Subtalar repositional arthrodesis for adult acquired flatfoot.

Arthrodesis of the subtalar joint is well recognized treatment option for moderate or severe flatfoot associated with adult acquired flatfoot secondary to posterior tibial tendon dysfunction. The success of the subtalar arthrodesis is dependent on restoration of normal bony relationships in the hindfoot and midfoot. For this reason, a distinction is made between a repositional arthrodesis and the traditional in situ type of arthrodesis.

Amyotrophic lateral sclerosis: Lou Gehrig's disease.

Amyotrophic lateral sclerosis (ALS), commonly called Lou Gehrig's disease, is a progressive neuromuscular condition characterized by weakness, muscle wasting, fasciculations and increased reflexes. Approximately 30,000 Americans currently have the disease. The annual incidence rate is one to two cases per 100,000.

Ki-1+ large-cell anaplastic lymphoma after Ewing sarcoma.

Purpose: A large cell anaplastic lymphoma that developed after treatment of a Ewing sarcoma (ES) is described.

Patient: An 11-year-old girl with a pelvic ES developed a large cell, Ki-1+, anaplastic lymphoma in the same anatomic location 10 months after multimodal therapy.

Results: ES recurred in the primary site 16 months after allogeneic marrow transplantation and 3.

Effect of angiotensin-converting enzyme inhibitor therapy in mitral regurgitation with normal left ventricular function.

Mitral regurgitation (MR) is a common, frequently asymptomatic valvulopathy that can ultimately lead to left ventricular failure. With the objective of forestalling MR progression, a prospective, placebo controlled, double-blind study was conducted. It measured the effectiveness of lisinopril, an angiotensin-converting enzyme inhibitor, in reducing the echocardiographic signs of MR severity over a one-year period.

Propionibacterium acnes endocarditis.

Propionibacterium acnes endocarditis is a rare disease. A case of prosthetic valve endocarditis involving P acnes complicated by multiple mycotic aneurysms is reported. A brief review of the literature is presented.

Subungual (Dupuytren's) exostosis.

Dupuytren's subungual exostosis is an uncommon osteochondral lesion affecting the distal phalanx of adolescents. Lack of awareness of this unusual lesion causes many to be initially misdiagnosed. Accurate diagnosis based on clinical findings and radiographs and appropriate treatment methods are outlined.

Subungual exostosis: a simple technique of excision.

Subungual or Dupuytren's exostosis is a benign lesion of the distal phalanx that is prone to recurrence if incompletely excised. We report on a series of five patients treated with our simple excision technique. Despite sacrifice of a portion of the nail bed, the cosmetic appearance of the nail was excellent in four patients and good in one patient.

Soft-tissue and bone tumors about the foot and ankle.

The development of primary and malignant tumors of the soft tissues and bones of the foot and ankle are uncommon. A potential for misdiagnosis and increased morbidity exists for those patients who do indeed have a malignancy. This article illustrates the proper steps in staging lesions and the appropriate techniques for biopsy.

Chlamydia trachomatis screening in a family planning clinic.

Objective: The purpose of this study was to determine the prevalence of chlamydia in women attending a family planning clinic and to explore the feasibility of making chlamydia screening part of the routine procedure for all women. This study also investigated clinical and demographic parameters that may be associated with chlamydial infections.

Methods: Subjects were 239 female patients who attended the Planned Parenthood Clinic in Wichita, Kansas, during July 1990.

Prurigo nodularis.

Prurigo nodularis is a chronic skin disorder that is frequently misdiagnosed. It is characterized by multiple pea-sized nodules that develop on the skin, particularly on the anterior leg and thigh. These lesions are intensely pruritic and frequently become excoriated and infected.

Exercise testing in women with chest pain: applications and limitations of computer analysis.

Background: The frequent occurrence of false-positive results of standard electrocardiographic (ECG) treadmill exercise testing in women limits its diagnostic value. In men, a commercially available computer-derived treadmill exercise score (TES), which quantifies the exercise ECG, has been reported to have high diagnostic accuracy. The purpose of this study was to test TES accuracy in women.

Bell's palsy in pregnancy and the puerperium.

The incidence of Bell's palsy is significantly higher during the last trimester of pregnancy and the puerperium. Suggested explanations for this association include fluid retention, hypertension, compromise of the vasa nervorum, infection (particularly with herpes simplex virus), and an autoimmune process. The diagnosis is confirmed by identifying lower motor neurone paralysis and excluding secondary causes for the symptom complex.

Cluster headache.

Cluster headache is a rare condition that predominantly affects older men. The diagnosis is based on the history and clinical characteristics, which are distinctive. The headache is always unilateral, excruciating and, most uniquely, occurs in timed attacks, called "clusters.

Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification.

From January 1987 to September 1990, 132 displaced intraarticular calcaneal fractures were treated operatively using a lateral approach, lag screws, and side plate without bone graft. To evaluate the results, a classification for intraarticular calcaneal fractures was developed, based on standardized coronal and transverse computed tomography (CT) scans of both feet. Type 1 fractures were nondisplaced (and received nonoperative treatment); Type II were two-part or split fractures; Type III were three-part or split depression fractures; and Type IV were four-part or highly comminuted articular fractures.

Primary treatment of pelvic osteosarcoma. Report of five cases.

Five patients, ages 12 to 20 years, with nonresectable primary (Patients 2, 3, and 5) and metastatic (Patients 1 and 4) pelvic osteosarcomas were treated with intraarterial cisplatin and concurrent radiation therapy from 1983 to 1987. Long-term local tumor control was achieved in all five patients. Patients 1 and 3 are alive with no evidence of local recurrence or metastatic disease at 77 and 56 months of follow-up, respectively, since diagnosis of the pelvic tumor.