Opening Cuboid Wedge Osteotomy (Zoom Osteotomy) for Triplanar Correction of Flexible Pes Planovalgus Deformities.

Surgical correction of flexible pes planovalgus often involves reestablishing the length of the lateral column. This is a review of a cohort of patients who underwent an opening cuboid osteotomy with interpositional graft for triplanar correction of flexible pes planovalgus. The medical records of 35 patients involving 51 feet were reviewed. All patients were treated with an opening wedge osteotomy of the cuboid in combination with adjunctive procedures as needed for correction of the pes planovalgus deformity. Radiographs were obtained before and a minimum of 12 months after surgery. Preoperative and postoperative cuboid abduction and Meary's (lateral talometatarsal) angles were measured using the radiographs, and adjunctive procedures and complications were recorded. Mean follow-up was 46 (range, 12-85) months. The mean cuboid abduction angle improved from 20.3° (range, 8°-31°) to 6.6° (range, 0°-15°), and the mean Meary's angle improved from 10.5° (range, 0°-25°) to 2° (range, -3° to 15°). All patients also underwent adjunctive procedures at the time of cuboid osteotomy. In the 51 feet treated, there were 3 (6%) complications, including wound dehiscence, neuritis, and deep vein thrombosis. There were no recurrences. Triplanar correction of flexible pes planovalgus can be performed safely and successfully with an opening cuboid osteotomy as an alternative to the Evans Osteotomy.

Estrogen prevents sustained COLO-205 human colon cancer cell growth by inducing apoptosis, decreasing c-myb protein, and decreasing transcription of the anti-apoptotic protein bcl-2.

The proto-oncogene c-myb is overexpressed in human colon cancer cells. c-myb is known to be affected by estrogen in some breast cancers and leukemias. However, the mechanism of c-myb regulation via estrogen in colon cancer requires further investigation. Human COLO-205 colon cancer cells were cultured and treated with beta-estradiol for 24 h. Apoptosis was quantified using acridine orange/propidium iodide labeling and confirmed with DNA fragmentation gel electrophoresis. Expression of c-myb protein was assessed via SDS-PAGE and immunoblotting and RT-PCR was used to quantify bcl-2 RNA. Protein and RNA expression levels were also assayed after c-myb siRNA treatment for 24 h. We demonstrate an increase in apoptosis after 24 h of beta-estradiol treatment of human COLO-205 colon cancer cells. Estrogen treatment also decreases c-myb protein levels as well as expression of its transcriptional target bcl-2. Suppression of c-myb protein also results in increased apoptosis and decreases bcl-2 expression. These results indicate that estrogen has a protective effect from sustained colon cancer cell growth at least partly through suppression of c-myb and bcl-2.