicular coverage angle on anteroposterior (AP) view changed from 20.2 degrees to 16.0 degrees (p=0.002). The mean calcaneal pitch angle on lateral view changed from 12.6 degrees preoperatively to 14.5 degrees at latest follow-up (p=0.001). Regarding these radiographic parameters, the difference between interobserver measurements was larger than that between pre- and post-operative measurements. The calcaneus was transferred medially by average 11.8 mm (p=0.003), which was 27.9% of the width of calcaneal tuberosity (p=0.000). The mean talo-first metatarsal angle on AP and lateral views, and navicular height on lateral view were not significantly changed. CONCLUSION: Medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot could lead to improve the clinical outcomes, although the restoration of medial longitudinal arch was not clinically significant.

Range of Motion of Great Toe after Sesamoidectomy: A Cadaveric Study / 대한족부족관절학회지

PURPOSE: Regardless of potential and actual complications, the sesamoidectomy either tibial side or fibular side or both, had been used as a surgical option for various pathologic conditions. The objective of this cadaveric study was to identify the changes of range of motion of great toe after sesamoidectomy. MATERIAL AND METHODS: Eight fresh cadaver legs were used. The angular changes of the hallucal articulations were measured by traction of the flexor hallucis longus tendon at the proximal border of fibro-osseous tarsal tunnel and by traction of the extensor hallucis longus tendon at the superior border of inferior extensor retinaculum. The measurement started at neutral position and proceeded to the maximum for respective tendons. After sesamoidectomy either partial or total, same procedures were repeated and the angular changes were measured. RESULTS: In flexion of great toe, there were significant metatarsophalangeal angular differences at 1 cm traction in total sesamoidectomy and lateral sesamoidectomy. In extension of great toe, there were significant metatarsophalangeal angular differences at more than 2 cm traction in total sesamoidectomy. In other measurements, there were no significant angular changes of the hallucal articulations. CONCLUSION: The sesamoidectomy resulted in change of motion of great toe. Statistical analysis showed that the significant increases in the initial flexion and maximal extension occurred with total sesamoidectomy and the significant increase in the initial flexion occurred with lateral sesamoidectomy.

Clinical Results of the Subtalar Arthroereisis for the Flat Foot / 대한족부족관절학회지

PURPOSE: To determine the clinical and radiographic results of arthroereisis using the Kalix(R) implant (Newdeal, Lyon, France) for the treatment of flexible flatfoot deformity. MATERIALS AND METHODS: From February 2005 to February 2007, we performed the subtalar arthroereisis on 8 patients (9 feet) of symptomatic flexible flat feet after more than 6 months of conservative treatment. Average age was 14.5 years (11~29 years) old. We checked the functional status with AOFAS functional score pre-operatively and at final follow-up. Radiologically, we took weight bearing anterior to posterior and lateral view of the feet, and measured the talo-first metatarsal angle, calcaneal pitch angle in pre-operatively and at final follow-up. RESULTS: Mean follow up period was 34.4 months. Average AOFAS score improved from preoperatively 65.6 to postoperatively 94.8. Average lateral talo-first metatarsal angle reduced from 12.8degrees preoperatively to 1.6degrees at final follow-up. Average anterior to posterior talo-first metatarsal angle was reduced from 15.1degrees preoperatively to 8.3degrees at final follow-up. Average calcaneal pitch angle was increased from 9.5degrees preoperatively to 12.0degrees at final follow-up. CONCLUSIONS: Subtalar arthroereisis with Kalix(R) implant can be considered to be one of treatment options symptomatic flatfoot deformity patients.

Clinical Outcome after Septic versus Aseptic Revision Total Knee Arthroplasty / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to compare the clinical outcomes of septic and aseptic revision total knee arthroplasty. MATERIALS AND METHODS: This study compared the clinical and radiographic results of 12 septic and 10 aseptic revisions. All septic revisions were treated with two-stage reimplantation using an articulating cement spacer. The range of motion, Knee Society score, WOMAC score, and radiographic results of the American Knee Society were assessed. RESULTS: The preoperative data, which included the average range of motion, Knee Society score, WOMAC score and femoro-tibial angle, were similar in both groups. At the final follow-up, the average range of motion was similar in the two groups: 102.5degrees in the septic revisions, and 114.5degrees in the aseptic revisions (p=0.070). In addition, the Knee Society score, WOMAC score and femoro-tibial angle were similar in both groups. There was no loosening or failure of either component observed in any case. A patellar tendon rupture was observed in one septic revision after surgery. CONCLUSION: Two-stage reimplantation using an articulating cement spacer in septic revisions could achieve functional results that are compatible to aseptic revisions.

The Availability of Total Knee Prostheses in Korean Knees

PURPOSE: This study is to compare the size distribution of current total knee prostheses with a measurements of Korean knees. MATERIALS AND METHODS: 566 consecutive osteoarthritic knees were measured, intraoperatively, for anteroposterior(AP) dimension of medial and lateral condyle, and mediolateral(ML) dimension of distal femur and proximal tibia. The size distribution of 5 total knee arthroplasty(TKA) systems were compared with these measurements. RESULTS: Regarding femoral component, the numbers of available lateral AP sizes within +/-1SD of Korean knees were two in Genesis II, PFC-RPF, Scorpio and one in Advance MPK, LPS-Flex. Those of available ML sizes for +/-1SD range were two in all systems. Regarding tibial component, the numbers of available lateral AP sizes for +/-1SD range were four in Scorpio, three in LPS-Flex, PFC-RPF and two in Advance MPK, Genesis II. Those of available ML sizes for +/-1SD range were two in Advance MPK, Scorpio and one in the others. CONCLUSION: Korean-friendly total knee prostheses should incorporate the size distribution as well as the dimension of the Korean knees.

The Height and Volume of Medial Longitudinal Arch in Normal and Painful Feet / 대한족부족관절학회지

PURPOSE: The purpose of this study was to investigate the differences in simple radiographic parameters and results of 3-D scan among normal and patient groups. MATERIALS AND METHODS: Seventy subjects in each group were studied. Control group consisted of subjects without plantar foot pain (normal group), and two patient groups were one with plantar forefoot pain (metatarsalgia group), the other with plantar heel pain (heel pain group). Simple radiographic parameters were obtained and 3-D scan was done with foot scanner (Nexscan, K&I, Korea) and The height and volumn of the space under the medial longitudinal arch was analyzed (Enfoot, K&I, Korea). These parameters were compared and correlation between radiological parameters and results of the 3-D scan were studied. RESULTS: The results of all parameters distributed normally. There was no signigicant differences among the groups in radiological parameters (talo-first metatarsal angle, calcaneal pitch angle and height of the talar head in standing lateral radiograph) and arch height and arch volumn on 3-D scan. There were statistically significant correlations between radiological and 3-D scan results. CONCLUSION: This study revealed that there is no significant differences in medial longitudinal arch height and volumn among normal and different patient groups and there are variety of arch height in patients with similar symptoms.

The Clinical Results of Autologous Osteochondral Grafts in Osteochondral Lesion of the Talus / 대한족부족관절학회지

PURPOSE: To evaluate clinical results of autologous osteochondral graft in osteochondral lesions of the talus. MATERIALS AND METHODS: Twenty feet in twenty patients underwent osteochondral autologous transfer in the osteochondral lesions of the talus. Sixteen were men and four were women. The mean age was 40.8 years old. The mean follow up was 2 years 9 months. Eighteen cases were medial, one case was lateral and one case was both, respectively. The average duration of symptom was 4 years 3 months. AOFAS ankle/hindfoot score (AOFAS score), visual analogue scale (VAS), Lysholm knee score were evaluated preoperatively and at the final follow up. RESULTS: Postoperative AOFAS score was 87.3 (range, 69-100), which was significantly improved from preoperative AOFAS score of 62.0 (p=0.000). Postoperative VAS was 2.9 (range, 0-7), which was significantly improved from preoperative VAS of 7.5 (p=0.000). Postoperative Lysholm knee score was 92.4 (range, 80-100). All osteotomy of medial malleolus was united by the 4th month after surgery. Postoperative VAS was conversely correlated with the follow up period (p=0.024). There was no complications associated with surgery. CONCLUSION: Autologous osteochondral grafts in osteochondral lesion of the talus demonstrated excellent results with a short-term follow up.

A Comparative Study between High-Flex and Non High-Flex TotalKnee Arthroplasty / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to compare the clinical results of a high-flex design (Scorpioflex(R), Stryker) in total knee arthroplasty with those of a non-high-flex design (Scorpio(R) PS type, Stryker). MATERIALS AND METHODS: Fifty-two knees with at least 120 degrees of further flexion preoperatively underwent total knee arthroplasty. Of the 52 knees, there were 35 knees in the high-flex design (HF group) and 17 knees in the non high-flex design (non-HF group). The clinical results were evaluated by postoperative further flexion at 3 months, 6 months, 1 year, 2 years and 3 years, as well as by Delta flexion, which means postoperative flexion improvement. The Knee Society Score and X-rays were evaluated preoperatively and at the 3-year follow-up. RESULTS: The HF group showed significantly greater flexion than the non-HF group at 3 months postoperatively (p=0.000). The delta flexion was also greater in the HF group at 3 months postoperatively (p=0.000). The Knee Society Score and X-rays were similar in the two groups at the final follow-up (p>0.05). CONCLUSION: High-flex total knee arthroplasty appears to facilitate greater flexion in the first 3 months postoperatively, but there is no significant difference between both groups with regard to the range of motion, clinical and radiographic variables after 3 months.

Effects of the Human-Mesenchymal Stem Cells Transplantation on Spinal Cord Injury of the Rats / 대한해부학회지

Two sources of adult stem cells that have aroused great interest are human bone marrow-derived mesenchymal stem cells (hMSCs) and human umbilical cord blood cells. hMSCs have been reported to maintain their ability to differentiate into neuronal lineage cells in the central nervous system. Therefore, transplantation of hMSCs represents an attractive new form of cellular therapy for clinical application in spinal cord injury (SCI). The aim of this study was to investigate how transplanted hMSCs from the venous circulation moved into a target zone of compression injury in the spinal cord of rats, and if they ameliorated the behavioral impairments associated with SCI. SCI in rats was induced by compressing the spinal cord for 30 s with an aneurysm clip. hMSCs labeled with cholera toxin subunit B conjugated to fluorescein isothiocyanate (CTX B-FITC) were injected intravenously through the tail vein or directly on the SCI site using a 27-g needle. Suspensions of hMSCs collected from adult humans were delivered at concentrations (1x10(6)cells/200 microliter) in 1 or 5 d after experimental SCI. After transplantation of hMSCs, the SCI regions displayed some endogenous background fluorescence, but CTX B-FITC-labeled hMSCs were clearly identifiable. They were observed in injured but not in intact areas; they were usually round or slightly elongated with a prominent nucleus. Only a few hMSCs were found in the spinal cord in each case but there were more cells in the rats injected at day one than at day five. This study confirmed that these were indeed transplanted hMSCs using antisera recognizing human-specific nuclei or human-specific mitochondria. Double immunofluorescence analysis showed the production of some neuronal and glial cell markers in the SCI lesions. Behavioral test scores of SCI rats treated with hMSCs at day one were significantly better than those for rats treated at day five and for the untreated SCI group. Thus, hMSCs appear to be beneficial in reversing the behavioral effects of SCI in this rat model, even when infused one day after injury. They might be a viable source of stem cells for the treatment of human neurological disorders.

Morphological Changes in Vasopressin-immunoreactive Neurons in the Hypothalamus of the Aged Rats / 체질인류학회지

The role of neuropeptides in the central nervous system (CNS) has received increasing attention. Numerous peptide molecules are found in the mammalian CNS and many of them are thought to act as either neurotransmitters or neuromodulators. The neuropeptides found in high concentration in the hypothalamus include vasopressin (VP), vasoactive intestinal polypeptide, somatostatin, and oxytocin. The main approches to assess the involvement of neuropeptides can be focused on functions affecting the aging of the brain. Morphological aging of the CNS has been characterized by degenerative changes of fiber connections and cell loss, although degeneration does not always occur to the same extent throughout various parts of the brain and, moreover, varies for different cell types. Despite of many studies in VP containing neurons , there exist discrepancies in results about the changes of aged rat brain. The aim of the present study is, therefore, to investigative possible changes in the number and morphology of VPimmunoreactive neurons with aging in each area of the hypothalmus of the aged rats. As a result, the number of VP-immunoreactive neurons was decreased in hypothalamus nucleus of aged group. Especially, in VP-immunoreactive neurons of hypothalamus, the size of neuronal cell body and nuclei in aged group is larger than in young group and the fiber density of immunoreactivity neurons of median eminance (ME) in aged group is stronger than in young group. But, the total number of VP-immunoreactive neurons in the suprachiasmatic nucleus (SCN) of the aged group is larger than in the young group. These studies indicate the involvement of VP-immunoreactive neurons in aging process of hypothalamus, and aging process may affect the synthesis of VP in the neurons of hypothalamic nuclei. Whereas, in VP expression, aging process induces an enlargement of the cell size of surviving neurons to compensate.

Anthropometric Analyses of Korean Female Knees

PURPOSE: This study is to establish a detailed anthropometric data of Korean female knee and to compare the data with current total knee prostheses. MATERIALS AND METHODS: 476 consecutive osteoarthritic knees were measured intraoperatively about anteroposterior (AP) dimension of medial and lateral condyle, and mediolateral (ML) dimension of distal femur as well as proximal tibia. Dimensions of 5 total knee arthroplasty (TKA) systems were compared with these measurements. RESULTS: The AP dimension of medial and lateral condyle, and ML dimension of distal femur were 60.3+/-3.5 mm, 60.9+/-3.2 mm and 68.4+/-3.9 mm, respectively. Those of proximal tibia were 47.4+/-2.8 mm, 39.5+/-3.1 mm and 67.4+/-2.9 mm, respectively. Korean femurs below -1 standard deviation (SD) in lateral AP dimension had narrower ML dimension than femoral prostheses. And most femurs above -1 SD in lateral AP dimension had wider ML dimension than femoral prostheses. Korean tibias had wider ML dimension than tibial prostheses. CONCLUSION: Current total knee prostheses had tendency to ML overhang in small femurs and ML undercoverage in other femurs, and tendency to ML undercoverage or posterolateral overhang in tibias. Thus, Korean anthropometric data should be considered in Korean-friendly prostheses.

Effect of Maternal Thyroxine Treatment on the Postnatal Development of Brain-derived Neurotrophic Factor-containing Neuron in the Brain of Pups of Alcohol Abused Mother / 대한해부학회지

Maternal alcohol abuse is thought to be the common cause of mental retardation. Especially, continuous alcohol consumption during critical period of brain development induce fetal alcohol effects. In this study, the authors investigated the effects of maternal alcohol drinking on the postnatal changes of BDNF contents and patterns of BDNF-containing neuron in neonatal rat brain, and, the influence of maternal thyroxine treatment on the brain of pups of alcohol abused mother. Pregnant rats were divided into three groups. Alcohol-fed group (n=4) received 35 calories of liquid alcohol diet daily from gestation day 6; control pair-fed group (n=4) was fed a liquid diet in dextrin replaced alcohol isocalorically; alcohol+T4 group (n=4) received 35 calories liquid alcohol diet and exogenous thyroxine (5 microgram/kg/day) subcutaneously. The amount of BDNF was significantly higher in the alcohol+T4 group as compared to the alcohol group at P7, P14 and P21, especially, alcohol+T4-exposed pups showed a significant increase of BDNF at P7. The decrease in BDNF was found in alcohol group compared to control pair-fed group at all ages. In alcohol+T4 group, BDNF-containing Purkinje cells exhibited mature pattern and monolayer arrangement at P14. Alcohol+T4 group showed mature pattern and numerical increase of BDNF-containing cells in cerebral cortex, hypothalamus and hippocampus at P7. The BDNF immunoreactivity of hippocampus continued to show prominent configuration in alcohol+T4 group at P28. These results indicate that the increase of the BDNF-containing neurons and BDNF amount in pups of thyroxinesupplemented alcohol-exposed dams as compared to control pair-fed and alcohol-exposed pups at P7, presumably suggest the early postnatal growth stimulatory effect of the exogenously supplemented thyroxine. Therefore, the increase of BDNF synthesis caused by maternal administration of exogenous thyroxine may ameliorate fetal alcohol effects, one of the ill effects as a result of the dysthyroid state following maternal alcohol abuse.

Difference in HLA-DR Expression of Human Umbilical Cord Blood Derived Mesenchymal Stem Cells after Tri-lineage Differentiation / 대한정형외과연구학회지

PURPOSE: The aim of this study was to examine the expression of HLA-DR surface antigen in undifferentiated human umbilical cord blood (hUCB) derived mesenchymal stem cells (MSCs) and after osteogenic, chondrogenic, and adipogenic differentiation. MATERIALS AND METHODS: hUCB-derived MSCs were differentiated into osteogenic, chondrogenic, and adipogenic lineages. Differentiation was assessed by immunohistochemical staining and RT-PCR. The expression of HLA-DR was assessed with antihuman HLA-DR antibody in undifferentiated hUCB-derived MSCs and after tri-lineage differentiation. RESULTS: HLA-DR expression was negative in undifferentiated hUCB-derived MSCs and after osteogenic and adipogenic differentiation. However, HLA-DR surface antigen was expressed after chondrogenic differentiation. CONCLUSION: The immunologic properties of hUCB-derived MSCs differ from known reports on bone marrow derived MSCs from the results of this study. Careful immunological survey seems to be needed in case of considering the transplantation of hUCB-derived MSCs differentiated into chondrocytes or cartilaginous tissue.

MRI findings of Root Tear of Medial Meniscus

PURPOSE: This study was to elevate the accuracy of MRI diagnosis by means of inspection of the demonstrable findings of the root tear of medial meniscus. MATERIALS AND METHODS: From September 2003 to August 2004, MR images were obtained from 15 of 29 patients who had a root tear of medial meniscus on arthroscopic examination. Each sagittal, axial and coronal images was obtained. Of 15 patients, three were men and 12 were women. The mean age was 59.3 years. RESULTS: All of 15 patients were diagnosed as medial meniscus root tear. Sagittal images showed loss of shape and signal intensity. Axial images showed radial linear defect. And coronal images showed vertical linear defect. CONCLUSION: The characteristic findings from three planes of MRI were helpful for diagnosis of medial meniscus root tear.

A Radiographic Analysis of the Feet in Heel Pain / 대한족부족관절학회지

PURPOSE: This study is to compare the medial longitudinal arch between heel pain group and normal painless group. MATERIALS AND METHODS: Heel pain group 242 feet and normal group 140 feet were evaluated through the radiographic images of standing foot-ankle lateral view. Four radiographic indices, talo-1stmetatarsal angle (TMA), calcaneal-1st metatarsal angle (CMA), calcaneal pitch angle (CPA), and arch ratio (AR), were used as well as BMI. RESULTS: There was no difference between heel pain group and normal group in the TMA, CMA, CPA, and AR. But in the BMI, heel pain group showed 1.7 kg/m2 (p=0.0002) higher than normal group. To eliminate the sexual error, male and female were evaluated separately. Male heel pain group showed 2.9 degrees more dorsiflexion (p=0.001) in the TMA, 3.1 degrees greater (p=0.007) in the CMA, 0.01 lower (p=0.028) in the AR, and 1.0 kg/m2 greater (p=0.033) in the BMI than normal male group. There were no difference in the CPA. Female heel pain group showed 3.6 degree greater (p=0.035) in the CMA, and 1.9 kg/m2 greater (p=0.002) in the BMI than normal female group. But other indices demonstrated no differences. CONCLUSION: talo-1stmetatarsal angle, calcaneal-1st metatarsal angle and arch ratio were radiographic indices related with heel pain.

A Radiographic Analysis of the Feet in Heel Pain / 대한족부족관절학회지

PURPOSE: This study is to compare the medial longitudinal arch between heel pain group and normal painless group. MATERIALS AND METHODS: Heel pain group 242 feet and normal group 140 feet were evaluated through the radiographic images of standing foot-ankle lateral view. Four radiographic indices, talo-1stmetatarsal angle (TMA), calcaneal-1st metatarsal angle (CMA), calcaneal pitch angle (CPA), and arch ratio (AR), were used as well as BMI. RESULTS: There was no difference between heel pain group and normal group in the TMA, CMA, CPA, and AR. But in the BMI, heel pain group showed 1.7 kg/m2 (p=0.0002) higher than normal group. To eliminate the sexual error, male and female were evaluated separately. Male heel pain group showed 2.9 degrees more dorsiflexion (p=0.001) in the TMA, 3.1 degrees greater (p=0.007) in the CMA, 0.01 lower (p=0.028) in the AR, and 1.0 kg/m2 greater (p=0.033) in the BMI than normal male group. There were no difference in the CPA. Female heel pain group showed 3.6 degree greater (p=0.035) in the CMA, and 1.9 kg/m2 greater (p=0.002) in the BMI than normal female group. But other indices demonstrated no differences. CONCLUSION: talo-1stmetatarsal angle, calcaneal-1st metatarsal angle and arch ratio were radiographic indices related with heel pain.

Effect of Maternal Thyroxine Treatment on the Postnatal Development of Brain-derived Neurotrophic Factor-containing Purkinje Cell in Fetal Alcohol Effects in the Rat Cerebellum / 체질인류학회지

Maternal alcohol abuse is thought to be the common cause of mental retardation. Even moderate maternal alcohol consumption may produce fetal alcohol effects with behavioral and learning difficulties, if the drinking is associated with malnutrition. Especially, continuous alcohol consumption during critical period of brain development is very likely to produce fetal alcohol effects. The aims of this study are to investigate whether exogenous thyroxine treatment to alcohol -fed dams may ameliorate the detrimental effects of alcohol on the postnatal development of BDNF -containing Purkinje cell of the cerebellar cortex of the offspring. The morphological features of the growth and maturation were observed at 0, 7, 14, 21, 28 postnatal days via immunohistochemistry. In addition, electron microscopic finding of BDNF -containing Purkinje cell at P14 was also examined. Time -pregnant rats were divided into three groups. Alcohol -fed group received 35 calories of liquid alcohol diet daily from gestation day 6; control pair -fed group was fed a liquid diet in which dextrin replaced alcohol isocalorically; alcohol +/-T4 group received 35 calories liquid alcohol diet and exogenous thyroxine subcutaneously. As a result, a similar developmental pattern of BDNF -immunoreactive Purkinje cells was observed in control pair - fed and alcohol+/-T4 group on and after P14. These cells of alcohol -fed group showed immature features. Single -layer arrangement of these cells in alcohol -fed group was not completely achieved throughout postnatal life. Electron microscopic observations of BDNF -immunoreactive Purkinje cells at P14 revealed large nucleus, small cytoplasm, small amount of ribosomal collection and rudimentary cytoplasmic organelles in alcohol -fed group. The morphology of BDNF -immunoreactive Purkinje cell in alcohol +/-T4 group was similar to that in control pair -fed group. It was characterized by numerous short segments of rough endoplasmic reticulum, many of which showed a tendency of parallel alignment that suggested an attempt at Nissl body configuration. The cytology of Golgi complexes was also found within the cytoplasm in perinuclear location. Those observed differences of postnatal maturation patterns between alcohol -fed and alcohol +/-T4 group may indicate the beneficial effects on the postnatal development of BDNF -containing Purkinje cells in cerebellar cortex in the pups of thyroxine -treated alcohol -exposed dams. These results suggest that the increase of BDNF synthesis during early postnatal life caused by maternal administration of exogenous thyroxine may ameliorate fetal alcohol effects as a result of the dysthyroid state following maternal alcohol abuse.