The plantar ligaments of the human proximal tarsus.
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We report on the treatment of a 39 year old patient who suffered from subtotal amputation of the middle foot area after fall from tall height. He was treated by an arthrodesis between ventral tibia and distal Chopart-joint which was carried out as late-primary care. Therefore calcaneus and talus were totally and os cuboideum and os scaphoideum were partially removed. This form of arthrodesis is a rare indication. With remaining blood flow and sensibility in the fore foot it is an alternative to amputation/exarticulation in the tibiotalar joint. Advantages are the improved plantar weightbearing area, a simplified supply of orthopedic shoes and a better tactile ground contact.
Both Proboscipedia (PB) and Sex Combs Reduced (SCR) activities are required for determination of proboscis identity. Here we show that simultaneous removal of PB and SCR activity results in a proboscis-to-antenna transformation. Dominant negative PB molecules inhibit the activity of SCR indicating that PB and SCR interact in a multimeric protein complex in determination of proboscis identity. These data suggest that the expression pattern of PB and SCR and the ability of PB and SCR to interact in a multimeric complex control the determination of four adult structures. The absence of PB and SCR expression leads to antennal identity; expression of only PB leads to maxillary palp identity; expression of only SCR leads to tarsus identity; and expression of both PB and SCR, which results in the formation of a PB-SCR-containing complex, leads to proboscis identity. However, the PB-SCR interaction is not detectable in vitro and is not detectable genetically in the head region during embryogenesis, indicating the PB-SCR interaction may be regulated and indirect. This regulation may also explain why ectopic expression of SCR(Q50K) and SCR do not result in the expected transformation of the maxillary palp to an antennae and proboscis, respectively. Previous analysis of the requirements of SCR activity for adult pattern formation has shown that ectopic expression of SCR results in an antenna-to-tarsus transformation, but removal of SCR activity in a clone of cells does not result in a tarsus-to-arista transformation. Here we show in five independent assays the reason for this apparent contradictory requirement of SCR activity in tarsus determination. SCR activity is required cell nonautonomously for tarsus determination. Specifically, we propose that SCR activity is required in the mesodermal adepithelial cells of all leg imaginal discs at late second/early third instar larval stage for the synthesis of a mesoderm-specific, tarsus-inducing, signaling factor, which after secretion from the adepithelial cells acts on the overlaying ectodermal cells determining tarsus identity. This study characterizes a combinatorial interaction between two HOX proteins; a mechanism that may have a major role in patterning the anterior-posterior axis of other animals.
Aging is often associated with locomotor deficits. Behavior in aged Blaberus discoidalis cockroaches was analyzed during horizontal walking, climbing, righting and inclined walking. Adult animals showed a decrease in spontaneous locomotion with increasing age. Tarsal abnormalities, termed 'tarsus catch', were often present in aged individuals. In 'tarsus catch', the prothoracic leg catches on the mesothoracic leg during the swing phase. This deficit causes alterations of the gait, but animals are able to regain a tripod gait after the perturbation. The tibio-tarsal joint angle in individuals with 'tarsus catch' was significantly less than in intact animals. Structural defects were consistently associated with 'tarsus catch'. The tracheal tubes in the tarsus and around the tibio-tarsal joint were often discolored and the tarsal pads were hardened in aged cockroaches. All aged individuals were able to climb. However, prior to climbing, some animals with 'tarsus catch' failed to show postural changes that are normally seen in young animals. Aged individuals can right as rapidly as 1-week-old adults. However, animals with 'tarsus catch' take longer to right than aged intact individuals. Old cockroaches have difficulty climbing an incline of 45 degrees, and leg slipping is extensive. Slipping may be caused by tarsal degeneration, but animals that are unsuccessful in inclined walking often show uncoordinated gaits during the attempt. Escape behavior was examined in aged American cockroaches (Periplaneta americana). They do not show normal escape. However, after decapitation, escape movements return, suggesting that degeneration in head ganglia may actually interfere with escape. These findings provide evidence for age-related changes both in the periphery and in the central nervous system of cockroaches and stress the importance of multi-level approaches to the study of locomotion.
UNLABELLED: In the past 3 years, 85 basal cell carcinomas were treated in our clinic using eyelid reconstruction. During the same period, 54 lids were reconstructed after other diseases, mostly after chemical burns. In one of the 54 patients, the upper lid was reconstructed using a tarso-marginal graft after congenital coloboma. METHOD: In 31 of the 85 patients with basal-well carcinoma (36%), so much tarsus was lost that a transplantation of tarsus was necessary. Fifteen of the 31 patients were treated with a Hughes-plasty and 16 using a tarsomarginal graft, two in the upper lid. RESULTS: In eight of the remaining 16 cases, the defect was less than one half of length, so that the graft was taken from the second lower lid. In the remaining eight patients, the defect was two thirds of length or longer. In six cases, a 7 mm-graft was taken from the upper lid. As the tarsus from the upper lid measures 10 mm and is thus twice as big as the lower lid tarsus, it was divided into two grafts, resulting in two grafts measuring 7 x 5 mm. They were placed in the lower lid ("double tarsomarginal graft"). The former lower part with lashes was placed in the middle of the lower lid, the former upper part peripherally. In two patients, the defect was healed with three tarsomarginal grafts. A pedicle skin flap was transposed to cover the posterior grafts. Remaining defects were closed with free skin transplants. CONCLUSION: The tarsomarginal graft permits a short operation time and early rehabilitation of the patients. The disadvantage of the double tarsomarginal graft is that the more valuable upper lid tarsus is used to reconstruct the less valuable lower lid tarsus.
In two patients (a 60-year-old man and a 69-year-old woman) vertical buckling of the superior tarsus followed surgery to correct levator aponeurosis disinsertions for the management of acquired upper eyelid blepharoptosis. The superior tarsus rotated posteriorly and folded on itself because the sutures reattaching the levator aponeurosis to the tarsus were placed too low on the anterior tarsal plate. This complication can be prevented by placing the tarsal sutures above the vertical midpoint of the tarsus. If this complication develops, early correction is possible by revising the suture heights and keeping the tarsus flat with a symblepharon ring. This led to a satisfactory outcome in one of our cases. Late correction of vertical tarsal buckling requires excision of the buckled tarsus and repositioning the levator aponeurosis sutures. In one of our patients, an entropion developed as a result of insufficient vertical tarsal height that caused instability of the upper eyelid. The outcome was otherwise satisfactory.
REASONS FOR PERFORMING STUDY: The tarsal joint is a frequent site of lameness, but little objective information is available regarding the effects of tarsal conformation on joint movements or forces. OBJECTIVE: To compare tarsal kinematics and kinetics in horses with large, intermediate and small tarsal angles. METHODS: Sagittal plane standing angle of the right tarsal joint was measured in 16 horses as they stood squarely with the hind hooves vertically beneath the hip joint. Tarsal angles were classified as small (< 155.5 degrees), intermediate (155.5-165.5 degrees) or large (> 165.5 degrees). Reflective markers, attached over the centres of joint rotation, were tracked during stance as the horses trotted across a force plate at a standardised speed. Joint angles and ground reaction forces were combined with morphometric data to calculate net joint moments and net joint powers across the tarsus using inverse dynamics. RESULTS: In all horses, the tarsus flexed during the impact phase and extended in late stance. Tarsal angles were stratified according to standing tarsal angle throughout stance. Horses with large standing angles showed less flexion and less energy absorption at the tarsus during the impact phase than those with intermediate or small angles and generated less vertical impulse than horses with small standing angles. Net extensor moment at the tarsus during stance was lower for horses with large standing angles. CONCLUSIONS: In horses with large tarsal angles, less concussion was absorbed during the impact phase, which may be a factor in the development of degenerative joint disease; and the smaller vertical impulse and extensor moment later in stance may limit propulsive ability. However, the smaller net joint moment may reduce the risk of plantar ligament desmitis. CLINICAL SIGNIFICANCE: The effects of conformation on kinematics and kinetics of the tarsal joint may influence both performance and soundness.
PURPOSE: To evaluate the role of amniotic membrane transplantation in the management of cicatricial eyelid entropion. DESIGN: Prospective, noncomparative interventional case series. PARTICIPANTS: Eighteen consecutive patients with cicatricial entropion. METHODS: A gray line lid split procedure with vertical anterior lamella repositioning was performed on 25 eyelids (upper or lower) of 18 patients with moderate to severe cicatricial entropion. Preserved human amniotic membrane (AM) was used to cover the bare tarsus up to the lid margin and secured with running 7-0 Vicryl. Impression cytology of the AM was performed at various stages postoperatively to study the epithelialization process. MAIN OUTCOME MEASURES: (1) Reepithelialization of bare tarsus, (2) extent of tarsal shrinkage, (3) recurrence of entropion. RESULTS: All the AM grafts took well. The most common complication was hemorrhage below the graft, which occurred in six cases. Complete success with no lashes touching the globe was achieved in 22 of 25 (88%) lids after a minimum follow-up of 12.0 months. The mean follow-up was 17.8 months. Two cases (qualified success) had recurrent trichiasis treated successfully with electrolysis. One case with severe trachomatous upper lid entropion recurred 14 months after surgery. The AM accelerated the epithelialization of bare tarsus; this was demonstrated by lack of fluorescein staining and reversion to skin color within 2 to 3 weeks. However, AM could not prevent tarsal shrinkage. Impression cytology demonstrated that features of conjunctival epithelium were present for the first postoperative month, but this was gradually replaced by squamous metaplasia, with keratinization appearing as early as 3 weeks postoperatively. CONCLUSIONS: The use of AM in a lid split procedure for correction of cicatricial entropion helps the bare tarsus epithelialize rapidly and improves the initial cosmetic result of surgery.
This study investigated genetic variation in growth and final size in relationship to differences in heritabilities under good and poor feeding conditions. Heritabilities of growth and final size were estimated for several traits under ad libitum and restricted feeding conditions. A 30% feed restriction from hatching to 44 days of age in Japanese quail chicks decreased body weight and tarsus length at 44 days of age and the length of the third primary convert feather at 24 days of age relative to controls fed ad libitum. Wing length at 44 days of age was not significantly different for ad libitum fed and restricted quail. Genetic variances for body weight and tarsus length were very large throughout growth which resulted in heritability estimates close to one for these traits. The genetic correlations among feeding treatments were low, indicating that different genes were affecting growth under the two treatments. Growth was described by the components: asymptote, growth period, and shape of the growth curve following the modified Richards growth curve model (Brisbin et al. 1986). Tarsus length, which had high heritability of the parameter 'growth period' of the model, tended to display a higher heritability under the restriction than under ad libitum feeding. Body weight and feather length, which had either no heritable or low heritable 'growth periods' estimates, tended to be more heritable under ad libitum feeding. The shape parameter of the growth curve was not heritable for any trait, except tarsus length under restricted feeding.
Global warming may affect the physiology, distributions, phenology and adaptations of plants and animals. In Israel, minimum summer temperatures increased by an average of 0.26 degrees C per decade during the second half of the 20th century. Bergmann's rule predicts that, in warm-blooded animals, races from warm regions are smaller than races from cold regions. Numerous studies have reported general correlations between body mass in fossil animals and independently established palaeoclimatic changes from various parts of the world in accordance with this rule. Using museum specimens, I tested the prediction that the body mass and tarsus length of five resident passerine species in Israel declined between 1950 and 1999. The body mass of four species (the graceful warbler Prinia gracilis, the house sparrow Passer domesticus, the yellow-vented bulbul Pycnonotus xanthopygos and the Sardinian warbler Sylvia melanocephala, but not of the crested lark Galerida cristata) declined significantly during this period. Tarsus length also declined significantly during this period for two species (the graceful warbler and the house sparrow). Body condition (body mass-to-tarsus length ratio) decreased in the Sardinian warbler, the yellow-vented bulbul and the crested lark. It is suggested that the above declines in body mass and tarsus length are due to global warming and also in accordance with Bergmann's rule. The above explanation does not exclude the possibility that other factors, such as a decrease in food availability, contributed to the decline in body mass. These declines may have serious implications for community structure and competition among bird species and may affect the survival of small passerines.
The objectives of this study were to measure the effect of walking velocity on net joint moments and joint powers in the hindlimb during stance and to use the data to predict these variables at different walking velocities. Videographic and force data were collected synchronously from 5 sound horses walking over a force plate at a range of velocities. Force and kinematic data from 56 trials were combined using an inverse dynamic solution to determine net joint moments and joint powers. Analysis by simple regression and correlation (P < 0.05, r2 > or = 0.30, r > 0.50) showed that, in early stance, there were significant velocity-dependent increases in the peak magnitudes of the following variables: extensor moment and positive power at the hip, flexor moment and positive power at the stifle, extensor moment, negative and positive power at the tarsus, and flexor moment and negative power at the fetlock. In late stance, there were significant velocity-dependent increases in the peak magnitudes of the following variables: flexor moment at the hip, negative power at the stifle and flexor moment and positive power at the tarsus. As velocity increased, the hip showed an increase in energy generation, whereas the tarsus showed increases in both energy generation and absorption. It is concluded that an increase in walking velocity is associated with increases in peak magnitudes of the net joint moments and joint powers in the hindlimb; and that energy generation at the hip makes the largest contribution to the increase in velocity.
The prevalence of degenerative joint disease (DJD) in the distal tarsal joints and the relation between radiographic and clinical signs compatible with the disease were estimated in a population of Icelandic horses used for riding. The material consisted of 614 horses age 6-12 years (mean age = 7.9 years). Radiographs with 3 projections of each tarsus were made and a clinical examination, including palpation of the medial aspect of the distal tarsus and motion evaluation of the hindlimbs before and after a flexion test of the tarsus, was performed. Radiographic signs of DJD in the distal tarsal joints were found in 30.3% of the horses and the prevalence was strongly correlated with age. Hindlimb lameness before and after flexion test and palpation abnormalities were significantly associated with the radiographic findings. The lameness was usually mild and, in most cases, detectable only after the flexion test. The prevalence of lameness was not significantly correlated with age. Lameness could not be predicted by details of the radiographic findings.
For good cosmesis the upper eyelid creases and folds must be symmetric. The lid creases must be the same height above the upper lid margins. The skin below the crease must be smooth and firmly attached to the tarsus, or, in cases with a short tarsus, adherent to the short tarsus and levator muscle up to the crease. The skin above the crease must be loosely attached so that it forms symmetric folds over the crease. We have developed surgical procedures aimed at the following: (1) equalizing the upper lid creases and folds where they are asymmetric, (2) creating lid creases and folds where absent, as in Orientals, (3) removing excess unsightly skin folds, as in dermatochalasis, and (4) forming a lid fold by skin grafting where there is insufficient skin above the crease.
At the distal end of a mesothoracic tibia of the locust, Schistocerca gregaria, is a chordotonal organ which monitors the position and movement of the tarsus relative to the tibia. It contains approximately 35 receptors that variously encode different spatial and temporal parameters (position, velocity and direction of movement). Some excite intersegmental interneurones that respond phasically or tonically, with directional sensitivity to active or imposed movements of the tarsus. Some of these interneurones are also excited by intrinsic movements of the tarsal segments. Others, besides being excited by tarsal proprioceptive inputs, are also excited by exteroreceptors on the tarsus. When stimulated mechanically or electrically, chordotonal afferents evoke excitatory postsynaptic potentials with a central latency of between 0.9 and 1.4 ms simultaneously in the intersegmental interneurones and in tarsal motor neurones. The central arborizations of the afferents, the intersegmental interneurones and the tarsal motor neurones overlap in certain neuropilar regions of the mesothoracic ganglion. Other afferents cause an inhibition of the motor neurones, with a longer and non-consistent latency suggesting the involvement of other intercalated interneurones. These results indicate that proprioceptive inputs from the tarsal joint receptors are transmitted in parallel and monosynaptically to tarsal motor neurones and to the intersegmental interneurones.
In four patients, rotation of the inferior tarsus around the tarsal-tendon horizontal axis caused a contracted socket with loss of lower fornix and the inability to retain an artificial eye. Exposure of the lower border of the inferior tarsus through a skin incision, separating the tarsus from the overlying orbicularis oculi muscle, and suturing its lower margin to the skin corrected the abnormality.