... José Zariffa1,2,3, Mary K. Nagai1,3, Zafiris J. Daskalakis4 and Milos R. Popovic1,2,3 ... The... more ... José Zariffa1,2,3, Mary K. Nagai1,3, Zafiris J. Daskalakis4 and Milos R. Popovic1,2,3 ... The authors would like to thank Dr. Thomas Stieglitz and Dr. Martin Schuettler for providing us with the cuff electrodes, as well as Lori Dixon, Ashlie Soko and Dr. Dimitry Sayenko for their help ...
We used the dynamic pedobarographs to study pressure distribution patterns in the foot after surg... more We used the dynamic pedobarographs to study pressure distribution patterns in the foot after surgical correction of cavovarus feet. We also assessed the influence of ankle power generation on pressure distribution in these feet. Nine children (14 feet) diagnosed with Charcot-Marie-Tooth disease who had undergone operative treatment with a combination of osteotomies and muscle transfers were the subjects of this study. Preoperative and postoperative pedobarographic measurements recorded included pressure over the medial forefoot, lateral forefoot, medial midfoot (MMF), lateral midfoot (LMF), and heel segments. In 6 patients (9 feet) who had a complete gait analysis, the power generation of the ankle was also obtained both preoperatively and postoperatively. Lateral radiographic measurements included the (1) talus-first metatarsal angle, (2) calcaneus-first metatarsal angle, and (3) calcaneal pitch. The radiographs showed significant improvements in all 3 angles. Increased LMF and decreased forefoot pressures were seen on preoperative pedobarographic measures. Postoperatively, improvement in pressure at the LMF was seen. When postoperative measurements were compared with the normal values, only the LMF was similar; the other 4 segments showed decreased forefoot and MMF pressures and increased heel pressures (P = 0.000 for the lateral forefoot and MMF; 0.040 for the heel and medial forefoot). The heel pressures displayed an inverse relationship to ankle power generation. The amount of correction achieved radiographically did not correlate with pedobarographic measurements. The increased heel pressure that was noted was not addressed by treatment. Normalization of pressure patterns should be the goal in treating children with symptomatic cavovarus feet. Although the foot deformity is corrected completely in neuromuscular disorders, pressure distribution was not normalized, and therefore, symptoms might persist. Both patients and parents should be informed about this possible problem before surgical intervention.
A previous study from our laboratory (L. C. Eriksson et al., Biochem. Biophys. Res. Commun., 117:... more A previous study from our laboratory (L. C. Eriksson et al., Biochem. Biophys. Res. Commun., 117: 740-745, 1983) revealed that a cytosolic polypeptide of approximate M, 21,000 (designated P-21) was markedly elevated in amount in hepatocyte nodules induced by six different regi mens. The molecular weight of this polypeptide, subsequently revised to approximately 26,000, was redesignated P-26 and was identified (T. H.
Context Firing rates of single cortical neurons can be volitionally modulated through biofeedback... more Context Firing rates of single cortical neurons can be volitionally modulated through biofeedback (i.e. operant conditioning), and this information can be transformed to control external devices (i.e. brain-machine interfaces; BMIs). However, not all neurons respond to operant conditioning in BMI implementation. Establishing criteria that predict neuron utility will assist translation of BMI research to clinical applications. Findings Single cortical neurons (n=7) were recorded extracellularly from primary motor cortex of a Long-Evans rat. Recordings were incorporated into a BMI involving up-regulation of firing rate to control the brightness of a light-emitting-diode and subsequent reward. Neurons were classified as 'fast-spiking', 'bursting' or 'regular-spiking' according to waveform-width and intrinsic firing patterns. Fast-spiking and bursting neurons were found to up-regulate firing rate by a factor of 2.43±1.16, demonstrating high utility, while regular...
Injury to the central nervous system (CNS) often results in the loss of motor and sensory activit... more Injury to the central nervous system (CNS) often results in the loss of motor and sensory activity with a tragic impact on quality of life. The anatomic and cellular complexity of the nervous system limits its ability to repair itself, making the effects of the injury permanent. To date, the majority of attempts to restore normal function after damage to the brain or spinal cord have been unsuccessful. Recent studies have demonstrated significant improvements in voluntary motor function in patients with chronic and subacute stroke and spinal cord injury (SCI) using functional electrical stimulation (FES) therapy. In this therapy, patients are asked to perform multitudes of specific motor tasks. During each session, the therapist instructs patients to perform a specific movement at a time, and, after a few seconds of trying, highly controlled electrical stimulation is applied to facilitate that specific movement of the paralyzed limb. After completing this therapy program, individuals are often able to perform the tasks voluntarily, i.e., unassisted by the FES system. Using this approach, we have been able to assist patients with complete and incomplete spinal cord injuries, severe stroke, and pediatric stroke to recover the ability to reach, grasp, stand, and walk. In this chapter, we explain why we believe FES has achieved such extraordinary results.
We describe 2 cases of intrauterine gangrene involving the lower extremity in 2 unrelated neonate... more We describe 2 cases of intrauterine gangrene involving the lower extremity in 2 unrelated neonates. Both cases were complicated by prematurity, and 1 case was complicated by an intrauterine distal femur fracture and twin-twin transfusion syndrome. Both cases resulted in profound ischemic necrosis from the knee to the foot, requiring knee disarticulation. In both cases, a follow-up period of 7 years is now completed, and no further medical or surgical complications have arisen.
Teratogenicity of the anticonvulsant phenytoin may be due in part to its bioactivation by prostag... more Teratogenicity of the anticonvulsant phenytoin may be due in part to its bioactivation by prostaglandin synthetase, forming a reactive free radical intermediate. We examined whether teratogenicity of the structurally similar oxazolidinedione anticonvulsants, ...
Valgus deformity of the hindfoot in cerebral palsy (CP) patients is common and causes functional ... more Valgus deformity of the hindfoot in cerebral palsy (CP) patients is common and causes functional deterioration and shoe fitting problems together with skin ulcerations. Our aims in this study are, to present an intra-articular technique of subtalar fusion using allograft and internal fixation to achieve stabilization and second to report the results and clinical outcome of a series of intra-articular subtalar arthrodesis performed in CP children. We performed a retrospective review of radiographs and medical records of 145 children with CP who underwent intra-articular subtalar fusion from January 1994 to December 2004. The subtalar joint was fixed through the anterior facet with a cannulated screw whereas the anterior aspect of the calcaneus was parallel to the anterior aspect of the head of the talus. Tricortical iliac crest allograft was placed into the sinus tarsi and the denuded posterior facet area. Results are grouped as good, satisfactory, and poor according to the radiographic and clinical outcomes. The mean age at the time of surgery was 12.7 years (range: 5 to 20 y) and the average follow-up was 4.8 years (range: 2 to 11 y). Good results were obtained in 242 feet (96%). Satisfactory results were obtained in 6 feet (2%) which were painless pseudoarthrosis of subtalar joint in 2 feet and screw removal was required in 4 feet because of pain. Nonunion of thesubtalar joint together with recurrence of deformity was observed in 5 feet (2%) which is accepted as poor result and required revision surgery. No deep infections, implant failure, allograft failure were observed in a mean of 4.8 years. Our described technique of intra-articular subtalar joint fusion is safe and reliable in CP children with high rate of satisfactory results. Therapeutic studies-Level IV.
Abstract: It is not uncommon to see a patient with bilateral cavovarus feet in the outpatient set... more Abstract: It is not uncommon to see a patient with bilateral cavovarus feet in the outpatient setting. A large percentage of these patients are subsequently diagnosed with an associated condition, such as Charcot-Marie-Tooth disease. The purpose of the present report was to ...
... José Zariffa1,2,3, Mary K. Nagai1,3, Zafiris J. Daskalakis4 and Milos R. Popovic1,2,3 ... The... more ... José Zariffa1,2,3, Mary K. Nagai1,3, Zafiris J. Daskalakis4 and Milos R. Popovic1,2,3 ... The authors would like to thank Dr. Thomas Stieglitz and Dr. Martin Schuettler for providing us with the cuff electrodes, as well as Lori Dixon, Ashlie Soko and Dr. Dimitry Sayenko for their help ...
We used the dynamic pedobarographs to study pressure distribution patterns in the foot after surg... more We used the dynamic pedobarographs to study pressure distribution patterns in the foot after surgical correction of cavovarus feet. We also assessed the influence of ankle power generation on pressure distribution in these feet. Nine children (14 feet) diagnosed with Charcot-Marie-Tooth disease who had undergone operative treatment with a combination of osteotomies and muscle transfers were the subjects of this study. Preoperative and postoperative pedobarographic measurements recorded included pressure over the medial forefoot, lateral forefoot, medial midfoot (MMF), lateral midfoot (LMF), and heel segments. In 6 patients (9 feet) who had a complete gait analysis, the power generation of the ankle was also obtained both preoperatively and postoperatively. Lateral radiographic measurements included the (1) talus-first metatarsal angle, (2) calcaneus-first metatarsal angle, and (3) calcaneal pitch. The radiographs showed significant improvements in all 3 angles. Increased LMF and decreased forefoot pressures were seen on preoperative pedobarographic measures. Postoperatively, improvement in pressure at the LMF was seen. When postoperative measurements were compared with the normal values, only the LMF was similar; the other 4 segments showed decreased forefoot and MMF pressures and increased heel pressures (P = 0.000 for the lateral forefoot and MMF; 0.040 for the heel and medial forefoot). The heel pressures displayed an inverse relationship to ankle power generation. The amount of correction achieved radiographically did not correlate with pedobarographic measurements. The increased heel pressure that was noted was not addressed by treatment. Normalization of pressure patterns should be the goal in treating children with symptomatic cavovarus feet. Although the foot deformity is corrected completely in neuromuscular disorders, pressure distribution was not normalized, and therefore, symptoms might persist. Both patients and parents should be informed about this possible problem before surgical intervention.
A previous study from our laboratory (L. C. Eriksson et al., Biochem. Biophys. Res. Commun., 117:... more A previous study from our laboratory (L. C. Eriksson et al., Biochem. Biophys. Res. Commun., 117: 740-745, 1983) revealed that a cytosolic polypeptide of approximate M, 21,000 (designated P-21) was markedly elevated in amount in hepatocyte nodules induced by six different regi mens. The molecular weight of this polypeptide, subsequently revised to approximately 26,000, was redesignated P-26 and was identified (T. H.
Context Firing rates of single cortical neurons can be volitionally modulated through biofeedback... more Context Firing rates of single cortical neurons can be volitionally modulated through biofeedback (i.e. operant conditioning), and this information can be transformed to control external devices (i.e. brain-machine interfaces; BMIs). However, not all neurons respond to operant conditioning in BMI implementation. Establishing criteria that predict neuron utility will assist translation of BMI research to clinical applications. Findings Single cortical neurons (n=7) were recorded extracellularly from primary motor cortex of a Long-Evans rat. Recordings were incorporated into a BMI involving up-regulation of firing rate to control the brightness of a light-emitting-diode and subsequent reward. Neurons were classified as 'fast-spiking', 'bursting' or 'regular-spiking' according to waveform-width and intrinsic firing patterns. Fast-spiking and bursting neurons were found to up-regulate firing rate by a factor of 2.43±1.16, demonstrating high utility, while regular...
Injury to the central nervous system (CNS) often results in the loss of motor and sensory activit... more Injury to the central nervous system (CNS) often results in the loss of motor and sensory activity with a tragic impact on quality of life. The anatomic and cellular complexity of the nervous system limits its ability to repair itself, making the effects of the injury permanent. To date, the majority of attempts to restore normal function after damage to the brain or spinal cord have been unsuccessful. Recent studies have demonstrated significant improvements in voluntary motor function in patients with chronic and subacute stroke and spinal cord injury (SCI) using functional electrical stimulation (FES) therapy. In this therapy, patients are asked to perform multitudes of specific motor tasks. During each session, the therapist instructs patients to perform a specific movement at a time, and, after a few seconds of trying, highly controlled electrical stimulation is applied to facilitate that specific movement of the paralyzed limb. After completing this therapy program, individuals are often able to perform the tasks voluntarily, i.e., unassisted by the FES system. Using this approach, we have been able to assist patients with complete and incomplete spinal cord injuries, severe stroke, and pediatric stroke to recover the ability to reach, grasp, stand, and walk. In this chapter, we explain why we believe FES has achieved such extraordinary results.
We describe 2 cases of intrauterine gangrene involving the lower extremity in 2 unrelated neonate... more We describe 2 cases of intrauterine gangrene involving the lower extremity in 2 unrelated neonates. Both cases were complicated by prematurity, and 1 case was complicated by an intrauterine distal femur fracture and twin-twin transfusion syndrome. Both cases resulted in profound ischemic necrosis from the knee to the foot, requiring knee disarticulation. In both cases, a follow-up period of 7 years is now completed, and no further medical or surgical complications have arisen.
Teratogenicity of the anticonvulsant phenytoin may be due in part to its bioactivation by prostag... more Teratogenicity of the anticonvulsant phenytoin may be due in part to its bioactivation by prostaglandin synthetase, forming a reactive free radical intermediate. We examined whether teratogenicity of the structurally similar oxazolidinedione anticonvulsants, ...
Valgus deformity of the hindfoot in cerebral palsy (CP) patients is common and causes functional ... more Valgus deformity of the hindfoot in cerebral palsy (CP) patients is common and causes functional deterioration and shoe fitting problems together with skin ulcerations. Our aims in this study are, to present an intra-articular technique of subtalar fusion using allograft and internal fixation to achieve stabilization and second to report the results and clinical outcome of a series of intra-articular subtalar arthrodesis performed in CP children. We performed a retrospective review of radiographs and medical records of 145 children with CP who underwent intra-articular subtalar fusion from January 1994 to December 2004. The subtalar joint was fixed through the anterior facet with a cannulated screw whereas the anterior aspect of the calcaneus was parallel to the anterior aspect of the head of the talus. Tricortical iliac crest allograft was placed into the sinus tarsi and the denuded posterior facet area. Results are grouped as good, satisfactory, and poor according to the radiographic and clinical outcomes. The mean age at the time of surgery was 12.7 years (range: 5 to 20 y) and the average follow-up was 4.8 years (range: 2 to 11 y). Good results were obtained in 242 feet (96%). Satisfactory results were obtained in 6 feet (2%) which were painless pseudoarthrosis of subtalar joint in 2 feet and screw removal was required in 4 feet because of pain. Nonunion of thesubtalar joint together with recurrence of deformity was observed in 5 feet (2%) which is accepted as poor result and required revision surgery. No deep infections, implant failure, allograft failure were observed in a mean of 4.8 years. Our described technique of intra-articular subtalar joint fusion is safe and reliable in CP children with high rate of satisfactory results. Therapeutic studies-Level IV.
Abstract: It is not uncommon to see a patient with bilateral cavovarus feet in the outpatient set... more Abstract: It is not uncommon to see a patient with bilateral cavovarus feet in the outpatient setting. A large percentage of these patients are subsequently diagnosed with an associated condition, such as Charcot-Marie-Tooth disease. The purpose of the present report was to ...
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