Citations

AbstractBackgroundNeuropathic deformities impair foot and ankle joint mobility, often leading to abnormal stresses and impact forces. The purpose of our study was to determine differences in radiographic measures of hind foot alignment and ankle joint and subtalar joint motion in participants with and without neuropathic midfoot deformities and to determine the relationships between radiographic measures of hind foot alignment to ankle and subtalar joint motion in participants with and without neuropathic midfoot deformities.MethodsSixty participants were studied in three groups. Forty participants had diabetes mellitus (DM) and peripheral neuropathy (PN) with 20 participants having neuropathic midfoot deformity due to Charcot neuroarthropathy (CN), while 20 participants did not have deformity. Participants with diabetes and neuropathy with and without deformity were compared to 20 young control participants without DM, PN or deformity. Talar declination and calcaneal inclination angles were assessed on lateral view weight bearing radiograph. Ankle dorsiflexion, plantar flexion and subtalar inversion and eversion were assessed by goniometry.ResultsTalar declination angle averaged 34±9, 26±4 and 23±3 degrees in participants with deformity, without deformity and young control participants, respectively (p< 0.010). Calcaneal inclination angle averaged 11±10, 18±9 and 21±4 degrees, respectively (p< 0.010). Ankle plantar flexion motion averaged 23±11, 38±10 and 47±7 degrees (p<0.010). The association between talar declination and calcaneal inclination angles with ankle plantar flexion range of motion is strongest in participants with neuropathic midfoot deformity. Participants with talonavicular and calcaneocuboid dislocations result in the most severe restrictions in ankle joint plantar flexion and subtalar joint inversion motions.ConclusionsAn increasing talar declination angle and decreasing calcaneal inclination angle is associated with decreases in ankle joint plantar flexion motion in individuals with neuropathic midfoot deformity due to CN that may contribute to excessive stresses and ultimately plantar ulceration of the midfoot.

This study concerns the development and preliminary experimental verification of a topological sensitivity–based platform for the material characterization of tissue anomalies exposed by vibroacoustography-type imaging techniques. Vibroacoustography (VA) is a high-resolution imaging method that has been applied to the detection of pathological changes in soft tissues. Although the data provided by this method is related to the mechanical properties of tissue, the viscoelastic parameters of the object cannot be estimated by this imaging method itself. Topological sensitivity (TS) method is a data processing methodology that can be used to estimate the viscoelastic parameters of an object from vibration data. In this study, the concept of topological sensitivity is applied to interpret the vibroacoustography measurements for the purpose of lesion characterization. In the proposed approach, the topological sensitivity function, which signifies the variation of a given cost functional when an infinitesimal inclusion with trial material parameters is placed at the location of a point force, is formulated in terms of the adjoint field. The effectiveness of the resulting formula as a material indicator for lesion characterization is demonstrated by estimating the relative elastic parameters of a well-controlled neoprene sphere embedded in a tissue-mimicking phantom specimen.

AbstractIntercellular adhesion proteins are poorly characterized in acantholytic squamous cell carcinoma (ASCC), a more aggressive tumor than nonacantholytic invasive well-differentiated squamous cell carcinoma (SCC) of the skin. In this study we compared expression of Dsg3, E-cadherin, and syndecan-1 in ASCC and SCC. Immunohistochemical detection of Dsg3, E-cadherin, and syndecan-1 in 22 ASCCs and 22 SCCs was graded on a semiquantitative scale for intensity of staining (SI) and degree of circumferential staining (CS) about the cell membrane. Results were assessed by means of conditional logistic regression and χ2 analysis. Dsg3 and E-cadherin expression (SI, CS) was significantly decreased (P &lt; .05) in ASCC compared with SCC, whereas staining for syndecan-1 was similar in the 2 tumor types. Differences in expression of adhesion markers between ASCC and SCC may contribute to the development of acantholysis in ASCC and its more aggressive biologic behavior.