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Müllers muscle-conjunctival resection ptosis procedure.

The Müllers muscle-conjunctival resection procedure is a relatively simple means of relieving upper eyelid ptosis. Candidates for the operation are chosen by placing several drops of 10% phenylephrine hydrochloride into the upper ocular fornix. If the upper lid elevates close to a normal level after five minutes, the patient is selected for the operation. A specially designed clamp is applied to 6.5 to 9.5 mm of conjunctiva and Müllers muscle above the superior tarsal border. A suture is run distal to the clamp, connecting conjunctiva and Müllers muscle to the superior tarsal border, and then the tissues held in the clamp are resected. The Müllers muscle-conjunctival resection has advantages over the Fasanella procedure, because tarsus is preserved, and over the levator aponeurosis advancement and tuck procedures, because the results are much more predictable.

Blepharoptosis↗

Involutional ptosis.

Involutional ptosis was corrected by either an anterior or posterior approach in 105 eyelids. The posterior approach was preferred unless there was a specific indication for the anterior approach which included excess skin and bulky eyelids. At operation approximately 10% of cases were found to have fatty degenerative changes in the anterior part of the levator muscle. These changes were associated with a relatively normal skin crease, bulky eyelids, lateral displacement of the tarsus, and a more marked ptosis in the medial part of the lid. A second procedure was required in 14 eyelids to achieve eyelid heights which remained within approximately 1 mm of each other for the follow-up period, which extended to eight years.

Blepharoptosis↗

Peripheral, but not central, nervous system abnormalities are reversed by pancreatic islet transplantation in diabetic Lewis rats.

Neuroelectrophysiological recordings represent a non-invasive and reproducible method of detecting central and peripheral nervous system alterations in diabetes mellitus. In order to evaluate whether the normalization of metabolic control obtained by pancreatic islet transplantation could reverse diabetic neuroelectrophysiological alterations, or prevent further deterioration, we used an experimental model in which pancreatic islets (n = 1200) were injected into the portal vein of inbred Lewis rats (used as islet donors as well as recipients). Islets were injected 4 months after diabetes induction, since previous work had shown functional but not morphological damage at the nervous tissue level at this stage of the disease. Visual (V), brainstem auditory (BA) and somatosensory (S) evoked potentials (EPs) were measured in streptozotocin-induced, islet-recipient diabetic rats (n = 7), streptozotocin-induced diabetic rats (n = 16) and non-diabetic control rats (n = 12). Metabolic parameters and electrophysiological recordings were evaluated before diabetes induction, before transplantation and 4 months later. After transplantation, glycaemic levels returned to normal values within 1 week and remained so until the end of the study, as confirmed by a normal oral glucose tolerance test and by an increase in body weight. Electrophysiological recordings were altered in diabetic animals before transplantation. Four months after transplantation EP recordings improved, with a detectable gradient from the peripheral to the central structures. SEPs were significantly improved in the peripheral tarsus-L6 tract and the L6-cortex tract (P < 0.005 and P < 0.01 versus diabetic rats) and were ameliorated without achieving statistical significance in the central L6-cortex tract. BAEP latency values tended to improve in transplanted rats, but the differences versus non-transplanted diabetic animals failed to reach significance. VEP values remained clearly pathological and even deteriorated after transplantation. These results show that normalization of metabolic control by pancreatic islet transplantation can reverse some of the already established neuroelectrophysiological alterations at the peripheral nervous system level, but does not affect other alterations at the central nervous system level.

Animals↗

Evidence for canalization of Distal-less function in the leg of Drosophila melanogaster.

A considerable body of theory pertaining to the evolution of canalization has emerged recently, yet there have been few empirical investigations of their predictions. To address this, patterns of canalization and trait correlation were investigated under the individual and joint effects of the introgression of a loss-of-function allele of the Distal-less gene and high-temperature stress on a panel of iso-female lines. Variation was examined for number of sex comb teeth and the length of the basi-tarsus on the pro-thoracic leg of male Drosophila melanogaster. I demonstrate that whereas there is evidence for trait canalization, there is no evidence to support the hypothesis of the evolution of genetic canalization as a response to microenvironmental canalization. Furthermore, I demonstrate that although there are genetic correlations between these traits, there is no association between their measures of canalization. I discuss the prospects of the evolutionary lability of the Distal-less gene within the context of changes in genetic variation and covariation.

Animals↗

Ultrasonographic evaluation of tarsocrural joint cartilage in normal adult horses.

Ultrasonographic examination of the tarsus was performed on four clinically and radiographically normal limbs of adult horses. Particular attention was paid to the articular cartilage surfaces of the trochlear ridges of the talus and the distal intermediate ridge of the tibia. Two separate measurements of articular cartilage thickness were acquired from a longitudinal view at each site. Anatomy was confirmed with post mortem dissection. Ultrasonography was found to be a practical method for imaging the articular cartilage over the trochlear ridges of the talus and distal intermediate ridge of the tibia. The cartilage appeared as a hypoechoic band overlying the hyperechoic subchondral bone. The mean cartilage thickness over the lateral and medial trochlear ridges of the talus and the distal intermediate ridge of the tibia were 0.57 mm, 0.58 mm and 0.7 mm respectively. These measurements may have value for comparison to thickened cartilage and lesions of osteochondrosis and abnormally thinned cartilage of osteoarthritis. Ultrasound examination was not helpful in evaluating the proximal and distal intertarsal and tarsometatarsal joints, the close proximity of the articular surfaces obscured visualization of the articular cartilage.

Animals↗

Comparison of single-phase and high-frequency generators for x-ray units.

The purpose of this study was to compare characteristics and performances between single-phase (SP) and high-frequency (HF) generators for x-ray units dedicated to veterinary radiology practice. A 30-kW SP and a 30-kW high HF generator connected to a rotating anode x-ray tube were used for the study. Source-film distance, screen/film combination, and film processing were kept the same during the experiment. The mAs value yielding a similar film optical density of a stair step phantom, as assessed by a densitometer and a similar dose, as assessed by a solid state detector, was estimated for different kVp values. The ratio of the mAs used with the SP generator to the equivalent mAs used with the HF generator to produce similar film density or radiation dose was calculated. Subject contrast was measured for different kVp values as the relative difference in film optical density between two steps of the phantom. The waveform of the tube current was recorded for the two generators using an oscilloscope. Motion artifact was produced on a lateral radiograph of a canine tarsus using the two generators. Reproducibility was assessed by comparing the variances of film density measurements made on the central step of the phantom on 10 consecutive images produced with the two generators. mAs ratios (SP/HF) to obtain similar film optical density ranged from 2 (for 90kVp) to 2.5 (for 70 kVp), and mAs ratios to obtain similar radiation dose ranged from 1.2 (for 100 kVp) to 1.4 (for 70 kVp). Image contrast was slightly higher for the SP than for the HF generator. Current waveform for the SP generator was half-sinusoidal and it was almost continuous for the HF generator. Motion artifact appeared as blur for the HF generator and as several regularly placed images of the subject for the SP generator. Reproducibility was significantly better for the HF than for the SP generator (P = 0.047). It was concluded that the HF generator was approximately two times more efficient, had a better reproducibility, and produced images with a lower contrast than the SP generator. Motion artifact appears differently due to different current waveform.

Animals↗

Computed tomographic determination of tibial torsion in the dog.

The goal of this study was to develop a method for computed tomographic (CT) measurement of tibial torsion, and to compare this technique with direct anatomic measurement of tibial torsion in cadaveric canine tibiae. Paired hind limbs of 10 cadaveric dogs were mounted on a custom-designed limb holding apparatus. One-millimeter thick, contiguous, transverse CT slices were obtained from the distal femur to the proximal tibia and 2 mm CT slices were obtained from the distal tibia to the proximal tarsus. The tibiae were freed of soft tissues and digital photographic images of the proximal and distal articular surfaces were obtained with the camera lens aligned perpendicular to the long axis of the tibia. Multiple proximal and distal tibial axes were identified on the images; two proximal and two distal axes were found to be repeatable in all specimens in both the direct and CT methods. The torsion angle was calculated by determining the difference between the axis angles for each pair of proximal and distal axes. There was no significant difference in torsion angle identified between the direct photographic and CT method for any pair of proximal and distal axes. CT determination of tibial torsion is a rapid and accurate method, and warrants investigation in clinical patients.

Animals↗

Use of an ankle-foot orthosis in a dog with traumatic sciatic neuropathy.

Traumatic unilateral sciatic neuropathy secondary to a gunshot wound was diagnosed in a seven-month-old, intact male golden retriever. Findings on neurological assessment, performed after cardiovascular stabilisation, were incompatible with a return to normal limb function. An ankle-foot orthosis was used to correct excessive flexion of the digits and tarsus. This device greatly improved the dog's willingness to ambulate and could serve as an alternative to amputation in companion animals with severe sciatic axonotmesis or neurotmesis. Complications associated with chronic tibiotarsal hyperflexion necessitated a pantarsal arthrodesis one year after initial presentation; the dog also developed cranial cruciate disease in the affected limb three years after the gunshot injury.

Animals↗

Chronic methylmercurialism in the cat.

The mercury levels in 69 muscle samples from fish weighing from 0.3 to 200 kg caught in Moreton Bay, Queensland, in the latter half of 1976 ranged from less than 10 to 2,030 ng/g. Mercury levels in blood samples from 53 humans and 100 dogs in Brisbane almost all contained less than 10 ng/ml while the level in 162 cats sampled ranged from less than 10 to 329 ng/ml. Chronic methylmercurialism developed in 2 cats dosed daily with methylmercury, bound to cysteine, at the rate of 0.6 mg/kg body weight for 74 and 77 days respectively. Terminal clinical signs included anorexia, weight loss, knuckling over at the carpus and tarsus, hypermetria initially involving the forelegs and later the hindlegs, sluggish reflexes, paresis involving all limbs, persistent crying, apparent blindness, tonic and clonic convulsions and salivation. Pathological changes were confined to the nervous system and included degeneration of neurones and perivascular cuffing in the cerebrocortical grey matter, focal atrophy of the granular layer, focal spongiosus of the molecular layer and degeneration and loss of Purkinje cells in the cerebellum and demyelination in the fibre tracts of the dorsal funiculus, mainly the fasciculus cuneatus and in the lateral and ventral corticospinal tracts. Terminal blood methylmercury levels were in excess of 18 microgram/ml, while brain methylmercury levels ranged from 21.0 to 28.4 microgram/g. The liver and kidney contained the highest total levels of mercury of 50 to 80 microgram/g, of which 23 to 37% was inorganic.

Animals↗

Vital staining properties of neutral red. Vital staining of cornea and conjunctiva.

Vital staining by instillation in the conjunctival sac of 1% neutral red in 54 normal and 153 differently affected eyes was studied by slit lamp examination. Of these, 134 eyes were after-stained by a mixture of 1% tetrazolium and 1/4% alcian blue and 73 eyes were after-stained by a mixture of 1% rose bengal and 1% fluorescein. Microscopy of a further 10 conjunctival scrapings and 40 mucous conjunctival threads disclosed neutral-red-stained inclusion bodies in the cytoplasm of the epithelial cells and the granulocytes. In the slit lamp the cornea and the conjunctiva were seen to be stained only rarely and, if so, poorly by neutral red, both in normal and affected eyes. Better staining was obtained with tetrazolium, and the best with rose bengal. The plica semilunaris, Marx' line, and the mucous thread were stained by neutral red, more intensely by rose bengal, and the least by tetrazolium. The inferior fornix and the tarsus were rarely stained by any of the three dyes. Neutral red seems to offer no diagnostic advantages over the vital stains with which the dye has been compared in the present study. More particularly we found no pathological processes that were stained more intensely by neutral red than by the other vital stains.

Cataract↗

Postmortal "vital" staining of the external eye.

Two hundred and two eyes from 112 individuals were vital-stained from 2 to 46 h after death. Intensity and extension of staining were studied in ten regions. The staining gradually progressed after death, also within non-exposed areas. It most often started anteriorly on the tarsus and finanally included the fornix. Microscopy revealed diffuse cell staining by rose bengal or trypan blue. The cell nucleus was most often more intensely stained than the cytoplasm. Up to five h after death, neutral red had only stained vacuoles in the cytoplasm. Later diffuse staining of cells occurred. Tetrazolium differed from the above dyes in that the pronounced staining seen immediately after death gradually decreased in the course of time. Microscopy disclosed stained inclusion bodies in the cytoplasm up to 18 h after death. Then cell staining was only seen as a rare exception in relation to extracellular dye granules. However, the mucous thread in the inferior fornix showed gradually increasing postmortal tetrazolium staining. The amount of mucus was found to be the same in dead persons as in the living. The characteristic appearance of the dead eye is due, among other things, to ruptures of the corneal epithelium (fluorescein-stained) and cell death, and not to drying up or coating by mucus.

Adult↗

Giant papillary conjunctivitis in connection with corneoscleral supramid (nylon) suture knots.

A material consisting of 27 patients had corneoscleral wound closure by 8-0 polyamide (supramid, nylon) sutures after intracapsular cataract extraction and intraocular lens implantation. A few months after surgery 16 patients had developed giant papillary conjunctivitis of the upper tarsus of the operated eye, associated with itching and blurring. The earlier stages of the condition, as described by other authors, could be defined in the remaining 11 patients. Cytologic tests - pipette samples of tear fluid and tarsal conjunctival scrapings - demonstrated eosinophil leucocytes and neutrophilia in most of the giant papillary conjunctivitis cases. The conjunctival scraping proved the more sensitive test for detection of eosinophils, the pipette test being mainly an indicator of inflammatory reaction. The condition seems to be allergic with an element of mechanical irritation. The use of polyamide sutures of the 8-0 size is not recommended.

Aged↗

Expressibility of meibomian secretion. Relation to age, lipid precorneal film, scales, foam, hair and pigmentation.

The lower lids of 274 normal subjects have been examined in the slit-lamp for expressibility of secretion from the Meibomian glands. Secretion could be expressed from on an average 10 glands (median 11), dependent on age, decreasing with increasing age (from 14.5 glands at about the age of 20 to 7 glands above the age of 80). The expressibility was seen to be positively correlated to the thickness of the lipid layer of the precorneal film, estimated by the semiquantitative interference method. It was positively correlated to pigmentation and to ordinary greasy scales on the lid margin. The expressibility negatively correlated to retraction of the Meibomian orifices. The expressibility was found not to be correlated to elevated orifices, foam formation in the external part of the eye, cysts in the tarsus, nor with casts round the eyelashes. It is important to distinguish between cylindric casts (Demodex-induced) and ordinary greasy scales on eye lashes and lid margin.

Adult↗

The correction of ptosis with adjustable suture technique.

We discuss here the results of a simple technique for the correction of ptosis, performed by us as an alternative to other techniques. The basic principal of this technique is to suspend the ptotic upper eyelid to the frontalis muscle by 3/0 silk sutures passed above the tarsus using a peritoneal needle and to adjust the rima palpebrarum in the post-operative period. This method is simple and easy to perform with few complications.

Adolescent↗

Touch sensitivity of the eyelid margin and palpebral conjunctiva.

Using a slit-lamp biomicroscope mounted Cochet-Bonnet aesthesiometer, the touch sensitivity of the eyelid margin and palpebral conjunctiva was determined for both upper and lower lids in 30 subjects. Thresholds for the occlusal surface of the lid, the marginal angle and the middle of the tarsus were measured centrally. A significantly higher touch sensitivity was found for the marginal zone compared with the occlusal surface, and tarsal conjunctival sensitivity was substantially the lowest. The occlusal and marginal zones of the lower lid displayed a significantly higher touch sensitivity than the upper lid but the tarsal sensitivity of the two lids was similar. The sharp peaking of sensitivity at the leading edge of each eyelid provides a mechanism for the detection of superficial foreign bodies and presumably augments the protective role of the cornea. A large inter-subject variation in marginal touch sensitivity was found which may explain individual variation in contact lens adaptation.

Adolescent↗

Use of high-speed cinematography and computer generated gait diagrams for the study of equine hindlimb kinematics.

High-speed cinematography with computer aided analysis was used to study equine hindlimb kinematics. Eight horses were filmed at the trot or the pace. Filming was done from the side (lateral) and the back (caudal). Parameters measured from the lateral filming included the heights of the tuber coxae and tailhead, protraction and retraction of the hoof and angular changes of the tarsus and stifle. Abduction and adduction of the limb and tarsal height changes were measured from the caudal filming. The maximum and minimum values plus the standard deviations and coefficients of variations are presented in tabular form. Three gait diagrams were constructed to represent stifle angle versus tarsal angle, metatarsophalangeal height versus protraction-retraction (fetlock height diagram) and tuber coxae and tailhead height versus stride (pelvic height diagram). Application of the technique to the group of horses revealed good repeatability of the gait diagrams within a limb and the diagrams appeared to be sensitive indicators of left/right asymmetries.

Animals↗

Angular kinematic patterns of limbs in elite and riding horses at trot.

Normal speed videography was used to determine the angular parameters of 28 Spanish Thoroughbreds at trot. Horses were divided into 3 groups: Group UT, comprising 9 animals (provided by the VII National Stud, Cordoba, Spain) which had undergone no specific training programme and which were hand led at the trot; Group T, formed by 19 horses considered to be highly bred and trained, and which were also hand led; and Group RT, comprising the same horses as the latter group but this time trotted by a rider. Each animal was filmed 6 times from the right-hand side, using a Hi8 (25 Hz) video camera. Angular parameters for fore- and hindlimb joints were measured in each stride from computer-grabbed frames and entered into a spreadsheet for calculation; parameters included maximum and minimum angles, range of motion, and angles at landing, lift off and maximum hoof height; the times at which maximum angle, minimum angle, lift off and maximum hoof height occurred were calculated as percentages of total stride duration. Stride velocity (mean [s.d.]) was 4.01 (0.62), 3.60 (0.34) and 3.07 (0.36) m/s for Groups UT, T and RT, respectively. Data were then compared between Groups UT-T and Groups T-RT. Compared with Group UT, horses from Group T featured a shorter stance percentage (P<0.001) in both fore- and hindlimbs. The range of motion in forelimbs was smaller (P<0.05), due to lower retraction (P<0.001); moreover, maximum retraction appeared earlier (P<0.05). Greater scapular inclination was in evidence (P<0.05) and the shoulder joint extended further (P<0.05). Fore- and hind fetlock joints revealed a relatively shorter hyperextension period during the stance phase (P<0.01). Compared with Group T, horses from Group RT had a longer stance percentage, with belated maximum retraction of the fore- and hindlimbs. The range of movement in scapular inclination was greater (P<0.05), due to a smaller minimum angle (P<0.01), and the shoulder joint flexed more (P<0.05). The elbow joint extended more and for longer during the stance phase. Initial extension of the hip joint (P<0.05) and tarsus (P<0.001) lasted longer. The carpal and fore and hind fetlock joints recorded relatively longer hyperextension times, in addition to greater hyperextension during the stance phase. The results from the present study suggest that rider-effect must be taken in consideration when well gaited horses are selected for dressage purposes.

Animals↗

The effect of shoeing on kinetics and kinematics during the stance phase.

The increasing range of of horseshoes and hoofpads makes it important to be able to evaluate their influence on performance and stress in the locomotor apparatus. The aim of this study was to describe the changes in ground reaction forces and locomotion pattern during the stance phase due to the application of a standard iron shoe. Six Swedish Warmblood horses were evaluated kinetically and kinematically before and after they were shod with an 8 mm iron shoe. Data were used to calculate ground reaction forces in the vertical and craniocaudal directions, point of application of the force, hoof segment angle and hoof joint, pastern joint, fetlock, carpal and tarsal angles. Finally joint angular velocity and landing velocity of the hoof were calculated. During the initial phase of the stance or the concussion phase, the horses altered the conditions of the limb, as reflected by hoof-landing velocities. Concussion-dampening mechanisms of the distal limb subsequently were altered. In the nonshod condition, the coffin and fetlock joints rotated more rapidly in the forelimb and less rapidly in the hindlimb, while earlier proximal off-loading by the carpus and tarsus resulted in a decrease in initial horizontal loading at the hoof. It was concluded that horses accustomed to standard iron shoes demonstrate slight but significant differences in the movement and loading of the distal limb due to shoeing. Though the main differences were related to the concussion phase of the stance, even mid-stance loading and roll-over were altered. The study provides a basis for further investigation of the effect of various farriery techniques on the hoof and movement of the horse.

Animals↗