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This study is an attempt to assess the role of dietary supplementation in the treatment and prevention of diabetic peripheral neuropathy. The authors developed an animal model system to study this problem. Animals given streptozotocin to induce a type I diabetic state showed elevated glucose levels and decreased body weight. Analysis of the sciatic nerve revealed a decrease in nerve conduction velocity and Na(+)-K(+)-ATPase activity. The activity of protein kinase C, another component of the nerve transmission process, was also affected by the diabetic state. The dietary intervention of polyunsaturated fatty acids seemed to revert some of these changes toward normal.
A retrospective evaluation consisting of a written survey and physical examination was completed on flexor digitorum longus tendon transfer patients. The tendon transfer is used to alleviate symptoms and address imbalance of extrinsic and intrinsic muscles. The authors present an evaluation of 110 procedures with an average follow-up period of 65.7 months (range 7 to 198 months). A literature review, discussion of a new theory as to the etiology of hammer toes, and criteria for using the procedure are included.
Subcutaneous fungal infections are relatively uncommon in the lower extremity. Mycetoma begins as painless papules or nodules that increase in size and progresses to involve the connective tissue. Diagnosis is based on biopsy, with definitive identification of the organism needed for effective treatment. Treatment consists of antifungal medications and surgical debridement. This article provides an overview of this disorder and reports on a case of recurrent mycetoma in a 70-year-old woman.