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Evidence for allelism of the recessive insertional mutation add and the dominant mouse mutation extra-toes (Xt).

A recessive mutant caused by insertional mutagenesis in transgenic mice has been detected in which the anterior part of the forelimb is disorganized. The morphology of the thumb is always altered and sometimes the adjacent finger has an extra phalanx. This phenotype suggests that a body plan gene is affected. We have named the mutation add (anterior digit-pattern deformity). Using the cloned DNA from the flanking region of the integrated transgene, add has been mapped close to the centromere of chromosome 13. This position links add to a genetically mapped locus called extra-toes (Xt). The phenotype of the double-mutant add/Xt as well as the molecular analysis suggest that add and Xt are allelic.

Alleles↗

Expression of the zinc finger gene Gli3 is affected in the morphogenetic mouse mutant extra-toes (Xt).

Genetic analysis and homology between the phenotypic alterations of the human Greig Cephalopolysyndactyly Syndrome (GCPS) and the mouse mutant extra-toes (Xt) have suggested a dominant mutation in the same gene of both species. Recently, the GLI3 gene, a member of the Krüppel-related zinc finger genes, has been proposed as a candidate gene for GCPS. We examined the expression of the mouse Gli3 gene in both Xt mutant animals and during normal mouse development. Northern and RNAase protection analysis of embryos revealed that Gli3 expression was reduced about 50% in heterozygous Xt/+ mice and completely absent in homozygous Xt/Xt mice. In addition, in situ analysis of wild-type mice documented Gli3 expression in the developing limb and brain, structures affected in Xt mutant mice. This pattern suggests an important function of the Gli3 gene during morphogenesis.

Abnormalities, Multiple↗

Programmed cell death is affected in the novel mouse mutant Fused toes (Ft).

We have identified a novel dominant mouse mutant that is characterised by fused toes on the fore limbs and a thymic hyperplasia, in heterozygous animals. Homozygosity of the mutation leads to malformation of the developing brain, lost of the genetic control of left-right asymmetry and to death around day 10 of development. Analysis of both limb development and induction of apoptosis in immature thymocytes in vitro suggest that programmed cell death is affected by the mutation. Since the mutation was caused via a transgene insertion we were able to map it to the D region on mouse chromosome 8. So far, no mutation that affects programmed cell death has been mapped to this chromosome. Thus, this mutation will allow the identification of a novel gene involved in programmed cell death during mammalian development.

Animals↗

Effect of dantrolene sodium on excitation-contraction coupling of frog toe muscle.

Dantrolene sodium (1.0 to 10.0 mug/ml) inhibited twitch tension, tetanus tension, and contracture induced by potassium and low concentration of caffeine in the frog toe muscles. The drug also inhibited rapid cooling contracture (RCC), i.e., contracture caused by rapidly cooling the muscle from room temperature to 0 degrees C after immersing it in Ringer's solution containing a subthreshold concentration of caffein. The drug also suppressed RCC in depolarized muscle fibres which were treated with high concentration of potassium. Comparing the effect of the drug on twitches augmented with nitrate and with caffeine, the former was more markedly inhibited than the latter. On the basis of these results, the possibility that the drug acts mainly by inhibiting the movement of "trigger calcium" which in turn releases calcium from the sarcoplasmic reticulum is discussed.

Animals↗

Use of gyroscopic sensors for objective evaluation of trimming and shoeing to alter time between heel and toe lift-off at end of the stance phase in horses walking and trotting on a treadmill.

OBJECTIVE: To determine whether a shoe with an axialcontoured lateral branch would induce greater lateral roll of the forelimb hoof during the time between heel and toe lift-off at end of the stance phase (breakover). Animals-10 adult horses. PROCEDURE: A gyroscopic transducer was placed on the hoof of the right forelimb and connected to a transmitter. Data on hoof angular velocity were collected as each horse walked and trotted on a treadmill before (treatment 1, no trim-no shoe) and after 2 treatments by a farrier (treatment 2, trim-standard shoe; and treatment 3, trim-contoured shoe). Data were converted to hoof angles by mathematical integration. Breakover duration was divided into 4 segments, and hoof angles in 3 planes (pitch, roll, and yaw) were calculated at the end of each segment. Multivariable ANOVA was performed to detect differences among treatments and gaits. RESULTS: Trimming and shoeing with a shoe with contoured lateral branches induced greater mean lateral roll to the hoof of 3.2 degrees and 2.5 degrees during the first half of breakover when trotting, compared with values for no trim-no shoe and trim-standard shoe, respectively. This effect dissipated during the second half of breakover. When horses walked, lateral roll during breakover was not significantly enhanced by use of this shoe. CONCLUSIONS AND CLINICAL RELEVANCE: A shoe with an axial-contoured lateral branch induced greater lateral roll during breakover in trotting horses, but change in orientation of the hoof was small and limited to the first half of breakover.

Analysis of Variance↗

Radiologic case study. First metarsophalangeal plantar plate injury (turf toe).

Turf toe and related injuries to the first metatarsophalangeal joint are common injuries that occur in several sports. Although often a clinical diagnosis, advanced imaging can help grade severity of sprain and evaluate for associated or unsuspected injuries. Without proper rest and conservative management, a treatable injury can have chronic sequelae and morbidity. Operative management is uncommon, but successful in returning high-level competitive athletes to their sport.

Adolescent↗

LaPorta great toe implant. Long-term study of its efficacy. Student Research Group.

The purpose of this study was to evaluate the long-term function of the LaPorta design great toe implant. Eight cases were evaluated preoperatively and on a short-term (mean = 3.6 months) and a long-term basis (mean = 20.5 months) postoperatively. Findings of clinical importance included decreased hallux dorsiflexion and radiographic evidence of hyperostosis formation at the implant hinge. However, all of the patients studied were satisfied with their results.

Aged↗

Arthroplasty of the second toe.

The pathology, pathophysiology, and clinical anatomy of claw, hammer, and crossover toe deformities are presented. Emphasis is placed on the deforming role of the collateral ligaments and intrinsic tendons. A sequential approach to soft-tissue releases about the metatarsophalangeal joint for correction of deformity is presented. In addition to these static deformities, instability of the second metatarsophalangeal joint, including subluxation and dislocation, is discussed.

Arthroplasty↗

[Transposition of the fibular skin flap of the great toe to repair the fore plantar defect].

The sole, as the body weight-bearing region, is characterized with the skin of thick stratum corneum. Wound in the region is difficult to cure. Based on the blood supply of the foot, a fibular skin flap of the great toe was designed and used to treat the defect of the planta pedis. Clinical applications in 6 cases were successful. The operation results were satisfactory.

Adult↗

Electromyographic differentiation of diplegic cerebral palsy from idiopathic toe walking: involuntary coactivation of the quadriceps and gastrocnemius.

Clinical differentiation of patients with mild diplegic cerebral palsy (CP) and idiopathic toe walking (ITW) can be difficult. However, an involuntary extensor pattern may be a distinguishing sign. The purpose of this study was to determine if selected gait parameters or patterns of electromyogram (EMG) timing of quadriceps, gastrocnemius, and tibialis anterior during knee extension while sitting can distinguish between these patients. The hypothesis was that EMG testing for selective control of the quadriceps and gastrocnemius could differentiate patients with diplegic CP from normal controls and from patients with ITW. We evaluated 10 control, eight CP, and eight ITW subjects. Measurements included walking speed, energy expenditure index (EEI), ankle position during stance, and EMG of the quadriceps, gastrocnemius, and tibialis anterior during gait and during knee extension while sitting. Dynamic EMG timing during gait showed significant differences in the mean onset of the gastrocnemius between subjects with CP and ITW, but there was considerable overlap. More consistent differences were found during active and active-resisted knee extension while sitting. Mean values for gastrocnemius EMG timing recorded as a percentage of duration of quadriceps EMG while sitting were 0 and 0.4% for controls, 0 and 3.9% for ITW subjects, and 84.3% and 93.4% for CP subjects. Patterns of EMG timing of the quadriceps and gastrocnemius during knee extension while sitting can help to differentiate patients with mild diplegic CP from those with ITW.

Cerebral Palsy↗

[On the duality of the sign of fanning of the toes].

Starting from Babinski's original description, the author carries out a revision of semeiological value of the sign "fanning of the toes". It is considered that there are two clinical variants. The first, present in most cases of connatal encephalopathy, is due to involvement of the premotor area, which is usually accompanied by pyramidal, dystonic or athetoid signs. The second variant is present in cases of multiple sclerosis presumably attributable to involvement of the lateral spinal tracts including the reticulospinal one. The author proposes the need of using modern neuroimaging and electrophysiological techniques for further pathophysiological investigation of both clinical variants of the sign.

Brain Diseases↗

Solitary nodule of the great toe.

We describe a 21-year-old woman with a subungual exostosis exhibiting both skin and nail findings. The patient presented with a firm, flesh-colored, nontender, subungual nodule in the distal nail bed of the great toe. Radiographic examination revealed focal calcification of the nodule, with direct communication to the underlying phalanx. Subungual exostosis should be considered in the differential diagnosis of any digital mass. Surgical excision, followed by curettage of the base, is the treatment of choice.

Adult↗

Unusual pattern of Sonic hedgehog expression in the polydactylous mouse mutant Hemimelic extra-toes.

We have examined the dynamic expression of Sonic hedgehog (Shh) in limb buds of the Hemimelic extra-toes (Hx) mutant. An ectopic domain of expression appears in the limb bud at embryonic day 11.5, which is not restricted to the anterior mesenchyme as in other polydactylous mutants, but extends along the entire apical ectodermal ridge. No difference in expression was observed between heterozygotes and homozygotes. This ectopic expression domain forms later and is maintained longer than the normal one. We verified that the Shh signal is properly transduced in the ectopic expression domain by analysing the expression of downstream target genes and provide evidence that the ectopic domain is functional. Interactions between Msx1 and Hx were investigated by constructing a double mutant strain. Embryos from this strain exhibit little difference in Shh expression compared to Hx simple mutants. However, homozygous Msx1/Hx double mutants exhibit a postaxial polydactyly at birth, demonstrating that the two genes interact.

Animals↗

Open-label study of the safety and efficacy of Fungoid tincture in patients with distal subungual onychomycosis of the toes.

Onychomycosis is the most frequent cause of nail diseases. An open-label study has been conducted to evaluate the safety and efficacy of Fungoid Tincture, a topical antifungal agent approved by the Food and Drug Administration for the treatment of onychomycosis of the toes. Ten patients with culture-proven distal subungual onychomycosis were treated twice daily for twelve months with topical Fungoid Tincture. Another ten patients with the same condition were treated with the vehicle alone. At monthly intervals, the target nail was trimmed, the nail bed debrided, and global clinical assessment recorded. After twelve months of therapy, all patients applying Fungoid Tincture showed negative findings on fungal culture. The vehicle alone benefitted several patients, and may have antifungal activity. Adverse effects were minimal, with mild peeling occurring in seven patients and erythema noted in one.

Antifungal Agents↗

[Livedo racemosa, skin necrosis at the basal toe joint].

An 81 year old male patient treated by sulfonylurea and diet was known to have type II diabetes for three years. Because of pulmonary embolism phenprocoumon had been administered for four months. Painful livedo racemosa developed acutely on both lateral sides of the feet and the left knee. A necrosis of the skin over the base of the left small toe developed within a few days. On the basis of the clinical picture cholesterol-embolism was diagnosed. Since anticoagulation is known to promote cholesterol-embolism it was discontinued. Prostaglandin E1 infusions into both legs were administered. Within 3 months the cutaneous lesions healed completely.

Aged↗