ObjectivesTo evaluate the applicability of MRI for the quantitative assessment
of anterior talofibular ligaments (ATFLs) in symptomatic chronic
ankle instability (CAI).MethodsBetween 1997 and 2010, 39 patients with symptomatic CAI underwent
surgical treatment (22 male, 17 female, mean age 25.4 years (15
to 40)). In all patients, the maximum diameters of the ATFLs were
measured on pre-operative T2-weighted MR images in planes parallel
to the path of the ATFL. They were classified into three groups based
on a previously published method with modifications: ‘normal’, diameter
= 1.0 - 3.2 mm; ‘thickened’, diameter > 3.2 mm; ‘thin or absent’,
diameter < 1.0 mm. Stress radiography was performed with the
maximum manual force in inversion under general anaesthesia immediately
prior to surgery. In surgery, ATFLs were macroscopically divided
into two categories: ‘thickened’, an obvious thickened ligament
and ‘thin or absent’. The imaging results were compared with the
macroscopic results that are considered to be of a gold standard.ResultsAgreement was reached when comparison was made between groups,
based on MRI and macroscopic findings. ATFLs were abnormal in all
39 cases and classified as ten ‘thickened’ and 29 ‘thin or absent’.
As to talar tilt stress radiography, a clear cut-off angle, which
would allow discrimination between ‘thickened’ and ‘thin or absent’ patients,
was not identified.ConclusionMRI is valuable as a pre-operative assessment tool that can provide
the quantitative information of ATFLs in patients with CAI.Cite this article Bone Joint Res 2014;3:241–5.
The depressant effect of interferon-alpha on drug metabolizing activity in the liver has been investigated in 12 patients with chronic active hepatitis B. 7-methoxy-coumarin (7-MC) O-demethylase and 7-ethoxycoumarin (7-EC) O-deethylase, in specimens obtained by liver biopsy, were measured before and after interferon treatment. 7-MC and 7-EC O-dealkylase activity were significantly reduced after interferon treatment, from 13.4 to 9.24 nmol.g-1 liver.min-1, and from 3.22 to 2.16 nmol.g-1 liver.min-1, respectively. The magnitude of the fall varied widely between individual patients. The study provides the first direct evidence that interferon-alpha can impair the activity of drug metabolizing enzymes in the human liver.
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