Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Toes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed2002

Atheroembolic signals detected by Doppler ultrasound scan monitoring in a patient with blue toe syndrome: report of a case.

It is generally accepted that clinical symptoms give the only clue to the presence of atheroemboli in patients with blue toe syndrome (BTS). We report a case of atheroemboli originating from the abdominal aortic aneurysm in which Doppler ultrasound successfully detected atheroembolic signals, which vanished immediately after surgery. To our knowledge, this is the first such case to be documented. When a 67-year-old man was given warfarin after aortocoronay bypass, digital cyanosis suddenly developed, which became worse and was very painful. Angiography and computed tomography scanning revealed an infrarenal aortic aneurysm with mural thrombus. Doppler ultrasound detected atheroemboli as high-intensity transient signals in the bilateral tibioperoneal trunks. After aneurysmectomy and a bifurcated graft replacement, the cyanotic and painful toes improved immediately. Microscopically, cholesterin crystals were seen in the arterioles of the amputated digits. Thus, Doppler ultrasound could be a valuable test to determine the appropriate treatment for patients at risk of atheroembolic BTS.

Aged↗
PubMed2004

Distal site testing of sympathetic skin response (big toe) in diabetic polyneuropathy.

The aim of this study was to determine whether the sympathetic skin response (SSR) recorded from the big toe is more sensitive than standard SSR recorded from the sole for the detection of sudomotor fiber dysfunction in diabetic neuropathy. We recorded big toe SSR (SSRBT) and plantar SSR (SSRP) in 17 diabetic patients with non-disabling neuropathy (group A), 13 patients with disabling neuropathy (group B) and 30 age-matched normal controls. With regard to controls, SSRP amplitude was reduced only in group B. In contrast, SSRBT amplitude was reduced in both groups of patients (p<0.0001). In 8 patients in group B, SSRBT was not recordable while the SSRP still persisted. Our results suggest that SS-RBT is a more sensitive test than SSRP in detecting distal sudomotor failure in patients with diabetic neuropathy.

Body Temperature Regulation↗
PubMed1983

Median cleft lip, polydactyly, syndactyly and toe anomalies in a non-Indian infant.

A case is reported of a child who presented with a median cleft of the lip and alveolus with polydactyly, a complex form of syndactyly and multiple toe anomalies. This is the fifth case to be reported with these features and the second case to be reported in a non-Indian patient. Our case is characterised by unique features, consisting of a complexity of hand anomalies in association with other facial anomalies such as median alveolar cleft, epicanthus, fusion of the tongue to the floor of the mouth and rare big toe anomalies.

Abnormalities, Multiple↗
PubMedDate not supplied

Free second toe transfer for reconstruction of the distal phalanx of the fingers.

Free transfers of the distal parts of the second toe for reconstruction of distal phalangeal losses of the fingers were successfully carried out. This method is believed to be the best for functional and cosmetic reasons, but major postoperative vascular problems exist. To overcome these problems, multiple vascular anastomoses were employed at operation. The indications for this method are limited in Japanese patients, and its use depends on the patient's age, sex, religious beliefs and the shape of the second toe.

Adolescent↗
PubMed1992

Free thin osteo-onychocutaneous flaps from the big toe for reconstruction of the distal phalanx of the fingers.

Free osteo-onychocutaneous flaps from the big toe have frequently been used for the reconstruction of distal phalangeal loss of the fingers. The thickness of the fatty tissue, however, makes these flaps bulky. We believe this disadvantage can be overcome with a free thin osteo-onychocutaneous flap from the big toe and consider this thin composite flap to be a superior method of reconstruction for the treatment of distal phalangeal loss.

Adolescent↗
PubMed1985

Effects of ischemia on capillary density and flow velocity in nailfolds of human toes.

The purpose of this study was to investigate reactive hyperemia in the capillary network of human skin in terms of the flow per capillary and the density of flow-active capillaries. Seventeen male subjects 20 to 40 years of age were seated with their right foot placed on the stage of a Leitz epi-ilumination microscope such that the nailfold capillary field in their large toes could be viewed. These vessels were video taped while flow velocity in the right posterior tibial artery was recorded via Doppler ultrasound at rest, then following a 45-sec period of arterial occlusion to the foot. Subsequent to experimentation flow velocity in single nailfold capillaries was measured via video densitometry and the number of flow-active capillaries in the field of view were counted. Following the release of arterial occlusion arterial flow velocity increased 142% above rest, the velocity in single capillaries increased by 54%, and the density of flow-active capillaries, as identified by the presence of red cells, decreased by 37%. The fact that capillary flow velocity increased to a lesser degree than arterial velocity during reactive hyperemia vis-a-vis a decrease in the number of flow-active capillaries indicates that ischemia to the foot elicits a smaller dilatory effect in vascular elements controlling blood flow to the superficial cutaneous region of the toe as compared to other regional vascular networks.

Adult↗
PubMed1982

Endothelial factors, toe temperature and leg circulation in diabetics with and without autonomic neuropathy.

A low plasminogen activator response to venous occlusion is frequently found in diabetes. The aims of this investigation were to study any relationships between plasminogen activator activity and autonomic neuropathy (AN), and between abnormal toe temperature reactions and AN. Asymptomatic AN is frequently found in insulin dependent diabetics. The results might be an abnormal balance between the parasympathetic and sympathetic innervation of the vessels, which in turn will lead to a change of the reaction to cooling of the feet followed by indirect heating. In this study 52 insulin dependent diabetics were examined with a combination of tests for AN and blood flow measurements as well as plasminogen activator activities of the blood and vascular walls. In patients with a short duration of diabetes (mean 11 years) the prevalence of AN was high in those with abnormally slow increase in toe temperature after cooling followed by indirect heating. The mechanism behind appeared to be a functional vasospasm. In diabetics of short as well as of long duration (mean 35 years), an abnormally low plasminogen activator activity of the blood during venous occlusion was found in those without AN, while those with AN showed a normal activity. Thus, AN might influence the deterioration of the circulation in diabetes.

Adult↗
PubMed1990

Microbial ecology of interdigital infections of toe web spaces.

The microbial flora of normal and macerated interdigital toe web spaces was qualitatively and quantitatively identified in 77 patients. Dermatophyte fungi were recovered from 11% of normal patients compared with a 31% recovery from patients with macerated interspaces. Macerated interspaces were characterized by a greater recovery of organisms with pathogenic potential, with Staphylococcus aureus recovered from 36% of patients, Micrococcus sedentarius in 37%, Brevibacterium epidermidis in 54%, Corynebacterium minutissimum in 69%, and Pseudomonas species in 26%. The bacterial flora of macerated interspaces showed a significantly higher incidence of resistance to multiple antibiotics, and the recovery of antibiotic-resistant bacteria correlated with the recovery of dermatophytes that produce penicillin-like substances. The results of this study support the hypothesis that overgrowth of the resident bacterial population determines the severity of interdigital toe-web infections.

Adult↗
PubMed1989

Restoration of sensibility in fingers repaired with free sensory flaps from the toe.

The sensibility of 25 fingers reconstructed with three different types of free sensory flaps from the toe was evaluated. The relationships between sensory restoration and the patient's age, type of sensory flap, selection of sutured nerves, and circulatory complications in the flap were analyzed. Wrap-around flaps were used in 5 fingers, hemipulp flaps in 11, and toe-to-finger transfers in 9. The follow-up period ranged from 16 to 79 months. Restoration of sensibility in the flap was closely related to the patient's age and vascular insufficiency of the flap. Therefore, establishing and maintaining and adequate circulation in the flap at operation is essential for good sensory restoration.

Adolescent↗
PubMed1992

Salvage in a case of ring avulsion injury with an immediate second-toe wrap-around flap.

A nonreplantable complete degloving injury to the small finger of a young woman was treated with the immediate microsurgical transfer of a second-toe wrap-around flap. One year after the operation, the donor foot was free of symptoms, and the reconstructed finger had an excellent cosmetic appearance, a range of motion of 0/90 degrees at both the metacarpophalangeal and the proximal interphalangeal joints, and a two-point discrimination of 6 mm. In selected patients, when the degloved skin envelope cannot be revascularized and when the skeletal and tendinous units are still intact, an immediate second-toe wrap-around flap may be a good alternative to amputation.

Adult↗
PubMed1993

Toe-to-hand transfer: an analysis of 14 failed cases.

Fourteen failed cases of 325 patients who had undergone the operation of toe-to-hand transfer to reconstruct the thumb and/or the finger are reported. Five key factors were related to the survival of the transferred toe: two sets of arterial blood supply in the case of an arterial anomaly, the resection of diseased vascular segments, the observation of capillary blood refill for the judgment of circulatory crisis, and the prevention and treatment of a hypercoagulable state.

Adult↗
PubMed2004

Toe blood pressure measurements in patients suspected of leg ischaemia: a new laser Doppler device compared with photoplethysmography.

OBJECTIVES: To study the usefulness of a new laser Doppler (LD) device as compared with photoplethysmography (PPG) to measure toe systolic blood pressures (TBP) in patients suspected of arterial insufficiency of the legs. DESIGN: Prospective comparative clinical study. MATERIALS AND METHODS: Seventy patients (121 legs) referred to our vascular laboratory for TBP measurements were investigated using a standard PPG and a new LD instrument, incorporating a cuff inflator and probe heater. RESULTS: Mean toe pressures with the PPG, unheated LD, and heated LD (37 degrees C) were 68.1, 67.2, and 75.5 mmHg, respectively. TBP with heated LD was systematically higher than with PPG (7.7 mmHg; p<0.001). Intra-class correlations between PPG vs. unheated LD and PPG vs. heated LD were good: 0.91 and 0.93, respectively. However, a considerable variation existed between PPG and LD (95% confidence interval: 45 mmHg), which were unrelated to the value of the TBP. Kappa values of agreement between PPG and unheated and heated LD to detect critical ischaemia (TBP below 30 mmHg) were good (kappa=0.77 and 0.63, respectively). CONCLUSIONS: The new LD device appears a good alternative to standard PPG measurements to assess TBP, despite a rather wide variation.

Blood Pressure Determination↗
PubMed2005

Non-vascularized free toe phalanx transplantation in the treatment of symbrachydactyly and constriction ring syndrome.

Forty-eight patients underwent a total number of 113 non-vascularized free toe phalanx transplantations for congenital short digits between 1975 and 2003, a mean number of 2.3 transplanted phalanges per patient. The mean age at the time of initial surgery was 3.6 years (range 6 months to 21 years). The follow-up time ranged from 4 months to 14 years with a mean of 6 years. Sixty-four phalanges showed radiographically measured growth, 22 phalanges showed signs of resorption, while 27 phalanges showed neither growth nor resorption. Resorption increased with patient age. Three patients developed donor site problems. The optimum timing for initial surgery is as early as possible because of the safer and greater growth potential and less resorption of the transplanted phalanges. Non-vascularized free toe phalanx transplantations offer a simple and safe method of lengthening with a significant improvement of hand function.

Age Factors↗
PubMed1990

Recovery of non-specific cholinesterase activity in sensory corpuscles of mouse toe skin after irreversible inhibition of this enzyme and cold injury.

Mouse digital corpuscles, located in the dermal papillae of toe pad skin, consist of the sensory axon terminals enveloped by the cytoplasmic processes of Schwann-derived cells forming the so-called inner core. The inner core cells are capable to synthetize nCHE molecules which are released into the interlamellar spaces filled by the basal lamina, collagenous microfibrils, and amorphous matrix. In the present study, the histochemical detection of the nCHE activity was investigated in the sensory corpuscles after sciatic and saphenous nerve transections and subsequent application of irreversible nCHE inhibitor (iso-OMPA) or cryo-treatment of toe pad skin. The recovery of the nCHE reaction product in both intact and denervated corpuscles revealed the resynthesis of the nCHE molecules by the inner core cells without assistance of sensory terminals, as well. The cellular constituents of corpuscles were degraded while extracellular matrix appeared to be undamaged after freezing injury. The molecules of nCHE attached to the extracellular matrix components disappeared in coincidence with the disintegration of Schwann-derived cells. After about 5 d of survival, the Schwann cells exhibiting the nCHE reactivity migrated through the basal lamina tubes as guidance of regrowing axons or alone. After 7 d from the treatment, immature Schwann cells marked by the nCHE reaction product occupied the scaffolds of old damaged sensory corpuscles. During further days of surviving, the Schwann cells entering the extracellular matrix of degraded corpuscles were differentiated to the inner core cells. The re-differentiation of the Schwann cells into the inner core cells was observed not only in the presence but also in the absence of sensory terminals. These findings suggest certain trophic independence of inner core cells upon sensory terminals in the sensory corpuscles of adult animals.

Animals↗
PubMed1976

Amputation of the toes for vascular disease: fate of the affected leg.

53 patients coming to amputation of one or more toes for the late results of degenerative vascular disease were studied prospectively. By a median time of thirteen months, 26 of the 53 had undergone a major amputation of the affected side. Diabetes was associated with the same prognosis as atherosclerosis obliterans uncomplicated by diabetes. A palpable pedal pulse or a functioning arterial reconstruction carried a virtual guarantee of success for the toe amputation. The presence of a popliteal pulse, however, was not associated with any better prognosis than the presence of a femoral pulse alone. Smoking seemed to exert little influence. With the passage of time, the major-amputation rate rose steadily, and by 3 1/2 years almost three-quarters of the patients had come to major amputation.

Aged↗
PubMed1997

Somatosensory evoked magnetic fields and potentials following passive toe movement in humans.

The somatosensory evoked magnetic fields (SEFs) and evoked potentials (SEPs) following passive toe movement were studied in 10 normal subjects. Five main components were identified in SEFs recorded around the vertex around the foot area of the primary sensory cortex (SI). The first and second components, 1M and 2M, were identified at approximately 35 and 46 ms. Equivalent current dipoles (ECDs) of both 1M and 2M were estimated around SI in the hemisphere contralateral to the movement toe, and were probably generated in area 3a or area 2, which mainly receive inputs ascending through muscle and joint afferents. The large inter-individual difference of 1M and 2M in terms of ECD orientation was probably due to a large anatomical variance of the foot area of SI. The third and fourth components, 3M and 4M, were identified at approximately 62 ms and 87 ms, respectively. They appeared to be a single large long-duration component with two peaks. Since the 3M and 4M components were significantly larger than the 1M and 2M components in amplitude and their ECD location was significantly superior to that of 1M and 2M, we suspected that they were generated in different sites from those of 1M and 2M, probably area 3b or area 4. Four components, 1E, 2E, 3E and 4E, were identified in SEPs, which appeared to correspond to 1M, 2M, 3M and 4M, respectively. The variation observed in the scalp distribution of the primary component, 1E, could be accounted for by the variation of the orientation of ECD of the 1M component. There was a large difference in the waveform of the long-latency component (longer than 100 ms) between SEFs and SEPs. The 5E of SEPs was a large amplitude component, but the 5M of SEFs was small or absent. We speculate that this long-latency component was generated by multiple generators.

Adult↗
PubMed2003

Functional evaluation of a great toe transfer and the osteoplastic technique for thumb reconstruction in the same individual.

Since the popularization of microvascular toe transfer, there has been a tendency to relegate osteoplastic reconstruction techniques for the thumb to history. A case is presented which shows that a successful and well-planned osteoplastic thumb reconstruction can match microsurgical reconstruction in all functional activities. Cosmetically, the toe transfer is the better reconstructive option but it may cause significant donor site morbidity.

Activities of Daily Living↗