Multicentric giant cell tumor involving the same foot: A case report and review of literature
Indian Journal of Orthopaedics
ORIGINAL ARTICLE: Multicentric giant cell tumour (GCT) is extremely rare; no case has been previously reported where two lesions occurred in the same foot at different sites. We report a case involving the calcaneus and subsequently the 3 rd toe of the same foot and review the reported literature. In established cases of multicentricity, the histopathology has to be properly reviewed and the patient has to be followed up for a longer time with serial whole body assessment to pick up any subsquent lesions. The treatment of the local disease does not differ from a standard GCT.
Cellular and molecular basis of wound healing in diabetes
The Journal of Clinical Investigation 
ORIGINAL ARTICLE: Diabetic foot ulcers (DFUs), a leading cause of amputations, affect 15% of people with diabetes. A series of multiple mechanisms, including decreased cell and growth factor response, lead to diminished peripheral blood flow and decreased local angiogenesis, all of which can contribute to lack of healing in persons with DFUs. In this issue of the JCI, Gallagher and colleagues demonstrate that in diabetic mice, hyperoxia enhances the mobilization of circulating endothelial progenitor cells (EPCs) from the bone marrow to the peripheral circulation (see the related article beginning on page 1249). Local injection of the chemokine stromal cell-derived factor-1 then recruits these EPCs to the cutaneous wound site, resulting in accelerated wound healing. Thus, Gallagher et al. have identified novel potential targets for therapeutic intervention in diabetic wound healing. Diabetes affects approximately 170 million people worldwide, including 20.8 million in the USA (1), and by 2030 these numbers are projected to double (2). The foot ulcer is a leading cause of hospital admissions for people with diabetes in the developed world (3) and is a major morbidity associated with diabetes, often leading to pain, suffering, and a poor quality of life for patients. Diabetic foot ulcers (DFUs) are estimated to occur in 15% of all patients with diabetes (3) and precede 84% of all diabetes-related lower-leg amputations (4). Despite the existence of protocols to standardize care, the physiological impairments that can result in a DFU complicate the healing process. Currently, the only FDA-approved growth factor and cell therapies for DFUs are not routinely used during treatment, preventing professionals from implementing evidence- based protocols (5).
Mesenteric Extraskeletal Osteosarcoma with Telangiectatic Features: A Case Report
BMC Cancer
ORIGINAL ARTICLE: Extraskeletal osteosarcoma is a rare malignant mesenchymal tumor, with a predominant occurrence in the extremities. Only two cases of mesenteric extraskeletal osteosarcoma have been documented. We describe an unusual case of extraskeletal osteosarcoma with telangiectatic features occurring in the mesentery. A 67-year-old male presented with blood-tinged stool of 1-months duration. On colonoscopy, a solid mass was detected protruding from the colon wall. Computed tomography showed a 15 x 9.7 cm heterogeneously enhancing mass, with mottled calcification and a cystic portion, occupying the left upper quadrant of the abdominal cavity. Curative resection of the tumor was performed, and the excised tumor was composed of large multilocular cysts containing old hematomas and necrotic debris. The histology revealed an osteosarcoma showing osteoid formation and blood-filled spaces lined with atypical cells. Despite postoperative chemotherapy, he developed a recurred peritoneal mass and multiple lung metastases 3 months postoperatively. Given the rarity of cases of mesenteric extraskeletal osteosarcoma, its biologic behavior at this location remains to be determined. However, extraskeletal osteosarcoma with telangiectatic features is an uncommon entity to be recognized because of the possible fatal outcome related to the tumors.
Pediatric endurance and limb strengthening for children with cerebral palsy (PEDALS) – A randomized controlled trial protocol for a stationary cycling intervention
BMC Pediatrics
ORIGINAL ARTICLE: In the past, effortful exercises were considered inappropriate for children with spastic cerebral palsy (CP) due to concern that they would escalate abnormalities including spasticity and abnormal movement patterns. Current scientific evidence indicates that these concerns were unfounded and that therapeutic interventions focused on muscle strengthening can lead to improved functional ability. However, few studies have examined the potential benefits of cardiorespiratory fitness exercises in this patient population. The rationale and design of a randomized controlled trial examining the effects of a stationary cycling intervention for children with CP are outlined here. Sixty children with spastic diplegic CP between the ages of 7 and 18 years and Gross Motor Function Classification System (GMFCS) levels of I, II, or III will be recruited for this study. Participants will be randomly assigned to either an intervention (cycling) or a control (no cycling) group. The cycling intervention will be divided into strengthening and cardiorespiratory endurance exercise phases. During the strengthening phase, the resistance to lower extremity cycling will be progressively increased using a uniquely designed limb-loaded mechanism. The cardiorespiratory endurance phase will focus on increasing the intensity and duration of cycling. Children will be encouraged to exercise within a target heart rate range (70 – 80% maximum heart rate). Thirty sessions will take place over a 10-12 week period. All children will be evaluated before (baseline) and after (follow-up) the intervention period. Primary outcome measures are: knee joint extensor and flexor moments, or torque; the Gross Motor Function Measure (GMFM); the 600 Yard Walk-Run test and the Thirty-Second Walk test (30 sec WT). This paper presents the rationale, design and protocol for Pediatric Endurance and Limb Strengthening (PEDALS); a Phase I randomized controlled trial evaluating the efficacy of a stationary cycling intervention for children with spastic diplegic cerebral palsy.
Understanding Pain Mechanisms-CME Instructional Series
Podiatry Management Magazine
Original article: CME instructional series: Dr.’s Steven Abraham, DPM and Simon Young, DPM present an article in this months issue of PM magazine discussing pain. The series objectives include identifying the anatomy of the pain pathway, understanding the different parts of the pain pathway where analgesics can be influenced, understanding how medications can affect the various points of the pain pathway, appreciate the importance of choosing the appropriate pain medication and developing a strategy for pain management in acute and chronic pain.
Read original article [PDF] . . .
Podiatry Today ENews
Podiatry Today-Volume 5, Issue 16
How To Manage Venous Stasis Ulcers
By Tamara D. Fishman, DPM
Given the poor healing rates, high recurrence and costly nature of venous stasis ulcerations, this author offers a primer on key clinical signs, helpful insights on compression and wound care modalities, and underscores the importance of appropriate referrals.
When Patients With Diabetes Have Lower Extremity Nerve Entrapments
By Greg Mowen, DPM
Editor’s note: Peripheral nerve decompression for patients with diabetes and lower extremity neuropathy continues to be a hotly debated topic in podiatric medicine and other specialties. The driving force of evidence based medicine has looked critically upon this procedure while many respected surgeons in a variety of fields have found great clinical successes. Dr. Mowen reviews many of the debate topics and presents some helpful information and opinion in this column.
Is A Unique Topical Ideal For Diabetic Skin Care?
By Aaron Becker, Special Projects Editor
For many patients with diabetes, skin care of the foot can be a primary concern. Neglecting skin conditions as simple as dry or cracked skin can lead to minor wounds or even ulceration.
New Products
Podiatry Today advertisement
Patients with diabetes who need extra foot protection may turn to a new compression sock.
The Foot Blog News this Week
The Foot Blog
Issue 16-June 2007:
- 15 minutes of walking can do some good
- Increased Coffee Consumption Linked To Decreased Risk Of Gout In Men Over Age 40
- When It Comes To Preventing Amputation In Diabetics, Site, Not Size, Matters
- Mother dies after she stubs toe in the street
- Sally Field Addresses Members Of Congress About Osteoporosis During National Osteoporosis Awareness Month
- Foot fracture often overlooked
- Get your skates on to tackle arthritis
- Sun Tan News for the Summer
- Discovery Of The Cellular Origin Of Ewing’s Sarcoma
- Raynaud’s Disease: The Reason Behind Cold, White Fingers And Toes
Podiatry Related Abstracts this Week
Entrez Pub Med, Wiley Interscience, Ingenta Connect, Blackwell Synergy and more . . .
Relation of increased hemoglobin a(1c) levels to severity of peripheral arterial disease in patients with diabetes mellitus.Am J Cardio
Clinical Utility of a Stability- Based Ankle Fracture Classification System. J Ortho Trauma
Resection of the so-called fibular cord in congenital absence of fibula Ortho & Trauma
Prognostic Significance of Declining Ankle-brachial Index Values in Patients with Suspected or Known Peripheral Arterial Disease.Eur J Vasc Endovasc Surg
Transcutaneous oximetry compared to ankle-brachial-index measurement in the evaluation of percutaneous transluminal angioplastyEur J Radio
Gait patterns of a patient with myoclonus of a lower limb, when OFF and ON treatment with antiepileptic drugs Neuro Science
Point: Vancomycin Is Not Obsolete for the Treatment of Infection Caused by Methicillin-Resistant Staphylococcus aureusClinical Inf Diseases
Counterpoint: Vancomycin and Staphylococcus aureusAn Antibiotic Enters ObsolescenceClinical Inf Diseases
© Podiatry Internet Communications (PICOMM)
ORIGINAL ARTICLE: Subtalar dislocation is the simultaneous dislocation of the distal articulations of the talus at both the talocalcaneal and talonavicular joints. It can occur in any direction and always produce significant deformity. Most common is the medial dislocation. Less common presentations are lateral, anterior and posterior dislocations. These dislocations are associated with osteochondral fractures. Closed reduction and immobilization remains the mainstay of treatment. Proper radiographs and CT scan confirms the post reduction alignment stability of subtalar joints and intra-articular fracture fragments. We report a case of lateral subtalar dislocation without osteochondral fracture fragments in a 30-year-old man. 
ORIGINAL ARTICLE: Open talar extrusion is an uncommon injury that the foot and ankle surgeon may encounter. Possible sequelae of this injury include arthrosis, osteomyelitis and avascular necrosis (AVN). The authors present a case involving an open lateral talar extrusion, with further discussion including mechanism of injury, anatomical considerations, incidence of AVN and perioperative concerns. 
ORIGINAL ARTICLE: This work was originally undertaken to determine the effective conditions of essential oils against Trichophyton mentagrophytes in vitro for the treatment of tinea pedis in a foot bath. Agar blocks implanted with T. mentagrophytes were immersed in 0.1% aqueous agar containing two-fold dilutions of essential oils with or without sodium chloride at 27 degrees C, 37 degrees C and 42 degrees C for 10 and 20 min. The number of surviving mycelia on the agar blocks was determined from the standard curves of the colony diameter and original inocula of the conidia. At the same time, the thermal effect on the cellular morphology was examined using SEM. Most fungal mycelia (99.7%) were killed after treatment at 42 degrees C for 20 min without essential oil. The fungicidal activity of essential oils was markedly enhanced by treating at 42 degrees C for 20 min as compared with that at 27 degrees C, showing 1/4 – 1/32-fold reduction of minimum fungicidal concentration (MFC to kill 99.99%). The order of the fungicidal activity of 11 essential oils was oregano, thyme thymol, cinnamon bark > lemongrass > clove, palmarose, peppermint, lavender > geranium Bourbon, tea tree > thyme geraniol oils. MFCs were further reduced to 1/2 – 1/8 by the addition of 10% sodium chloride. The salt effect was explained, at least partly, by an increase in mycelial adsorption of antifungal constituents in the presence of sodium chloride. Considerable hyphal damage was done at 27 degrees C by the essential oils, but no further alteration in morphology of the hyphae treated at 42 degrees C with or without oil was observed by SEM. The inhibitory effect of heat and oils was also observed against mycelia of T. rubrum and conidia of T. mentagrophytes. Thermotherapy combined with essential oils and salt would be promising to treat tinea pedis in a foot bath. 
Original article: This report describes a case of acute flaccid paralysis after administration of oral polio vaccine (OPV). A 4 month-old male patient with the decreased movement of left lower extremity for 1 month was transferred to the Department of Pediatrics. He received OPV with DTaP at 2 months of age. Flaccid paralysis was detected 4 weeks after OPV immunization. Attempts to isolate Sabin-like viruses in the two stool and CSF samples failed because those specimens were collected more than 2 month after the onset of paralysis. Hypotonic monoparesis (GIV/V), hypotonia and atrophy on the left lower extremity, and ipsilateral claw foot persisted for more than 18 months, while we followed him with rehabilitation therapy. This is the first case of officially approved, recipient vaccine-associated paralytic poliomyelitis in Korea. 
