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PubMed2002

Three-dimensional kinematics of the tarsal joint at the trot.

The tarsal joint is a common site of injury for many sport horses. Understanding the biomechanics of this complex joint begins with developing a clear picture of the kinematics during normal locomotion. This study describes the 3D kinematics of the tarsal joint by measuring the motion of the tibia and third metatarsus in 4 sound Quarter Horses with targets attached directly to the bones via steel pins. The objective was to determine if the tarsus had significant motion outside the tarsocrural joint. Two Steinmann pins were inserted into the lateral side of the right hindlimb and marker triads were fixed to the end of each pin. 3D motion of the bones was recorded as each subject trotted in hand. Three rotations were expressed using an attitude vector based on the finite helical angle method. Three translations were calculated as the motion of the tibia relative to the third metatarsus. Angular and translation data were mostly coupled with flexion angle. Internal/external rotation during stance and translations during swing showed evidence of noncoupled motion. Although the majority of tarsal motion occurs in the tarsocrural joint, there is evidence that translations and rotations occur in other locations within the tarsal joint and that some of these are related to the tarsal joint 'snapping' phenomenon. This research provides a set of reference 3D kinematics which will aid in the study of the aetiology and mechanical effects of tarsal joint lameness.

Animals↗
PubMed2001

The ground state of the ventral appendage in Drosophila.

In Drosophila melanogaster, the antennae, legs, genitalia, and analia make up a serially homologous set of ventral appendages that depend on different selector genes for their unique identities. The diversity among these structures implies that there is a common ground state that selector genes modify to generate these different appendage morphologies. Here we show that the ventral appendage that forms in the absence of selector gene activity is leglike but consists of only two segments along its proximo-distal axis: a proximal segment and a distal tarsus. These results raise the possibility that, during evolution, leglike appendages could have developed without selector gene activity.

Animals↗
PubMed2002

Leg patterning driven by proximal-distal interactions and EGFR signaling.

wingless and decapentaplegic signaling establishes the proximal-distal axis of Drosophila legs by activating the expression of genes such as Distalless and dachshund in broad proximal-distal domains during early leg development. However, here we show that wingless and decapentaplegic are not required throughout all of proximal-distal development. The tarsus, which has been proposed to be an ancestral structure, is instead defined by the activity of Distalless, dachshund, and a distal gradient of epidermal growth factor receptor (EGFR)-Ras signaling. Our results uncover a mechanism for appendage patterning directed by genes expressed in proximal-distal domains and possibly conserved in other arthropods and vertebrates.

Animals↗
PubMed1990

Comparison of long term evolution of adult onset and juvenile onset Still's disease, both followed up for more than 10 years.

Still's disease is a clinical entity of unknown origin, which can appear before 15 years of age (juvenile onset Still's disease) or later (adult onset Still's disease). There are few reported data about the long term prognosis of Still's disease and no study compares the long term evolution of adult onset and juvenile onset Still's disease. Eighteen patients fulfilling the American Rheumatism Association criteria for Still's disease were followed up for more than 10 years. Ten (group 1) had juvenile onset Still's disease and eight (group 2) adult onset Still's disease. A comparison of the groups showed no significant differences in the initial systemic manifestations of Still's disease, or in the joint lesions. Both groups had severe sequelae, which appeared between six and 10 years after the initial flare up of Still's disease. Nine patients had articular damage and nine had only arthritis without apparent x ray abnormalities. Nine patients had bilateral hip destruction in less than four years. Of these nine, seven required 13 total hip replacements before the age of 45. In the whole group of 18 patients bilateral involvement of the following joints was also seen: carpus (seven patients), knee (four), tarsus (four), ankle (three); three patients had ankylosis of the cervical spine. The occurrence of amyloidosis (three cases, two deaths) was restricted to group 2. This was the only difference between the groups, as the treatments were identical. It is concluded that the articular prognosis of Still's disease is poor, be it adult onset or juvenile onset, with severe joint destruction in half of the patients.

Adult↗
PubMed2002

Development of a radiographic index to assess the tarsal involvement in patients with spondyloarthropathies.

OBJECTIVE: To develop and test an index to evaluate the radiographic changes that occur in the tarsus and adjacent areas of the foot in patients with spondyloarthropathies (SpA). METHODS: The spondyloarthropathy tarsal radiographic index (SpA-TRI) was developed in three consecutive steps: (a) detection of descriptors after reviewing 70 radiographic files; (b) descriptor gradation and subsequent modifications performed by a consensus committee, and (c) interobserver variability assessed by three blinded and independent observers on 272 radiographs: anteroposterior 118, lateral 90, oblique 64 from 121 patients with SpA, and intraobserver variability on 75 radiographs from 25 patients with SpA. Statistical analysis included percentage of agreement and kappa test. SpA-TRI score ranges from 0 to 4 (0=normal; 1=osteopenia or suspicious findings; 2=definite joint space narrowing, bony erosion(s), periosteal whiskering, or enthesophyte(s) in the plantar fascia or Achilleal tendon attachments; 3=para-articular enthesophyte(s); 4=bony ankylosis (joint space fusion or complete bridging)). RESULTS: Complete agreement for every evaluation was >40%, and discordance >1 grade was <15%. The kappa scores among the three observers were acceptable for all the single projections: oblique (0.52, 0.36, 0.35), lateral (0.50, 0.42, 0.56), and anteroposterior (0.40, 0.41, 0.21) views. The combination of lateral and oblique views achieved the highest concordance rates (0.72, 0.33, 0.66), surpassing that of the three projections altogether (0.34, 0.58, 0.37). In every case the concordance was comparable with that of sacroiliac joints (0.47, 0.41, 0.34); intraobserver concordance showed a similar trend. CONCLUSION: The SpA-TRI is an index that includes the most prominent features of tarsal disease and adjacent areas of the foot in SpA and grades them accordingly, it has an adequate reproducibility, and is suitable for use with two or more projections, preferably the combination of oblique and lateral.

Adolescent↗
PubMed2007

Confident complete excision of lid-margin BCCs using a marginal strip: an alternative to Mohs' surgery.

AIMS: To report a new technique of tissue preparation, using a marginal strip, after the excision of eyelid basal cell carcinomas (BCCs) and to report the long-term results of BCCs excised using this technique. METHOD: After the excision of eyelid BCC with a safety margin of 4 mm, a 1 mm strip was excised along the whole perimeter from the margin of the freshly excised specimen. This marginal strip had intact conjunctival mucosa along one edge and skin along the other. The marginal strip and the central tumour mass were then fixed immediately in formal saline and subjected to conventional histopathology. RESULTS: Of the 61 patients who completed a 5 years follow-up, the results of 28 eye-lid BCCs that were within 4 mm of the lid margin are reported. The marginal strip was clear in 22 specimens and had the presence of residual tumour in its margin in 6 specimens. These six 6 cases were further managed by observation (n = 2), by further surgical excision using marginal strip (n = 2) and by Mohs' surgery (n = 2). CONCLUSION: Marginal strip examines the entire resection margins analogous to Mohs' technique and we recommend its use in lid margin where tarsus is present throughout the specimen and >4 mm from the lid margin.

Aged↗
PubMed1979

Isolation of Chlamydia trachomatis from different areas of conjunctiva in relation to intensity of hyperendemic trachoma in school children in Southern Tunisia.

The simplified one-passage technique of culture in irradiated McCoy cells, in conjunction with certain other developments in technique, was used to isolate Chlamydia trachomatis from specimens collected from 78 children with trachoma in Douz, Southern Tunisia. The results show that C. trachomatis is not confined to the upper tarsal area of the conjunctiva in hyperendemic trachoma. The higher isolation rate and corresponding increase in the number of inclusions obtained from swabbings of the upper fornix and lower lid in addition to the conventional collection from the upper tarsus show the superiority of collecting specimens for culture from the whole conjunctiva. Specimens could be collected from the whole conjunctiva by using 1 swab for each eye and pooled for subsequent inoculation, so that the laboratory incurred no additional work. A close correlation was observed between isolation rate, together with the number of inclusions, obtained in cell culture, and intensity of inflammatory disease in hyperendemic trachoma. The sensitivity and practicability of this cultural test should provide a valuable laboratory index for use in epidemiological and therapeutic studies of trachoma.

Child↗
PubMed1980

Comparative sensitivity of fluorescent antibody staining of conjunctival scrapings and irradiated McCoy cell culture for the diagnosis of hyperendemic trachoma.

The sensitivity of an indirect fluorescent antibody (FA) staining technique for detecting chlamydial inclusions in scrapings from the whole conjunctiva (upper tarsus, upper fornix, and lower lid) was compared with the sensitivity of culture in irradiated McCoy cells for the diagnosis of hyperendemic trachoma. In a group of 211 patients with various grades of active trachoma from the Bandar Abbas area of Southern Iran 42 patients were positive for chlamydiae by either method. There was little difference between the rates of positivity of FA staining of the scrapings from the whole conjunctiva (28 positives) and culture in irradiated McCoy cells (32 positives). In the patients included in this study chlamydial inclusions were detected in 15 eyes by examination of FA stained scrapings taken from the upper tarsal conjunctiva, whereas inclusions were detected in 40 eyes by the additional examination of scrapings taken from the upper fornix and lower lid (P less than 0.001). The examination of FA stained scrapings taken from the whole conjunctiva and spread as a single but larger smear may provide a satisfactory alternative to cell culture methods for the diagnosis of trachoma, particularly for field studies when cell culture facilities are not available.

Cells, Cultured↗
PubMed1981

Clinical features and diagnosis of adult atopic keratoconjunctivitis and the effect of treatment with sodium cromoglycate.

This study describes 17 cases of atopic keratoconjunctivitis in adults. In 8 cases the clinical appearances were nonspecific and sufficiently different from vernal keratoconjunctivitis to make diagnosis difficult. These atypical cases often showed a fine papillary conjunctival reaction on the upper tarsus, subconjunctival scarring, and in 1 case severe symblepharon. Corneal features included corneal microcysts, peripheral vascularisation, and various patterns of punctate epithelial keratitis. It was therefore important to establish the atopic status of the patient. A personal or family history of other atopic disease was elicited in every case, and the diagnosis was confirmed by the detection of raised serum IgE level. Uncontrolled clinical assessment suggested that 10 out of 15 patients experienced improvement in symptoms with the use of 2% sodium cromoglycate eyedrops 4 times a day. A subsequent double-masked cross-over trial comparing the same treatment with a matched placebo preparation indicated that 6 out of 9 patients preferred sodium cromoglycate while 1 preferred the placebo. Two patients noted no difference. Cases showing nonspecific or atypical clinical features responded to treatment just as frequently as did cases of typical vernal keratoconjunctivitis.

Adolescent↗
PubMed1999

A single technique to correct various degrees of upper lid retraction in patients with Graves' orbitopathy.

BACKGROUND: Several lengthening techniques have been proposed for upper eyelid retraction in patients with Graves' orbitopathy and variable rates of success have been reported. Most authors recommend different procedures for different degrees of retraction, but cannot prevent residual temporal retraction in a significant number of cases. The modified levator aponeurosis recession described by Harvey and colleagues, in which the lateral horn is cut completely, seems to be an exception to this rule, but was evaluated in a limited number of cases only. METHOD: The authors further modified Harvey's technique by dissecting the aponeurosis together with Müller's muscle of the tarsus and the conjunctiva medially only to the extent necessary to achieve an acceptable position and contour of the eyelid in upright position. They also used an Ethilon 6.0 suture, instead of Vicryl, on a loop. It is placed between the tarsal plate and the detached aponeurosis to prevent spontaneous disinsertion. This modification was used in 50 Graves' patients (78 eyelids) with a upper lid margin-limbus distance ranging from 1 to 7 mm and evaluated using strict criteria. RESULTS: A perfect or acceptable result was obtained in 23 of 28 patients (82%) with bilateral retraction and in 18 of 22 patients (82%) with unilateral retraction. Seven eyelids were overcorrected (too low) and three undercorrected, necessitating reoperation. All other eyelids had an almond-like contour and a lid crease of 10 mm or less. No complications except subcutaneous haematomas were seen. Two patients showed a recurrence of lid retraction 9 months after the operation. CONCLUSION: This technique is safe and efficacious and can be used for all degrees of eyelid retraction.

Adult↗
PubMed2001

Autogenous hard palate mucosa: the ideal lower eyelid spacer?

BACKGROUND/AIMS: Raising a displaced lower eyelid frequently involves recession of the lower eyelid retractors with interposition of a "spacer," and several materials for this purpose have been described. This study reviewed the results of autogenous palatal mucosa in the treatment of lower eyelid displacement, including assessment of any donor site morbidity. METHODS: A retrospective case note review of consecutive patients treated at Moorfields Eye Hospital between 1993 and 1998. All patients underwent insertion of hard palate mucosa between the inferior border of the tarsus and the recessed conjunctiva and lower eyelid retractors. Parameters studied included the underlying diagnosis, measurements of lower lid displacement or retraction, related previous surgery, the experience of the operating surgeon, intraoperative and postoperative complications, surgical outcome, and length of follow up. The main outcome measure was the position of the lower eyelid relative to the globe in primary position of gaze. RESULTS: 102 lower eyelids of 68 patients were included and a satisfactory lid position was achieved in 87/102 (85%), with inadequate lengthening or significant recurrence of displacement occurring in 15 cases. Donor site haemorrhage requiring treatment in the early postoperative period occurred in seven patients (10%). CONCLUSION: Autogenous hard palate mucosa is an effective eyelid spacer and provides good long term support for the lower eyelid. Donor site complications are the main disadvantage, but may be minimised by attention to meticulous surgical technique and appropriate postoperative management.

Adult↗
PubMed1996

Protection of experimentally infected pigs by suilysin, the thiol-activated haemolysin of Streptococcus suis.

Three groups of three pigs were vaccinated either with vaccine VAC-SLY, containing purified suilysin derived from Streptococcus suis strain P1/7 (serotype 2), or with vaccine VAC-SCF, containing most of the other extracellular antigens produced by strain P1/7 (but essentially free from suilysin), or with a placebo vaccine. The pigs were vaccinated twice at four weeks and six weeks of age and were challenged intravenously with S suis strain P1/7 at eight weeks of age. On the day of challenge, only the VAC-SLY vaccinated pigs showed an increase in haemolysin neutralisation titre. After challenge the placebo vaccinated pigs developed severe clinical signs characterised by lameness involving several joints, a depressed appearance, high temperatures and/or neurological signs. The VAC-SCF vaccinated pigs showed the same clinical signs but less severely. The VAC-SLY vaccinated pigs were the least affected and showed only mild signs which subsided more quickly than those of the other groups. A post mortem investigation and histology of brain tissue samples confirmed the clinical findings; fibrinous arthritis was less severe and less frequently observed in the VAC-SLY vaccinated pigs than in the VAC-SCF or placebo vaccinated pigs, and none of the VAC-SLY vaccinated pigs had meningitis whereas two of the VAC-SCF and two of the placebo vaccinated pigs did so. All the samples of brain, lung and tarsus taken from the VAC-SLY vaccinated pigs were sterile whereas S suis was reisolated from most of these tissues from the other groups.

Animals↗
PubMed2003

Clinical and radiographic study of bone and joint lesions in 26 dogs with leishmaniasis.

Twenty-six dogs with parasitologically confirmed leishmaniasis and abnormalities of gait were studied to determine the most common radiological patterns of bone and joint lesions. The clinical findings included either lameness, joint pain and crepitation, soft tissue swelling and/or muscle atrophy. Bone lesions were observed radiographically in 12 of the 26 dogs; the radius and ulna were affected in seven, the tibia in six and the femur in six. Joint lesions were observed radiographically in 15 of the 26 dogs; the carpus and stifle were affected in all 15, and the tarsus in nine. There was a tendency for the bones and joints to be affected bilaterally. The radiographic patterns observed were different in the long bones and the joints. In the long bones, the most common pattern was periosteal and intramedullary proliferation, involving the diaphyses and related to the nutrient foramen; in the joints, two patterns, either non-erosive or erosive polyarthritis with soft-tissue swelling, were observed. The changes observed in the synovial fluid were associated in most cases with osteolytic lesions. However, Leishmania organisms were identified in the synovial fluid from joints without bony radiographic changes.

Animals↗
PubMed2003

Graded limb targeting in an insect is caused by the shift of a single movement pattern.

Grooming responses are movements of a multi-jointed limb that are targeted toward a stimulus site on the body. To be successful, they require a continuous transformation of stimulus location into a corresponding motor pattern or selection and blending of a subset of cardinal motor patterns. Tactile stimulation of one forewing of a locust elicits characteristic grooming movements of the ipsilateral hind leg. An initial targeted trajectory that moves the tarsus toward the site of stimulation is followed by a cyclic trajectory in the region of the stimulus. We have analyzed both components of this behavior to quantify the relative effects of somatotopic stimulus position and leg start posture on three parameters: initial movement direction, accuracy, and grooming distribution. Accuracy and grooming distribution were significantly affected by the stimulus location but were not influenced by the initial leg posture. Both cues systematically shifted the initial movement direction from the onset of the response. The subsequent cyclic component of grooming movements forms a behavioral continuum with no clustering in joint angle space. We therefore conclude that forewing grooming in locusts is generated by a single movement pattern that is continuously shifted by a sensory cue signaling position on the forewing surface. Both vertebrates and invertebrates can switch between distinct movement forms to groom different parts of their bodies. Our data provide the first evidence that invertebrates, like vertebrates, also have graded control of limb targeting within the somatosensory receptive field of a single form of motor response.

Animals↗
PubMed2004

Signals from load sensors underlie interjoint coordination during stepping movements of the stick insect leg.

During stance and swing phase of a walking stick insect, the retractor coxae (RetCx) and protractor coxae (ProCx) motoneurons and muscles supplying the thorax-coxa (TC)-joint generate backward and forward movements of the leg. Their activity is tightly coupled to the movement of the more distal leg segments, i.e., femur, tibia, and tarsus. We used the single middle leg preparation to study how this coupling is generated. With only the distal leg segments of the middle leg being free to move, motoneuronal activity of the de-afferented and -efferented TC-joint is similarly coupled to leg stepping. RetCx motoneurons are active during stance and ProCx motoneurons during swing. We studied whether sensory signals are involved in this coordination of TC-joint motoneuronal activity. Ablation of the load measuring campaniform sensilla (CS) revealed that they substantially contribute to the coupling of TC-joint motoneuronal activity to leg stepping. Individually ablating trochanteral and femoral CS revealed the trochanteral CS to be necessary for establishing the coupling between leg stepping and coxal motoneuron activity. When the locomotor system was active and generated alternating bursts of activity in ProCx and RetCx motoneurons, stimulation of the CS by rearward bending of the femur in otherwise de-afferented mesothoracic ganglion terminated ongoing ProCx motoneuronal activity and initiated RetCx motoneuronal activity. We show that cuticular strain signals from the trochanteral CS play a major role in shaping TC-joint motoneuronal activity during walking and contribute to their coordination with the stepping pattern of the distal leg joints. We present a model for the sensory control of timing of motoneuronal activity in walking movements of the single middle leg.

Action Potentials↗
PubMed1998

Cooperative mechanisms between leg joints of Carausius morosus II. Motor neuron activity and influence of conditional bursting interneuron.

The activity of the motor neuron pools of the protractor coxae muscle and of the thoracic part of the depressor trochanteris muscle during forward walking in the stick insect was investigated, and a spiking local interneuron, able to produce "endogenous bursting" and innervating both motor neuron pools, was identified. Extracellular recordings of the motor neurons innervating the protractor and the thoracic depressor of front, middle, and rear legs, respectively, were made with oil-hook electrodes from the peripheral nerves nl2c and nl4a while the animals were walking on a styrofoam treadwheel. The corresponding leg movements were registered and phase histograms were created with the software Spike2. Intracellular recordings were made in the neuropile of the metathoracic ganglion with glass electrodes filled with the dye Lucifer yellow. In all three legs measured (front, middle, and rear), both motor neuron pools increased their activity during the swing movement. The increase in the activity of the protractor motor neurons started at the end of the stance approximately 100 ms before reaching the posterior extreme position (PEP), and the activity of the large-sized depressor motor neurons increased as soon as the tarsus was lifted at the PEP. A local spiking interneuron was identified that excited both motor neuron pools. In 4 of 23 recordings the interneuron started to burst in synchrony with protractor and thoracic depressor motor neurons. During bursting a depolarizing stimulus reinforced and a hyperpolarizing stimulus inhibited the activity of both motor neuron pools. Thus we conclude that the thoracic part of the depressor trochanteris muscle might be a component of the neuromuscular system that shapes the swing movement. The two proximal joints, subcoxal and coxa-trochanter, connected mechanically via the thoracic part of the depressor trochanteris muscle, are also connected neurally by segmental and intersegmental spiking interneurons (this paper) and by nonspiking local interneurons (see companion paper).

Animals↗
PubMed2005

[Pneumococcal septic arthritis in a Spanish university hospital (1993- 2003)].

INTRODUCTION: Cases of pneumococcal septic arthritis treated in the Fundación Jiménez Díaz (Madrid, Spain) were reviewed. METHODS: A retrospective record review was conducted for all patients presenting with pneumococcal septic arthritis between January 1993 and August 2003. RESULTS: Four patients out of a total of 267 reviewed had a clinical and microbiological diagnosis of septic arthritis caused by Streptococcus pneumoniae. The most frequent locations were the knee, ankle and tarsus. Three of the four patients had underlying diseases and one patient died. CONCLUSIONS: Pneumococcal septic arthritis, a very rare clinical entity diagnosed by clinical and microbiological findings, should be suspected in patients with underlying disease. Early antibiotic therapy focussed on the most common microorganisms causing septic arthritis is necessary for optimal outcome.

Aged↗
PubMed1999

Chondroplast: A new material for eyelid reconstruction.

After tumor excision both lamellae of the eyelid require reconstruction in order to achieve good functional and cosmetic results. The tarsus is replaced either by autologous or heterologous material. We used Chondroplast as a tarsal replacement in 25 patients who had undergone extensive tumor excision. Chondroplast is a beta-irradiated bovine cartilage. A 1-mm-thick lamella is fixed to the rest of the tarsal plate or the canthal tendon and positioned in a preformed pocket or the conjunctiva and a thin layer of orbicularis muscle and skin. All implants took well. Postoperative results, lid closure and cosmetic appearance were excellent. No complications such as infection or loss of the implant occurred. The advantages of Chondroplast are: its availability in large pieces, no need for harvesting procedures and good biocompatibility.

Aged↗