Magnetic resonance imaging classification provides more information to surgeons in choosing the appropriate treatment methods, although the final decision regarding procedure is made during arthroscopy after thorough analysis of the tear.
DFT calculations using a PCM solvation model were carried out to examine the reaction pathways for the formation of carbamate from CO 2 and monoethanolamine (MEA) in the presence of an additional proton acceptor, MEA or H 2 O. In both cases, the zwitterionic species [HO(CH 2 ) 2 NH 2 + sCOO -] has a lower energy than the reactants. Proton transfer from the zwitterionic species to the base (MEA) produced a carbamate product with an accompanying gradual decrease in energy. However, a similar process for the water case resulted in an implausible increase in energy, which suggests that MEA is suitable as a base but H 2 O is not.
Metatarsal lengthening by distraction osteogenesis was performed on 17 brachymetatarsia patients with 39 metatarsal bones. To lengthen the first metatarsal in an attempt to prevent development of varus deformity of the hindfoot after lengthening, horizontal lengthening in the anterior direction was performed rather than lengthening through the anatomical axis. In addition, care was taken to ensure that the fourth metatarsal bone screw did not interpose with the fifth extensor tendon during the fourth metatarsal lengthening. Lengthening was successful except in 1 case with mean lengthening of 19.5 mm (48.8%) for the first metatarsal and 17.1 mm (36.2%) for the fourth metatarsal. Because of joint stiffness, plantar capsulotomy was performed on 7 cases, 6 of which had been previously operated on bilaterally. Varus deformity of the hindfoot after the first metatarsal lengthening and entrapment of the fifth extensor tendon after the fourth metatarsal lengthening was not detected in any case.
These results demonstrate the presence and localization of a specialized nail mesenchyme containing onychofibroblasts in a well-defined area beneath the nail matrix and nail bed. Thus, we propose the term onychodermis for this specialized nail mesenchyme that is histologically and immunohistochemically distinct from the dermis of other parts of the nail unit.
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