Biomechanical analysis of the calcaneocuboid joint pressure after sequential lengthening of the lateral column.

BACKGROUND: Lengthening of the lateral column by means of the Evans osteotomy is commonly used for reconstruction of adult and pediatric flatfoot. However, some reports have shown that the Evans osteotomy is linked with increased calcaneocuboid joint pressures and an increased risk of arthritis in the joint. The purpose of this study was to measure the pressure across the calcaneocuboid joint and demonstrate the changing trends of the pressure within the calcaneocuboid joint after sequential lengthening of the lateral column. METHODS: Six cadaver specimens were physiologically loaded and the peak pressure of the calcaneocuboid joint was measured under the following conditions: (1) normal foot, (2) flatfoot, and (3) sequential lengthening of the lateral column by means of the Evans procedure (from 4 mm to 12 mm, in 2 mm increments). RESULTS: Peak pressures across the joint increased significantly from baseline in the flatfoot (P < .05). In the corrected foot, with the increment of the graft, the peak pressure decreased initially and then increased. The pressure reached its minimum value (11.04 ± 1.15 kg/cm(2)) with 8 mm lengthening of the lateral column. The differences were significant compared to the flatfoot (P < .05) and corrected foot with the other sizes of grafts (P < .05), but differences were not significant compared to the intact foot (P = .143). CONCLUSIONS: Lateral column lengthening within a certain extent will decrease the pressure in calcaneocuboid joint with a flatfoot deformity. CLINICAL RELEVANCE: Performing the procedure with an 8 mm lengthening may reduce the risk of the secondary calcaneocuboid osteoarthritis.

Demographic and clinical characteristics of resectable hepatocellular carcinoma in China and Japan.

BACKGROUND/AIMS: To describe and compare the demographic and clinical characteristics of hepatocellular carcinoma (HCC) patients subject to surgical operation at two referral centers in China and Japan. METHODOLOGY: Information on surgical HCC patients was retrieved from medical records. All patients were subjected to regular follow-up. The characteristics of HCC cases from two countries were described and compared. RESULTS: A total of 353 newly diagnosed cases subject to surgical resection for HCC from 1995 to 1999 were analyzed in China and Japan. Differences were noted in the demographic and clinical characteristics of HCC patients between the two countries, such as average age of incidence, history of blood transfusion, serum examination, and history of hepatic viral infection. Statistical analysis also indicated differences in surgical systematic anatomical resection (p < 0.001), liver cirrhosis (p < 0.05), tumor diameter, and distant metastases (p < 0.001). The Chinese patients in early TNM stage I showed poorer outcomes in terms of cumulative survival in comparison with Japanese patients (p < 0.001). CONCLUSIONS: HCC patients in Japan were diagnosed earlier, subject to more standard treatment, and had better prognosis. Examination with a larger population and more clinical data, including repeated treatment for recurrent HCC, will be required to provide a more accurate assessment of HCC in the two countries.

[Analysis of hepatitis virus infection in hepatocellular carcinoma patients receiving surgical operation in China and Japan].

OBJECTIVE: To describe and compare the hepatitis virus infection in hepatocellular carcinoma (HCC) patients receiving surgical operation in China and Japan. METHODS: Information of surgical HCC patients was retrieved from the medical records. The concerned characteristics of the HCC cases from two countries were described and compared. RESULTS: A total of 425 diagnosed cases that underwent surgical resection for HCC in China were investigated, and the corresponding cases in Japan were 247. The proportion of the hepatitis virus infection was 75.53% in patients with HCC from China. Within the infection cases, 91.28% were positive for HBsAg but negative for anti-HCV. The proportion was 82.59% in patients with HCC from Japan. Within the infection cases, 77.94% were positive for anti-HCV but negative for HBsAg. The proportion of hepatocirrhosis in the hepatitis virus infection patients with HCC were 89.10% and 68.14% in China and Japan, respectively. CONCLUSION: The hepatitis B virus infection showed be a main cause of HCC in China, however, the HCC in Japan be mostly related to hepatitis C virus infection.