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In a manner similar to dermabrasion, epidermalized tarsal conjunctiva is polished and then the tarsus is grafted with full-thickness buccal mucous membrane. This has been applied with rewarding results in patients afflicted with Stevens-Johnson syndrome, ocular pemphigoid and scarred eyelids with secondary epidermalization.
Dysplasia epiphysealis hemimelica is a condition characterised by asymmetrical and uneven growth of the epiphyses of the long bones of the limbs and of the bones of the tarsus and carpus. The growth disturbance is caused by the development of accessory nuclei that exhibit histological and histochemical features similar to those found in ossifying epiphyseal cartilage and in the ossific centres of developing carpal and tarsal bones. The common histogenesis, as confirmed by the authors, could explain the elective localisations of the disorder.
In many insects, grafting a larval leg onto the contralateral leg stump reverses one transverse axis and leads to the regeneration of supernumerary legs at each of the two points of maximum discrepancy on the graft/host junction. These operations were performed on the cricket Acheta domesticus, grafting between tibiae of pro- and metathoracic legs, and between tibia and tarsus, in order to deduce the mode of origin of the supernumeraries from their graft type, host type or composite structure. Supernumerary legs formed after A/P axis reversal are always half-and-half in structure, being of host type on the host side and graft type on the graft side, while supernumeraries formed after M/L axis reversal are variable in structure. These results are generally consistent with the recent Polar Co-ordinate Model (whereby supernumeraries form because the pattern of intercalation between graft and host generates two complete circumferences at the junction), provided that intercalation is restricted by the borders between anterior and posterior leg compartments. However there are features of the structure of the M/L supernumeraries which the Polar Co-ordinate Model does not explain. Medial supernumeraries are often of pure graft type (and lateral ones of host type) or half-and-half with anterior graft type and posterior of host type (while lateral supernumeraries often have the converse structure).
Adults of the Argas subgenera Secretargas (3 species) and Ogadenus (1 species) were studied by scanning electron microscopy. In each species, the anterior pit and Haller's organ are situated in a large dorsal hump of Tarsus I and the 9 setae of the anterior pit are characteristic of the genus Argas in structure and numbers. In A. (S.) transgariepinus, an Ethiopian-Palearctic crevice-dwelling parasite of bats, the Haller's organ capsule roof is solid with a slitlike transverse aperture. In A. (S.) hoogstraali and A. (S.) echinops, Malagasy soil-dwelling parasites of Oplurus (Varanidae) lizards and the hedgehog-tenrec (Insectivora: Tenrecidae), respectively, the Haller's organ is virtually unroofed but partially screened by arborescent dorsal projections from the posterior wall of the capsule, and the open capsule contains numerous fine pleomorphs. In A. (O.) brumpti, a soil-dwelling parasite of the hyrax (Procavia), other terrestrial mammals, and lizards in the Ethiopian Region, the capsule is also virtually unroofed and contains numerous fine pleomorphs. The unroofed capsule is probably phylogenetically primitive and occurs only in these 3 and 2 other Argas species. The soil microhabitat (in Argas confined to 3 of the 4 species recorded here), and the reptile or ancient mammal hosts of these 3 species, as well as the zoogeographical isolation of 2 of the species in the Malagasy Region, are distinctive in this genus of 56 species. The interrelationships between an unroofed Haller's organ capsule and unusual biological properties remain to be determined.
The treatment of tarsal fractures in children was analysed in a joint research project performed in eight GDR surgical clinics of various size. 63 fractures of the tarsal bones were treated over a seven-years period. Each single bone of the tarsus was analysed separately. For reasons of comparison, however, the results were evaluated of all tarsal fractures in the follow-up in connection with Seyfarth's classification as applied with respect to calcaneal fractures. The findings show that tarsal fractures in children can be thoroughly cured by conservative treatment. Operative treatment is indicated only in few cases.
In Greyhounds, 2 plantar sesamoid bones were identified in radiographs taken of the intact tarsus and also of the tarsometatarsal fibrocartilage, that had been dissected free from the joints. Anatomic dissections defined the precise position of each sesamoid. A prominent sesamoid was present on the lateral side of the tarsometatarsal articulation in 50% of the tarsi; it is proposed that this bone be named the lateral plantar tarsometatarsal sesamoid bone. A smaller bone was detected on the medial side of the tarsometatarsal articulation in 27% of the tarsi; it is proposed that this bone be named the intra-articular tarsometatarsal sesamoid bone.
A method of alleviating full thickness lower eyelid retraction is described. Transposition flaps of tarsus-conjunctiva and skin-muscle are transposed from the ipsilateral upper lid into an infratarsal transverse blepharotomy in the retracted lower lid.
Adults of 18 of the 22 species constituting the subgenus Argas, which parasitize birds nesting and resting in rocky habitats in each faunal region of the world (15 species) or in trees (e species) (2 Neotropical, 1 Nearctic), were studies by SEM. In each except three Neotropical species, the nine setae of the anterior pit of tarsus I are arranged in an anterior group (1 serrate, 1 setiform, 1 conical) and a posterior group (2 fine, e porose, 2 grooved), or the two groups are more or less confluent. Abnormally, additional setae may occur on one or both tarsi of a single specimen. In one Neotropical species, only the three anterior group setae are present. In three Neotropical species, only these three setae and a fourth seta are present (whether 6 or 5 additional setae are concealed within the tarsal structure should be investigated). The Haller's organ capsule is entirely open (unroofed) (3 species), roofed posteriorly and open anteriorly (7 species), or mostly roofed by a plate which is pierced by one large aperture and by more or less numerous, small, or medium-sized perforations (8 species plus one other not studied by use). This study suggests that the structure of Haller's organ has evolved in different lines in response to a multiplicity of biologic al factors related to the behavior and habitat of individual species.
Adults of 13 of the 17 species constituting the subgenus Persicargas (parasitizing birds nesting in trees) and the single species of the subgenus Microargas (parasitizing the Galapagos giant tortoise) were studied by scanning electron microscopy. The setae of the anterior pit of tarsus I number nine(1 serrate, 1 setiform, 1 conical, 2 fine, 2 porose, 2 grooved) in Persicargas. The single, serrate seta arises from an anterior section of the pit, the other eight setae arise from a posterior section. Abnormally, fewer or more setae occur on one or both tarsi of a single specimen. The setal arrangement is similar in Microargas, but the total number is eight (setiform seta absent). The capsule roof of Haller's organ in Persicargas is typically flat and platelike with a circular central aperture and few to moderately numerous small perforations. Thus, this roof is more solid than in other subgenera of Argas, except in Microargas and subgenera associated with cave-dwelling bats (Carios and Chiropterargas). The roof structure is quite variable in samples of A. (P). radiatus. The roofs of two Persicargas species differ from the typical pattern, the A. (P.) minatus roof is more extensively perforated and in some specimens of A. (P.) streptopedia the roof is netlike. The Microargas roof, on a sloping surface bounded by a transverse anterior groove, is more solid than those of Argas and has a circular aperture surrounded by small perforations. The biological implications of these structural properties should be investigated.
Congenital eversion of the eyelids is a rare condition which has never had a proven anatomic etiology. A one-day-old male presented with severe congenital eversion of both upper eyelids. Medical therapy was unsuccessful. At surgery, adipose tissue was found beneath the tendon of the levator palpebrae and extended anterior to the tarsus because the orbital septum was not attached inferiorly. The defect was repaired. In this case, non-attachment of the orbital septum may have induced eversion of the upper eyelids.
The late Marvin Quickert originated a lower lid entropion repair successful especially in recurrent cases. Probable reasons for its success is correction of all three main conditions predisposing to entropion, namely increased horizontal length, excessive vertically mobile preseptal orbicularis, and lax retractors, whereas other entropion procedures correct only one or two factors. A bridge flap of lid is created by an incision at the base of the tarsus, and this is then transected vertically in its outer third. The amount of horizontal redundance determined, a rectangle of full thickness lid is excised, and the ends reapproximated. Wies type sutures are placed approximating superior anterior lamella to inferior posterior lamella. Redundant skin is excised laterally and the entire skin incision closed. A Wies procedure resulting in immediate ectropion can easily be converted to this procedure.
The fixing shoe with rolling sole (arthrodesis shoe) serves to ensure pain-free or at least tolerably painless walking in case of changes due to arthrosis or lesion sequelae in the ankle joints or the tarsus. This is achieved by means of a high shaft of adequate strength, an accurate bedding of the foot, and a rolling sole with sufficient lift at the tip. This shoe is indicated in cases where the load alone is well tolerated whereas load in conjunction with movement produces pain. Several types of these orthopedic shoes have been developed. Of these, the model with interchangeable built-in element has proved most successful in the authors' experience. This built-in element consists of a drummed (milled) cap reinforced with cast resin, and a cork bedding. This removable or interchangeable unit is advantageous compared with a firmly integrated system insofar as any changes or repairs can be effected easily and at a lower cost.
While one of the most basic techniques in eyelid surgery is the repair of an eyelid defect that involves the margin, many eyelid defects are still poorly repaired; and much confusion still exists in this area. Based upon sound anatomic and surgical principles, we suggest several modifications of classically described techniques: (1) The greyline suture is replaced by a tarsal suture through the meibomian gland orifices to provide a stronger closure and better alignment. (2) All tension of closure is supported by the deep tarsal sutures rather than by the margin sutures to avoid notch formation or unsightly scars. (3) A two-layered closure where orbicularis and tarsus is closed in a single layer is technically easier and gives results comparable to the classically taught three-layered closure. Conjunctival sutures in the tarsal portion of the eyelid are unnecessary and frequently cause corneal irritation. (4) When lid resection is performed, a pentagonal excision rather than a "V" or wedge resection should be used to minimize tension on the margin when closed. We present in an illustrated step-by-step fashion our preferred technique which gives consistently good results.
Ligneous conjunctivitis is a rare, usually bilateral, chronic membranous conjunctivitis, which begins acutely in childhood and persists for many years. In view of the poor results obtained with other forms of therapy in the past, the resection of the involved conjunctiva and tarsus with the grafting of donor sclera is offered as another alternative in the management of this distressing condition.
A simple technique for resection of the superior tarsal muscle through a cutaneous approach, for the surgical treatment of ptosis, was employed in severe or moderate, congenital and acquired forms of the affection. Muller's muscle and the aponeurotic fascia are removed in a single piece, while conserving the tarsus.
The output and immunoglobulin class of antibody-containing cells (ACC) in lymph from different regions of adult sheep has been compared following intraperitoneal or subcutaneous injection of ovalbumin in Freund's complete adjuvant (FCA). Intraperitoneal injection of antigen in FCA elicited no response at all in popliteal lymph, but there were substantial responses in lymph from the hepatic, coeliac (which carries lymph mainly from the abomasum and anterior duodenum) and intestinal lymphatic ducts. A significant increase in the number of blast cells accompanied the ACC response. ACC reached a peak 7- days after injection when ACC comprised 3.7% +/- 0.7%, 2.3% +/- 0.7% and 3.3% +/- 0.6% of total lymphocytes in lymph from the hepatic, coeliac and intestinal ducts respectively. At this time ACC were distributed among three immunoglobulin classes IgM, IgG1 and IgA with the latter constituting 25%--40% of ACC in lymph from the three regions. ACC did not appear in intestinal lymph following subcutaneous injection of ovalbumin in FCA in the leg immediately below the tarsus. This contrasted with the vigorous response in popliteal lymph where 6 days after the injection ACC constituted 3.9% of cells in lymph. Most (83%) of the ACC were IgG1-specific at the peak of the response. The remaining ACC were distributed among the IgM, IgG2 and IgA classes with the latter comprising 3% of total ACC.
Hepatozoon canis gametocytes were identified in circulating neutrophils of 3 dogs from different parts of Texas. Clinical signs included intermittent fever, stiffness, and inappetence. The dogs had marked neutrophilic leukocytosis (35,000--51,000/mm3). Parasitemia varied from less than 1% to 60% of the circulating neutrophils. Two of the dogs had periosteal new born reaction on the vertebrae, ilia, ribs, and bones of the limbs proximal to the carpus and tarsus. There was no evidence that specific drug therapy was of value, although use of corticosteroids, aspirin, and antimicrobial agents was accompanied by clinical improvement.
Upper eyelid retraction secondary to thyroid disease can be relieved in a controlled manner by a graded detachment and excision of Müller's muscle and stripping and recession of the levator aponeurosis. This improves cosmesis, lessens the exophthalmic appearance, and relieves ocular irritation secondary to exposure keratopathy and conjunctivopathy. Recessing the lower eyelid retractors and placing a scleral graft between them and the tarsus can relieve lower eyelid retraction. Edema and inflammation of orbital fat secondary to thyroid disease cause separation of the orbital septum from the capsulopalpebral fascia, allowing fat to prolapse into the orbit as in a true hernia. To prevent full fledged lower eyelid retraction and to relieve slight amounts that already exist, the lower eyelid retractors are recessed when orbital fat is excised.