The urinary excretion of vanilmandelic acid (VMA), homovanillic acid (HVA), and parahydroxyphenylacetic acid (pHPAA) was measured in 55 children with meningomyelocoele selected at random. In 96% of the children the levels of one or other of these compounds was significantly raised above the normal, usually by a factor of about 3. High VMA levels usually meant high HVA levels but the values for pHPAA appeared to be quite independent of the others. These results suggest a disorder of tyrosine metabolism, and the possible implications are discussed.

Catecholamines↗

PubMed1968

Hemimyelocele.

Explore the source record for details and available documents.

Humans↗

PubMed1966

A study of anophthalmia in an adult.

Explore the source record for details and available documents.

Aged↗

PubMedDate not supplied

Abnormalities of foot pressure in early diabetic neuropathy.

Dynamic foot pressure has been studied in 44 diabetic subjects of mean age 52 years with no clinical evidence of neuropathy and in an age and sex matched non-diabetic control group. Vibration perception threshold (VPT), sensory (SCV), and motor conduction velocities (MCV) were also measured in the diabetic subjects. Sixteen diabetic subjects (Group A) had abnormally high pressures under the metatarsal heads (greater than 10 kg/cm2), whereas the remaining 28 diabetic subjects had normal results (Group B). The ratio of toe to metatarsal head loading (normal 0.112) was significantly reduced in Group A (0.077) compared to Group B (0.127: p less than 0.05). VPT and sural nerve SCV were also significantly abnormal in Group A subjects compared with Group B (p less than 0.005 and p less than 0.02, respectively), though there were no differences in MCV. A significant inverse correlation was obtained between toe loading and VPT. It is concluded that abnormalities of foot pressure occur in early sensory neuropathy and may precede clinical abnormalities. Assessment of the toe-loading ratio may provide a sensitive measure of motor dysfunction in early diabetic neuropathy.

Adult↗

PubMedDate not supplied

The measurement of pressures under the foot.

An apparatus is described which gives a rapid and detailed picture of the distribution of pressure under the foot, this being displayed either as a continuous grey scale or a color contour map on a television monitor. Automatic analysis systems are outlined which enable the quantitation of the distribution of pressures and loads under the foot during standing and walking, utilizing computer techniques. The use of the static system is illustrated by the results of analytic procedures carried out on normal feet and in the assessment of surgical correction of a series of equino-varus feet in children suffering from spina bifida. The clinical application of the dynamic system is illustrated by the measurement of pressure/time curves encountered under the heel, the five metatarsal heads, and the great toe of a control group of feet and the feet of patients who had undergone metatarsophalangeal fusions, Keller arthroplasties, and Swanson arthroplasties.

Adolescent↗

PubMedDate not supplied

Dynamic foot pressure and other studies as diagnostic and management aids in diabetic neuropathy.

The pressures and loads under the feet during walking have been compared in three groups of 41 patients each, using a microprocessor-controlled optical system. Group A consisted of patients with diabetic neuropathy, group B of non-neuropathic diabetic patients, and group C of nondiabetic controls. Thirteen patients in group A had a history of neuropathic foot ulceration. Other investigations in the diabetic patients included motor conduction velocity (MCV) in the median and peroneal nerves, vibration perception threshold (VPT) in the great toes, the valsalva response (VR), skin resistance (SR), and the ankle pressure index (API). Fifty-one percent of neuropathic feet had abnormally high pressures underneath the metatarsal heads compared with 17% of the diabetic controls and 7% of nondiabetic subjects. All those feet with previous ulceration had abnormally high pressures at the ulcer sites. Of the other investigations, the VPT correlated most significantly with the presence of foot ulceration. In addition, a low median and peroneal nerve MCV, an abnormal VR, a high API, and the absence of sweating all correlated with the presence of foot ulceration. We therefore conclude that simple bedside investigations, such as measurement of the VPT alone, may be useful in identifying those patients at risk of foot ulceration. Foot pressure studies may then be used in such patients as a predictive and management aid by determining specific areas under the foot that are prone to ulceration.

Adult↗

PubMedDate not supplied

Reduction of abnormal foot pressures in diabetic neuropathy using a new polymer insole material.

The precise pressures and loads under 69 neuropathic feet have been measured during walking using a modified microprocessor-controlled optical system. Abnormally high pressures were demonstrated in 94% of feet with a history of foot ulceration, with pressures as high as 20-30 kg X cm-2 under the forefoot. All subjects were also studied using a new visco-elastic polymer material recently used for insole manufacture. A reduction in pressure was demonstrated that was proportional to peak pressure (linear regression line correlation coefficient of 0.91; P less than 0.001). We conclude that this material causes a significant reduction in the abnormally high pressures recorded under neuropathic feet, and should provide a useful insole for the management of patients at risk of neuropathic foot ulceration.

Adult↗

PubMedDate not supplied

The hindfoot and its relation to rotational deformities of the forefoot.

The movements occurring at the various joints of the foot are complex, and since deformities can arise at each joint, classification of the deformities of the foot can be confusing. The position of the hindfoot can be conveniently described using the relationship of the long axis of the calcaneus to the long axis of the tibia. The position of the forefoot can then be related to that of the hindfoot. Rotation of the forefoot occurs as a result of relative movements of the talus and calcaneus and is a noticeable feature of the valgus or flat foot. Various types of valgus foot are recognized, e.g., calcaneovalgus, equinovalgus or "vertical talus," and so-called "postural" valgus. A variation is described in which the hindfoot is valgus by definition, when the patient is standing, but in which after correction the talus moves into an abnormally horizontal position relative to the calcaneus and the forefoot assumes a position of marked supination, almost appearing to stand on its lateral edge. This deformity has been observed in paralytic conditions and also in an idiopathic form. It may be correctable if detected early but if allowed to progress may result in a persistent deformity, producing discomfort and excessive shoe wear. In the late stage correction of the hindfoot may, if the rotational component is not recognized, result in an unacceptable forefoot position.

Child↗