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Glands of the eyelids of rhesus monkeys (Macaca mulatta).

The various glands of rhesus monkey eyelids and human eyelids are similar. Numerous modified sebaceous glands are located along the tarsus. These conform with the meibomian glands, while typical sebaceous glands associated with the hair follicles of the lashes are consistent with the glands of Zeis. Lobules of accessory lacrimal tissue, corresponding to the glands of Krause and Wolfring, are located in the conjunctiva of the fornix and along the orbital border of the tarsal plate. Goblet cells are plentiful in the mucosa of the palpebral and bulbar conjunctiva, and along the lid margin are the sweat glands of Moll.

Animals↗

[Surgical treatment of instability of the ankle joint caused by inveterate injuries of the ligaments of the lateral malleolus].

The results of surgical Chrisman-Snook reconstruction of the lateral malleolus ligaments in 9 patients, aged 19-37 years, have been discussed. The follow-up ranged from 2 to 4 years. In all the patients, good functional results were obtained. Among many methods of reconstruction of the lateral malleolus ligaments, the Chrisman-Snook method distinguishes itself because of simplicity of procedure and furthermore, it can be used for reconstruction of injuries of the tarsus ligaments in the region of the malleolus. It can be recommended in the treatment of patients with the symptoms of instability of the talocrural joint.

Adult↗

Histology of partial thickness double composite eyelid graft.

Double composite grafting is a technique used in the repair of large (greater than 75%) eyelid defects due to tumor resection, trauma, or congenital coloboma. The procedure utilizes two partial thickness composite grafts derived from two unaffected lids. The skin defect is covered by a pedicle skin graft to provide an adequate blood supply. This is thought to be superior to revascularization occurring from the margin of the graft alone. We examined histologically the lid margins of two such grafts 2 and 9 months postoperatively. Each demonstrated scarred tarsus and absent meibomian glands. One of the two grafts had loss of cilia. The architecture of the graft tissue otherwise was preserved.

Aged↗

Descriptive and functional morphology of the locomotory apparatus of the spotted hyaena (Crocuta crocuta, Erxleben, 1777).

The musculature of the limbs, neck and back of Crocuta crocuta is described and some functional aspects are discussed. The myology of C. crocuta generally corresponds with that of H. hyaena. Both species show adaptations to lifting and carrying heavy loads, but the larger size and more robust morphology of C. crocuta enables it to master larger prey than H. hyaena. A remarkable over-extension of the tarsus in C. crocuta is described which was observed both in the cadaver and in vivo, during the gallop.

Animals↗

Dorsal subluxation of the proximal interphalangeal joint in the pelvic limb of three horses.

In horses, dorsal subluxation of the proximal interphalangeal joint in the pelvic limb, which realigned when weight was applied to the limb, improved following surgery. Improvement was observed, if not immediately, at least within two weeks after treatment. The severity and duration of the condition appear to be important considerations in predicting the time necessary for resolution of the condition following surgery. Treatment consisted of surgical resection of a small segment of the medial head of the deep digital flexor tendon in the pelvic limb. The section removed was positioned distal to the tarsus, at the level prior to the tendon joining the main portion of the deep digital flexor tendon. Previously, a surgical treatment was described in which a portion of the accessory ligament (distal check ligament) of the deep digital flexor muscle was resected. Because the medial head is much stronger than the accessory ligament, resection of the tendon of the medial head provides more release of tension to allow stretching of the deep digital flexor muscle tendon.

Animals↗

Intersegmental interneurons can control the gain of reflexes in adjacent segments of the locust by their action on nonspiking local interneurons.

The gain of local reflexes of one leg of a locust can be altered by mechanosensory inputs generated by movements of or tactile inputs to an adjacent leg. Touching the mesothoracic tarsus, for example, increases the number of spikes that are produced by the metathoracic slow extensor tibiae motor neuron and enhances the depolarization of flexor tibiae motor neuron in response to imposed movements of the chordotonal organ in the ipsilateral hind femur. The sensory information from the middle leg is conveyed directly to nonspiking interneurons and motor neurons controlling the movements of the hindleg by a population of mesothoracic intersegmental interneurons (Laurent and Burrows, 1989). The metathoracic nonspiking interneurons receive direct inputs from receptors on a hindleg and are, therefore, a point of convergence for local and intersegmental inputs. We examine here the role of the connections between mesothoracic intersegmental interneurons and metathoracic nonspiking interneurons in controlling metathoracic local reflexes. The amplitude of synaptic potentials evoked in leg motor neurons by the stimulation of local afferents can be modulated by altering the membrane potential of an interposed nonspiking interneuron with current injected through an intracellular electrode. These imposed voltage changes mimic a mesothoracic input and show that the state of a nonspiking local interneuron is a determining factor in the expression of a local reflex. Inputs from mesothoracic intersegmental interneurons may cause large changes in the input conductance of nonspiking interneurons that can shunt a local afferent input. In some nonspiking interneurons, synaptic potentials caused by mesothoracic interneurons can be recorded, but no underlying conductance change can be detected at the recording site. Similarly, a particular nonspiking interneuron may receive synaptic inputs when two distinct regions of a middle leg are touched, but only one of these intersegmental inputs may be effective in reducing the amplitude of a synaptic potential caused by afferents from the hindleg. These results suggest that nonspiking local interneurons may be compartmentalized, with synaptic inputs and their associated conductance changes restricted to particular branches. In this way, an individual nonspiking neuron could contribute simultaneously to several local circuits. The inputs from different intersegmental interneurons could then modulate these pathways independently.

Animals↗

[X-ray examination of foot injuries].

Fractures and luxations of the phalanges, metatarsus, tarsus and their joints are discussed. Correct radiological projections, knowledge of their pitfalls and a systematical interpretation are necessary for correct diagnosis.

Calcaneus↗

Treatment of upper eyelid entropion. Lid split surgery and fibrin sealing of free skin transplants.

The repair of severe upper eyelid entropion with trichiasis was reported early in ophthalmological literature; a historical review of the main operative techniques is provided. The aim of treatment is to bring the eyelashes away from the lid margin. Recent procedures use an upward transposition of the anterior lamella, which is performed by a lid split technique. The free anterior tarsal surface must be covered by a free, autologous skin graft or mucous-membrane graft to stabilize the free lid margin and to prevent the tarsal plate from shrinking. A fibrin-sealing method is used for the fixation of the graft on the tarsus, thus making sutures unnecessary. The anterior tarsal surface is covered by the fibrin-glued transplant, which prevents the posterior lamella from shrinking and does not allow the lashes to descend to the lid margin again. The results of using this new method on seven patients are presented.

Entropion↗

Nasolacrimal evaluation and surgery.

The lacrimal drainage system is a very important functional and anatomic assembly in the orbit and midface. For surgeons who intend to become involved in its repair or reconstruction, it is mandatory to understand the full range of anatomic, physiologic, and diagnostic considerations prior to embarking upon a surgical course. Proper eyelid function depends upon the integrity of its constituent parts, including the margin, tarsus, muscle, and globe apposition. The lacrimal pump mechanism is produced by proper eyelid function and structure, and must be adequately assessed. The puncta and canaliculi are delicate structures and must be manipulated with care and gentleness. The lacrimal sac is a static structure that serves as a collecting sphere but also may be forced to evacuate its contents into the nasolacrimal duct by the "squeezing" action of the investing tendons. Proper tendon position must be maintained after surgery or trauma to facilitate this action. The nasolacrimal sac may be damaged after facial fractures or blocked from intranasal conditions. If the blockage cannot be relieved, it must be bypassed by performing a dacryocystorhinostomy. The use of long-term, indwelling silicone intubation catheters greatly facilitates the successful reconstruction of the lacrimal drainage system. Proper attention to all of these points will be appreciated by the patient.

Dacryocystitis↗

Modification of Bick's procedure for treatment of eyelid laxity.

A modification of Bick's procedure is presented that offers a simple, effective treatment of ectropion and entropion secondary to eyelid laxity. A full-thickness lid-shortening procedure performed at the lateral canthus avoids lid notching, with good cosmetic results. The success of the procedure is determined by suture of the tarsus directly to the orbital periosteum. The modification of Bick's procedure improves the outcome of the operation and simplifies its performance.

Aged↗

Involutional entropion: a simple and stable repair.

A simple technique for repair of involutional entropion is described. A 4 x 20 mm strip of cartilage is removed from the concha of the ear and placed in the lower lid, deep to the orbicularis muscle. Over the past 6 years, I have performed this procedure on 15 patients. Fourteen patients had an excellent result; one patient required a secondary lateral wedge resection. There have been no recurrences. The tarsal plate of the lower eyelid appears to soften and shrink with advancing age. As the tarsus shrinks, the lid becomes less rigid and the margin tends to roll inward. Creating a neotarsus out of ear cartilage provides a simple and stable repair for involutional entropion because it restores the structural rigidity of the lower lid. The operative procedure is technically simple. Its long-term effectiveness confirms the view, not widely held, that one primary cause of involutional entropion is a shrunken and atrophic tarsal plate.

Aged↗

[Roentgen diagnosis of fracture of the calcaneus with involvement of the lower ankle joint].

The prognosis and therapy of the fracture of the calcaneum largely depend on an involvement of the talo-calcaneonavicular joint. Incongruities and grated fractures in the region of the posterior joint facet are prognostically unfavourable but can be tackled by surgery. Standard X-ray films of the calcaneonavicular joint and of the tarsus do not offer sufficiently conclusive criteria. Oblique X-ray films with 60 degree internal and external rotation visualise the talo-calcaneonavicular joint almost free from overshadowing. The diagnostic value and technique of the standard and oblique X-ray films, as well as the topography of the joint facets under different projections, are demonstrated in this article by means of X-ray films of preparations and by case reports.

Adult↗

A tarsal resection procedure for senile entropion with lid retraction.

1. A method of tarso-conjunctival resection for correction of spastic entropion associated with lid retraction has been presented which prevents a) the presence of suture knots against the cornea, b) localized trichiasis, and c) tissue reaction to absorbable sutures. 2. These advantages are achieved through the use of several figure-of-8 silk sutures which are tied on the skin surface. 3. By keeping the apex of the excised triangle of tarsus 2 mm below the lid margin trichiasis may be avoided. 4. Twelve operations have been followed for 1 to 6 years. The retraction and entropion were markedly improved in eleven lids. One under-correction resulted. There were no other complications.

Entropion↗

[Skeletal anomalies in the VATER syndrome in human embryos].

Anomalies of the skeleton and internal organs have been described in 9- and 12-week-old human fetuses with the VATER syndrome. Together with the known anomalies occurring at the syndrome, certain anomalies in development of the skin, tarsus and wrist bones are revealed.

Abnormalities, Multiple↗

Fractures associated with neuropathic arthropathy in adults who have juvenile-onset diabetes.

Eighteen patients, twenty-five to fifty-two years old, who had juvenile-onset diabetes, had neuropathic arthropathy and fractures at the ankle or tarsus, most of which were bilateral. After a minimum follow-up of one year, four patients could not walk and fourteen were dependent on orthoses. In nine patients, the lesions produced fixed skeletal deformities that caused severe malum perforans, which in three patients was so severe that a below-the-knee amputation had to be done. In patients who had bilateral lesions, when the extremity that was initially involved was prevented from bearing weight, involvement of the contralateral limb became evident after an average of 4.5 months, compared with an average of twelve months in the patients who were allowed weight-bearing on the extremity that was initially involved. Our current treatment protocol is non-weight-bearing immobilization of the involved extremity, and we recommend prophylactic immobilization of the contralateral extremity with a protective cast or orthosis. All of the patients who had this treatment regimen could walk; in contrast, of the eleven patients who were not so treated, four could not walk.

Adult↗

Early growth rates and their relationships to mortalities of five breeds of chickens following exposure to acute gamma radiation stress.

Growth and mortality responses were recorded for 541 chicks, representing five different breeds of chickens, following acute exposures to gamma radiation stress at two days of age. Although there were no statistically significant differences in the LD50/30 of the five breeds studied, Cobb broilers showed the highest (1580R) and White Leghorn bantams the lowest (980R) levels, respectively. Other breeds studied included the standard White Leghorn, Athens Randombreds and a strain of feral bantam. Growth rates of body weights were proportionately more depressed by radiation stress than were body sizes, as measured by the lengths of the culmen, tarsus, middle toe and longest primary wing feather of all 32 day-old survivors. Among these structures, the length of the culmen seemed to be the least affected by radiation stress in all of the breeds studied. Feral bantams were able to tolerate the greatest depression in weight gain before exhibiting mortality at exposures below their LD50/30' while Cobb broilers tolerated the greatest depression of weight gain at higher exposure levels. There was a suggestion that those characteristics which were strongly selected for in the course of a particular breed's development were those which experienced the greatest proportional depressions following exposure to gamma radiation stress.

Animals↗

[Surgical treatment of entropium senile (author's transl)].

The authors report on a modification of the entropion surgery of Celsus-Hotz which was successfully carried out in 87 patients with entropion senile from 1969 to 1976. After excision of an about 5 mm wide crescentshaped dermal tissue of the lower eyelid about 3 mm down the margin the muscle fibres of the M. orbicularis near the margin are resected. Before suturing the skin 3-6 stitches of Hotz are done to reduce the tarsus. The advantages of this technique are the safe therapeutical effect, the cosmetical effect and the easy correction of this operation in case of a failure.

Aged↗

The role of spiking local interneurons in shaping the receptive fields of intersegmental interneurons in the locust.

Intracellular recordings were made simultaneously from pairs of spiking local and intersegmental interneurons in the mesothoracic ganglion of the locust Schistocerca gregaria (Forskal). The spiking local interneurons belong to a midline group, and the intersegmental interneurons to a lateral-posterior population that projects ipsilaterally to the metathoracic ganglion. Both respond to mechanosensory inputs from one middle leg. The receptive fields of both types of interneurons were plotted and the contribution of the local interneurons to the shaping of the receptive fields of the intersegmental interneurons was studied. The spiking local interneurons are excited by specific arrays of exteroreceptors and proprioceptors of one leg. They make inhibitory connections with specific intersegmental interneurons which thus have corresponding inhibitory regions to their receptive fields. For example, inhibition from local interneurons with inputs from hairs or campaniform sensilla on the tarsus could sharpen the boundaries of the excitatory receptive field of an intersegmental interneuron by lateral inhibition. Inhibition from local interneurons with inputs from joint proprioceptors suppresses the excitation of an intersegmental interneuron during the antipreferred direction of movement. Rapid alternate movements about one joint can in this way be signaled by an intersegmental interneuron in a phase-locked manner. Certain intersegmental interneurons are excited by exteroreceptive inputs and inhibited by proprioceptive signals, or vice versa. The inhibition could become significant during walking, where the excitatory and inhibitory inputs to an interneuron are likely to be evoked during the different phases of a step cycle. The inhibitory regions of the receptive field of an intersegmental interneuron have never been found to be smaller than the excitatory regions of the receptive field of a presynaptic local interneuron and can result from converging inhibitory inputs from several spiking local interneurons. The inhibitory connections are highly specific: Several local interneurons may be excited by a particular stimulus that also inhibits an intersegmental interneuron, but only a small proportion of the former are the cause of the inhibition in the intersegmental interneuron.

Animals↗