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Fate determination of Drosophila leg distal regions by trachealess and tango through repression and stimulation, respectively, of Bar homeobox gene expression in the future pretarsus and tarsus.

During tissue patterning, developing fields may be subdivided into several non-overlapping domains by region-specific expression of transcription factors. In Drosophila leg development, the most distal segments, the pretarsus and tarsal segment 5 (ta5), are precisely specified by interactions between tarsus homeobox genes (BarH1 and BarH2) and pretarsus homeobox genes (aristaless, clawless, and Lim1). Here, we demonstrate that trachealess and tango, both encoding bHLH-PAS proteins that are required for the formation of the embryonic tracheal system, are essential for forming two adjacent distal segments of the leg. trachealess is expressed in the pretarsus and ta5, and the concerted action of trachealess and tango seems to modulate the activity of homeobox gene regulatory loops by repressing Bar in the pretarsus and activating Bar in ta5.

Animals↗

[Funicular myelosis--an unusual case of unilateral destruction of the tarsus].

The presentation includes an unusual destruction of the tarsus of a 64 year old patient with subacute combined degeneration of the spinal cord caused by chronical vitamin-B12-deficiency. This case report will be shown a systemical disease as a possible cause of localized bone-destruction in differentialdiagnosis.

Arthropathy, Neurogenic↗

Perforating follicular hybrid cyst of the tarsus.

Follicular hybrid cysts are cutaneous tumors that arise from different portions of the hair follicle. We describe a follicular hybrid cyst of the tarsus that contained features of pilomatricoma and steatocystoma and perforated the palpebral conjunctiva. The unusual location and histopathologic features are discussed.

Adult↗

The use of tarsus as a free autogenous graft in eyelid surgery.

This is a report of the use of autogenous tarsus as a free graft in 121 eyelid surgical procedures. Seventy-three operations were for reconstruction of full-thickness defects and 30 were for repair of eyelid retraction. The remainder were for repair of cicatricial entropion, symblepharon, distichiasis, and irregularity of the eyelid margin. No grafts failed. There were three complications to a donor eyelid. It is believed that donor eyelid complications are less likely when the graft is harvested so as to include the upper tarsal margin. The free autogenous tarsal graft was found to be effective in repairing a variety of eyelid defects.

Ankle↗

A histological study of the lower tarsus and the significance in the surgical management of a involutional (senile) entropion.

The dimension of the lower tarsus diminishes with aging. Changes in the number and size of the meibomian glands and in the character of intermingling fibroconnective tissues are thought to be responsible. Furthermore, such alterations of the structural integrity play an important role in the pathogenesis of entropion encountered commonly in the elderly. We have advocated the use of an autogenous cartilage graft harvested from the ear to correct the deformity, especially in instances where the conventional methods of correction have failed.

Aged↗

Disinsertion of the levator aponeurosis from the tarsus in growing children.

To confirm when the levator aponeurosis is disinserted and how the disinsertion is compensated for in growing children, the earliest and latest photographs of the same children were the subjects of a retrospective comparative study regarding upward displacement of the superior palpebral crease and the eyeball in the palpebral fissure. Ninety-four children (48 boys and 46 girls) were selected from 615 patients with cleft lip and palate who were followed for more than several years at our outpatient clinic and whose 58,000 photographs were digitized. The earliest and latest photographs of the patients were taken in primary gaze position; the former, taken at less than 3 years of age, and the latter, taken at more than 6 years of age, were selected for this study. The intervals between the two photographs ranged from 3 to 14 years (mean, 9.61 years; SD, 3.11). The superior palpebral crease moved upward parallel with the growth of the children (p < 0.0001) as well as with the length of the growth period (p = 0.0141). The lower eyelid did not move downward (p < 0.0001). The eyeball also displaced upward parallel with growth (p < 0.0001) and with the length of the growth period (p = 0.0302). The more the superior palpebral crease was displaced upward, the more the eyeball was displaced upward (p = 0.0005). The levator aponeurosis may be likely to disinsert from the tarsus in growing children, thus requiring compensatory, excessive contraction of the levator muscle, which may cause upward displacement of the superior palpebral crease. Subsequently, excessive contraction of the superior rectus muscle in conjunction of the levator muscle may rotate the eyeball upward, which may incline the head. When the head is not inclined in the primary gaze position, compensatory contraction of the inferior rectus muscle to maintain the horizontal visual axis may displace the eyeball upward in the orbit by means of the inferior suspensory ligament of Lockwood.

Adult↗

Haemolytic anaemia due to glucose-6-phosphate dehydrogenase (G6PD) deficiency: demonstration of two new biochemical variants, G6PD Hamm and G6PD Tarsus.

Two new variants of erythrocytic glucose-6-phosphate dehydrogenase have been found in one German patient and in another patient of Turkish origin. The enzymes were partially purified 165-fold and 111-fold respectively. Both revealed reduced activity, increased thermolability and a pH-optimum in the alkaline region (8.5 and 9.0). One variant (G6PD Hamm) had a low Km-value for glucose-6-phosphate, the other (G6PD Tarsus) exhibited an increased affinity for glucose-6-phosphate and a reduced affinity for NADP+. This enzyme showed an increased inhibitor constant for NADPH with respect to NADP+. Electrophoretic mobility was normal in both cases. 2-Desoxy glucose-6-phosphate was utilized to an increased rate by both variant enzymes (46% and 33%). Also galactose-6-phosphate (29% and 25%) and deamino-NADP+ (230% and 261%) gave increased utilization rates. The mothers of both patients could be identified as heterozygous for this enzyme deficiency.

Adolescent↗

Pattern formation in the limbs of Drosophila: bric à brac is expressed in both a gradient and a wave-like pattern and is required for specification and proper segmentation of the tarsus.

We have identified the gene bric à brac and show that it is required for pattern formation along the proximal-distal axis of the leg and antenna of Drosophila. In bric à brac mutant legs, the bristle pattern of the three central tarsal segments is transformed towards the pattern of the most proximal tarsal segment. In addition, bric à brac mutant legs and antennae have segmentation defects. bric à brac encodes a nuclear protein that shares a highly conserved domain with two transcription factors from Drosophila. bric à brac function is dosage dependent and is required in a graded manner for the specification of tarsal segments. The graded requirement for bric à brac correlates with its graded expression pattern, suggesting that the concentration of BRIC A BRAC protein specifies segment identity in the tarsus.

Animals↗

Histiocytic sarcoma in the tarsus of a cat.

A 12-year-old Persian cat was examined for a firm swelling of the right tarsal region and enlargement of the corresponding right popliteal lymph node. Cytologic evaluation demonstrated a population of malignant cells consistent with large cell lymphoma. Necropsy revealed a multi-lobulated subcutaneous mass involving the tarsus with some extension into adjacent deep muscular tissue. Histologically, the mass was composed of round cells with eosinophilic cytoplasm and pleomorphic anisokaryotic nuclei. Evidence of articular and nodal infiltration by these cells was observed. Differential diagnoses included synovial sarcoma and histiocytic sarcoma. Neoplastic cells were negative for cytokeratin, CD79a, and CD3 and positive for CD18, vimentin, lysozyme, and alpha-1-antitrypsin, most consistent with a diagnosis of histiocytic sarcoma. This is the first report of a histiocytic sarcoma involving a joint of a cat. The final diagnosis was based on the light microscopic appearance in combination with the immunohistochemical stains.

Animals↗

[Course of bone lesions of leprosic feet towards dislocation of the tarsus and metatarsus].

The authors have observed 135 dislocations of the tarsus in leprosic feet. They recall the mechanism of the lesion and propose a classification. 42 cases were operated on to prevent further deformities. When early treated limited arthrodeses may be beneficial in some cases. In more severe cases rebuilding arthrodesis alone or associated to cancellous bone grafting is indicated. In very severe cases amputation is only indicated because the Wladimiroff-Mickulicz technique as well as grafts lead to failures related to the metatarsophalangeal joints stiffness.

Arthrodesis↗

[Ear cartilage as tarsus replacement (with long-term results)].

The authors report on 52 lid operations in combination with the transplantation of ear cartilage to serve as tarsus. The preoperative diagnoses were: ectropion (22); entropion (5); tumors (18); lid reconstruction following trauma (7). The long-term results were determined in 24 patients with 29 lids, with an average follow-up time of 26 months. The lid margin fit and the cartilage was palpable in nearly 90% of the long-term results; 83% of the patients were content with the cosmetic outcome.

Cartilage↗

[The possibilities of osteoplastic measures in mid-foot amputation and osteomyelitis of the tarsus].

Osteomyelitis after trauma or after operations and amputations at the midfoot or tarsus leads to a disadvantage in terms of motion and of weightbearing on the foot. Once local fistula, exophytic bone growth, skin defects and instability of the metatarsus have arisen, hygiene and recovery of joint function are difficult. Four patients were treated by reamputation at the midfoot and bone autografts. The osteomyelitic part was excised and the tarsal and metatarsal bones stabilized. The result at follow up showed painfree stumps without recurrence of infection within 3 years. Little support is needed in the way of orthopedic appliances, and all four patients can walk easily with no pain. This operation is recommended for the primary surgical procedure.

Adult↗

[The frondiformis ligament and stabilization of the posterior tarsus].

The frondiformis ligament is a part of the retinaculum extensorum of the instep. Actuated by the tendons of the extensor digitorum longus, it takes a direct effect on the talus and the calcaneum, induces the valgus of the tarsus and contributes to the stability of the ankle and the foot.

Ankle↗

Solitary metastasis in the tarsus preceding the diagnosis of primary endometrial cancer. A case report.

A solitary metastasis in the left tarsus led to the diagnosis of primary endometrial cancer in a 61 year-old patient with no history of postmenopausal bleeding. Lower leg amputation, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic and paraaortic lymphadenectomy were performed. Histopathology showed a well-differentiated endometrioid adenocarcinoma of the uterus with a low mitotic rate, but infiltration of the outer third of the myometrium and lymph vessel invasion (FIGO Stage IVb). Immunostaining was positive for progesterone receptors, but negative for estrogen receptors and p53. The lymph nodes were free of metastases. Ascites was positive for malignant cells. Postoperatively the patient received carboplatin, cyclophosphamide and medroxyprogesterone acetate and is alive with no evidence of disease 10 months after diagnosis.

Adenocarcinoma↗

Tarsoconjunctival advancement: a modified surgical technique to correct cicatricial entropion and metaplasia of the marginal tarsus.

Severe eye burns and mucocutaneous cicatricial disorders frequently cause upper and lower lid entropion with metaplasia of the tarsal conjunctiva, dislocation of the meibomian gland orifices, trichiasis, and tarsal scars near the lid margin. Between 1985 and 1993, 26 patients (29 eyes, 36 lids) were treated by excision of pathologic tissue and advancement of the tarsoconjunctival layer. The presented procedure is used mainly in cicatricial entropion with keratinization of the marginal tarsus.

Cicatrix, Hypertrophic↗