Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

PubMed

Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

2015-06-01

Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture.

Phalangeal joints kinematics during ostrich (Struthio camelus) locomotion

PubMed Central

Ji, Qiaoli; Luo, Gang; Xue, Shuliang; Ma, Songsong; Li, Jianqiao

2017-01-01

The ostrich is a highly cursorial bipedal land animal with a permanently elevated metatarsophalangeal joint supported by only two toes. Although locomotor kinematics in walking and running ostriches have been examined, these studies have been largely limited to above the metatarsophalangeal joint. In this study, kinematic data of all major toe joints were collected from gaits with double support (slow walking) to running during stance period in a semi-natural setup with two selected cooperative ostriches. Statistical analyses were conducted to investigate the effect of locomotor gait on toe joint kinematics. The MTP3 and MTP4 joints exhibit the largest range of motion whereas the first phalangeal joint of the 4th toe shows the largest motion variability. The interphalangeal joints of the 3rd and 4th toes present very similar motion patterns over stance phases of slow walking and running. However, the motion patterns of the MTP3 and MTP4 joints and the vertical displacement of the metatarsophalangeal joint are significantly different during running and slow walking. Because of the biomechanical requirements, osctriches are likely to select the inverted pendulum gait at low speeds and the bouncing gait at high speeds to improve movement performance and energy economy. Interestingly, the motions of the MTP3 and MTP4 joints are highly synchronized from slow to fast locomotion. This strongly suggests that the 3rd and 4th toes really work as an “integrated system” with the 3rd toe as the main load bearing element whilst the 4th toe as the complementary load sharing element with a primary role to ensure the lateral stability of the permanently elevated metatarsophalangeal joint. PMID:28097064

Quantifying phalangeal curvature: an empirical comparison of alternative methods.

PubMed

Stern, J T; Jungers, W L; Susman, R L

1995-05-01

It has been generally assumed and theoretically argued that the curvature of finger and toe bones seen in some nonhuman primates is associated with cheiridial use in an arboreal setting. Assessment of such curvature in fossil primates has been used to infer the positional behavior of these animals. Several methods of quantifying curvature of bones have been proposed. The measure most commonly applied to phalanges is that of included angle, but this has come under some criticism. We consider various other approaches for quantifying phalangeal curvature, demonstrating that some are equivalent to use of included angle, but that one--normalized curvature moment arm (NCMA)--represents a true alternative. A comparison of NCMA to included angle, both calculated on manual and pedal proximal phalanges of humans, apes, some monkeys, and the Hadar fossils, revealed that these two different measures of curvature are highly correlated and result in very similar distributional patterns.

Pedal symphalangism in modern American and Japanese skeletons.

PubMed

Case, D T; Heilman, J

2005-01-01

Pedal symphalangism is a surprisingly common heritable trait of the human foot. In individuals exhibiting the trait, the joint between the intermediate and distal phalanges of one or more lateral toes never develops, resulting in toes with two phalanges rather than three. This study was undertaken to explore variation in the frequency of pedal symphalangism among groups with widely different geographic ancestry, and to consider the applicability of this trait to skeletal biological distance studies. A total of 460 Euro-American, 191 African-American and 99 Japanese skeletons were examined for presence of pedal symphalangism. The American individuals date to the first half of the 20th c, while the Japanese individuals date to the late 19th and early 20th c. Although the country of ancestry is unknown for most of the American individuals, the Euro-Americans appear to be largely northern European, with roots in Germany, Ireland and Scandinavia, while the African-Americans are primarily descendants of slaves with roots in west African countries such as Nigeria, Benin, Togo, Ghana and Sierra Leone. Frequencies of fifth toe pedal symphalangism were calculated and compared among all three samples and found to be significantly higher in modern Japanese (83.7%) than in either Euro-Americans (46.4%) or African-Americans (44.0%). The Euro- and African-American frequencies were statistically indistinguishable for symphalangism of the fifth toe. In the fourth toe, however, the opposite result was found. The African-American frequency (7.9%) was significantly higher than the Euro-American frequency (2.6%), while no difference was found between the African-Americans and Japanese (11.7%). Since fourth toe pedal symphalangism has never been observed in the absence of fifth toe involvement, some of the same genes are clearly involved in producing the trait in both toes. However, differences in the pattern of fourth and fifth toe expression among the three groups identified in this study suggest that additional genetic or developmental factors may play a role in expression of pedal symphalangism in each of the toes.

Congenital sensori-neural deafness associated with onycho-osteo dystrophy and mental retardation (D.O.O.R. syndrome).

PubMed

Cantwell, R J

1975-01-01

A characteristic syndrome is described in which congenital sensori-neural deafness is associated not only with onychodystrophy but also with congenital bony anomalies the most characteristic of which are tri-phalangeal thumbs, bi-phalangeal digits of hands and feet, and dystrophic terminal phalanges of some of the fingers and toes. In addition, there is mental retardation and the dermatoglyphics are characterized by the presence of 10 arches and elevation of the atd angles. The syndrome is inherited as an autosomal recessive. It is suggested that this entity be named the D.O.O.R. Syndrome because of the deafness, onychodystrophy, osteodystrophy and retardation. A similar syndrome without retardation as described by Goodman et al. (1969) appears to be inherited as an autosomal dominant.

Five- and 10-Year Follow-Up of Nonvascularized Toe Phalanx Transfers.

PubMed

Kawabata, Hidehiko; Tamura, Daisuke

2018-05-01

The purpose of this study was to evaluate long-term outcomes of nonvascularized toe phalanx transfer. We retrospectively reviewed 54 nonvascularized toe phalanx transfers in 29 children with symbrachydactyly. Forty-seven transfers in 24 children were evaluated at 5-year follow-up and 27 transfers in 14 children were evaluated at 10-year follow-up. We recorded the incidence of the early physeal closure and the length of the transferred toe phalanx on plain radiographs at 5- and 10-year follow-up. Growth rate in the first 5 years and the following 5 years were calculated. Function of the metacarpophalangeal joint (motion, stability, and alignment) was also evaluated. The mean age at surgery was 1.5 years. Seven toe phalanges were trimmed because the skin pocket was tight. Five transfers required revision surgery for partial necrosis of the skin pocket. At 5-year follow-up, the physis was closed in 23%, and at 10 years, 78% of physes were closed. The phalanx length was 87% of expected at 5-year follow-up and 71% at 10-year follow-up. Growth rate was 0.83 mm/y in the first 5 years and 0.22 mm/y in the following 5 years. Active motion was rated as good in 24, fair in 7, and poor in 16. Stability and alignment were rated as good in 37 and 33, fair in 8 and 5, and poor in 2 and 9, respectively. Nonvascularized toe phalanx transfer offered a relatively simple method to lengthen short digits and to provide satisfactory function. The transferred toe phalanges grew at a near-normal rate in the first 5 years, but the growth rate decreased between 5 and 10 years. Therapeutic IV. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Longitudinal bracketed epiphysis of proximal phalanx of the great toe with congenital hallux varus managed simultaneously with monorail external fixator: a case report.

PubMed

Verma, Vineet; Batra, Amit; Singla, Rohit; Gogna, Paritosh; Magu, Narender; Gupta, Rakesh

2014-02-01

Longitudinal bracketed epiphysis (delta phalanx) is a rare congenital anomaly that affects phalanges in the hand more commonly than toes. We present a rare case of congenital hallux varus with longitudinal bracketed epiphysis of proximal phalanx with bifid distal phalanx of the great toe, which was managed with monorail type of external fixator. To the best of our knowledge, this is the first report of its successful implementation in simultaneous treatment of longitudinal bracketed epiphysis of the proximal phalanx of the great toe and hallux varus. Apart from adding to the literature a case of rare subtype of delta phalanx with hallux varus, the present study highlights the role of a reliable alternative in its management.

[The biphalangy of the thumb. General review of the literature].

PubMed

Guillem, P; Demondion, X; Drizenko, A; Fontaine, C

1999-09-01

The thumb has only two phalanges whereas the other fingers present three. For two millennia, many anatomists tried to solve this riddle. Four different theories can be found in the review of literature, to explain what element misses in the radial column. In the first theory (Galen), the first metacarpal should be the proximal phalanx of the thumb. The particular ossification of the first metacarpal advocates for this theory. In the second theory (Sappey), the first metacarpal should result from the fusion between the true first metacarpal and the proximal phalanx of the thumb, and the proximal epiphysis should be constituted from both metacarpal and phalangeal parts. In the third theory (Paturet), the middle phalanx is thought to be missing. Apart morphological considerations, the main argument refers to symbrachydactyly, which consists in decreasing digital ray length (by reducing the middle phalanx), and usually affects digits excluding the thumb. In case the thumb is affected (in complex symbrachydactylies), the reduction concerns thus the first metacarpal, suggesting that the thumb middle phalanx has already disappeared. In the fourth theory (Pfitzner), the distal phalanx of the thumb should result from the fusion between the second and third phalanges of the thumb. This mechanism, named symphalangy, is well known in the foot, especially in the fifth toe, but also for the other toes, and even in the two ulnar fingers.

Clinical study of symbrachydactyly of the foot.

PubMed

Uchida, T; Kojima, T; Hirakawa, M

1995-07-01

Seventeen patients with symbrachydactyly of the foot are described. Patient characteristics including sex, the side of the affected foot, age at first medical examination, and condition of the nails were recorded. Compared with the unaffected side, the lengths of the proximal phalangeal and metatarsal bones were significantly shorter. The abnormalities of the feet were classified into four types: typical axial, atypical axial, medial ray, and rudimentary. The anomaly progresses from hypoplasia of the central rays to a deformity of the great toe, but rarely involves the fifth toe. The fact that this differs from symbrachydactyly of the hand is of considerable interest.

Description of a new species of Microhyla from Bali, Indonesia (Amphibia, Anura).

PubMed

Matsui, Masafumi; Hamidy, Amir; Eto, Koshiro

2013-01-01

We describe a microhylid frog from Bali, Indonesia as a new species, Microhyla orientalis sp. nov. It belongs to the M. achatina group and is close to M. mantheyi, M. malang, and M. borneensis. It is distinguished from its congeners by a combination of the following characters: small size (adult males about 16-17 mm in SVL); a faint vertebral stripe present; a black lateral stripe from behind eye to half length of trunk; snout rounded in profile; eyelid without supraciliary spines; first finger less than one-fifth of third; tips of three outer fingers weakly dilated, forming weak disks, dorsally with median longitudinal groove; outer palmar tubercle single; tibiotarsal articulation reaching up to center of eye; tips of toes distinctly dilated into disks, dorsally with median longitudinal groove; inner and outer metatarsal tubercles present; four or more phalanges on inner and outer sides of fourth toe, and three phalanges on inner side of fifth toe free of web; and tail of larva with a black marking at middle. The male advertisement call of the new species consists of a series of notes each lasts for 0.01-0.08 s and composed of 3-5 pulses with a dominant frequency of 3.2-3.6 kHz. Uncorrected sequence divergences between M. orientalis and all homologous 16S rRNA sequences available were > 6.6%. At present, the new species is known from rice fields between 435-815 m elevation in Wongaya Gede and Batukaru.

Non-vascularized free toe phalanx transfers in congenital hand deformities--the Great Ormond Street experience.

PubMed

Cavallo, A V; Smith, P J; Morley, S; Morsi, A W

2003-12-01

Many options of varying complexity are available for the management of congenital short digits resulting from aphalangia in symbrachydactyly and constriction ring syndrome. We have used non-vascularized free toe phalanx transfers for these children when a vascularized toe transfer has been contraindicated. We describe our technique and experience with 22 children who underwent a total of 64 transfers of the proximal (35) or middle (29) toe phalanges (average 3 per child). The mean age at initial surgery was 15 months, and the mean follow-up was 5 years. Duration of time until epiphyseal closure could not be determined accurately, but total digital elongation averaged 6mm. Complications of this technique include joint instability, premature epiphyseal closure and, in one patient, infection and graft loss. Donor site deformity was determined according to measured growth deficit and toe function. This technique is a simple option for digital elongation and, if performed in the appropriate age group in short fingered and monodactylous subtypes of symbrachydactyly, has the potential to allow growth and function with minimal donor site deficit.

Grasping primate development: Ontogeny of intrinsic hand and foot proportions in capuchin monkeys (Cebus albifrons and Sapajus apella).

PubMed

Young, Jesse W; Heard-Booth, Amber N

2016-09-01

Young primates have relatively large hands and feet for their body size, perhaps enhancing grasping ability. We test the hypothesis that selection for improved grasping ability is responsible for these scaling trends by examining the ontogeny of intrinsic hand and foot proportions in capuchin monkeys (Cebus albifrons and Sapajus apella). If selection for improved grasping ability is responsible for the observed patterns of hand and foot growth in primates, we predicted that fingers and toes would be longer early in life and proportionally decline with age. We measured the lengths of manual and pedal metapodials and phalanges in a mixed-longitudinal radiographic sample. Bone lengths were (a) converted into phalangeal indices (summed non-distal phalangeal length/metapodial length) to test for age-related changes in intrinsic proportions and (b) fit to Gompertz models of growth to test for differences in the dynamics of phalangeal versus metapodial growth. Manual and pedal phalangeal indices nearly universally decreased with age in capuchin monkeys. Growth curve analyses revealed that metapodials generally grew at a faster rate, and for a longer duration, than corresponding phalanges. Our findings are consistent with the hypothesis that primates are under selection for increased grasping ability early in life. Relatively long digits may be functionally adaptive for growing capuchins, permitting a more secure grasp on both caregivers and arboreal supports, as well as facilitating early foraging. Additional studies of primates and other mammals, as well as tests of grasping performance, are required to fully evaluate the adaptive significance of primate hand and foot growth. © 2016 Wiley Periodicals, Inc.

A new genus and species of treefrog from Medog, southeastern Tibet, China (Anura, Rhacophoridae)

PubMed Central

JIANG, Ke; YAN, Fang; WANG, Kai; ZOU, Da-Hu; LI, Cheng; CHE, Jing

2016-01-01

A new genus and species of threefrog is described from Medog, southeastern Tibet, China based on morphological and phylogenetic data. The new genus can be distinguished from other treefrog genera by the following combination of characters: (1) body size moderate, 45.0 mm in male; (2) snout rounded; (3) canthus rostralis obtuse and raised prominently, forming a ridge from nostril to anterior corner of eyes; (4) web rudimentary on fingers; (5) web moderately developed on toes; (6) phalange "Y" shaped, visible from dorsal side of fingers and toes; (7) skin of dorsal surfaces relatively smooth, scatted with small tubercles; (8) iris with a pale yellow, "X" shaped pattern of pigmentation. PMID:26828030

Immediate effects of an artificial change in hoof angulation on the dorsal metacarpophalangeal joint angle and cross-sectional areas of both flexor tendons.

PubMed

Hagen, Jenny; Kojah, Kaid; Geiger, Michael; Vogel, Mandy

2018-06-16

Corrective shoeing is used to change hoof angulation with the intention to influence the angulation of the digital joints to reduce strain on associated tendons. The objective of this study is to examine how gradual changes in hoof angulation affect the dorsal metacarpophalangeal joint (DMPJ) angulation and cross-sectional areas (CSAs) of the deep digital flexor tendon (DDFT) and superficial digital flexor tendon (SDFT) concerning the individual toe conformation. Forelimbs of 30 horses were examined barefoot and equipped with 5°, 10° and 20° toe wedges (TWs) and heel wedges (HWs). Phalangeal angulation and lengths were measured in lateromedial radiographs of the digit. CSAs of both flexor tendons was calculated in sonographic images. Significant effects on the DMPJ and CSA of the DDFT/SDFT were measured with 10° and 20° HWs or 20° TWs. Both flexor tendons showed increasing CSA after heel elevation. Significant interindividual variations occurred. Phalangeal angulation and length influenced the responsivity of the parameters to a changed hoof angulation. Significant impact of corrective shoeing on the DMPJ and flexor tendons is related to a distinct change in hoof orientation and varies with individual toe conformation. Similar response of the DDFT and SDFT to raised and lowered hoof orientation needs further investigation for a more specific application of therapeutic shoeing. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Hardness map of human meta tarsals and phalanges of toes.

PubMed

Manarvi, Irfan

2016-08-01

Predicting location of fracture in human bones has been a keen area of research for the past few decades. A variety of tests for hardness, deformation and strain field measurement have been conducted in the past; but considered insufficient due to various limitations. Researchers therefore have proposed further studies due to inaccuracies in measurement methods, testing machines and experimental errors. Advancement and availability of hardware, measuring instrumentation and testing machines can now provide remedies to these limitations. Human foot is a critical part of body exposed to various forces throughout its life. A number of products are developed for using over it for protection and care. Which many times do not provide sufficient protection and may itself become a source of stress due to non-consideration of the delicacy of bones in the feet. A continuous strain or overloading on feet may occur resulting to discomfort and even fracture. Not knowing how the hardness is spread all over the Meta tarsals and phalanges is one of major contributory factor for unsatisfactory design of foot protection products. This paper provides a complete hardness distribution map developed by experimental testing of all the Meta tarsals and Phalanges of toes for a typical human foot. The bones were taken from two left feet of a 40 and 42 year old male cadaver. These were dehydrated prior to measurements of hardness using Leeb hardness testing method. Hardness was measured around the circumference of a bone as well as along its length. Hardness values can be related to tensile strength of the bones to predict possible values of stress that could be borne by these bones. Results may also be used for design and developing various accessories for human feet health care and comfort.

Modified toe pulp fillet flap coverage: Better wound healing and satisfactory length preservation.

PubMed

Baek, Sang Oon; Suh, Hyo Wan; Lee, Jun Yong

2018-01-01

Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes. Unlike the pulp of the finger in the distal phalanx, the toe has abundant teardrop-shaped pulp tissue. The ratio of the vertical length to the longitudinal length in the distal phalanx was compared between the toes and fingers. Amputation was performed at the proximal interphalangeal joint level. Then, a mobilizable pulp flap was rotated 90° cephalad to replace the distal soft tissue defect. This modified toe fillet flap was performed in 5 patients. The toe pulp was found to have a vertically oriented morphology compared to that of the fingers, enabling length preservation through cephalad rotation. All defects were successfully covered without marginal ischemia. While conventional toe fillet flap coverage focuses on the principle of length preservation as the first priority, our modified method takes both wound healing and length into account. The fattiest part of the pulp is advanced to the toe tip, providing a cushioning effect and enough length to substitute for phalangeal bone loss. Our modified method led to satisfactory functional and aesthetic outcomes.

A case of symbrachydactyly with oligodactyly.

PubMed

Seven, M; Yuksel, A; Ozkilic, A

2001-01-01

The term symbrachydactyly describes syndactyly accompanied by brachydactyly. Brachydactyly is seen in middle phalanges of both hands and feet and very short in length or absent. As for syndactyly it is a cutaneous type. It has always been observed unilaterally and sporadically. A familial type of this syndrome has also been reported. There have been many classifications of symbrachydactyly. Of these, Blauth classification is the most favored one. Yet these classifications have been inadequate to include many recently discovered other forms of symbrachydactyly. A three month old child was brought to the Istanbul University Genetic Research Center because of his abnormal hands and feet. He was the second child of a couple who had no kinship ties to each other. In the history of the family, there was no mention of any anomaly as such. There was a complete syndactyly involving the 3rd through the 5th fingers, partial syndactyly between the 2nd and 3rd, and the thumb was normal in the right hand. There was only one finger in the left hand. There was total syndactyly in four toes of the right foot with oligodactyly and absence of the big toe. The left foot had five toes with a complete syndactyly between the 2nd and the 3rd. Radiological observation indicated that the middle phalanges of both extremities were rudimentary or never developed. There was no osseous syndactyly. As observed in this case, oligodactylous type that is bilateral and involves both hands and feet together is very unusual. The purpose of this study is to present a rare case of this anomaly that requires a reassessment of symbrachydactyly and its traditional classifications.

Two novel disease-causing variants in BMPR1B are associated with brachydactyly type A1.

PubMed

Racacho, Lemuel; Byrnes, Ashley M; MacDonald, Heather; Dranse, Helen J; Nikkel, Sarah M; Allanson, Judith; Rosser, Elisabeth; Underhill, T Michael; Bulman, Dennis E

2015-12-01

Brachydactyly type A1 is an autosomal dominant disorder primarily characterized by hypoplasia/aplasia of the middle phalanges of digits 2-5. Human and mouse genetic perturbations in the BMP-SMAD signaling pathway have been associated with many brachymesophalangies, including BDA1, as causative mutations in IHH and GDF5 have been previously identified. GDF5 interacts directly as the preferred ligand for the BMP type-1 receptor BMPR1B and is important for both chondrogenesis and digit formation. We report pathogenic variants in BMPR1B that are associated with complex BDA1. A c.975A>C (p.(Lys325Asn)) was identified in the first patient displaying absent middle phalanges and shortened distal phalanges of the toes in addition to the significant shortening of middle phalanges in digits 2, 3 and 5 of the hands. The second patient displayed a combination of brachydactyly and arachnodactyly. The sequencing of BMPR1B in this individual revealed a novel c.447-1G>A at a canonical acceptor splice site of exon 8, which is predicted to create a novel acceptor site, thus leading to a translational reading frameshift. Both mutations are most likely to act in a dominant-negative manner, similar to the effects observed in BMPR1B mutations that cause BDA2. These findings demonstrate that BMPR1B is another gene involved with the pathogenesis of BDA1 and illustrates the continuum of phenotypes between BDA1 and BDA2.

[New varieties of lateral metatarsophalangeal dislocations of the great toe].

PubMed

Bousselmame, N; Rachid, K; Lazrak, K; Galuia, F; Taobane, H; Moulay, I

2001-04-01

We report seven cases of traumatic dislocation of the great toe, detailing the anatomy, the mechanism of injury and the radiographic diagnosis. We propose an additional classification based on three hereto unreported cases. Between october 1994 and october 1997, we treated seven patients with traumatic dislocation of the first metatarso-phalangeal joint of the great toe. There were six men and one woman, mean age 35 years (range 24 - 44 years). Dislocation was caused by motor vehicle accidents in four cases and by falls in three. Diagnosis was made on anteroposterior, lateral and medial oblique radiographs. According to Jahss' classification, there was one type I and three type IIB dislocations. There was also one open lateral dislocation and two dorsomedial dislocations. Only these dorsomedial dislocations required open reduction, done via a dorsal approach. Mean follow-up was 17.5 months (range 9 - 24 months) in six cases. One patient was lost to follow-up. The outcome was good in six cases and poor in one (dorsomedial dislocation). Dislocation of the first metatarso-phalangeal joint of the great toe is an uncommon injury. In 1980, Jahss reported two cases and reviewed three others described in the literature. He proposed three types of dislocation based on the feasibility of closed reduction (type I, II and IIB). In 1991, Copeland and Kanat reported a unique case in which there was an association of IIA and IIB lesions. They proposed an addition to the classification (type IIC). In 1994, Garcia Mata et al. reported another case which had not been described by Jahss and proposed another addition. All dislocations reported to date have been sagittal dislocations. Pathological alteration of the collateral ligaments has not been previously reported. In our experience, we have seen one case of open lateral dislocation due, at surgical exploration, to medial ligament rupture and two cases of dorsomedial dislocation due, at surgical exploration, to lateral ligament rupture. We propose another additional classification with pure lateral dislocation (type III) and dorso-lateral dislocation (type IL or IIL+), which are related to the formerly described variants.

Foot shape in arboreal birds: two morphological patterns for the same pincer-like tool.

PubMed

Abourachid, Anick; Fabre, Anne-Claire; Cornette, Raphaël; Höfling, Elizabeth

2017-07-01

The feet are the only contact between the body and the substrate in limbed animals and as such they provide a crucial interface between the animal and its environment. This is especially true for bipedal and arboreal species living in a complex three-dimensional environment that likely induces strong selection on foot morphology. In birds, foot morphology is highly variable, with different orientations of the toes, making it a good model for the study of the role of functional, developmental, and phylogenetic constraints in the evolution of phenotypic diversity. Our data on the proportions of the phalanges analyzed in a phylogenetic context show that two different morphological patterns exist that depend mainly on habitat and toe orientation. In the anisodactyl foot, the hallux is the only backward-oriented toe and is enlarged in climbing species and reduced in terrestrial ones. Moreover, a proximo-distal gradient in phalanx size is observed depending on the degree of terrestriality. In the two other cases (heterodactyl and zygodactyl) that have two toes that point backward, the hallux is rather small in contrast to the other backward-pointing toe, which is enlarged. The first pattern is convergent and common among tetrapods and follows rules of skeletal development. The second pattern is unique for the clade and under muscle-morphogenetic control. In all cases, the functional result is the same tool, a pincer-like foot. © 2017 Anatomical Society.

Digital Lengthening to Treat Finger Deficiency: An Experience of 201 Digits in 104 Patients

PubMed Central

2017-01-01

Objectives. We evaluated the results of digital lengthening by distraction and second-stage bone graft. Methods. We treated finger deficiency of 201 digits in 104 patients (68 males, 36 females) by digital distraction and second-stage bone graft. The distraction was performed with a rate of 1 mm/day (for the first ten days) and 0.5 mm/day followed by using a self-designed bilateral tubal-helical external fixator. The mean follow-up period was 42 months (range 6 to 60 months). Results. The mean lengthening was 29.2 mm (range 25 to 40 mm) and 18.7 mm (range 12 to 32 mm) for metacarpal bones and phalanges, respectively. The mean elongation rate was 174.4% (range 145% to 202%) and 184.8% (range 115% to 283%) for metacarpal bones and phalanges, respectively. The static two-point discriminations and SpO2 showed no significant differences before and after distraction. Four complications were observed (two skin ruptures and two phalangeal splitting). No pin tract infection or tendon rupture showed. Digital lengthening improved functions of the hand. Conclusion. Digital distraction and second-stage bone graft is an effective method to compensate disabilities caused by lack of finger length. It could be an alternative plan for patients with thumb deficiency instead of toe-to-thumb transplant and patients with finger deficiency instead of ray resection. PMID:28286765

Digital Lengthening to Treat Finger Deficiency: An Experience of 201 Digits in 104 Patients.

PubMed

Ding, Zhenyu; Zhu, Xiaozhong; Fu, Kai; Zheng, Xianyou

2017-01-01

Objectives. We evaluated the results of digital lengthening by distraction and second-stage bone graft. Methods. We treated finger deficiency of 201 digits in 104 patients (68 males, 36 females) by digital distraction and second-stage bone graft. The distraction was performed with a rate of 1 mm/day (for the first ten days) and 0.5 mm/day followed by using a self-designed bilateral tubal-helical external fixator. The mean follow-up period was 42 months (range 6 to 60 months). Results. The mean lengthening was 29.2 mm (range 25 to 40 mm) and 18.7 mm (range 12 to 32 mm) for metacarpal bones and phalanges, respectively. The mean elongation rate was 174.4% (range 145% to 202%) and 184.8% (range 115% to 283%) for metacarpal bones and phalanges, respectively. The static two-point discriminations and SpO 2 showed no significant differences before and after distraction. Four complications were observed (two skin ruptures and two phalangeal splitting). No pin tract infection or tendon rupture showed. Digital lengthening improved functions of the hand. Conclusion. Digital distraction and second-stage bone graft is an effective method to compensate disabilities caused by lack of finger length. It could be an alternative plan for patients with thumb deficiency instead of toe-to-thumb transplant and patients with finger deficiency instead of ray resection.

Treatment alternatives of congenital hand differences with thumb hypoplasia involvement.

PubMed

Papadogeorgou, Ellada V; Soucacos, Panayotis N

2008-01-01

Congenital thumb hypoplasia is a complex and heterogeneous congenital difference that is detrimental to hand function. Apart from its' classic form, which is now considered to be part of radial dysplasia, it can occur as part of other congenital anomalies including, syndactyly, symbrachydactyly, atypical cleft hand, bifid thumb, triphalangeal thumb, mirror hand, constriction band syndrome, as well as generalized anomalies and syndromes. Management is aimed primarily at restoring basic hand function, specifically, power grasp and precision pinch, and secondarily to improve cosmoses, which inevitably is going to be impaired. Several treatment alternatives have been proposed to manage the specific disabling condition and include, 1st web space reconstruction and opponensplasty, pollicization, toe-to-hand transfer, distraction lengthening, free toe phalangeal transfer or the use of allograft, stabilization of the metacarpophalangeal joint, and surgery of "spare parts." The purpose of this study is to evaluate the various alternatives available today and propose an algorithm applicable for the appropriate management of thumb deficiency, based on their specific characteristics. Copyright 2008 Wiley-Liss, Inc. Microsurgery, 2008.

Multiple congenital brachymetatarsia. A one-stage combined shortening and lengthening procedure without iliac bone graft.

PubMed

Kim, J S; Baek, G H; Chung, M S; Yoon, P W

2004-09-01

We performed nine metatarsal and three proximal phalangeal lengthenings in five patients with congenital brachymetatarsia of the first and one or two other metatarsal bones, by a one-stage combined shortening and lengthening procedure using intercalcary autogenous bone grafts from adjacent shortened metatarsal bones. Instead of the isolated lengthening of the first and the other metatarsal bones, we shortened the adjacent normal metatarsal and used the excised bone to lengthen the short toes, except for the great toe, to restore the normal parabola. One skin incision was used. All the operations were performed bilaterally and the patients were followed up for a mean period of 69.5 months (29 to 107). They all regained a nearly normal parabola and were satisfied with the cosmetic results. Our technique is straightforward and produces good cosmetic results. Satisfactory, bony union is achieved, morbidity is low, and no additional surgery is required for the removal of metal implants.

[Digital gigantism of the foot: a clinical study of 12 cases].

PubMed

Wang, Hai-hua; Tian, Guang-lei; Zhu, Yin; Zhang, You-le; Zhao, Jun-hui; Tian, Wen

2008-03-15

To summarize the clinical characteristic and outcome of digital gigantism of the foot. Retrospectively analyze the clinical documents of cases of digital gigantism of the foot. Twelve 12 cases with 13 feet in this study included 8 male and 4 female with an average 4.6-years-old. All the deformities were found at birth. Multiple toes involved were more than single toe, and tibial toe involved more than fibular. Forefoot was enlarged. All the phalanges involved and partial metatarsal bones were enlarged. Marked increase in subcutaneous fat was found in all cases in the operation which infiltrated interossei and articular capsules. The appearance of the nerves and its branches in the foot were normal and fat infiltrating was not discovered. The operation types included debulking, epiphyseal arrest, amputation, nerve stripping and anastomosis. Seven cases were followed up with mean periods 25.6 months. Functional evaluation according to a criterion formulated by author revealed a result of 2 excellent, 2 good and 3 fair. Digital gigantism of the foot is an uncommon congenital deformity of the foot characterized by overgrowth of both the soft-tissue and the osseous elements of the enlarged toe and forefoot. Surgical treatment is the unique method, and the goal is to reduce the size of the foot to allow fitting regular shoes and walking readily. There are several types of operations which to be chosen. The indication, the timing of operative intervention and the selection of operation type should be paid more attention.

A new species of flea-toad (Anura: Brachycephalidae) from southern Atlantic Forest, Brazil.

PubMed

Condez, Thais Helena; Monteiro, Juliane Petry De Carli; Comitti, Estevão Jasper; Garcia, Paulo Christiano De Anchietta; Amaral, Ivan Borel; Haddad, Célio Fernando Baptista

2016-02-18

We describe a new species of Brachycephalus that is morphologically similar to the flea-toads B. didactylus, B. hermogenesi, and B. pulex. The new species occurs from the sea level up to 1000 m and it is widely distributed throughout southern Atlantic Forest. Brachycephalus sulfuratus sp. nov. is distinguished from all of its congeners by the combination of the following characters: (1) small body size (SVL of adults: 7.4-8.5 mm for males and 9.0-10.8 mm for females); (2) "leptodactyliform" body; (3) pectoral girdle arciferal and less robust compared to the Brachycephalus species with "bufoniform" body; (4) procoracoid and epicoracoid fused with coracoid but separated from the clavicle by a large fenestrae; (5) toe I externally absent; toes II, III, IV, and V distinct; phalanges of toes II and V reduced; (6) skin smooth with no dermal ossifications; (7) in life, general background color brown with small dark-brown spots; skin of throat, chest, arms, and forearms with irregular yellow blotches; in ventral view, cloacal region of alive and preserved specimens surrounded by a dark-brown inverted v-shaped mark outlined with white; (8) advertisement call long, composed of a set of 4-7 high-frequency notes (6.2-7.2 kHz) repeated regularly.

Case report: severe melorheostosis involving the ipsilateral extremities.

PubMed

Long, Hai-Tao; Li, Kang-Hua; Zhu, Yong

2009-10-01

Melorheostosis is a rare, noninheritable bone dysplasia characterized by its classic radiographic feature of flowing hyperostosis resembling dripping candle wax, generally on one side of the long bone. The condition originally was described by Leri and Joanny in 1922. Its etiology remains speculative, and treatment in most instances has been symptomatic. Melorheostosis usually affects one limb, more often the lower extremity, and rarely the axial skeleton. We report a rare case of severe melorheostosis in the ipsilateral upper and lower extremities with normal contralateral extremities. The plain radiographs revealed almost all the bones in the affected extremities, from clavicle and scapula to distal phalanges of the fingers and from femur to distal phalanges of the toes, presented extensive, dense hyperostosis and heterotopic ossification in the periarticular soft tissue. Physical examination showed considerable swelling and deformities of the left limbs, stiffness and distortion of the joints, and anesthesia in the left ulnar regions of the forearm and hand. The examination of the right side was normal. Computed tomography scans showed multiple areas of classic candle wax-like hyperostosis and narrowing or disappearance of the medullary cavity. Histologic analysis confirmed the clinical and imaging diagnosis and revealed extremely dense sclerotic bone of cortical pattern.

Prostaglandin PGE2: a possible mechanism for bone destruction in calcinosis circumscripta.

PubMed

Caniggia, A; Gennari, C; Vattimo, A; Runci, F; Bombardieri, S

1978-02-28

A patient showed evident osteolysis in phalanges and heavy periarticular calcium deposits of the fingers, wrists and toes which avidly took up 47Ca. The dense, white, tooth-paste like fluid contained in the periarticular calcium deposits has been studied by two different X-ray diffraction methods, by Ubatuba's bioassay for prostaglandin, by thin layer chromatography and by mass spectrometry. The calcium deposits were hydroxyapatite and prostaglandin PGE2 was detected in them. The bone resorption stimulating activity of PGE2 would be expected to result in increased bone destruction with release of calcium salts and this could be a working hypothesis of the pathogenesis of calcinosis circumscripta.

Ilizarov distraction-lengthening in congenital anomalies of the upper limb.

PubMed

Hülsbergen-Krüger, S; Preisser, P; Partecke, B D

1998-04-01

Nine patients underwent Ilizarov distraction-lengthening for congenital anomalies. All were late cases and had undergone other procedures. In five radial club hand patients with very short forearms, we achieved an average 5.8 cm increase in length with each distraction cycle. In two patients with symbrachydactyly of the cleft hand type, we achieved pinch grip between a radial and an ulnar digit by lengthening the short ray. Another case of the monodactyly type in which we tried to lengthen three transplanted proximal toe phalanges ended in failure. A soft tissue distraction was attempted in a case of camptodactyly but failed. We report the problems we encountered and suggest some solutions.

[Sarcoidosis of the skeleton. Review of the literature and case report. (author's transl)].

PubMed

Uehlinger, E; Wurm, K

1976-08-01

The frequency of sarcoidosis in the skeleton varies between 3 and 36%. Skeletal sarcoidosis is rare in early stages (Löfgren-syndrom), relatively frequent in late stages. The initial phase is characterized by the formation of miliary non-caseating epitheloid-cell granulomas in the bone marrow. The invasion of the bone marrow may either be tolerated by the bone tissue or it initiates a perifocal osteosclerosis or a osteolysis. Correspondingly the X-ray of the skeleton shows normal structure or focal osteosclerosis or osteolysis. Therefore in the first case the sarcoidosis cannot be identified by X-ray. Most frequent locations are the phalanges of the fingers and toes, less common the stem skelton (skull, vertebrae, pelvis) and very rare the long tubular bones. In most cases the skeletal sarcoidosis is well tolerated. Report of a case of osteosclerotic sarcoidosis of the pelvis of a 39-years old woman with generalized sarcoidosis which was diagnozed four years earlier. The X-rays of the phalanges were normal. The biopsy of the iliac crest shows miliary sarcoid granuloma of the bone marrow and accretion of lamellar bone on the surface of the bone trabeculi with a distinct mosaic pattern. Treatment with steroids during the following five years was ineffective.

Tiptoeing through the rest of his life: A functional adaptation to a leg shortened by femoral neck fracture.

PubMed

Lovell, Nancy C

2016-06-01

Salvage excavation of a Roman cemetery (1st-2nd century CE) at the site of ancient Erculam (region of Campania), Italy, yielded the skeleton of an older male with a healed fracture of the femoral neck that reduced the femoral neck angle and resulted in leg shortening. The right foot shows bony alterations that appear to have developed as a consequence. The distal joint surfaces of the first and second metatarsals extend dorsally for articulation of the proximal phalanges in hyper-dorsiflexion. I argue that, in order to compensate for the shortened leg, the man lengthened it functionally by bearing weight primarily on his toes when he walked, rather than striking the heel first and then pushing off from the toe. The severity of degenerative joint disease in the right knee and in the metatarsophalangeal joints suggests that the injury occurred years before the man's death. This case adds to the bioarchaeological record of individuals who adapted to impaired mobility in the past, and it may be of interest to scholars who study the bioarchaeology of impairment and disability. Copyright © 2016 Elsevier Inc. All rights reserved.

Robotic Finger Assembly

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Diftler, Myron A. (Inventor); Askew, Scott R. (Inventor); Linn, Douglas Martin (Inventor); Platt, Robert J., Jr. (Inventor); Bridgwater, Lyndon (Inventor); Hargrave, Brian (Inventor); Valvo, Michael C. (Inventor)

2014-01-01

A robotic hand includes a finger with first, second, and third phalanges. A first joint rotatably connects the first phalange to a base structure. A second joint rotatably connects the first phalange to the second phalange. A third joint rotatably connects the third phalange to the second phalange. The second joint and the third joint are kinematically linked such that the position of the third phalange with respect to the second phalange is determined by the position of the second phalange with respect to the first phalange.

Robotic Finger Assembly

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Bridgwater, Lyndon (Inventor); Diftler, Myron A. (Inventor); Linn, Douglas M. (Inventor); Platt, Robert (Inventor); Hargrave, Brian (Inventor); Askew, Scott R. (Inventor); Valvo, Michael C. (Inventor)

2013-01-01

A robotic hand includes a finger with first, second, and third phalanges. A first joint rotatably connects the first phalange to a base structure. A second joint rotatably connects the first phalange to the second phalange. A third joint rotatably connects the third phalange to the second phalange. The second joint and the third joint are kinematically linked such that the position of the third phalange with respect to the second phalange is determined by the position of the second phalange with respect to the first phalange.

How many entities exist for the spectrum of disorders associated with brachydactyly, syndactyly, short stature, microcephaly, and intellectual disability?

PubMed

Ravel, Aimé; Chouery, Eliane; Stora, Samantha; Jalkh, Nadine; Villard, Laurent; Temtamy, Samia; Mégarbané, André

2011-04-01

We describe a French young man with digital anomalies consisting of brachydactyly, F1-5 bilateral camptodactyly, interdigital webbing, F5 bilateral radial clinodactyly, and partial syndactyly of some fingers and toes. He had psychomotor retardation, short stature, umbilical hernia, a secundum atrial septal defect, seizures, hearing impairment, and dysmorphic features consisting of microcephaly, a prominent metopic ridge, upslanting palpebral fissures, synophrys, enophthalmia, large ears, a bulbous nose, a high palate, a smooth and short philtrum, a low hanging columella, a thin upper vermillion, an everted lower lip, prognathism, pectum excavatum, and supernumerary nipples. Osteotendinous reflexes were brisk. Mild nystagmus, myopia, and astigmatia were also noted. Total body X-rays showed short terminal phalanges of the hands, short middle phalanges of the index and little fingers, clinodactyly of the little fingers, short and fused proximal 4th and 5th metacarpals of the right hand, a short 5th metacarpal of the left hand, a fused left lunate-triquetrum, fused capitate-hamates, a prominent mandibula, and partial sacral agenesis. A thin posterior corpus callosum was apparent by MRI. Differential diagnoses for mainly the Rubinstein-Taybi syndrome, the Tsukahara syndrome, the Filippi syndrome, the Feingold syndrome, and the Tonoki syndrome are discussed, and the possibility that we might be reporting a novel entity is raised. © 2011 Wiley-Liss, Inc. Copyright © 2011 Wiley-Liss, Inc.

Correlations between the equine metacarpophalangeal joint angulation and toe conformation in statics

PubMed Central

Hagen, Jenny; Kojah, Kaid; Geiger, Michael

2018-01-01

The angulation of the equine fetlock determines the load of associated tendons and probably their predisposition for injuries. However, it is questionable how the individual toe conformation and tendon properties interact with the dorsal metacarpophalangeal joint angle (DMPJ). Data are needed for a tangible evaluation of the equine limb conformation for more specific orthopaedic treatment. The aim was to evaluate the correlation between the DMPJ, toe conformation and cross-sectional area (CSA) of both flexor tendons; the superficial digital flexor tendon (SDFT) and deep digital flexor tendon (DDFT). Thirty Warmblood horses were available for the study. Lateromedial radiographs of the toe and fetlock and transverse ultrasound images of both flexor tendons were obtained from three zones. The DMPJ, length and angle of the phalanges and CSA SDFT/DDFT were measured. In addition, hoof angle, wither height, age, and sex were documented. Correlations were calculated using Pearson’s test. A paired t-test was used to evaluate left–right differences. Length and angle of the proximal and middle phalanx were significantly associated with the DMPJ (r = -0.28 – -0.45, p<0.001-0.04). Neither the angle of the hoof and distal phalanx nor the CSA SDFT/DDFT, showed a noticeable correlation with the DMPJ. Significant left–right differences occurred for the DMPJ (p<0.002) and the angle of the proximal and middle phalanx (p<0.01 – 0.002). A moderate negative correlation was shown between the DMPJ and wither height (r = - 0.31, p=0.04). Results represent only a specific population. The study provides only a static evaluation of a dynamic situation. In a clinical context, it might be useful to focus on the angulation and length of the pastern to evaluate the individual load affecting the DMPJ and its associated structures. These findings might be relevant for orthopaedic treatments and shoeing recommendations. PMID:29721438

The potential of toe flexor muscles to enhance performance.

PubMed

Goldmann, Jan-Peter; Sanno, Maximilian; Willwacher, Steffen; Heinrich, Kai; Brüggemann, Gert-Peter

2013-01-01

The metatarsal phalangeal joint (MPJ) and its crossing toe flexor muscles (TFM) represent the link between the large energy generating leg extensor muscles and the ground. The purpose of this study was to examine the functional adaptability of TFM to increased mechanical stimuli and the effects on walking, running and jumping performance. Fifteen men performed a heavy resistance TFM strength training with 90% of the maximal voluntary isometric contraction (MVIC) for 7 weeks (560 contractions) for the left and right foot. Maximal MPJ and ankle plantar flexion moments during MVICs were measured in dynamometers before and after the intervention. Motion analyses (inverse dynamics) were performed during barefoot walking, running, and vertical and horizontal jumping. Athletic performance was determined by measuring jump height and distance. Left (0.21 to 0.38 Nm · kg(-1); P < 0.001) and right (0.24 to 0.40 Nm · kg(-1); P < 0.001) MPJ plantar flexion moments in the dynamometer, external MPJ dorsiflexion moments (0.69 to 0.75 Nm · kg(-1); P = 0.012) and jump distance (2.25 to 2.31 m; P = 0.006) in horizontal jumping increased significantly. TFM responded highly to increased loading within a few weeks. The increased force potential made a contribution to an athlete's performance enhancement.

[Symbrachydactyly].

PubMed

Samson, P; Mevio, G

2008-12-01

Symbrachydactyly is literally defined as a combination of short fingers with syndactyly. Blauth and Gekeler described four types of symbrachydactyly, ranging from simple shortness of middle phalanges to complete absence of digital rays. In type I (short finger) function is quite normal and syndactyly release is usually the only procedure needed. In type II (cleft hand), presence of a thumb and at least one ulnar finger allows pinch function. Surgical treatment, when needed, consists in separation of webbed fingers, resection of nonfunctional digital stumps, or finger translocation. In type III (monodactyly) all long fingers are absent. Pinch function can be created between the thumb and a toe transfer in ulnar location. Bone lengthening is an alternative procedure to create a pincer. Surgery is not always indicated in type IV (peromely) as function can only be restored if active motion is already present at wrist or carpometacarpal levels.

Lower Robotic Arm Assembly Having a Plurality of Tendon Driven Digits

NASA Technical Reports Server (NTRS)

Bridgwater, Lyndon (Inventor); Nguyen, Vienny (Inventor); Radford, Nicolaus A. (Inventor); Guo, Raymond (Inventor)

2016-01-01

A lower robotic arm includes a base structure, a plurality of digits, and a plurality of tendons. The digits each include first, second, third, and fourth phalanges. Each digit is operatively attached to the base structure at the respective first phalange. A first joint operatively connects the first and second phalange to define a first axis, a second operatively connects the second and third phalange to define a second axis, and a third joint operatively connects the third and fourth phalange to define a third axis, such that the phalanges are selectively rotatable relative to the adjacent phalange, about the respective axis. The tendons are operatively connected to a respective one of the fourth phalanges. Each tendon selectively applies a first torque to the respective fourth phalange to urge the respective phalanges to rotate in a first direction about the respective axes.

Artificial dexterous hand

NASA Technical Reports Server (NTRS)

Lee, Sukhan (Inventor)

1990-01-01

An artificial dexterous hand is provided for conformally engaging and manipulating objects. The hand includes an articulated digit which is connected to an engagement sub-assembly and has a first shape adaption mechanism associated with it. The digit has a digit base and first and second phalanges. The digit base is operatively interconnected to the first phalange by a base joint having a base pulley. The phalanges are operatively interconnected by a separate first phalange joint having a first phalange pulley. The engagement sub-assembly includes a tendon, which is received by the base pulley and by the first phalange pulley, and an actuation device for selectively tensioning the tendon. The first shape adaption mechanism is responsive to and receives the tendon. It is also situated between the base joint and the first phalange joint and is connected to the first phalange. Upon actuation by the actuation device, the phalanges are caused to pivot relative to the base joint and the second phalange is caused to pivot relative to the first phalange. At the same time, the first shape adaption mechanism controls the sequence of the aforementioned pivoting of the phalanges through application of braking force to the tendon.

Knuckle walking signal in the manual digits of Pan and Gorilla.

PubMed

Matarazzo, Stacey

2008-01-01

This article examines the curvature of the manual proximal and middle phalanges of species belonging to Pan, Gorilla, Ateles, Macaca, Pongo, Hylobates, and Cebus to determine whether middle phalangeal curvature, when considered in conjunction with proximal phalangeal curvature, yields a locomotor signal. Prior studies have demonstrated the discriminatory power of proximal phalanges for separating suspensory species (including knuckle walkers) from pronograde quadrupedal species, but less emphasis has been placed on the distinguishing phalangeal characteristics of taxa within the suspensory category. This study demonstrates, first, that middle phalanges discriminate suspensory from nonsuspensory species, although not as cleanly as proximal phalanges. Finer discrimination of locomotor signals, including subtle differences among animals employing different modes of suspension, is possible through a comparison of the curvatures of the proximal phalanges and corresponding middle phalanges. Their relative curvature differs in quadrupeds, brachiators, and knuckle walkers. Knuckle walkers (Pan and Gorilla) have relatively little curvature of the middle phalanges coupled with marked curvature of the proximal phalanges, whereas brachiators (Ateles and Hylobates) display marked curvature of both proximal and middle phalanges, and pronograde quadrupeds (Cebus and Macaca) have relatively straight proximal and moderately curved middle phalanges. Quadrumanous climbers (Pongo) have a unique combination of traits, whereby curvature is high in both proximal and middle phalanges, but less so in the latter than the former. These differences, predictable on the basis of the biomechanical forces to which digits are subjected, may open a new venue for future research on the locomotor repertoire of prebipedal ancestors of hominins. (c) 2007 Wiley-Liss, Inc.

Hallux valgus (bunions)

PubMed Central

2014-01-01

Introduction Hallux valgus (bunions) are prominent and often inflamed metatarsal heads and overlying bursae. They are associated with valgus deviation of the great toe which moves towards the second toe. Hallux valgus is found in at least 2% of children aged 9 to 10 years, and almost half of adults, with greater prevalence in women. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of conservative treatments for hallux valgus (bunions)? What are the effects of osteotomy for hallux valgus (bunions)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 15 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: chevron osteotomy plus adductor tenotomy; distal metatarsal osteotomy; minimally invasive surgery (percutaneous distal metatarsal osteotomy, SERI [Simple, Effective, Rapid, Inexpensive] distal metatarsal osteotomy); phalangeal (Akin) osteotomy plus distal chevron osteotomy; proximal osteotomy; night splints; and orthoses (including antipronatory orthoses in children).

The potential of human toe flexor muscles to produce force

PubMed Central

Goldmann, Jan-Peter; Brüggemann, Gert-Peter

2012-01-01

The maximal force a muscle produces depends among others on the length of the muscle and therefore on the positions of the joints the muscle crosses. Long and short toe flexor muscles (TFM) cross the ankle joints and metatarsal phalangeal joints (MPJ) and work against gravity during human locomotion. The purpose of this study was to describe the maximal moments around the MPJ during maximal voluntary isometric contractions (MVIC) of the TFM as a function of ankle joint and MPJ position. Twenty men performed MVIC of the TFM in a custom-made dynamometer. Ankle and MPJ angles were modified after each contraction. External moments of force around the MPJ were determined. Moments ranged between 6.3 ± 2.6 Nm and 14.2 ± 5.8 Nm. Highest moments were produced at 0°–10° ankle joint dorsal flexion and 25°–45° MPJ dorsal flexion. Lowest moments were generated at 35° ankle joint plantar flexion and 0° MPJ dorsal flexion. In conclusion, if the ankle is plantar-flexed, dorsal flexion of the MPJ avoids a disadvantage of the force–length relationship of TFM. Therefore, MPJ dorsal flexion is a necessary function in the push-off phase of human locomotion to work against the loss of the mechanical output at the forefoot caused by plantar flexion of the ankle. PMID:22747582

Tuberculous Dactylitis with Concomitant Thyroid Involvement: A Rare Presentation of Childhood Tuberculosis.

PubMed

Qamar, Sobia; Naz, Farrah; Naz, Samia; Ejaz, Iftikhar

2017-03-01

Extrapulmonary tuberculosis rarely presents as thyroid involvement along with other manifestations, and poses a diagnostic challenge on account of paucibacillary nature of disease. In general, the diagnosis of tuberculosis is based on epidemiological risk factors, clinical features, imaging studies, in addition to a positive skin testing or Interferon Gamma Release Assay (IGRA). A 14-year boy presented with history of fever and weight loss for one year. On examination, he had painful swelling of fingers and toes along with a painless thyroid nodule and squint. Hand X-ray showed lytic-sclerotic lesions in phalanges. MRI of brian showed multiple ring enhancing lesions and radionuclide thyroid scan showed multinodular goitre. Histology showed epithelioid cell granulomas (thyroid and bone) and tuberculomas of brain confirmed tuberculosis. He responded well to four-drug anti-tuberculous therapy and his fever, squint, thyroid nodule, and dactylitis disappeared. Tuberculosis of thyroid, a rare phenomenon, can be diagnosed and treated well; if clinical index of suspicion is kept high, particularly in tuberculosis prevalent areas.

A new species of Pseudopaludicola Miranda-Ribeiro (Leiuperinae: Leptodactylidae: Anura) from the Cerrado of Southeastern Brazil.

PubMed

De Andrade, Felipe Silva; De Carvalho, Thiago Ribeiro

2013-01-22

A new species of Pseudopaludicola is described from the Cerrado of southeastern Brazil. Pseudopaludicola facureae sp. nov. is diagnosed from the P. pusilla species group by the absence of either T-shaped terminal phalanges or toe tips expanded, and distinguished from almost all recognized taxa currently assigned to Pseudopaludicola (except P. canga, P. giarettai, and P. hyleaustralis) by possessing a non-pulsed advertisement call. However, the advertisement call of the new species consists of the emission of well-defined call series, whereas the advertisement call of P. giarettai is long (117-187 ms) and with an isolated emission pattern; respecting to P. canga, the new species emits very long notes series (up to 53 notes/advertisement call), compared to the short call series of P. canga (up to 9 notes/advertisement call); considering P. hyleaustralis, the new species has a shorter note duration (15-35 ms), higher note rate per minute (480-1860), and higher dominant frequency (4076-5108).

The choice of procedure following thumb amputation.

PubMed

Lister, G

1985-05-01

The attributes that make the thumb unique are position, stability, strength, length, motion, sensibility, and appearance. Of these qualities, the first four must be present to an acceptable extent for function to approach normality, while the latter three are very desirable but not essential. Reconstructive alternatives following amputation can be considered in four broad groups: where the length is acceptable but the covering is poor; subtotal amputation, where length is equivocal; total amputation with the basal joint preserved; and total amputation with the basal joint destroyed. In the first group, soft-tissue cover can be improved by local flaps with or without a neurovascular pedicle or by microvascular free pulp transfer. In the second group, metacarpal lengthening by distraction, with or without phalangization, may give adequate length. In total amputations, one may choose osteoplastic reconstruction, pollicization, or toe-to-hand transfer. Which solution is selected depends on the level of the amputation, the presence and nature of injuries to other digits, occupational and social factors, and the availability of tissues.

Growth of severely hypoplastic phalanges and metacarpals in symbrachydactyly: an experimental study in mice.

PubMed

Kanauchi, Yumiko; Takahara, Masatoshi; Harada, Mikio; Ogino, Toshihiko

2008-11-01

Severely hypoplastic phalanges and metacarpals in symbrachydactyly are often associated with a delay or failure of primary ossification evident by radiography at birth. However, little is known about the ossification pattern and further growth of severely hypoplastic bones in symbrachydactyly. To clarify this mechanism, we observed development during ossification of the hypoplastic phalanges in brachypodism mice (which carry functional null mutations of growth differentiation factor 5 and exhibit hypoplastic phalanges) as a model of the bone hypoplasia in symbrachydactyly. Forelimbs of wild-type and brachypodism mice from embryonic day 16.5 to 21 days after birth were sectioned. We used radiography to examine the progression of ossification; safranin O fast green-iron hematoxylin staining and in situ hybridization for type II collagen to demonstrate cartilage; the transferase-mediated nick end-labeling assay to identify apoptosis; and tartrate-resistant acid phosphatase staining to demonstrate osteoclastic activity. In brachypodism mice, radiography showed markedly delayed ossification of the proximal phalanges in comparison with wild-type mice. Safranin O staining and type II collagen in situ hybridization showed that the cartilage anlagen of the proximal phalanges were extremely small, with diffuse endochondral ossification throughout, resulting in lack of growth plate and chondroepiphysis formation. Apoptotic cells were present under the perichondrium on the plantar side of the proximal phalanges from day 7 after birth and had spread randomly by day 14. Diffuse osteoclastic activity was evident throughout the proximal phalanges from days 7 to 14 after birth. These results indicate that severely hypoplastic proximal phalanges in brachypodism mice, although showing an endochondral ossification pattern, lack a growth plate and have no potential for secondary growth. These findings may be relevant to the treatment of symbrachydactyly with severely hypoplastic bones, which are not evident radiographically at birth.

Factors that influence bone mass of healthy children and adolescents measured by quantitative ultrasound at the hand phalanges: a systematic review☆

PubMed Central

Krahenbühl, Tathyane; Gonçalves, Ezequiel Moreira; Costa, Eduardo Tavares; Barros, Antonio de Azevedo

2014-01-01

Objective: To analyze the main factors that influence bone mass in children and teenagers assessed by quantitative ultrasound (QUS) of the phalanges. Data source: A systematic literature review was performed according to the PRISMA method with searches in databases Pubmed/Medline, SciELO and Bireme for the period 2001-2012, in English and Portuguese languages, using the keywords: children, teenagers, adolescent, ultrasound finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound. Data synthesis: 21 articles were included. Girls had, in QUS, Amplitude Dependent Speed of Sound (AD-SoS) values higher than boys during pubertal development. The values of the parameters of QUS of the phalanges and dual-energy X-ray Absorptiometry (DXA) increased with the increase of the maturational stage. Anthropometric variables such as age, weight, height, body mass index (BMI), lean mass showed positive correlations with the values of QUS of the phalanges. Physical activity has also been shown to be positively associated with increased bone mass. Factors such as ethnicity, genetics, caloric intake and socioeconomic profile have not yet shown a conclusive relationship and need a larger number of studies. Conclusions: QUS of the phalanges is a method used to evaluate the progressive acquisition of bone mass during growth and maturation of individuals in school phase, by monitoring changes that occur with increasing age and pubertal stage. There were mainly positive influences variables of sex, maturity, height, weight and BMI, with similar data when compared to the gold standard method, the DXA. PMID:25479860

Saw injuries causing phalangeal neck fractures in adults.

PubMed

Al-Qattan, Mohammad M

2012-07-01

The outcome of adult phalangeal neck fractures caused by saws has not been previously investigated. Over a 15-year period, a total of 36 cases of saw-related injuries resulting in phalangeal neck fractures of the middle phalanx of the finger or the proximal phalanx of the thumb were treated. All injuries were industrial and covered by insurance. They were all adult males with type II fractures. The fracture were managed by K-wire fixation, immobilizing the distal joint only. The proximal joints were mobilized immediately after surgery and the K-wire was removed after 5 weeks. The following 2 patterns of saw injuries were observed: dorsal impact injuries resulting in a phalangeal neck fracture and concurrent extensor tendon injury (group I, n = 20 patients), and dorsolateral impact injuries resulting in concurrent extensor (± partial flexor) tendon and nerve injury (group II, n = 16 patients). The outcome with respect to range of motion and return to work was significantly better in the former group. Major complications such as nonunion, malunion, avascular necrosis of the phalangeal head, osteomyelitis, or contractures of the proximal interphalangeal joints were not observed. Two patients (1 in each group) had superficial pin-site infection. It was concluded that adult phalangeal neck fractures caused by saws is a separate entity from the previously reported series of closed phalangeal neck fractures in adults.

A new species of Pseudopaludicola Miranda-Ribeiro, 1926 (Anura: Leptodactylidae: Leiuperinae) from northwestern state of São Paulo, Brazil.

PubMed

Pansonato, André; Mudrek, Jessica Rhaiza; Veiga-Menoncello, Ana Cristina Prado; Rossa-Feres, Denise De Cerqueira; Martins, Itamar Alves; Strüssmann, Christine

2014-09-15

A new species of Pseudopaludicola is described from human-altered areas originally covered by Semideciduous Forest in northwestern state of São Paulo, southeastern Brazil. Morphologically, the new species differs from four species belonging to the P. pusilla group by the absence of either T-shaped terminal phalanges or toe tips expanded, and from all other congeners except P. canga and P. facureae by possessing an areolate vocal sac, with dark reticulation. The higher duration (300-700 ms) of each single, pulsed note (9-36 nonconcatenated pulses) that compose the call in the new species distinguishes it from all other 14 species of Pseudopaludicola with calls already described (10-290 ms). Absence of harmonics also differ the advertisement call of the new species from the call of its sister species P. facureae, even though these two species presented unexpected low genetic distances. Although we could not identify any single morphological character distinguishing the new species from P. facureae, a PCA and DFA performed using 12 morphometric variables evidenced significant size differences between these two species. 

Metacarpophalangeal joint orientation in anthropoid manual phalanges.

PubMed

Rein, Thomas R; McCarty, Laura A

2012-12-01

The proximal articular surface angle of orientation (AO) of proximal phalanges of the hand and foot has been used to infer the locomotor profile of extinct Miocene catarrhines and early hominins. Previous work has found that joint orientation distinguishes quadrupedal from suspensory anthropoids. The purpose of this study is to expand on previous research by examining this feature within and across several primate clades, allowing us to investigate the potential influences of locomotion, substrate usage, hand posture, and phylogeny. We also report AO measurements in human proximal hand phalanges, allowing us to examine human skeletal variation within a wide comparative context. The angle of orientation was measured on manual proximal third phalanges of 21 extant anthropoid species using a Microscribe digitizer. Comparisons were made between locomotor groups within hominoids, platyrrhines, and cercopithecoids. Proximal phalanges of quadrupedal species were characterized by greater dorsal orientation than those of suspensory taxa in hominoids and atelids. In addition, arboreal quadrupeds had greater AO values than terrestrial quadrupeds within the Cercopithecoidea. However, within the terrestrial locomotor group, mean AO values did not differ between palmigrade and digitigrade taxa. Thus, while there appears to be a functional signal related to substrate usage, differences in use of hand postures when moving on the ground were not reflected in proximal joint orientation of the proximal phalanx. Finally, we measured relatively low AO values in human phalanges, which might be related to integration with serially homologous pedal phalanges that are under strong selective pressure related to bipedalism. Copyright © 2012 Wiley Periodicals, Inc.

Neglected nonunion of phalangeal neck fractures of the thumb in children: the outcome of delayed bone grafting in adulthood.

PubMed

Al-Qattan, Mohammad M

2012-03-01

Over a 12-year period, the author treated a total of 5 adults (mean age, 23 years) with neglected nonunion of phalangeal neck fractures of the thumb that were sustained in early childhood. Cosmetically, the affected thumb was shorter and smaller than the contralateral thumb. The thumb tip was flail and thumb pinch was weak. X-rays showed a nonunited phalangeal neck fracture with no radiologic evidence of avascular necrosis of the phalangeal head. All patients underwent iliac crest bone grafting. Bone union was obtained in all patients. At final follow-up (mean, 9 months), all patients were satisfied with the cosmetic appearance of the thumb. The thumb length increased by an average of 6 mm (range, 5-8 mm). Pinch improved in the range of 69% to 87% of the power of the contralateral thumb. However, there was restricted range of motion of the interphalangeal joint (mean range of motion of 10 degree only). It was concluded that delayed bone grafting of neglected nonunions of pediatric phalangeal neck fractures of the thumb is a worthwhile procedure and has a high satisfaction rate.

Towards Humanlike Social Touch for Prosthetics and Sociable Robotics: Three-Dimensional Finite Element Simulations of Synthetic Finger Phalanges

NASA Astrophysics Data System (ADS)

Cabibihan, John-John; Ge, Shuzhi Sam

Synthetic skins with humanlike characteristic would make it possible to address some of the psychosocial requirements of prosthetic hands as well as the safety and acceptance issues in social robotics. This paper describes the development of three-dimensional finite element models of synthetic finger phalanges. With the aim of duplicating the skin compliance of human finger phalanges, the model was used to investigate the effects of (i) introducing open pockets in the internal structure and (ii) combining different materials as external and internal layers. The results show that having pockets in the internal structure of the design can increase the skin compliance of the synthetic phalanges and make it comparable with the human counterpart. Moreover, having different layers can be used to satisfy skin compliance and other design requirements such as wear and tear.

Megalosauripus transjuranicus ichnosp. nov. A new Late Jurassic theropod ichnotaxon from NW Switzerland and implications for tridactyl dinosaur ichnology and ichnotaxomy

PubMed Central

Razzolini, Novella L.; Belvedere, Matteo; Marty, Daniel; Paratte, Géraldine; Lovis, Christel; Cattin, Marielle; Meyer, Christian A.

2017-01-01

A new ichnospecies of a large theropod dinosaur, Megalosauripus transjuranicus, is described from the Reuchenette Formation (Early–Late Kimmeridgian, Late Jurassic) of NW Switzerland. It is based on very well-preserved and morphologically-distinct tracks (impressions) and several trackways, including different preservational types from different tracksites and horizons. All trackways were excavated along federal Highway A16 near Courtedoux (Canton Jura) and systematically documented in the field including orthophotos and laserscans. The best-preserved tracks were recovered and additional tracks were casted. Megalosauripus transjuranicus is characterized by tridactyl tracks with clear claw and digital pad impressions, and notably an exceptionally large and round first phalangeal pad on the fourth digit (PIV1) that is connected to digit IV and forms the round heel area. Due to this combination of features, M. transjuranicus clearly is of theropod (and not ornithopod) origin. M. transjuranicus is compared to other Megalosauripus tracks and similar ichnotaxa and other unassigned tracks from the Early Jurassic to Early Cretaceous. It is clearly different from other ichnogenera assigned to large theropods such as Eubrontes–Grallator from the Late Triassic and Early Jurassic or Megalosauripus–Megalosauropus–Bueckeburgichnus and Therangospodus tracks from the Late Jurassic and Early Cretaceous. A second tridactyl morphotype (called Morphotype II) is different from Megalosauripus transjuranicus in being subsymmetric, longer than wide (sometimes almost as wide as long), with blunt toe impressions and no evidence for discrete phalangeal pad and claw marks. Some Morphotype II tracks are found in trackways that are assigned to M. transjuranicus, to M.? transjuranicus or M. cf. transjuranicus indicating that some Morphotype II tracks are intra-trackway preservational variants of a morphological continuum of Megalosauripus transjuranicus. On the other hand, several up to 40 steps long trackways very consistently present Morphotype II features (notably blunt digits) and do not exhibit any of the features that are typical for Megalosauripus (notably phalangeal pads). Therefore, it is not very likely that these tracks are preservational variants of Megalosauripus transjuranicus or Megalosauripus isp. These trackways are interpreted to have been left by an ornithopod dinosaur. The high frequency of large theropod tracks in tidal-flat deposits of the Jura carbonate platform, associated on single ichnoassemblages with minute to medium-sized tridactyl and tiny to large sauropod tracks has important implications for the dinosaur community and for paleoenvironmental and paleogeographical reconstructions. As with most other known occurrences of Megalosauripus tracks, M. transjuranicus is found in coastal settings, which may reflect the preference of their theropod trackmakers for expanded carbonate flats where food was abundant. PMID:28715504

Megalosauripus transjuranicus ichnosp. nov. A new Late Jurassic theropod ichnotaxon from NW Switzerland and implications for tridactyl dinosaur ichnology and ichnotaxomy.

PubMed

Razzolini, Novella L; Belvedere, Matteo; Marty, Daniel; Paratte, Géraldine; Lovis, Christel; Cattin, Marielle; Meyer, Christian A

2017-01-01

A new ichnospecies of a large theropod dinosaur, Megalosauripus transjuranicus, is described from the Reuchenette Formation (Early-Late Kimmeridgian, Late Jurassic) of NW Switzerland. It is based on very well-preserved and morphologically-distinct tracks (impressions) and several trackways, including different preservational types from different tracksites and horizons. All trackways were excavated along federal Highway A16 near Courtedoux (Canton Jura) and systematically documented in the field including orthophotos and laserscans. The best-preserved tracks were recovered and additional tracks were casted. Megalosauripus transjuranicus is characterized by tridactyl tracks with clear claw and digital pad impressions, and notably an exceptionally large and round first phalangeal pad on the fourth digit (PIV1) that is connected to digit IV and forms the round heel area. Due to this combination of features, M. transjuranicus clearly is of theropod (and not ornithopod) origin. M. transjuranicus is compared to other Megalosauripus tracks and similar ichnotaxa and other unassigned tracks from the Early Jurassic to Early Cretaceous. It is clearly different from other ichnogenera assigned to large theropods such as Eubrontes-Grallator from the Late Triassic and Early Jurassic or Megalosauripus-Megalosauropus-Bueckeburgichnus and Therangospodus tracks from the Late Jurassic and Early Cretaceous. A second tridactyl morphotype (called Morphotype II) is different from Megalosauripus transjuranicus in being subsymmetric, longer than wide (sometimes almost as wide as long), with blunt toe impressions and no evidence for discrete phalangeal pad and claw marks. Some Morphotype II tracks are found in trackways that are assigned to M. transjuranicus, to M.? transjuranicus or M. cf. transjuranicus indicating that some Morphotype II tracks are intra-trackway preservational variants of a morphological continuum of Megalosauripus transjuranicus. On the other hand, several up to 40 steps long trackways very consistently present Morphotype II features (notably blunt digits) and do not exhibit any of the features that are typical for Megalosauripus (notably phalangeal pads). Therefore, it is not very likely that these tracks are preservational variants of Megalosauripus transjuranicus or Megalosauripus isp. These trackways are interpreted to have been left by an ornithopod dinosaur. The high frequency of large theropod tracks in tidal-flat deposits of the Jura carbonate platform, associated on single ichnoassemblages with minute to medium-sized tridactyl and tiny to large sauropod tracks has important implications for the dinosaur community and for paleoenvironmental and paleogeographical reconstructions. As with most other known occurrences of Megalosauripus tracks, M. transjuranicus is found in coastal settings, which may reflect the preference of their theropod trackmakers for expanded carbonate flats where food was abundant.

Metacarpal and phalangeal fractures.

PubMed

Bowman, S H; Simon, R R

1993-08-01

Metacarpal and phalangeal fractures are common presenting injuries in many emergency departments. The emergency physician should become skilled at properly evaluating and initiating appropriate management and follow-up for these injuries when they occur. Failure to properly do so may result in permanent disability.

Tricho-rhino-phalangeal syndrome type I in a Belgian family.

PubMed

Verbruggen, L A; Van Laere, C; Lamoureux, J; Van Tiggelen, R

1987-06-01

We report three cases of tricho-rhino-phalangeal syndrome (TRPS) type I in a Belgian family. They presented typical characteristics such as a pear-shaped nose, and short, deformed fingers with cone-shaped epiphyses of some middle phalanges of the hands. Hair growth was practically normal in our patients, except for some narrowing of the lateral part of the eyebrows. Perthes-like hip dysplasia was documented in two of our cases. The proband presented at the age of 31 with Kienböch's disease of the right wrist. Blood and urine analysis showed no clear anomalies. In this patient, echography revealed a renal cyst containing a stone. The relationship of these findings to TRPS is discussed.

Investigation of methods for estimating hand bone dimensions using X-ray hand anthropometric data.

PubMed

Kong, Yong-Ku; Freivalds, Andris; Kim, Dae-Min; Chang, Joonho

2017-06-01

This study examined two conversion methods, M1 and M2, to predict finger/phalange bone lengths based on finger/phalange surface lengths. Forty-one Korean college students (25 males and 16 females) were recruited and their finger/phalange surface lengths, bone lengths and grip strengths were measured using a vernier caliper, an X-ray generator and a double-handle force measurement system, respectively. M1 and M2 were defined as formulas able to estimate finger/phalange bone lengths based on one dimension (i.e., surface hand length) and four finger dimensions (surface finger lengths), respectively. As a result of conversion, the estimation errors by M1 presented mean 1.22 mm, which was smaller than those (1.29 mm) by M2. The bone lengths estimated by M1 (mean r = 0.81) presented higher correlations with the measured bone lengths than those estimated by M2 (0.79). Thus, the M1 method was recommended in the present study, based on conversion simplicity and accuracy.

Biomechanics of phalangeal curvature.

PubMed

Richmond, Brian G

2007-12-01

Phalangeal curvature has been widely cited in primate functional morphology and is one of the key traits in the ongoing debate about whether the locomotion of early hominins included a significant degree of arboreality. This study examines the biomechanics of phalangeal curvature using data on hand posture, muscle recruitment, and anatomical moment arms to develop a finite element (FE) model of a siamang manual proximal phalanx during suspensory grasping. Strain patterns from experiments on intact cadaver forelimbs validated the model. The strain distribution in the curved siamang phalanx FE model was compared to that in a mathematically straight rendition in order to test the hypotheses that curvature: 1) reduces strain and 2) results in lower bending strains but relatively higher compression. In the suspensory posture, joint reaction forces load the articular ends of the phalanx in compression and dorsally, while muscle forces acting through the flexor sheath pull the mid-shaft palmarly. These forces compress the phalanx dorsally and tense it palmarly, effectively bending it 'open.' Strains in the curved model were roughly half that of the straight model despite equivalent lengths, areas, mechanical properties, and loading conditions in the two models. The curved model also experienced a higher ratio of compressive to tensile strains. Curvature reduces strains during grasping hand postures because the curved bone is more closely aligned with the joint reaction forces. Therefore, phalangeal curvature reduces the strains associated with arboreal, and especially suspensory, activity involving flexed digits. These results offer a biomechanical explanation for the observed association between phalangeal curvature and arboreality.

The correspondence between proximal phalanx morphology and locomotion: implications for inferring the locomotor behavior of fossil catarrhines.

PubMed

Rein, Thomas R

2011-11-01

Phalanges are considered to be highly informative in the reconstruction of extinct primate locomotor behavior since these skeletal elements directly interact with the substrate during locomotion. Variation in shaft curvature and relative phalangeal length has been linked to differences in the degree of suspension and overall arboreal locomotor activities. Building on previous work, this study investigated these two skeletal characters in a comparative context to analyze function, while taking evolutionary relationships into account. This study examined the correspondence between proportions of suspension and overall substrate usage observed in 17 extant taxa and included angle of curvature and relative phalangeal length. Predictive models based on these traits are reported. Published proportions of different locomotor behaviors were regressed against each phalangeal measurement and a size proxy. The relationship between each behavior and skeletal trait was investigated using ordinary least-squares, phylogenetic generalized least-squares (pGLS), and two pGLS transformation methods to determine the model of best-fit. Phalangeal curvature and relative length had significant positive relationships with both suspension and overall arboreal locomotion. Cross-validation analyses demonstrated that relative length and curvature provide accurate predictions of relative suspensory behavior and substrate usage in a range of extant species when used together in predictive models. These regression equations provide a refined method to assess the amount of suspensory and overall arboreal locomotion characterizing species in the catarrhine fossil record. Copyright © 2011 Wiley-Liss, Inc.

Safe corridors for K-wiring in phalangeal fractures.

PubMed

Rex, C; Vignesh, R; Javed, M; Balaji, Subba Chandra; Premanand, C; Zakki, Syed Ashfaque

2015-01-01

Unstable phalangeal fractures are commonly treated with K-wire fixation. Operative fixation must be used judiciously and with the expectation that the ultimate outcome should be better than the outcome after nonoperative management. It is necessary to achieve a stable fracture fixation and early mobilization. In order to achieve this goal, one should closely understand the safe portals/corridors in hand for K-wire entry for fractures of the phalanges. Safe corridors were defined and tested using a pilot cadaveric and a clinical case study by assessing the outcome. In our prospective case series, 50 patients with 64 phalangeal fractures were treated with closed reduction and K-wires were inserted through safe portals identified by a pilot cadaveric study. On table active finger movement test was done and the results were analyed using radiology, disabilities of the arm, shoulder, and hand (DASH) score and total active motion (TAM). In our study, little finger (n = 28) was the most commonly involved digit. In fracture pattern, transverse (n = 20) and spiral (n = 20) types were common. Proximal phalanx (n = 38) was commonly involved and the common site being the base of the phalanx (n = 28). 47 (95%) patients had excellent TAM and the mean postoperative DASH score was 58.05. All patients achieved excellent and good scores proving the importance of the safe corridor concept. K-wiring through the safe corridor has proved to yield the best clinical results because of least tethering of soft tissues as evidenced by performing "on-table active finger movement test" at the time of surgery. We strongly recommend K-wiring through safe portals in all phalangeal fractures.

Effect of Cortical Screw Diameter on Reduction and Stabilization of Type III Distal Phalanx Fractures: An Equine Cadaveric Study.

PubMed

Kay, Alastair T; Durgam, Sushmitha; Stewart, Matthew; Joslyn, Stephen; Schaeffer, David J; Horn, Gavin; Kesler, Richard; Chew, Peter

2016-11-01

To compare reduction of type III distal phalangeal fractures using 4.5 and 5.5 mm cortical screws placed in lag fashion and an intact hoof capsule model. Cadaveric experimental study. Hooves from 12 adult horses (n=24). Sagittal fractures were created in pairs of distal phalanges after distal interphalangeal joint disarticulation and were reduced with either 4.5 or 5.5 mm cortical screws placed in lag fashion. Contralateral phalanges served as non-reduced controls. Fracture reduction following screw placement was assessed by comparing pre-reduction and post-reduction fracture gap measurements from radiographs using paired t-tests. Effects of incremental loading (0, 135, 270, 540, 800, 1070, and 1335 kg) on fracture gaps in 6 phalanges reduced with 4.5 mm screws and 5 phalanges reduced with 5.5 mm screws were measured from fluoroscopic images and assessed by 2-way ANOVA. Significance was set at P<.05. Type III distal phalanx fractures were reliably created. Only 5.5 mm cortical screws, not 4.5 mm screws, significantly reduced fracture gaps and constrained fracture gap expansion 3 cm distal to the articular surface. Compressive loading closed the fracture gaps at the articular surface in both non-reduced control groups and those reduced with either 5.5 or 4.5 mm screws. The 5.5 mm cortical screws were more effective than 4.5 mm screws in reducing type III distal phalanx fractures and restricting distal fracture gap expansion under load. © Copyright 2016 by The American College of Veterinary Surgeons.

[Demographic features and difficulties in rehabilitation in patients referred to hand rehabilitation unit for phalangeal fractures].

PubMed

Sahin, Füsun; Yücel, Serap Dalgiç; Yilmaz, Figen; Ergöz, Ernur; Kuran, Banu

2006-01-01

We evaluated demographic and occupational features of patients with phalangeal fractures of the hand, etiologies and types of injuries, and the results of rehabilitation. The study included 91 fingers of 62 patients (54 males, 8 females; mean age 28+/-13 years; range 4 to 59 years) who were referred to our hand rehabilitation unit for phalangeal fractures. Demographic features, the cause and localization of injury, the type of surgery, time from surgery to rehabilitation, and the follow-up period were determined. At the end of rehabilitation, range of motion (ROM) of the phalangeal joint and total ROM of the injured fingers were assessed using the Strickland-Glogovac rating system. A great majority of injuries were caused by work accidents, followed by sport injuries and falls occurring in students. Sixty patients (96.8%) were right-handed. The fractures occurred in the dominant hand in 29 patients (46.8%). The majority of patients (n=45) were primary school graduates. The most common mechanism of injury was accidents related to heavy work machinery (n=18). The most commonly injured finger and the phalanx were the third finger (n=25, 27.5%) and the proximal phalanx (n=59, 56.7%), respectively. Only 27 patients (43.6%) had a sufficient follow-up with a mean of 79.7+/-46.6 days (range 30 to 254 days). Following rehabilitation, the mean ROM and the total ROM were 45.0+/-22.9 degrees and 63.3+/-16.1 degrees for the injured joint and the thumb, and 31.3+/-22.5 degrees and 122+/-60.3 degrees for the injured joint and the other fingers, respectively. Our data provide important insight into appropriate treatment and rehabilitation of phalangeal fractures, in particular, shortcomings in the treatment and follow-up.

[Symbrachydactyly--a roentgenographic and clinical study of 126 cases].

PubMed

Senrui, H

1984-07-01

One hundred and twenty-six cases of symbrachydactyly were analyzed roentgenographically and clinically. This curious anomaly of the hand is sporadic and of unknown etiology. It is predominantly one-sided, either isolated or combined with ipsilateral pectoral muscle defect (fifty-one cases). On X-ray pictures, the skeletal abnormalities of the hands ranged from mild involvement featured with hypoplastic or aplastic middle phalanges to the most severe involvement in which all the phalanges were missing, providing a continuous spectrum. Even in the mildly affected hands hypoplasia involves all the phalanges and metacarpals, most severely in the middle phanges followed by distal, proximal phalanges and metacarpals in turn. The forearms and arms are less affected than the hands. The tendency is observed in the severely affected hands. In the most severely affected hand all the digits are missing, but there exist several finger-buds which carry often nail rudiments. Synostosis is seen in the remaining hypoplastic metacarpals often and in carpals infrequently. Although remarkable shortening and curving forearm bones are observed often, the humeral involvement remains mild. Abnormalities of muscles and tendons are frequently observed in the hand and forearm. The anomaly is classified roentgenographically into three types: Type I (brachydactyly type) which is featured with fingers having three or two phalanges (fifty-four hands), Type II (partial ectrodactyly type) in which one to four digits have only one phalanx or none(thirty-nine hands), and Type III(total ectrodactyly type) in which all the digits have only one phalanx or none (thirty-five hands). The symbrachydactyly seems to be caused by a extensive defect in an undifferentiated mesenchyme of the arm bud at about developmental stage 16, which may later cause a failure of separation of skeletal and muscular tissues of the hand and forearm or an arrest in their development.

Phalangeal quantitative ultrasound and metabolic control in pre-menopausal women with type 1 diabetes mellitus.

PubMed

Catalano, A; Morabito, N; Di Vieste, G; Pintaudi, B; Cucinotta, D; Lasco, A; Di Benedetto, A

2013-05-01

Several studies have reported increased fracture risk in Type 1 diabetes mellitus (T1DM). Quantitative Ultrasound (QUS) provides information on the structure and elastic properties of bone, which are important determinants of fracture risk, along with bone mineral density. To study phalangeal sites by QUS, examine bone turnover markers and analyze association between these factors with metabolic control in a population of pre-menopausal women with T1DM. Thirty-five T1DM pre-menopausal women (mean age 34.5 ± 6.8 yr) attending the Diabetic Outpatients Clinic in the Department of Internal Medicine, University of Messina, were consecutively enrolled and divided into two groups, taking into account the mean value of glycated hemoglobin in the last three years. Twenty healthy age-matched women served as controls. Phalangeal ultrasound measurements [Amplitude Dependent Speed of Sound (AD-SoS), Ultrasound Bone Profile Index (UBPI), TScore, Z-Score] were performed using a DBM Sonic Bone Profiler. Osteocalcin and deoxypyridinoline served as markers of bone formation and bone resorption, respectively. T1DM women with poor metabolic control showed lower phalangeal QUS values compared to healthy controls (p<0.01) and T1DM women with good metabolic control (p<0.05). No significant differences in QUS measurements were detected between T1DM women with good metabolic control and healthy controls. Lower bone formation and increased bone resorption, although not statistically significant, were observed in patients with poor metabolic control in comparison to patients with good metabolic control. Poor metabolic control may worsen the quality of bone in T1DM. Phalangeal QUS could be considered as a tool to screen T1DM women for osteoporosis in pre-menopausal age.

Two rare cases of adult-onset phalangeal microgeodic syndrome with magnetic resonance imaging-proven bone edema transiently occurring in winter.

PubMed

Nishino, Ayako; Kawashiri, Shin-ya; Nakashima, Yoshikazu; Kawakami, Atsushi

2013-10-01

We report two rare cases of adult-onset phalangeal microgeodic syndrome (PMS), which commonly develops in children. Both cases were Japanese women, with case 1: 60 years old and case 2: 58 years old. They developed swelling and stiffness in their fingers in winter, and their symptoms disappeared without any treatment in summer. Magnetic resonance imaging (MRI) of bilateral hands showed diffuse bone edema of the middle and proximal phalanges in winter, but the abnormal findings also disappeared in summer. The specific abnormalities observed on MRI were very useful for the diagnosis of PMS. Interestingly, they appeared in winter and disappeared in summer in parallel with the symptoms. Copyright © 2013 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Inhibition of Shh signalling in the chick wing gives insights into digit patterning and evolution.

PubMed

Pickering, Joseph; Towers, Matthew

2016-10-01

In an influential model of pattern formation, a gradient of Sonic hedgehog (Shh) signalling in the chick wing bud specifies cells with three antero-posterior positional values, which give rise to three morphologically different digits by a self-organizing mechanism with Turing-like properties. However, as four of the five digits of the mouse limb are morphologically similar in terms of phalangeal pattern, it has been suggested that self-organization alone could be sufficient. Here, we show that inhibition of Shh signalling at a specific stage of chick wing development results in a pattern of four digits, three of which can have the same number of phalanges. These patterning changes are dependent on a posterior extension of the apical ectodermal ridge, and this also allows the additional digit to arise from the Shh-producing cells of the polarizing region - an ability lost in ancestral theropod dinosaurs. Our analyses reveal that, if the specification of antero-posterior positional values is curtailed, self-organization can then produce several digits with the same number of phalanges. We present a model that may give important insights into how the number of digits and phalanges has diverged during the evolution of avian and mammalian limbs. © 2016. Published by The Company of Biologists Ltd.

Unstable metacarpal and phalangeal fractures: treatment by internal fixation using AO mini-fragment plates and screws.

PubMed

Mumtaz, Mohammad Umar; Farooq, Muneer Ahmad; Rasool, Altaf Ahmad; Kawoosa, Altaf Ahmad; Badoo, Abdul Rashid; Dhar, Shabir Ahmad

2010-07-01

Accurate open reduction and internal fixation for metacarpal and phalangeal fractures of the hand is required in less than 5% of the patients; otherwise, closed treatment techniques offer satisfactory results in most of these cases as these fractures are stable either before or after closed reduction. AO mini-fragment screws and plates, when used in properly selected cases, can provide rigid fixation, allowing early mobilization of joints and hence good functional results while avoiding problems associated with protruding K-wires and immobilization. The advantages of such internal fixation urged us to undertake such a study in our state where such hand injuries are commonly seen. Forty patients with 42 unstable metacarpal and phalangeal fractures were treated with open reduction and internal fixation using AO mini-fragment screws and plates over a period of three years in a prospective manner. The overall results were good in 78.5% of cases, fair in 19% of cases and poor in 2.5% of cases, as judged according to the criteria of the American Society for Surgery of the Hand. This technique is a reasonable option for treating unstable metacarpal and phalangeal fractures as it provides a highly rigid fixation, which is sufficient to allow early mobilization of the adjacent joints, thus helping to achieve good functional results.

Surgical and medical management for fractures of the second through fifth metacarpals in a red ruffed lemur (Varecia rubra).

PubMed

Cerveny, Shannon N S; Harper, Justin; Voges, Andra; Coke, Rob L

2013-03-01

A 21-yr-old female red ruffed lemur (Varecia rubra) was presented with swelling and disuse of the right manus. Severely displaced fractures of metacarpals II-V were diagnosed radiographically. The fractures were surgically stabilized with intramedullary Kirschner wires attached externally with an acrylic external fixator and a bone plate on the dorsal aspect of metacarpal III. The fractures of metacarpals II-V were predominantly healed on radiographs obtained 12 wk after surgery. However, diffuse disuse osteopenia and phalangeal contracture were present, with possible osteomyelitis. An exercise regimen of the affected hand was initiated due to the incomplete extension of the phalanges. After 4 wk of therapy, the extension of the phalanges had improved and the fractures appeared radiographically to be nearly completely healed. Although metacarpal fractures are common in nonhuman primates, they are reported infrequently in the literature.

Phalange Tactile Load Cell

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Diftler, Myron A. (Inventor); Linn, Douglas Martin (Inventor); Platt, Robert (Inventor); Griffith, Bryan Kristian (Inventor)

2010-01-01

A tactile load cell that has particular application for measuring the load on a phalange in a dexterous robot system. The load cell includes a flexible strain element having first and second end portions that can be used to mount the load cell to the phalange and a center portion that can be used to mount a suitable contact surface to the load cell. The strain element also includes a first S-shaped member including at least three sections connected to the first end portion and the center portion and a second S-shaped member including at least three sections coupled to the second end portion and the center portion. The load cell also includes eight strain gauge pairs where each strain gauge pair is mounted to opposing surfaces of one of the sections of the S-shaped members where the strain gauge pairs provide strain measurements in six-degrees of freedom.

Development of a neural network for early detection of renal osteodystrophy

NASA Astrophysics Data System (ADS)

Cheng, Shirley N.; Chan, Heang-Ping; Adler, Ronald; Niklason, Loren T.; Chang, Chair-Li

1991-07-01

Bone erosion presenting as subperiosteal resorption on the phalanges of the hand is an early manifestation of hyperparathyroidism associated with chronic renal failure. At present, the diagnosis is made by trained radiologists through visual inspection of hand radiographs. In this study, a neural network is being developed to assess the feasibility of computer-aided detection of these changes. A two-pass approach is adopted. The digitized image is first compressed by a Laplacian pyramid compact code. The first neural network locates the region of interest using vertical projections along the phalanges and then the horizontal projections across the phalanges. A second neural network is used to classify texture variations of trabecular patterns in the region using a concurrence matrix as the input to a two-dimensional sensor layer to detect the degree of associated osteopenia. Preliminary results demonstrate the feasibility of this approach.

Clinical and radiological assessment of a family with mild brachydactyly type A1: the usefulness of metacarpophalangeal profiles.

PubMed

Armour, C M; Bulman, D E; Hunter, A G

2000-04-01

The brachydactylies are a group of conditions in which various subtypes have been defined based upon the specific pattern of digital bones involved. Type A1 brachydactyly is principally characterised by maximal involvement of the middle phalanges. We report an extended family with a mild brachydactyly A1 which was, except for some short stature, not associated with any of the additional clinical findings reported in several published families. While all the hand bones tended to be small, the principal features of the affected members were shortened middle and distal phalanges, proximal 1st phalanges, and 5th metacarpals. The feet were similarly involved and tended to have a broad, slightly adducted forefoot. The two affected children showed multiple coned epiphyses. This paper provides a detailed description of the family including the radiographic signs and metacarpophalangeal profiles, which proved to be useful in distinguishing the mildly affected persons.

Prosthetic finger phalanges with lifelike skin compliance for low-force social touching interactions

PubMed Central

2011-01-01

Background Prosthetic arms and hands that can be controlled by the user's electromyography (EMG) signals are emerging. Eventually, these advanced prosthetic devices will be expected to touch and be touched by other people. As realistic as they may look, the currently available prosthetic hands have physical properties that are still far from the characteristics of human skins because they are much stiffer. In this paper, different configurations of synthetic finger phalanges have been investigated for their skin compliance behaviour and have been compared with the phalanges of the human fingers and a phalanx from a commercially available prosthetic hand. Methods Handshake tests were performed to identify which areas on the human hand experience high contact forces. After these areas were determined, experiments were done on selected areas using an indenting probe to obtain the force-displacement curves. Finite element simulations were used to compare the force-displacement results of the synthetic finger phalanx designs with that of the experimental results from the human and prosthetic finger phalanges. The simulation models were used to investigate the effects of (a) varying the internal topology of the finger phalanx and (b) varying different materials for the internal and external layers. Results and Conclusions During handshake, the high magnitudes of contact forces were observed at the areas where the full grasping enclosure of the other person's hand can be achieved. From these areas, the middle phalanges of the (a) little, (b) ring, and (c) middle fingers were selected. The indentation experiments on these areas showed that a 2 N force corresponds to skin tissue displacements of more than 2 mm. The results from the simulation model show that introducing an open pocket with 2 mm height on the internal structure of synthetic finger phalanges increased the skin compliance of the silicone material to 235% and the polyurethane material to 436%, as compared to a configuration with a solid internal geometry. In addition, the study shows that an indentation of 2 N force on the synthetic skin with an open pocket can also achieve a displacement of more than 2 mm, while the finger phalanx from a commercially available prosthetic hand can only achieve 0.2 mm. PMID:21447188

Pahoehoe toe dimensions, morphology, and branching relationships at Mauna Ulu, Kilauea Volcano, Hawai'i

NASA Astrophysics Data System (ADS)

Crown, David A.; Baloga, Stephen M.

Pahoehoe toe dimensions, morphology, and branching relationships were analyzed in flows emplaced during 1972 at Mauna Ulu, a satellitic shield on the east rift zone of Kilauea Volcano, Hawai'i. In order to characterize regions within flow fields dominated by networks of pahoehoe toes, measurements of toe length, width, thickness, and orientation were completed for 445 toes at 13 sites. Variations in site characteristics, including slope, substrate, and position in the flow field allow an evaluation of the effects of such parameters on toe dimensions. Toe surface morphology (ropy or smooth), local flow lobe position (interior or margin), and connective relationships between toes were documented in the form of detailed toe maps. These maps show the number of branches connecting a given toe to other toes in its local pahoehoe network and illustrate branching patterns. Statistical analyses of toe dimensions and comparisons of pahoehoe toe study sites and sub-populations combined with field observations, evaluation of toe maps, and qualitative examination of toe dimension size distributions show the following: (a) Although there are significant variations at a given site, toes typically have mean lengths (101cm) greater than mean widths (74cm) and mean widths greater than mean thicknesses (19cm) sites that have mean widths greater than mean lengths are those with lower slopes. (b) Where significant site-to-site variations in mean values of a given toe dimension were apparent, these differences could not be directly related to site characteristics. (c) Ropy toes have significantly larger mean values of length, width, and number of branches than smooth toes, and toes with three or more branches have greater lengths, widths, and thicknesses than toes with two or fewer branches, suggesting concentration of flow in these toe types. (d) The skewness of all size distributions of toe length and width to larger values suggests that toes are transitional to larger sheets and channels, consistent with field observations; and (e) Two distinct types of branching patterns (called monolayer and centrally ridged) were observed in preserved pahoehoe flow lobes. The significant variability in measured toe dimensions at Mauna Ulu suggests that toe dimensions are influenced by numerous locally defined, random factors, and that an approach based on stochastic methods can be used to model pahoehoe flow emplacement.

[Relationship of certain skeletal maturity indicators of hand and wrist with adolescent growth spurt].

PubMed

Zhang, Shao-yan; Liu, Gang; Liu, Li-juan; Ma, Zhen-guo; Han, Yi-san; Shen, Xun-zhang; Xu, Rui-long

2008-08-12

To investigate the relationship of certain skeletal maturity indicators of hand and wrist with adolescent growth spurt. 14 757 normal urban children, 7373 boys and 7384 girls, aged 7 - 20, all of Han nationality, from Shanghai, Guangzhou, Wenzhou, Dalian, and Shijiazhuang underwent measurement of height and weight, and left wrist anterior-posterior radiography. The incremental curve was fitted graphically according to the differences between the means for height at series ages. The ages of attainment of eleven skeletal indicators were defined by regression analysis for middle phalange 3, radius, and adductor sesamoid of the first finger. The accelerative phase of adolescent growth spurt was accompanied by becoming square of middle phalange 3 and the appearance of adductor sesamoid of the first finger. Peak growth velocity (PGV) was reached at about the time of epiphysis capping in middle phalange 3 and ossification of the adductor sesamoid of first finger. Decelerated phase of growth was indicated by the beginning of epiphysis fusion in radius and full maturity in adductor sesamoid of first finger. When the epiphysis of middle phalange 3 and the half of epiphysis of radius were respectively fused with their diaphyses, the growth spurt was ended. Certain skeletal maturity indicators of hand and wrist can be used to indicate the period of adolescent growth that a child has reached.

Point-of-Care Phalangeal Bone Mineral Density Measurement Can Reduce the Need of Dual-Energy X-Ray Absorptiometry Scanning in Danish Women at Risk of Fracture.

PubMed

Holmberg, Teresa; Bech, Mickael; Gram, Jeppe; Hermann, Anne Pernille; Rubin, Katrine Hass; Brixen, Kim

2016-03-01

Identifying persons with a high risk of osteoporotic fractures remains a challenge. DXA uptake in women with elevated risk of osteoporosis seems to be depending on distance to scanning facilities. This study aimed to investigate the ability of a small portable scanner in identifying women with reduced bone mineral density (BMD), and to define triage thresholds for pre-selection. Total hip and lumbar spine BMD was measured by dual-energy X-ray absorptiometry and phalangeal BMD by radiographic absorptiometry in 121 Danish women with intermediate or high 10-year fracture probability (aged 61-81 years). Correlation between the two methods was estimated using correlation coefficient (r) and Bland-Altman plots. A moderate correlation between phalangeal BMD versus total hip (r = 0.47) and lumbar spine (r = 0.51), and an AUC on 0.80 was found. The mean difference between phalangeal T score and total hip T score/lumbar spine T score was low, and ranged from -0.26 SD to -0.31 SD depending on site and reference database used for calculation of T scores, but, large variation was seen at an individual level. When applying a triage approach approx. one-third of all DXA scan could be avoided and only 6 % of women in the low-risk group would be false negatives.

Predictors of the postoperative range of finger motion for comminuted periarticular metacarpal and phalangeal fractures treated with a titanium plate.

PubMed

Shimizu, Takamasa; Omokawa, Shohei; Akahane, Manabu; Murata, Keiichi; Nakano, Kenichi; Kawamura, Kenji; Tanaka, Yasuhito

2012-06-01

Plate and screw fixation was introduced for complex fractures of the hand. Several risk factors for a poor functional outcome have been identified, but there is a paucity of evidence regarding predictors of finger stiffness in difficult hand fractures. The purpose of this prospective cohort study was to identify independent prognostic factors of the postoperative total active motion (%TAM) in the treatment of metacarpal and phalangeal fractures. Seventy-two patients (62 males, 10 females; 37±15 years) with periarticular fractures involving metaphyseal comminution and displacement were evaluated at a minimum of 1 year following surgery. There were 49 phalangeal bone fractures, 30 intra-articular fractures and 20 associated soft-tissue injuries. The locations of plate placement were lateral in 42 patients and dorsal in 30. The mean duration from injury to surgery was 7.6 days (range, 0-40 days). There were eight examined variables related to patient characteristics (age, gender and hand dominance), fracture characteristics (fracture location, joint involvement and associated soft-tissue injury) and surgical variables (location of plate placement and duration from injury to surgery). Univariate and multivariate linear regression analysis were used to identify the degree to which variables affect %TAM at the final follow-up. Univariate analysis indicated moderate correlations of %TAM with fracture location, associated soft-tissue injury and age. Multiple linear regression modelling including fracture location, age and associated soft-tissue injury resulted in formulae that could account for 46.3% of the variability in %TAM: fracture location (β=-0.388, p<0.001), age (β=-0.339, p<0.001) and associated soft-tissue injury (β=-0.296, p=0.002). Phalangeal fracture, increasing age and associated soft-tissue injury were important risk factors to identify the postoperative %TAM in the treatment of comminuted periarticular metacarpal or phalangeal fracture with a titanium plate. Copyright © 2012 Elsevier Ltd. All rights reserved.

Aggressive intraosseous lipoma of the intermediate phalanges of the thumb.

PubMed

Hashimoto, Kazuhiko; Nishimura, Shunji; Kakinoki, Ryosuke; Akagi, Masao

2018-07-01

Intraosseous lipomas occurring in the bones of the upper limbs are very rare. The tumor often occurs in long bones, especially the calcaneus. Usually patients with intraosseous lipomas present with mild clinical features. Thus far, bone destruction caused by the tumor has not been reported. The present study reported a case of an aggressive intraosseous lipoma that developed in the intermediate phalanges of the thumb. This is an extremely rare case with extraosseous development, which occurred at a rare site. A 47-year old woman presented to us with right thumb pain and swelling. Computed tomography and magnetic resonance imaging revealed a mass extending to the outer edge of the phalangeal bone. The patient was treated with surgery the remove the tumor. Artificial bone was used to refill the area due to the lack of cancellous bone. During the clinical management of lipomas, it is important to consider that intraosseous lipomas may spread out of the bone; moreover, the tumor should be removed immediately to help reduce the possibility of bone destruction.

An interdigit signalling centre instructs coordinate phalanx-joint formation governed by 5′Hoxd–Gli3 antagonism

PubMed Central

Huang, Bau-Lin; Trofka, Anna; Furusawa, Aki; Norrie, Jacqueline L.; Rabinowitz, Adam H.; Vokes, Steven A.; Mark Taketo, M.; Zakany, Jozsef; Mackem, Susan

2016-01-01

The number of phalanges and joints are key features of digit ‘identity' and are central to limb functionality and evolutionary adaptation. Prior chick work indicated that digit phalanges and their associated joints arise in a different manner than the more sparsely jointed long bones, and their identity is regulated by differential signalling from adjacent interdigits. Currently, there is no genetic evidence for this model, and the molecular mechanisms governing digit joint specification remain poorly understood. Using genetic approaches in mouse, here we show that functional 5′Hoxd–Gli3 antagonism acts indirectly, through Bmp signalling from the interdigital mesenchyme, to regulate specification of joint progenitors, which arise in conjunction with phalangeal precursors at the digit tip. Phalanx number, although co-regulated, can be uncoupled from joint specification. We propose that 5′Hoxd genes and Gli3 are part of an interdigital signalling centre that sets net Bmp signalling levels from different interdigits to coordinately regulate phalanx and joint formation. PMID:27713395

Broken toe - self-care

MedlinePlus

Fractured toe - self-care; Broken bone - toe - self-care; Fracture - toe - self-care; Fracture phalanx - toe ... often treated without surgery and can be taken care of at home. Severe injuries include: Breaks that ...

Incidence of Treatment for Infection of Buried Versus Exposed Kirschner Wires in Phalangeal, Metacarpal, and Distal Radial Fractures.

PubMed

Ridley, Taylor J; Freking, Will; Erickson, Lauren O; Ward, Christina Marie

2017-07-01

To determine whether there is a difference in the incidence of infection between exposed and buried K-wires when used to treat phalangeal, metacarpal, and distal radius fractures. We conducted a retrospective review identifying all patients aged greater than 16 years who underwent fixation of phalangeal, metacarpal, or distal radius fractures with K-wires between 2007 and 2015. We recorded patient demographic data, fracture location, number of K-wires used, whether K-wires were buried or left exposed, and duration of K-wire placement. A total of 695 patients met inclusion criteria. Surgeons buried K-wires in 207 patients and left K-wires exposed in 488. Infections occurred more frequently in exposed K-wire cases than in buried K-wire ones. Subgroup analysis based on fracture location revealed a significantly increased risk of being treated for infection when exposed K-wires were used for metacarpal fractures. Patients with exposed K-wires for fixation of phalangeal, metacarpal, or distal radius fractures were more likely to be treated for a pin-site infection than those with K-wires buried beneath the skin. Metacarpal fractures treated with exposed K-wires were 2 times more likely to be treated for a pin-site infection (17.6% of exposed K wire cases vs 8.7% of buried K wire cases). Therapeutic IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Individual left-hand and right-hand intra-digit representations in human primary somatosensory cortex.

PubMed

Schweisfurth, Meike A; Frahm, Jens; Schweizer, Renate

2015-09-01

Individual intra-digit somatotopy of all phalanges of the middle and little finger of the right and left hand was studied by functional magnetic resonance imaging in 12 healthy subjects. Phalanges were tactilely stimulated and activation in BA 3b of the human primary somatosensory cortex could be observed for each individual phalanx. Activation peaks were further analysed using the Direction/Order (DiOr) method, which identifies somatotopy, if a significantly high number of subjects exhibit ordered distal-to-proximal phalanx representions along a similar direction. Based on DiOr, ordered and similar-direction-aligned intra-digit maps across subjects were found at the left hand for the little and middle finger and at the right hand for the little finger. In these digits the proximal phalanges were represented more medially along the course of the central sulcus than the distal phalanges. This is contrasted by the intra-digit maps for the middle finger of the right hand, which showed larger inter-subject variations of phalanx alignments without a similar within-digit representation across subjects. As all subjects were right-handed and as the middle finger of the dominant hand probably plays a more individual role in everyday tactile performance than the little finger of the right hand and all left-hand digits, the observed variation might reflect a functional somatotopy based on individual use of that particular digit at the dominant hand. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Assessment of Lactose-Free Diet on the Phalangeal Bone Mineral Status in Italian Adolescents Affected by Adult-Type Hypolactasia

PubMed Central

Tagliati, Sylvie; Saccomandi, Daniela; Brusaferro, Andrea; Busoli, Laura; Scala, Andrea; Malaventura, Cristina; Borgna-Pignatti, Caterina

2018-01-01

Adult-type hypolactasia (ATH) is a clinical syndrome of primary lactase deficiency. A lactose-free diet is advisable to avoid the symptoms linked to the condition, but this potentially creates problems for optimal bone mineralization due to reduced calcium intake. To evaluate the effect of the lactose-free diet on the bone mineral status (BMS), we compared the phalangeal BMS of adolescents with ATH to that of peers on a normal diet. Also, we analyzed the correlations between BMS and dietary behavior, physical exercise, and calcium and vitamin D intake. A total of 102 cases and 102 healthy controls filled out a diet record and underwent phalangeal Quantitative Ultrasound (QUS). No difference in BMS was observed. The time spent on lactose-free diet (4.8 ± 3.1 years) was inversely correlated to the BMS. More than 98% of cases consumed lactose-free milk, but calcium and vitamin D intake were significantly lower. Calcium intake was correlated to physical exercise but not to BMS. Our results suggest that a lactose-free diet does not affect the phalangeal BMS of adolescents with primary lactase deficiency when their diet includes lactose-free cow’s milk. However, there is still a significantly lower calcium intake than in the population reference. The inverse correlation observed between the BMS and the time spent on a lactose-free diet suggests that a long-term follow-up is advisable. PMID:29723971

Distraction lengthening of the proximal phalanx in distal thumb amputations.

PubMed

Cansü, Eren; Ünal, Mehmet Bekir; Parmaksızoğlu, Fatih; Gürcan, Serkan

2015-01-01

Thumb amputation is a major cause of hand dysfunction, and the treatment for distal thumb amputations remains controversial. Although finger reconstruction methods using distraction lengthening are known to restore finger length and function, we found no reports in the literature regarding phalangeal lengthening in thumb amputations. We aimed to evaluate proximal phalangeal lengthening in thumb amputations at or near the interphalangeal (IP) joint. We retrospectively evaluated patients who had undergone distraction lengthening of the proximal phalanx of the thumb. All patients underwent osteotomy, either during the initial procedure or as a second-stage procedure. Distraction began 10 days after osteotomy with the use of an external fixator that remained in place until ossification of the gap occurred without bone grafting. Patients were evaluated using the QuickDASH score. Fourteen patients with a mean age of 27 years and a mean follow-up period of 7 years were enrolled. The mean phalangeal lengthening achieved was 20 mm. Ossification occurred at all distraction sites, and the fixators were maintained for a mean of 85 days. The mean healing index was 42.5 days/cm. All 14 patients achieved the desired amount of phalangeal lengthening without major complications such as nonunion, premature union, or gross infection. For reconstruction in cases of distal thumb amputations, distraction lengthening of the proximal phalanx can be used to improve absolute length, web space, and grip distance. The technique is safe and effective, improves functionality/cosmesis, and offers a low complication risk.

Quantitative Analysis and Development of the Fore Feet of Arabian Foals from Birth to 1 Year of Age.

PubMed

Faramarzi, Babak; Salinger, Allison; Kaneps, Andris; Nout-Lomas, Yvette; Greene, Holly; Dong, Fanglong

2017-11-01

Objectives  The goal of this study was to quantify external and internal anatomical characteristics of the foal foot throughout the first year of age. Methods  Digital radiographs and photographs were taken bimonthly of the forefeet of nine Arabian foals, beginning at about 2 weeks of age until 12 months of age. Sixty-eight linear and angular variables were measured using NIH (National Institutes of Health) Image J software. Statistical analyses were performed using piecewise random coefficient model and p -values < 0.05 were considered significant. Results  Distinct changes in hoof development were identified between 4 and 8 months of age. Distinct changes were identified in several external (conformational) measurements including hoof solar widths and lengths, palmar heel lengths, toe and heel angles and in several internal (radiographic) measurements including the widths and lengths of the phalanges and sesamoid bones as well as joint angles. Clinical Significance  Existing knowledge of distal limb development in foals, particularly the foot, is limited. These findings define the measurable changes of the foal foot as it grows during the first year of life. These data provide an insight into the transformation of the hoof from its initial oval to a circular shape and from a club-like, cylindrical conformation to a more angled, conical conformation. This paper quantifies this development, ultimately allowing a better understanding of morphological changes in the foot of the growing foal. Schattauer GmbH Stuttgart.

Comparison of Two Alternative Methods for Tracking Toe Trajectory

NASA Technical Reports Server (NTRS)

Miller, Chris; Peters, Brian; Brady, Rachel; Mulavara, Ajitkumar; Warren, Liz; Feiveson, Al; Bloomberg, Jacob

2007-01-01

Toe trajectory during the swing phase of locomotion has been identified as a precise motor control task (Karst, et al., 1999). The standard method for tracking toe trajectory is to place a marker on the superior aspect of the distal end of the 2nd toe itself (Karst, et al., 1999; Winter, 1992). However, others have based their toe trajectory results either on a marker positioned on the lateral aspect of the 5th metatarsal head (Dingwell, et al., 1999; Osaki, et al., 2007), or on a virtual toe marker computed at the anterior tip of the second toe based on the positions of other real foot markers (Miller, et al., 2006). While these methods for tracking the toe may seem similar, their results may not be directly comparable. The purpose of this study was to compute toe trajectory parameters using a 5th metatarsal marker and a virtual toe marker, and compare their results with those of the standard toe marker.

Impact on DARCOM of Nonstandard MTOE.

DTIC Science & Technology

1981-03-01

DIFFERENCES BETWEEN TOE AND MTOE TYPE NR RECORDS TOTAL QTY OF TOTAL QTY OF TOTAL DIFF ORGN IDENTIFIED ITEMS AUTH ITEMS AUTH BETWEEN TOE BY TOE BY MTOE AND MTOE...BETWEEN TOE AND MTOE TYPE NR RECORDS TOTAL QTY OF TOTAL QTY OF TOTAL DIFF ORGN IDENTIFIED ITEMS AUTH ITEMS AUTH BETWEEN TOE BY TOE BY MTOE AND MTOE 01

Effects of toe-in and toe-in with wider step width on level walking knee biomechanics in varus, valgus, and neutral knee alignments.

PubMed

Bennett, Hunter J; Shen, Guangping; Cates, Harold E; Zhang, Songning

2017-12-01

Increased peak external knee adduction moments exist for individuals with knee osteoarthritis and varus knee alignments, compared to healthy and neutrally aligned counterparts. Walking with increased toe-in or increased step width have been individually utilized to successfully reduce 1st and 2nd peak knee adduction moments, respectfully, but have not previously been combined or tested among all alignment groups. The purpose of this study was to compare toe-in only and toe-in with wider step width gait modifications in individuals with neutral, valgus, and varus alignments. Thirty-eight healthy participants with confirmed varus, neutral, or valgus frontal-plane knee alignment through anteroposterior radiographs, performed level walking in normal, toe-in, and toe-in with wider step width gaits. A 3×3 (group×intervention) mixed model repeated measures ANOVA compared alignment groups and gait interventions (p<0.05). The 1st peak knee adduction moment was reduced in both toe-in and toe-in with wider step width compared to normal gait. The 2nd peak adduction moment was increased in toe-in compared to normal and toe-in with wider step width. The adduction impulse was also reduced in toe-in and toe-in with wider step width compared to normal gait. Peak knee flexion and external rotation moments were increased in toe-in and toe-in with wider step width compared to normal gait. Although the toe-in with wider step width gait seems to be a viable option to reduce peak adduction moments for varus alignments, sagittal, and transverse knee loadings should be monitored when implementing this gait modification strategy. Copyright © 2017 Elsevier B.V. All rights reserved.

Daughter and her mildly affected father with Keipert syndrome.

PubMed

Dumic, Miroslav; Kokic, Durda Dovzak; Matic, Toni; Potocki, Kristina

2006-11-15

A 10-year-old girl with characteristic features of Keipert syndrome (broad terminal phalanges, especially of the thumb and hallux, sensorineural deafness, unusual facial features, large head circumference, maxillary hypoplasia, hoarse voice) and her mildly affected father (broad terminal phalanges, especially of the thumb and hallux, large head circumference, maxillary hypoplasia, and hoarse voice) are presented. The girl is the first reported female with this rare syndrome to date, and the fact that she probably inherited the disease from her father suggests an autosomal dominant pattern of inheritance. (c) 2006 Wiley-Liss, Inc.

Effects of toe-out and toe-in gait with varying walking speeds on knee joint mechanics and lower limb energetics.

PubMed

Khan, Soobia Saad; Khan, Saad Jawaid; Usman, Juliana

2017-03-01

Toe-out/-in gait has been prescribed in reducing knee joint load to medial knee osteoarthritis patients. This study focused on the effects of toe-out/-in at different walking speeds on first peak knee adduction moment (fKAM), second peak KAM (sKAM), knee adduction angular impulse (KAAI), net mechanical work by lower limb as well as joint-level contribution to the total limb work during level walking. Gait analysis of 20 healthy young adults was done walking at pre-defined normal (1.18m/s), slow (0.85m/s) and fast (1.43m/s) walking speeds with straight-toe (natural), toe-out (15°>natural) and toe-in (15°

Fine-tuning of Notch signaling sets the boundary of the organ of Corti and establishes sensory cell fates

PubMed Central

Basch, Martin L; Brown, Rogers M; Jen, Hsin-I; Semerci, Fatih; Depreux, Frederic; Edlund, Renée K; Zhang, Hongyuan; Norton, Christine R; Gridley, Thomas; Cole, Susan E; Doetzlhofer, Angelika; Maletic-Savatic, Mirjana; Segil, Neil; Groves, Andrew K

2016-01-01

The signals that induce the organ of Corti and define its boundaries in the cochlea are poorly understood. We show that two Notch modifiers, Lfng and Mfng, are transiently expressed precisely at the neural boundary of the organ of Corti. Cre-Lox fate mapping shows this region gives rise to inner hair cells and their associated inner phalangeal cells. Mutation of Lfng and Mfng disrupts this boundary, producing unexpected duplications of inner hair cells and inner phalangeal cells. This phenotype is mimicked by other mouse mutants or pharmacological treatments that lower but not abolish Notch signaling. However, strong disruption of Notch signaling causes a very different result, generating many ectopic hair cells at the expense of inner phalangeal cells. Our results show that Notch signaling is finely calibrated in the cochlea to produce precisely tuned levels of signaling that first set the boundary of the organ of Corti and later regulate hair cell development. DOI: http://dx.doi.org/10.7554/eLife.19921.001 PMID:27966429

Cardiovascular Effect Is Independent of Hemolytic Toxicity of Tentacle-Only Extract from the Jellyfish Cyanea capillata

PubMed Central

Qianqian, Wang; Sihua, Liu; Yang, Wang; Guoyan, Liu; Jia, Lu; Xuting, Ye; Liming, Zhang

2012-01-01

Our previous studies have confirmed that the crude tentacle-only extract (cTOE) from the jellyfish Cyanea capillata (Cyaneidae) exhibits hemolytic and cardiovascular toxicities simultaneously. So, it is quite difficult to discern the underlying active component responsible for heart injury caused by cTOE. The inactivation of the hemolytic toxicity from cTOE accompanied with a removal of plenty of precipitates would facilitate the separation of cardiovascular component and the investigation of its cardiovascular injury mechanism. In our research, after the treatment of one-step alkaline denaturation followed by twice dialysis, the protein concentration of the treated tentacle-only extract (tTOE) was about 1/3 of cTOE, and SDS-PAGE showed smaller numbers and lower density of protein bands in tTOE. The hemolytic toxicity of tTOE was completely lost while its cardiovascular toxicity was well retained. The observations of cardiac function, histopathology and ultrastructural pathology all support tTOE with significant cardiovascular toxicity. Blood gas indexes and electrolytes changed far less by tTOE than those by cTOE, though still with significant difference from normal. In summary, the cardiovascular toxicity of cTOE can exist independently of the hemolytic toxicity and tTOE can be employed as a better venom sample for further purification and mechanism research on the jellyfish cardiovascular toxic proteins. PMID:22905209

[Hand reconstruction by microsurgical free toe transfer].

PubMed

Stamate, T; Budurcă, A R; Hermeziu, Oana

2003-01-01

Reconstruction of complex hand mutilations with multi-digital or thumb amputations are best treated with microsurgical toe transfers. We present the results of the first 15 cases operated by the first author, of which 12 are thumb reconstructions (6 great toe and 6 second toe transfers) and 3 long fingers reconstructions with combined second and third toe transfers. There were no microsurgical complications. Cortical integration and functional integration was achieved for all transferred toes, with discriminatory sensibility (m2PD between 5 and 13 mm) and active mobility range between 30 and 60 degrees.

The thumb of Miocene apes: new insights from Castell de Barberà (Catalonia, Spain).

PubMed

Almécija, Sergio; Alba, David M; Moyà-Solà, Salvador

2012-07-01

Primate hands display a major selective compromise between locomotion and manipulation. The thumb may or may not participate in locomotion, but it plays a central role in most manipulative activities. Understanding whether or not the last common ancestor of humans and Pan displayed extant-ape-like hand proportions (i.e., relatively long fingers and a short thumb) can be clarified by the analysis of Miocene ape hand remains. Here we describe new pollical remains-a complete proximal phalanx and a partial distal phalanx-from the middle/late Miocene site of Castell de Barberà (ca., 11.2-10.5 Ma, Vallès-Penedès Basin), and provide morphometric and qualitative comparisons with other available Miocene specimens as well as extant catarrhines (including humans). Our results show that all available Miocene taxa (Proconsul, Nacholapithecus, Afropithecus, Sivapithecus, Hispanopithecus, Oreopithecus, and the hominoid from Castell de Barberà) share a similar phalangeal thumb morphology: the phalanges are relatively long, and the proximal phalanges have a high degree of curvature, marked insertions for the flexor muscles, a palmarly bent trochlea and a low basal height. All these features suggest that these Miocene apes used their thumb with an emphasis on flexion, most of them to powerfully assist the fingers during above-branch, grasping arboreal locomotion. Moreover, in terms of relative proximal phalangeal length, the thumb of Miocene taxa is intermediate between the long-thumbed humans and the short-thumbed extant apes. Together with previous evidence, this suggests that a moderate-length hand with relatively long thumb-involved in locomotion-is the original hand morphotype for the Hominidae. Copyright © 2012 Wiley Periodicals, Inc.

Postural and Intention Tremors: A Detailed Clinical Study of Essential Tremor vs. Parkinson’s Disease

PubMed Central

Sternberg, Eliezer J.; Alcalay, Roy N.; Levy, Oren A.; Louis, Elan D.

2013-01-01

Background: An estimated 30–50% of essential tremor (ET) diagnoses are incorrect, and the true diagnosis in those patients is often Parkinson’s disease (PD) or other tremor disorders. There are general statements about the tremor in these ET and PD, but published data on the more subtle characteristics of tremor are surprisingly limited. Postural tremor may occur in both disorders, adding to the difficulty. There are several anecdotal impressions regarding specific features of postural tremor in ET vs. PD, including joint distribution (e.g., phalanges, metacarpal-phalangeal joints, wrist), tremor directionality (e.g., flexion-extension vs. pronation-supination), and presence of intention tremor. However, there is little data to support these impressions. Methods: In this cross-sectional study, 100 patients (ET, 50 PD) underwent detailed videotaped neurological examinations. Arm tremor was rated by a movement disorder neurologist who assessed severity and directionality across multiple joints. Results: During sustained arm extension, ET patients exhibited more wrist than metacarpal-phalangeal and phalangeal joint tremor than did PD patients (p < 0.001), and more wrist flexion-extension tremor than wrist pronation-supination tremor (p < 0.001). During the finger-nose-finger maneuver, intention tremor was present in approximately one in four (28%) ET patients vs. virtually none (4%) of the Parkinson’s patients (p < 0.001). Conclusions: We evaluated the location, severity, and directionality of postural tremor in ET and PD, and the presence of intention tremor, observing several clinical differences. We hope that detailed phenomenological data on tremor in ET and PD will help practicing physicians delineate the two diseases. PMID:23717300

Return to Play After Forearm and Hand Injuries in the National Basketball Association.

PubMed

Morse, Kyle W; Hearns, Krystle A; Carlson, Michelle Gerwin

2017-02-01

Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Descriptive epidemiology study. The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play ( P < .05). All thumb ligament tears required surgery and had the longest return to play of 67.5 ± 17.7 days ( P < .05). The return to play for surgically treated metacarpal fractures (56.7 ± 26.3 days) was significantly greater than nonsurgically treated metacarpal fractures (26.3 ± 12.1 days; P < .01). Return to play for surgically repaired phalangeal fractures (46.2 ± 10.8 days) trended greater but was not significantly different than phalangeal fractures treated nonsurgically (33.3 ± 28.5 days; P = .21). Hand injuries in professional basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries.

Broken Toe

MedlinePlus

... fracture is severe — particularly if it involves your big toe — you may need a cast or even surgery to ensure proper healing. Most broken toes heal well, usually within four to six weeks. Sometimes, a broken toe may become infected ...

Age-related reduction and independent predictors of toe flexor strength in middle-aged men.

PubMed

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Iwase, Mitsunori; Yokochi, Takashi

2017-01-01

Toe flexor muscles play an important role in posture and locomotion, and poor toe flexor strength is a risk factor for falls. In this cross-sectional study, we estimated the age-related change in toe flexor strength and compared it with that of handgrip strength. Independent factors predicting toe flexor and handgrip strength were also determined. A total of 1401 male (aged 35-59 years) study participants were divided into five groups according to their chronological age; 35-39, 40-44, 45-49, 50-54, and 55-59 years. Toe flexor and handgrip strength, anthropometry, and resting blood pressure were measured. Fasting blood samples were collected to measure blood glucose, triglycerides, high- and low-density lipoprotein-cholesterols, and albumin. A self-administered lifestyle questionnaire was conducted. Decline in absolute toe flexor and handgrip strength began in the age groups 50-55 and 55-59 years, respectively. In comparison to the mean values of the youngest group, relative toe flexor strength (87.0 ± 26.6%) was significantly lower than handgrip strength (94.4 ± 13.1%) for the oldest group. Multiple regression analyses showed that independent factors predicting both toe flexor and handgrip strength were lean body mass, age, serum albumin, drinking habit, and fat mass. Additionally, fasting blood glucose, diastolic blood pressure, sleeping time and exercise habit were predicting factors of toe flexor strength but not of handgrip strength. Age-related reduction in toe flexor strength was earlier and greater than handgrip strength, and toe flexor strength reflects body composition and metabolic status.

Toe-to-hand transfer: Evolving Indications and Relevant Outcomes

PubMed Central

Waljee, Jennifer F.; Chung, Kevin C.

2014-01-01

In the late 19th century, the first toe to hand transfer was performed in Vienna, Switzerland as a staged procedure by Nicolandi.(1) Since that time, the advent of microsurgery has revolutionized toe to hand transfers. In 1966, Buncke performed the first microvascular toe to thumb transfer in a rhesus monkey.(2) The first toe to thumb transfer using microsurgical techniques in humans was performed by Cobbett in 1969, followed shortly thereafter by the first transfer of a second toe to the thumb position.(3,4) Today, due to expanding microsurgical techniques and surgeon innovation, the indications and techniques for toe-to-hand transfer procedures continue to evolve and now encompass patients with a variety of acquired and congenital hand defects.(5) PMID:23790426

Bunions

MedlinePlus

... toe turned toward the other toes and may cross over the second toe. Corns and calluses develop as a result where the first and second toes overlap. Difficulty wearing regular shoes. You may have problems finding shoes that fit or that do not cause pain.

Toe spreading ability in men with chronic pelvic pain syndrome

PubMed Central

Yilmaz, Ugur; Rothman, Ivan; Ciol, Marcia A; Yang, Claire C; Berger, Richard E

2005-01-01

Background We examined toe-spreading ability in subjects with chronic pelvic pain syndrome (CPPS) to test the hypothesis that subjects with CPPS could have deficiencies in lower extremity functions innervated by sacral spinal roots. Methods Seventy two subjects with CPPS and 98 volunteer controls were examined as part of a larger study on CPPS. All the subjects underwent a detailed urologic and neurological examination including a toe-spreading examination with a quantitative scoring system. We compared the groups in terms of ability of toe-spreading as either "complete" (all toes spreading) or "incomplete" (at least one interdigital space not spreading) and also by comparing the number of interdigital spaces. For CPPS subjects only, we also analyzed the variation of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scales by toe-spreading categories. Results CPPS subjects were less often able to spread all toes than subjects without CPPS (p = 0.005). None of the NIH-CPSI sub-scales (pain, urinary symptoms, and quality of life), nor the total score showed an association with toe spreading ability. Conclusion We found toe spreading to be diminished in subjects with CPPS. We hypothesize that incomplete toe spreading in subjects with CPPS may be related to subtle deficits involving the most caudal part of the spinal segments. PMID:15949041

Effects of Speed and Visual-Target Distance on Toe Trajectory During the Swing Phase of Treadmill Walking

NASA Technical Reports Server (NTRS)

Miller, Christopher A.; Feiveson, Al; Bloomberg, Jacob J.

2007-01-01

Toe trajectory during swing phase is a precise motor control task that can provide insights into the sensorimotor control of the legs. The purpose of this study was to determine changes in vertical toe trajectory during treadmill walking due to changes in walking speed and target distance. For each trial, subjects walked on a treadmill at one of five speeds while performing a dynamic visual acuity task at either a far or near target distance (five speeds two targets distances = ten trials). Toe clearance decreased with increasing speed, and the vertical toe peak just before heel strike increased with increasing speed, regardless of target distance. The vertical toe peak just after toe-off was lower during near-target visual acuity tasks than during far-target tasks, but was not affected by speed. The ankle of the swing leg appeared to be the main joint angle that significantly affected all three toe trajectory events. The foot angle of the swing leg significantly affected toe clearance and the toe peak just before heel strike. These results will be used to enhance the analysis of lower limb kinematics during the sensorimotor treadmill testing, where differing speeds and/or visual target distances may be used.

Early reduction in toe flexor strength is associated with physical activity in elderly men.

PubMed

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Yokochi, Takashi

2016-05-01

[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18-23 years) and elderly (n=60, 65-88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men's mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men.

Paws for thought: comparative radiologic anatomy of the mammalian forelimb.

PubMed

Gough-Palmer, Antony L; Maclachlan, Jody; Routh, Andrew

2008-01-01

All mammals share a remarkably similar skeleton based on a common template. This commonality is particularly well illustrated by the versatile pentadactyl limb, upon which all mammalian limbs are based. For most mammals, the primary function of the forelimb is locomotion. The forelimb has been successfully adapted in mammals of all sizes and in terrestrial, arboreal, aquatic, and airborne environments. In primates, the forelimbs have developed such that speed and stamina have been sacrificed for an increased range of movement, which in turn has provided increased manual dexterity. For instance, chimpanzee hands are pronated and the fingers are flexed, and the phalanges are longer and exhibit much more robust insertion areas for flexor tendons. Ungulates (hoofed mammals), on the other hand, have evolved to maximize speed and stamina in quadrupedal locomotion. The two main orders of ungulates have elongated phalanges and metacarpals; all ungulates have lost the first metacarpal. The cat family represents some of the most highly evolved predators. Cats' forelimbs are designed for speed, power, and acceleration rather than for stamina; they maintain all five metacarpals and phalanges, although the first digit is relatively small. (c) RSNA, 2008

[Clinical and radiographic evaluation of a new percutaneous technique for moderate to severe hallux valgus deformity].

PubMed

Vélez-de Lachica, J C; Valdez-Jiménez, L A; Inzunza-Sánchez, J M

2017-01-01

Hallux valgus is considered the most common musculoskeletal deformity, with a prevalence of 88%. There are more than 130 surgical techniques for its treatment; currently, percutaneous ones are popular; however, they do not take into account the metatarsal-phalangeal correction angle. The aim of this study is to propose a modified technique for the correction of the percutaneous metatarsal-phalangeal and inter-metatarsal angles and to evaluate its clinical and radiological results. An experimental, prospective and longitudinal study in 10 patients with moderate to severe hallux valgus according to the classification of Coughlin and Mann were collected; the results were evaluated with the AOFAS scale at 15, 30, 60 and 90 days. The McBride technique and the technique of percutaneous anchor with the proposed amendment were performed. The AOFAS scale was applied as described, finding a progressive increase of the rating; the average correction of the inter-metatarsal angle was 8.8 degrees and of the metatarsal-phalangeal, 9.12. The modified technique of percutaneous anchor showed clear clinical and radiographic improvements in the short term. Our modified technique is proposed for future projects, including a large sample with long-term follow-up.

Urinary corticosterone responses to capture and toe-clipping in the cane toad (Rhinella marina) indicate that toe-clipping is a stressor for amphibians.

PubMed

Narayan, Edward J; Molinia, Frank C; Kindermann, Christina; Cockrem, John F; Hero, Jean-Marc

2011-11-01

Toe-clipping, the removal of one or more toes, is a common method used to individually mark free-living animals. Whilst this method is widely used in studies of amphibians, the appropriateness of the method, and its potential detrimental effects have been the subject of debate. Here, we provide for the first time, evidence that toe-clipping is a stressor in a wild amphibian. We measured urinary corticosterone responses of male cane toads (Rhinella marina) to capture and handling only, and to toe-clipping under field conditions. Urinary testosterone concentrations and white blood cell proportions were also measured. Urinary corticosterone metabolite concentrations increased 6h after capture and handling only and remained high for 24h; corticosterone returned to baseline levels after 48 h and remained low at 72 h post capture and handling. Corticosterone concentrations in toads subjected to toe-clipping increased at 6h to significantly higher concentrations than after capture and handling only, then decreased more slowly than after capture and handling, and were still elevated (approximately double basal level) 72 h after toe-clipping. Testosterone did not change significantly after capture and handling only, whereas after toe-clipping testosterone decreased at 6h and remained low at 72 h. There were weak short-term effects of toe-clipping compared with capture and handling only on white blood cell proportions. We have clearly shown that toe-clipping is a distinctly stronger stressor than capture and handling alone. This indicates that there is an ethical cost of toe-clipping, and this should be considered when planning studies of amphibians. Copyright © 2011 Elsevier Inc. All rights reserved.

Linking clinical measurements and kinematic gait patterns of toe-walking using fuzzy decision trees.

PubMed

Armand, Stéphane; Watelain, Eric; Roux, Emmanuel; Mercier, Moïse; Lepoutre, François-Xavier

2007-03-01

Toe-walking is one of the most prevalent gait deviations and has been linked to many diseases. Three major ankle kinematic patterns have been identified in toe-walkers, but the relationships between the causes of toe-walking and these patterns remain unknown. This study aims to identify these relationships. Clearly, such knowledge would increase our understanding of this gait deviation, and could help clinicians plan treatment. The large quantity of data provided by gait analysis often makes interpretation a difficult task. Artificial intelligence techniques were used in this study to facilitate interpretation as well as to decrease subjective interpretation. Of the 716 limbs evaluated, 240 showed signs of toe-walking and met inclusion criteria. The ankle kinematic pattern of the evaluated limbs during gait was assigned to one of three toe-walking pattern groups to build the training data set. Toe-walker clinical measurements (range of movement, muscle spasticity and muscle strength) were coded in fuzzy modalities, and fuzzy decision trees were induced to create intelligible rules allowing toe-walkers to be assigned to one of the three groups. A stratified 10-fold cross validation situated the classification accuracy at 81%. Twelve rules depicting the causes of toe-walking were selected, discussed and characterized using kinematic, kinetic and EMG charts. This study proposes an original approach to linking the possible causes of toe-walking with gait patterns.

Early reduction in toe flexor strength is associated with physical activity in elderly men

PubMed Central

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Yokochi, Takashi

2016-01-01

[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18–23 years) and elderly (n=60, 65–88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men’s mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men. PMID:27313353

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

Kinematic Gait Changes Following Serial Casting and Bracing to Treat Toe Walking in a Child With Autism.

PubMed

Barkocy, Marybeth; Dexter, James; Petranovich, Colleen

2017-07-01

To evaluate the effectiveness of serial casting in a child with autism spectrum disorder (ASD) exhibiting a toe-walking gait pattern with equinus contractures. Although many children with ASD toe walk, little research on physical therapy interventions exists for this population. Serial casting has been validated for use in idiopathic toe walking to increase passive dorsiflexion and improve gait, but not for toe walking in children with ASD. Serial casting followed by ankle-foot orthosis use was implemented to treat a child with ASD who had an obligatory equinus gait pattern. Gait analysis supported improvements in kinematic, spatial, and temporal parameters of gait, and the child maintained a consistent heel-toe gait at 2-year follow-up. STATEMENT OF CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE:: Serial casting followed by ankle-foot orthosis use is a viable treatment option for toe walking in children with ASD.

Modeling the effect of toe clipping on treefrog survival: Beyond the return rate

USGS Publications Warehouse

Waddle, J.H.; Rice, K.G.; Mazzotti, F.J.; Percival, H.F.

2008-01-01

Some studies have described a negative effect of toe clipping on return rates of marked anurans, but the return rate is limited in that it does not account for heterogeneity of capture probabilities. We used open population mark-recapture models to estimate both apparent survival (ϕ) and the recapture probability (p) of two treefrog species individually marked by clipping 2–4 toes. We used information-theoretic model selection to examine the effect of toe clipping on survival while accounting for variation in capture probability. The model selection results indicate strong support for an effect of toe clipping on survival of Green Treefrogs (Hyla cinerea) and only limited support for an effect of toe clipping on capture probability. We estimate there was a mean absolute decrease in survival of 5.02% and 11.16% for Green Treefrogs with three and four toes removed, respectively, compared to individuals with just two toes removed. Results for Squirrel Treefrogs (Hyla squirella) indicate little support for an effect of toe clipping on survival but may indicate some support for a negative effect on capture probability. We believe that the return rate alone should not be used to examine survival of marked animals because constant capture probability must be assumed, and our examples demonstrate how capture probability may vary over time and among groups. Mark-recapture models provide a method for estimating the effect of toe clipping on anuran survival in situations where unique marks are applied.

Immediate toe-to-hand transfer in acute hand injuries: overall results, compared with results for elective cases.

PubMed

Woo, Sang-Hyun; Kim, Joo-Sung; Seul, Jung-Hyun

2004-03-01

In the past 5 years, 25 mutilated digits were reconstructed with immediate toe-to-hand transfers after acute hand injuries, for 21 patients. The overall results of the immediate toe-to-hand transfers were evaluated and compared with the results of 65 elective procedures performed during the same period by the same surgeon. There were 15 cases of great toe-to-hand transfer for thumb reconstruction, two cases of second toe transfer for index finger reconstruction, and four cases of simultaneous two-toe transfer for reconstruction of multiple-digit amputations. Two cases (two of 25 cases, 8 percent) were successfully salvaged with emergency reexploration. The incidences of emergency reexploration and postoperative infection were not significantly different from those for elective toe-to-hand transfer cases. The duration of industrial insurance coverage was much shorter than for elective cases, averaging 225 days (p < 0.001). Approximately 44 percent of the patients maintained their original jobs after immediate toe-to-hand transfer. The subjective satisfaction self-assessment scores of aesthetic appearance and function for the newly reconstructed thumb averaged 80 and 88 (of a total score of 100), respectively. Although satisfaction was lower than for elective reconstruction (p < 0.001), it was higher than for reconstruction of other digits. The donor-site appearance after great toe harvesting was mostly unsatisfactory. Immediate toe-to-hand transfer provides many advantages over the elective procedure in acute hand injuries, including single-stage reconstruction, shortened convalescence, early return to work, and socioeconomic efficiency. Because there were no significant differences in the success rates, frequencies of complications, or ultimate functional results, immediate toe-to-hand transfer is a safe and reliable procedure that is indicated for specific cases of acute digital amputation.

Trabecular architecture of the manual elements reflects locomotor patterns in primates.

PubMed

Matarazzo, Stacey A

2015-01-01

The morphology of trabecular bone has proven sensitive to loading patterns in the long bones and metacarpal heads of primates. It is expected that we should also see differences in the manual digits of primates that practice different methods of locomotion. Primate proximal and middle phalanges are load-bearing elements that are held in different postures and experience different mechanical strains during suspension, quadrupedalism, and knuckle walking. Micro CT scans of the middle phalanx, proximal phalanx and the metacarpal head of the third ray were used to examine the pattern of trabecular orientation in Pan, Gorilla, Pongo, Hylobates and Macaca. Several zones, i.e., the proximal ends of both phalanges and the metacarpal heads, were capable of distinguishing between knuckle-walking, quadrupedal, and suspensory primates. Orientation and shape seem to be the primary distinguishing factors but differences in bone volume, isotropy index, and degree of anisotropy were seen across included taxa. Suspensory primates show primarily proximodistal alignment in all zones, and quadrupeds more palmar-dorsal orientation in several zones. Knuckle walkers are characterized by having proximodistal alignment in the proximal ends of the phalanges and a palmar-dorsal alignment in the distal ends and metacarpal heads. These structural differences may be used to infer locmotor propensities of extinct primate taxa.

Kaufman oculo-cerebro-facial syndrome in a child with small and absent terminal phalanges and absent nails.

PubMed

Kariminejad, Ariana; Ajeawung, Norbert Fonya; Bozorgmehr, Bita; Dionne-Laporte, Alexandre; Molidperee, Sirinart; Najafi, Kimia; Gibbs, Richard A; Lee, Brendan H; Hennekam, Raoul C; Campeau, Philippe M

2017-04-01

Kaufman oculo-cerebro-facial syndrome (KOS) is caused by recessive UBE3B mutations and presents with microcephaly, ocular abnormalities, distinctive facial morphology, low cholesterol levels and intellectual disability. We describe a child with microcephaly, brachycephaly, hearing loss, ptosis, blepharophimosis, hypertelorism, cleft palate, multiple renal cysts, absent nails, small or absent terminal phalanges, absent speech and intellectual disability. Syndromes that were initially considered include DOORS syndrome, Coffin-Siris syndrome and Dubowitz syndrome. Clinical investigations coupled with karyotype analysis, array-comparative genomic hybridization, exome and Sanger sequencing were performed to characterize the condition in this child. Sanger sequencing was negative for the DOORS syndrome gene TBC1D24 but exome sequencing identified a homozygous deletion in UBE3B (NM_183415:c.3139_3141del, p.1047_1047del) located within the terminal portion of the HECT domain. This finding coupled with the presence of characteristic features such as brachycephaly, ptosis, blepharophimosis, hypertelorism, short palpebral fissures, cleft palate and developmental delay allowed us to make a diagnosis of KOS. In conclusion, our findings highlight the importance of considering KOS as a differential diagnosis for patients under evaluation for DOORS syndrome and expand the phenotype of KOS to include small or absent terminal phalanges, nails, and the presence of hallux varus and multicystic dysplastic kidneys.

A Midterm Review of Lesser Toe Arthrodesis With an Intramedullary Implant.

PubMed

Harmer, James Lee; Wilkinson, Anthony; Maher, Anthony John

2017-10-01

Lesser toe deformities are one of the most common conditions encountered by podiatric surgeons. When conservative treatments fail surgical correction is indicated. Many surgical options have been described to address the complex nature of these deformities but no perfect solution has been reported to date. However, with the continued advancement of internal fixation technology, interphalangeal joint (IPJ) arthrodesis with an intramedullary implant may be a good option. This retrospective study presents patient reported outcomes and complications at 6 months and 3 years following lesser toe proximal interphalangeal joint (PIPJ) arthrodesis with a polyketone intrameduallary implant (Toe Grip, Orthosolutions, UK). Between September 2011 and November 2012, a total of 38 patients attended for second toe PIPJ arthrodesis by means of the Toe Grip device. At 6 months postoperation, 94.7% of patients and at 3 years postoperation, 92.8% of patients felt that their original complaint was better or much better. Health-related quality of life scores continued to improve overtime as measured by the Manchester Oxford Foot Questionnaire. Complications were generally observational and asymptomatic. The most common complications were floating toes (17.8%), mallet deformities (14.2%), metatarsalgia (17.8%), and transverse plane deformity of the toe (10.7%). This study demonstrates excellent patient-eported outcomes with minimal symptomatic complications making the "Toe Grip" implant a safe and effective alternative fixation device for IPJ arthrodesis when dealing with painful digital deformities. Therapeutic, Level IV: Case series.

Increased healing in diabetic toe ulcers in a multidisciplinary foot clinic-An observational cohort study.

PubMed

Almdal, T; Nielsen, A Anker; Nielsen, K E; Jørgensen, M E; Rasmussen, A; Hangaard, S; Siersma, V; Holstein, P E

2015-12-01

To study toe ulcer healing in patients with diabetic foot ulcers attending a multidisciplinary foot clinic over a 10 years period. The study was retrospective, consecutive and observational during 2001 through 2011. The patients were treated according to the International Consensus on the Diabetic Foot. During the period the chiropodist staffing in the foot clinic was doubled; new offloading material and orthopedic foot corrections for recalcitrant ulcers were introduced. Healing was investigated in toe ulcers in Cox regression models. 2634 patients developed foot ulcers, of which 1461 developed toe ulcers; in 790 patients these were neuropathic, in 551 they were neuro-ischemic and in 120 they were critically ischemic. One-year healing rates increased in the period 2001-2011 from 75% to 91% for neuropathic toe ulcers and from 72% to 80% for neuro-ischemic toe ulcers, while no changes was observed for ischemic toe ulcers. Adjusted for changes in the patient population, the overall rate of healing for neuropathic and neuro-ischemic toe ulcers almost doubled (HR=1.95 [95% CI: 1.36-2.80]). The results show that the healing of toe ulcers improved. This outcome could not be explained by changes in the patient characteristics, but coincided with a number of improvements in organization and therapy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Tactile Toe Agnosia and Percept of a "Missing Toe" in Healthy Humans.

PubMed

Cicmil, Nela; Meyer, Achim P; Stein, John F

2016-03-01

A disturbance of body representation is central to many neurological and psychiatric conditions, but the mechanisms by which body representations are constructed by the brain are not fully understood. We demonstrate a directional disturbance in tactile identification of the toes in healthy humans. Nineteen young adult participants underwent tactile stimulation of the digits with the eyes closed and verbally reported the identity of the stimulated digit. In the majority of individuals, responses to the second and third toes were significantly biased toward the laterally neighboring digit. The directional bias was greater for the nondominant foot and was affected by the identity of the immediately preceding stimulated toe. Unexpectedly, 9/19 participants reported the subjective experience of a "missing toe" or "missing space" during the protocol. These findings challenge current models of somatosensory localization, as they cannot be explained simply by a lack of distinct representations for toes compared with fingers, or by overt toe-finger correspondences. We present a novel theory of equal spatial representations of digit width combined with a "preceding neighbor" effect to explain the observed phenomena. The diagnostic implications for neurological disorders that involve "digit agnosia" are discussed. © The Author(s) 2015.

Effect of toe extension on EMG of triceps surae muscles during isometric dorsiflexion.

PubMed

Siddiqi, Ariba; Arjunan, Sridhar P; Kumar, Dinesh

2016-12-01

The protocol for estimating force of contraction by triceps surae (TS) muscles requires the immobilization of the ankle during dorsiflexion and plantar flexion. However, large variability in the results has been observed. To identify the cause of this variability, experiments were conducted where ankle dorsiflexion force and electromyogram (EMG) of the TS were recorded under two conditions: (i) toes were strapped and (ii) toes were unstrapped, with all other conditions such as immobilization of the ankle remaining unchanged. The root mean square (RMS) of the EMG and the force were analyzed and one-tail Student's t-test was performed for significance between the two conditions. The RMS of the EMG from TS muscles was found to be significantly higher (~55%) during dorsiflexion with toes unstrapped compared with when the toes were strapped. The torque corresponding to dorsiflexion was also higher with toes unstrapped. Our study has shown that it is important to strap the toes when measuring the torque at the ankle and EMG of the TS muscles.

[Distraction Osteogenesis is an Effective Method to Lengthen Digits in Congenital Malformations].

PubMed

Mann, M; Hülsemann, W; Winkler, F; Habenicht, R

2016-02-01

The aim of this study was to investigate the feasible amount of lengthening by distraction osteogenesis in congenital hand deficiencies. A total of 60 patients (1.6-17.8 years) underwent lengthening of 71 bones between 1994 and 2014. Bone lengthening was performed on 46 metacarpals and 25 phalanges. Mostly the first (n=30) and the fifth (n=21) rays were lengthened. Bone lengthening was performed to treat primarily symbrachydactyly (b=32) and amniotic band syndrome (n=10). To analyze the amount of lengthening preoperative radiographs and radiographs taken while removing the external fixator were compared. The charts were reviewed regarding age at surgery, duration of lengthening, duration of bony consolidation, complication, etc. The average of metacarpal distraction was 18.4 mm=73% lengthening with respect to the preoperative length; the average of phalange distraction was 14.0 mm=77% of the preoperative length. In both, metacarpals and phalanges, a lengthening of > 100% of the preoperative bone length was possible. In target length was reached in 89% of the procedures. The average time for consolidation was 6.1 (1-20) days/mm lengthening. The external fixator was in use on average for 140 (50-346) days. After removing of the external fixator an axial K-wire was used to stabilize the callus in 9 procedure, and an iliac bone craft plus axial K-wire in 11 procedures. The rate of complications was 30% (early consolidation, deviation, joint dislocation, pin infection, tendon dislocation). All complications could be treated without with acceptable results. Metacarpal and phalangeal distraction lengthening is an effective but demanding technique for ray reconstruction in congenital malformations of the hand. It is possible to lengthen a bone by more than 100%. Complications are common, but in most cases easy to handle. © Georg Thieme Verlag KG Stuttgart · New York.

Return to Play After Forearm and Hand Injuries in the National Basketball Association

PubMed Central

Morse, Kyle W.; Hearns, Krystle A.; Carlson, Michelle Gerwin

2017-01-01

Background: Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. Purpose: To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Study Design: Descriptive epidemiology study. Methods: The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. Results: One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play (P < .05). All thumb ligament tears required surgery and had the longest return to play of 67.5 ± 17.7 days (P < .05). The return to play for surgically treated metacarpal fractures (56.7 ± 26.3 days) was significantly greater than nonsurgically treated metacarpal fractures (26.3 ± 12.1 days; P < .01). Return to play for surgically repaired phalangeal fractures (46.2 ± 10.8 days) trended greater but was not significantly different than phalangeal fractures treated nonsurgically (33.3 ± 28.5 days; P = .21). Conclusion: Hand injuries in professional basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries. PMID:28251168

Hammertoe and Mallet Toe

MedlinePlus

... hammertoe and mallet toe may involve changing your footwear and wearing shoe inserts. If you have a ... linked to: Certain shoes. High-heeled shoes or footwear that's too tight in the toe box can ...

The effect of shoe toe box shape and volume on forefoot interdigital and plantar pressures in healthy females

PubMed Central

2013-01-01

Background Ill-fitting footwear can be detrimental to foot health with the forefoot being an area for most discomfort. Studies on footwear have primarily examined sports or orthopaedic prescription shoes and little is known about the effects that everyday flat shoes have on the forefoot. The aim of this study was to investigate the effect of toe box shape in a popular slip-on pump on dorsal and plantar pressures with particular interest around the forefoot in a healthy female population. Method A convenience sample of 27 female participants with no known foot pathologies was recruited. After assessment of foot size, plantar foot pressure and interdigital pressures were recorded for each of the 3 different toe box styles; round, square and pointed. Participants walked at a self-selected speed over a 10 m walkway whilst wearing each of the 3 styles of shoe and also whilst barefoot. Processed and analysed data extracted included peak pressure, time to peak pressure, contact time and pressure time integral. ANOVA and Freidman analysis was used to test for statistical significance. Results Shoes with a round toe showed least pressure around the medial aspect of the toes whilst the pointed shoe had least pressure on the lateral toes. Contact times for the plantar regions were not altered in any shoe condition yet contact around the medial aspect of the toes was highest in the pointed shoe. Conclusion This study highlights that the shape of the toe box in footwear can significantly influence the amount of pressure applied to the forefoot. Furthermore, the contours of the shoe also have an impact on the contact time and pressure time integral around the forefoot and also the peak plantar pressure in the toe region. The changes observed could be significant in the development of pathology in certain footwear toe box shapes. Consideration should be given to footwear design around the toe box to improve fit and reduce pressure. Further work is required to investigate the effect of toe box shape and volume on a pathological population with pressure related lesions. PMID:23886242

The effect of foot landing position on biomechanical risk factors associated with anterior cruciate ligament injury.

PubMed

Tran, Andrew A; Gatewood, Corey; Harris, Alex H S; Thompson, Julie A; Dragoo, Jason L

2016-12-01

Identification of biomechanical risk factors associated with anterior cruciate ligament (ACL) injury can facilitate injury prevention. The purpose of this study is to investigate the effects of three foot landing positions, "toe-in", "toe-out" and "neutral", on biomechanical risk factors for ACL injury in males and females. The authors hypothesize that 1) relative to neutral, the toe-in position increases the biomechanical risk factors for ACL injury, 2) the toe-out position decreases these biomechanical risk factors, and 3) compared to males, females demonstrate greater changes in lower extremity biomechanics with changes in foot landing position. Motion capture data on ten male and ten female volunteers aged 20-30 years (26.4 ± 2.50) were collected during double-leg jump landing activities. Subjects were asked to land on force plates and target one of three pre-templated foot landing positions: 0° ("neutral"), 30° internal rotation ("toe-in"), and 30° external rotation ("toe-out") along the axis of the anatomical sagittal plane. A mixed-effects ANOVA and pairwise Tukey post-hoc comparison were used to detect differences in kinematic and kinetic variables associated with biomechanical risk factors of ACL injury between the three foot landing positions. Relative to neutral, landing in the toe-in position increased peak hip adduction, knee internal rotation angles and moments (p < 0.01), and peak knee abduction angle (p < 0.001). Landing in the toe-in position also decreased peak hip flexion angle (p < 0.001) and knee flexion angle (p = 0.023). Landing in the toe-out position decreased peak hip adduction, knee abduction, and knee internal rotation angles (all p < 0.001). Male sex was associated with a smaller increase in hip adduction moment (p = 0.043) and knee internal rotation moment (p = 0.032) with toe-in landing position compared with female sex. Toe-in landing position exacerbates biomechanical risk factors associated with ACL injury, while toe-out landing position decreases these factors.

Biomechanical effects of a 2 suture-pass medial inter-implant mattress on transosseous-equivalent rotator cuff repair and considerations for a "technical efficiency ratio".

PubMed

Park, Maxwell C; Peterson, Alexander; Patton, John; McGarry, Michelle H; Park, Chong J; Lee, Thay Q

2014-03-01

Rotator cuff repair involving fewer tendon suture passes without compromising biomechanical performance would represent a technical advancement. An inter-implant "medial pulley-mattress" transosseous-equivalent (MP-TOE) repair requiring fewer tendon suture-passes was hypothesized to provide equivalent biomechanical characteristics compared to the control. In 6 human cadaveric shoulders, a transosseous-equivalent (TOE) repair (control) was performed utilizing 2 separate medial mattresses resulting in 4 tendon-bridging sutures. In 6 matched-pairs, 2 single-loaded anchors were used to create a medial inter-implant mattress construct (all sutures shuttled in 1 tendon pass per anchor)-after knot-tying, the same tendon-bridging pattern as the control was created. A materials testing machine cyclically loaded each repair from 10-180 N for 30 cycles; each repair subsequently underwent failure testing. Gap and strain were measured with a video digitizing system. A "technical efficiency ratio" (TER) was defined as: (#knots + #suture passes + #suture limbs)/#fixation points. Cyclic and failure testing demonstrated no significant differences between constructs. Gap formation at cycle 30 was 5.3 ± 0.8 mm (TOE) and 5.0 ± 0.3 mm (MP-TOE) (P = .62). Cycle 30 anterior strain values were -16.0 ± 7.3% (TOE) and -15.8 ± 6.6% (MP-TOE) (P = .99). Yield loads were 208.7 ± 2.7 N (TOE) and 204.0 ± 1.3 N (MP-TOE) (P = .17). Mode of failure demonstrated less tendon cut-out with the MP-TOE repair. The MP-TOE repair has a TER of 2.0 vs 2.5 for the control. The MP-TOE repair requiring fewer tendon suture passes, yet creating an additional inter-implant mattress configuration, is biomechanically equivalent to the original TOE technique, and may limit failure with improved medial load-sharing capacity. A TER may help quantify technical ease and help standardize comparisons between repair techniques. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

Safety and efficiency of the new micro-multiplane transoesophageal probe in paediatric cardiology.

PubMed

Hascoët, Sébastien; Peyre, Marianne; Hadeed, Khaled; Alacoque, Xavier; Chausseray, Gérald; Fesseau, Rose; Amadieu, Romain; Léobon, Bertrand; Berthomieu, Lionel; Dulac, Yves; Acar, Philippe

2014-01-01

Transoesophageal echocardiography (TOE) is feasible in neonates using a miniaturized probe, but is not widely used because of low imaging quality. To assess handling and imaging quality of a new release of a micro-TOE probe in children. Thirty-eight consecutive children, enrolled during February and May 2013, underwent TOE with the Philips S8-3t probe. Insertion, handling and image quality were assessed. The 38 children (aged 7days to 12years; weight 3.1-27kg) underwent 75 TOE (30 [40.0%] before cardiac surgery, 31 [41.3%] after cardiac surgery, 4 [5.3%] during a percutaneous procedure, 10 [13.3%] in the intensive care unit). Insertion of the micro-TOE probe was 'very easy' in 37/38 patients (97.4%). Handling was better in the lightest children (P=0.001). Image quality was mainly 'good' or 'very good', with no significant changes between preoperative and postoperative examinations or over time. Total scores (insertion, handling, image quality) were significantly better in the lightest children (P=0.02). Preoperative TOE did not provide additional information over transthoracic echocardiography. Postoperative TOE was useful to assess surgical results, but no residual lesions required extracorporeal circulation return. Micro-TOE was useful during the postoperative care of neonatal surgery with open breastbone to assess the surgical result and ventricular function. It was also useful to guide extracorporeal membrane oxygenation (ECMO) indication and withdrawal; and was a useful guide for percutaneous procedures. Micro-multiplane TOE is safe and efficient for use in neonates and children. This minimally invasive tool increases the impact of TOE in paediatric cardiology. Copyright © 2014. Published by Elsevier Masson SAS.

Toe Walking in Children

MedlinePlus

... walking sometimes can result from certain conditions, including cerebral palsy, muscular dystrophy and autism spectrum disorder. Symptoms Toe ... can prevent the heel from touching the ground. Cerebral palsy. Toe walking can be caused by a disorder ...

McArdle's disease: A differential diagnosis of idiopathic toe walking.

PubMed

Pomarino, David; Martin, Stephan; Pomarino, Andrea; Morigeau, Stefanie; Biskup, Saskia

2018-06-01

Idiopathic toe walking (ITW) is a pathological gait pattern in which children walk on their tip toes with no orthopedic or neurological reason. Physiological characteristics of the gastrocnemius muscles, the Achilles tendon, and the foot of toe walkers differ from subjects with a plantigrade walking pattern. McArdle's disease is characterized by the inability to break down muscle glycogen. It is an autosomal-recessive condition, characterized by low exercise tolerance, muscular atrophy at the shoulder girdle, episodes of myoglobinuria after vigorous physical activities and the occurrence of the second wind phenomenon. The aim of this review is to present the case studies of two subjects who were originally diagnosed as idiopathic toe walkers, but were then found to have McArdle's disease. This review will describe some physical characteristics that distinguish McArdle´s disease from Idiopathic toe walkers.

Toe transfer in congenital hand malformations.

PubMed

Foucher, G; Medina, J; Navarro, R; Nagel, D

2001-01-01

Fifty-eight patients with congenital hand abnormalities underwent 65 toe-to-hand transfers. Symbrachydactyly (51 cases) was the most frequent indication. Forty-seven second toe-to-hand transfers were performed in 44 patients. The mean follow-up time was 5.2 years. Two failures occurred in cases in which only one artery was anastomosed; no failures were noted when more than one artery fed the transfer. Two patients with a single second-toe transfer presented with lateral instability of the transferred metatarsophalangeal joint. The mean active range of motion was 38 degrees, with a mean extension lag of 25 degrees. The mean two-point discrimination was 5 mm. Forty-one patients used the transferred toe well, when performing activities of daily living and playing games. Toe-to-hand transfer, prior to the establishment of the grip pattern, facilitates integration of the transfer.

The effect of toe marker placement error on joint kinematics and muscle forces using OpenSim gait simulation.

PubMed

Xu, Hang; Merryweather, Andrew; Bloswick, Donald; Mao, Qi; Wang, Tong

2015-01-01

Marker placement can be a significant source of error in biomechanical studies of human movement. The toe marker placement error is amplified by footwear since the toe marker placement on the shoe only relies on an approximation of underlying anatomical landmarks. Three total knee replacement subjects were recruited and three self-speed gait trials per subject were collected. The height variation between toe and heel markers of four types of footwear was evaluated from the results of joint kinematics and muscle forces using OpenSim. The reference condition was considered as the same vertical height of toe and heel markers. The results showed that the residual variances for joint kinematics had an approximately linear relationship with toe marker placement error for lower limb joints. Ankle dorsiflexion/plantarflexion is most sensitive to toe marker placement error. The influence of toe marker placement error is generally larger for hip flexion/extension and rotation than hip abduction/adduction and knee flexion/extension. The muscle forces responded to the residual variance of joint kinematics to various degrees based on the muscle function for specific joint kinematics. This study demonstrates the importance of evaluating marker error for joint kinematics and muscle forces when explaining relative clinical gait analysis and treatment intervention.

In-Toeing and Out-Toeing in Children

PubMed Central

Wiley, James J.

1987-01-01

In-toeing and out-toeing problems are generally physiologic variants that arise from in utero posturing, and that gradually correct spontaneously during the active growing years of the child. Few torsional deformities result in genuine problems. Most residual effects are cosmetic, compounded by the anguish of concerned relatives and friends. Rarely is operative correction warranted. If corrective surgery comes under consideration, it is usually deferred until the patient reaches the age of 10. PMID:21263851

Correlation between toe flexor strength and ankle dorsiflexion ROM during the countermovement jump.

PubMed

Yun, Sung Joon; Kim, Moon-Hwan; Weon, Jong-Hyuck; Kim, Young; Jung, Sung-Hoon; Kwon, Oh-Yun

2016-08-01

[Purpose] This study assessed the relationships between peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Subjects and Methods] Eighteen healthy volunteers participated in the study. Each participant completed tests for peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Results] The results showed (1) a moderate correlation between ankle dorsiflexion range of motion and countermovement jump height and (2) a high correlation between peak first toe flexor muscle strength and countermovement jump height. Peak first toe flexor muscle strength and ankle dorsiflexion range of motion are the main contributors to countermovement jump performance. [Conclusion] These findings indicate that the measurement of peak first toe flexor muscle strength and ankle dorsiflexion range of motion may be useful in clinical practice for improving jump performance in athletes training for sports such as volleyball and basketball.

The effects of Taraxacum officinale extracts (TOE) supplementation on physical fatigue in mice.

PubMed

Jinchun, Zhang; Jie, Chen

2011-01-01

The study is to investigate the effect of Taraxacum officinale extracts (TOE) supplementation on physical fatigue based on the forced swimming capacity in mice. Forty Kunming male mice were randomly divided into 4 groups, i.e., normal control (NC) and three doses of TOE treated group (High-dose, Middle-dose and Low-dose). Three TOE treated groups were treated by oral TOE with 10, 30 and 100mg/kg b.w respectively for a period of 42 days. The normal control group was given a corresponding volume of sterile distilled water. After 6 weeks, the forced swimming capacity and blood biochemical parameters in mice were measured, and the result showed that TOE had an anti- physical fatigue effect. It enhanced the maximum swimming capacity of mice, effectively delayed the lowering of glucose in the blood, and prevented the increase in lactate and triglyceride concentrations.

Nailfold Capillaroscopy of Fingers and Toes - Variations of Normal.

PubMed

Lambova, Sevdalina Nikolova; Muller-Ladner, Ulf

2018-04-20

Nailfold capillaroscopy is the only method for morphological assessment of nutritive capillaries. The literature data about capillaroscopic findings in healthy individuals are scarce. To evaluate and compare the capillaroscopic findings of fingers and toes in healthy subjects. 22 healthy individuals were included in the study. Capillaroscopic examination was performed with videocapillaroscope Videocap 3.0 (DS Medica). Exclusion criteria were as follows: history of vasospasm, presence of accompanying diseases, taking any medications, arterial hypertension in first degree relatives, overweight or obesity (body mass index > 25kg/m2) and presence of chronic arterial or venous insufficiency. Poor visibility of nailfold capillaries was found significantly more frequently in the toes (22.7%, 5/22) as compared with fingers (0/22). Slight irregularities in capillary distribution and orientation to their parallel axis were significantly more common in the toes (31.8%, 7/22) as compared with fingers (9%, 2/22), (p<0.05). The mean diameter of the arterial (0.012±0.002mm) and the venous limb (0.017±0.002mm) of the toes did not differ significantly as compared to the respective parameters in the fingers (0.013±0.002mm for the arterial limb, p=0.46 and 0.018±0.002mm for the venous limb, p=0.25). The mean capillary density also did not differ significantly in the fingers and toes. The mean capillary length of the toes (0.165±0.096mm) was shorter as compared with hands (0.220±0.079mm), but the difference was not statistically significant (p=0.37). Presence of tortuous capillaries (>10%) was found significantly more often in the toes (12/22) as compared with fingers (6/22, χ2=6.769, p<0.05). Short capillary loops (length<100µm) were observed significantly more often in the toes (11/22 - toes, 1/22 - fingers, χ2=14.666, p<0.05). Capillaroscopic examination of the toes shows some differences as compared to those of the fingers such as greater number of cases with poor visibility and slight irregularities of distribution, greater number of shorter capillaries and increased tortuosity, which might be related to the thicker epidermis of the toes and increased capillary pressure due to gravity. The values of the major capillaroscopic parameters such as capillary diameters and capillary density in fingers and toes do not differ significantly. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The miR172 target TOE3 represses AGAMOUS expression during Arabidopsis floral patterning.

PubMed

Jung, Jae-Hoon; Lee, Sangmin; Yun, Ju; Lee, Minyoung; Park, Chung-Mo

2014-02-01

microRNA172 (miR172) regulates phase transition and floral patterning in Arabidopsis by repressing targets that encode the APETALA2 (AP2) and AP2-like transcription factors. The miR172-mediated repression of the AP2 gene restricts AGAMOUS (AG) expression. In addition, most miR172 targets, including AP2, redundantly act as floral repressors, and the overexpression of the target genes causes delayed flowering. However, how miR172 targets other than AP2 regulate both of the developmental processes remains unclear. Here, we demonstrate that miR172-mediated repression of the TARGET OF EAT 3 (TOE3) gene is critical for floral patterning in Arabidopsis. Transgenic plants that overexpress a miR172-resistant TOE3 gene (rTOE3-ox) exhibit indeterminate flowers with numerous stamens and carpelloid organs, which is consistent with previous observations in transgenic plants that overexpress a miR172-resistant AP2 gene. TOE3 binds to the second intron of the AG gene. Accordingly, AG expression is significantly reduced in rTOE3-ox plants. TOE3 also interacts with AP2 in the nucleus. Given the major role of AP2 in floral patterning, miR172 likely regulates TOE3 in floral patterning, at least in part via AP2. In addition, a miR156 target SQUAMOSA PROMOTER BINDING PROTEIN-LIKE 3 directly activates TOE3 expression, revealing a novel signaling interaction between miR156 and miR172 in floral patterning. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The DEP domain-containing protein TOE-2 promotes apoptosis in the Q lineage of C. elegans through two distinct mechanisms

PubMed Central

Gurling, Mark; Talavera, Karla; Garriga, Gian

2014-01-01

Neuroblast divisions in the nematode Caenorhabditis elegans often give rise to a larger neuron and a smaller cell that dies. We have previously identified genes that, when mutated, result in neuroblast divisions that generate daughter cells that are more equivalent in size. This effect correlates with the survival of daughter cells that would normally die. We now describe a role for the DEP domain-containing protein TOE-2 in promoting the apoptotic fate in the Q lineage. TOE-2 localized at the plasma membrane and accumulated in the cleavage furrow of the Q.a and Q.p neuroblasts, suggesting that TOE-2 might position the cleavage furrow asymmetrically to generate daughter cells of different sizes. This appears to be the case for Q.a divisions where loss of TOE-2 led to a more symmetric division and to survival of the smaller Q.a daughter. Localization of TOE-2 to the membrane is required for this asymmetry, but, surprisingly, the DEP domain is dispensable. By contrast, loss of TOE-2 led to loss of the apoptotic fate in the smaller Q.p daughter but did not affect the size asymmetry of the Q.p daughters. This function of TOE-2 required the DEP domain but not localization to the membrane. We propose that TOE-2 ensures an apoptotic fate for the small Q.a daughter by promoting asymmetry in the daughter cell sizes of the Q.a neuroblast division but by a mechanism that is independent of cell size in the Q.p division. PMID:24961802

Hallux valgus correction using transarticular lateral release with distal chevron osteotomy.

PubMed

Choi, Young Rak; Lee, Ho Seong; Jeong, Jae Jung; Kim, Sang Woo; Jeon, In-Ho; Lee, Dong Ho; Lee, Woo Chun

2012-10-01

Transarticular lateral release through a medial incision can avoid a dorsal incision. This study investigated outcomes following hallux valgus correction using transarticular lateral release, distal chevron metatarsal osteotomy and Akin phalangeal osteotomy through one medial incision. Between June 2004 and May 2009, a single surgeon performed a transarticular lateral release, distal chevron metatarsal osteotomy and Akin phalangeal osteotomy through one medial incision for hallux valgus on a total of 103 feet of 68 patients. The average patient age at the time of surgery was 51 years, and the average followup was 27 months. The average preoperative and final followup results were: 1) hallux valgus angle improvement from 29 degrees to 5 degrees, 2) intermetatarsal angle from 13 degrees to 5 degrees and 3) medial sesamoid bone position from 3 to 1 (p < 0.05 for each variable). The average AOFAS scores were improved from 49 to 92, and the VAS pain scores were improved from 7 to 1 (p < 0.05 for both variables). No patient had a serious complication such as infection, avascular necrosis, nonunion, transfer-metatarsalgia, or first metatarsophalangeal joint arthritis. Hallux valgus correction using transarticular lateral release, distal chevron metatarsal osteotomy and Akin phalangeal osteotomy through one medial incision was found to be effective and safe. The advantages include that the procedure is simple, early ambulation is possible, and there is no dorsal scarring.

Automated bone age assessment of older children using the radius

NASA Astrophysics Data System (ADS)

Tsao, Sinchai; Gertych, Arkadiusz; Zhang, Aifeng; Liu, Brent J.; Huang, Han K.

2008-03-01

The Digital Hand Atlas in Assessment of Skeletal Development is a large-scale Computer Aided Diagnosis (CAD) project for automating the process of grading Skeletal Development of children from 0-18 years of age. It includes a complete collection of 1,400 normal hand X-rays of children between the ages of 0-18 years of age. Bone Age Assessment is used as an index of skeletal development for detection of growth pathologies that can be related to endocrine, malnutrition and other disease types. Previous work at the Image Processing and Informatics Lab (IPILab) allowed the bone age CAD algorithm to accurately assess bone age of children from 1 to 16 (male) or 14 (female) years of age using the Phalanges as well as the Carpal Bones. At the older ages (16(male) or 14(female) -19 years of age) the Phalanges as well as the Carpal Bones are fully developed and do not provide well-defined features for accurate bone age assessment. Therefore integration of the Radius Bone as a region of interest (ROI) is greatly needed and will significantly improve the ability to accurately assess the bone age of older children. Preliminary studies show that an integrated Bone Age CAD that utilizes the Phalanges, Carpal Bones and Radius forms a robust method for automatic bone age assessment throughout the entire age range (1-19 years of age).

Brazilian Pediatric Reference Data for Quantitative Ultrasound of Phalanges According to Gender, Age, Height and Weight

PubMed Central

de Carvalho, Wellington Roberto Gomes; de Moraes, Anderson Marques; Roman, Everton Paulo; Santos, Keila Donassolo; Medaets, Pedro Augusto Rodrigues; Veiga-Junior, Nélio Neves; Coelho, Adrielle Caroline Lace de Moraes; Krahenbühl, Tathyane; Sewaybricker, Leticia Esposito; Barros-Filho, Antonio de Azevedo; Morcillo, Andre Moreno; Guerra-Júnior, Gil

2015-01-01

Aims To establish normative data for phalangeal quantitative ultrasound (QUS) measures in Brazilian students. Methods The sample was composed of 6870 students (3688 females and 3182 males), aged 6 to 17 years. The bone status parameter, Amplitude Dependent Speed of Sound (AD-SoS) was assessed by QUS of the phalanges using DBM Sonic BP (IGEA, Carpi, Italy) equipment. Skin color was obtained by self-evaluation. The LMS method was used to derive smoothed percentiles reference charts for AD-SoS according to sex, age, height and weight and to generate the L, M, and S parameters. Results Girls showed higher AD-SoS values than boys in the age groups 7–16 (p<0.001). There were no differences on AD-SoS Z-scores according to skin color. In both sexes, the obese group showed lower values of AD-SoS Z-scores compared with subjects classified as thin or normal weight. Age (r2 = 0.48) and height (r2 = 0.35) were independent predictors of AD-SoS in females and males, respectively. Conclusion AD-SoS values in Brazilian children and adolescents were influenced by sex, age and weight status, but not by skin color. Our normative data could be used for monitoring AD-SoS in children or adolescents aged 6–17 years. PMID:26043082

A Non-Contact Measurement System for the Range of Motion of the Hand

PubMed Central

Pham, Trieu; Pathirana, Pubudu N.; Trinh, Hieu; Fay, Pearse

2015-01-01

An accurate and standardised tool to measure the active range of motion (ROM) of the hand is essential to any progressive assessment scenario in hand therapy practice. Goniometers are widely used in clinical settings for measuring the ROM of the hand. However, such measurements have limitations with regard to inter-rater and intra-rater reliability and involve direct physical contact with the hand, possibly increasing the risk of transmitting infections. The system proposed in this paper is the first non-contact measurement system utilising Intel Perceptual Technology and a Senz3D Camera for measuring phalangeal joint angles. To enhance the accuracy of the system, we developed a new approach to achieve the total active movement without measuring three joint angles individually. An equation between the actual spacial position and measurement value of the proximal inter-phalangeal joint was established through the measurement values of the total active movement, so that its actual position can be inferred. Verified by computer simulations, experimental results demonstrated a significant improvement in the calculation of the total active movement and successfully recovered the actual position of the proximal inter-phalangeal joint angles. A trial that was conducted to examine the clinical applicability of the system involving 40 healthy subjects confirmed the practicability and consistency in the proposed system. The time efficiency conveyed a stronger argument for this system to replace the current practice of using goniometers. PMID:26225976

The Pace of Perceivable Extreme Climate Change

NASA Astrophysics Data System (ADS)

Tan, X.; Gan, T. Y.

2015-12-01

When will the signal of obvious changes in extreme climate emerge over climate variability (Time of Emergence, ToE) is a key question for planning and implementing measures to mitigate the potential impact of climate change to natural and human systems that are generally adapted to potential changes from current variability. We estimated ToEs for the magnitude, duration and frequency of global extreme climate represented by 24 extreme climate indices (16 for temperature and 8 for precipitation) with different thresholds of the signal-to-noise (S/N) ratio based on projections of CMIP5 global climate models under RCP8.5 and RCP4.5 for the 21st century. The uncertainty of ToE is assessed by using 3 different methods to calculate S/N for each extreme index. Results show that ToEs of the projected extreme climate indices based on the RCP4.5 climate scenarios are generally projected to happen about 20 years later than that for the RCP8.5 climate scenarios. Under RCP8.5, the projected magnitude, duration and frequency of extreme temperature on Earth will all exceed 2 standard deviations by 2100, and the empirical 50th percentile of the global ToE for the frequency and magnitude of hot (cold) extreme are about 2040 and 2054 (2064 and 2054) for S/N > 2, respectively. The 50th percentile of global ToE for the intensity of extreme precipitation is about 2030 and 2058 for S/N >0.5 and S/N >1, respectively. We further evaluated the exposure of ecosystems and human societies to the pace of extreme climate change by determining the year of ToE for various extreme climate indices projected to occur over terrestrial biomes, marine realms and major urban areas with large populations. This was done by overlaying terrestrial, ecoregions and population maps with maps of ToE derived, to extract ToEs for these regions. Possible relationships between GDP per person and ToE are also investigated by relating the mean ToE for each country and its average value of GDP per person.

29 CFR 1910.132 - General requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS Personal Protective Equipment § 1910.132 General requirements. (a... pay for non-specialty safety-toe protective footwear (including steel-toe shoes or steel-toe boots...

Emplacement of Pahoehoe Toe Networks: Observations of May, 2010 Tube-fed Flows at Kilauea Volcano, Hawai'i

NASA Astrophysics Data System (ADS)

Crown, D. A.; Ramsey, M.; Hon, K.

2010-12-01

Pahoehoe lava flows are compound features that consist of multiple overlapping and interfingering lobes and exhibit morphologically diverse surfaces characterized by channelized zones, smooth-surfaced sheets, and numerous, small toe networks. Previous work compiled detailed planform maps of solidified pahoehoe toe networks to document their morphology, morphometry and connective relationships in order to provide constraints on lava transport models. In order to expand this research to active flow emplacement, we observed slow-moving, tube-fed pahoehoe flows on the coastal plain near Kalapana, Hawaii in May, 2010. The evolution of pahoehoe toe and toe network characteristics over their emplacement history was examined and the role of small-scale flow inflation on the advance of pahoehoe lobes evaluated. We collected both visible video footage and high-speed, high-precision thermal infrared (TIR) data using a FLIR S-40 camera. The TIR data provide surface temperature maps that can be easily used to identify formation of new toes and track their growth and surface cooling. From these maps, lobe development, connective relationships, and frontal and lateral spreading rates can be analyzed. Preliminary results suggest that regular cycles of activity characterize the development of these pahoehoe lobes: 1) emplacement of new toes in local topographic lows at the front, margin, and within the interior of an active lobe forming small interconnected networks, 2) decline and sometimes temporary cessation in the production of new pahoehoe toes, 3) inflation of the recently emplaced flow surface, either partially or en masse depending on the rate of influx of new lava, the degree of irregularity of the pre-flow surface, and/or the slope across the recently emplaced lava surface, and 4) fracturing of the recently emplaced surface crust that feeds emplacement of new toes. Inflation fractures typically cut across several previously emplaced toes and can occur at the front, along the margins, or within the active lobe, even at significant distances behind the flow front.

Footwear

MedlinePlus

... the Big Toe Ailments of the Smaller Toes Diabetic Foot Treatments Injections and other Procedures Treatments of the ... Shoe IQ How to "Read" Your Shoes Custom Diabetic Shoes 10 Points of Proper Shoe Fit ... Footwear Page Content Do you experience disabling foot problems like bunions, corns, calluses or hammer toes? ...

Developmental and Behavioral Effects of Toe Clipping on Neonatal and Preweanling Mice with and without Vapocoolant Anesthesia

PubMed Central

Paluch, Lee-Ronn; Lieggi, Christine C; Dumont, Magali; Monette, Sebastien; Riedel, Elyn R; Lipman, Neil S

2014-01-01

Toe clipping is used to identify and genotype preweanling mice, but the procedure generates concerns relevant to pain and distress. The few pertinent studies available evaluated mice between postnatal days (PND) 3 and 7, advocate the use of toe clipping in mice PND 7 or younger, and identify handling as the most distressing aspect of the procedure. Because both toe and tail clipping may be necessary in older mice to obtain sufficient DNA for genotyping, we surmised that performing these procedures concurrently to minimize handling would be beneficial. We also examined reflex development until PND 21 and adult behavior at 8 to 10 wk of age in mice toe clipped at PND 7 or 17 and the benefits of using topical vapocoolant anesthesia. C57BL/6J pups at PND 7 and 17 were assigned to 1 of 4 groups: 1) clipping of digit 3 of contralateral fore- and hindpaws; 2) toe clipping after topical vapocoolant anesthesia; 3) unclipped, unsprayed controls; and, 4) unclipped and vapocoolant-sprayed. Compared with unanesthetized pups, those sprayed with vapocoolant vocalized and struggled more when handled and had more bleeding, erythema, and swelling, which persisted for as long as 12 h after toe clipping. Reflex development, anxiety, locomotion, and motor coordination were not different among groups or with regard to the age of toe clipping. No tissue reaction was noted microscopically in paws collected at 10 wk of age. We conclude that the use of vapocoolant cannot be recommended due to its harmful effects and that toe clipping at PND 7 or 17 does not significantly affect the long-term welfare of mice. PMID:24602538

Toe spatiotemporal differences between transition steps when ascending shorter flight stairways of different heights.

PubMed

Ajisafe, Toyin; Wu, Jianhua; Geil, Mark

2017-03-01

Studies have typically treated the first and second floor-to-stair transition steps (TS1 and TS2) as one stride. However, because the foot is devoid of plantar cutaneous input from the stair surface at TS1, these steps may have different toe spatiotemporal profiles, and resultantly, different susceptibilities to a trip and/or a fall. This study compared vertical toe clearance, forward velocity, and their respective variability magnitudes between TS1 and TS2 when ascending stairs of different heights. Twenty young adults (seven males and 13 females) (21.68 ± 2.49 years; 169.70 ± 9.56 cm; 63.91 ± 9.62 kg) negotiated an intervening three-step staircase placed midpoint on a 10 m walkway. There were three stair heights: low stairs (LS), medium stairs (MS), and high stairs (HS). Vertical toe clearance, forward velocity, and their variability magnitudes were calculated. Vertical toe clearance was only higher (P < 0.05) at TS1 than TS2 in the medium and high stairs. Vertical toe clearance was more variable (P < 0.05) in the low compared to medium stairs. Also, forward toe velocity was greater at TS1 than TS2, but was lower in the medium and high stairs. The locomotor system appeared cautious by exaggerating vertical toe clearance at both TS1 and TS2 only in low stairs, possibly due to higher forward toe velocity. If the exaggeration strategy consistently persists, this finding may suggest decreased trip or fall risk at both TS1 and TS2 only when transitioning onto low stairs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Antiphospholipid Antibodies and Recurrent Thrombotic Events: Persistence and Portfolio

PubMed Central

Amory, Colum F.; Levine, Steve R.; Brey, Robin L.; Gebregziabher, Mulugeta; Tuhrim, Stanley; Tilley, Barbara C.; Simpson, Ann-Catherin N.; Sacco, Ralph L.; Mohr, J.P.

2015-01-01

Background There are very limited prospective data on the significance of persistent of antiphospholipid antibodies (aPL) and recurrent thrombo-occlusive events (TOEs). We investigated the prognostic value of (1) two newer aPL assays, (2) an aPL portfolio, and (3) persistent aPL positivity following stroke. Methods 1,770 subjects from the APASS-WARSS study underwent further aPL testing for antibodies to phosphatidylserine (aPS) and β2-glycoprotein-I (anti-β2GPI) from stored sera. Follow-up aPL status was also tested in a subset of subjects. Primary analysis was based on time to any TOE (ischemic stroke, MI, TIA, DVT, PE, or systemic arterial occlusion)/death at 2 years. Cox proportional hazard analyses assessed whether aPL independently related to outcome. Results Persistent anti-β2GPI decreased the time to TOE/death after adjustment for potential confounders (HR=2.86, CI 1.21-6.76, p=0.017). When persistent anti-β2GPI was combined with another persistently positive aPL, time to TOE/death was also reduced (HR=3.79, CI 1.18-12.14, p=0.025). Neither persistent aCL, persistent aPS alone, nor a single positive anti-β2GPI or aPS was associated with decreased time to TOE/death. No single positive aPL, portfolio of baseline aPL, or any persistent aPL increased the rate of TOE/death. Conclusions Rates of TOE/death were not influenced by aPL results at baseline or follow-up. Persistent anti-β2GPI alone and with persistent second aPL were independently associated with decreased time to TOE/death. Persistent aPL, an aPL portfolio, and newer aPL in ischemic stroke patients are not helpful in predicting an increased rate of recurrent TOEs. PMID:26513489

Effect of Sweating on Insulation of Footwear.

PubMed

Kuklane, Kalev; Holmér, Ingvar

1998-01-01

The study aimed to find out the influence of sweating on footwear insulation with a thermal foot model. Simultaneously, the influence of applied weight (35 kg), sock, and steel toe cap were studied. Water to 3 sweat glands was supplied with a pump at the rate of 10 g/hr in total. Four models of boots with steel toe caps were tested. The same models were manufactured also without steel toe. Sweating reduced footwear insulation 19-25% (30-37% in toes). During static conditions, only a minimal amount of sweat evaporated from boots. Weight affected sole insulation: Reduction depended on compressibility of sole material. The influence of steel toe varied with insulation. The method of thermal foot model appears to be a practical tool for footwear evaluation.

Molded foot orthosis after great toe or medial ray amputations in diabetic feet.

PubMed

Due, T M; Jacobs, R L

1985-12-01

Necrosis of the tip of the next lateral remaining toe has been found to be a late complication of great toe and medial ray amputations in diabetic feet. The use of custom-molded insert foot orthoses helps avoid this complication.

29 CFR 1917.96 - Payment for protective equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... employer at no cost to employees. (b) The employer is not required to pay for non-specialty safety-toe protective footwear (including steel-toe shoes or steel-toe boots) and non-specialty prescription safety...

29 CFR 1917.96 - Payment for protective equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... employer at no cost to employees. (b) The employer is not required to pay for non-specialty safety-toe protective footwear (including steel-toe shoes or steel-toe boots) and non-specialty prescription safety...

29 CFR 1917.96 - Payment for protective equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... employer at no cost to employees. (b) The employer is not required to pay for non-specialty safety-toe protective footwear (including steel-toe shoes or steel-toe boots) and non-specialty prescription safety...

Effect of turf toe on foot contact pressures in professional American football players.

PubMed

Brophy, Robert H; Gamradt, Seth C; Ellis, Scott J; Barnes, Ronnie P; Rodeo, Scott A; Warren, Russell F; Hillstrom, Howard

2009-05-01

The relationship between turf toe and plantar foot pressures has not been extensively studied. Two hypotheses were tested in a cohort of professional American football players: first, that a history of turf toe is associated with increased peak hallucal and first metatarsophalangeal (MTP) plantar pressures; second, that decreased range of motion (ROM) of the first MTP correlates with increased peak hallucal and first MTP plantar pressures. Forty-four athletes from one National Football League (NFL) team were screened for a history of turf toe during preseason training. Dorsal passive MTP ROM and dynamic plantar pressures were measured in both feet of each player. Anatomical masking was used to assess peak pressure at the first MTP and hallux. First MTP dorsiflexion was significantly lower in halluces with a history of turf toe (40.6 +/- 15.1 degrees versus 48.4 +/- 12.8 degrees, p = 0.04). Peak hallucal pressures were higher in athletes with turf toe (535 +/- 288 kPa versus 414 +/- 202 kPa, p = 0.05) even after normalizing for athlete body mass index (p = 0.0003). Peak MTP pressure was not significantly different between the two groups tested. First MTP dorsiflexion did not correlate with peak hallucal or first MTP pressures. This study showed that turf toe is associated with decreased MTP motion. In addition, increased peak hallucal pressures were found. Further study is warranted to determine whether these pressures correlate with the severity of symptoms or progression of turf toe to first MTP arthritis.

Relationships Between Simple Toe Elevation Angle in the Standing Position and Dynamic Balance and Fall Risk Among Community-Dwelling Older Adults.

PubMed

Takatori, Katsuhiko; Matsumoto, Daisuke

2015-10-01

To investigate the relationships between toe elevation ability in the standing position and dynamic balance and fall risk among community-dwelling older adults. Cross-sectional survey. General community. Community-dwelling older adults (N = 287). Toe elevation angles in the standing position. Intra-rater and inter-rater reliability of measurements of the toe elevation angle was high (internal coefficient of correlation [ICC] (1,2) = 0.94 for the former and ICC (2,1) = 0.90 for the latter). Significant correlations were found between the toe elevation angle and age (r = -0.20, P < .01), 5-m walking time (r = -0.31, P < .01), Functional Reach Test (r = 0.36, P < .01), Timed Up and Go Test (r = -0.36, P < .01), and Chair Stand Test (r = 0.26, P < .01). Subjects who experienced a fall in the previous 6 months had a significantly lower toe elevation angle compared with subjects who did not experience a fall (t = 2.19, P < .05). Multiple regression analysis revealed that results of the Functional Reach Test (β = .22, P < .001) and Timed Up and Go Test (β = -0.74, P < .001) were significantly associated with the toe elevation angle. Toe elevation angle was an index of dynamic balance ability and appears to be a simple screening test for fall risk in community-dwelling older adults. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Flexor digitorum brevis transfer for floating toe prevention after Weil osteotomy: a cadaveric study.

PubMed

Lee, Lydia C; Charlton, Timothy P; Thordarson, David B

2013-12-01

A floating toe deformity occurs in many patients who undergo Weil osteotomies. It is likely caused by the failure of the windlass mechanism in shortening the metatarsal. For patients who require a proximal interphalangeal (PIP) joint arthroplasty or fusion in addition to a Weil osteotomy, the transfer of the flexor digitorum brevis (FDB) tendon to the PIP joint might restore the windlass mechanism and decrease the incidence of floating toes. Fourteen cadaveric foot specimens were examined to determine the effects of changing metatarsal length as well as tensioning the FDB tendon on the angle of the metatarsophalangeal (MTP) joint as a measure of a floating toe. Shortening and lengthening the second metatarsal resulted in a significant change in MTP angle (P = .03 and .02, respectively), though there was no clear relationship found between the amount of change in metatarsal length and the change in MTP angle. Transferring the FDB to a PIP arthroplasty site plantarflexed the MTP joint and corrected floating toes; the change in angle was significant compared with the control and shortening groups (P = .0001 and .002, respectively). This study supports the theory that change in length of the metatarsal, possibly via the windlass mechanism, plays a role in the pathophysiology of the floating toe deformity. Tensioning and transferring the FDB tendon into the PIP joint helped prevent the floating toe deformity in this cadaveric model. Continued research in this subject will help to refine methods of prevention and correction of the floating toe deformity.

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

Repair, Evaluation, Maintenance, and Rehabilitation Research Program. Stability of Toe Berm Armor Stone and Toe Buttressing Stone on Rubble-Mound Breakwaters and Jetties. Physical Model Investigation

DTIC Science & Technology

1989-09-01

Rehabilitation of Rubble-Mound Structure Toes. The first objective of this work unit was to gain an iinderstanding of the toe stability problems experi- enced ...6.75-FT WAVE FLUMES 12.0- 11.0 - Be10.0- z 0 8.0 0 n- 7.0- _U Z 0 0 6.0 --- (0cc 5.0- h 0 0 LADo cc 4.0 0 . 0 -3 -P - -2 - - 01.0-0.0- - 0_0 co 2.0

[Modification of the Furnas-Vilkki technic in the reconstruction of congenital or traumatic carpal hands].

PubMed

Foucher, G

1995-01-01

A technique is described for reconstruction of a pincer, by a second toe transfer, in traumatic and congenital deformities, leaving only the wrist. Transfer on the anterior aspect of the radius allows to benefit from the wrist mobility to compensate for the limited range of motion of the second toe. Proximal situation of the toe gives the possibility of harvesting plenty of tendons to balance the toe. Results have been encouraging in two traumatic and 6 congenital cases of peromelic type of symbrachydactyly.

Extreme Cost Growth: Themes from Six U.S. Air Force Major Defense Acquisition Programs

DTIC Science & Technology

2015-01-01

launch company SpaceX brought anti-trust litigation against the ULA as early as 2005, arguing that the agreement foreclosed competition. Legal maneuvering...was still under way through 2014. See “ SpaceX and ULA Go Toe-to-Toe Over EELV Contracts,” NASA Spaceflight.com, March 5, 2014. 16 Again, it is...December 9, 2014: http://www.rand.org/pubs/papers/P4748.html “ SpaceX and ULA Go Toe-to-Toe Over EELV Contracts,” NASA Spaceflight.com, March 5

A topical aqueous oxygen emulsion stimulates granulation tissue formation in a porcine second-degree burn wound.

PubMed

Li, Jie; Zhang, Yan-Ping; Zarei, Mina; Zhu, Linjian; Sierra, Jose Ollague; Mertz, Patricia M; Davis, Stephen C

2015-08-01

Oxygen is an essential substance for wound healing. Limited studies have shown that topical oxygen can influence healing. This study evaluated the effects of a Topical Oxygen Emulsion (TOE) on burn wound healing. A porcine second-degree burn wound model was used in the study. Burn wounds were randomly assigned to TOE, vehicle control, and no-treatment (air) groups. Effects of TOE on the granulation tissue formation and angiogenesis were studied using hematoxylin and eosin histological analysis. Protein production and gene expression of types I and III collagen and vascular endothelial growth factor (VEGF) were determined using immunofluorescent staining and Reverse Transcription and Polymerase Chain Reaction (RT-PCR), respectively. The TOE treated wounds exhibited better angiogenesis and granulation tissue formation by histology examination. The immunofluorescence staining and RT-PCR analysis demonstrated that protein production and mRNA expression of VEGF and collagen III were significantly higher in TOE treatment group than vehicle alone and air control groups, while there was no significant difference in the level of collagen I. Our data demonstrate that TOE enhances burn wound healing via stimulating the expression of VEGF and type III collagen and strongly indicates the potential use of TOE in wounds. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Clinical and biomechanical changes following a 4-month toe-out gait modification program for people with medial knee osteoarthritis: a randomized controlled trial.

PubMed

Hunt, M A; Charlton, J M; Krowchuk, N M; Tse, C T F; Hatfield, G L

2018-04-27

To compare changes in knee pain, function, and loading following a 4-month progressive walking program with or without toe-out gait modification in people with medial tibiofemoral knee osteoarthritis. Individuals with medial knee osteoarthritis were randomized to a 4-month program to increase walking activity with (toe-out) or without (progressive walking) concomitant toe-out gait modification. The walking program was similar between the two groups, except that the gait modification group was trained to walk with 15° more toe-out. Primary outcomes included: knee joint pain (WOMAC), foot progression angles and knee joint loading during gait (knee adduction moment (KAM)). Secondary outcomes included WOMAC function, timed stair climb, and knee flexion moments during gait. Seventy-nine participants (40 in toe-out group, 39 in progressive walking group) were recruited. Intention-to-treat analysis showed no between-group differences in knee pain, function, or timed stair climb. However, the toe-out group exhibited significantly greater changes in foot progression angle (mean difference = -9.04° (indicating more toe-out), 95% CI: -11.22°, -6.86°; P < 0.001), late stance KAM (mean difference = -0.26 %BW*ht, 95% CI: -0.39 %BW*ht, -0.12 %BW*ht, P < 0.001) and KAM impulse (-0.06 %BW*ht*s, 95% CI: -0.11 %BW*ht*s, -0.01 %BW*ht*s; P = 0.031) compared to the progressive walking group at follow-up. The only between-group difference that remained at a 1-month retention assessment was foot progression angle, with greater changes in the toe-out group (mean difference = -6.78°, 95% CI: -8.82°, -4.75°; P < 0.001). Though both groups experienced improvements in self-reported pain and function, only the toe-out group experienced biomechanical improvements. NCT02019108. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Comparison of Two Alternate Methods for Tracking Toe Clearance

NASA Technical Reports Server (NTRS)

Miller, Christopher A.; Feiveson, Alan H.; Bloomberg, Jacob J.

2007-01-01

Analyses of toe clearance during the swing phase of locomotion has often been utilized in determining a subject s propensity to trip while either walking or stepping over an obstacle. In the literature, toe clearance has been studied using a marker on the superior aspect of the second toe (rtoe), a marker on the lateral aspect of the fifth metatarsal head (mth5), or a virtual marker positioned at the anterior tip of the toe (vtoe). The purpose of this study was to compute toe clearance and associated parameters using a fifth metatarsal marker and a virtual toe marker, and compare the results with those of the standard toe marker. Subjects walked on a motorized treadmill at five different speeds while performing a visual acuity task at two separate target distances (ten 60-second trials). The minimum vertical height (TCl) was determined for each stride, along with its point of occurence in the gait cycle, and the angles of the foot and ankle at that time. A regression analysis was performed on the vtoe and mth5 results versus rtoe individually. For all TCl parameters, the mth5 marker did not correlate well with rtoe; the vtoe marker showed better agreement. Most importantly, the mth5 marker predicted a later occurence of TCl than rtoe and vtoe - thereby missing the most dangerous point in swing phase for a trip. From this analysis, the vtoe marker proved to be a better analog to rtoe than mth5, especially for determining a subject s propensity to trip.

From tails to toes: developing nonlethal tissue indicators of mercury exposure in five amphibian species.

PubMed

Pfleeger, Adam Z; Eagles-Smith, Collin A; Kowalski, Brandon M; Herring, Garth; Willacker, James J; Jackson, Allyson K; Pierce, John R

2016-04-01

Exposure to environmental contaminants has been implicated as a factor in global amphibian decline. Mercury (Hg) is a particularly widespread contaminant that biomagnifies in amphibians and can cause a suite of deleterious effects. However, monitoring contaminant exposure in amphibian tissues may conflict with conservation goals if lethal take is required. Thus, there is a need to develop non-lethal tissue sampling techniques to quantify contaminant exposure in amphibians. Some minimally invasive sampling techniques, such as toe-clipping, are common in population-genetic research, but it is unclear if these methods can adequately characterize contaminant exposure. We examined the relationships between mercury (Hg) concentrations in non-lethally sampled tissues and paired whole-bodies in five amphibian species. Specifically, we examined the utility of three different tail-clip sections from four salamander species and toe-clips from one anuran species. Both tail and toe-clips accurately predicted whole-body THg concentrations, but the relationships differed among species and the specific tail-clip section or toe that was used. Tail-clips comprised of the distal 0-2 cm segment performed the best across all salamander species, explaining between 82 and 92% of the variation in paired whole-body THg concentrations. Toe-clips were less effective predictors of frog THg concentrations, but THg concentrations in outer rear toes accounted for up to 79% of the variability in frog whole-body THg concentrations. These findings suggest non-lethal sampling of tails and toes has potential applications for monitoring contaminant exposure and risk in amphibians, but care must be taken to ensure consistent collection and interpretation of samples.

Your Bones

MedlinePlus

... part of the foot is similar to the hand, with five bones. Each toe has three tiny bones, except for your big toe, which has just two. This brings the bone total in both feet and ankles to 52! Most people don't use their toes and feet for grabbing stuff or writing, but they do use them for two very ...

A pictorial review of reconstructive foot and ankle surgery: hallux abductovalgus

PubMed Central

Meyr, Andrew J; Singh, Salil; Chen, Oliver; Ali, Sayed

2015-01-01

This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for the hallux abductovalgus or “bunion” deformity. Our goal is to define objective radiographic parameters that surgeons utilize to initially define deformity, lead to procedure selection and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries. First, relevant radiographic measurements are defined and their role in procedure selection explained. Second, the specific surgical procedures of the distal metatarsal, metatarsal shaft, metatarsal base, and phalangeal osteotomies are described in detail. Additional explanations of arthrodesis of the first metatarsal-phalangeal and metatarsal-cuneiform joints are also provided. Finally, specific plain film radiographic findings that judge post-operative outcomes for each procedure are detailed. PMID:26622935

In-vivo investigation of material quality of bone tissue by measuring apparent phalangeal ultrasound transmission velocity.

PubMed

Kann, P; Schulz, U; Klaus, D; Piepkorn, B; Beyer, J

1995-01-01

The square of ultrasound transmission velocity in a material is related to the modulus of elasticity, which is known to be an indicator of stability in bone. The aim of our study was to use ultrasound transmission velocity to obtain information about the material properties of bone tissue, keeping other factors possibly influencing ultrasound transmission as constant as possible. Apparent phalangeal ultrasound transmission velocity (APU) measured in 54 isolated, fresh pig phalanges was shown to be independent of bone mineral density (BMD) measured by SPA. Fastest sound transmission led exclusively through cortical bone so that intertrabecular connectivity in spongious bone could not influence the result. In humans APU was measured in the mediolateral direction at the midphalanx of the middle finger. In 53 healthy subjects (15-81 years old; 27 women, 26 men), there was a decrease of APU with age (r = -0.30, p < 0.05). Further, when comparing the results of both hands intraindividually almost identical values indicated constant intraindividual architecture of bone at this location. There was no evidence for a relation of APU to physical load comparing dominant and nondominant hand and relating the results to subjectively estimated physical load. In a second group of 43 perimenopausal women (47-60 years old), APU, which again decreased with age (r = -0.33, p < 0.05), was found not to be correlated to BMD measured by SPA at the distal forearm (cortical bone).(ABSTRACT TRUNCATED AT 250 WORDS)

Receptor tyrosine kinase-like orphan receptor 2 (ROR2) and Indian hedgehog regulate digit outgrowth mediated by the phalanx-forming region.

PubMed

Witte, Florian; Chan, Danny; Economides, Aris N; Mundlos, Stefan; Stricker, Sigmar

2010-08-10

Elongation of the digit rays resulting in the formation of a defined number of phalanges is a process poorly understood in mammals, whereas in the chicken distal mesenchymal bone morphogenetic protein (BMP) signaling in the so-called phalanx-forming region (PFR) or digit crescent (DC) seems to be involved. The human brachydactylies (BDs) are inheritable conditions characterized by variable degrees of digit shortening, thus providing an ideal model to analyze the development and elongation of phalanges. We used a mouse model for BDB1 (Ror2(W749X/W749X)) lacking middle phalanges and show that a signaling center corresponding to the chick PFR exists in the mouse, which is diminished in BDB1 mice. This resulted in a strongly impaired elongation of the digit condensations due to reduced chondrogenic commitment of undifferentiated distal mesenchymal cells. We further show that a similar BMP-based mechanism accounts for digit shortening in a mouse model for the closely related condition BDA1 (Ihh(E95K/E95K)), altogether indicating the functional significance of the PFR in mammals. Genetic interaction experiments as well as pathway analysis in BDB1 mice suggest that Indian hedgehog and WNT/beta-catenin signaling, which we show is inhibited by receptor tyrosine kinase-like orphan receptor 2 (ROR2) in distal limb mesenchyme, are acting upstream of BMP signaling in the PFR.

Towards Robot-Assisted Echocardiographic Monitoring in Catheterization Laboratories : Usability-Centered Manipulator for Transesophageal Echocardiography.

PubMed

Pahl, Christina; Ebelt, Henning; Sayahkarajy, Mostafa; Supriyanto, Eko; Soesanto, Amiliana

2017-08-15

This paper proposes a robotic Transesophageal Echocardiography (TOE) system concept for Catheterization Laboratories. Cardiovascular disease causes one third of all global mortality. TOE is utilized to assess cardiovascular structures and monitor cardiac function during diagnostic procedures and catheter-based structural interventions. However, the operation of TOE underlies various conditions that may cause a negative impact on performance, the health of the cardiac sonographer and patient safety. These factors have been conflated and evince the potential of robot-assisted TOE. Hence, a careful integration of clinical experience and Systems Engineering methods was used to develop a concept and physical model for TOE manipulation. The motion of different actuators of the fabricated motorized system has been tested. It is concluded that the developed medical system, counteracting conflated disadvantages, represents a progressive approach for cardiac healthcare.

Time of emergence in regional precipitation changes: an updated assessment using the CMIP5 multi-model ensemble

NASA Astrophysics Data System (ADS)

Nguyen, Thuy-Huong; Min, Seung-Ki; Paik, Seungmok; Lee, Donghyun

2018-01-01

This study conducted an updated time of emergence (ToE) analysis of regional precipitation changes over land regions across the globe using multiple climate models from the Coupled Model Intercomparison Project phase 5 (CMIP5). ToEs were estimated for 14 selected hotspots over two seasons of April to September (AS) and October to March (OM) from three RCP scenarios representing low (RCP2.6), medium (RCP4.5), and high (RCP8.5) emissions. Results from the RCP8.5 scenario indicate that ToEs would occur before 2040 over seven hotspots including three northern high-latitude regions (OM wettening), East Africa (OM wettening), South Asia (AS wettening), East Asia (AS wettening) and South Africa (AS drying). The Mediterranean (both OM and AS drying) is expected to experience ToEs in the mid-twenty-first century (2040-2080). In order to measure possible benefits from taking low-emission scenarios, ToE differences were examined between the RCP2.6 scenario and the RCP4.5 and RCP8.5 scenarios. Significant ToE delays from 26 years to longer than 67 years were identified over East Africa (OM wettening), the Mediterranean (both AS and OM drying), South Asia (AS wettening), and South Africa (AS drying). Further, we investigated ToE differences between CMIP3-based and CMIP5-based models using the same number of models for the comparable scenario pairs (SRESA2 vs. RCP8.5, and SRESB1 vs. RCP4.5). Results were largely consistent between two model groups, indicating the robustness of ToE results. Considerable differences in ToEs (larger than 20 years) between two model groups appeared over East Asia and South Asia (AS wettening) and South Africa (AS drying), which were found due to stronger signals in CMIP5 models. Our results provide useful information on the timing of emerging signals in regional and seasonal hydrological changes, having important implications for associated adaptation and mitigation plans.

Operative Outcomes of Grade 3 Turf Toe Injuries in Competitive Football Players.

PubMed

Smith, Kenneth; Waldrop, Norman

2018-06-01

Turf toe is a term used to describe a hyperextension injury to the first metatarsophalangeal joint. Although the vast majority of turf toe injuries can be treated successfully without operative intervention, there are instances where surgery is required to allow the athlete to return to play. Although there is a plethora of literature on turf toe injuries and nonoperative management, there are currently few reports on operative outcomes in athletes. We obtained all cases of turf toe repair according to the ICD-10 procedural code. The inclusion criteria included: age greater than 16, turf toe injury requiring operative management and at least a varsity level high school football player. The charts were reviewed for age, BMI, level of competition, injury mechanism, football position, setting of injury and playing surface. In addition, we recorded the specifics of the operative procedure, a listing of all injured structures, the implants used and the great toe range of motion at final follow-up visit. The AOFAS Hallux score and VAS was used postoperatively as our outcome measures. Our patient population included 15 patients. The average follow-up time was 27.5 months. The average patient was 19.3 years old with a body mass index of 32.3. The average playing time missed was 16.5 weeks. The average dorsiflexion range of motion at the final follow-up was 42.3 degrees. At final follow-up, the average AOFAS Hallux score was 91.3. The average VAS pain score was 0.7 at rest and 0.8 with physical activity. Complete turf toe injuries are often debilitating and may require operative management to restore a pain-free, stable, and functional forefoot. This study represents the largest cohort of operatively treated grade 3 turf toe injuries in the literature and demonstrates that good clinical outcomes were achieved with operative repair. Level IV, case series.

Antiphospholipid Antibodies and Recurrent Thrombotic Events: Persistence and Portfolio.

PubMed

Amory, Colum F; Levine, Steven R; Brey, Robin L; Gebregziabher, Mulugeta; Tuhrim, Stanley; Tilley, Barbara C; Simpson, Ann-Catherin C; Sacco, Ralph L; Mohr, Jay P

2015-01-01

There are very limited prospective data on the significance of persistent antiphospholipid antibodies (aPL) and recurrent thrombo-occlusive events (TOEs). We investigated the prognostic value of (1) 2 newer aPL assays, (2) an aPL portfolio and (3) persistent aPL positivity following stroke. A total of 1,770 subjects from the APASS-WARSS study underwent further aPL testing for antibodies to phosphatidylserine (aPS) and anti-β2-glycoprotein-I (anti-β2GPI) from stored sera. Follow-up aPL status was also tested in a subset of subjects. Primary analysis was based on time to any TOE (ischemic stroke, myocardial infarction, transient ischemic attack, deep vein thrombosis, pulmonary embolism or systemic arterial occlusion)/death at 2 years. Cox proportional hazard analyses assessed whether aPL independently related to outcome. Persistent anti-β2GPI decreased the time to TOE/death after adjustment for potential confounders (hazards ratio (HR) 2.86, 95% CI 1.21-6.76, p = 0.017). When persistent anti-β2GPI was combined with another persistently positive aPL, time to TOE/death was also reduced (HR 3.79, 95% CI 1.18-12.14, p = 0.025). Neither persistent anticardiolipin antibodies nor persistent aPS alone nor a single positive anti-β2GPI nor aPS was associated with decreased time to TOE/death. No single positive aPL, portfolio of baseline aPL or any persistent aPL increased the rate of TOE/death. Rates of TOE/death were not influenced by aPL results at baseline or follow-up. Persistent anti-β2GPI alone, and with persistent second aPL, was independently associated with decreased time to TOE/death. Persistent aPL, an aPL portfolio and newer aPL in ischemic stroke patients are not helpful in predicting an increased rate of recurrent TOEs. © 2015 S. Karger AG, Basel.

Gradual digital lengthening with autologous bone graft and external fixation for correction of flail toe in a patient with Raynaud's disease.

PubMed

Lamm, Bradley M; Ades, Joe K

2009-01-01

Iatrogenic flail toe is a complication of hammertoe surgery that occurs when an overaggressive resection of the proximal phalanx occurs. This can cause both functional and cosmetic concerns for the patient. We present a case report of the correction of a flail second toe in a patient with Raynaud's disease. The correction was achieved by means of gradual soft tissue lengthening with external fixation and an interposition autologous bone graft digital arthrodesis. After 5 months, this 2-stage procedure lengthened, stabilized, and restored the function of the toe. 4.

Toe-to-hand transfer.

PubMed

Yoshimura, M

1980-07-01

Toe-to-hand transfer was performed in 28 patients, involving 33 fingers, using microvascular technique. Of this number, 26 patients (31 fingers) had experienced trauma, and the remaining 2 patients (2 fingers) had a congenital deformity. The toew used for grafting were the great toe (1), the second tow (30), and third toe (2). Success was achieved in all cases, sensory recovery was good, and remarkable improvement was attained in function and cosmetic appearance. Metacarpal hand, amputation of thumb, and amputation thumb and three fingers were good indications for this procedure, which gave satisfactory aesthetic results, even in patients with amputation of single digits.

Accurate localization of organ representation areas on the feet & hands using the bi-digital O-ring test resonance phenomenon: its clinical implication in diagnosis & treatment--Part I.

PubMed

Omura, Y

1994-01-01

Accuracy of the widely used organ representation areas, currently used in different schools of foot and hand reflexology was evaluated using Bi-Digital O-Ring test resonance phenomenon. Our previous study indicated that mapping organ representation areas of the tongue using Bi-Digital O-Ring Test resonance phenomenon between 2 identical substances often provided more reliable clinical information for both diagnosis and treatment than the 2 widely used, but crude, traditional schools of Chinese tongue diagnosis. This same method was applied for the mapping of the organ representation areas on the feet and hands. We succeeded in mapping the following areas on human feet: 1) Middle (3rd) toe on the sole side represents the following starting from the tip: A) Head, B) Face with eye, ear, nose, and mouth (1st Digit) C) Neck and organs within the neck (narrow band of space between 1st crease after the 1st digit and crease at the junction of the beginning of the sole); 2) 2nd and 4th toe represent upper extremities, the beginning tip being fingers and hands. The crease at the base of these toes represents the shoulder. The 2nd toe represents right upper extremity, and the 4th toe represents left upper extremity; 3) 1st and 5th toes in both the right and left feet represent lower extremities with the tip being the toes and soles of feet. The crease at the base of these toes represents the inguinal area. The 1st toe of each foot represents right lower extremity, and 5th toe represents left lower extremity. The sole of the foot is divided into the following 3 distinctive sections. 1) Upper (1st) section represents organs in the chest cavity including 2 thymus glands, trachea, 2 lungs, with the heart between them, and with the esophagus appearing as a narrow band outside of the lung near and below the 1st and 2nd toe depending upon the individual. Chest section occupies the first 1/3 to 1/5 (on a relatively long foot) of the entire sole. The boundary between the chest and G.I. system can be approximately estimated by extending the length of the entire toe or up to 25% longer to the sole, but it can be accurately determined using a diaphragm tissue microscope slide as a reference control substance. 2) Middle (2nd) section represents Gastro-Intestinal system, including lower end of the esophagus, liver, stomach, spleen, gall bladder, pancreas, duodenum, jejunum, ileum, appendix, colon, and anus.(ABSTRACT TRUNCATED AT 400 WORDS)

Material and biofilm load of K wires in toe surgery: titanium versus stainless steel.

PubMed

Clauss, Martin; Graf, Susanne; Gersbach, Silke; Hintermann, Beat; Ilchmann, Thomas; Knupp, Markus

2013-07-01

Recurrence rates for toe deformity correction are high and primarily are attributable to scar contractures. These contractures may result from subclinical infection. We hypothesized that (1) recurrence of toe deformities and residual pain are related to low-grade infections from biofilm formation on percutaneous K wires, (2) biofilm formation is lower on titanium (Ti) K wires compared with stainless steel (SS) K wires, and (3) clinical outcome is superior with the use of Ti K wires compared with SS K wires. In this prospective nonrandomized, comparative study, we investigated 135 lesser toe deformities (61 patients; 49 women; mean ± SD age, 60 ± 15 years) temporarily fixed with K wires between August 2010 and March 2011 (81 SS, 54 Ti). K wires were removed after 6 weeks. The presence of biofilm-related infections was analyzed by sonication. High bacterial loads (> 500 colony-forming units [CFU]/mL) were detected on all six toes requiring revision before 6 months. Increased bacterial load was associated with pain and swelling but not recurrence of the deformity. More SS K wires had greater than 100 CFU/mL bacteria than Ti K wires. For K wires with a bacterial count greater than 100 CFU/mL, toes with Ti K wires had a lower recurrence rate, less pain, and less swelling than toes with SS K wires. Ti K wires showed superior clinical outcomes to SS K wires. This appears to be attributable to reduced infection rates. Although additional study is needed, we currently recommend the use of Ti K wires for the transfixation of toe deformities. Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Importance and challenges of measuring intrinsic foot muscle strength

PubMed Central

2012-01-01

Background Intrinsic foot muscle weakness has been implicated in a range of foot deformities and disorders. However, to establish a relationship between intrinsic muscle weakness and foot pathology, an objective measure of intrinsic muscle strength is needed. The aim of this review was to provide an overview of the anatomy and role of intrinsic foot muscles, implications of intrinsic weakness and evaluate the different methods used to measure intrinsic foot muscle strength. Method Literature was sourced from database searches of MEDLINE, PubMed, SCOPUS, Cochrane Library, PEDro and CINAHL up to June 2012. Results There is no widely accepted method of measuring intrinsic foot muscle strength. Methods to estimate toe flexor muscle strength include the paper grip test, plantar pressure, toe dynamometry, and the intrinsic positive test. Hand-held dynamometry has excellent interrater and intrarater reliability and limits toe curling, which is an action hypothesised to activate extrinsic toe flexor muscles. However, it is unclear whether any method can actually isolate intrinsic muscle strength. Also most methods measure only toe flexor strength and other actions such as toe extension and abduction have not been adequately assessed. Indirect methods to investigate intrinsic muscle structure and performance include CT, ultrasonography, MRI, EMG, and muscle biopsy. Indirect methods often discriminate between intrinsic and extrinsic muscles, but lack the ability to measure muscle force. Conclusions There are many challenges to accurately measure intrinsic muscle strength in isolation. Most studies have measured toe flexor strength as a surrogate measure of intrinsic muscle strength. Hand-held dynamometry appears to be a promising method of estimating intrinsic muscle strength. However, the contribution of extrinsic muscles cannot be excluded from toe flexor strength measurement. Future research should clarify the relative contribution of intrinsic and extrinsic muscles during intrinsic foot muscle strength testing. PMID:23181771

Measuring systolic ankle and toe pressure using the strain gauge technique--a comparison study between mercury and indium-gallium strain gauges.

PubMed

Broholm, Rikke; Wiinberg, Niels; Simonsen, Lene

2014-09-01

Measurement of the ankle and toe pressures are often performed using a plethysmograph, compression cuffs and a strain gauge. Usually, the strain gauge contains mercury but other alternatives exist. From 2014, the mercury-containing strain gauge will no longer be available in the European Union. The aim of this study was to compare an indium-gallium strain gauge to the established mercury-containing strain gauge. Consecutive patients referred to the Department of Clinical Physiology and Nuclear Medicine at Bispebjerg and Frederiksberg Hospitals for measurements of systolic ankle and toe pressures volunteered for the study. Ankle and toe pressures were measured twice with the mercury and the indium-gallium strain gauge in random order. Comparison of the correlation between the mean pressure using the mercury and the indium-gallium device and the difference between the two devices was performed for both toe and ankle level. A total of 53 patients were included (36 male). Mean age was 69 (range, 45-92 years). Mean pressures at toe and ankle level with the mercury and the indium-gallium strain gauges were 77 (range, 0-180) mm Hg and 113 (range, 15-190) mm Hg, respectively. Comparison between the mercury and the indium-gallium strain gauge showed a difference in toe blood pressure values of - 0.7 mm Hg (SD: 7.0). At the ankle level, a difference of 2.0 mm Hg (SD: 8.6) was found. The two different devices agree sufficiently in the measurements of systolic ankle and toe pressure for the indium-gallium strain gauge to replace the mercury strain gauge.

[Second toe transfer in congenital hand differences].

PubMed

Dautel, G; Barbary, S

2008-12-01

In congenital hand differences, microsurgical toe transfer involves the creation of one or several rays in a child that never possessed them before. Second toe transplantation was uniformly used in this series that include 65 consecutive cases. Etiologies were represented by symbrachydactyly, constriction band syndrome or central cleft hand. Second toe transfer was performed with or without the MTP joint and followed by proximal ray resection of the donor toe. In the vast majority of theses cases, transplantation was performed in adactylic or monodactylic hand, the ultimate functional goal was the creation of a "tip-to-tip" two fingers pinch. Implantation site was chosen according to the situation of the existing finger(s). The existence of a functioning recipient MCP joint was one of the key factors of the final functional outcome. There were two vascular failures in this series with complete necrosis of the transplanted toe. Two additional toes appeared mediocre with respect to the overall transfer integration. The final mobility of the fingers reconstructed was measured using the total active motion score. Average TAM was poor (42 degrees +/-24 degrees ). In 12 out of 15 patients that were evaluated with a follow-up of at least five years, the static two-point discrimination was found to be excellent (less than 6mm). Our series did not allow us to establish a firm correlation between the type of nerve suture used and the quality of sensory recovery. Growth was measured as a percentage of the intact second toe (68 to 95%). All children on a long term basis had a normal gait without any impediment during sports or leisure activities. Clinical results obtained in this series lead to think that the cerebral cortex has got some plasticity which allows the integration of the transplants.

Nonlinear finite element analysis of the plantar fascia due to the windlass mechanism.

PubMed

Cheng, Hsin-Yi Kathy; Lin, Chun-Li; Chou, Shih-Wei; Wang, Hsien-Wen

2008-08-01

Tightening of plantar fascia by passively dorsiflexing the toes during walking has functional importance. The purpose of this research was to evaluate the influence of big toe dorsiflexion angles upon plantar fascia tension (the windlass effect) with a nonlinear finite element approach. A two-dimensional finite element model of the first ray was constructed for biomechanical analysis. In order to imitate the windlass effect and to evaluate the mechanical responses of the plantar fascia under various conditions, 12 model simulations--three dorsiflexion angles of the big toe (45 degrees, 30 degrees, and 15 degrees), two plantar fascia properties (linear, nonlinear), and two weightbearing conditions (with body weight, without body weight)--were designed and analyzed. Our results demonstrated that nonlinear modeling of the plantar fascia provides a more sophisticated representation of experimental data than the linear one. Nonlinear plantar fascia setting also predicted a higher stress distribution along the fiber directions especially with larger toe dorsiflexion angles (45 degrees>30 degrees>15 degrees). The plantar fascia stress was found higher near the metatarsal insertion and faded as it moved toward the calcaneal insertion. Passively dorsiflexing the big toe imposes tension onto the plantar fascia. Windlass mechanism also occurs during stance phase of walking while the toes begin to dorsiflex. From a biomechanical standpoint, the plantar fascia tension may help propel the body upon its release at the point of push off. A controlled stretch via dorsiflexing the big toe may have a positive effect on treating plantar fasciitis by providing proper guidance for collagen regeneration. The windlass mechanism is also active during the stance phase of walking when the toes begin to dorsiflex.

Plantar pressure distribution of ostrich during locomotion on loose sand and solid ground

PubMed Central

Han, Dianlei; Ma, Songsong; Luo, Gang; Ji, Qiaoli; Xue, Shuliang; Yang, Mingming; Li, Jianqiao

2017-01-01

Background The ostrich is a cursorial bird with extraordinary speed and endurance, especially in the desert, and thus is an ideal large-scale animal model for mechanic study of locomotion on granular substrate. Methods The plantar pressure distributions of ostriches walking/running on loose sand/solid ground were recorded using a dynamic pressure plate. Results The center of pressure (COP) on loose sand mostly originated from the middle of the 3rd toe, which differed from the J-shaped COP trajectory on solid ground. At mid-stance, a high-pressure region was observed in the middle of the 3rd toe on loose sand, but three high-pressure regions were found on solid ground. The gait mode significantly affected the peak pressures of the 3rd and 4th toes (p = 1.5 × 10−6 and 2.39 × 10−8, respectively), but not that of the claw (p = 0.041). The effects of substrate were similar to those of the gait mode. Discussion Ground reaction force trials of each functional part showed the 3rd toe bore more body loads and the 4th toe undertook less loads. The pressure distributions suggest balance maintenance on loose sand was provided by the 3rd and 4th toes and the angle between their length axes. On loose sand, the middle of the 3rd toe was the first to touch the sand with a smaller attack angle to maximize the ground reaction force, but on solid ground, the lateral part was the first to touch the ground to minimize the transient loading. At push-off, the ostrich used solidification properties of granular sand under the compression of the 3rd toe to generate sufficient traction. PMID:28761792

Comparison of implant cost and surgical time in arthroscopic transosseous and transosseous equivalent rotator cuff repair.

PubMed

Black, Eric M; Austin, Luke S; Narzikul, Alexa; Seidl, Adam J; Martens, Kelly; Lazarus, Mark D

2016-09-01

We investigated the cost savings associated with arthroscopic transosseous (anchorless) double-row rotator cuff repair compared with double-row anchored (transosseous-equivalent [TOE]) repair. All patients undergoing double-row arthroscopic rotator cuff repair from 2009 to 2012 by a single surgeon were eligible for inclusion. The study included 2 consecutive series of patients undergoing anchorless or TOE repair. Excluded from the study were revision repairs, subscapularis repairs, patients with poor tendon quality or excursion requiring medialized repair, and partial repairs. Rotator cuff implant costs (paid by the institution) and surgical times were compared between the 2 groups, controlling for rotator cuff tear size and additional procedures performed. The study included 344 patients, 178 with TOE repairs and 166 with anchorless repairs. Average implant cost for TOE repairs was $1014.10 ($813.00 for small, $946.67 for medium, $1104.56 for large, and $1507.29 for massive tears). This was significantly more expensive compared with anchorless repairs, which averaged $678.05 ($659.75 for small, $671.39 for medium, $695.55 for large, and $716.00 for massive tears). Average total operative time in TOE and anchorless groups was not significantly different (99 vs. 98 minutes). There was larger (although not statistically significant) case time variation in the TOE group. Compared with TOE repair, anchorless rotator cuff repair provides substantial implant-related cost savings, with no significant differences in surgical time for medium and large rotator cuff tears. Case time for TOE repair varied more with extremes in tear size. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Non-MTC gait cycles: An adaptive toe trajectory control strategy in older adults.

PubMed

Santhiranayagam, Braveena K; Sparrow, W A; Lai, Daniel T H; Begg, Rezaul K

2017-03-01

Minimum-toe-clearance (MTC) above the walking surface is a critical representation of toe-trajectory control due to its association with tripping risk. Not all gait cycles exhibit a clearly defined MTC within the swing phase but there have been few previous accounts of the biomechanical characteristics of non-MTC gait cycles. The present report investigated the within-subject non-MTC gait cycle characteristics of 15 older adults (mean 73.1 years) and 15 young controls (mean 26.1 years). Participants performed the following tasks on a motorized treadmill: preferred speed walking, dual task walking (carrying a glass of water) and a dual-task speed-matched control. Toe position-time coordinates were acquired using a 3 dimensional motion capture system. When MTC was present, toe height at MTC (MTC height ) was extracted. The proportion of non-MTC gait cycles was computed for the age groups and individuals. For non-MTC gait cycles an 'indicative' toe height at the individual's average swing phase time (MTC time ) for observed MTC cycles was averaged across multiple non-MTC gait cycles. In preferred-speed walking Young demonstrated 2.9% non-MTC gait cycles and Older 18.7%. In constrained walking conditions both groups increased non-MTC gait cycles and some older adults revealed over 90%, confirming non-MTC gait cycles as an ageing-related phenomenon in lower limb trajectory control. For all participants median indicative toe-height on non-MTC gait cycles was greater than median MTC height . This result suggests that eliminating the biomechanically hazardous MTC event by adopting more of the higher-clearance non-MTC gait cycles, is adaptive in reducing the likelihood of toe-ground contact. Copyright © 2017 Elsevier B.V. All rights reserved.

From tails to toes: developing nonlethal tissue indicators of mercury exposure in five amphibian species

USGS Publications Warehouse

Pfleeger, Adam Z.; Eagles-Smith, Collin A.; Kowalski, Brandon M.; Herring, Garth; Willacker, James J.; Jackson, Allyson K.; Pierce, John

2016-01-01

Exposure to environmental contaminants has been implicated as a factor in global amphibian decline. Mercury (Hg) is a particularly widespread contaminant that biomagnifies in amphibians and can cause a suite of deleterious effects. However, monitoring contaminant exposure in amphibian tissues may conflict with conservation goals if lethal take is required. Thus, there is a need to develop non-lethal tissue sampling techniques to quantify contaminant exposure in amphibians. Some minimally invasive sampling techniques, such as toe-clipping, are common in population-genetic research, but it is unclear if these methods can adequately characterize contaminant exposure. We examined the relationships between mercury (Hg) concentrations in non-lethally sampled tissues and paired whole-bodies in five amphibian species. Specifically, we examined the utility of three different tail-clip sections from four salamander species and toe-clips from one anuran species. Both tail and toe-clips accurately predicted whole-body THg concentrations, but the relationships differed among species and the specific tail-clip section or toe that was used. Tail-clips comprised of the distal 0–2 cm segment performed the best across all salamander species, explaining between 82 and 92 % of the variation in paired whole-body THg concentrations. Toe-clips were less effective predictors of frog THg concentrations, but THg concentrations in outer rear toes accounted for up to 79 % of the variability in frog whole-body THg concentrations. These findings suggest non-lethal sampling of tails and toes has potential applications for monitoring contaminant exposure and risk in amphibians, but care must be taken to ensure consistent collection and interpretation of samples.

Agility, gnosis, and graphaesthesia for the toes and fingers in children: normative data (ages 7-14 years).

PubMed

Richards, P M; Persinger, M A

2004-01-01

The differential representation of the toes/feet and fingers/hands along the medial and lateral surfaces of the cerebral cortices, respectively, may have diagnostic utility. Normative data for errors for toe and finger graphaesthesia and gnosis, as well as foot and finger agility, were collected for 86 children (ages 7 to 14). The fingers were more agile than the feet, and the right side of the body was more agile than the left side, regardless of age. A marked improvement in toe gnosis, but not in finger gnosis occurred in children after 11-12 years of age. A statistically significant interaction between laterality and gender was due to the greater numbers of errors for both toe and finger gnosis, displayed by girls for the left sides of their bodies compared to their right sides. This discrepancy was not significant for boys.

Idiopathic toe walking.

PubMed

Oetgen, Matthew E; Peden, Sean

2012-05-01

Toe walking is a bilateral gait abnormality in which a normal heel strike is absent and most weight bearing occurs through the forefoot. This abnormality may not be pathologic in patients aged <2 years, but it is a common reason for referral to an orthopaedic surgeon. Toe walking can be caused by several neurologic and developmental abnormalities and may be the first sign of a global developmental problem. Cases that lack a definitive etiology are categorized as idiopathic. A detailed history, with careful documentation of the developmental history, and a thorough physical examination are required in the child with a primary report of toe walking. Treatment is based on age and the severity of the abnormality. Management includes observation, stretching, casting, bracing, chemodenervation, and surgical lengthening of the gastrocnemius-soleus complex and/or Achilles tendon. An understanding of idiopathic toe walking as well as treatment options and their outcomes can help the physician individualize treatment to achieve optimal results.

Treatment of Idiopathic Toe-Walking in Children with Autism Using GaitSpot Auditory Speakers and Simplified Habit Reversal

ERIC Educational Resources Information Center

Marcus, Ann; Sinnott, Brigit; Bradley, Stephen; Grey, Ian

2010-01-01

This study aimed to examine the effectiveness of a simplified habit reversal procedure (SHR) using differential reinforcement of incompatible behaviour (DRI) and a stimulus prompt (GaitSpot Auditory Squeakers) to reduce the frequency of idiopathic toe-walking (ITW) and increase the frequency of correct heel-to-toe-walking in three children with…

16 CFR Figures 6 and 7 to Part 1512 - Toe Clearance and Chain Guard Requirements

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Toe Clearance and Chain Guard Requirements 6 Figures 6 and 7 to Part 1512 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS REQUIREMENTS FOR BICYCLES Pt. 1512, Figs. 6 and 7 Figures 6 and 7 to Part 1512—Toe...

16 CFR Figures 6 and 7 to Part 1512 - Toe Clearance and Chain Guard Requirements

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Toe Clearance and Chain Guard Requirements 6 Figures 6 and 7 to Part 1512 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS REQUIREMENTS FOR BICYCLES Pt. 1512, Figs. 6 and 7 Figures 6 and 7 to Part 1512—Toe...

76 FR 2648 - Hand Trucks and Certain Parts Thereof From the People's Republic of China: Preliminary Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-14

... the vertical frame, the handling area and the projecting edges or toe plate, and any combination... edge or edges, or toe plate, perpendicular or angled to the vertical frame, at or near the lower section of the vertical frame. The projecting edge or edges, or toe plate, slides under a load for...

Toe-to-hand transfer in symbrachydactyly.

PubMed

Richardson, Philip W F; Johnstone, Bruce R; Coombs, Christopher J

2004-07-01

Symbrachydactyly, or central atypical cleft, is classified as a failure of formation. For the adactylous or monodactylous forms, free toe transfer is the treatment of choice. We present 18 free toe transfers in 13 patients for symbrachydactyly. Despite abnormal anatomy, the functional building blocks have always been available and transfer technically possible. The result has been improved function and high levels of parental satisfaction.

Foot agility and toe gnosis/graphaesthesia as potential indicators of integrity of the medial cerebral surface: normative data and comparison with clinical populations.

PubMed

Persinger, M A; Richards, P M

1995-06-01

A protocol was designed to identify quantitative indicators of the function of the medial surfaces of the cerebral hemispheres. Normative data were collected from 40 volunteers for foot agility, toe gnosis, and toe graphaesthesia. A total of 100 patients (most of whom had been referred for possible closed-head injuries) completed thorough neuropsychological and cognitive assessments. Deficits for toe graphaesthesia were most consistently correlated with general brain impairment and with scores for tasks whose normal performance requires the integrity of structures within the dorsal half of the medial cerebral hemispheres.

Rupture of the extensor hood of the fifth toe: a rare injury.

PubMed

Venturini, Sara; Gaba, Suchi; Mangwani, Jitendra

2017-02-27

Closed injuries of the extensor hood of the lesser toes are rare and seldom reported in the literature. We present the case of a woman aged 25 years who presented to the orthopaedic fracture clinic with a 2-week history of pain in the left fifth toe and inability to extend following a ballet dancing session. Investigations showed no fracture on plain radiographs, but an ultrasound scan demonstrated rupture to the extensor hood of the little toe. Successful surgical repair of the extensor hood was performed, and the patient made a good recovery with return to dancing activities. 2017 BMJ Publishing Group Ltd.

Sudden death in spondylo-meta-epiphyseal dysplasia, short limb-abnormal calcification type.

PubMed

Dias, Cristina; Cairns, Robyn; Patel, Millan S

2009-01-01

The spondylo-meta-epiphyseal dysplasias are an expanding group of skeletal dysplasias with specific features differentiating each subtype. We review the precocious carpal mineralization, unique metacarpal shape, triangular distal phalanges and mushroom cloud-shaped proximal phalanges present at an early age in spondylo-meta-epiphyseal dysplasia, short limb-abnormal calcification type (SMED SL-AC) and report two patients with clinical and radiographic features consistent with SMED SL-AC, who died suddenly because of spinal cord compression. The patients presented are female siblings, providing further evidence for autosomal recessive inheritance. Cervical cord compression is found in half of reported patients and is the major cause of mortality. SMED SL-AC should be added to the list of genetic causes of sudden death. Radiological features in the hand may be used in the first few years of life to support an early diagnosis and thus allow for prevention of premature demise.

Human grasp assist device and method of use

NASA Technical Reports Server (NTRS)

Linn, Douglas Martin (Inventor); Ihrke, Chris A. (Inventor); Diftler, Myron A. (Inventor)

2012-01-01

A grasp assist device includes a glove portion having phalange rings, contact sensors for measuring a grasping force applied by an operator wearing the glove portion, and a tendon drive system (TDS). The device has flexible tendons connected to the phalange rings for moving the rings in response to feedback signals from the sensors. The TDS is connected to each of the tendons, and applies an augmenting tensile force thereto via a microcontroller adapted for determining the augmenting tensile force as a function of the grasping force. A method of augmenting a grasping force of an operator includes measuring the grasping force using the sensors, encoding the grasping force as the feedback signals, and calculating the augmenting tensile force as a function of the feedback signals using the microcontroller. The method includes energizing at least one actuator of a tendon drive system (TDS) to thereby apply the augmenting tensile force.

Plantar-plate disruptions: "the severe turf-toe injury." three cases in contact athletes.

PubMed

Drakos, Mark C; Fiore, Russell; Murphy, Conor; DiGiovanni, Christopher W

2015-05-01

To present 3 cases of plantar-plate rupture and turf-toe injury in contact athletes at 1 university and to discuss appropriate diagnosis and treatment algorithms for each case. Turf toe is a common injury in athletes participating in outdoor cutting sports. However, it has been used as an umbrella term to describe many different injuries of the great toe. In some cases, the injury can be so severe that the plantar plate and sesamoid apparatus may be ruptured. These patients may be better managed with surgery than with traditional nonoperative interventions. Turf toe, plantar-plate disruption, sesamoid fracture. For stable injuries in which the plantar plate is not completely disrupted, nonoperative treatment with casting or a stiff-soled shoe, gradual weight bearing, and rehabilitation is the best practice. Unstable injuries require surgical intervention and plantar-plate repair. Turf toe and injury to the first metatarsophalangeal joint are relatively common injuries in athletes, but few researchers have detailed the operative and nonoperative treatments of plantar-plate disruption in these patients. We examine 3 cases that occurred over 4 seasons on a collegiate football team. Turf toe represents a wide array of pathologic conditions involving the first metatarsophalangeal joint. Stress and instability testing are key components to assess in determining whether surgical intervention is warranted to restore optimal function. Stiffer-soled shoes or shoes with steel-plate insertions may help to prevent these injuries and are useful tools for protection during the rehabilitation period.

The Development and Evaluation of an Online Formative Assessment upon Single-Player Game in E-Learning Environment

ERIC Educational Resources Information Center

Tsai, Fu-Hsing

2013-01-01

This study developed a game-based formative assessment, called tic-tac-toe quiz for single-player version (TRIS-Q-SP), in an energy education e-learning system. This assessment game combined tic-tac-toe with online assessment, and revised the rule of tic-tac-toe for stimulating students to use online formative assessment actively. Additionally, to…

Ultrasonography in determining pubertal growth and bone age.

PubMed

Torenek Ağırman, Kubra; Bilge, Osman Murat; Miloğlu, Özkan

2018-05-02

The purpose of this study is to evaluate the compatibility of ultrasonographic data with hand-wrist radiographs taken to determine the extent of pubertal growth and bone age in patients and investigate the usability of ionizing radiation-free ultrasonography instead of conventional radiography. In this study, a total of 120 children from 10 to 17 years old (mean age was 168 months ± 27.5 months) were treated with routine radiographs before orthodontic treatment, and ultrasonographic imaging was performed on the wrists the same day. Researchers examined the phalanges, sesamoid bone, and radial bone distal epiphysis-diaphysis comparatively in each patient by both imaging methods and statistical evaluation. There was no statistically significant difference between conventional radiography and ultrasonography values at 13 points except for PP1 (proximal phalanges of the first finger), PP2 (proximal phalanges of the second finger), and radial epiphysis (p > 0.05). PP1, PP2, and radial epiphysis showed a statistically significant difference (p < 0.05). The CBA (bone age obtained from conventional radiographs) of the females was found to be larger than their CA (chronological age) and their UBA (ultrasonographic bone age). For males; the means of the CBA, UBA and CA values close to each other. In females and males; there was a strong correlation between the CA, the UBA and the CBA (p < 0.01). Ultrasonography gives detailed information about epiphyseal diaphysis relations. It can be used as an alternative to conventional radiography in the detection of bone age and pubertal growth, owing to the absence of ionizing radiation.

Neuroleptic-induced "painful legs and moving toes" syndrome: successful treatment with clonazepam and baclofen.

PubMed

Sandyk, R

1990-12-01

The syndrome of "painful legs and moving toes" is characterised by spontaneous causalgic pain in the lower extremities associated with peculiar involuntary movements of the toes and feet. It has been observed after a variety of lesions affecting the posterior nerve roots, the spinal ganglia and the peripheral nerves. The pathophysiology of the syndrome is unknown. I report a patient who developed the syndrome during treatment for schizophrenia with the antipsychotic agent molindone hydrochloride. The patient's response to the combination of clonazepam and baclofen suggests that the pathophysiology of the "painful legs and moving toes" may be linked to impairment of spinal serotonergic and GABA functions.

[Therapy of the peromelic form of symbrachydactyly by double second-toe transplantation].

PubMed

Hülsemann, W; Preisser, P; Habenicht, R; Partecke, B-D

2002-09-01

From 1989 to 2001 eleven children with the peromelic type of symbrachydactyly underwent a staged double second toes transplantation for restoration of two finger rays. The second toe of the feet were transplanted first to the small finger position and in the second step to the thumb position. One failure occurred in the first toe transplantation and another developed a venous thrombosis with partial necrosis and eventually a useless ray. Eight children were reviewed retrospectively in a mean follow-up of 5.3 years. The ability to pinch was restored in four children. In all patients without complications the function of the hand improved and the sensitivity was good.

Elastic modulus of tree frog adhesive toe pads.

PubMed

Barnes, W Jon P; Goodwyn, Pablo J Perez; Nokhbatolfoghahai, Mohsen; Gorb, Stanislav N

2011-10-01

Previous work using an atomic force microscope in nanoindenter mode indicated that the outer, 10- to 15-μm thick, keratinised layer of tree frog toe pads has a modulus of elasticity equivalent to silicone rubber (5-15 MPa) (Scholz et al. 2009), but gave no information on the physical properties of deeper structures. In this study, micro-indentation is used to measure the stiffness of whole toe pads of the tree frog, Litoria caerulea. We show here that tree frog toe pads are amongst the softest of biological structures (effective elastic modulus 4-25 kPa), and that they exhibit a gradient of stiffness, being stiffest on the outside. This stiffness gradient results from the presence of a dense network of capillaries lying beneath the pad epidermis, which probably has a shock absorbing function. Additionally, we compare the physical properties (elastic modulus, work of adhesion, pull-off force) of the toe pads of immature and adult frogs.

When will trends in European mean and heavy daily precipitation emerge?

NASA Astrophysics Data System (ADS)

Maraun, Douglas

2013-03-01

A multi-model ensemble of regional climate projections for Europe is employed to investigate how the time of emergence (TOE) for seasonal sums and maxima of daily precipitation depends on spatial scale. The TOE is redefined for emergence from internal variability only; the spread of the TOE due to imperfect climate model formulation is used as a measure of uncertainty in the TOE itself. Thereby, the TOE becomes a fundamentally limiting timescale and translates into a minimum spatial scale on which robust conclusions can be drawn about precipitation trends. Thus, minimum temporal and spatial scales for adaptation planning are also given. In northern Europe, positive winter trends in mean and heavy precipitation, and in southwestern and southeastern Europe, summer trends in mean precipitation already emerge within the next few decades. However, across wide areas, especially for heavy summer precipitation, the local trend emerges only late in the 21st century or later. For precipitation averaged to larger scales, the trend, in general, emerges earlier.

SPECT (HMPAO) support for activation of the medial prefrontal cortices during toe graphaesthesia.

PubMed

Persinger, M A; Webster, D; Tiller, S G

1998-08-01

This experiment was designed to test the construct validity of psychometric analyses that suggested a strong functional association between the accuracy for toe graphaesthesia and selective activation of neurons within the medial prefrontal regions. Single Photon Emission Computerized Tomography (SPECT) profiles were obtained for three volunteers (2 men, 1 woman) after they had been exposed to a toe graphaesthesia task or had been exposed to the control setting. The two measurements for each participant were separated by at least one week. Qualitative evaluation, using criteria employed for clinical diagnoses, of serial coronal, sagittal, and horizontal sections clearly indicated a specific increase in uptake of tracer within the rostral one-third to one-half of the medial prefrontal cortices of all three subjects during the toe graphaesthesia task compared to that during baseline conditions. The results are consistent with our neuropsychological research which indicates that toe graphaesthesia may be an accurate and useful indicator of the functional integrity of the medial surfaces of the anterior cerebral hemispheres.

A simplified model for TIG-dressing numerical simulation

NASA Astrophysics Data System (ADS)

Ferro, P.; Berto, F.; James, M. N.

2017-04-01

Irrespective of the mechanical properties of the alloy to be welded, the fatigue strength of welded joints is primarily controlled by the stress concentration associated with the weld toe or weld root. In order to reduce the effects of such notch defects in welds, which are influenced by tensile properties of the alloy, post-weld improvement techniques have been developed. The two most commonly used techniques are weld toe grinding and TIG dressing, which are intended to both remove toe defects such as non-metallic intrusions and to re-profile the weld toe region to give a lower stress concentration. In the case of TIG dressing the weld toe is re-melted to provide a smoother transition between the plate and the weld crown and to beneficially modify the residual stress redistribution. Assessing the changes to weld stress state arising from TIG-dressing is most easily accomplished through a complex numerical simulation that requires coupled thermo-fluid dynamics and solid mechanics. However, this can be expensive in terms of computational cost and time needed to reach a solution. The present paper therefore proposes a simplified numerical model that overcomes such drawbacks and which simulates the remelted toe region by means of the activation and deactivation of elements in the numerical model.

Plantar-Plate Disruptions: “The Severe Turf-Toe Injury.” Three Cases in Contact Athletes

PubMed Central

Drakos, Mark C.; Fiore, Russell; Murphy, Conor; DiGiovanni, Christopher W.

2015-01-01

Objective: To present 3 cases of plantar-plate rupture and turf-toe injury in contact athletes at 1 university and to discuss appropriate diagnosis and treatment algorithms for each case. Background: Turf toe is a common injury in athletes participating in outdoor cutting sports. However, it has been used as an umbrella term to describe many different injuries of the great toe. In some cases, the injury can be so severe that the plantar plate and sesamoid apparatus may be ruptured. These patients may be better managed with surgery than with traditional nonoperative interventions. Differential Diagnosis: Turf toe, plantar-plate disruption, sesamoid fracture. Treatment: For stable injuries in which the plantar plate is not completely disrupted, nonoperative treatment with casting or a stiff-soled shoe, gradual weight bearing, and rehabilitation is the best practice. Unstable injuries require surgical intervention and plantar-plate repair. Uniqueness: Turf toe and injury to the first metatarsophalangeal joint are relatively common injuries in athletes, but few researchers have detailed the operative and nonoperative treatments of plantar-plate disruption in these patients. We examine 3 cases that occurred over 4 seasons on a collegiate football team. Conclusions: Turf toe represents a wide array of pathologic conditions involving the first metatarsophalangeal joint. Stress and instability testing are key components to assess in determining whether surgical intervention is warranted to restore optimal function. Stiffer-soled shoes or shoes with steel-plate insertions may help to prevent these injuries and are useful tools for protection during the rehabilitation period. PMID:25695855

Customizing Extensor Reconstruction in Vascularized Toe Joint Transfers to Finger Proximal Interphalangeal Joints: A Strategic Approach for Correcting Extensor Lag.

PubMed

Loh, Charles Yuen Yung; Hsu, Chung-Chen; Lin, Cheng-Hung; Chen, Shih-Heng; Lien, Shwu-Huei; Lin, Chih-Hung; Wei, Fu-Chan; Lin, Yu-Te

2017-04-01

Vascularized toe proximal interphalangeal joint transfer allows the restoration of damaged joints. However, extensor lag and poor arc of motion have been reported. The authors present their outcomes of treatment according to a novel reconstructive algorithm that addresses extensor lag and allows for consistent results postoperatively. Vascularized toe joint transfers were performed in a consecutive series of 26 digits in 25 patients. The average age was 30.5 years, with 14 right and 12 left hands. Reconstructed digits included eight index, 10 middle, and eight ring fingers. Simultaneous extensor reconstructions were performed and eight were centralization of lateral bands, five were direct extensor digitorum longus-to-extensor digitorum communis repairs, and 13 were central slip reconstructions. The average length of follow-up was 16.7 months. The average extension lag was 17.9 degrees. The arc of motion was 57.7 degrees (81.7 percent functional use of pretransfer toe proximal interphalangeal joint arc of motion). There was no significant difference in the reconstructed proximal interphalangeal joint arc of motion for the handedness (p = 0.23), recipient digits (p = 0.37), or surgical experience in vascularized toe joint transfer (p = 0.25). The outcomes of different techniques of extensor mechanism reconstruction were similar in terms of extensor lag, arc of motion, and reconstructed finger arc of motion compared with the pretransfer toe proximal interphalangeal joint arc of motion. With this treatment algorithm, consistent outcomes can be produced with minimal extensor lag and maximum use of potential toe proximal interphalangeal joint arc of motion. Therapeutic, IV.

Effects of shoe sole geometry on toe clearance and walking stability in older adults.

PubMed

Thies, S B; Price, C; Kenney, L P J; Baker, R

2015-07-01

Thirty-five percent of people above age 65 fall each year, and half of their falls are associated with tripping: tripping, an apparently 'mundane' everyday problem, therefore, significantly impacts on older people's health and associated medical costs. To avoid tripping and subsequent falling, sufficient toe clearance during the swing phase is crucial. We previously found that a rocker-shaped shoe sole enhances toe clearance in young adults, thereby decreasing their trip-risk. This study investigates whether such sole design also enhances older adults' toe clearance, without inadvertently affecting their walking stability. Toe clearance and its variability are reported together with measures of walking stability for twelve older adults, walking in shoes with rocker angles of 10°, 15°, and 20°. Surface inclinations (flat, incline, decline) were chosen to reflect a potential real-world environment. Toe clearance increased substantially from the 10° to the 15° rocker angle (p=0.003) without compromising measures of walking stability (p>0.05). A further increase in rocker angle to 20° resulted in less substantial enhancement of toe clearance and came at the cost of a decrease in gait speed on the decline. The novelty of this investigation lies in the exploration of the trade-off between reduction of trip-risk through footwear design and adverse effects on walking stability on real-life relevant surfaces. Our two studies suggest that the current focus on slip-resistance in footwear design may need to be generalised to include other factors that affect trip-risk. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Feedforward neural control of toe walking in humans.

PubMed

Lorentzen, Jakob; Willerslev-Olsen, Maria; Hüche Larsen, Helle; Svane, Christian; Forman, Christian; Frisk, Rasmus; Farmer, Simon Francis; Kersting, Uwe; Nielsen, Jens Bo

2018-03-23

Activation of ankle muscles at ground contact during toe walking is unaltered when sensory feedback is blocked or the ground is suddenly dropped. Responses in the soleus muscle to transcranial magnetic stimulation, but not peripheral nerve stimulation, are facilitated at ground contact during toe walking. We argue that toe walking is supported by feedforward control at ground contact. Toe walking requires careful control of the ankle muscles in order to absorb the impact of ground contact and maintain a stable position of the joint. The present study aimed to clarify the peripheral and central neural mechanisms involved. Fifteen healthy adults walked on a treadmill (3.0 km h -1 ). Tibialis anterior (TA) and soleus (Sol) EMG, knee and ankle joint angles, and gastrocnemius-soleus muscle fascicle lengths were recorded. Peripheral and central contributions to the EMG activity were assessed by afferent blockade, H-reflex testing, transcranial magnetic brain stimulation (TMS) and sudden unloading of the planter flexor muscle-tendon complex. Sol EMG activity started prior to ground contact and remained high throughout stance. TA EMG activity, which is normally seen around ground contact during heel strike walking, was absent. Although stretch of the Achilles tendon-muscle complex was observed after ground contact, this was not associated with lengthening of the ankle plantar flexor muscle fascicles. Sol EMG around ground contact was not affected by ischaemic blockade of large-diameter sensory afferents, or the sudden removal of ground support shortly after toe contact. Soleus motor-evoked potentials elicited by TMS were facilitated immediately after ground contact, whereas Sol H-reflexes were not. These findings indicate that at the crucial time of ankle stabilization following ground contact, toe walking is governed by centrally mediated motor drive rather than sensory driven reflex mechanisms. These findings have implications for our understanding of the control of human gait during voluntary toe walking. © 2018 The Authors. The Journal of Physiology © 2018 The Physiological Society.

Geode development and multiple fractures in rheumatoid arthritis.

PubMed

Lowthian, P J; Calin, A

1985-02-01

The radiological development from normal bone of geodes and subsequent fractures in phalanges of two adjacent fingers is described in a patient with classical rheumatoid arthritis. Presentation was as a septic, discharging focus, but infection was excluded; the pathology is described.

Guidelines for transoesophageal echocardiographic probe cleaning and disinfection from the British Society of Echocardiography.

PubMed

Kanagala, P; Bradley, C; Hoffman, P; Steeds, R P

2011-10-01

The clinical utility of transoesophageal echocardiography (TOE) is well established. Being a semi-invasive procedure, however, the potential for transmission of infection between sequential patients exists. This has implications for the protection of both patients and medical staff. Guidelines for disinfection during gastrointestinal endoscopy (GIE) have been in place for many years.(1,2) Unfortunately, similar guidance is lacking with respect to TOE. Although traversing the same body cavities and sharing many similarities with upper GIE, there are fundamental structural and procedural differences with TOE which merit special consideration in establishing a decontamination protocol. This document provides recommendations for TOE probe decontamination based on the available evidence, expert opinion, and modification of the current British Society of Gastroenterology guidelines.

Movement of a large, slow-moving landslide in the North Island, New Zealand, controlled by porewater pressure and river flow

NASA Astrophysics Data System (ADS)

McColl, Samuel; Holdsworth, Charlotte; Massey, Chris

2017-04-01

New Zealand has 7000 mapped large (> 2 ha) landslides, most of which occur in the Neogene cover rocks, and many of which are active. Active landslides in New Zealand damage lifeline infrastructure, entire suburbs, agricultural land, and they deliver large but little-quantified sediment load to rivers. Despite their prevalence in the landscape and these impacts, much remains unknown of their initiation, movement patterns and processes, or their contributions to landscape evolution. This research assesses how toe cutting and rainfall at a daily to seasonal timescale drive movement of a large (50 hectare) slow-moving, translational rockslide that is severely damaging a farm in the Rangitikei catchment, central North Island. Geomorphological mapping has been undertaken to define the landslide boundary, drainage lines and to assess zones of movements. Since July 2015, 3-monthly GPS-occupations of a survey mark network, and hourly time-lapse photography of the toe of the landslide have been used to identify the distribution and patterns of landslide movement. Pixel-tracking software is being used to quantify movement at the toe from the time-lapse photography at an daily timescale. Movement data are being compared with river flow data (i.e. toe cutting potential) and local rainfall and groundwater from a nearby site (i.e. a proxy for porewater-pressure changes at the landslide). Results so far indicate movement of several mm to cm per year in the upper part of the landslide through a block sliding mechanism, increasing to several metres per year towards the toe where block-sliding transitions sharply to more mobile earth flow-slide behaviour. In the upper part of the landslide, vertical displacements are larger closer to earth flow-slide zone, expressed as decimetre to metre-scale scarps and mini-grabens. The failure surface is exposed at the toe, which is being actively cut by a major river, and reveals a highly remoulded landslide body 1-3 metres thick, overlaying intact sandstone. Based on existing structural data and the landslide surface morphology it is assumed that the landslide thickens to about 60 m towards the head. The geomorphology suggests extension and thinning of the landslide body - which corroborates the movement data showing movement rates at the head (mm per year) increasing downslope to some metres per year at the toe - and without a zone of compression at the toe, suggesting near-continuous toe-unloading. Movement is fastest in the winter-spring months when water tables are high due to reduced evapotranspiration and slightly greater rainfall. However, this period also coincides with a period of higher river flow and flood events (i.e. toe cutting), and the landslide appears to be particularly sensitive (i.e. surges forward) following high river flow events that cut the toe. This observation suggests that movement is driven by both local and catchment-scale rainfall events.

A systematic review of discomfort due to toe or ear clipping in laboratory rodents

PubMed Central

Geessink, Florentine J.; Brouwer, Michelle A. E.; Tillema, Alice; Ritskes-Hoitinga, Merel

2017-01-01

Toe clipping and ear clipping (also ear notching or ear punching) are frequently used methods for individual identification of laboratory rodents. These procedures potentially cause severe discomfort, which can reduce animal welfare and distort experimental results. However, no systematic summary of the evidence on this topic currently exists. We conducted a systematic review of the evidence for discomfort due to toe or ear clipping in rodents. The review methodology was pre-specified in a registered review protocol. The population, intervention, control, outcome (PICO) question was: In rodents, what is the effect of toe clipping or ear clipping, compared with no clipping or sham clipping, on welfare-related outcomes? Through a systematic search in PubMed, Embase, Web of Science and grey literature, we identified seven studies on the effect of ear clipping on animal welfare, and five such studies on toe clipping. Studies were included in the review if they contained original data from an in vivo experiment in rodents, assessing the effect of toe clipping or ear clipping on a welfare-related outcome. Case studies and studies applying unsuitable co-interventions were excluded. Study quality was appraised using an extended version of SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE)’s risk of bias tool for animal studies. Study characteristics and outcome measures were highly heterogeneous, and there was an unclear or high risk of bias in all studies. We therefore present a narrative synthesis of the evidence identified. None of the studies reported a sample size calculation. Out of over 60 different outcomes, we found evidence of discomfort due to ear clipping in the form of increased respiratory volume, vocalization and blood pressure. For toe clipping, increased vocalization and decreased motor activity in pups were found, as well as long-term effects in the form of reduced grip strength and swimming ability in adults. In conclusion, there is too little evidence to reliably assess discomfort due to toe or ear clipping, and the quality of the available evidence is uncertain. Adequately powered, high-quality studies reporting reliable, relevant outcome measures are needed to accurately assess the impact of these identification techniques. Until more reliable evidence is available, any effect of toe clipping or ear clipping on animal welfare and study results cannot be confirmed or excluded. PMID:28429644

Impaired heel to toe progression during gait is related to reduced ankle range of motion in people with Multiple Sclerosis.

PubMed

Psarakis, Michael; Greene, David; Moresi, Mark; Baker, Michael; Stubbs, Peter; Brodie, Matthew; Lord, Stephen; Hoang, Phu

2017-11-01

Gait impairment in people with Multiple Sclerosis results from neurological impairment, muscle weakness and reduced range of motion. Restrictions in passive ankle range of motion can result in abnormal heel-to-toe progression (weight transfer) and inefficient gait patterns in people with Multiple Sclerosis. The purpose of this study was to determine the associations between gait impairment, heel-to-toe progression and ankle range of motion in people with Multiple Sclerosis. Twelve participants with Multiple Sclerosis and twelve healthy age-matched participants were assessed. Spatiotemporal parameters of gait and individual footprint data were used to investigate group differences. A pressure sensitive walkway was used to divide each footprint into three phases (contact, mid-stance, propulsive) and calculate the heel-to-toe progression during the stance phase of gait. Compared to healthy controls, people with Multiple Sclerosis spent relatively less time in contact phase (7.8% vs 25.1%) and more time in the mid stance phase of gait (57.3% vs 33.7%). Inter-limb differences were observed in people with Multiple Sclerosis between the affected and non-affected sides for contact (7.8% vs 15.3%) and mid stance (57.3% and 47.1%) phases. Differences in heel-to-toe progression remained significant after adjusting for walking speed and were correlated with walking distance and ankle range of motion. Impaired heel-to-toe progression was related to poor ankle range of motion in people with Multiple Sclerosis. Heel-to-toe progression provided a sensitive measure for assessing gait impairments that were not detectable using standard spatiotemporal gait parameters. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of foot rotation positions on knee valgus during single-leg drop landing: Implications for ACL injury risk reduction.

PubMed

Teng, P S P; Kong, P W; Leong, K F

2017-06-01

Non-contact anterior cruciate ligament (ACL) injuries commonly occur when athletes land in high risk positions such as knee valgus. The position of the foot at landing may influence the transmission of forces from the ankle to the knee. Using an experimental approach to manipulate foot rotation positions, this study aimed to provide new insights on how knee valgus during single-leg landing may be influenced by foot positions. Eleven male recreational basketball players performed single-leg drop landings from a 30-cm high platform in three foot rotation positions (toe-in, toe-forward and toe-out) at initial contact. A motion capture system and a force plate were used to measure lower extremity kinematics and kinetics. Knee valgus angles at initial contact (KVA) and maximum knee valgus moments (KVM), which were known risk factors associated with ACL injury, were measured. A one-way repeated measures Analysis of Variance was conducted (α=0.05) to compare among the three foot positions. Foot rotation positions were found to have a significant effect on KVA (p<0.001, η 2 =0.66) but the difference between conditions (about 1°) was small and not clinically meaningful. There was a significant effect of foot position on KVM (p<0.001, η 2 =0.55), with increased moment observed in the toe-out position as compared to toe-forward (p=0.012) or toe-in positions (p=0.002). When landing with one leg, athletes should avoid extreme toe-out foot rotation positions to minimise undesirable knee valgus loading associated with non-contact ACL injury risks. Copyright © 2017 Elsevier B.V. All rights reserved.

Transcutaneous oximetry: normal values for the lower limb.

PubMed

Blake, Denise F; Young, Derelle A; Brown, Lawrence H

2014-09-01

Current guidelines for transcutaneous oximetry measurement (TCOM) for the lower limb define tissue hypoxia as a transcutaneous oxygen partial pressure < 40 mmHg. Values obtained with some newer machines and current research bring these reference values into question. To determine 'normal' TCOM values for the lower limb in healthy, non-smoking adults using the TCM400 oximeter with tc Sensor E5250. Thirty-two healthy, non-smoking volunteers had TCOM performed at six positions on the lower leg and foot. Measurements were taken with subjects lying supine breathing air, then with leg elevated and whilst breathing 100 % oxygen. Room-air TCOM values (mean mmHg, 95 % confidence interval (CI) ) were: lateral leg 41.3, CI 37.8 to 44.7; lateral malleolus 38.6, CI 34.1 to 43.1; medial malleolus 43.9, CI 40.2 to 47.6; dorsum, between first and second toe 39.3, CI 35.9 to 42.7; dorsum, proximal to fifth metatarsal-phalangeal joint 46.4, CI 43.4 to 49.3; plantar 52.3, CI 49.6 to 55.1. Using the currently accepted value of less than 40 mmHg for tissue hypoxia, 24 of our 32 'healthy' subjects had at least one air sensor reading that would have been classified as hypoxic. Seventeen subjects had TCOM values less than 100 mmHg when breathing 100 % normobaric oxygen. Normal lower limb TCOM readings using the TCOM400 with tc Sensor E5250 may be lower than 40 mmHg, used to define tissue hypoxia, but consistent with the wide range of values found in the literature. Because of the wide variability in TCOM at the different sensor sites we cannot recommend one TCOM value as indicative of tissue hypoxia. A thorough clinical assessment of the patient is essential to establish appropriateness for hyperbaric oxygen treatment, with TCOM used as an aid to help guide this decision, but not as an absolute diagnostic tool.

Point Judith, Rhode Island, Breakwater Risk Assessment

DTIC Science & Technology

2015-08-01

output stations. Beach zones considered included the sandy beach to the west side of the HoR, which had significant dune features and was fronting...time dependency for crest height and wave parameters is assumed, hc = total damaged crest height of structure from toe , Lp is the local wave length...computed using linear wave theory and Tp, h is the toe depth, hc’ = total undamaged crest height of structure from toe , At = area of structure enclosed

Toe pressure determination by audiophotoplethysmography.

PubMed

Fronek, A; Blazek, V; Curran, B

1994-08-01

The purpose of this study was to evaluate the performance of audiophotoplethysmography as a modality to measure toe pressure without the requirement of a recorder. A portable photoplethysmograph with an audio output was used to determine toe pressures, and the results were compared with those obtained by a commercial photoplethysmograph with a recorder. Thirty-one measurements in control subjects and 62 measurements in patients with arterial occlusive disease were performed. The average toe pressure recorded with oscillography with standard photoplethysmography was 103.5 mm Hg +/- 14.7 SD and 95.9 mm Hg +/- 13.4 SD with audio-photoplethysmography. In the patient group the pressure recorded with a commercial photoplethysmograph was 65.3 mm Hg +/- 34.9 SD compared with 61.6 mm Hg +/- 34.8 SD obtained with audio-photoplethysmography. The difference in both groups was insignificant, and the correlation between both methods was very good. A portable hand-held photoplethysmograph equipped with an audio output was used to measure toe pressure in control subjects and in patients with arterial occlusive disease. The results have been compared with the oscillometric method by a standard commercial photoplethysmograph connected to a recorder. The correlation was very good in the control and patient groups, and the difference between both methods was below the level of statistical significance. The fact that no recorder is needed may help in introducing toe pressure measurement into everyday office diagnostic practice.

In-toeing in children with type I osteogenesis imperfecta: an observational descriptive study.

PubMed

Losa Iglesias, Marta Elena; Becerro de Bengoa Vallejo, Ricardo; Salvadores Fuentes, Paloma

2009-01-01

Osteogenesis imperfecta is an autosomal-dominant disorder of the connective tissue. Also known as brittle bone disease, it renders those affected susceptible to fractures after minimal trauma. Therefore, it is important to minimize the risk of falls and subsequent fractures in patients with this disease. In-toeing is a common condition in children that can result from various pathologic entities, including anteversion, internal tibial torsion, and metatarsus adductus. These conditions can result in frequent tripping and other functional problems. A descriptive study was undertaken to determine the prevalence of in-toeing gait attributable to tibial or femoral torsion or metatarsus adductus in children with type I osteogenesis imperfecta. The study involved orthopedic and biomechanical examination of 15 children (9 girls and 6 boys) aged 4 to 9 years with confirmed type I osteogenesis imperfecta. Patients who used assistive ambulatory devices, such as canes, crutches, and wheelchairs, were excluded from the study. Of the 15 children studied, 12 (80%) demonstrated previously undiagnosed in-toeing gait attributable to torsional deformity or metatarsus adductus in all but one child. Many children with confirmed type I osteogenesis imperfecta have in-toeing gait caused by torsional deformity or metatarsus adductus. Detection and control of in-toeing gait in children with osteogenesis imperfecta is important to prevent fractures resulting from trauma directly related to these conditions.

Hammertoe

MedlinePlus

... Hammertoe What Is Hammertoe? Hammertoe is a contracture (bending) deformity of one or both joints of the ... third, fourth or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing ...

When at what scale will trends in European mean and heavy precipitation emerge

NASA Astrophysics Data System (ADS)

Maraun, Douglas

2013-04-01

A multi-model ensemble of regional climate projections for Europe is employed to investigate how the time of emergence (TOE) for seasonal sums and maxima of daily precipitation depends on spatial scale. The TOE is redefined for emergence from internal variability only, the spread of the TOE due to imperfect climate model formulation is used as a measure of uncertainty in the TOE itself. Thereby the TOE becomes a fundamentally limiting time scale and translates into a minimum spatial scale on which robust conclusions can be drawn about precipitation trends. Thus also minimum temporal and spatial scales for adaptation planning are given. In northern Europe, positive winter trends in mean and heavy precipitation, in southwestern and southeastern Europe summer trends in mean precipitation emerge already within the next decades. Yet across wide areas, especially for heavy summer precipitation, the local trend emerges only late in the 21st century or later. For precipitation averaged to larger scales, the trend in general emerges earlier. Douglas Maraun, When at what scale will trends in European mean and heavy precipitation emerge? Env. Res. Lett., in press, 2013.

Lower-extremity rotational profile and toe-walking in preschool children with autism spectrum disorder.

PubMed

Arik, Atilla; Aksoy, Cemalettin; Aysev, Ayla; Akçakin, Melda

2018-04-24

The aim of this study was to establish the torsional and toe-walking profiles of children with autism spectrum disorder (ASD), and to analyze the correlations between torsion, toe-walking, autism severity score, and age. In total, 79 consecutive children with autism were examined to determine their hip rotations, thigh-foot angle, degree of toe-walking, and autism severity. Femoral and tibial torsion values, of the preschool patients, were compared statistically with age-matched controls. The hip rotation profile of the patients was similar to the normal group. Nearly a half of the patients with ASD present excessive external tibial torsion. The difference in the tibial torsion between patients and normal children was statistically significant. A weak correlation was found only between tibial torsion and the autism severity score, but no correlation was found between the other parameters. External tibial torsion is the cardinal and persistent orthopedic manifestation among patients with ASD. Toe-walking is the second most common such manifestation and is an independent orthopedic feature in these patients. External tibial torsion may potentially contribute toward the described gait abnormalities in patients with ASD.

Alarm toe switch. [Patent application

DOEpatents

Ganyard, F.P.

1980-11-18

An alarm toe switch inserted within a shoe for energizing an alarm circuit in a covert manner includes an insole mounting pad into which a miniature reed switch is fixedly molded. An elongated slot perpendicular to the reed switch is formed in the bottom surface of the mounting pad. A permanent cylindrical magnet positioned in the forward portion of the slot with a diameter greater than the pad thickness causes a bump above the pad. A foam rubber block is also positioned in the slot rearwardly of the magnet and holds the magnet in normal inoperative relation. A non-magnetic support plate covers the slot and holds the magnet and foam rubber in the slot. The plate minimizes bending and frictional forces to improve movement of the magnet for reliable switch activation. The bump occupies the knuckle space beneath the big toe. When the big toe is scrunched rearwardly the magnet is moved within the slot relative to the reed switch, thus magnetically activating the switch. When toe pressure is released the foam rubber block forces the magnet back into normal inoperative position to deactivate the reed switch.

Automatic segmentation of bones from digital hand radiographs

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Taira, Ricky K.; Shim, Hyeonjoon; Keaton, Patricia

1995-05-01

The purpose of this paper is to develop a robust and accurate method that automatically segments phalangeal and epiphyseal bones from digital pediatric hand radiographs exhibiting various stages of growth. The algorithm uses an object-oriented approach comprising several stages beginning with the most general objects to be segmented, such as the outline of the hand from background, and proceeding in a succession of stages to the most specific object, such as a specific phalangeal bone from a digit of the hand. Each stage carries custom operators unique to the needs of that specific stage which will aid in more accurate results. The method is further aided by a knowledge base where all model contours and other information such as age, race, and sex, are stored. Shape models, 1-D wrist profiles, as well as an interpretation tree are used to map model and data contour segments. Shape analysis is performed using an arc-length orientation transform. The method is tested on close to 340 phalangeal and epiphyseal objects to be segmented from 17 cases of pediatric hand images obtained from our clinical PACS. Patient age ranges from 2 - 16 years. A pediatric radiologist preliminarily assessed the results of the object contours and were found to be accurate to within 95% for cases with non-fused bones and to within 85% for cases with fused bones. With accurate and robust results, the method can be applied toward areas such as the determination of bone age, the development of a normal hand atlas, and the characterization of many congenital and acquired growth diseases. Furthermore, this method's architecture can be applied to other image segmentation problems.

Competitive Swimming and Handball Participation Have a Positive Influence on Bone Parameters as Assessed by Phalangeal Quantitative Ultrasound in Female Adolescents.

PubMed

Krahenbuhl, Tathyane; Gonçalves, Ezequiel M; Guimarães, Roseane Fatima; Guerra-Junior, Gil; Barros-Filho, Antonio

2016-08-01

To examine the influence of participation in competitive sports on bone parameters, as assessed by quantitative ultrasound (QUS) of the phalanges in female adolescents. Female adolescents (n = 329, 13.0-16.7 years old) were classified into handball (n = 55), swimming (n = 49) and control (n = 225) groups. QUS was used to evaluate the amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT), and their z-scores (zAD-SoS and zBTT) were calculated. Anthropometric measurements and Tanner's stages were also obtained. Swimmers had higher AD-SoS (2089 ± 43.8 m/s) and zAD-SoS (0.47 ± 0.8) than controls (2060 ± 54.0 m/s; 0.09 ± 1.0; both p ≤ .05) and both groups of athletes had higher BTT (handball: 1.44 ± 0.2 μs; swimming: 1.45 ± 0.2) and zBTT (handball: 0.71 ± 0.8; swimming: 0.72 ± 1.1) than the control group (1.37 ± 0.2 μs; 0.32 ± 0.9; all p ≤ .05). Swimmers had a higher total training time (TTT: 52.5 ± 27.6 months) and frequency of training per week (FT: 5.38 ± 0.1) compared with the handball group (35.9 ± 18.1; 3.32 ± 0.8; p ≤ .05). zAD-SoS, BTT and zBTT were positively correlated with FT, while BTT and zBTT showed a positive correlation with TTT. Sports practice influences bone parameters and higher bone parameter values are related to the amount of time and frequency of weekly training. The differences in phalangeal QUS parameters are independent of the impact of weight-bearing exercise.

Short stature Revealing a Pycnodysostosis: A Case Report

PubMed Central

Aynaou, Hayat; Skiker, Imane; Latrech, Hanane

2016-01-01

Introduction: Pycnodysostosis is a rare genetic disease characterized by osteosclerosis and bone fragility. The clinical aspects are varied including short stature, acro-osteolysis of distal phalanges, and dysplasia of the clavicles. Oral and maxillofacial manifestations of this disease are very clear. The head is usually large, a beaked nose, obtuse mandibular angle, and both maxilla and mandible are hypoplastic. Dental abnormalities are common. We report a case with the typical clinical and radiological characteristics of the Pycnodysostosis associated with a conductive hearing loss, an association rarely reported. Case Presentation: A 12-year-female was admitted in our institute for short stature with a dysmorphic facies for evaluation. The patient reported a history of multiple fractures of the long bones after a trivial fall. On physical examination, she had the following features: short stature, limited mouth opening, short hands and feet with dysplastic nails; frontal and occipital bossing; and hypoplasia of the maxilla and mandible. Examination of the mouth: grooved palate, caries of the teeth, impacted and malposed teeth, persistent deciduous teeth and missing teeth. Laboratory investigations were normal. The radiographic examination showed a generalized increase in the bone density, slight condensation of the skull base and a very open mandibular angle. X-rays showed tapered phalanges with acro-osteolysis of the distal phalanges. A symptomatic treatment was proposed based on fracture prevention, oral hygiene, frequent dental visits and psychiatric support. Conclusion: The clinical and radiological features are the bases for the diagnosis of this disease. It is important to make the diagnosis as early as possible in order to plan the treatment and to provide a better life quality to the patients. PMID:27703936

Relationship Between Muscle Strength Asymmetry and Body Sway in Older Adults.

PubMed

Koda, Hitoshi; Kai, Yoshihiro; Murata, Shin; Osugi, Hironori; Anami, Kunihiko; Fukumoto, Takahiko; Imagita, Hidetaka

2018-05-31

The purpose of this study was to investigate the relationship between muscle strength asymmetry and body sway while walking. We studied 63 older adult women. Strong side and weak side of knee extension strength, toe grip strength, hand grip strength, and body sway while walking were measured. The relationship between muscle strength asymmetry for each muscle and body sway while walking was evaluated using Pearson's correlation coefficient. Regarding the muscles recognized to have significant correlation with body sway, the asymmetry cutoff value causing an increased sway was calculated. Toe grip strength asymmetry was significantly correlated with body sway. Toe grip strength asymmetry causing an increased body sway had a cutoff value of 23.5%. Our findings suggest toe grip strength asymmetry may be a target for improving gait stability.

Ankle fracture - aftercare

MedlinePlus

... coldness in your foot, or your toes look dark. You cannot move your toes. You have increased ... to the principles of the Health on the Net Foundation (www.hon.ch). The information provided herein ...

Regional Sediment Management (RSM) Principles in Flood Recovery: Incorporating RSM after the 2011 Missouri River Flood

DTIC Science & Technology

2013-06-01

outer bank threatened a Fed- eral levee that protects adjacent homes and farmland. The eroded chute bank approached the toe of the levee causing...design drawing for repairing the levee toe . Approximately 30,000 tons of riprap were placed to re-establish the bank in front of the scour hole...Sediment was needed to fill and stabilize the scour hole between the riprap bank and the toe of the levee. The volume required to fill the scour hole

Dune Erosion Models and Swash Zone Kinematics from Remote Video Observations

DTIC Science & Technology

2010-12-09

system. Thus, successful prediction of dune erosion requires knowledge of the expected trajectory of the eroding dune toe . If we describe the... dune toe trajectory as following a slope, βT, two end member retreat trajectories exist. The first would be direct landward erosion so that zb never...changes     0 0   T bb ztz  (2.24) The second end member trajectory is that erosion moves the dune toe directly up the foreshore slope

First Year Sedimentological Characteristics and Morphological Evolution of an Artificial Berm at Fort Myers Beach, Florida

DTIC Science & Technology

2011-06-17

collected in the berm area. In the control areas, surface sediment samples were taken at approximately the toe of the dune (where present...In the berm area, surface sediment samples were taken at approximately the toe of the dune (where 29   present), backbeach, high tide line, mean...samples were taken at approximately the toe of the dune (where present), backbeach, high tide line, mean sea level, low tide line, 2 ft water depth

Geode development and multiple fractures in rheumatoid arthritis.

PubMed Central

Lowthian, P J; Calin, A

1985-01-01

The radiological development from normal bone of geodes and subsequent fractures in phalanges of two adjacent fingers is described in a patient with classical rheumatoid arthritis. Presentation was as a septic, discharging focus, but infection was excluded; the pathology is described. Images PMID:3977410

[Treatment of fractures of proximal phalanx of fingers by Eiffel Tower percutaneous pinning method. A review of 45 cases].

PubMed

Chbani, B; Amar, M F; Loudyi, D; Boutayeb, F

2010-04-01

The authors report in the treatment of fractures of the proximal phalanx of the fingers, the use of Eiffel Tower pinning, a relatively simple method, fast and stable, associated to a protection and early rehabilitation. The objective of this method is to offer to the patient a pollici-digital grip. Our study is a retrospective study of 45 patients treated for fractures of the proximal phalanx of the fingers by percutaneous pinning according to Eiffel Tower method. We detail this simple and economic technique and examine the functional and radiological results of this series of patients. The amplitude of the active total motion of the proximal interphalangeal joint is on average 94.16 degrees (78.5 % of the normal active mobility of the proximal interphalangeal joint), and the amplitude of the active total motion of the metacarpo-phalangeal joint is on average 90.05 degrees (75 % of the normal active mobility of the metacarpo-phalangeal joint). Copyright 2010 Elsevier Masson SAS. All rights reserved.

Kirschner wire pin tract infection rates between percutaneous and buried wires in treating metacarpal and phalangeal fractures.

PubMed

Rafique, Atif; Ghani, Shahab; Sadiq, Moiz; Siddiqui, Intisar Ahmed

2006-08-01

To compare pin tract infection rate between percutaneous and buried placement of Kirschner (K-) wiring for hand fractures. Quasi--experimental study. Plastic, Reconstructive, Hand and Burn Surgery Unit, Liaquat National Hospital, Karachi, from September 2005--February 2006. Patients with fractures of metacarpals and phalanges of hand were selected by non-probability purposive method. Assessment of pin tract infection by clinical examination and pin tract scoring was done by modification of Oppenheim classification. Statistical analysis was done using Chi-square test. Ten out of 55 percutaneous and 2 out of 45 buried wires were infected. The difference in infection rates of two groups was statistically significant at p<0.05. Three percutaneous, but not buried Kirschner wires, had to be removed before 4 weeks because of failure to respond to local wound care and oral antibiotics. Percutaneous K- wires had significantly greater infection rate than wires which were buried deep to the skin.

Training giraffe (Giraffa camelopardalis reticulata) for front foot radiographs and hoof care.

PubMed

Dadone, Liza I; Schilz, Amy; Friedman, Susan G; Bredahl, Jason; Foxworth, Steve; Chastain, Bob

2016-05-01

For a large herd of reticulated giraffes, a mainly operant-based training program was created for front foot radiographs and hoof trims in an effort to diagnose and better manage lameness. Behaviors were shaped in a restricted contact set-up, using a positive reinforcement procedure to teach a series of mastered cued behaviors. This training was used to obtain lateral and lateral oblique front foot radiographs for the entire herd. Radiographs were diagnostic for multiple possible causes of lameness including fractures and osteitis of the distal phalangeal bone, hoof overgrowth, osteoarthritis of the distal interphalangeal joint, rotation of the distal phalangeal bone, sesamoid bone cysts, and sole foreign bodies. By training giraffe for foot radiographs and hoof trims, potential causes of lameness could be identified and better managed. Long-term, the results may help zoos identify best practices for managing and preventing lameness in giraffe. Zoo Biol. 35:228-236, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Analogous cellular contribution and healing mechanisms following digit amputation and phalangeal fracture in mice

PubMed Central

Dawson, Lindsay A.; Simkin, Jennifer; Sauque, Michelle; Pela, Maegan; Palkowski, Teresa

2016-01-01

Abstract Regeneration of amputated structures is severely limited in humans and mice, with complete regeneration restricted to the distal portion of the terminal phalanx (P3). Here, we investigate the dynamic tissue repair response of the second phalangeal element (P2) post amputation in the adult mouse, and show that the repair response of the amputated bone is similar to the proximal P2 bone fragment in fracture healing. The regeneration‐incompetent P2 amputation response is characterized by periosteal endochondral ossification resulting in the deposition of new trabecular bone, corresponding to a significant increase in bone volume; however, this response is not associated with bone lengthening. We show that cells of the periosteum respond to amputation and fracture by contributing both chondrocytes and osteoblasts to the endochondral ossification response. Based on our studies, we suggest that the amputation response represents an attempt at regeneration that ultimately fails due to the lack of a distal organizing influence that is present in fracture healing. PMID:27499878

Interventions for treating osteoarthritis of the big toe joint.

PubMed

Zammit, Gerard V; Menz, Hylton B; Munteanu, Shannon E; Landorf, Karl B; Gilheany, Mark F

2010-09-08

Osteoarthritis affecting of the big toe joint of the foot (hallux limitus or rigidus) is a common and painful condition. Although several treatments have been proposed, few have been adequately evaluated. To identify controlled trials evaluating interventions for osteoarthritis of the big toe joint and to determine the optimum intervention(s). Literature searches were conducted across the following electronic databases: CENTRAL; MEDLINE; EMBASE; CINAHL; and PEDro (to 14th January 2010). No language restrictions were applied. Randomised controlled trials, quasi-randomised trials, or controlled clinical trials that assessed treatment outcomes for osteoarthritis of the big toe joint. Participants of any age or gender with osteoarthritis of the big toe joint (defined either radiographically or clinically) were included. Two authors examined the list of titles and abstracts identified by the literature searches. One content area expert and one methodologist independently applied the pre-determined inclusion and exclusion criteria to the full text of identified trials. To minimise error and reduce potential bias, data were extracted independently by two content experts. Only one trial satisfactorily fulfilled the inclusion criteria and was included in this review. This trial evaluated the effectiveness of two physical therapy programs in 20 individuals with osteoarthritis of the big toe joint. Assessment outcomes included pain levels, big toe joint range of motion and plantar flexion strength of the hallux. Mean differences at four weeks follow up were 3.80 points (95% CI 2.74 to 4.86) for self reported pain, 28.30 degrees (95% CI 21.37 to 35.23) for big toe joint range of motion, and 2.80 kg (95% CI 2.13 to 3.47) for muscle strength. Although differences in outcomes between treatment and control groups were reported, the risk of bias was high. The trial failed to employ appropriate randomisation or adequate allocation concealment, used a relatively small sample and incorporated a short follow up (four weeks). No adverse reactions were reported. The reviewed trial presented a high risk of bias, which limited conclusions that could be drawn from the presented data. The inclusion of only one trial indicates the need for more robust randomised controlled trials to determine the efficacy of interventions for this condition.

Effects of different foot progression angles and platform settings on postural stability and fall risk in healthy and medial knee osteoarthritic adults.

PubMed

Khan, Saad Jawaid; Khan, Soobia Saad; Usman, Juliana; Mokhtar, Abdul Halim; Abu Osman, Noor Azuan

2018-02-01

This study aims to investigate the effects of varying toe angles at different platform settings on Overall Stability Index of postural stability and fall risk using Biodex Balance System in healthy participants and medial knee osteoarthritis patients. Biodex Balance System was employed to measure postural stability and fall risk at different foot progression angles (ranging from -20° to 40°, with 10° increments) on 20 healthy (control group) and 20 knee osteoarthritis patients (osteoarthritis group) randomly (age: 59.50 ± 7.33 years and 61.50 ± 8.63 years; body mass: 69.95 ± 9.86 kg and 70.45 ± 8.80 kg). Platform settings used were (1) static, (2) postural stability dynamic level 8 (PS8), (3) fall risk levels 12 to 8 (FR12) and (4) fall risk levels 8 to 2 (FR8). Data from the tests were analysed using three-way mixed repeated measures analysis of variance. The participant group, platform settings and toe angles all had a significant main effect on balance ( p ≤ 0.02). Platform settings had a significant interaction effect with participant group F(3, 144) = 6.97, p < 0.01 and toe angles F(21, 798) = 2.83, p < 0.01. Non-significant interactions were found for group × toe angles, F(7, 266) = 0.89, p = 0.50, and for group × toe angles × settings, F(21, 798) = 1.07, p = 0.36. The medial knee osteoarthritis group has a poorer postural stability and increased fall risk as compared to the healthy group. Changing platform settings has a more pronounced effect on balance in knee osteoarthritis group than in healthy participants. Changing toe angles produced similar effects in both the participant groups, with decreased stability and increased fall risk at extreme toe-in and toe-out angles.

Toe and Metatarsal Fractures (Broken Toes)

MedlinePlus

... badly displaced. Follow-up care. Your foot and ankle surgeon will provide instructions for care following surgical or nonsurgical treatment. Physical therapy, exercises and rehabilitation may be included in a schedule for return ...

Capsulitis of the Second Toe

MedlinePlus

... second toe is a result of abnormal foot mechanics, where the ball of the foot beneath the ... options for early treatment of capsulitis: Rest and ice. Staying off the foot and applying ice packs ...

Hammer toe repair

MedlinePlus

... causing: Pain Irritation Sores Problems finding shoes that fit Skin infections Surgery may not be advised if: Treatment with paddings and strapping works You can still straighten your toe Changing to different shoe types can alleviate symptoms

Tinea pedis and onychomycosis frequency in diabetes mellitus patients and diabetic foot ulcers. A cross sectional - observational study.

PubMed

Akkus, Gamze; Evran, Mehtap; Gungor, Dilek; Karakas, Mehmet; Sert, Murat; Tetiker, Tamer

2016-01-01

Impaired cellular immunity and reduced phagocytic function of polymorphonuclear leukocytes facilitate the development of skin fungal and bacterial infections due to uncontrolled hyperglycemia in diabetic patients. In our study, we aimed to assess onychomycosis and/or tinea pedis frequency in diabetic patients, and effects on the development of chronic complications, particularly foot ulcer. We included 227 diabetic patients in the study. Forty-three patients had diabetic foot ulcer. We screened and recorded demographic characteristics, HbA1c levels of patients, and presence of complications We examined patients dermatologically, and collected samples by scalpel from skin between toes, and from sole, toe nail, and area surrounding nails from suspected to have fungal infection. Native positivity between toes was higher in men compared to women (p<0.05). We obtained significant relation between HbA1c elevation and native positivity between toes (p<0.05). Fungal infection between toes, at sole and toe nail significantly increased in patients with diabetic foot ulcer compared to patients without diabetic foot ulcer (p<0.05). Moreover, native positivity in patients with diabetic foot ulcer correlated with presence of fungal infection examination findings (p<0.05). Fungal infections were more frequently observed in the presence of poor glycemic control and peripheral vascular disease in diabetic patients in compliance with the literature, and the presence of fungal infection may also responsible for the development of foot ulcers.

Tinea pedis and onychomycosis frequency in diabetes mellitus patients and diabetic foot ulcers. A cross sectional – observational study

PubMed Central

Akkus, Gamze; Evran, Mehtap; Gungor, Dilek; Karakas, Mehmet; Sert, Murat; Tetiker, Tamer

2016-01-01

Objective: Impaired cellular immunity and reduced phagocytic function of polymorphonuclear leukocytes facilitate the development of skin fungal and bacterial infections due to uncontrolled hyperglycemia in diabetic patients. In our study, we aimed to assess onychomycosis and/or tinea pedis frequency in diabetic patients, and effects on the development of chronic complications, particularly foot ulcer. Methods: We included 227 diabetic patients in the study. Forty-three patients had diabetic foot ulcer. We screened and recorded demographic characteristics, HbA1c levels of patients, and presence of complications We examined patients dermatologically, and collected samples by scalpel from skin between toes, and from sole, toe nail, and area surrounding nails from suspected to have fungal infection. Results: Native positivity between toes was higher in men compared to women (p<0.05). We obtained significant relation between HbA1c elevation and native positivity between toes (p<0.05). Fungal infection between toes, at sole and toe nail significantly increased in patients with diabetic foot ulcer compared to patients without diabetic foot ulcer (p<0.05). Moreover, native positivity in patients with diabetic foot ulcer correlated with presence of fungal infection examination findings (p<0.05). Conclusion: Fungal infections were more frequently observed in the presence of poor glycemic control and peripheral vascular disease in diabetic patients in compliance with the literature, and the presence of fungal infection may also responsible for the development of foot ulcers. PMID:27648034

Experimental wave attenuation study over flexible plants on a submerged slope

NASA Astrophysics Data System (ADS)

Yin, Zegao; Yang, Xiaoyu; Xu, Yuanzhao; Ding, Meiling; Lu, Haixiang

2017-12-01

Using plants is a kind of environmentally-friendly coastal protection to attenuate wave energy. In this paper, a set of experiments were conducted to investigate the wave attenuation performance using flexible grasses on a submerged slope, and the wave attenuation coefficient for these experiments was calculated for different still water depths, slope and grass configurations. It was found that the slope plays a significant role in wave attenuation. The wave attenuation coefficient increases with increasing relative row number and relative density. For a small relative row number, the two configurations from the slope top to its toe and from the slope toe to its top performed equally to a large extent. For a medium relative row number, the configuration from the slope toe to its top performed more poorly than that from the slope top to its toe; however, it performed better than that from the slope top to its toe for a high relative row number. With a single row of grasses close to the slope top from the slope toe, the wave attenuation coefficient shows double peaks. With increasing grass rows or still water depth, the grass location corresponding to the maximum wave attenuation coefficient is close to the slope top. The dimensional analysis and the least square method were used to derive an empirical equation of the wave attenuation coefficient considering the effect of relative density, the slope, the relative row number and the relative location of the middle row, and the equation was validated to experimental data.

Fatigue Magnification Factors of Arc-Soft-Toe Bracket Joints

NASA Astrophysics Data System (ADS)

Fu, Qiang; Li, Huajun; Wang, Hongqing; Wang, Shuqing; Li, Dejiang; Li, Qun; Fang, Hui

2018-06-01

Arc-soft-toe bracket (ASTB), as a joint structure in the marine structure, is the hot spot with significant stress concentration, therefore, fatigue behavior of ASTBs is an important point of concern in their design. Since macroscopic geometric factors obviously influence the stress flaws in joints, the shapes and sizes of ASTBs should represent the stress distribution around cracks in the hot spots. In this paper, we introduce a geometric magnification factor for reflecting the macroscopic geometric effects of ASTB crack features and construct a 3D finite element model to simulate the distribution of stress intensity factor (SIF) at the crack endings. Sensitivity analyses with respect to the geometric ratio H t / L b , R/ L b , L t / L b are performed, and the relations between the geometric factor and these parameters are presented. A set of parametric equations with respect to the geometric magnification factor is obtained using a curve fitting technique. A nonlinear relationship exists between the SIF and the ratio of ASTB arm to toe length. When the ratio of ASTB arm to toe length reaches a marginal value, the SIF of crack at the ASTB toe is not influenced by ASTB geometric parameters. In addition, the arc shape of the ASTB slope edge can transform the stress flowing path, which significantly affects the SIF at the ASTB toe. A proper method to reduce stress concentration is setting a slope edge arc size equal to the ASTB arm length.

Changes in toe clearance during treadmill walking after long-duration spaceflight.

PubMed

Miller, Christopher A; Peters, Brian T; Brady, Rachel R; Richards, Jason R; Ploutz-Snyder, Robert J; Mulavara, Ajitkumar P; Bloomberg, Jacob J

2010-10-01

Astronauts exhibit sensorimotor changes upon return from long-duration spaceflight that can result in altered gait kinematics and possibly an increased risk of tripping. Toe trajectory during locomotion is a precise motor control task involving both legs, thus providing a composite metric of locomotor control. The purpose of this study was to determine whether astronauts are at an increased risk of tripping after their return from long-duration spaceflight. This was accomplished by assessing the pre- to postflight changes in toe clearance during treadmill walking. Ten crewmembers walked on a treadmill while performing a visual-acuity task pre- and postflight. In the three subjects on whom landing day data were available, each exhibited a characteristic of increased tripping risk on landing day: either a decreased median toe clearance or an increased interquartile range (a measure of variance). For all crewmembers, toe clearance median and interquartile range were not significantly different from preflight for the other postflight sessions (the earliest being 1 d after landing). A follow-up analysis showed that changes in foot pitch, ankle dorsiflexion, and pelvis roll angles were significant predictors of changes in toe clearance. The landing-day observations indicated an increased risk of tripping, which may pose a hazard during locomotion immediately upon return to Earth, especially in an emergency scenario. However, tripping risk on subsequent days was not different than preflight. The joint angle analysis suggested that the crewmembers tried to reestablish their normal walking pattern postflight, instead of developing a new motor control strategy.

Prediction of hip fracture risk by quantitative ultrasound in more than 7000 Swiss women > or =70 years of age: comparison of three technologically different bone ultrasound devices in the SEMOF study.

PubMed

Krieg, Marc-Antoine; Cornuz, Jacques; Ruffieux, Christiane; Van Melle, Guy; Büche, Daniel; Dambacher, Maximilian A; Hans, Didier; Hartl, Florian; Häuselmann, Hansjorg J; Kraenzlin, Marius; Lippuner, Kurt; Neff, Maurus; Pancaldi, Pierro; Rizzoli, Rene; Tanzi, Franco; Theiler, Robert; Tyndall, Alan; Wimpfheimer, Claus; Burckhardt, Peter

2006-09-01

To compare the prediction of hip fracture risk of several bone ultrasounds (QUS), 7062 Swiss women > or =70 years of age were measured with three QUSs (two of the heel, one of the phalanges). Heel QUSs were both predictive of hip fracture risk, whereas the phalanges QUS was not. As the number of hip fracture is expected to increase during these next decades, it is important to develop strategies to detect subjects at risk. Quantitative bone ultrasound (QUS), an ionizing radiation-free method, which is transportable, could be interesting for this purpose. The Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture Risk (SEMOF) study is a multicenter cohort study, which compared three QUSs for the assessment of hip fracture risk in a sample of 7609 elderly ambulatory women > or =70 years of age. Two QUSs measured the heel (Achilles+; GE-Lunar and Sahara; Hologic), and one measured the heel (DBM Sonic 1200; IGEA). The Cox proportional hazards regression was used to estimate the hazard of the first hip fracture, adjusted for age, BMI, and center, and the area under the ROC curves were calculated to compare the devices and their parameters. From the 7609 women who were included in the study, 7062 women 75.2 +/- 3.1 (SD) years of age were prospectively followed for 2.9 +/- 0.8 years. Eighty women reported a hip fracture. A decrease by 1 SD of the QUS variables corresponded to an increase of the hip fracture risk from 2.3 (95% CI, 1.7, 3.1) to 2.6 (95% CI, 1.9, 3.4) for the three variables of Achilles+ and from 2.2 (95% CI, 1.7, 3.0) to 2.4 (95% CI, 1.8, 3.2) for the three variables of Sahara. Risk gradients did not differ significantly among the variables of the two heel QUS devices. On the other hand, the phalanges QUS (DBM Sonic 1200) was not predictive of hip fracture risk, with an adjusted hazard risk of 1.2 (95% CI, 0.9, 1.5), even after reanalysis of the digitalized data and using different cut-off levels (1700 or 1570 m/s). In this elderly women population, heel QUS devices were both predictive of hip fracture risk, whereas the phalanges QUS device was not.

Bone indicators of grasping hands in lizards

PubMed Central

2016-01-01

Grasping is one of a few adaptive mechanisms that, in conjunction with clinging, hooking, arm swinging, adhering, and flying, allowed for incursion into the arboreal eco-space. Little research has been done that addresses grasping as an enhanced manual ability in non-mammalian tetrapods, with the exception of studies comparing the anatomy of muscle and tendon structure. Previous studies showed that grasping abilities allow exploitation for narrow branch habitats and that this adaptation has clear osteological consequences. The objective of this work is to ascertain the existence of morphometric descriptors in the hand skeleton of lizards related to grasping functionality. A morphological matrix was constructed using 51 morphometric variables in 278 specimens, from 24 genera and 13 families of Squamata. To reduce the dimensions of the dataset and to organize the original variables into a simpler system, three PCAs (Principal Component Analyses) were performed using the subsets of (1) carpal variables, (2) metacarpal variables, and (3) phalanges variables. The variables that demonstrated the most significant contributions to the construction of the PCA synthetic variables were then used in subsequent analyses. To explore which morphological variables better explain the variations in the functional setting, we ran Generalized Linear Models for the three different sets. This method allows us to model the morphology that enables a particular functional trait. Grasping was considered the only response variable, taking the value of 0 or 1, while the original variables retained by the PCAs were considered predictor variables. Our analyses yielded six variables associated with grasping abilities: two belong to the carpal bones, two belong to the metacarpals and two belong to the phalanges. Grasping in lizards can be performed with hands exhibiting at least two different independently originated combinations of bones. The first is a combination of a highly elongated centrale bone, reduced palmar sesamoid, divergence angles above 90°, and slender metacarpal V and phalanges, such as exhibited by Anolis sp. and Tropidurus sp. The second includes an elongated centrale bone, lack of a palmar sesamoid, divergence angles above 90°, and narrow metacarpal V and phalanges, as exhibited by geckos. Our data suggest that the morphological distinction between graspers and non-graspers is demonstrating the existence of ranges along the morphological continuum within which a new ability is generated. Our results support the hypothesis of the nested origin of grasping abilities within arboreality. Thus, the manifestation of grasping abilities as a response to locomotive selective pressure in the context of narrow-branch eco-spaces could also enable other grasping-dependent biological roles, such as prey handling. PMID:27168987

Thermographic Patterns of the Upper and Lower Limbs: Baseline Data

PubMed Central

Cassar, Kevin; Camilleri, Kenneth P.; De Raffaele, Clifford; Mizzi, Stephen; Cristina, Stefania

2015-01-01

Objectives. To collect normative baseline data and identify any significant differences between hand and foot thermographic distribution patterns in a healthy adult population. Design. A single-centre, randomized, prospective study. Methods. Thermographic data was acquired using a FLIR camera for the data acquisition of both plantar and dorsal aspects of the feet, volar aspects of the hands, and anterior aspects of the lower limbs under controlled climate conditions. Results. There is general symmetry in skin temperature between the same regions in contralateral limbs, in terms of both magnitude and pattern. There was also minimal intersubject temperature variation with a consistent temperature pattern in toes and fingers. The thumb is the warmest digit with the temperature falling gradually between the 2nd and the 5th fingers. The big toe and the 5th toe are the warmest digits with the 2nd to the 4th toes being cooler. Conclusion. Measurement of skin temperature of the limbs using a thermal camera is feasible and reproducible. Temperature patterns in fingers and toes are consistent with similar temperatures in contralateral limbs in healthy subjects. This study provides the basis for further research to assess the clinical usefulness of thermography in the diagnosis of vascular insufficiency. PMID:25648145

Effect of Guci powder on toe swelling induced by egg white in rats

NASA Astrophysics Data System (ADS)

Xie, Guoqi; Hao, Shaojun; Shen, Huiling; Ma, Zhenzhen; Zhang, Xuehui; Zhang, Zhengchen

2018-04-01

To observe the effect of Guci Powder on foot swelling induced by egg white in rats. 50 male rats were randomly divided into normal saline group (n=10), white vinegar group (n=10) and Guning lotion group (n=10). There were 10 rats in the high-dose group and 10 in the low-dose group. The rats in each group were treated with the drug on the left and right feet of the rats. 0.5 hours after the last administration, the rats in each group were inflamed. The left hindsole plantar volume was measured respectively, so that the difference of the posterior toe volume before inflammation was taken as the swelling degree, and the swelling degree of each group was calculated. Compared with physiological saline group, the rats' egg white toe swelling (P<0.01) was significantly inhibited at 0.5˜6h after administration. The swelling of egg white toe in rats was inhibited at 0.5˜2h (P<0.05). Bone spur powder has a good intervention effect on the model of toe swelling induced by egg white in rats, and the external application of bone spur powder has anti-inflammatory and swelling effect.

An uncommon presentation of non-small-cell lung cancer with acrometastases to the great toe and index finger.

PubMed

Reynolds, Jamie; Skandan, Savitri P

2016-03-01

Acrometastasis as initial presentation of metastatic cancer is an extremely rare finding. We describe an unusual case of late-stage non-small-cell lung cancer with metastatic lesions to the great toe and index fnger with associated pain in those areas as the only presenting symptom. A 71-year-old white woman was referred to the emergency department by her primary care physician for necrosis and swelling of the left great toe for work-up of possible osteomyelitis (Figure 1). Before she presented to her physician, she had been complaining of severe pain, swelling, and erythema of the left great toe that had lasted for 1-2 months. Infection was initially suspected. She completed 2 courses of oral antibiotics with no improvement. She was also complaining of similar symptoms on the left index finger and attributed her symptoms to an injury a month earlier (Figure 2). The pain was so severe that she was not able to bear weight on her left foot. An outpatient X-ray of her left great toe raised her physician's concerns that it might be osteomyelitis so she was referred to the emergency department. ©2016 Frontline Medical Communications.

A new small frog species of the genus Pristimantis (Anura: Craugastoridae) from the northern paramos of Colombia.

PubMed

González-Durán, Gustavo A

2016-01-18

I describe a new species of a small-sized frog of the genus Pristimantis found in the paramo ecosystem (3700 masl) on the northern slope of Los Nevados National Park, Cordillera Central, department of Caldas, Colombia. This new species is assigned to the Pristimantis leptolophus species-group, given that Toe V is much longer than Toe III and extends to the distal edge of the distal subarticular tubercle on Toe IV. The new species differs from other taxa by its dorsal golden or yellowish color patterns, the absence of nuptial pads, lateral fringes on its fingers and toes, and the absence of vomerine odontophores. Discriminant analyses of morphometric characters of females of P. leptolophus, P. uranobates, and the new species separate the new species by snout-vent length, tibia length, eye diameter, eye-to-nostril distance, tympanum diameter, and length of toe III. Vomer terms frequently used to describe species are reviewed, such as the oblique keels of the vomer and the different forms of the dentigerous process. Species belonging to the high Andean Pristimantis leptolophus species-group are allopatric, suggesting vicariant speciation in different areas of the paramos.

Assessment of leg muscle activity using toe tapping in patients with Parkinson's disease: comparison of two types of toe tapping.

PubMed

Taniguchi, Seira; Peper, Ferdinand; Shimokawa, Tetsuya

2018-05-01

[Purpose] This study investigates two types of toe tapping, i.e., "closed," with both feet on the floor, and "open," in which the foot does not touch the ground, and evaluates their usefulness in combination with monitoring of muscle activity during toe tapping. [Subjects and Methods] The study enrolled 11 patients with Parkinson's disease (PD) and 9 controls (Controls). The tibialis anterior (TA) and gastrocnemius (GS) muscle activity during toe tapping was measured using surface electromyography. [Results] In closed tapping, the minima in GS activation with the first tap was significantly higher in patients with PD than in Controls. In open tapping, the coefficient of variation (CV) of local maxima in TA activation was significantly higher in patients with PD than in Controls. In both types of tapping, the CV of extrema in GS activities increased with disease duration, but this may be due to the long-term administration of Levodopa, which itself tends to cause excessive GS activities. [Conclusion] Closed tapping is suitable for the assessment of GS activity and can detect excessive activities, which is observed as visible movement. Open tapping, on the other hand, is suitable for assessment of TA activity.

[Lesser toe deformities. Definition, pathogenesis, and options for surgical correction].

PubMed

Arnold, H

2005-08-01

Whereas in the past resection arthroplasty was - in analogy to hallux valgus surgery - the preferred therapy to correct lesser toe deformities, the point of view has undergone a change. Much interest is directed toward functional aspects that require reconstructive management. Whenever possible the integrity of joint play should be saved. Above all the metatarsophalangeal joint of the lesser toes is worth being preserved to prevent a severe disturbance of the biomechanics of the foot. Tendon transfers and subtle corrective osteotomies such as the Weil procedure allow restricting resection procedures to contraction deformities.

Improvisation in wrap-around toe-to-thumb transfer.

PubMed

Govila, A

1993-01-01

Wrap-around partial great toe transfer, a one time dream, is now a well established and universally accepted method of thumb reconstruction. In this technique, part of the soft tissue of the great toe are wrapped around and shaped to the size of the graft from iliac bone in such a manner that a thumb of normal dimensions and shape is produced. Instead of the iliac bone graft, we found great merit in using the second metacarpal from the traumatised hand to be reconstructed. In this paper its use and merits are elaborated.

A new treatment for parrot beak deformity of the toe.

PubMed

Kurokawa, M; Isshiki, N; Inoue, K

1994-03-01

Two cases of congenital parrot beak deformity of the toe were treated by pushing back the nail plate, nailbed, matrix, and proximal skin fold in one piece as a flap. The proximal skin portion of this flap was deepithelialized to facilitate this shift, and thus no dog-ear deformity was produced. The distal skin defect of the pulp was covered by a palmar advancement flap. This method does not require augmentation of the fingertip or toetip and is very useful for correcting parrot beak deformities of the toes.

Intercalary non-vascularised toe phalanx transplantation for short finger-type symbrachydactyly.

PubMed

Kanauchi, Yumiko; Takahara, Masatoshi; Ogino, Toshihiko; Kashiwa, Hideo; Ishigaki, Daisuke

2003-12-01

A two-year-old boy with short finger-type symbrachydactyly involving the index, middle, and ring fingers was treated with intercalary nonvascularised toe phalanx transplantation into the middle finger to obtain stability of the middle finger before syndactyly release. He underwent syndactyly release one year after the transplantation. Two years after the transplantation, the clinical result was satisfactory, although X-ray showed fibrous union between the transplanted phalanx and the host phalanx. Intercalary nonvascularised toe phalanx transplantation is one of the way of stabilising a finger after syndactyly release.

Double second toe transfer in congenital hand anomalies.

PubMed

Van Holder, C; Giele, H; Gilbert, A

1999-08-01

A series of 14 patients with congenital hand anomalies who received staged double second toe transfers to the same hand for restoration of function or form were reviewed retrospectively. There were three children with constriction ring syndrome, two with symbrachydactyly and nine with transverse absence (failure of formation). There were different indications, technical difficulties and results with the various anomalies. All transferred toes were mobile and sensate, and were reported to be of benefit in both function and appearance. However, secondary surgical procedures were required in all patients.

Long-Term Evolution of a Long-Term Evolution Model

DTIC Science & Technology

2011-01-01

equations for the movement of the dune toe yD and the berm crest location yB are dyD/dt=(qw-qo)/DD and dyB/dt=-(qw-qo)/(DB+DC) respectively, where qw...and sand properties, yB and yD = distances to the seaward end of the berm and the dune toe , respectively, with the y-axis pointing offshore, y50...relative to mean sea level, MSL); zD = dune toe elevation (with respect to MSL); T = swash period (taken to be the same as the wave period); and Cs

Calculation of Beach Change Under Interacting Cross-Shore and Longshore Processes

DTIC Science & Technology

2010-01-01

the dune toe , berm width, and shoreline position are calculated, while maintaining longshore transport rates representative of the regional long-term...during growth together with the dune shape, the seaward movement of the dune toe ΔyDw for a given increase in dune volume ΔVDw is: ΔyDw = ΔVDw DD ð2Þ...Expressing Eq. (1) in terms of dune toe advance yields: dyDw dt = qw DD ð3Þ It is assumed that sand transport to the dune is related to thewidth of the

Neural Networks and Their Application to Air Force Personnel Modeling

DTIC Science & Technology

1991-11-01

specifications of the error function ( Chauvin , 1990; Hanson & Pratt, 1989) and found that out-of-sample performance can be improved by this modification...X X Black X X X X Hispanic X X - White & female X Black & male X Female X X X X Xŕ] Single or married indicator X X X X X X Age less than or equal 17...administration, female in unknown specialty, and black male in support and administration. 7Five dummies: TOE 4 and YOS 2. TOE 6 and YOS 1. TOE 6 and

How to "Read" Your Shoes

MedlinePlus

... the Big Toe Ailments of the Smaller Toes Diabetic Foot Treatments Injections and other Procedures Treatments of the ... Find a Surgeon Información en Español Foot Health Foot ... Diabetic Shoes 10 Points of Proper Shoe Fit All ...

Effects of Long-duration Space Flight on Toe Clearance During Treadmill Walking

NASA Technical Reports Server (NTRS)

Miller, Chris; Peters, Brian; Brady, Rachel; Mulavara, Ajitkumar; Richards, Jason; Hayat, Matthew; Bloomberg, Jacob

2008-01-01

Upon returning from long-duration space flight, astronauts and cosmonauts must overcome physiologic and sensorimotor changes induced by prolonged exposure to microgravity as they readapt to a gravitational environment. Their compromised balance and coordination lead to an altered and more variable walking pattern (Bloomberg & Mulavara, 2003; McDonald, et al., 1996). Toe trajectory during the swing phase of locomotion has been identified as a precise motor control task (Karst, et al., 1999), thus providing an indication of the coordination of the lower limbs (Winter, 1992). Failure to achieve sufficient toe clearance may put the crew member at a greater risk of tripping and falling, especially if an emergency egress from the vehicle should be necessary upon landing. The purpose of this study was to determine the pre- to post-flight changes in toe clearance in crew members returning from long-duration missions and the recovery thereafter.

A Study to Determine the Best Method of Caring for Certain Short-Stay Surgical Patients at Reynolds Army Community Hospital

DTIC Science & Technology

1988-09-01

Perineoplasty Vaginal cyst, cautery Vaginal web, excision Surgical Patients 95 ORTHOPEDIC Arthrodesis of phalanges Arthroscopy Bone biopsy Bunionectomy...Manipulation of shoulder, knee, or hip Mass excision with scar revision Meniscectomy (if done through arthroscopy ) Metatarsal head, excision unilateral

Pain Experience is Somatotopically Organized and Overlaps with Pain Anticipation in the Human Cerebellum.

PubMed

Michelle Welman, F H S; Smit, Albertine E; Jongen, Joost L M; Tibboel, Dick; van der Geest, Jos N; Holstege, Jan C

2018-02-26

Many fMRI studies have shown activity in the cerebellum after peripheral nociceptive stimulation. We investigated whether the areas in the cerebellum that were activated after nociceptive thumb stimulation were separate from those after nociceptive toe stimulation. In an additional experiment, we investigated the same for the anticipation of a nociceptive stimulation on the thumb or toe. For his purpose, we used fMRI after an electrical stimulation of the thumb and toe in 19 adult healthy volunteers. Following nociceptive stimulation, different areas were activated by stimulation on the thumb (lobule VI ipsilaterally and Crus II mainly contralaterally) and toe (lobules VIII-IX and IV-V bilaterally and lobule VI contralaterally), i.e., were somatotopically organized. Cerebellar areas innervated non-somatotopically by both toe and thumb stimulation were the posterior vermis and Crus I, bilaterally. In the anticipation experiment, similar results were found. However, here, the somatotopically activated areas were relatively small for thumb and negligible for toe stimulation, while the largest area was innervated non-somatotopically and consisted mainly of Crus I and lobule VI bilaterally. These findings indicate that nociceptive stimulation and anticipation of nociceptive stimulation are at least partly processed by the same areas in the cerebellum. This was confirmed by an additional conjunction analysis. Based on our findings, we hypothesize that input that is organized in a somatotopical manner reflects direct input from the spinal cord, while non-somatotopically activated parts of the cerebellum receive their information indirectly through cortical and subcortical connections, possibly involved in processing contextual emotional states, like the expectation of pain.

Gender differences of sagittal knee and ankle biomechanics during stair-to-ground descent transition.

PubMed

Hong, Yoon No Gregory; Shin, Choongsoo S

2015-12-01

Falls on stairs often result in severe injury and occur twice as frequently in women. However, gender differences in kinetics and kinematics during stair descent are unknown. Thus, this study aimed to determine whether gender differences of knee and ankle biomechanics exist in the sagittal plane during the stair-to-ground descending transition. It was hypothesized that 1) women would reveal higher ground-toe-trochanter angle and lower ground-toe length during stair-to-ground descent transition than men; and 2) women would reveal lower peak knee extension moment during stair-to-ground descent transition than men. Fifteen men and fifteen women were recruited and performed a stair descent activity. Kinetic and kinematic data were obtained using a force plate and motion capture system. The women performed the stair descent with a lower peak knee extension moment and a peak knee power at the early weight acceptance phase. The women also revealed a higher ground-toe-trochanter angle and a lower ground-toe length, which indicated a more forward position of the lower extremity relative to the toe contact point at both the initial contact and at the time of peak kinematic and kinetic events. This study found that knee and ankle kinematics and kinetics differed significantly between the genders due to differences in ground-toe-trochanter angle. Women have a different stair descending strategy that reduces the demand of the lower extremity muscle function, but this strategy seems to increase the risk of falls. Copyright © 2015 Elsevier Ltd. All rights reserved.

A simplified measurement of pulse wave velocity is not inferior to standard measurement in young adults and children.

PubMed

Edgell, Heather; Stickland, Michael K; MacLean, Joanna E

2016-06-01

The standard measurement of pulse wave velocity (PWV) is restricted by the need for simultaneous tonometry measurements requiring two technicians and expensive equipment, limiting this technique to well-resourced settings. In this preliminary study, we compared a simplified method of pulse wave detection from the finger and toe to pulse wave detection from the carotid and radial arteries using applanation tonometry in children and young adults. We hypothesized that the simplified method of PWV measurement would strongly correlate with the standard measurement in different age groups and oxygen conditions. Participants included (a) boys and girls aged 8-12 years and (b) men and women aged 18-40 years. Participants rested supine while carotid and radial artery pulse waves were measured using applanation tonometry and finger and toe pulse waves were simultaneously collected using a Finometer Midi and a piezo-electric pulse transducer, respectively. These measurements were repeated under hypoxic conditions. Finger-toe PWV measurements were strongly correlated to carotid-radial PWV in adults (R=0.58; P=0.011), but not in children (R=0.056; P=0.610). Finger-toe PWV was sensitive enough to show increases in PWV with age (P<0.0001) and hypoxia in children (P<0.0001) and adults (P=0.003). These results indicate that the simplified measurement of finger-toe PWV strongly correlates with the standard measurement of carotid-radial PWV in adults, but not in children. However, finger-toe PWV can be used in either population to determine changes with hypoxia.

5. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING SOUTHWEST - High Mountain Dams in Upalco Unit, Kidney Lake Dam, Ashley National Forest, 4.7 miles North of Miners Gulch Campground, Mountain Home, Duchesne County, UT

6. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING SOUTHWEST - High Mountain Dams in Upalco Unit, Kidney Lake Dam, Ashley National Forest, 4.7 miles North of Miners Gulch Campground, Mountain Home, Duchesne County, UT

5. DETAIL VIEW OF TOE SPILLWAY SECTION OF LOWWATER DAM, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. DETAIL VIEW OF TOE SPILLWAY SECTION OF LOW-WATER DAM, LOOKING NORTHWEST (UPSTREAM). ST. LOUIS WATER DEPARTMENT INTAKE IN BACKGROUND - Upper Mississippi River 9-Foot Channel Project, Lock & Dam 27, Granite City, Madison County, IL

Application of Finite Element Method of Numerical Modelling to Understand Toe Buckling Deformation in the Southern Alps of New Zealand.

NASA Astrophysics Data System (ADS)

Ridl, Romy; Bell, David; Villeneuve, Marlene

2017-04-01

Toe buckling deformation is a temporal product of induced stresses concentrated at the base of a slope. Prolonged induced stresses may lead to yielding of an anisotropic rock mass, either through rheological creep deformation (flexural toe buckling) or brittle failure (hinge buckling). Progressive deformation can lead to the breakout at the buckled toe and ultimately result in deep seated displacements on a mountain range scale, referred to as deep seated gravitational slope deformation (DSGSD). DSGSD can have a considerable impact on civil infrastructure and should be well understood for hazard identification, to inform civil engineering design and for resource management purposes. Toe buckling deformation was identified beneath the basal sliding zone of three large (≥50 Mm3) landslides in the Cromwell Gorge, New Zealand. This area was subjected to extensive geotechnical investigations for the Clyde Hydropower Scheme. During these investigations seventeen major landslides were identified in the Cromwell Gorge and subsequently stabilised. The data from the landslide stabilisation project, including 26.7 km of boreholes and 9 km of tunnels, for the three landslides exhibiting toe buckling was made available for this study. This comprehensive database has enabled comparison and validation of numerical simulations carried out for the Cromwell Gorge. The application of numerical modelling has demonstrated that toe buckling within the Cromwell Gorge is a result of the combination of induced stresses acting on an anisotropic schistose rock mass. The induced stresses comprise: i) topographically-induced gravitational stresses parallel to the slope, associated with the evolution of the Cromwell Gorge from a relatively low relief surface to present day topography (1400 m deep valley), and ii) active far-field tectonic stresses associated with the obliquely convergent stress regime of the Australian-Pacific continent plate boundary. Finite Element Method (FEM) numerical models were used to model the anisotropic nature of the schist rock mass, and a sequential unloading method was adopted to simulate valley evolution. Far-field tectonics were incorporated into the model by comparing topographically induced gravitational stresses with in situ field stress measurements. The results of sensitivity analyses demonstrate that the dominant parameters governing toe buckling deformation in the Cromwell Gorge are a function of the anisotropy of the schist (foliation orientation and stiffness), and the intersection of the two induced stress fields near the base of the slopes.

Anatomic relationship of the proximal nail matrix to the extensor hallucis longus tendon insertion.

PubMed

Palomo López, P; Becerro de Bengoa Vallejo, R; López López, D; Prados Frutos, J C; Alfonso Murillo González, J; Losa Iglesias, M E

2015-10-01

The purpose of this study was to delineate the relationship of the terminal extensor hallucis longus tendon insertion to the proximal limit of the nail matrix of the great toe. Fifty fresh-frozen human cadaver great toes with no evidence of trauma (average age, 62.5 years; 29 males and 21 females) were used for this study. Under 25X magnification, the proximal limit of the nail matrix and the terminal bony insertion of the extensor hallucis longus tendons were identified. The distance from the terminal tendon insertion to the nail matrix was ascertained using precision calipers, an optical microscope, and autocad(®) software for windows. Twenty-five great toes were placed in a neutral formalin solution and further analysed by histological longitudinal-sections. The specimens were stained with haematoxylin and eosin and examined microscopically to determine the presence of the extensor hallucis longus tendon along the dorsal aspect of the distal phalanx of each great toe. The main result we found in great toes was that the extensor tendon is between the matrix and the phalanx and extends dorsally to the distal aspect of the distal phalanx in all, 100%, specimens. The nail matrix of the great toe is not attached to the periosteum of the dorsal aspect of the base of the distal phalanx as is the case for fingers, because the extensor hallucis tendon is plantar or directly underneath the nail matrix and the tendon is dorsal to the bone. We have found that the extensor tendon is between the matrix and the phalanx and extends dorsally to the distal aspect of the distal phalanx. The nail matrix of the great toe is not attached to the periosteum of the dorsal aspect of the base of distal phalanx as is the case in fingers, because the extensor hallucis tendon is plantar or directly underneath the nail matrix and the tendon is dorsal to the bone. Our anatomic study demonstrates that the proximal limit of the matrix and nail bed of the human great toe are dorsal and overlapping the terminal extensor hallucis longus tendon until its distal bony insertion in all specimens. © 2015 European Academy of Dermatology and Venereology.

49 CFR 214.115 - Foot protection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... shock or burns, or other hazardous condition. (b) Safety-toe footwear for railroad bridge workers shall conform to the national consensus standards for safety-toe footwear (American National Standards Institute, American National Standard Z41-1991, Standard for Personal Protection-Protective Footwear). This...

49 CFR 214.115 - Foot protection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... shock or burns, or other hazardous condition. (b) Safety-toe footwear for railroad bridge workers shall conform to the national consensus standards for safety-toe footwear (American National Standards Institute, American National Standard Z41-1991, Standard for Personal Protection-Protective Footwear). This...

49 CFR 214.115 - Foot protection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... shock or burns, or other hazardous condition. (b) Safety-toe footwear for railroad bridge workers shall conform to the national consensus standards for safety-toe footwear (American National Standards Institute, American National Standard Z41-1991, Standard for Personal Protection-Protective Footwear). This...

49 CFR 214.115 - Foot protection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... shock or burns, or other hazardous condition. (b) Safety-toe footwear for railroad bridge workers shall conform to the national consensus standards for safety-toe footwear (American National Standards Institute, American National Standard Z41-1991, Standard for Personal Protection-Protective Footwear). This...

Bunion removal - series (image)

MedlinePlus

... causes the joint to thicken and enlarge. This causes the bones of the big toe to angle in toward and over the ... pain-free (general anesthesia) and rarely requires a hospital ... the bones of the big toe into the foot. The deformed joint and ...

[Breast cancer metastasis in distal phalanx of the big toe. Case report].

PubMed

Carlesimo, B; Tempesta, M; Fioramonti, P; Bistoni, G; Ruggiero, M; Marchetti, F

2009-01-01

Breast cancer represents the most prevalent malignancies in women and bone is the first site of metastasis in 26-50% of cases. Usually metastasis involve limbs in 16%. We present a rare case of 47-year-old woman, who underwent to monolateral mastectomy for lobular cancer. After 8 years from surgery, she presented pain, swelling and functional limitations, gradually increasing, to the left big toe. X-rays and MRI showed a lucent area of bone destruction on the shaft of the distal phalanx of the left big toe. Surgical biopsy on the excised bone assessed for breast cancer metastasis.

Flood-Side Wave Erosion of Earthen Levees: Present State of Knowledge and Assessment of Armoring Necessity

DTIC Science & Technology

2010-08-01

levee crown and flood-side slope toe would have to be greater than 20 ft to maintain a suitable freeboard and still have waves break directly on...dike slope is smooth, and the toe of the flood-side slope is usually dry except during storm events (on average 20 per year). The presence of the...sides to complete the 5-m (16.4 ft) flume width. There was an asphalt covered surface from the toe of the slope up to the +2 m (+6.6 ft) elevation. The

Free toe pulp transfer for digital reconstruction after high-pressure injection injury.

PubMed

Chan, B K; Tham, S K; Leung, M

1999-10-01

We report two cases of high-pressure injection injuries to the fingertip in which free toe pulp flaps were used to resurface the palmar surface of the finger following extensive wound debridement. There was good return of sensibility and, because of the high durability of the donor skin, both patients regained good functional use of the injured digits and returned to heavy manual work. There was minimal associated morbidity of the donor sites. The free toe pulp flap represents an excellent alternative for resurfacing the digit with a large residual skin defect after high-pressure injection injury.

A prototype wireless inertial-sensing device for measuring toe clearance.

PubMed

Lai, Daniel T H; Charry, E; Begg, R; Palaniswami, M

2008-01-01

Tripping and slipping are serious health concerns for the elderly because they result in life threatening injuries i.e., fractures and high medical costs. Our recent work in detection of tripping gait patterns has demonstrated that minimum toe clearance (MTC) is a sensitive falls risk predictor. MTC measurement has previously been done in gait laboratories and on treadmills which potentially imposes controlled walking conditions. In this paper, we describe a prototype design of a wireless device for monitoring vertical toe clearance. The sensors consists of a tri-axis accelerometer and dual-axis gyroscope connected to Crossbow sensor motes for wireless data transmission. Sensor data are transmitted to a laptop and displayed on a Matlab graphic user interface (GUI). We have performed zero base and treadmill experiments to investigate sensor performance to environmental variations and compared the calculated toe clearance against measurements made by an Optotrak motion system. It was found that device outputs were approximately independent of small ambient temperature variations, had a reliable range of 20m indoors and 50m outdoors and a maximum transmission rate of 20 packets/s. Toe clearance measurements were found to follow the Optotrak measurement trend but could be improved further by dealing with double integration errors and improving data transmission rates.

Prediction of wound healing after minor amputations of the diabetic foot.

PubMed

Caruana, Luana; Formosa, Cynthia; Cassar, Kevin

2015-08-01

To identify any significant differences in physiological test results between healing and non healing amputation sites. A single center prospective non-experimental study design was conducted on fifty subjects living with type 2 diabetes and requiring a forefoot or toe amputation. Subjects underwent non-invasive physiological testing preoperatively. These included assessment of pedal pulses, preoperative arterial spectral waveforms at the ankle, absolute toe pressures, toe-brachial pressure index and ankle-brachial pressure index. After 6 weeks, patients were examined to assess whether the amputation site was completely healed, was healing, had developed complications, or did not heal. There was no significant difference in ABPI between the healed/healing and the non-healing groups. Mean TBI (p=0.031) and toe pressure readings (p=0.014) were significantly higher in the healed/healing group compared to the non healing group. A significant difference was also found in ankle spectral waveforms between the two groups (p=0.028). TBIs, toe pressures and spectral waveforms at the ankle are better predictors of likelihood of healing and non-healing after minor amputation than ABPIs. ABPI alone is a poor indicator of the likelihood of healing of minor amputations and should not be relied on to determine need for revascularization procedures before minor amputation. Copyright © 2015 Elsevier Inc. All rights reserved.

Finnish bioenergy research

DOE Office of Scientific and Technical Information (OSTI.GOV)

Malinen, H.

1993-12-31

Finland is one of the leading countries in the use of biofuels. The share of wood derived fuels of the total primary energy requirement was about 14% (ca. 4 million toe) and peat about 5% (1.4 million toe). The possibilities for increasing the use of biofuels in Finland are significant. There is theoretically about 10 million m{sup 3}/a (about 2 million toe/a) of harvestable wood. Areas suitable for fuel peat production (0.5 million ha) could produce ca. 420 million toe of peat. At present rates of use, the peat reserves are adequate for centuries. During the next few years 0.5--1more » million hectares of fields withdrawn from farming could be used for biofuel production. The production potential of this field area is estimated to be about 0.2--0.5 million toe. In addition, the use of wastes in energy production could be increased. The aim of the new Bioenergy Research Programme is to increase the use of economically profitable and environmentally sound bioenergy by improving the competitiveness of present peat and wood fuels. New economically competitive biofuels, new equipment and methods for production, handling and use of biofuels will also be developed. The main research areas are production of wood fuels, peat production, use of bioenergy and conversion of biomass.« less

Biomechanical comparison of single-row, double-row, and transosseous-equivalent repair techniques after healing in an animal rotator cuff tear model.

PubMed

Quigley, Ryan J; Gupta, Akash; Oh, Joo-Han; Chung, Kyung-Chil; McGarry, Michelle H; Gupta, Ranjan; Tibone, James E; Lee, Thay Q

2013-08-01

The transosseous-equivalent (TOE) rotator cuff repair technique increases failure loads and contact pressure and area between tendon and bone compared to single-row (SR) and double-row (DR) repairs, but no study has investigated if this translates into improved healing in vivo. We hypothesized that a TOE repair in a rabbit chronic rotator cuff tear model would demonstrate a better biomechanical profile than SR and DR repairs after 12 weeks of healing. A two-stage surgical procedure was performed on 21 New Zealand White Rabbits. The right subscapularis tendon was transected and allowed to retract for 6 weeks to simulate a chronic tear. Repair was done with the SR, DR, or TOE technique and allowed to heal for 12 weeks. Cyclic loading and load to failure biomechanical testing was then performed. The TOE repair showed greater biomechanical characteristics than DR, which in turn were greater than SR. These included yield load (p < 0.05), energy absorbed to yield (p < 0.05), and ultimate load (p < 0.05). For repair of a chronic, retracted rotator cuff tear, the TOE technique was the strongest biomechanical construct after healing followed by DR with SR being the weakest. Copyright © 2013 Orthopaedic Research Society.

Alarm toe switch

DOEpatents

Ganyard, Floyd P.

1982-01-01

An alarm toe switch inserted within a shoe for energizing an alarm circuit n a covert manner includes an insole mounting pad into which a miniature reed switch is fixedly molded. An elongated slot perpendicular to the reed switch is formed in the bottom surface of the mounting pad. A permanent cylindrical magnet positioned in the forward portion of the slot with a diameter greater than the pad thickness causes a bump above the pad. A foam rubber block is also positioned in the slot rearwardly of the magnet and holds the magnet in normal inoperative relation. A non-magnetic support plate covers the slot and holds the magnet and foam rubber in the slot. The plate minimizes bending and frictional forces to improve movement of the magnet for reliable switch activation. The bump occupies the knuckle space beneath the big toe. When the big toe is scrunched rearwardly the magnet is moved within the slot relative to the reed switch, thus magnetically activating the switch. When toe pressure is released the foam rubber block forces the magnet back into normal inoperative position to deactivate the reed switch. The reed switch is hermetically sealed with the magnet acting through the wall so the switch assembly S is capable of reliable operation even in wet and corrosive environments.

3D Printing Technology in Planning Thumb Reconstructions with Second Toe Transplant.

PubMed

Zang, Cheng-Wu; Zhang, Jian-Lei; Meng, Ze-Zu; Liu, Lin-Feng; Zhang, Wen-Zhi; Chen, Yong-Xiang; Cong, Rui

2017-05-01

To report preoperative planning using 3D printing to plan thumb reconstructions with second toe transplant. Between December 2013 and October 2015, the thumbs of five patients with grade 3 thumb defects were reconstructed using a wrap-around flap and second toe transplant aided by 3D printing technology. CT scans of hands and feet were analyzed using Boholo surgical simulator software (www.boholo.com). This allowed for the creation of a mirror image of the healthy thumb using the uninjured thumb. Using 3D images of the reconstructed thumb, a model of the big toe and the second toe was created to understand the dimensions of the donor site. This model was also used to repair the donor site defect by designing appropriate iliac bone and superficial circumflex iliac artery flaps. The polylactic acid model of the donor toes and reconstructed thumb was produced using 3D printing. Surgically, the wrap-around flap of the first dorsal metatarsal artery and vein combined with the joint and bone of the second toe was based upon the model donor site. Sensation was reconstructed by anastomosing the dorsal nerve of the foot and the plantar digital nerve of the great toe. Patients commenced exercises 2 weeks after surgery. All reconstructed thumbs survived, although partial flap necrosis occurred in one case. This was managed with regular dressing changes. Patients were followed up for 3-15 months. The lengths of the reconstructed thumbs are 34-49 mm. The widths of the thumb nail beds are 16-19 mm, and the thickness of the digital pulp is 16-20 mm. The thumb opposition function was 0-1.5 cm; the extension angle was 5°-20° (mean, 16°), and the angle of flexion was 38°-55° (mean, 47°). Two-point discrimination was 9-11 mm (mean, 9.6 mm). The reconstructed thumbs had good appearance, function and sensation. Based on the criteria set forth by the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of the Chinese Medical Association, the results were considered excellent for four cases and good for one case. The success rate was 100%. When planning a wrap-around flap and second toe transplant to reconstruct a thumb, both the donor and recipient sites can be modeled using 3D printing. This can shorten the operative time by supplying digital and accurate schematics for the operation. It can also optimize the function and appearance of the reconstructed thumb while minimizing damage to the donor site. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Hammer toe

MedlinePlus

... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Toe Injuries and Disorders Read more NIH MedlinePlus ...

In-Toeing and Out-Toeing in Toddlers

MedlinePlus

... life. Often this is most noticeable when a child learns to walk because if the tibia or femur ... a neuromuscular condition in rare cases. Have your child evaluated by a doctor if ... such as not learning to talk as expected gait abnormalities that worsen ...

EMG and force production of the flexor hallucis longus muscle in isometric plantarflexion and the push-off phase of walking.

PubMed

Péter, Annamária; Hegyi, András; Stenroth, Lauri; Finni, Taija; Cronin, Neil J

2015-09-18

Large forces are generated under the big toe in the push-off phase of walking. The largest flexor muscle of the big toe is the flexor hallucis longus (FHL), which likely contributes substantially to these forces. This study examined FHL function at different levels of isometric plantarflexion torque and in the push-off phase at different speeds of walking. FHL and calf muscle activity were measured with surface EMG and plantar pressure was recorded with pressure insoles. FHL activity was compared to the activity of the calf muscles. Force and impulse values were calculated under the big toe, and were compared to the entire pressed area of the insole to determine the relative contribution of big toe flexion forces to the ground reaction force. FHL activity increased with increasing plantarflexion torque level (F=2.8, P=0.024) and with increasing walking speed (F=11.608, P<0.001). No differences were observed in the relative contribution of the force under the big toe to the entire sole between different plantarflexion torque levels (F=0.836, P=0.529). On the contrary, in the push-off phase of walking, peak force under the big toe increased at a higher rate than force under the other areas of the plantar surface (F=3.801, P=0.018), implying a greater relative contribution to total force at faster speeds. Moreover, substantial differences were found between isometric plantarflexion and walking concerning FHL activity relative to that of the calf muscles, highlighting the task-dependant behaviour of FHL. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of two methods based on photoplethysmography for the diagnosis of peripheral arterial disease.

PubMed

Høyer, Christian; Nielsen, Nikolaj Schandorph; Jordansen, Malene Kragh Overvad; Zacho, Helle Damgaard

2017-12-01

To examine the interchangeability of two methods for distal pressure measurement based on photoplethysmography using a truncated or full display of the arterial inflow curve, respectively. Toe and ankle pressures were obtained from 69 patients suspected of peripheral arterial disease (PAD). Observer reproducibility of the curve readings was examined by blinded reassessment of the pressure curves in a randomly selected subgroup (60 limbs). There were no significant differences in mean pressures between the two methods (p for all > .455). The limits of agreement for the differences were -15.0-15.4 mmHg for right toe pressures, -16.3-16.2 mmHg for left toe pressures, -14.2-15.7 mmHg for right ankle pressures, and -18.3-17.7 mmHg for left ankle pressures. Correlation analysis revealed intraclass correlation coefficients ≥0.960 for all measuring sites. Cohen's Kappa showed excellent agreement in diagnostic classification, with κ = 0.930 for the diagnosis of PAD and perfect agreement in the diagnosis of critical limb ischemia (κ = 1.000). The analysis of intra-observer variation for curve reading showed limits of agreement of -3.9-4.0 for toe pressures and -7.6-7.7 for ankle pressures for the method involving truncated display and -3.1-3.2 for toe pressures and -6.3-8.6 for ankle pressures for the method involving full display of the signal. The present study shows minimal differences in diagnostic classification, as well as in ankle and toe pressures, between the full display and the truncated display of the photoplethysmographic pulse signal. Furthermore, the inter-observer variation was low for both of the photoplethysmographic methods investigated.

Effect of hoof boots and toe-extension shoes on the forelimb kinetics of horses during walking.

PubMed

Amitrano, Fernando N; Gutierrez-Nibeyro, Santiago D; Schaeffer, David J

2016-05-01

OBJECTIVE To determine and compare the effect of hoof boots (HBs) and shoes with a toe extension on stance duration, ground reaction force, and sole length in contact with the ground in nonlame horses during walking. ANIMALS 6 nonlame Standardbreds. PROCEDURES Force plate gait analyses of the forelimbs were performed while the horses were walking barefoot before manipulation of feet (baseline), while the horses were walking fitted with HBs, while the horses were walking shod with toe-extension shoes, and while the horses were walking barefoot after shoe removal. Horses underwent radiography of both forelimb feet to determine the sole length in contact with the ground when barefoot, wearing HBs, and shod with toe-extension shoes. Stance duration, ground reaction force, and sole length were compared among the various walking sessions. RESULTS Compared with baseline findings, stance duration increased significantly when horses were fitted with HBs (7%) or toe-extension shoes (5%). Peak forelimb ground reaction force was similar among walking sessions; however, time of braking force peak was significantly greater during the stance phase only when horses wore HBs. Also, the sole length in contact with the ground was significantly longer in horses fitted with HBs (14.3 cm) or shod with the toe-extension shoes (17.6 cm), compared with that for one of the barefoot hooves (12.7 cm). CONCLUSIONS AND CLINICAL RELEVANCE In nonlame horses, use of HBs prolonged the stance time and time of braking force peak, which is indicative of a slower deceleration phase during limb impact with the ground. Also, the use of HBs prolonged the deceleration phase of the stride and increased the sole length in contact with the ground.

Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling.

PubMed

Shen, Guangping; Zhang, Songning; Bennett, Hunter J; Martin, James C; Crouter, Scott E; Fitzhugh, Eugene C

2018-06-01

Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of knee alignment and use of a toe clip on the knee frontal plane biomechanics during stationary cycling. A total of 32 participants (11 varus, 11 neutral, and 10 valgus alignment) performed five trials in each of six cycling conditions: pedaling at 80 rpm and 0.5 kg (40 Watts), 1.0 kg (78 Watts), and 1.5 kg (117 Watts) with and without a toe clip. A motion analysis system and a customized instrumented pedal were used to collect 3D kinematic and kinetic data. A 3 × 2 × 3 (group × toe clip × workload) mixed design ANOVA was used for statistical analysis (p < 0.05). There were two different knee frontal plane loading patterns, internal abduction and adduction moment, which were affected by knee alignment type. The knee adduction angle was 12.2° greater in the varus group compared to the valgus group (p = 0.001), yet no difference was found for KAM among groups. Wearing a toe clip increased the knee adduction angle by 0.95º (p = 0.005). The findings of this study indicate that stationary cycling may be a safe exercise prescription for people with knee malalignments. In addition, using a toe clip may not have any negative effects on knee joints during stationary cycling.

A systematic review of the effect of pre-test rest duration on toe and ankle systolic blood pressure measurements

PubMed Central

2014-01-01

Background Measurement of toe and ankle blood pressure is commonly used to evaluate peripheral vascular status, yet the pre-test rest period is inconsistent in published studies and among practitioners, and could affect results. The aim of this systematic review is to evaluate all research that has investigated the effect of different periods of pre-test rest on toe and ankle systolic blood pressure. Methods The following databases were searched up to April 2012: Medline (from 1946), EMBASE (from 1947), CINAHL (from 1937), and Cochrane Central Register of Controlled Trials (CENTRAL) (from 1800). No language or publication restrictions were applied. Eighty-eight content experts and researchers in the field were contacted by email to assist in the identification of published, unpublished, and ongoing studies. Studies evaluating the effect of two or more pre-test rest durations on toe or ankle systolic blood pressure were eligible for inclusion. No restrictions were placed on participant characteristics or the method of blood pressure measurement. Outcomes included toe or ankle systolic blood pressure and adverse effects. Abstracts identified from the search terms were independently assessed by two reviewers for potential inclusion. Results 1658 abstracts were identified by electronic searching. Of the 88 content experts and researchers in the field contacted by email a total of 33 replied and identified five potentially relevant studies. No studies were eligible for inclusion. Conclusions There is no evidence of the effect of different periods of pre-test rest duration on toe and ankle systolic blood pressure measurements. Rigorous trials evaluating the effect of different durations of pre-test rest are required to direct clinical practice and research. PMID:24708870

Pseudohypoparathyroidism vs. tricho-rhino-phalangeal syndrome: patient reclassification.

PubMed

Pereda, Arrate; Azriel, Sharona; Bonet, Mariona; Garin, Intza; Gener, Blanca; Lecumberri, Beatriz; de Nanclares, Guiomar Pérez

2014-11-01

Given that tricho-rhino-phalangeal syndrome (TRPS) and pseudohypoparathyroidism/pseudopseudohypoparathyroidism (PHP/PPHP) are very rare monogenic disorders that share some features (distinctive facies, short stature, brachydactyly and, in some patients, intellectual disability) that lead to their misdiagnosis in some cases, our objective was to identify clinical, biochemical or radiological signs that could help to distinguish these two syndromes. We report on two cases, which were referred to the Endocrinology and Pediatric Endocrinology Services for obesity. Clinical evaluation initially suggested the diagnosis of PHP-Ia [phenotype suggestive of Albright hereditary osteodystrophy (AHO) with parathyroid hormone (PTH) resistance] and PPHP (phenotype resembling AHO, without PTH resistance), but (epi)genetic analysis of the GNAS locus ruled out the suspected diagnosis. Further clinical re-evaluation prompted us to suspect TRPS, and this was confirmed genetically. TRPS was mistakenly identified as PHP/PPHP because of the coexistence of obesity and brachydactyly, with PTH resistance in one of the cases. Specific traits such as sparse scalp hair and a pear-shaped nose, present in both cases, can be considered pathognomonic signs of TRPS, which could help us to reach a correct diagnosis.

New modified technique of osteotomy for hallux valgus.

PubMed

Oh, I S; Kim, M K; Lee, S H

2004-12-01

To improve the technique of osteotomy for hallux valgus (bunion). 38 cases of a new modified osteotomy procedure for hallux valgus were performed for 22 patients (21 women and one man). During a 3-year (range, 2-5 years) follow-up, the patients underwent physical examination; and their American Orthopedic Foot and Ankle Society hallux-metatarso-phalangeal-interphalangeal scale scores and standard foot radiographic measurements were recorded. 20 of the 22 patients (38 cases) had no pain, achieved good cosmesis, and were completely satisfied with the results of the operation. The remaining 2 patients had occasional mild discomfort. The mean hallux-metatarso-phalangeal-interphalangeal scale score was 93 points (range, 78-100 points). The mean preoperative and postoperative metatarsophalangeal angles were 34 degrees and 11 degrees, respectively. The mean postoperative reduction of the intermetatarsal angle and metatarsophalangeal angle were 6 degrees and 23 degrees, respectively. The new technique of osteotomy achieved even greater stability and accurate correction of the deformity in our 38 cases. Furthermore, it was more effective than conventional 'chevron' osteotomy in terms of correction of the deformity. Therefore, it should be used more widely.

Pedal proportions of Poposaurus gracilis: convergence and divergence in the feet of archosaurs.

PubMed

Farlow, James O; Schachner, Emma R; Sarrazin, John Cody; Klein, Hendrik; Currie, Philip J

2014-06-01

The crocodile-line basal suchian Poposaurus gracilis had body proportions suggesting that it was an erect, bipedal form like many dinosaurs, prompting questions of whether its pedal proportions, and the shape of its footprint, would likewise "mimic" those of bipedal dinosaurs. We addressed these questions through a comparison of phalangeal, digital, and metatarsal proportions of Poposaurus with those of extinct and extant crocodile-line archosaurs, obligate or facultatively bipedal non-avian dinosaurs, and ground birds of several clades, as well as a comparison of the footprint reconstructed from the foot skeleton of Poposaurus with known early Mesozoic archosaurian ichnotaxa. Bivariate and multivariate analyses of phalangeal and digital dimensions showed numerous instances of convergence in pedal morphology among disparate archosaurian clades. Overall, the foot of Poposaurus is indeed more like that of bipedal dinosaurs than other archosaur groups, but is not exactly like the foot of any particular bipedal dinosaur clade. Poposaurus likely had a digitigrade stance, and its footprint shape could have resembled grallatorid ichnotaxa, unless digit I of the foot of Poposaurus commonly left an impression. Copyright © 2014 Wiley Periodicals, Inc.

Radiographic anatomy of the foot and ankle-part 5. The phalanges.

PubMed

Christman, Robert A

2015-03-01

The normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates the detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional). Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation. Images of each foot and distal leg bone ("front" and "back" perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique. Foundational knowledge is provided that future researchers can use as a baseline ("normal") and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The results of the original project, owing to its broad scope, have been divided into five parts: the lower leg, the greater tarsus, the lesser tarsus, the metatarsals, and the phalanges (the focus of this article).

Simplicity and treatment of the typical cleft hand.

PubMed

Upton, J

2004-01-01

The typical cleft hand is now distinguished from symbrachydactyly. This review of the surgical treatment of 108 hands in 63 patients treated over a 28-year period concentrates upon the technical principles of surgical correction. The key to these reconstructions is a wide incision which extends from the ulnar side of the cleft around the malpositioned index finger to the thumb. This wide exposure provides clear identification of all anatomic structures within the palm. There are no tenuous flaps with narrow random pedicles. These difficult surgical corrections may often include index transposition, metacarpal and/or phalangeal osteotomies, joint releases, phalangeal ostectomies, preservation of the adductor pollicis muscle, first dorsal interosseous muscle release, syndactyly separation(s) and thumb duplication correction. Following reposition of all skeletal structures the dorsal and palmar full-thickness flaps are easily contoured to create a satisfactory first webspace. Outcomes data shows that although the pinch and grip remain weak, these hands are quite functional. It is important that the repositioned index ray not interfere with gripping and precision maneuvers between the mobile thumb and the ulnar two digits (ring and small) of the hand.

Extra-articular fractures of the digital metacarpals and phalanges of the long fingers.

PubMed

Le Nen, D

2014-02-01

Metacarpal and phalangeal fractures of the long fingers are the result of trauma occurring under extremely varied circumstances. As a consequence, the clinical presentation varies greatly, with every bone and joint potentially being involved. Each step of their treatment is crucial, although the benign appearance of these injuries can lead to steps being missed: diagnostic phase with clinical examination and radiographs; therapeutic phase where the most suitable treatment is chosen, which combines mobilization of the digital chains as soon as possible and in every patient; follow-up phase with regular monitoring to detect any complications, especially secondary displacement, and verify that good progress is being made during rehabilitation. The goal of any fracture treatment is to preserve or restore the anatomy, with the emphasis here being on the stability and mobility of the digital chains. The potential progression towards serious functional sequelae (pain, instability or stiffness in hand) and the resulting significant socio-economic repercussions must be at the forefront of a surgeon's mind early on during the initial care of any finger or hand trauma. Copyright © 2014. Published by Elsevier SAS.

7. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, WITH ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, WITH OUTLET CULVERT AND WING RETAINING WALLS, LOOKING NORTH - High Mountain Dams in Upalco Unit, Twin Pots Dam, Ashley National Forest, 10.1 miles North of Mountain Home, Mountain Home, Duchesne County, UT

29 CFR 1926.95 - Criteria for personal protective equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... steel-toe shoes or steel-toe boots) and non-specialty prescription safety eyewear, provided that the... 1926.95 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION Personal Protective and Life...

29 CFR 1926.95 - Criteria for personal protective equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... steel-toe shoes or steel-toe boots) and non-specialty prescription safety eyewear, provided that the... 1926.95 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION Personal Protective and Life...

A preliminary theoretical study of double blade two-dimensional aerodynamics for applications to vertical axis wind turbines

NASA Astrophysics Data System (ADS)

Weibust, E.

1981-04-01

A NASA model for computing the subsonic, viscous, attached flow around multielement airfoils was used to determine the amount of energy lost when using double blades rather than single ones. The resulting tangential force for the double or single blade configuration used as a criterion is found. Radial spacing, toe-in toe-out angle and tangential displacement (stagger) were varied to see how tagential force is affected. The greatest tangential force values are found to be achieved for maximum allowable radial spacing, which is determined by structural considerations, and is assumed to be on the order of 1.5 c. At this rather large distance, stagger as well as toe-in toe-out angle only gives slight improvements as long as the flow separation effects (stall region) are not considered. A large part of the energy is captured at relatively high wind speeds when the flow on the blades is partly separated (stalled).

Microsurgical transfer of the second toe for congenital deficiency of the thumb.

PubMed

Lister, G

1988-10-01

Twelve second-toe transfers have been performed to substitute for thumbs congenitally deficient through constriction ring syndrome, symbrachydactyly, and true transverse arrest. The children were on average 3 years of age, and the youngest was undertaken at 10 months. Anatomic variations were the rule in the six cases of transverse absence and the three cases of symbrachydactyly, requiring nerves, tendons, and vessels in the toe be connected to whatever appropriate structure could be located. All transfers survived, and only one required exploration. Sensation appeared good in the 11 seen in later review, but interphalangeal motion was achieved in only 3. However, good use was made of the digit by all except one patient, an early patient in whom there was not an adequate skeleton on which to base the transfer. This small series suggests that in appropriate cases toe transfer can be undertaken early for congenital deficiency with little fear of encountering microsurgical problems unique to the infant.

Accuracy and reproducibility of aortic annular measurements obtained from echocardiographic 3D manual and semi-automated software analyses in patients referred for transcatheter aortic valve implantation: implication for prosthesis size selection.

PubMed

Stella, Stefano; Italia, Leonardo; Geremia, Giulia; Rosa, Isabella; Ancona, Francesco; Marini, Claudia; Capogrosso, Cristina; Giglio, Manuela; Montorfano, Matteo; Latib, Azeem; Margonato, Alberto; Colombo, Antonio; Agricola, Eustachio

2018-02-06

A 3D transoesophageal echocardiography (3D-TOE) reconstruction tool has recently been introduced. The system automatically configures a geometric model of the aortic root and performs quantitative analysis of these structures. We compared the measurements of the aortic annulus (AA) obtained by semi-automated 3D-TOE quantitative software and manual analysis vs. multislice computed tomography (MSCT) ones. One hundred and seventy-five patients (mean age 81.3 ± 6.3 years, 77 men) who underwent both MSCT and 3D-TOE for annulus assessment before transcatheter aortic valve implantation were analysed. Hypothetical prosthetic valve sizing was evaluated using the 3D manual, semi-automated measurements using manufacturer-recommended CT-based sizing algorithm as gold standard. Good correlation between 3D-TOE methods vs. MSCT measurements was found, but the semi-automated analysis demonstrated slightly better correlations for AA major diameter (r = 0.89), perimeter (r = 0.89), and area (r = 0.85) (all P < 0.0001) than manual one. Both 3D methods underestimated the MSCT measurements, but semi-automated measurements showed narrower limits of agreement and lesser bias than manual measurements for most of AA parameters. On average, 3D-TOE semi-automated major diameter, area, and perimeter underestimated the respective MSCT measurements by 7.4%, 3.5%, and 4.4%, respectively, whereas minor diameter was overestimated by 0.3%. Moderate agreement for valve sizing for both 3D-TOE techniques was found: Kappa agreement 0.5 for both semi-automated and manual analysis. Interobserver and intraobserver agreements for the AA measurements were excellent for both techniques (intraclass correlation coefficients for all parameters >0.80). The 3D-TOE semi-automated analysis of AA is feasible and reliable and can be used in clinical practice as an alternative to MSCT for AA assessment. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.

Transthoracic echocardiography in patients undergoing mitral valve repair: comparison of new transthoracic 3D techniques to 2D transoesophageal echocardiography in the localization of mitral valve prolapse.

PubMed

Gripari, Paola; Mapelli, Massimo; Bellacosa, Ilaria; Piazzese, Concetta; Milo, Maria; Fusini, Laura; Muratori, Manuela; Ali, Sarah Ghulam; Tamborini, Gloria; Pepi, Mauro

2018-02-26

Successful mitral valve (MV) repair for degenerative mitral regurgitation (DMR) is mainly related to surgical expertise and MV anatomy. Although 2D echocardiography, specifically transoesophageal (TOE), provides precise information regarding MV anatomy, recent advancements in matrix technology meant a decisive step forward to the point where segmental MV analysis can be accurately performed from a noninvasive 3D transthoracic (TTE) approach. The aims of this study were: (a) to evaluate the feasibility and time required for real-time 3D TTE in a large consecutive cohort of patients with severe DMR in the assessment of MV anatomy; (b) to compare the accuracy of 3D TTE and 2D TOE versus surgical inspection in the recognition and localization of all components of the MV leaflets; (c) to establish the added diagnostic value of 3D colourDoppler examination to pure 3D morphologic evaluation. 149 consecutive patients with severe DMR underwent complete 3D TTE before surgery and 2D TOE in the operating room. Echocardiographic data obtained by the different techniques were compared with surgical inspection. 3D TTE was feasible in a relatively short time (8 ± 4 min), with good (49%) and optimal (33%) imaging quality in the majority of cases. 3D TTE had significant better overall accuracy compared to 2D TOE (93 and 91%, p < 0.05, respectively). 2D TOE was significantly more specific than 3D TTE in the identification of A3 prolapse (99 vs. 96%). The colourDoppler mode did not improve significantly the accuracy of 3D TTE, albeit it determined a better sensitivity in the detection of A2 prolapse if compared to 2D TOE (95 vs. 85%). 3D TTE with or without colourDoppler is a feasible and useful method in the analysis of MV prolapse; it allows a preoperative and noninvasive description of the pathology as accurate as the 2D TOE.

Comparative Study of Intramedullary Hammertoe Fixation.

PubMed

Obrador, Caterina; Losa-Iglesias, Marta; Becerro-de-Bengoa-Vallejo, Ricardo; Kabbash, Christina A

2018-04-01

Temporary Kirschner wire fixation (K-wire) is a widely used, low-cost fixation method for the correction of hammertoe deformity. Reported complications associated with K-wires prompted the development of new implants over the past decade. However, there is a lack of literature on comparative studies analyzing functional outcomes using validated questionnaires. The purpose of this study was to analyze functional outcomes in patients who had undergone proximal interphalangeal joint fusion using 2 types of intramedullary implant, the Smart Toe and the TenFuse, and to compare them with the outcomes in patients treated with standard K-wire fixation. A retrospective review of operative hammertoe correction by a single surgeon was performed in 96 patients followed for more than 12 months. Functional outcome was assessed using the Foot Function Index (FFI), the Short Form 36 (SF-36), and the 10-point visual analog scale (VAS) validated questionnaires. Complications and fusion rates were also evaluated. Several patients in the study underwent corrections in different toes; thus, a total of 186 toes were included in the study. From these, 65 toes (34.9%) were treated with K-wire fixation, 94 (50.5%) with Smart Toe titanium implant, and 27 (14.5%) with TenFuse allograft implant. No statistically significant differences in functional outcome and incidence of complications were observed among the 3 fixation groups, although the 2 intramedullary implants were associated with greater fusion rates and patient satisfaction. Breakage of the Smart Toe implant was significantly higher than that of the other fixations, with 10.6% of implants breaking within the first year postoperatively. SF-36 and VAS scores decreased 12 months after surgery for the 3 types of fixation, with no statistically significant differences observed. The use of Smart Toe and TenFuse implants provided operative outcomes comparable to those obtained using a K-wire fixation and slightly better patient satisfaction. Our results suggest that utilization of these implants for hammertoe correction was a reasonable choice that provided good alignment, pain reduction, and improved function at final follow-up. However, they are more expensive than K-wires. For this reason, in-depth cost-benefit studies would be required to justify their use as a standard treatment. Level III, comparative series.

Minimum toe clearance events in divided attention treadmill walking in older and young adults: a cross-sectional study.

PubMed

Santhiranayagam, Braveena K; Lai, Daniel T H; Sparrow, W A; Begg, Rezaul K

2015-07-12

Falls in older adults during walking frequently occur while performing a concurrent task; that is, dividing attention to respond to other demands in the environment. A particularly hazardous fall-related event is tripping due to toe-ground contact during the swing phase of the gait cycle. The aim of this experiment was to determine the effects of divided attention on tripping risk by investigating the gait cycle event Minimum Toe Clearance (MTC). Fifteen older adults (mean 73.1 years) and 15 young controls (mean 26.1 years) performed three walking tasks on motorized treadmill: (i) at preferred walking speed (preferred walking), (ii) while carrying a glass of water at a comfortable walking speed (dual task walking), and (iii) speed-matched control walking without the glass of water (control walking). Position-time coordinates of the toe were acquired using a 3 dimensional motion capture system (Optotrak NDI, Canada). When MTC was present, toe height at MTC (MTC_Height) and MTC timing (MTC_Time) were calculated. The proportion of non-MTC gait cycles was computed and for non-MTC gait cycles, toe-height was extracted at the mean MTC_Time. Both groups maintained mean MTC_Height across all three conditions. Despite greater MTC_Height SD in preferred gait, the older group reduced their variability to match the young group in dual task walking. Compared to preferred speed walking, both groups attained MTC earlier in dual task and control conditions. The older group's MTC_Time SD was greater across all conditions; in dual task walking, however, they approximated the young group's SD. Non-MTC gait cycles were more frequent in the older group across walking conditions (for example, in preferred walking: young - 2.9 %; older - 18.7 %). In response to increased attention demands older adults preserve MTC_Height but exercise greater control of the critical MTC event by reducing variability in both MTC_Height and MTC_Time. A further adaptive locomotor control strategy to reduce the likelihood of toe-ground contacts is to attain higher mid-swing clearance by eliminating the MTC event, i.e. demonstrating non-MTC gaits cycles.

Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling

PubMed Central

Shen, Guangping; Zhang, Songning; Bennett, Hunter J.; Martin, James C.; Crouter, Scott E.; Fitzhugh, Eugene C.

2018-01-01

Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of knee alignment and use of a toe clip on the knee frontal plane biomechanics during stationary cycling. A total of 32 participants (11 varus, 11 neutral, and 10 valgus alignment) performed five trials in each of six cycling conditions: pedaling at 80 rpm and 0.5 kg (40 Watts), 1.0 kg (78 Watts), and 1.5 kg (117 Watts) with and without a toe clip. A motion analysis system and a customized instrumented pedal were used to collect 3D kinematic and kinetic data. A 3 × 2 × 3 (group × toe clip × workload) mixed design ANOVA was used for statistical analysis (p < 0.05). There were two different knee frontal plane loading patterns, internal abduction and adduction moment, which were affected by knee alignment type. The knee adduction angle was 12.2° greater in the varus group compared to the valgus group (p = 0.001), yet no difference was found for KAM among groups. Wearing a toe clip increased the knee adduction angle by 0.95º (p = 0.005). The findings of this study indicate that stationary cycling may be a safe exercise prescription for people with knee malalignments. In addition, using a toe clip may not have any negative effects on knee joints during stationary cycling. Key points Varus or valgus alignment did not cause increased frontal-plane knee joint loading, suggesting stationary cycling is a safe exercise. This study supports that using a toe clip did not lead to abnormal frontal-plane knee loading during stationary cycling. Two different knee frontal plane loading patterns, knee abduction and adduction moment, were observed during stationary cycling, which are likely affected by the type of knee alignment. PMID:29769833

Dynamics of Debris Supply and Removal from Coastal Cliffs

NASA Astrophysics Data System (ADS)

Dickson, M. E.; Vann Jones, E. C.; Payo, A.; Matsumoto, H.

2016-12-01

Progress in obtaining a morphodynamic understanding of rocky shores has been limited by slow rates of change and lack of preserved evidence of erosion processes. As a result we do not have a detailed understanding of the relative contributions of failure events across the magnitude-frequency spectrum. This talk describes field experiments, supported by simple stock-flow modelling, on a coastal cliff-face in eastern New Zealand. Key features of this site are that it is composed of near-homogenous rapidly eroding mudstone, and it is fronted by a wide intertidal rock platform that results in the cliff toe being exposed to waves every high tide. Several techniques were used to measure the cliff debris supply-removal system. Sediment traps at the cliff toe directly recorded rates of debris supply from the cliff-face at five discrete locations. Repeated high-resolution terrestrial laser scans over several consecutive low-tide stages documented changes in cliff-toe talus volumes along 50m of shoreline. Optical back-scatter sensors located on the rock shore platform in front of the cliff toe constrained the timing of talus-debris resuspension during tidal inundation of the cliff toe. Wave pressure gauges were used to characterise the wave field acting on the cliff. Results demonstrate that high-resolution (<5mm) laser scanning can meaningfully characterise rates of coastal cliff erosion at the very high-frequency low-magnitude end of the erosion spectrum. We find that rates of debris supply from the cliff face are dependent on the subaerial weathering system, in particular wetting and drying and associated expansion and contraction of clay minerals within the cliff rock. Rates of debris removal from the cliff toe depend on tide and wave conditions: even under low wave-energy conditions, waves at infragravity frequencies can access the cliff toe at high tide leading to sediment suspension. We explore the basic feedback structure of cliff, talus and debris removal using a simple stock-flow model, and discuss implications for progressive (ongoing) cliff erosion in the presence of an ever-widening shore platform.

Does the thickening of Achilles tendon and plantar fascia contribute to the alteration of diabetic foot loading?

PubMed

Giacomozzi, C; D'Ambrogi, E; Uccioli, L; Macellari, V

2005-06-01

The diabetic foot often undergoes abnormal plantar pressures, changing in walking strategy, ulcerative processes. The present study focuses on the effects that diabetes-induced alterations of Achilles tendon, plantar fascia and first metatarso-phalangeal joint-both anatomical and functional-may have on foot loading. Sixty-one diabetic patients, with or without neuropathy, and 21 healthy volunteers were recruited. Thickness of Achilles tendon and plantar fascia was measured by ultrasound. Flexion-extension of the first metatarso-phalangeal joint was measured passively. Main biomechanic parameters of foot-floor interaction during gait were acquired and related to the above measurements. Plantar fascia and Achilles tendon were significantly (P<0.05) thicker in diabetics than in controls; mean values (SD) for controls, diabetics without and with neuropathy were 2.0 mm (0.5), 2.9 mm (1.2) and 3.0 mm (0.8) for plantar fascia, respectively, and 4.0 mm (0.5), 4.6 mm (1.0) and 4.9 mm (1.7) for Achilles tendon, respectively. Flexion-extension of the first metatarso-phalangeal joint was significantly (P<0.05) smaller in diabetics than in controls; mean values (SD) for controls, diabetics without and with neuropathy were 100.0 degrees (10.0), 54.0 degrees (29.4) and 54.9 degrees (17.2), respectively. The increase in the vertical force under the metatarsals was strongly related (R=0.83, explained variance=70.1%) to the changes in the three above parameters. Thickening of plantar fascia and Achilles tendon in diabetics, more evident in the presence of neuropathy, concurs to develop a rigid foot, which poorly absorbs shock during landing (performs the physiological impact force absorption during landing). More generally, an overall alteration of the foot-ankle complex motion likely occurs throughout the whole gait cycle, which partly explains the abnormal loading under the forefoot.

Connective Tissue Fibroblast Properties Are Position-Dependent during Mouse Digit Tip Regeneration

PubMed Central

Wu, Yuanyuan; Wang, Karen; Karapetyan, Adrine; Fernando, Warnakulusuriya Akash; Simkin, Jennifer; Han, Manjong; Rugg, Elizabeth L.; Muneoka, Ken

2013-01-01

A key factor that contributes to the regenerative ability of regeneration-competent animals such as the salamander is their use of innate positional cues that guide the regeneration process. The limbs of mammals has severe regenerative limitations, however the distal most portion of the terminal phalange is regeneration competent. This regenerative ability of the adult mouse digit is level dependent: amputation through the distal half of the terminal phalanx (P3) leads to successful regeneration, whereas amputation through a more proximal location, e.g. the subterminal phalangeal element (P2), fails to regenerate. Do the connective tissue cells of the mammalian digit play a role similar to that of the salamander limb in controlling the regenerative response? To begin to address this question, we isolated and cultured cells of the connective tissue surrounding the phalangeal bones of regeneration competent (P3) and incompetent (P2) levels. Despite their close proximity and localization, these cells show very distinctive profiles when characterized in vitro and in vivo. In vitro studies comparing their proliferation and position-specific interactions reveal that cells isolated from the P3 and P2 are both capable of organizing and differentiating epithelial progenitors, but with different outcomes. The difference in interactions are further characterized with three-dimension cultures, in which P3 regenerative cells are shown to lack a contractile response that is seen in other fibroblast cultures, including the P2 cultures. In in vivo engraftment studies, the difference between these two cell lines is made more apparent. While both P2 and P3 cells participated in the regeneration of the terminal phalanx, their survival and proliferative indices were distinct, thus suggesting a key difference in their ability to interact within a regeneration permissive environment. These studies are the first to demonstrate distinct positional characteristics of connective tissue cells that are associated with their regenerative capabilities. PMID:23349966

A new species of rainfrog of the Eleutherodactylus milesi species group (Anura: Leptodactylidae) from Guatemala.

PubMed

Savage, J M

2000-12-01

A new rainfrog of the Eleutherodactylus milesi group is described from the Sierra de Xucaneb, Guatemala. It is compared to the other 11 upland species from southern Mexico, Guatemala and Honduras referred to the group. Within the milesi group the new species differs from the other five forms which also have toe fringes in size of the finger disks, the snout shape in profile and the amount of toe webbing and dorsal tuberculation. Difficulties in distinguishing among the character states for the tympanum (distinct, indistinct and hidden) and between toe ridges and fringes indicate that very subtle differences separate recognized species.

Repair of webbed fingers or toes

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Finger Injuries and Disorders Read more Toe Injuries ...

Effect of Toe Clips During Bicycle Ergometry on VO2 max.

ERIC Educational Resources Information Center

Moffat, Roger S.; Sparling, Phillip B.

1985-01-01

Eight men participated in three randomized maximal oxygen uptake tests to investigate the hypothesis that the use of toe clips on bicycle ergometers produced a higher VO2 max. No significant difference in mean VO2 max or performance time was observed. (Author/MT)

Timing of intermittent torque control with wire-driven gait training robot lifting toe trajectory for trip avoidance.

PubMed

Miyake, Tamon; Kobayashi, Yo; Fujie, Masakatsu G; Sugano, Shigeki

2017-07-01

Gait training robots are useful for changing gait patterns and decreasing risk of trip. Previous research has reported that decreasing duration of the assistance or guidance of the robot is beneficial for efficient gait training. Although robotic intermittent control method for assisting joint motion has been established, the effect of the robot intervention timing on change of toe clearance is unclear. In this paper, we tested different timings of applying torque to the knee, employing the intermittent control of a gait training robot to increase toe clearance throughout the swing phase. We focused on knee flexion motion and designed a gait training robot that can apply flexion torque to the knee with a wire-driven system. We used a method of timing detecting for the robot conducting torque control based on information from the hip, knee, and ankle angles to establish a non-time dependent parameter that can be used to adapt to gait change, such as gait speed. We carried out an experiment in which the conditions were four time points: starting the swing phase, lifting the foot, maintaining knee flexion, and finishing knee flexion. The results show that applying flexion torque to the knee at the time point when people start lifting their toe is effective for increasing toe clearance in the whole swing phase.

Foot pressures during gait: a comparison of techniques for reducing pressure points.

PubMed

Lawless, M W; Reveal, G T; Laughlin, R T

2001-07-01

Various methods have been used to redistribute plantar surface foot pressure in patients with foot ulcers. This study was conducted to determine the effectiveness of four modalities (fracture walker, fracture walker with insert, and open and closed toe total contact casts) in reducing plantar foot pressure. Ten healthy, normal volunteer subjects had an F-scan sensor (ultra thin shoe insert pressure monitor) placed under the right foot. They then ambulated on a flat surface, maintaining their normal gait. Dynamic plantar pressures were averaged over 10 steps at four different sites (plantar surface of great toe, first metatarsal head, base of fifth metatarsal, and plantar heel). All subjects repeated this sequence under five different testing conditions (barefoot, with a fracture walker, fracture walker with arch support insert, open and closed toe total contact cast). Each subject's barefoot pressures were then compared with the pressures during the different modalities. All four treatment modalities significantly reduced (p < 0.05) plantar pressure at the first metatarsal head (no method was superior). The fracture walker, fracture walker with insert, and open toe total contact cast significantly reduced pressure at the heel. Pressures at the base of the fifth metatarsal and great toe were not significantly reduced with any treatment form. The fracture walker, with and without arch support, and total contact cast can effectively reduce plantar pressure at the heel and first metatarsal head.

Topical oxygen emulsion: a novel wound therapy.

PubMed

Davis, Stephen C; Cazzaniga, Alejandro L; Ricotti, Carlos; Zalesky, Paul; Hsu, Li-Chien; Creech, Jeffrey; Eaglstein, William H; Mertz, Patricia M

2007-10-01

To investigate the use of a topical oxygen emulsion (TOE), consisting of a supersaturated oxygen suspension using perfluorocarbon components, on second-degree burns and partial-thickness wounds. Oxygen is a required substance for various aspects of wound repair, and increased oxygen tension in a wound has been shown to stimulate phagocytosis and to reduce the incidence of wound infection. Second-degree burns and partial-thickness wounds were created on the backs of specific pathogen-free pigs. Wounds were then randomly assigned to 1 of the following treatment groups: TOE, TOE vehicle, or air-exposed control. Wounds were assessed for complete epithelialization using a salt-split technique. The TOE was able to significantly (P = .001) enhance the rate of epithelialization compared with both vehicle and untreated control. These data suggest that topical oxygen may be beneficial for acute and burn wounds. The results obtained from this double-blind, control, in vivo study demonstrate that TOE can significantly enhance the rate of epithelialization of partial-thickness excisional wounds and second-degree burns. These findings could have considerable clinical implications for patients with surgical and burn wounds by providing functional skin at an earlier date to act as a barrier against environmental factors, such as bacteria invasion. Other types of wounds may also benefit from this therapy (eg, chronic wounds and surgical incisions). Additional studies, including clinical studies, are warranted.

Impairment of Skin Capillary Recruitment Precedes Chronic Complications in Patients with Type 1 Diabetes

PubMed Central

Tibirica, Eduardo; Rodrigues, Elba; Cobas, Roberta; Gomes, Marilia B.

2007-01-01

Microvascular function in patients with type 1 diabetes without chronic complications was assessed using skin capillary recruitment during post-occlusive reactive hyperemia (PORH). Structural (maximal) capillary density was evaluated during venous occlusion. The study included 48 consecutive outpatients aged 26.3 ± 10.8 years with type 1 diabetes (duration of 9.5 years) without chronic complications and 34 control subjects. Intravital capillary video-microscopy was used in the dynamic study of skin capillaries in the dorsum of the fingers and toes. Capillary recruitment during PORH (% increase in mean capillary density, MCD) was significantly higher in the controls than the patients in both the fingers (p < 0.001) and toes (p < 0.001). During venous occlusion, MCD increase was also higher in the controls than the patients in both the fingers (p < 0.05) and toes (p < 0.0001). In patients, no difference was found between MCD at baseline and after venous occlusion in the fingers but a decrease was observed in the toes (p < 0.001). It is concluded that skin capillary function is significantly impaired in both fingers and toes of patients with type 1 diabetes without chronic complications. Moreover, capillary density during venous occlusion did not increase in either extremity in the patients, suggesting that their capillaries at rest are already maximally recruited. PMID:17823692

Predictors of Early Growth in Academic Achievement: The Head-Toes-Knees-Shoulders Task

ERIC Educational Resources Information Center

McClelland, Megan M.; Cameron, Claire E.; Duncan, Robert; Bowles, Ryan P.; Acock, Alan C.; Miao, Alicia; Pratt, Megan E.

2014-01-01

Children's behavioral self-regulation and executive function (EF; including attentional or cognitive flexibility, working memory, and inhibitory control) are strong predictors of academic achievement. The present study examined the psychometric properties of a measure of behavioral self-regulation called the Head-Toes-Knees-Shoulders (HTKS) by…

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

Medical Aspects of Cold Weather Operations: A Handbook for Medical Officers

DTIC Science & Technology

1993-04-01

forefoot tissues, hammer toe deformities, flexion contracture of the great toe, hyperhidrosis predisposing to skin maceration and dermato- phytosis...Even more striking are the reports of mass deaths among shipwreck survivors, who had been able to climb aboard rescuing ships, only to be found dead

The Hemimelic extra toes mouse mutant: Historical perspective on unraveling mechanisms of dysmorphogenesis

EPA Science Inventory

Hemimelic extra toes (Hx) arose spontaneously as a dominant mutation in B10.D2/nSnJ mice in 1967. It specifically affects the appendicular skeleton, causing variable foreshortening of the tibia (radius) and preaxial polydactylism. Early anatomical studies revealed anterior overgr...

Tic Tac Toe Math. Train the Trainer.

ERIC Educational Resources Information Center

Center for Alternative Learning, Bryn Mawr, PA.

This report describes a project that developed a "Train the Trainer" program that would enable individuals to learn and teach the alternative instructional technique, Tic Tac Toe Math, developed by Richard Cooper for adult basic education students. The pilot workshop conducted as part of the project identified problems that traditional…

An Exploration of the Factors Influencing the Adoption of an IS Governance Framework

ERIC Educational Resources Information Center

Parker, Sharon L.

2013-01-01

This research explored IT governance framework adoption, leveraging established IS theories. It applied both the technology acceptance model (TAM) and the technology, organization, environment (TOE) models. The study consisted of developing a model utilizing TOE and TAM, deriving relevant hypotheses. Interviews with a group of practitioners…

Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 3: Toe fractures in adults.

PubMed

Paradise, David

2012-11-01

A short cut review was carried out to establish whether intervention and follow up of patients with toe phalanx fractures is better than no treatment at reducing time to return to normal activity and need for surgical intervention. 40 papers were found using the reported searches, of which 1 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper is tabulated. It is concluded that there is no evidence to determine whether intervention of any type improves outcome in toe phalanx fractures.

Tic Tac Toe Math. Instructional Guide.

ERIC Educational Resources Information Center

Cooper, Richard

This instructional guide and set of three companion workbooks are intended for use in an arithmetic course based on the Tic Tac Toe method of addition and multiplication, which is an alternative means of learning to add and multiply that was developed for students whose learning disabilities (including difficulty in distinguishing left from right…

Science 101: Why Are Hippos Unguligrades?

ERIC Educational Resources Information Center

Robertson, Bill

2014-01-01

In this article, Bill Robinson describes the three main classifications of gait for animals: (1) Plantigrade--animals that walk on their entire foot; (2) Digitigrade--animals that walk on their "toes"; and (3) Unguligrade--animals that walk on the tips of their toes or hooves. Robinson explains each gait in great detail, but leaves his…

Mat-Rix-Toe: Improving Writing through a Game-Based Project in Linear Algebra

ERIC Educational Resources Information Center

Graham-Squire, Adam; Farnell, Elin; Stockton, Julianna Connelly

2014-01-01

The Mat-Rix-Toe project utilizes a matrix-based game to deepen students' understanding of linear algebra concepts and strengthen students' ability to express themselves mathematically. The project was administered in three classes using slightly different approaches, each of which included some editing component to encourage the…

A Two-Step Integrated Theory of Everything (TOE)

NASA Astrophysics Data System (ADS)

Colella, Antonio

2017-01-01

Two opposing TOE visions are my Two-Step (physics/math) and Hawking's single math step. My Two-Step should replace the single step because of the latter's near zero results after a century of attempts. My physics step had 3 goals. First ``Everything'' was defined as 20 interrelated amplified theories (e.g. string, Higgs forces, spontaneous symmetry breaking, particle decays, dark matter, dark energy, stellar black holes) and their intimate physical interrelationships. Amplifications of Higgs forces theory (e.g. matter particles and their associated Higgs forces were one and inseparable, spontaneous symmetry breaking was bidirectional and caused by high temperatures not Higgs forces, and sum of 8 Higgs forces of 8 permanent matter particles was dark energy) were key to my Two-Step TOE. The second goal answered all outstanding physics questions: what were Higgs forces, dark energy, dark matter, stellar black holes, our universe's creation, etc.? The third goal provided correct inputs for the two part second math step, an E8 Lie algebra for particles and an N-body cosmology simulation (work in progress). Scientific advancement occurs only if the two opposing TOEs are openly discussed/debated.

Early emergence of anthropogenically forced heat waves in the western United States and Great Lakes

NASA Astrophysics Data System (ADS)

Lopez, Hosmay; West, Robert; Dong, Shenfu; Goni, Gustavo; Kirtman, Ben; Lee, Sang-Ki; Atlas, Robert

2018-05-01

Climate projections for the twenty-first century suggest an increase in the occurrence of heat waves. However, the time at which externally forced signals of anthropogenic climate change (ACC) emerge against background natural variability (time of emergence (ToE)) has been challenging to quantify, which makes future heat-wave projections uncertain. Here we combine observations and model simulations under present and future forcing to assess how internal variability and ACC modulate US heat waves. We show that ACC dominates heat-wave occurrence over the western United States and Great Lakes regions, with ToE that occurred as early as the 2020s and 2030s, respectively. In contrast, internal variability governs heat waves in the northern and southern Great Plains, where ToE occurs in the 2050s and 2070s; this later ToE is believed to be a result of a projected increase in circulation variability, namely the Great Plain low-level jet. Thus, greater mitigation and adaptation efforts are needed in the Great Lakes and western United States regions.

Initiation of movement from quiet stance: comparison of gait and stepping in elderly subjects of different levels of functional ability.

PubMed

Brunt, Denis; Santos, Valeria; Kim, Hyeong Dong; Light, Kathye; Levy, Charles

2005-04-01

This study describes how elderly subjects initiate gait, and step from a position of quiet stance. Based on scores from selected standardized tests subjects were placed in either a high (HFL) or low functional level (LFL) group and were asked to initiate gait, step onto a 10 cm high, 1.22 m wide curb and step over a 10 cm high, 9 cm wide obstacle at a self paced speed. Stepping conditions affected the velocity of movement. It was clear that all subjects decreased initiation velocity for both curb and obstacle compared to gait initiation. Swing and stance limb acceleration ground reaction forces and EMG amplitude were modulated according to initiation velocity. Toe clearance was greater for obstacle than curb and gait initiation. Swing toe-off was significantly earlier and there was a trend for obstacle clearance to be greater for the HFL group. Those in the LFL group appear to be at a greater risk for falling due to the possible effect of slower rate of toe-off that could influence toe clearance over the obstacle.

LEFT-RIGHT DIFFERENCES ON TIMED MOTOR EXAMINATION IN CHILDREN

PubMed Central

Roeder, Megan B.; Mahone, E. Mark; Larson, J. Gidley; Mostofsky, S. H.; Cutting, Laurie E.; Goldberg, Melissa C.; Denckla, Martha B.

2008-01-01

Age-related change in the difference between left- and right-side speed on motor examination may be an important indicator of maturation. Cortical maturation and myelination of the corpus callosum are considered to be related to increased bilateral skill and speed on timed motor tasks. We compared left minus right foot, hand, and finger speed differences using the Revised Physical and Neurological Assessment for Subtle Signs (PANESS; Denckla, 1985); examining 130 typically developing right-handed children (65 boys, 65 girls) ages 7−14. Timed tasks included right and left sets of 20 toe taps, 10 toe-heel alternation sequences, 20 hand pats, 10 hand pronate-supinate sets, 20 finger taps, and 5 sequences of each finger-to-thumb apposition. For each individual, six difference scores between left- and right-sided speeded performances of timed motor tasks were analyzed. Left-right differences decreased significantly with age on toe tapping, heel-toe alternations, hand pronation-supination, finger repetition, and finger sequencing. There were significant gender effects for heel-toe sequences (boys showing a greater left-right difference than girls), and a significant interaction between age and gender for hand pronation-supination, such that the magnitude of the left-right difference was similar for younger, compared with older girls, while the difference was significantly larger for younger, compared to older boys. Speed of performing right and left timed motor tasks equalizes with development; for some tasks, the equalization occurs earlier in girls than in boys. PMID:17852124

Retrograde tracing and toe spreading after experimental autologous nerve transplantation and crush injury of the sciatic nerve: a descriptive methodological study.

PubMed

van Neerven, Sabien Ga; Bozkurt, Ahmet; O'Dey, Dan Mon; Scheffel, Juliane; Boecker, Arne H; Stromps, Jan-Philipp; Dunda, Sebastian; Brook, Gary A; Pallua, Norbert

2012-04-30

Evaluation of functional and structural recovery after peripheral nerve injury is crucial to determine the therapeutic effect of a nerve repair strategy. In the present study, we examined the relationship between the structural evaluation of regeneration by means of retrograde tracing and the functional analysis of toe spreading. Two standardized rat sciatic nerve injury models were used to address this relationship. As such, animals received either a 2 cm sciatic nerve defect (neurotmesis) followed by autologous nerve transplantation (ANT animals) or a crush injury with spontaneous recovery (axonotmesis; CI animals). Functional recovery of toe spreading was observed over an observation period of 84 days. In contrast to CI animals, ANT animals did not reach pre-surgical levels of toe spreading. After the observation period, the lipophilic dye DiI was applied to label sensory and motor neurons in dorsal root ganglia (DRG; sensory neurons) and spinal cord (motor neurons), respectively. No statistical difference in motor or sensory neuron counts could be detected between ANT and CI animals.In the present study we could indicate that there was no direct relationship between functional recovery (toe spreading) measured by SSI and the number of labelled (motor and sensory) neurons evaluated by retrograde tracing. The present findings demonstrate that a multimodal approach with a variety of independent evaluation tools is essential to understand and estimate the therapeutic benefit of a nerve repair strategy.

An automated approach for extracting Barrier Island morphology from digital elevation models

NASA Astrophysics Data System (ADS)

Wernette, Phillipe; Houser, Chris; Bishop, Michael P.

2016-06-01

The response and recovery of a barrier island to extreme storms depends on the elevation of the dune base and crest, both of which can vary considerably alongshore and through time. Quantifying the response to and recovery from storms requires that we can first identify and differentiate the dune(s) from the beach and back-barrier, which in turn depends on accurate identification and delineation of the dune toe, crest and heel. The purpose of this paper is to introduce a multi-scale automated approach for extracting beach, dune (dune toe, dune crest and dune heel), and barrier island morphology. The automated approach introduced here extracts the shoreline and back-barrier shoreline based on elevation thresholds, and extracts the dune toe, dune crest and dune heel based on the average relative relief (RR) across multiple spatial scales of analysis. The multi-scale automated RR approach to extracting dune toe, dune crest, and dune heel based upon relative relief is more objective than traditional approaches because every pixel is analyzed across multiple computational scales and the identification of features is based on the calculated RR values. The RR approach out-performed contemporary approaches and represents a fast objective means to define important beach and dune features for predicting barrier island response to storms. The RR method also does not require that the dune toe, crest, or heel are spatially continuous, which is important because dune morphology is likely naturally variable alongshore.

Improvement of isometric dorsiflexion protocol for assessment of tibialis anterior muscle strength.

PubMed

Siddiqi, Ariba; Arjunan, Sridhar P; Kumar, Dinesh

2015-01-01

It is important to accurately estimate the electromyogram (EMG)/force relationship of triceps surae (TS) muscle for detecting strength deficit of tibalis anterior (TA) muscle. In literature, the protocol for recording EMG and force of dorsiflexion have been described, and the necessity for immobilizing the ankle has been explained. However, there is a significant variability of the results among researchers even though they report the fixation of the ankle. We have determined that toe extension can cause significant variation in the dorsiflexion force and EMG of TS and this can occur despite following the current guidelines which require immobilizing the ankle. The results also show that there was a large increase in the variability of the force and the RMS of EMG of TS when the toes were not strapped compared with when they were strapped. Thus, with the current guidelines, where there are no instructions regarding the necessity of strapping the toes, the EMG/force relationship of TS could be incorrect and give an inaccurate assessment of the dorsiflexor TA strength. In summary, •Current methodology to estimate the dorsiflexor TA strength with respect to the TS activity, emphasizing on ankle immobilization is insufficient to prevent large variability in the measurements.•Toe extension during dorsiflexion was found to be one source of variability in estimating the TA strength.•It is recommended that guidelines for recording force and EMG from TA and TS muscles should require the strapping of the toes along with the need for immobilizing the ankle.

Experimental analysis of perching in the European starling (Sturnus vulgaris: Passeriformes; Passeres), and the automatic perching mechanism of birds.

PubMed

Galton, Peter M; Shepherd, Jeffrey D

2012-04-01

The avian automatic perching mechanism (APM) involves the automatic digital flexor mechanism (ADFM) and the digital tendon-locking mechanism (DTLM). When birds squat on a perch to sleep, the increased tendon travel distance due to flexion of the knee and ankle supposedly causes the toes to grip the perch (ADFM) and engage the DTLM so perching while sleeping involves no muscular effort. However, the knees and ankles of sleeping European starlings (Sturnus vulgaris) are only slightly flexed and, except for occasional balancing adjustments, the distal two-thirds of the toes are not flexed to grip a 6-mm-diameter perch. The cranial ankle angle (CAA) is ∼120° and the foot forms an inverted "U" that, with the mostly unflexed toes, provides a saddle-like structure so the bird balances its weight over the central pad of the foot (during day weight further back and digits actively grasp perch). In the region of the pad, the tendon sheath of many birds is unribbed, or only very slightly so, and it is always separated from the tendon of the M. flexor digitorum longus by tendons of the other toe flexor muscles. Passive leg flexion produces no toe flexion in anesthetized Starlings and only after 15-20 min, at the onset of rigor mortis, in freshly sacrificed Starlings. Anesthetized Starlings could not remain perched upon becoming unconscious (ADFM, DTLM intact). Birds whose digital flexor tendons were severed or the locking mechanism eliminated surgically (no ADFM or DTLM), so without ability to flex their toes, slept on the perch in a manner similar to unoperated Starlings (except CAA ∼90°-110°). Consequently, there is no APM or ADFM and the DTLM, although involved in lots of other activities, only acts in perching with active contraction of the digital flexor muscles. © 2012 WILEY PERIODICALS, INC.

Intrinsic Foot Muscle Activation During Specific Exercises: A T2 Time Magnetic Resonance Imaging Study.

PubMed

Gooding, Thomas M; Feger, Mark A; Hart, Joseph M; Hertel, Jay

2016-08-01

The intrinsic foot muscles maintain the medial longitudinal arch and aid in force distribution and postural control during gait. Impaired intrinsic foot-muscle function has been linked to various foot conditions. Several rehabilitative exercises have been proposed to improve it; however, literature that identifies which individual muscles are activated during specific intrinsic foot-muscle exercises is lacking. To describe changes in activation of the intrinsic plantar foot muscles after 4 exercises as measured with T2 magnetic resonance imaging (MRI). Descriptive laboratory study. Research laboratory. Eight healthy National Collegiate Athletic Association Division I collegiate cross-country and track athletes (5 men and 3 women: age = 20 ± 0.93 years, height = 180.98 ± 10.84 cm, mass = 70.91 ± 7.82 kg). Participants underwent T2 MRI before and after each exercise. They completed 1 set of 40 repetitions of each exercise (short-foot exercise, toes spread out, first-toe extension, second- to fifth-toes extension). Percentage increases in muscle activation of the abductor hallucis, flexor digitorum brevis, abductor digiti minimi, quadratus plantae, flexor digiti minimi, adductor hallucis oblique, flexor hallucis brevis, and interossei and lumbricals (analyzed together) after each exercise were assessed using T2 MRI. All muscles showed increased activation after all exercises. The mean percentage increase in activation ranged from 16.7% to 34.9% for the short-foot exercise, 17.3% to 35.2% for toes spread out, 13.1% to 18.1% for first-toe extension, and 8.9% to 22.5% for second- to fifth-toes extension. All increases in activation had associated 95% confidence intervals that did not cross zero. Each of the 4 exercises was associated with increased activation in all of the plantar intrinsic foot muscles evaluated. These results may have clinical implications for the prescription of specific exercises to target individual intrinsic foot muscles.

Accuracy and reproducibility of novel echocardiographic three-dimensional automated software for the assessment of the aortic root in candidates for thanscatheter aortic valve replacement.

PubMed

García-Martín, Ana; Lázaro-Rivera, Carla; Fernández-Golfín, Covadonga; Salido-Tahoces, Luisa; Moya-Mur, Jose-Luis; Jiménez-Nacher, Jose-Julio; Casas-Rojo, Eduardo; Aquila, Iolanda; González-Gómez, Ariana; Hernández-Antolín, Rosana; Zamorano, José Luis

2016-07-01

A specialized three-dimensional transoesophageal echocardiography (3D-TOE) reconstruction tool has recently been introduced; the system automatically configures a geometric model of the aortic root from the images obtained by 3D-TOE and performs quantitative analysis of these structures. The aim of this study was to compare the measurements of the aortic annulus (AA) obtained by the new model to that obtained by 3D-TOE and multidetector computed tomography (MDCT) in candidates to transcatheter aortic valve implantation (TAVI) and to assess the reproducibility of this new method. We included 31 patients who underwent TAVI. The AA diameters and area were evaluated by the manual 3D-TOE method and by the automatic software. We showed an excellent correlation between the measurements obtained by both methods: intra-class correlation coefficient (ICC): 0.731 (0.508-0.862), r: 0.742 for AA diameter and ICC: 0.723 (0.662-0.923), r: 0.723 for the AA area, with no significant differences regardless of the method used. The interobserver variability was superior for the automatic measurements than for the manual ones. In a subgroup of 10 patients, we also found an excellent correlation between the automatic measurements and those obtained by MDCT, ICC: 0.941 (0.761-0.985), r: 0.901 for AA diameter and ICC: 0.853 (0.409-0.964), r: 0.744 for the AA area. The new automatic 3D-TOE software allows modelling and quantifying the aortic root from 3D-TOE data with high reproducibility. There is good correlation between the automated measurements and other 3D validated techniques. Our results support its use in clinical practice as an alternative to MDCT previous to TAVI. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Detection of a megabase deletion in a patient with brachio-oto-renal syndrome (BOR) and tricho-rhino-phalangeal syndrome (TRPS): Implications for mapping and cloning the BOR gene

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gu, J.Z.; Wells, D.E.; Wagner, M.J.

Genetic linkage analysis has previously mapped the locus for the autosomal dominant disorder branchio-oto-renal syndrome (BOR) to the pericentric region of chromosome 8q. A YAC contig spanning the putative BOR region, from D8S543 to D8S541, was constructed and confirmed by sequence-tagged site content mapping using microsatellite markers and by DNA hybridization analysis. YACs spanning the BOR interval were used as fluorescence in situ hybridization probes on a cell line from a patient with BO and tricho-rhino-phalangeal syndrome I that involves a chromosome 8q rearrangement. In addition to the cytogenetically defined direct insertion of material from 8q13.3-q21.13 into 8q24.11, a previouslymore » unidentified deletion of just under one megabase was found in 8q13.3. These data narrowed the most likely location of the BOR gene to a region corresponding to the proximal two-thirds of YAC 869E10 between D8S543 and D8S279. 23 refs., 3 figs.« less

[Carpal bones of the Chiroptera in the comparative-anatomical and functional aspects].

PubMed

Manziĭ, S F; Kovtun, M F

1977-09-01

Data on investigation of hand sceletal bones carried out in eight genera of three families of bats were subjected to comparative-anatomical and functional analysis. Quantitatively, the hand sceletal bones of Chiroptera preserve constructive pattern general for the hand of terrestrial mammalians Pentadactilus. It has rudiments of the prefirst (Pp) and the seventh (Pm) rays. The latter is situated on the volar surface of the base Mc5. Scaphoid, semilunar and central carnal bones of Chiroptera, like those of Mototremata, some Marsupialia, Insectivorona and Carnivora merge together into one large bone--os lunatum. At the same time, the hand of Chiropter is a highly specialized structure, that is evident from the presence of articular restricotrs of anterior sagging of the wrist, crests and grooves directing movements in a strictly definite plane, from fan-like spreading and bringing together the rays, from very long metacarpal bones and proximal phalanges, from reduction of distal phalangs of the 3d and 5th fingers. Thus, the hand of Chiroptera is a unique example of combination of primitive, initial for pentadactule plantigrades wrist with signs of narrow specialization resembling, to some extent, those of Ungulata; only in Ungulata those signs developed on the base of digitigrades wrist.

A novel TRPS1 mutation in a Moroccan family with Tricho-rhino-phalangeal syndrome type III: case report.

PubMed

Smaili, W; Elalaoui, S Chafai; Meier, S; Zerkaoui, M; Sefiani, A; Heinimann, K

2017-05-03

Tricho-rhino-phalangeal syndrome (TRPS) is an autosomal dominant disorder characterized by craniofacial and skeletal malformations including short stature, thin scalp hair, sparse lateral eyebrows, pear-shaped nose and cone shaped epiphyses. This condition is caused by haploinsufficiency of the TRPS1 gene. Previous genotype-phenotype studies have correlated exon 6 missense mutations with TRPS type III, a severe form of type I with pronounced, facial characteristics, short stature and brachydactyly and differing from type II by the absence of exostoses and mental retardation. We report the first case of a Moroccan family, a father and his three children, in which the diagnosis of type III TRPS was suspected based on severe clinical and radiological features. Molecular analysis of the TRPS1 gene revealed a novel missense mutation in exon 6, (p.Ala932Ser), located in the GATA-type DNA-binding zinc finger domain. Our observations in this kindred support the previous genotype-phenotype results suggesting that patients with more pronounced facial characteristics and more severe shortening of hands and feet are more likely to have mutation in exon 6 of TRPS1.

[Bone ultrasonography in kidney disease: applications and limitations].

PubMed

Aucella, Filippo; Gesuete, Antonio; Cicchella, Antonio; Granata, Antonio; Fiorini, Fulvio; Guglielmi, Giuseppe

2012-01-01

Quantitative ultrasound (QUS) of the bone is a technique that is generating great interest among bone structure researchers because of its intrinsic features. Its safety and low cost make it an ideal technique for repeated measurements over time such as in chronic disease or when it is necessary to monitor the effects of prescribed therapies. The method was developed for the study of osteoporosis and the sites of measurement are all peripheral, including the distal diaphyses and metaphyses of the phalanges, calcaneus, radius and tibia. QUS parameters, however, cannot be used directly for the diagnosis of osteoporosis according to the WHO criteria, although many authors have shown that ultrasound parameters, particularly those of calcaneal QUS, can predict the risk of osteoporotic fractures independently of MBD. Very promising results with the use of QUS have been obtained in corticosteroid-induced osteoporosis, rheumatoid arthritis, Cushing's syndrome, cystic fibrosis, osteomalacia, thalassemia and osteopenia related to parenteral nutrition. QUS can also monitor the effectiveness of therapy in various pathological conditions. In nephrology the combined use of phalangeal QUS and biochemical markers of bone turnover allows adequate follow-up of patients on dialysis and renal transplant recipients with alterations or disorders of the bone.

Skeletal changes in lower limb bones in domestic cattle from Eketorp ringfort on the Öland island in Sweden.

PubMed

Telldahl, Ylva

2012-12-01

In this paper the nature and frequency of skeletal changes in the lower limb bones of cattle are investigated. The bones derive from the archaeological site of Eketorp ringfort on the Öland island in Sweden dated between Iron Age-Middle Age (ca. A.D. 300-1200/50). The analysis was conducted to explore whether skeletal lesions were associated with traction activity, and if changes in the type and prevalence of lesions occurred over time. Different skeletal lesions were recorded by bone and precise anatomical location: the joint surfaces of metapodia and phalanges were divided into four to seven zones to determine if different types of lesions were located on particular regions of the articular surface. The results show that metatarsals exhibited a higher frequency of pathologies in the Iron Age and medieval period compared to metacarpals, while anterior phalanges 1 and 2 had a higher occurrence of lesions than the posterior elements. The study also demonstrates that the type and location of depressions on joint surfaces are unevenly distributed between bone elements. Finally, the results show that skeletal lesions were more common in robust animals. Copyright © 2012 Elsevier Inc. All rights reserved.

KIPP and Teachers' Union Go Toe to Toe in Baltimore

ERIC Educational Resources Information Center

Zehr, Mary Ann

2011-01-01

Leaders of the Knowledge Is Power Program (KIPP) charter schools are optimistic that they can reach a long-term agreement with the Baltimore (Maryland) Teachers Union in a nationally watched dispute over teacher pay for an extended school day, reducing the likelihood that the charter network will carry out its threat to close its two schools in…

Translational Response of Toe-Restrained Retaining Walls to Earthquake Ground Motions Using CorpsWallSlip (CWSlip)

DTIC Science & Technology

2007-06-01

corresponding software developed for the translational response of rock- founded retaining walls buttressed at their toe by a reinforced concrete slab...by a Reinforced Concrete Slab ...........................................................................................................32 2.1...2.5 New translational analysis model of a wall retaining a partially submerged backfill and buttressed by a reinforced concrete slab

Tic Tac TOE: Effects of Predictability and Importance on Acoustic Prominence in Language Production

ERIC Educational Resources Information Center

Watson, Duane G.; Arnold, Jennifer E.; Tanenhaus, Michael K.

2008-01-01

Importance and predictability each have been argued to contribute to acoustic prominence. To investigate whether these factors are independent or two aspects of the same phenomenon, naive participants played a verbal variant of Tic Tac Toe. Both importance and predictability contributed independently to the acoustic prominence of a word, but in…

Young Children's Reasoning in Games of Nonsocial and Social Logic: "Tic Tac Toe" and a "Guessing Game".

ERIC Educational Resources Information Center

Fernie, David E.; DeVries, Rheta

This research study tests Selman's (1980) hypothesis that different games pull players toward particular kinds of reasoning through a developmental comparison of children's reasoning in two games, Tic Tac Toe and the Guessing Game. The present study focuses on two basic questions and their educational implications: (1) What differences and…

The Utility of Silos and Bunkers in the Evolution of Kinesiology

ERIC Educational Resources Information Center

Kretchmar, R. Scott

2008-01-01

Silos and bunkers have been allies in the development of kinesiology for nearly 50 years. Silos of specialization allow us to go toe-to-toe with researchers in parent disciplines, compete for grants, and otherwise spread our academic wings. The bunkers of utility and generic movement provide an important degree of legitimacy for a subject matter…

A physically-based channel-modeling framework integrating HEC-RAS sediment transport capabilities and the USDA-ARS bank-stability and toe-erosion model (BSTEM)

USDA-ARS?s Scientific Manuscript database

Classical, one-dimensional, mobile bed, sediment-transport models simulate vertical channel adjustment, raising or lowering cross-section node elevations to simulate erosion or deposition. This approach does not account for bank erosion processes including toe scour and mass failure. In many systems...

Heel and toe driving on fuel cell vehicle

DOEpatents

Choi, Tayoung; Chen, Dongmei

2012-12-11

A system and method for providing nearly instantaneous power in a fuel cell vehicle. The method includes monitoring the brake pedal angle and the accelerator pedal angle of the vehicle, and if the vehicle driver is pressing both the brake pedal and the accelerator pedal at the same time and the vehicle is in a drive gear, activating a heel and toe mode. When the heel and toe mode is activated, the speed of a cathode compressor is increased to a predetermined speed set-point, which is higher than the normal compressor speed for the pedal position. Thus, when the vehicle brake is removed, the compressor speed is high enough to provide enough air to the cathode, so that the stack can generate nearly immediate power.

Turbulent flow structures and aeolian sediment transport over a barchan sand dune

NASA Astrophysics Data System (ADS)

Wiggs, G. F. S.; Weaver, C. M.

2012-03-01

The turbulent structure of airflow over a barchan sand dune is determined using quadrant analysis of wind velocity data derived from sonic anemometers. Results indicate an increased frequency of ejection and sweep events in the toe region of the dune, characteristic of the turbulent bursting process. In contrast, at the crest there was a significant increase in the occurrence of outward interactions. Combined with high frequency saltation data our analyses show that turbulent structures characterised by a positive streamwise fluctuating velocity (+u‧ sweeps at the toe and outward interactions at the crest) have a dominant influence on sand transport on the dune, together accounting for up to 83% and 95% of transporting events at the toe and crest respectively.

Vascular responses of the extremities to transdermal application of vasoactive agents in Caucasian and African descent individuals.

PubMed

Maley, Matthew J; House, James R; Tipton, Michael J; Eglin, Clare M

2015-08-01

Individuals of African descent (AFD) are more susceptible to non-freezing cold injury than Caucasians (CAU) which may be due, in part, to differences in the control of skin blood flow. We investigated the skin blood flow responses to transdermal application of vasoactive agents. Twenty-four young males (12 CAU and 12 AFD) undertook three tests in which iontophoresis was used to apply acetylcholine (ACh 1 w/v %), sodium nitroprusside (SNP 0.01 w/v %) and noradrenaline (NA 0.5 mM) to the skin. The skin sites tested were: volar forearm, non-glabrous finger and toe, and glabrous finger (pad) and toe (pad). In response to SNP on the forearm, AFD had less vasodilatation for a given current application than CAU (P = 0.027-0.004). ACh evoked less vasodilatation in AFD for a given application current in the non-glabrous finger and toe compared with CAU (P = 0.043-0.014) with a lower maximum vasodilatation in the non-glabrous finger (median [interquartile], AFD n = 11, 41[234] %, CAU n = 12, 351[451] %, P = 0.011) and non-glabrous toe (median [interquartile], AFD n = 9, 116[318] %, CAU n = 12, 484[720] %, P = 0.018). ACh and SNP did not elicit vasodilatation in the glabrous skin sites of either group. There were no ethnic differences in response to NA. AFD have an attenuated endothelium-dependent vasodilatation in non-glabrous sites of the fingers and toes compared with CAU. This may contribute to lower skin temperature following cold exposure and the increased risk of cold injuries experienced by AFD.

The effects of laterality on obstacle crossing performance in unilateral trans-tibial amputees.

PubMed

De Asha, Alan R; Buckley, John G

2015-05-01

Unilateral trans-tibial amputees have bilaterally reduced toe clearance, and an increased risk of foot contact, while crossing obstacles compared to the able-bodied. While the able-bodied tend to lead with a 'preferred' limb it is equivocal whether amputees prefer to lead with the intact or prosthetic limb. This study determined the effects of laterality, compared to side of amputation, on amputees' obstacle crossing performance. To help understand why laterality could affect performance we also assessed knee proprioception for both limbs. Foot placement and toe clearance parameters were recorded while nine amputees crossed obstacles of varying heights leading with both their intact and prosthetic limbs. Joint-position sense was also assessed. Participants self-reported which limb was their preferred (dominant) limb. There were no significant differences in foot placements or toe clearance variability across lead-limb conditions. There were no significant differences in toe clearance between intact and prosthetic lead-limbs (p=0.28) but toe clearance was significantly higher when amputees led with their preferred compared to non-preferred limb (p=0.025). There was no difference in joint-position sense between the intact and residual knees (p=0.34) but joint-position sense tended to be more accurate for the preferred, compared to non-preferred limb (p=0.08). Findings suggest that, despite the mechanical constraints imposed by use of a prosthesis, laterality may be as important in lower-limb amputees as it is in the able bodied. This suggests that amputees should be encouraged to cross obstacles leading with their preferred limb. Copyright © 2015. Published by Elsevier Ltd.

Effects of a 10-week toe-out gait modification intervention in people with medial knee osteoarthritis: a pilot, feasibility study.

PubMed

Hunt, M A; Takacs, J

2014-07-01

To examine the feasibility of a 10-week gait modification program in people with medial tibiofemoral knee osteoarthritis (OA), and to assess changes in clinical and biomechanical outcomes. Fifteen people with medial knee OA completed 10 weeks of gait modification focusing on increasing toe-out angle during stance 10° compared to their self-selected angle measured at baseline. In addition to adherence and performance difficulty outcomes, knee joint symptoms (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and total score, numerical rating scale (NRS) of pain), and knee joint loading during gait (late stance peak knee adduction moment (KAM)) were assessed. Participants were able to perform the toe-out gait modification program with minimal to moderate difficulty, and exhibited significant increases in self-selected toe-out angle during walking (P < 0.001). Joint discomfort was reported by five participants (33%) in the hip or knee joints, though none lasted longer than 2 weeks. Participants reported statistically significant reductions in WOMAC pain (P = 0.02), NRS pain (P < 0.001), WOMAC total score (P = 0.02), and late stance KAM (P = 0.04). These preliminary findings suggest that toe-out gait modification is feasible in people with medial compartment knee OA. Preliminary changes in clinical and biomechanical outcomes provide the impetus for conducting larger scale studies of gait modification in people with knee OA to confirm these findings. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

The effect of pretest rest time on automated measures of toe systolic blood pressure and the toe brachial index.

PubMed

Sadler, Sean G; Hawke, Fiona E; Chuter, Vivienne H

2015-10-01

Evaluation of peripheral blood supply is fundamental to risk categorization and subsequent ongoing monitoring of patients with lower extremity peripheral arterial disease. Toe systolic blood pressure (TSBP) and the toe brachial index (TBI) are both valid and reliable vascular screening techniques that are commonly used in clinical practice. However, the effect of pretest rest duration on the magnitude of these measurements is unclear. Eighty individuals meeting current guidelines for lower extremity peripheral arterial disease screening volunteered to participate. The Systoe and MicroLife automated devices were used to measure toe and brachial systolic blood pressures, respectively, following 5, 10 and 15 min of rest in a horizontal supine position. A ratio of TSBP to brachial pressure was used to calculate the TBI and change in TBI at each time interval was investigated. A significant increase in TSBP [3.66 mmHg; 95% confidence interval (CI): 1.44-5.89; P≤0.001] and the TBI (0.03; 95% CI: 0.01-0.05; P≤0.001) occurred between 5 and 10 min. Between 10 and 15 min, there was a nonsignificant decrease in TSBP (-0.73 mmHg; 95% CI: -1.48 to 2.93; P=1.000) and the TBI (0.00; 95% CI: -0.02 to 0.02; P=1.000). Ten minutes of pretest rest is recommended for measurement of TSBP and for both pressure measurements used in the calculation of a TBI to ensure that stable pressures are measured.

[Toe transplantation in congenital malformations of the hand].

PubMed

Foucher, G

1997-11-01

Toe transfer is a well established procedure for thumb and finger reconstruction after mutilation. The indications in congenital malformations are a mater of controversy. Out of a personal series of 209 patients, 42 were children presenting a congenital malformation. Thirty six, with 46 transfers were available for review. There is only one failure at the beginning of our experience. The main indication was absence of pinch either due to absence of thumb (like in congenital band syndrome or some extreme cases of ulnar club hand or cleft hand) or absence of long finger (like in symbrachydactyly monodactylous type) or lack of both thumb and finger (like in peromelic type of symbrachydactyly). In this last type, we have been disappointed by the functional result of the distal implantation of two second toes taken from both feet; we have proposed a "stub" operation consisting in a second toe transfer on the anterior aspect of the radial epiphysis to take advantage of the mobility of the wrist and the availability of plenty tendon transfer (in this proximal situation). When planing to "built" an absent pincer, an early age is mandatory for operation (mean 12 months), to ensure a good cortical integration. A less frequent indication is a partial toe transfer with a vascularized epiphysis to provide growth and mobility in some cases of thumb hypoplasia (like in symbrachydactyly or Blauth and Manske type III b). Results are difficult to assess due to the early operation but if the mobility has been disappointing (mean 32 degrees), sensibility (mean 2PD 5 mm) and growth were excellent.

Improvement of isometric dorsiflexion protocol for assessment of tibialis anterior muscle strength☆

PubMed Central

Siddiqi, Ariba; Arjunan, Sridhar P.; Kumar, Dinesh

2015-01-01

It is important to accurately estimate the electromyogram (EMG)/force relationship of triceps surae (TS) muscle for detecting strength deficit of tibalis anterior (TA) muscle. In literature, the protocol for recording EMG and force of dorsiflexion have been described, and the necessity for immobilizing the ankle has been explained. However, there is a significant variability of the results among researchers even though they report the fixation of the ankle. We have determined that toe extension can cause significant variation in the dorsiflexion force and EMG of TS and this can occur despite following the current guidelines which require immobilizing the ankle. The results also show that there was a large increase in the variability of the force and the RMS of EMG of TS when the toes were not strapped compared with when they were strapped. Thus, with the current guidelines, where there are no instructions regarding the necessity of strapping the toes, the EMG/force relationship of TS could be incorrect and give an inaccurate assessment of the dorsiflexor TA strength. In summary, • Current methodology to estimate the dorsiflexor TA strength with respect to the TS activity, emphasizing on ankle immobilization is insufficient to prevent large variability in the measurements. • Toe extension during dorsiflexion was found to be one source of variability in estimating the TA strength. • It is recommended that guidelines for recording force and EMG from TA and TS muscles should require the strapping of the toes along with the need for immobilizing the ankle. PMID:26150978

Effect of stretching program in an industrial workplace on hamstring flexibility and sagittal spinal posture of adult women workers: a randomized controlled trial.

PubMed

Muyor, José M; López-Miñarro, Pedro A; Casimiro, Antonio J

2012-01-01

To determine the effect of a stretching program performed in the workplace on the hamstring muscle extensibility and sagittal spinal posture of adult women. Fifty-eight adult women volunteers (mean age of 44.23 ± 8.87 years) from a private fruit and vegetable company were randomly assigned to experimental (n=27) or control (n=31) groups. The experimental group performed three exercises of hamstrings stretching of 20 seconds per exercise, three sessions a week for a period of 12 weeks. The control group did not participate in any hamstring stretching program. Hamstring flexibility was evaluated through the passive straight leg raise test and toe-touch test, performed both before and after the stretching program. Thoracic and lumbar curvatures and pelvic inclination were measured in relaxed standing and toe-touch test with a Spinal Mouse. Significant increases (p < 0.01) in toe-touch score and straight leg raise angle (in both legs) were found in the experimental group during post-test, while the control group showed a non-significant decrease for both toe-touch score and straight leg raise test. A significant decrease in thoracic curve and significant increase in pelvic inclination were found in the toe-touch test for the experimental group (p <0.05). However, no significant changes were found in standing posture for any group. Hamstring stretching exercises performed in the working place are effective for increasing hamstring muscle extensibility. This increase generates a more aligned thoracic curve and more anterior pelvic inclination when maximal trunk flexion is performed.

Dance Therapy with Physical Therapy for Children with Down Syndrome.

ERIC Educational Resources Information Center

Dupont, Blanche Burt; Schulmann, Diana

This study sought to investigate effects of a dance program on bilateral toe-standing balance and single-point static balance skills of a group of children with Down Syndrome. Thirteen experimental and 10 control group students between the ages of 3 and 13 years were assessed on toe-standing balance and single-point standing balance on the right…

Tic-Tac-Toe Performance as a Function of Maturational Level of Retarded Adolescents and Nonretarded Children

ERIC Educational Resources Information Center

Spitz, Herman H.; Winters, Emilia A.

1977-01-01

Available from: Ablex Publishing Corporation, 355 Chestnut Street, Norwood, New Jersey 07648. Two groups (36 Ss) of educable and trainable mentally retarded adolescents in an institution were compared with two groups (38 Ss) of nonretarded children (ages 8-9 years old) on a modified tic-tac-toe game for foresight in logical problem solving. (MH)

The Limerick Reading Initiative: A Reading Intervention Targeted at Struggling Readers in Primary School

ERIC Educational Resources Information Center

O'Rourke, Diarmuid; Olshtroon, Aoife; O'Halloran, Claire

2016-01-01

In this study we examined the effectiveness of a reading intervention targeting a group of 24 struggling readers in ten primary schools in Ireland. The intervention consisted of two components; component one consisted of 15-20 minutes delivery of the Toe-by-Toe programme (a well established systematic synthetic phonics programme) and the second…

Command Post Program Study. Volume 1 - Main Report

DTIC Science & Technology

1973-03-01

Field Manual 30-9, Military Intelligence Battalion - Field Am. Washington: March 1968. _ Field Manual 32-20, Electronic Warfare. Washington: 14...Mechanized). A-18 TOE 30-88T, Military Intelligence Support Detachment, Military Intelligence Battalion, Field Army. TOE 30-206T, Headquarters and... Field Manual 30-9, Military Intelligence Battalion - Field Army. Washington: March 1968. _ Field Manual 32-20, Electronic Warfare. Washington: 14

Idiopathic toe-walking in children, adolescents and young adults: a matter of local or generalised stiffness?

PubMed Central

2011-01-01

Background Idiopathic Toe Walking (ITW) is present in children older than 3 years of age still walking on their toes without signs of neurological, orthopaedic or psychiatric diseases. ITW has been estimated to occur in 7% to 24% of the childhood population. To study associations between Idiopathic Toe Walking (ITW) and decrease in range of joint motion of the ankle joint. To study associations between ITW (with stiff ankles) and stiffness in other joints, muscle strength and bone density. Methods In a cross-sectional study, 362 healthy children, adolescents and young adults (mean age (sd): 14.2 (3.9) years) participated. Range of joint motion (ROM), muscle strength, anthropometrics sport activities and bone density were measured. Results A prevalence of 12% of ITW was found. Nine percent had ITW and severely restricted ROM of the ankle joint. Children with ITW had three times higher chance of severe ROM restriction of the ankle joint. Participants with ITW and stiff ankle joints had a decreased ROM in other joints, whereas bone density and muscle strength were comparable. Conclusion ITW and a decrease in ankle joint ROM might be due to local stiffness. Differential etiological diagnosis should be considered. PMID:21418634

Predicting ground contact events for a continuum of gait types: An application of targeted machine learning using principal component analysis.

PubMed

Osis, Sean T; Hettinga, Blayne A; Ferber, Reed

2016-05-01

An ongoing challenge in the application of gait analysis to clinical settings is the standardized detection of temporal events, with unobtrusive and cost-effective equipment, for a wide range of gait types. The purpose of the current study was to investigate a targeted machine learning approach for the prediction of timing for foot strike (or initial contact) and toe-off, using only kinematics for walking, forefoot running, and heel-toe running. Data were categorized by gait type and split into a training set (∼30%) and a validation set (∼70%). A principal component analysis was performed, and separate linear models were trained and validated for foot strike and toe-off, using ground reaction force data as a gold-standard for event timing. Results indicate the model predicted both foot strike and toe-off timing to within 20ms of the gold-standard for more than 95% of cases in walking and running gaits. The machine learning approach continues to provide robust timing predictions for clinical use, and may offer a flexible methodology to handle new events and gait types. Copyright © 2016 Elsevier B.V. All rights reserved.

Idiopathic toe-walking in children, adolescents and young adults: a matter of local or generalised stiffness?

PubMed

Engelbert, Raoul; Gorter, Jan Willem; Uiterwaal, Cuno; van de Putte, Elise; Helders, Paul

2011-03-21

Idiopathic Toe Walking (ITW) is present in children older than 3 years of age still walking on their toes without signs of neurological, orthopaedic or psychiatric diseases. ITW has been estimated to occur in 7% to 24% of the childhood population. To study associations between Idiopathic Toe Walking (ITW) and decrease in range of joint motion of the ankle joint. To study associations between ITW (with stiff ankles) and stiffness in other joints, muscle strength and bone density. In a cross-sectional study, 362 healthy children, adolescents and young adults (mean age (sd): 14.2 (3.9) years) participated. Range of joint motion (ROM), muscle strength, anthropometrics sport activities and bone density were measured. A prevalence of 12% of ITW was found. Nine percent had ITW and severely restricted ROM of the ankle joint. Children with ITW had three times higher chance of severe ROM restriction of the ankle joint. Participants with ITW and stiff ankle joints had a decreased ROM in other joints, whereas bone density and muscle strength were comparable. ITW and a decrease in ankle joint ROM might be due to local stiffness. Differential etiological diagnosis should be considered.

The conventional tuning fork as a quantitative tool for vibration threshold.

PubMed

Alanazy, Mohammed H; Alfurayh, Nuha A; Almweisheer, Shaza N; Aljafen, Bandar N; Muayqil, Taim

2018-01-01

This study was undertaken to describe a method for quantifying vibration when using a conventional tuning fork (CTF) in comparison to a Rydel-Seiffer tuning fork (RSTF) and to provide reference values. Vibration thresholds at index finger and big toe were obtained in 281 participants. Spearman's correlations were performed. Age, weight, and height were analyzed for their covariate effects on vibration threshold. Reference values at the fifth percentile were obtained by quantile regression. The correlation coefficients between CTF and RSTF values at finger/toe were 0.59/0.64 (P = 0.001 for both). Among covariates, only age had a significant effect on vibration threshold. Reference values for CTF at finger/toe for the age groups 20-39 and 40-60 years were 7.4/4.9 and 5.8/4.6 s, respectively. Reference values for RSTF at finger/toe for the age groups 20-39 and 40-60 years were 6.9/5.5 and 6.2/4.7, respectively. CTF provides quantitative values that are as good as those provided by RSTF. Age-stratified reference data are provided. Muscle Nerve 57: 49-53, 2018. © 2017 Wiley Periodicals, Inc.

Dynamic self-cleaning in gecko setae via digital hyperextension

PubMed Central

Hu, Shihao; Lopez, Stephanie; Niewiarowski, Peter H.; Xia, Zhenhai

2012-01-01

Gecko toe pads show strong adhesion on various surfaces yet remain remarkably clean around everyday contaminants. An understanding of how geckos clean their toe pads while being in motion is essential for the elucidation of animal behaviours as well as the design of biomimetic devices with optimal performance. Here, we test the self-cleaning of geckos during locomotion. We provide, to our knowledge, the first evidence that geckos clean their feet through a unique dynamic self-cleaning mechanism via digital hyperextension. When walking naturally with hyperextension, geckos shed dirt from their toes twice as fast as they would if walking without hyperextension, returning their feet to nearly 80 per cent of their original stickiness in only four steps. Our dynamic model predicts that when setae suddenly release from the attached substrate, they generate enough inertial force to dislodge dirt particles from the attached spatulae. The predicted cleaning force on dirt particles significantly increases when the dynamic effect is included. The extraordinary design of gecko toe pads perfectly combines dynamic self-cleaning with repeated attachment/detachment, making gecko feet sticky yet clean. This work thus provides a new mechanism to be considered for biomimetic design of highly reuseable and reliable dry adhesives and devices. PMID:22696482

Modeling of Liquid Steel/Slag/Argon Gas Multiphase Flow During Tundish Open Eye Formation in a Two-Strand Tundish

NASA Astrophysics Data System (ADS)

Chatterjee, Saikat; Li, Donghui; Chattopadhyay, Kinnor

2018-04-01

Multiphase flows are frequently encountered in metallurgical operations. One of the most effective ways to understand these processes is by flow modeling. The process of tundish open eye (TOE) formation involves three-phase interaction between liquid steel, slag, and argon gas. The two-phase interaction involving argon gas bubbles and liquid steel can be modeled relatively easily using the discrete phase modeling technique. However, the effect of an upper slag layer cannot be captured using this approach. The presence of an upper buoyant phase can have a major effect on the behavior of TOEs. Hence, a multiphase model, including three phases, viz. liquid steel, slag, and argon gas, in a two-strand slab caster tundish, was developed to study the formation and evolution of TOEs. The volume of fluid model was used to track the interphase between liquid steel and slag phases, while the discrete phase model was used to trace the movement of the argon gas bubbles in liquid steel. The variation in the TOE areas with different amounts of aspirated argon gas was examined in the presence of an overlying slag phase. The mathematical model predictions were compared against steel plant measurements.

Comparison of Varying Heel to Toe Differences and Cushion to Barefoot Running in Novice Minimalist Runners

PubMed Central

MOODY, DANNY; HUNTER, IAIN; RIDGE, SARAH; MYRER, J. WILLIAM

2018-01-01

There are many different types of footwear available for runners in today’s market. Many of these shoes claim to help runners run more efficiently by altering an individual’s stride mechanics. Minimalist footwear claims to aid runners run more on their forefeet whereas more traditional footwear provides more cushioning specifically for a heel first landing. The purpose of this paper was to determine if runners, who were accustomed to running in traditional footwear would alter their running mechanics while running acutely in various types of minimalist footwear. Twelve subjects, accustomed to running in traditional 12 mm heel/toe differential footwear, ran in five footwear conditions on a treadmill at a controlled pace for two minutes after warming up in each condition for 5 minutes. While running in 12 mm heel/toe differential footwear compared to barefoot, subjects ran with a significantly longer ground time, a lower stride rate and greater vertical oscillation. There were not any differences in variables when running in the shod conditions despite the varying heel/toe differentials. Running barefoot proved to be different than running in traditional 12 mm drop cushioned footwear. PMID:29795721

Comparison of Varying Heel to Toe Differences and Cushion to Barefoot Running in Novice Minimalist Runners.

PubMed

Moody, Danny; Hunter, Iain; Ridge, Sarah; Myrer, J William

2018-01-01

There are many different types of footwear available for runners in today's market. Many of these shoes claim to help runners run more efficiently by altering an individual's stride mechanics. Minimalist footwear claims to aid runners run more on their forefeet whereas more traditional footwear provides more cushioning specifically for a heel first landing. The purpose of this paper was to determine if runners, who were accustomed to running in traditional footwear would alter their running mechanics while running acutely in various types of minimalist footwear. Twelve subjects, accustomed to running in traditional 12 mm heel/toe differential footwear, ran in five footwear conditions on a treadmill at a controlled pace for two minutes after warming up in each condition for 5 minutes. While running in 12 mm heel/toe differential footwear compared to barefoot, subjects ran with a significantly longer ground time, a lower stride rate and greater vertical oscillation. There were not any differences in variables when running in the shod conditions despite the varying heel/toe differentials. Running barefoot proved to be different than running in traditional 12 mm drop cushioned footwear.

Modeling and analysis of passive dynamic bipedal walking with segmented feet and compliant joints

NASA Astrophysics Data System (ADS)

Huang, Yan; Wang, Qi-Ning; Gao, Yue; Xie, Guang-Ming

2012-10-01

Passive dynamic walking has been developed as a possible explanation for the efficiency of the human gait. This paper presents a passive dynamic walking model with segmented feet, which makes the bipedal walking gait more close to natural human-like gait. The proposed model extends the simplest walking model with the addition of flat feet and torsional spring based compliance on ankle joints and toe joints, to achieve stable walking on a slope driven by gravity. The push-off phase includes foot rotations around the toe joint and around the toe tip, which shows a great resemblance to human normal walking. This paper investigates the effects of the segmented foot structure on bipedal walking in simulations. The model achieves satisfactory walking results on even or uneven slopes.

Rocky coast processes: with special reference to the recession of soft rock cliffs.

PubMed

Sunamura, Tsuguo

2015-01-01

Substantial progress in research on the recession of coastal cliffs composed of soft materials has been made in recent years and data with higher accuracy have been accumulated. This paper provides the state of the art review in the recession studies and highlights two new findings obtained from the reanalysis of existing data. The review topics are: episodic and localized nature of cliff recession; the development of cliffline; the relationship between cliff height and recession rate; mechanisms of cliff toe erosion by waves; a fundamental equation for wave-induced toe erosion; factors controlling toe erosion; and slope instabilities and mass movements. The findings are presented on (1) the temporal change in cliffline recession mode and (2) the effect of beach sediment at the cliff base on the cliff erosion.

Paleopathological study of hallux valgus.

PubMed

Mays, S A

2005-02-01

Hallux valgus is the abnormal lateral deviation of the great toe. The principal cause is biomechanical, specifically the habitual use of footwear which constricts the toes. In this study, descriptions of the anatomical changes of hallux valgus from published cadaveric and clinical studies were used to generate criteria for identifying the condition in ancient skeletal remains. The value of systematic scoring of hallux valgus in paleopathology is illustrated using two British skeletal series, one dating from the earlier and one from the later Medieval period. It was found that hallux valgus was restricted to later Medieval burials. This appears consistent with archaeological and historical evidence for a rise in popularity, during the late Medieval period (at least among the richer social classes), of narrow, pointed shoes which would have constricted the toes. 2004 Wiley-Liss, Inc.

[Hand and wrist bone maturation in children with central precocious puberty and idiopathic short stature].

PubMed

Wang, Anru; Yang, Fangling; Yu, Baosheng; Shan, Ye; Gao, Lanying; Zhang, Xiaoxiao; Peng, Ya

2013-07-01

To investigate the maturation of individual bones on the hand and wrist in children with central precocious puberty (CPP) and idiopathic short stature (ISS). Hand and wrist films of 25 children with CPP, 29 children with ISS and 21 normal controls were evaluated by conventional Greulich-Pyle (GP) atlas method and individual bone assessment method, in which all twenty bones of the hand and wrist were evaluated based on GP atlas, including 2 radius and ulna, 7 carpal bones, 11 metacarpal and phalangeal bones, the average bone age (BA) was calculated. The differences in groups were analyzed by independent samples t test. The differences between the two methods were analyzed by paired sample t test. The differences between BA and chronological age (CA) were analyzed by ROC with SPSS 17.0. Compared with the normal control group, the advance of BA in the CPP group was 0.70-2.26 y (1.48 ±0.78) by the GP atlas method, while that was 0.28-2.00 y(1.14 ±0.86) by the individual bone evaluation method. In all twenty bones, the advance of metacarpal and phalangeal BA was the greatest [0.34-2.06 y(1.2±0.86)]. In the ISS group,the delay of BA was 0.47-2.91 y(-1.69±1.22) by the GP atlas method, while that was 0.48-2.50 y (-1.49±1.01) by individual bone evaluation method.The delay of carpal BA was the greatest [0.59-2.73 y(-1.66±1.07)] in all twenty bones. In the ISS group and the normal control group, there were no statistic differences between the two methods. In the CPP group, statistic difference was found between two methods. There were no statistic differences for the areas under ROC curves between two methods. The advance of metacarpal and phalangeal BA is the greatest in CPP group and the delay of carpal BA is the greatest in ISS group.Both methods provide diagnostic information for bone age in CPP and ISS children.

[DORSALIS PEDIS FLAP SERIES-PARALLEL BIG TOE NAIL COMPOSITE TISSUE FLAP TO REPAIR HAND SKIN OF DEGLOVING INJURY WITH THUMB DEFECT].

PubMed

Shi, Pengju; Zhang, Wenlong; Zhao, Gang; Li, Zhigang; Zhao, Shaoping; Zhang, Tieshan

2015-07-01

To investigate the effectiveness of dorsalis pedis flap series-parallel big toe nail composite tissue flap in the repairment of hand skin of degloving injury with tumb defect. Between March 2009 and June 2013, 8 cases of hand degloving injury with thumb defect caused by machine twisting were treated. There were 7 males and 1 female with the mean age of 36 years (range, 26-48 years). Injury located at the left hand in 3 cases and at the right hand in 5 cases. The time from injury to hospitalization was 1.5-4.0 hours (mean, 2.5 hours). The defect area was 8 cm x 6 cm to 15 cm x 1 cm. The thumb defect was rated as degree I in 5 cases and as degree II in 3 cases. The contralateral dorsal skin flap (9 cm x 7 cm to 10 cm x 8 cm) combined with ipsilateral big toe nail composite tissue flap (2.5 cm x 1.8 cm to 3.0 cm x 2.0 cm) was used, including 3 parallel anastomosis flaps and 5 series anastomosis flaps. The donor site of the dorsal flap was repaired with thick skin grafts, the stumps wound was covered with tongue flap at the shank side of big toe. Vascular crisis occurred in 1 big toe nail composite tissue flap, margin necrosis occurred in 2 dorsalis pedis flap; the other flaps survived, and primary healing of wound was obtained. The grafted skin at dorsal donor site all survived, skin of hallux toe stump had no necrosis. Eight cases were followed up 4-20 months (mean, 15.5 months). All flaps had soft texture and satisfactory appearance; the cutaneous sensory recovery time was 4-7 months (mean, 5 months). At 4 months after operation, the two-point discrimination of the thumb pulp was 8-10 mm (mean, 9 mm), and the two-point discrimination of dorsal skin flap was 7-9 mm (mean, 8.5 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the results were excellent in 4 cases, good in 3 cases, and fair in 1 case. The donor foot had normal function. Dorsalis pedis flap series-parallel big toe nail composite tissue flap is an ideal way to repair hand skin defect, and reconstructs the thumb, which has many advantages, including simple surgical procedure, no limitation to recipient site, soft texture, satisfactory appearance and function of reconstructing thumb, and small donor foot loss.

Determination of Optimum Cross-section for Oran Highway Revetment

NASA Astrophysics Data System (ADS)

Sogut, E.; Velioglu, D.; Guler, I.

2016-12-01

Revetments are shore parallel, sloping coastal structures which are built to provide protection from the negative effects of the sea. The revetment mentioned in this study is located in the City of Oran, Algeria and is currently under construction. This study investigates the determination of the optimum revetment cross section for Oran highway, considering both the hydraulic stability of the revetment and economy. The existence of cliffs in the region and the settlement of the City of Oran created a necessity to re-align Oran highway; therefore, it was shifted towards the Gulf of Oran. Approximately 1 km of the highway is to be constructed on the Mediterranean Sea due to the new alignment. In order to protect the sea side of the road from the adverse effects of the sea, a revetment was designed. The proposed cross section had an armour layer composed of 23 tons of antifer units and regular placement of armour units was recommended. In order to check the hydraulic stability of the proposed section, physical model tests were performed in the laboratory of LEM (Laboratoire d'Etudes Maritimes) in Algeria, using the pre-determined design wave conditions. The physical model tests revealed that the trunk of the revetment was totaly damaged. Accordingly, the proposed section was found insufficient and certain modifications were required. The first modification was made in the arrangement of armour units, changing them from regular to irregular. After testing the new cross section, it was observed that the revetment was vulnerable to breaking wave attack due to the toe geometry and thus the toe of the revetment had to be re-shaped. Therefore, the second option was to reduce the toe elevation. It was observed that even though the revetment trunk was safe, the damage in the toe was not in acceptable limits. The new cross section was found insufficient and as the final option, the weight of the antifer units used in the armour layer was increased, the toe length of the structure was increased and the size of the armour units in the toe was decreased. After the modifications, the new section was tested physically and it was selected as the most optimum option.

Quantifying skin motion artifact error of the hindfoot and forefoot marker clusters with the optical tracking of a multi-segment foot model using single-plane fluoroscopy.

PubMed

Shultz, R; Kedgley, A E; Jenkyn, T R

2011-05-01

The trajectories of skin-mounted markers tracked with optical motion capture are assumed to be an adequate representation of the underlying bone motions. However, it is well known that soft tissue artifact (STA) exists between marker and bone. This study quantifies the STA associated with the hindfoot and midfoot marker clusters of a multi-segment foot model. To quantify STA of the hindfoot and midfoot marker clusters with respect to the calcaneus and navicular respectively, fluoroscopic images were collected on 27 subjects during four quasi-static positions, (1) quiet standing (non-weight bearing), (2) at heel strike (weight-bearing), (3) at midstance (weight-bearing) and (4) at toe-off (weight-bearing). The translation and rotation components of STA were calculated in the sagittal plane. Translational STA at the calcaneus varied from 5.9±7.3mm at heel-strike to 12.1±0.3mm at toe-off. For the navicular the translational STA ranged from 7.6±7.6mm at heel strike to 16.4±16.7mm at toe-off. Rotational STA was relatively smaller for both bones at all foot positions. For the calcaneus they varied between 0.1±2.2° at heel-strike to 0.2±0.6° at toe-off. For the navicular, the rotational STA ranged from 0.6±0.9° at heel-strike to 0.7±0.7° at toe-off. The largest translational STA found in this study (16mm for the navicular) was smaller than those reported in the literature for the thigh and the lower leg, but was larger than the STA of individual spherical markers affixed to the foot. The largest errors occurred at toe-off position for all subjects for both the hindfoot and midfoot clusters. Future studies are recommended to quantify true three-dimensional STA of the entire foot during gait. Copyright © 2011. Published by Elsevier B.V.

People with stroke who fail an obstacle crossing task have a higher incidence of falls and utilize different gait patterns compared with people who pass the task.

PubMed

Said, Catherine M; Galea, Mary P; Lythgo, Noel

2013-03-01

Obstacle crossing is impaired in people following stroke. It is not known whether people with stroke who fail an obstacle crossing task have more falls or whether the gait adjustments used to cross an obstacle differ from those used by people who pass the task. The purposes of this study were (1) to identify whether a group of people with stroke who failed an obstacle crossing task had a greater incidence of falling and (2) to determine whether people who fail an obstacle crossing task utilize different gait adjustments. This was a prospective, observational study. Thirty-two participants with a recent stroke were recruited. Participants walked at self-selected speed and stepped over a 4-cm-high obstacle. Performance was rated as pass or fail, and spatiotemporal, center of mass (COM), and center of pressure (COP) data were collected. Prospective falls data were recorded for 20 participants over a 6-month period. The incidence of fallers was significantly higher (incidence rate=0.833) in the group that failed the obstacle crossing task than in the group that passed the task (incidence rate=0.143). The group that failed the task had a slower walking speed and greater normalized separation between the trail heel (unaffected support limb) and COM as the affected lead toe cleared the obstacle. This group exhibited greater normalized times from affected lead toe clearance to landing, unaffected trail toe clearance to landing, and affected trail toe-off to toe clearance. The sample size was small, and falls data were available for only 20 participants. Obstacle crossing is an important task to consider in people following stroke and may be useful in identifying those at risk of falls.

Emergence of the significant local warming of Korea in CMIP5 projections

NASA Astrophysics Data System (ADS)

Boo, Kyung-On; Shim, Sungbo; Kim, Jee-Eun

2016-04-01

According to IPCC AR5, anthropogenic influence on warming is obvious in local scales, especially in some tropical regions. Detection of significant local warming is important for adaptation to climate change of society and ecosystem. Recently much attention has focused on the time of emergence (ToE) for the signal of anthropogenic climate change against the natural climate variability. Motivated from the previous studies, this study analyzes ToE of regional surface air temperature over Korea. Simulations of CMIP5 15 models are used for RCP 2.6, 4.5 and 8.5. For each year, JJA and DJF temperature anomalies are calculated for the time period 1900-1929. For noise of interannual variability, natural-only historical simulations of CMIP5 12 models are used and the standard deviation of the time series is obtained. For signal of warming, we examine the year when the signal above 2 standard deviations is detected in 80% of the models using 30-year smoothed time series. According to our results, interannual variability is larger in land than ocean. Seasonally, it is larger in winter than in summer. Accordingly, ToE of summertime temperature is earlier than that in winter and is expected to appear in 2030s from three RCPs. The seasonal difference is consistent with previous studies. Wintertime ToE appears in 2040s for RCP85 and 2060s for RCP4.5. The different emergence time between RCP8.5 and RCP4.5 reflects the influence of mitigation. In a similar way, daily maximum and minimum temperatures are analyzed. ToE of Tmin appears earlier than that of Tmax and difference is small. Acknowledgements. This study is supported by the National Institute of Meteorological Sciences, Korea Meteorological Administration (NIMR-2012-B-2).

Investigating Patients' Perception of Microvascular Free Toe Flap for Reconstruction of Amputated Thumbs: A Guide for Surgeons during Informed Consent.

PubMed

Efanov, Johnny Ionut; Wong, Christopher; Guilbault, Clarence; Bou-Merhi, Joseph; Harris, Patrick G; Izadpanah, Ali; Danino, Michel Alain

2018-04-24

 After thumb amputations, restoration of function and aesthetic can be accomplished with microvascular free toe flaps. However, many patients in clinical practice do not choose this reconstruction despite positive reported outcomes. This study aims to determine patients' perceptions with respect to free toe flaps to improve areas of informed consent.  A retrospective survey was administered to patients with thumb amputations. Participants were required to complete a questionnaire about patient demographics, the Brief Michigan Hand Questionnaire (bMHQ), the standard gamble/time trade-off questionnaires for utility scores, and a questionnaire investigating potential reasons for electing not to undergo a free toe transfer.  Thirty patients were enrolled in the study wherein 53% underwent a replantation procedure, 27% a revision amputation, and 20% a delayed reconstruction. Mean normalized score on the bMHQ was recorded as 63.54. Utility questionnaires yielded mean measures of 0.8967 and 0.86 on the standard gamble and time trade-off, respectively. From 14 elements, a majority (87%) stated flap failure as a major source of concern, followed by lack of understanding of risks and benefits (80%) and prolonged hospital stay (53%). Cultural/religious beliefs, aesthetic appearance of the foot, and concerns about footwear were not reported as important reasons in 90, 80, and 79% of patients, respectively.  A better understanding of patients' attitudes and beliefs with respect to free toe flaps will allow surgeons to better address their concerns during informed consent. This study emphasizes the importance to discuss about failure rates, risks, and benefits of the operation and prolonged hospital stay. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Plantar pressure of clipless and toe-clipped pedals in cyclists - A pilot study

PubMed Central

Davis, Andrea; Pemberton, Troy; Ghosh, Subhajit; Maffulli, Nicola; Padhiar, Nat

2011-01-01

Summary To determine the effect of clipless and toe-clipped pedals on plantar foot pressure while cycling. Seven bikers and 11 healthy volunteers were tested on a Giant ATX Team mountain bike, Tekscan Clinical 5.24 F-scan® system with an inner sole pressure sensor, a Tacx Cycle force One Turbo Trainer and a Cateye Mity 8 computerized speedometer were used. The subjects wore Shimano M037 shoes and used a standard clipless and toe-clipped pedal. The seat height was set at 100% of subject’s trochanteric height. Plantar pressures were recorded over 12 consecutive crank cycles at a constant speed for each of the power outputs. The videos were analysed to record the pressure exerted at 12 positions on the foot for each variable. Whether there is any dominance of any of the metatarsals, and any difference in plantar pressures between clipped and clipless pedal. There was a significant difference in the pressure at many positions of the foot, but the sites were different for each individual. General regression analysis indicated that pedal type had a statistically significant effect on plantar pressure at the sites of 1st metatarsal (p=0.042), 3rd metatarsal (p<0.001), 5th metatarsal (<0.001), 2nd (p=0.018) and 5th toe (p<0.001), lateral midfoot (p<0.001) and central heel (p<0.001) areas. Clipless pedals produce higher pressures which are more spread across the foot than toe-clipped pedals. This may have implications for their use in the prevention and/or management of overuse injuries in the knee and foot. PMID:23738240

Measurement of Toe-Brachial Indices in People with Subnormal Toe Pressures Complexities and Revelations.

PubMed

McAra, Sylvia; Trevethan, Robert

2018-03-01

Insufficient information exists about the nature of toe-brachial indices (TBIs) and how best to obtain them, yet their validity may be particularly important for the identification and management of peripheral artery disease and cardiovascular disease risk. We explore ways in which valid TBI measurements might be obtained. The TBI data were recorded from 97 people with subnormal toe pressures. Most people provided three TBI readings from each foot on six different occasions over a 6-month period. The foot with the lower baseline TBI was noted. For most people, only small inconsistencies existed among the three readings taken from each foot on a single occasion, and there were no consistent differences based on sequence. However, for some people there were noticeable and unsystematic differences among the measures. Selecting any specific one of the three readings based on its sequential position, or averaging specific readings, did not yield TBIs that were unequivocally typical for a person, and taking the lowest reading of each set seemed to offer the most expedient solution in this context. That permitted baseline descriptive statistics to be produced for both the higher and lower pressure feet, between which there was a statistically significant TBI difference. Accurate and consistent TBI readings cannot be assumed for people with subnormal toe pressures, and taking only a single reading or indiscriminately averaging readings seems inadvisable. Two readings and, if they are discrepant, additional readings, are recommended for each foot, ideally on several occasions, and careful consideration should be given to determine the most representative reading for each foot. Cuff sizes and other sources of inaccuracy or distortion should not be ignored, and standardized protocols for obtaining TBIs are recommended.

A role for the gene regulatory module microRNA172/TARGET OF EARLY ACTIVATION TAGGED 1/FLOWERING LOCUS T (miRNA172/TOE1/FT) in the feeding sites induced by Meloidogyne javanica in Arabidopsis thaliana.

PubMed

Díaz-Manzano, Fernando E; Cabrera, Javier; Ripoll, Juan-José; Del Olmo, Iván; Andrés, Mari Fe; Silva, Ana Cláudia; Barcala, Marta; Sánchez, María; Ruíz-Ferrer, Virginia; de Almeida-Engler, Janice; Yanofsky, Martin F; Piñeiro, Manuel; Jarillo, Jose Antonio; Fenoll, Carmen; Escobar, Carolina

2018-01-01

Root knot nematodes (RKNs) penetrate into the root vascular cylinder, triggering morphogenetic changes to induce galls, de novo formed 'pseudo-organs' containing several giant cells (GCs). Distinctive gene repression events observed in early gall/GCs development are thought to be mediated by post-transcriptional silencing via microRNAs (miRNAs), a process that is far from being fully characterized. Arabidopsis thaliana backgrounds with altered activities based on target 35S::MIMICRY172 (MIM172), 35S::TARGET OF EARLY ACTIVATION TAGGED 1 (TOE1)-miR172-resistant (35S::TOE1 R ) and mutant (flowering locus T-10 (ft-10)) lines were used for functional analysis of nematode infective and reproductive parameters. The GUS-reporter lines, MIR172A-E::GUS, treated with auxin (IAA) and an auxin-inhibitor (a-(phenyl ethyl-2-one)-indole-3-acetic acid (PEO-IAA)), together with the MIR172C AuxRE::GUS line with two mutated auxin responsive elements (AuxREs), were assayed for nematode-dependent gene expression. Arabidopsis thaliana backgrounds with altered expression of miRNA172, TOE1 or FT showed lower susceptibility to the RKNs and smaller galls and GCs. MIR172C-D::GUS showed restricted promoter activity in galls/GCs that was regulated by auxins through auxin-responsive factors. IAA induced their activity in galls while PEO-IAA treatment and mutations in AuxRe motifs abolished it. The results showed that the regulatory module miRNA172/TOE1/FT plays an important role in correct GCs and gall development, where miRNA172 is modulated by auxins. © 2017 The Authors. New Phytologist © 2017 New Phytologist Trust.

Vertical Jump Height Estimation Algorithm Based on Takeoff and Landing Identification Via Foot-Worn Inertial Sensing.

PubMed

Wang, Jianren; Xu, Junkai; Shull, Peter B

2018-03-01

Vertical jump height is widely used for assessing motor development, functional ability, and motor capacity. Traditional methods for estimating vertical jump height rely on force plates or optical marker-based motion capture systems limiting assessment to people with access to specialized laboratories. Current wearable designs need to be attached to the skin or strapped to an appendage which can potentially be uncomfortable and inconvenient to use. This paper presents a novel algorithm for estimating vertical jump height based on foot-worn inertial sensors. Twenty healthy subjects performed countermovement jumping trials and maximum jump height was determined via inertial sensors located above the toe and under the heel and was compared with the gold standard maximum jump height estimation via optical marker-based motion capture. Average vertical jump height estimation errors from inertial sensing at the toe and heel were -2.2±2.1 cm and -0.4±3.8 cm, respectively. Vertical jump height estimation with the presented algorithm via inertial sensing showed excellent reliability at the toe (ICC(2,1)=0.98) and heel (ICC(2,1)=0.97). There was no significant bias in the inertial sensing at the toe, but proportional bias (b=1.22) and fixed bias (a=-10.23cm) were detected in inertial sensing at the heel. These results indicate that the presented algorithm could be applied to foot-worn inertial sensors to estimate maximum jump height enabling assessment outside of traditional laboratory settings, and to avoid bias errors, the toe may be a more suitable location for inertial sensor placement than the heel.

Footprint Contact Area and Interface Pressure Comparison Between the Knotless and Knot-Tying Transosseous-Equivalent Technique for Rotator Cuff Repair.

PubMed

Kim, Sung-Jae; Kim, Sung-Hwan; Moon, Hyun-Soo; Chun, Yong-Min

2016-01-01

To quantify and compare the footprint contact area and interface pressure on the greater tuberosity between knotless and knot-tying transosseous-equivalent (TOE) repair using pressure-sensitive film. We used 11 pairs of fresh-frozen cadaveric shoulders (22 specimens), in which rotator cuff tears were created before repair. Each pair was randomized to either conventional medial knot-tying TOE repair (group A) or medial knotless TOE repair using the modified Mason-Allen technique (group B). Pressure-sensitive film was used to quantify the pressurized contact area and interface pressure between the greater tuberosity and supraspinatus tendon. The mean pressurized contact area was 33.2 ± 2.5 mm(2) for group A and 28.4 ± 2.4 mm(2) for group B. There was a significant difference between groups (P = .005). Although the overall contact configuration of both groups was similar and showed an M shape, group A showed a greater pressurized configuration around the medial row. The mean interface pressure was 0.20 ± 0.02 MPa for group A and 0.17 ± 0.02 MPa for group B. There was a significant difference between groups (P = .001). Contrary to our hypothesis, in this time-zero study, medial knotless TOE repair using a modified Mason-Allen suture produced a significantly inferior footprint contact area and interface pressure compared with conventional medial knot-tying TOE repair. Even though we found a statistically significant difference between the 2 repair methods, it is still unknown if this statistical difference seen in our study has any clinical and radiologic significance. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

A novel device for measuring arterial stiffness using finger-toe pulse wave velocity: Validation study of the pOpmètre®.

PubMed

Alivon, Maureen; Vo-Duc Phuong, Thao; Vignon, Virginie; Bozec, Erwan; Khettab, Hakim; Hanon, Olivier; Briet, Marie; Halimi, Jean-Michel; Hallab, Magid; Plichart, Matthieu; Mohammedi, Kamel; Marre, Michel; Boutouyrie, Pierre; Laurent, Stéphane

2015-04-01

The finger-toe pathway could be a good alternative for assessing arterial stiffness conveniently. To evaluate the accuracy of the pOpmètre®--a new device that measures finger-toe pulse wave velocity (ft-PWV). The pOpmètre has two photodiode sensors, positioned on the finger and the toe. Pulse waves are recorded continuously for 20 seconds, and the difference in pulse wave transit time between toe and finger (ft-TT) is calculated. The travelled distance is estimated using subject height. Study 1 compared ft-PWV with carotid-femoral PWV (cf-PWV) obtained by the reference method (SphygmoCor®) in 86 subjects (mean age 53±20 years), including 69 patients with various pathologies and 17 healthy normotensives. Study 2 compared changes in ft-PWV and cf-PWV during a cold pressor test in 10 healthy subjects. Study 3 assessed repeatability in 45 patients. ft-PWV correlated significantly with cf-PWV (R2=0.43; P<0.0001). A better correlation was found in terms of transit time (R2=0.61; P<0.0001). The discrepancy between transit times was related to age. The cold pressor test induced parallel changes in cf-PWV and ft-PWV, with increased aortic stiffness that was reversible during recovery. Intra-session repeatability was very good, with a coefficient of variation of 4.52%. The pOpmètre® allows measurement of arterial stiffness in routine clinical practice. The greatest advantages of ft-PWV are simplicity, rapidity, feasibility, acceptability by patients and correct agreement with the reference technique. Further studies are needed to adjust for bias and to validate the pOpmètre in larger populations. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Effects of Walking Speed and Visual-Target Distance on Toe Trajectory During Swing Phase

NASA Technical Reports Server (NTRS)

Miller, Chris; Peters, Brian; Brady, Rachel; Warren, Liz; Richards, Jason; Mulavara, Ajitkumar; Sung, Hsi-Guang; Bloomberg, Jacob

2006-01-01

After spaceflight, astronauts experience disturbances in their ability to walk and maintain postural stability (Bloomberg, et al., 1997). One of the post-flight neurovestibular assessments requires that the astronaut walk on a treadmill at 1.8 m/sec (4.0 mph), while performing a visual acuity test, set at two different distances ( far and near ). For the first few days after landing, some crewmembers can not maintain the required pace, so a lower speed may be used. The slower velocity must be considered in the kinematic analysis, because Andriacchi, et al. (1977) showed that in clinical populations, changes in gait parameters may be attributable more to slower gait speed than pathology. Studying toe trajectory gives a global view of control of the leg, since it involves coordination of muscles and joints in both the swing and stance legs (Karst, et al., 1999). Winter (1992) and Murray, et al. (1984) reported that toe clearance during overground walking increased slightly as speed increased, but not significantly. Also, toe vertical peaks in both early and late swing phase did increase significantly with increasing speed. During conventional testing of overground locomotion, subjects are usually asked to fix their gaze on the end of the walkway a far target. But target (i.e., visual fixation) distance has been shown to affect head and trunk motion during treadmill walking (Bloomberg, et al., 1992; Peters, et al., in review). Since the head and trunk can not maintain stable gaze without proper coordination with the lower body (Mulavara & Bloomberg, 2003), it would stand to reason that lower body kinematics may be altered as well when target distance is modified. The purpose of this study was to determine changes in toe vertical trajectory during treadmill walking due to changes in walking speed and target distance.

Anatomical characterization of hoof growth pattern in six Iranian sheep breeds and its possible implication for trimming recommendations.

PubMed

Azarpajouh, S; Marchewka, J; Segura Correa, J C; Calderón Díaz, J A

2018-03-11

The objective of this study was to compare hoof anatomy, hoof growth pattern, and hoof weight-bearing surface of six different Iranian sheep breeds to identify possible differences in the hoof anatomical features that could help to minimize adverse effects of hoof trimming methods. Front and hind hooves of 2-year-old, previously untrimmed, pastured dairy ewes of six Iranian breeds (Afshari, Moghani, Kurdi, Makoui, Chaleshtori, and Lori-Bakhtiari; n = 180 ewes; 30 ewes per breed) were collected after slaughter. Medial and lateral claws were incised sagittally and anatomical measurements such as toe length, heel height, toe height, sole thickness, sole length, and toe angle were recorded in each claw. Data were analyzed using mixed model equations including breed, claw (lateral or medial), hoof (front or hind) and their interactions as fixed effects, and ewe as random effect. Breed differences were observed for all hoof measurements (P < 0.05). Chaleshtori sheep had higher measurements for most of the traits studied while Afshari and Makoui sheep had lower measurements. All measurements, except for toe length and toe height to solar surface to heel height ratio, were significantly greater in the front hooves than in the hind hooves (P < 0.05). Soles were longer in the medial claws compared to the lateral claws of the front hooves (P < 0.05). Results suggest the observed breed differences could interfere with establishing a standard, uniform hoof trimming method for sheep. For instance, it might be possible that while Afshari and Makoui sheep could require more conservative trimming, Chaleshtori sheep could require to be trimmed more. In consequence, hoof trimming methods might need to be adjusted to specific breed characteristics to avoid possible tissue damage.

[Melorheostosis of the foot: a case report of a rare entity].

PubMed

Craiovan, B; Zeiler, G; Delling, G; Schuh, A

2006-12-01

Melorheostosis is a rare bony dysplasia and often recognised just sporadically by chance. We present a case of a 15 year old girl who presented a melorheostosis of the left foot. After birth there was recognized a shortening and deformity of the 2nd toe on the left foot. Furthermore she had an interphalangeal hallux valgus that displaced the 2nd toe increasingly. Thus in the last years there were more and more difficulties to wear normal shoes. Conservative therapy was not successful. We performed a lengthening extending osteotomy of the 2nd toe (a modified Weil osteotomy) and an Akin osteotomy of the interphalangeal hallux valgus. Since the surgical procedure the patient is out of any complaints. We demonstrate the radiologic and histologic findings and discuss the relevant literature and possible etiology.

Rocky coast processes: with special reference to the recession of soft rock cliffs

PubMed Central

SUNAMURA, Tsuguo

2015-01-01

Substantial progress in research on the recession of coastal cliffs composed of soft materials has been made in recent years and data with higher accuracy have been accumulated. This paper provides the state of the art review in the recession studies and highlights two new findings obtained from the reanalysis of existing data. The review topics are: episodic and localized nature of cliff recession; the development of cliffline; the relationship between cliff height and recession rate; mechanisms of cliff toe erosion by waves; a fundamental equation for wave-induced toe erosion; factors controlling toe erosion; and slope instabilities and mass movements. The findings are presented on (1) the temporal change in cliffline recession mode and (2) the effect of beach sediment at the cliff base on the cliff erosion. PMID:26568322

A Unique Case of Classic Kaposi's sarcoma restricted to the toes.

PubMed

Renteria, Anne S; Marshall, Vickie A; Sun, Yanyu; Chockalingam, Porselvi; Cooper, Jay S; Huang, Yiwu; Whitby, Denise

2013-01-01

Kaposi's sarcoma associated-herpesvirus causes all forms of Kaposi's sarcoma, and six major subtypes have been described based on the amino acid sequences of the open reading frame K1. A 71-year-old man from China, HIV negative, presented with nodules on the dorsal aspect of his toes. Biopsy confirmed the diagnosis of Kaposi's sarcoma and virology studies of his blood and saliva confirmed the presence of Kaposi's sarcoma associated-herpesvirus infection. Viral genotyping was consistent with subtype C3. Intervention has been deferred as our patient has remained clinically asymptomatic and without evident growth of his lesions over a 2-year follow up. We herein report the first known case of Kaposi's sarcoma restricted to the toes caused by the viral subtype C3 in an HIV-negative patient from Harbin, China.

Siblicide, splayed-toes-flight display, and grappling in the Saker Falcon

USGS Publications Warehouse

Ellis, D.H.; Whitlock, P.L.; Tsengeg, Pu; Nelson, R.W.

1999-01-01

We observed two incidents of novel social behavior in the saker falcon (Falco cherrug) in Mongolia. First, we provide an account of a two-week-old saker falcon chick killing its nest mate, the first direct observation of siblicide in the genus Falco. We also report aerial combat between three adult saker falcons including observations of talon grappling, whirling, and Splayed-toes-flight, a previously undescribed social display.

US Army Armor Reference Data in Three Volumes. Volume I. The Army Division.

DTIC Science & Technology

1981-01-01

dental treatment ASSIGNMENT Organic Armored Division, TOE 17 (d) Optometrc services CAPABILITIES a Provides the following combat service support to a...Support Command. Infantry Division (Mechaniied TOE 29-ft 1 Provides expedient dental treatment CAPABILITIES a Provides medical staff services, including g...administration, and supervision of and f Provides expedient dental treatment plan, mrt division level ol4 uii novel medicaf support rendered by

An Inverse Kinematic Approach Using Groebner Basis Theory Applied to Gait Cycle Analysis

DTIC Science & Technology

2013-03-01

stance phase begins with initial contact, heel strike , and ends with toe off. The swing phase begins at toe off and ends with the heel striking the ground...and transition phase (10%). Recall, that the gait cycle begins when the heel strikes the ground of one foot and ends when that same foot strikes the...Validation of Knee Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 12 Validation of Ankle Angle

Automatic Adjustments of a Trans-oesophageal Ultrasound Robot for Monitoring Intra-operative Catheters

NASA Astrophysics Data System (ADS)

Wang, Shuangyi; Housden, James; Singh, Davinder; Rhode, Kawal

2017-12-01

3D trans-oesophageal echocardiography (TOE) has become a powerful tool for monitoring intra-operative catheters used during cardiac procedures in recent years. However, the control of the TOE probe remains as a manual task and therefore the operator has to hold the probe for a long period of time and sometimes in a radiation environment. To solve this problem, an add-on robotic system has been developed for holding and manipulating a commercial TOE probe. This paper focuses on the application of making automatic adjustments to the probe pose in order to accurately monitor the moving catheters. The positioning strategy is divided into an initialization step based on a pre-planning method and a localized adjustments step based on the robotic differential kinematics and related image servoing techniques. Both steps are described in the paper along with simulation experiments performed to validate the concept. The results indicate an error less than 0.5 mm for the initialization step and an error less than 2 mm for the localized adjustments step. Compared to the much bigger live 3D image volume, it is concluded that the methods are promising. Future work will focus on evaluating the method in the real TOE scanning scenario.

[Microsurgical 2nd toe transfer for catastrophic hand reconstruction].

PubMed

Placer, A; Lozano, Ja

2007-01-01

The correct reconstruction of the catastrophic hand requires complex surgical techniques. The microsurgical transference of a toe is indicated when all other reconstructive options are shown to be useless for the reconstruction of the required clamp function. In this clinical note we set out the case of a 32 year old man, who came to our accident and emergency department after suffering a traffic accident. After exploration the diagnosis was that of catastrophic left hand, among other policontusions. Urgent surgery was carried out, saving the maximum possible viable structures. The immediate result of this surgery was a hand with 1st, 4th and 5th functional fingers. As the essential clamp function between the 1st and 4th or 5th fingers was not totally satisfactory, we decided to reconstruct the 3rd finger of his hand with his ipsilateral 2nd toe. All pertinent studies to determine vascularisation of the flap were carried out in planning the surgery, and the microsurgical transfer was then realized, which was successful. Today, after a suitable rehabilitation, the patient has recovered a satisfactory function of heavy and fine clamp in the operated hand. Toe to hand transfer is a good option for finger reconstruction and its function. Rehabilitation is the key to functional recovery.

Effect of Foot Progression Angle and Lateral Wedge Insole on a Reduction in Knee Adduction Moment.

PubMed

Tokunaga, Ken; Nakai, Yuki; Matsumoto, Ryo; Kiyama, Ryoji; Kawada, Masayuki; Ohwatashi, Akihiko; Fukudome, Kiyohiro; Ohshige, Tadasu; Maeda, Tetsuo

2016-10-01

This study evaluated the effect of foot progression angle on the reduction in knee adduction moment caused by a lateral wedged insole during walking. Twenty healthy, young volunteers walked 10 m at their comfortable velocity wearing a lateral wedged insole or control flat insole in 3 foot progression angle conditions: natural, toe-out, and toe-in. A 3-dimensional rigid link model was used to calculate the external knee adduction moment, the moment arm of ground reaction force to knee joint center, and the reduction ratio of knee adduction moment and moment arm. The result indicated that the toe-out condition and lateral wedged insole decreased the knee adduction moment in the whole stance phase. The reduction ratio of the knee adduction moment and the moment arm exhibited a close relationship. Lateral wedged insoles decreased the knee adduction moment in various foot progression angle conditions due to decrease of the moment arm of the ground reaction force. Moreover, the knee adduction moment during the toe-out gait with lateral wedged insole was the smallest due to the synergistic effect of the lateral wedged insole and foot progression angle. Lateral wedged insoles may be a valid intervention for patients with knee osteoarthritis regardless of the foot progression angle.

Sensorimotor cortical activity in patients with complete spinal cord injury: a functional magnetic resonance imaging study.

PubMed

Sabbah, P; de, Schonen S; Leveque, C; Gay, S; Pfefer, F; Nioche, C; Sarrazin, J L; Barouti, H; Tadie, M; Cordoliani, Y S

2002-01-01

Residual activation of the cortex was investigated in nine patients with complete spinal cord injury between T6 and L1 by functional magnetic resonance imaging (fMRI). Brain activations were recorded under four conditions: (1) a patient attempting to move his toes with flexion-extension, (2) a patient imagining the same movement, (3) passive proprio-somesthesic stimulation of the big toes without visual control, and (4) passive proprio-somesthesic stimulation of the big toes with visual control by the patient. Passive proprio-somesthesic stimulation of the toes generated activation posterior to the central sulcus in the three patients who also showed a somesthesic evoked potential response to somesthesic stimulation. When performed under visual control, activations were observed in two more patients. In all patients, activations were found in the cortical areas involved in motor control (i.e., primary sensorimotor cortex, premotor regions and supplementary motor area [SMA]) during attempts to move or mental imagery of these tasks. It is concluded that even several years after injury with some local cortical reorganization, activation of lower limb cortical networks can be generated either by the attempt to move, the mental evocation of the action, or the visual feedback of a passive proprio-somesthesic stimulation.

Evaluation of the effectiveness of toe board energy-absorbing material for foot, ankle, and lower leg injury reduction.

PubMed

Patalak, John P; Stitzel, Joel D

2018-02-17

Since 2000, numerous improvements have been made to the National Association for Stock Car Auto Racing, Incorporated (NASCAR®) driver restraint system, resulting in improved crash protection for motorsports drivers. Advancements have included seats, head and neck restraints (HNRs), seat belt restraint systems, driver helmets, and others. These enhancements have increased protection for drivers from severe crash loading. Extending protection to the driver's extremities remains challenging. Though the drivers' legs are well contained for lateral and vertical crashes, they remain largely unrestrained in frontal and frontal oblique crashes. Sled testing was conducted for the evaluation of an energy-absorbing (EA) toe board material to be used as a countermeasure for leg and foot injuries. Testing included baseline rigid toe boards, tests with EA material-covered toe boards, and pretest positioning of the 50th percentile male frontal Hybrid III anthropomorphic test device (ATD) lower extremities. ATD leg and foot instrumentation included foot acceleration and tibia forces and moments. The sled test data were evaluated using established injury criteria for tibial plateau fractures, leg shaft fractures, and calcaneus, talus, ankle, and midfoot fractures. A polyurethane EA foam was found to be effective in limiting axial tibia force and foot accelerations when subjected to frontal impacts using the NASCAR motorsport restraint system.

Closed reduction of a rare type III dislocation of the first metatarsophalangeal joint.

PubMed

Tondera, E K; Baker, C C

1996-09-01

To discuss a rare Type III dislocation of the first metatarsophalangeal (MP) joint, without fracture, that used a closed reduction technique for correction. A 43-yr-old man suffered from an acute severe dislocation of his great toe as the result of acute forceful motion applied to the toe as his foot was depressed onto a brake pedal to avoid a motor vehicle accident. Physical examination and X-rays revealed the dislocation, muscle spasm, edema and severely restricted range of motion. The dislocation was corrected using a closed reduction technique, in this case a chiropractic manipulation. Fourteen months after reduction, the joint was intact, muscle strength was graded +5 normal, ranges of motion were within normal limits and no crepitation was noted. X-rays revealed normal intact joint congruency. The patient experienced full weight bearing, range of motion and function of the joint. Although a Type III dislocation of the great toe has only once been cited briefly in the literature, this classification carries a recommended surgical treatment protocol for correction. No literature describes a closed reduction of a Type III dislocation as described in this case report. It is apparent that a closed reduction technique using a chiropractic manipulation may be considered a valid alternative correction technique for Type III dislocations of the great toe.

Bionic Design for Mars Sampling Scoop Inspired by Himalayan Marmot Claw

PubMed Central

2016-01-01

Cave animals are often adapted to digging and life underground, with claw toes similar in structure and function to a sampling scoop. In this paper, the clawed toes of the Himalayan marmot were selected as a biological prototype for bionic research. Based on geometric parameter optimization of the clawed toes, a bionic sampling scoop for use on Mars was designed. Using a 3D laser scanner, the point cloud data of the second front claw toe was acquired. Parametric equations and contour curves for the claw were then built with cubic polynomial fitting. We obtained 18 characteristic curve equations for the internal and external contours of the claw. A bionic sampling scoop was designed according to the structural parameters of Curiosity's sampling shovel and the contours of the Himalayan marmot's claw. Verifying test results showed that when the penetration angle was 45° and the sampling speed was 0.33 r/min, the bionic sampling scoops' resistance torque was 49.6% less than that of the prototype sampling scoop. When the penetration angle was 60° and the sampling speed was 0.22 r/min, the resistance torque of the bionic sampling scoop was 28.8% lower than that of the prototype sampling scoop. PMID:28127229

Ankle-Brachial Index, Toe-Brachial Index, and Pulse Volume Recording in Healthy Young Adults

PubMed Central

Masaki, Hisao; Yunoki, Yasuhiro; Tabuchi, Atushi; Morita, Ichiro; Mohri, Satoshi; Tanemoto, Kazuo

2015-01-01

Objective: To clarify the characteristics of ankle-brachial index (ABI), toe-brachial index (TBI), and pulse volume recording (PVR) of the ankle with brachial-ankle pulse wave velocity (baPWV) in healthy young adults. Material and Methods: We analyzed ABI, TBI, baPWV, and PVR in the ankle of healthy adults aged 20 to 25 years (median, 20 years) using an automatic oscillometric device between 2002 and 2013. The ABI, baPWV, and PVR in 1282 legs of 641 subjects (301 men and 340 women) and the TBI in 474 toes of 237 subjects (117 men and 120 women) were evaluated. Results: The measured values showed no bilateral differences. ABI and baPWV were higher in men than in women, but TBI was similar in both sexes. ABI <1.0 was observed in 18.1% of the legs in men and in 25.6% in women. TBI <0.7 was observed in 16.2% of the toes in men and 19.1% in women. For ankle PVR, the % mean arterial pressure was higher in women than in men. The upstroke time was <180 ms in most subjects. Conclusions: For young people, ABI <1.0 or TBI <0.7 may not always indicate vascular abnormalities. When evaluating circulatory indexes, age and sex should be considered. PMID:26421072

Three-Dimensional Imaging of the Mouse Organ of Corti Cytoarchitecture for Mechanical Modeling

NASA Astrophysics Data System (ADS)

Puria, Sunil; Hartman, Byron; Kim, Jichul; Oghalai, John S.; Ricci, Anthony J.; Liberman, M. Charles

2011-11-01

Cochlear models typically use continuous anatomical descriptions and homogenized parameters based on two-dimensional images for describing the organ of Corti. To produce refined models based more closely on the actual cochlear cytoarchitecture, three-dimensional morphometric parameters of key mechanical structures are required. Towards this goal, we developed and compared three different imaging methods: (1) A fixed cochlear whole-mount preparation using the fluorescent dye Cellmask®, which is a molecule taken up by cell membranes and clearly delineates Deiters' cells, outer hair cells, and the phalangeal process, imaged using confocal microscopy; (2) An in situ fixed preparation with hair cells labeled using anti-prestin and supporting structures labeled using phalloidin, imaged using two-photon microscopy; and (3) A membrane-tomato (mT) mouse with fluorescent proteins expressed in all cell membranes, which enables two-photon imaging of an in situ live preparation with excellent visualization of the organ of Corti. Morphometric parameters including lengths, diameters, and angles, were extracted from 3D cellular surface reconstructions of the resulting images. Preliminary results indicate that the length of the phalangeal processes decreases from the first (inner most) to third (outer most) row of outer hair cells, and that their length also likely varies from base to apex and across species.

Variation in the myosoricine hand skeleton and its implications for locomotory behavior (Eulipotyphla: Soricidae)

USGS Publications Warehouse

Woodman, Neal; Stabile, Frank A.

2015-01-01

Substrate use and locomotory behavior of mammals are typically reflected in external characteristics of the forefeet, such as the relative proportions of the digits and claws. Although skeletal anatomy of the forefeet can be more informative than external characters, skeletons remain rare in systematic collections. This is particularly true for the Myosoricinae (Eulipotyphla: Soricidae), a small clade of African shrews that includes both ambulatory forest shrews (Myosorex) and semifossorial mole shrews (Surdisorex). Most species in this subfamily have restricted distributions, and their behavior and ecology are mostly unstudied. To better understand the potential range of locomotory behavior among myosoricines, we used digital x-rays to image and facilitate measuring the forefoot skeletons of 9 species. As a gauge of potential variation, we compared them with the ambulatory talpid Uropsilus (Talpidae) and the semifossorial talpid Neurotrichus. The hand morphologies of myosoricines show a graded range of potential substrate use between ambulatory and semifossorial. Some of these shrews exhibit adaptations for increased burrowing efficiency that are similar to those seen in talpids and other mammals, such as longer, broader distal phalanges and claws and shorter, wider metacarpals and proximal and middle phalanges. They also, however, have characteristics that are distinct from talpids, such as maintenance of forefoot asymmetry and an increased emphasis of ray III.

An inversion involving the mouse Shh locus results in brachydactyly through dysregulation of Shh expression.

PubMed

Niedermaier, Michael; Schwabe, Georg C; Fees, Stephan; Helmrich, Anne; Brieske, Norbert; Seemann, Petra; Hecht, Jochen; Seitz, Volkhard; Stricker, Sigmar; Leschik, Gundula; Schrock, Evelin; Selby, Paul B; Mundlos, Stefan

2005-04-01

Short digits (Dsh) is a radiation-induced mouse mutant. Homozygous mice are characterized by multiple defects strongly resembling those resulting from Sonic hedgehog (Shh) inactivation. Heterozygous mice show a limb reduction phenotype with fusion and shortening of the proximal and middle phalanges in all digits, similar to human brachydactyly type A1, a condition caused by mutations in Indian hedgehog (IHH). We mapped Dsh to chromosome 5 in a region containing Shh and were able to demonstrate an inversion comprising 11.7 Mb. The distal breakpoint is 13.298 kb upstream of Shh, separating the coding sequence from several putative regulatory elements identified by interspecies comparison. The inversion results in almost complete downregulation of Shh expression during E9.5-E12.5, explaining the homozygous phenotype. At E13.5 and E14.5, however, Shh is upregulated in the phalangeal anlagen of Dsh/+ mice, at a time point and in a region where WT Shh is never expressed. The dysregulation of Shh expression causes the local upregulation of hedgehog target genes such as Gli1-3, patched, and Pthlh, as well as the downregulation of Ihh and Gdf5. This results in shortening of the digits through an arrest of chondrocyte differentiation and the disruption of joint development.

An inversion involving the mouse Shh locus results in brachydactyly through dysregulation of Shh expression

PubMed Central

Niedermaier, Michael; Schwabe, Georg C.; Fees, Stephan; Helmrich, Anne; Brieske, Norbert; Seemann, Petra; Hecht, Jochen; Seitz, Volkhard; Stricker, Sigmar; Leschik, Gundula; Schrock, Evelin; Selby, Paul B.; Mundlos, Stefan

2005-01-01

Short digits (Dsh) is a radiation-induced mouse mutant. Homozygous mice are characterized by multiple defects strongly resembling those resulting from Sonic hedgehog (Shh) inactivation. Heterozygous mice show a limb reduction phenotype with fusion and shortening of the proximal and middle phalanges in all digits, similar to human brachydactyly type A1, a condition caused by mutations in Indian hedgehog (IHH). We mapped Dsh to chromosome 5 in a region containing Shh and were able to demonstrate an inversion comprising 11.7 Mb. The distal breakpoint is 13.298 kb upstream of Shh, separating the coding sequence from several putative regulatory elements identified by interspecies comparison. The inversion results in almost complete downregulation of Shh expression during E9.5–E12.5, explaining the homozygous phenotype. At E13.5 and E14.5, however, Shh is upregulated in the phalangeal anlagen of Dsh/+ mice, at a time point and in a region where WT Shh is never expressed. The dysregulation of Shh expression causes the local upregulation of hedgehog target genes such as Gli1-3, patched, and Pthlh, as well as the downregulation of Ihh and Gdf5. This results in shortening of the digits through an arrest of chondrocyte differentiation and the disruption of joint development. PMID:15841179

Space suit glove design with advanced metacarpal phalangeal joints and robotic hand evaluation.

PubMed

Southern, Theodore; Roberts, Dustyn P; Moiseev, Nikolay; Ross, Amy; Kim, Joo H

2013-06-01

One area of space suits that is ripe for innovation is the glove. Existing models allow for some fine motor control, but the power grip--the act of grasping a bar--is cumbersome due to high torque requirements at the knuckle or metacarpal phalangeal joint (MCP). This area in particular is also a major source of complaints of pain and injury as reported by astronauts. This paper explores a novel fabrication and patterning technique that allows for more freedom of movement and less pain at this crucial joint in the manned space suit glove. The improvements are evaluated through unmanned testing, manned testing while depressurized in a vacuum glove box, and pressurized testing with a robotic hand. MCP joint flex score improved from 6 to 6.75 (out of 10) in the final glove relative to the baseline glove, and torque required for flexion decreased an average of 17% across all fingers. Qualitative assessments during unpressurized and depressurized manned testing also indicated the final glove was more comfortable than the baseline glove. The quantitative results from both human subject questionnaires and robotic torque evaluation suggest that the final iteration of the glove design enables flexion at the MCP joint with less torque and more comfort than the baseline glove.

Conceptual Model Development for Sea Turtle Nesting Habitat: Support for USACE Navigation Projects

DTIC Science & Technology

2015-08-01

regional values. • Beach Width: The width of the beach (m) defines the region from the shoreline to the dune toe . Loggerhead turtles tend to prefer...primary drivers of the model parameters. • Beach Elevation: Beach elevation (m) is measured from the shoreline to the dune toe . Elevation influences...mapping, and morphological features in combination with imagery-derived environmental parameters (i.e., dune vegetation) have not been attempted

Crew Exploration Vehicle (CEV) Water Landing Simulation

NASA Technical Reports Server (NTRS)

Littell, Justin D.; Lawrence, Charles; Carney, Kelly S.

2007-01-01

Crew Exploration Vehicle (CEV) water splashdowns were simulated in order to find maximum acceleration loads on the astronauts and spacecraft under various landing conditions. The acceleration loads were used in a Dynamic Risk Index (DRI) program to find the potential risk for injury posed on the astronauts for a range of landing conditions. The DRI results showed that greater risks for injury occurred for two landing conditions; when the vertical velocity was large and the contact angle between the spacecraft and the water impact surface was zero, and when the spacecraft was in a toe down configuration and both the vertical and horizontal landing velocities were large. Rollover was also predicted to occur for cases where there is high horizontal velocity and low contact angles in a toe up configuration, and cases where there was a high horizontal velocity with high contact angles in a toe down configuration.

Apparently new osteodysplastic and primordial short stature with severe microdontia, opalescent teeth, and rootless molars in two siblings.

PubMed

Kantaputra, Piranit N

2002-09-01

A Thai man and his sister affected with a newly recognized syndrome of proportionate primordial short stature are reported. The patients had severe intrauterine and postnatal growth retardation, prominent nose and nasal bridge, small pinnae, large sella turcica, areas of hypo- and hyperpigmentation of skin, dry and thin scalp hair, and long and straight clavicles. Ivory epiphyses and cone-shaped epiphyses of the hands were found when they were young, but most of them disappeared as they grew up. Scaphoid and trapezium had angular appearance. The second toes were unusually long. Distal symphalangism of toes and barchymesophalangy of fingers were noted. The findings that appear to distinguish this syndrome from the previously reported syndromes are long second toes, opalescent and rootless teeth, severe microdontia, severely hypoplastic alveolar process, and unerupted tooth. The mode of inheritance is suspected to be autosomal recessive. Copyright 2002 Wiley-Liss, Inc.

Three-Axis Ground Reaction Force Distribution during Straight Walking.

PubMed

Hori, Masataka; Nakai, Akihito; Shimoyama, Isao

2017-10-24

We measured the three-axis ground reaction force (GRF) distribution during straight walking. Small three-axis force sensors composed of rubber and sensor chips were fabricated and calibrated. After sensor calibration, 16 force sensors were attached to the left shoe. The three-axis force distribution during straight walking was measured, and the local features of the three-axis force under the sole of the shoe were analyzed. The heel area played a role in receiving the braking force, the base area of the fourth and fifth toes applied little vertical or shear force, the base area of the second and third toes generated a portion of the propulsive force and received a large vertical force, and the base area of the big toe helped move the body's center of mass to the other foot. The results demonstrate that measuring the three-axis GRF distribution is useful for a detailed analysis of bipedal locomotion.

The analysis of the accuracy of the wheel alignment inspection method on the side-slip plate stand

NASA Astrophysics Data System (ADS)

Gajek, A.; Strzępek, P.

2016-09-01

The article presents the theoretical basis and the results of the examination of the wheel alignment inspection method on the slide slip plate stand. It is obligatory test during periodic technical inspection of the vehicle. The measurement is executed in the dynamic conditions. The dependence between the lateral displacement of the plate and toe-in of the tested wheels has been shown. If the diameter of the wheel rim is known then the value of the toe-in can be calculated. The comparison of the toe-in measurements on the plate stand and on the four heads device for the wheel alignment inspection has been carried out. The accuracy of the measurements and the influence of the conditions of the tests on the plate stand (the way of passing through the plate) were estimated. The conclusions about the accuracy of this method are presented.

Red hot chili pepper. A new Calluella stoliczka, 1872 (Lissamphibia: Anura: Microhylidae) from Sarawak, East Malaysia (Borneo).

PubMed

Das, Indraneil; Min, Pui Yong; Hsu, Wayne W; Hertwig, Stefan T; Haas, Alexander

2014-04-07

A new brightly-coloured (olive and red) species of microhylid frog of the genus Calluella Stoliczka 1872 is described from the upper elevations of Gunung Penrissen and the Matang Range, Sarawak, East Malaysia (Borneo). Calluella capsa, new species, is diagnosable in showing the following combination of characters: SVL up to 36.0 mm; dorsum weakly granular; a faint dermal fold across forehead; toe tips obtuse; webbing on toes basal; lateral fringes on toes present; outer metatarsal tubercle present; and dorsum greyish-olive, with red spots; half of venter bright red, the rest with large white and dark areas. The new species is the eighth species of Calluella to be described, and the fourth known from Borneo. A preliminary phylogeny of Calluella and its relatives is presented, and the new taxon compared with congeners from Malaysia and other parts of south-east Asia. 

Determination of Optimum Cross-section for Oran Highway Revetment

NASA Astrophysics Data System (ADS)

Velioglu, Deniz; Sogut, Erdinc; Guler, Isikhan

2017-04-01

Revetments are shore parallel, sloping coastal structures which are built to provide protection from the negative effects of the sea. The revetment mentioned in this study is located in the City of Oran, Algeria and is currently under construction. This study investigates the determination of the optimum revetment cross section for Oran highway, considering both the hydraulic stability of the revetment and economy. The existence of cliffs in the region and the settlement of the City of Oran created a necessity to re-align Oran highway; therefore, it was shifted towards the Gulf of Oran. Approximately 1 km of the highway is to be constructed on the Mediterranean Sea due to the new alignment. In order to protect the sea side of the road from the adverse effects of the sea, a revetment was designed. The proposed cross section had an armour layer composed of 23 tons of antifer units and regular placement of armour units was recommended. In order to check the hydraulic stability of the proposed section, physical model tests were performed in the laboratory of LEM (Laboratoire d'Etudes Maritimes) in Algeria, using the pre-determined design wave conditions. The physical model tests revealed that the trunk of the revetment was totaly damaged. Accordingly, the proposed section was found insufficient and certain modifications were required. The first modification was made in the arrangement of armour units, changing them from regular to irregular. After testing the new cross section, it was observed that the revetment was vulnerable to breaking wave attack due to the toe geometry and thus the toe of the revetment had to be re-shaped. Therefore, the second option was to reduce the toe elevation. It was observed that even though the revetment trunk was safe, the damage in the toe was not in acceptable limits. The new cross section was found insufficient and as the final option, the weight of the antifer units used in the armour layer was increased, the toe length of the structure was increased and the size of the armour units in the toe was decreased. After the modifications, the new section was tested physically and it was selected as the most optimum option. Acknowledgements: Yuksel Proje Uluslararasi A.S. is acknowledged for its contributon to this study.

Sailplane Glide Performance and Control Using Fixed and Articulating Winglets. M.S. Thesis

NASA Technical Reports Server (NTRS)

Colling, James David

1995-01-01

An experimental study was conducted to investigate the effects of controllable articulating winglets on glide performance and yawing moments of high performance sailplanes. Testing was conducted in the Texas A&M University 7 x 10 foot Low Speed Wind Tunnel using a full-scale model of the outboard 5.6 feet of a 15 meter class high performance sailplane wing. Different wing tip configurations could be easily mounted to the wing model. A winglet was designed in which the cant and toe angles as well as a rudder on the winglet could be adjusted to a range of positions. Cant angles used in the investigation consisted of 5, 25, and 40 degrees measured from the vertical axis. Toe-out angles ranged from 0 to 22.5 degrees. A rudder on the winglet was used to study the effects of changing the camber of the winglet airfoil on wing performance and wing yawing moments. Rudder deflections consisted of-10, 0, and 10 degrees. Test results for a fixed geometry winglet and a standard wing tip are presented to show the general behavior of winglets on sailplane wings, and the effects of boundary-layer turbulators on the winglets are also presented. By tripping the laminar boundary-layer to turbulent before laminar separation occurs, the wing performance was increased at low Reynolds numbers. The effects on the lift and drag, yawing moment, pitching moment, and wing root bending moment of the model are presented. Oil flows were used on the wing model with the fixed geometry winglet and the standard wing tip to visualize flow directions and areas of boundary layer transition. A cant angle of 25 degrees and a toe-out angle of 2.5 degrees provided an optimal increase in wing performance for the cant and toe angles tested. Maximum performance was obtained when the winglet rudder remained in the neutral position of zero degrees. By varying the cant, toe, and rudder angles from their optimized positions, wing performance decreases. Although the winglet rudder proved to be more effective in increasing the yawing moment compared to varying the cant and toe angles, the amount of increased yawing moment was insignificant when compared to that produced by the vertical tail. A rudder on the winglet was determined to be ineffective for providing additional yaw control.

Sea-level rise impacts on seawater intrusion in coastal aquifers: Review and integration

NASA Astrophysics Data System (ADS)

Ketabchi, Hamed; Mahmoodzadeh, Davood; Ataie-Ashtiani, Behzad; Simmons, Craig T.

2016-04-01

Sea-level rise (SLR) influences groundwater hydraulics and in particular seawater intrusion (SWI) in many coastal aquifers. The quantification of the combined and relative impacts of influential factors on SWI has not previously been considered in coastal aquifers. In the present study, a systematic review of the available literature on this topic is first provided. Then, the potential remaining challenges are scrutinized. Open questions on the effects of more realistic complexities such as gradual SLR, parameter uncertainties, and the associated influences in decision-making models are issues requiring further investigation. We assess and quantify the seawater toe location under the impacts of SLR in combination with recharge rate variations, land-surface inundation (LSI) due to SLR, aquifer bed slope variation, and changing landward boundary conditions (LWBCs). This is the first study to include all of these factors in a single analysis framework. Both analytical and numerical models are used for these sensitivity assessments. It is demonstrated that (1) LSI caused by SLR has a significant incremental impact on the seawater toe location, especially in the flatter coasts and the flux-controlled (FC) LWBCs, however this impact is less than the reported orders of magnitude differences which were estimated using only analytical solutions; (2) LWBCs significantly influence the SLR impacts under almost all conditions considered in this study; (3) The main controlling factors of seawater toe location are the magnitudes of fresh groundwater discharge to sea and recharge rate. Regional freshwater flux entering from the landward boundary and the groundwater hydraulic gradient are the major contributors of fresh groundwater discharge to sea for both FC and head-controlled (HC) systems, respectively; (4) A larger response of the aquifer and larger seawater toe location changes are demonstrable for a larger ratio of the aquifer thickness to the aquifer length particularly in the HC systems; (5) The lowest sensitivity of seawater toe location is found for the density difference ratio of the seawater and freshwater, and also for the aquifer bed slope; (6) The early-time observations show seawater fingers below the inundated lands due to SLR which are diminished and ultimately extinguished; and (7) A less than 2% reversal effect on the seawater toe location after overshoot mechanism is observed in the transient simulations which suggests that this mechanism is an insignificant and impractical factor compared to other more significant factors.

Correction of Brachymetatarsia and Medial Angulation of the Great Toe of Apert Foot By Distraction Osteogenesis: A Review of 7 Years of Experience.

PubMed

Calis, Mert; Oznur, Ali; Ekin, Omer; Vargel, Ibrahim

2016-09-01

Apert foot anomalies may cause severe problems such as pain and development of callus formation related to weight redistribution, problems with footwear, and gait disturbances that may limit their daily activities. The main purpose of this study was to review our experience with distraction osteogenesis for the correction of brachymetatarsia and the great toe angulation of the patients with Apert syndrome. This study retrospectively reviewed 7 patients (14 extremities) followed up for Apert syndrome who underwent distraction for the correction of bilateral congenital brachymetatarsia and angulation of the great toe between 2004 and 2008. Correction of the metatarsal inclination angle, the medial angulation of the great toe, the percentage of lengthening, and lengthening rates of distracted bones were evaluated. Patients ranged in age from 4 to 8 years at the distraction operation, with a mean age of 5.4±1.3 years, and the average length of follow-up was 86.6±21.0 months. The length of the first metatarsal bone increased significantly from the average length of 32.6±5.7 mm to an average of 46.7±6.5 mm (P<0.001). The mean lengthening rate and lengthening percentages of distracted bones were 0.4%±0.1%/month and 30.2%±6.4%/month, respectively. Preoperative and postoperative metatarsal inclination angles were at a mean of 43.8±5.12 and 32.6±3.8, respectively, and the correction of metatarsal inclination was considered as statistically significant (P<0.001). The mean angulation of the great toe reduced significantly from 49.8±11.76 to 13.2±8.5 degrees after distraction (P<0.001). Minor complications such as pin loosening, pin-tract infection, and early union that required reoperation were observed in 5 extremities (35.7%). Anatomic features of Apert foot may lead to complaints that may limit patients' daily activities and require as much attention as associated hand and craniofacial anomalies. Distraction appears to be an effective and safe approach for the simultaneous correction of the shortness of the first ray and medial angulation of the great toe. Level IV.

GUTs and TOEs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lincoln, Don

2015-01-20

Albert Einstein said that what he wanted to know was “God’s thoughts,” which is a metaphor for the ultimate and most basic rules of the universe. Once known, all other phenomena would then be a consequence of these simple rules. While modern science is far from that goal, we have some thoughts on how this inquiry might unfold. In this video, Fermilab’s Dr. Don Lincoln tells what we know about GUTs (grand unified theories) and TOEs (theories of everything).

An Integrated Theory of Everything (TOE)

NASA Astrophysics Data System (ADS)

Colella, Antonio

2014-03-01

An Integrated TOE unifies all known physical phenomena from the Planck cube to the Super Universe (multiverse). Each matter/force particle is represented by a Planck cube string. Any Super Universe object is a volume of contiguous Planck cubes. Super force Planck cube string singularities existed at the start of all universes. An Integrated TOE foundations are twenty independent existing theories and without sacrificing their integrities, are replaced by twenty interrelated amplified theories. Amplifications of Higgs force theory are key to an Integrated TOE and include: 64 supersymmetric Higgs particles; super force condensations to 17 matter particles/associated Higgs forces; spontaneous symmetry breaking is bidirectional; and the sum of 8 permanent Higgs force energies is dark energy. Stellar black hole theory was amplified to include a quark star (matter) with mass, volume, near zero temperature, and maximum entropy. A black hole (energy) has energy, minimal volume (singularity), near infinite temperature, and minimum entropy. Our precursor universe's super supermassive quark star (matter) evaporated to a super supermassive black hole (energy). This transferred total conserved energy/mass and transformed entropy from maximum to minimum. Integrated Theory of Everything Book Video: https://www.youtube.com/watch?v=4a1c9IvdoGY Research Article Video: http://www.youtube.com/watch?v=CD-QoLeVbSY Research Article: http://toncolella.files.wordpress.com/2012/07/m080112.pdf.

Foot ulcer risk and location in relation to prospective clinical assessment of foot shape and mobility among persons with diabetes.

PubMed

Cowley, Matthew S; Boyko, Edward J; Shofer, Jane B; Ahroni, Jessie H; Ledoux, William R

2008-11-01

We assessed baseline clinical foot shape for 2939 feet of diabetic subjects who were monitored prospectively for foot ulceration. Assessments included hammer/claw toes, hallux valgus, hallux limitus, prominent metatarsal heads, bony prominences, Charcot deformity, plantar callus, foot type, muscle atrophy, ankle and hallux mobility, and neuropathy. Risk factors were linked to ulcer occurrence and location via a Cox proportional hazards model. Hammer/claw toes (hazard ratio [HR] (95% confidence interval [CI])=1.43 (1.06, 1.94) p=0.02), marked hammer/claw toes (HR=1.77 (1.18, 2.66) p=0.006), bony prominences (HR=1.38 (1.02, 1.88), p=0.04), and foot type (Charcot or drop foot vs. neutrally aligned) (HR=2.34 (1.33, 4.10), p=0.003) were significant risk factors for ulceration adjusting for age, body mass index, insulin medication, ulcer history and amputation history. With adjustment for neuropathy only hammer/claw toes (HR=1.40 (1.03, 1.90), p=0.03) and foot type (HR=1.76 (1.04, 3.04), p=0.05) were significantly related to ulceration. However, there was no relationship between ulcer location and foot deformity. Certain foot deformities were predictive of ulceration, although there was no relationship between clinical foot deformity and ulcer location.

Teaching the physical examination: a longitudinal strategy for tomorrow's physicians.

PubMed

Uchida, Toshiko; Farnan, Jeanne M; Schwartz, Jennifer E; Heiman, Heather L

2014-03-01

The physical examination is an essential clinical skill. The traditional approach to teaching the physical exam has involved a comprehensive "head-to-toe" checklist, which is often used to assess students before they begin their clinical clerkships. This method has been criticized for its lack of clinical context and for promoting rote memorization without critical thinking. In response to these concerns, Gowda and colleagues surveyed a national sample of clinical skills educators in order to develop a consensus "core" physical exam, which they report in this issue. The core physical exam is intended to be performed for every patient admitted by students during their medicine clerkships and to be supplemented by symptom-driven "clusters" of additional history and physical exam maneuvers.In this commentary, the authors review the strengths and limitations of this Core + Clusters technique as well as the head-to-toe approach. They propose that the head-to-toe still has a place in medical education, particularly for beginning students with little knowledge of pathophysiology and for patients with vague or multiple symptoms. The authors suggest that the ideal curriculum would include teaching both the head-to-toe and the Core + Clusters exams in sequence. This iterative approach to physical exam teaching would allow a student to assess a patient in a comprehensive manner while incorporating more clinical reasoning as further medical knowledge is acquired.

A comparison of kinematic algorithms to estimate gait events during overground running.

PubMed

Smith, Laura; Preece, Stephen; Mason, Duncan; Bramah, Christopher

2015-01-01

The gait cycle is frequently divided into two distinct phases, stance and swing, which can be accurately determined from ground reaction force data. In the absence of such data, kinematic algorithms can be used to estimate footstrike and toe-off. The performance of previously published algorithms is not consistent between studies. Furthermore, previous algorithms have not been tested at higher running speeds nor used to estimate ground contact times. Therefore the purpose of this study was to both develop a new, custom-designed, event detection algorithm and compare its performance with four previously tested algorithms at higher running speeds. Kinematic and force data were collected on twenty runners during overground running at 5.6m/s. The five algorithms were then implemented and estimated times for footstrike, toe-off and contact time were compared to ground reaction force data. There were large differences in the performance of each algorithm. The custom-designed algorithm provided the most accurate estimation of footstrike (True Error 1.2 ± 17.1 ms) and contact time (True Error 3.5 ± 18.2 ms). Compared to the other tested algorithms, the custom-designed algorithm provided an accurate estimation of footstrike and toe-off across different footstrike patterns. The custom-designed algorithm provides a simple but effective method to accurately estimate footstrike, toe-off and contact time from kinematic data. Copyright © 2014 Elsevier B.V. All rights reserved.

[Necrosis in fingers and toes following local anaesthesia with adrenaline--an urban legend?].

PubMed

Finsen, Vilhjalmur

2013-09-17

It is often maintained that a local anaesthetic (usually lidocaine) with adrenaline must not be used in fingers and toes because it may cause necrosis due to vascular spasm in end arteries. This review article is an attempt to find evidence to support this warning. Relevant literature was found by means of searches in PubMed limited downwards to 1946 and in EMBASE from 1980 to 2012, and in reference lists. Five review articles on finger necrosis following local anaesthesia concluded that lidocaine with adrenaline does not entail a risk of ischaemic injury. One article found 48 reported cases of finger necrosis in the period 1880 to 2000. Most were from the first half of the 1900s, and none involved lidocaine. Gangrene of part of the finger tip has subsequently been described in one patient with Raynaud's syndrome. No cases of necrosis have been described in a large number of reported accidents in which EpiPen injections contained the same quantity of adrenaline as is found in 60 ml lidocaine with adrenaline. Over a quarter of a million reports have been made of operations on feet, hands, fingers and toes anaesthetised with lidocaine with adrenaline without resulting necrosis. There are no grounds for the warning against using lidocaine with adrenaline in fingers and toes. This anaesthetic offers considerable practical advantages. Care should be taken with infected fingers or fingers with poor circulation.

Common foot problems in diabetic foot clinic.

PubMed

Tantisiriwat, Natthiya; Janchai, Siriporn

2008-07-01

To study common foot problems presented in diabetic foot clinic. A retrospectively review of out patient department records and diabetic foot evaluation forms of patients who visited the diabetic foot clinic at King Chulalongkorn Memorial Hospital between 2004 and 2006. Of all diabetic patients, 70 men and 80 women with the average age of 63.8 years were included in this study. About 32% of all reported cases had lower extremity amputation in which the toe was the most common level. Foot problems were evaluated and categorized in four aspects, dermatological, neurological, musculoskeletal, and vascular, which were 67.30%, 79.3%, 74.0%, and 39.3% respectively. More than half of the patients had skin dryness, nail problem and callus formation. Fifty six percent had the abnormal plantar pressure area, which was presented as callus. The great toe was the most common site of callus formation, which was correlated with gait cycle. The current ulcer was 18.8%, which was presented mostly at heel and great toe. Three-fourth of the patients (75.3%) had lost protective sensation, measured by the 5.07 monofilament testing. The most common problem found in musculoskeletal system was limited motion of the joint (44.0%). Claw toe or hammer toe were reported as 32.0% whereas the other deformities were bunnion (12.0%), charcot joint (6.0%) and flat feet (5.3%). The authors classified patients based on category risk to further lower extremity amputation into four groups. Forty-seven percent had highest risk for having further amputation because they had lost protective sensation from monofilament testing, previous current ulcer, or history of amputation. Only half of the patients had previous foot care education. Multidisciplinary diabetic foot care including patient education (proper foot care and footwear), early detection, effective management of foot problems, and scheduled follow-up must be emphasized to prevent diabetes-related lower extremities amputation.

Reliability of laser Doppler flowmetry curve reading for measurement of toe and ankle pressures: intra- and inter-observer variation.

PubMed

Høyer, C; Paludan, J P D; Pavar, S; Biurrun Manresa, J A; Petersen, L J

2014-03-01

To assess the intra- and inter-observer variation in laser Doppler flowmetry curve reading for measurement of toe and ankle pressures. A prospective single blinded diagnostic accuracy study was conducted on 200 patients with known or suspected peripheral arterial disease (PAD), with a total of 760 curve sets produced. The first curve reading for this study was performed by laboratory technologists blinded to clinical clues and previous readings at least 3 months after the primary data sampling. The pressure curves were later reassessed following another period of at least 3 months. Observer agreement in diagnostic classification according to TASC-II criteria was quantified using Cohen's kappa. Reliability was quantified using intra-class correlation coefficients, coefficients of variance, and Bland-Altman analysis. The overall agreement in diagnostic classification (PAD/not PAD) was 173/200 (87%) for intra-observer (κ = .858) and 175/200 (88%) for inter-observer data (κ = .787). Reliability analysis confirmed excellent correlation for both intra- and inter-observer data (ICC all ≥.931). The coefficients of variance ranged from 2.27% to 6.44% for intra-observer and 2.39% to 8.42% for inter-observer data. Subgroup analysis showed lower observer-variation for reading of toe pressures in patients with diabetes and/or chronic kidney disease than patients not diagnosed with these conditions. Bland-Altman plots showed higher variation in toe pressure readings than ankle pressure readings. This study shows substantial intra- and inter-observer agreement in diagnostic classification and reading of absolute pressures when using laboratory technologists as observers. The study emphasises that observer variation for curve reading is an important factor concerning the overall reproducibility of the method. Our data suggest diabetes and chronic kidney disease have an influence on toe pressure reproducibility. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Hyposensitivity of C-fiber Afferents at the Distal Extremities as an Indicator of Early Stages Diabetic Bladder Dysfunction in Type 2 Diabetic Women

PubMed Central

Lee, Wei-Chia; Wu, Han-Ching; Huang, Kuo-How; Wu, Huey-Peir; Yu, Hong-Jeng; Wu, Chia-Ching

2014-01-01

Purpose To investigate the relationship between distal symmetric peripheral neuropathy and early stages of autonomic bladder dysfunction in type 2 diabetic women. Materials and Methods A total of 137 diabetic women with minimal coexisting confounders of voiding dysfunction followed at a diabetes clinic were subject to the following evaluations: current perception threshold (CPT) tests on myelinated and unmyelinated nerves at the big toe for peroneal nerve and middle finger for median nerve, uroflowmetry, post-void residual urine volume, and overactive bladder (OAB) symptom score questionnaire. Patients presenting with voiding difficulty also underwent urodynamic studies and intravesical CPT tests. Results Based on the OAB symptom score and urodynamic studies, 19% of diabetic women had the OAB syndrome while 24.8% had unrecognized urodynamic bladder dysfunction (UBD). The OAB group had a significantly greater mean 5 Hz CPT test value at the big toe by comparison to those without OAB. When compared to diabetic women without UBD, those with UBD showed greater mean 5 Hz CPT test values at the middle finger and big toe. The diabetic women categorized as C-fiber hyposensitivity at the middle finger or big toe by using CPT test also had higher odds ratios of UBD. Among diabetic women with UBD, the 5 Hz CPT test values at the big toe and middle finger were significantly associated with intravesical 5 Hz CPT test values. Conclusions Using electrophysiological evidence, our study revealed that hyposensitivity of unmyelinated C fiber afferents at the distal extremities is an indicator of early stages diabetic bladder dysfunction in type 2 diabetic women. The C fiber dysfunction at the distal extremities seems concurrent with vesical C-fiber neuropathy and may be a sentinel for developing early diabetic bladder dysfunction among female patients. PMID:24466107

Pathogenesis of Fifth Metatarsal Fractures in College Soccer Players

PubMed Central

Fujitaka, Kohei; Taniguchi, Akira; Isomoto, Shinji; Kumai, Tsukasa; Otuki, Shingo; Okubo, Mamoru; Tanaka, Yasuhito

2015-01-01

Background: The pathogenesis of fifth metatarsal stress fractures remains uncertain. Hypothesis: Physical characteristics and environmental factors, which have received limited attention in the literature thus far, might be involved in the development of fifth metatarsal stress fractures. Study Design: Case-control study; Level of evidence, 3. Methods: To test the study hypothesis, a medical examination and survey of the living environment of collegiate soccer players was conducted and correlated with the existence of fifth metatarsal stress fractures. The survey and measurements were conducted in 273 male athletes from the same college soccer team between 2005 and 2013. A medical examination comprising assessment of stature, body weight, body mass index, foot–arch height ratio, toe-grip strength, quadriceps angle, leg-heel angle, functional reach test, single-leg standing time with eyes closed, straight-leg raise angle, finger-floor distance, heel-buttock distance, ankle joint range of motion, and a general joint laxity test were performed once a year, along with a questionnaire survey. The survey was also repeated when a fifth metatarsal stress fracture was diagnosed. The study participants were separated into a fifth metatarsal stress fracture injury group and a noninjury group. The measurement items and survey items were compared, and the association between the factors and the presence or absence of injuries was analyzed. Results: Toe-grip strength was significantly weaker in the injury group compared with the noninjury group, suggesting that weak toe-grip is associated with fifth metatarsal stress fracture (P < .05). In addition, fifth metatarsal stress fractures were more common in the nondominant leg (P < .05). Between-group comparisons of the other items showed no statistically significant differences. Conclusion: The association between weak toe-grip strength and fifth metatarsal fracture suggests that weak toe-grip may lead to an increase in the load applied onto the lateral side of the foot, resulting in stress fracture. The finding of stress fracture being more common in the nondominant leg needs further study. PMID:26535399

Evolution of the APETALA2 Gene Lineage in Seed Plants.

PubMed

Zumajo-Cardona, Cecilia; Pabón-Mora, Natalia

2016-07-01

Gene duplication is a fundamental source of functional evolutionary change and has been associated with organismal diversification and the acquisition of novel features. The APETALA2/ETHYLENE RESPONSIVE ELEMENT-BINDING FACTOR (AP2/ERF) genes are exclusive to vascular plants and have been classified into the AP2-like and ERF-like clades. The AP2-like clade includes the AINTEGUMENTA (ANT) and the euAPETALA2 (euAP2) genes, both regulated by miR172 Arabidopsis has two paralogs in the euAP2 clade, namely APETALA2 (AP2) and TARGET OF EAT3 (TOE3) that control flowering time, meristem determinacy, sepal and petal identity and fruit development. euAP2 genes are likely functionally divergent outside Brassicaceae, as they control fruit development in tomato, and regulate inflorescence meristematic activity in maize. We studied the evolution and expression patterns of euAP2/TOE3 genes to assess large scale and local duplications and evaluate protein motifs likely related with functional changes across seed plants. We sampled euAP2/TOE3 genes from vascular plants and have found three major duplications and a few taxon-specific duplications. Here, we report conserved and new motifs across euAP2/TOE3 proteins and conclude that proteins predating the Brassicaceae duplication are more similar to AP2 than TOE3. Expression data show a shift from restricted expression in leaves, carpels, and fruits in non-core eudicots and asterids to a broader expression of euAP2 genes in leaves, all floral organs and fruits in rosids. Altogether, our data show a functional trend where the canonical A-function (sepal and petal identity) is exclusive to Brassicaceae and it is likely not maintained outside of rosids. © The Author 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Relationship between early motor milestones and severity of restricted and repetitive behaviors in children and adolescents with autism spectrum disorder.

PubMed

Uljarević, Mirko; Hedley, Darren; Alvares, Gail A; Varcin, Kandice J; Whitehouse, Andrew J O

2017-06-01

This study explored the relationships between the later age of achievement of early motor milestones, current motor atypicalities (toe walking), and the severity of restricted and repetitive behaviors (RRBs) in individuals with autism spectrum disorder (ASD). Parents of 147 children and adolescents with ASD (M age  = 8.09 years, SD = 4.28; 119 males) completed an early developmental milestones questionnaire and the Social Responsiveness Scale as a measure of Insistence on Sameness (IS) and Repetitive Mannerisms (RM). Two hierarchical regression analyses were conducted to test whether RM and IS behaviors were predicted by early motor milestones, or current toe walking. The final model predicting RM accounted for 15% of the variance (F = 3.02, p = .009), with toe walking as a unique and independent predictor of RM scores (t = 3.568, p = .001). The final model predicting IS accounted for 19.1% of variance in IS scores (F = 4.045, p = .001), with chronological age (CA) (t = 2.92, p = .004), age when first standing (t = 2.09, p = .038), and toe walking (t = 2.53, p = .013) as unique independent predictors. Toe walking (t = 2.4, p = .018) and age when first sitting (t = 2.08, p = .04) predicted the severity of RRBs on the Autism Diagnostic Observation Schedule (F = 2.334, p = .036). Our study replicates previous findings on the relationship between concurrent motor impairments and RRBs, and provides the first evidence for the association between RRBs and age of attainment of early motor milestones. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1163-1168. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

The flutter-by effect: a comprehensive study of the fluttering cusps of the Perceval heart valve prosthesis.

PubMed

Aljalloud, Ali; Shoaib, Mohamed; Egron, Sandrine; Arias, Jessica; Tewarie, Lachmandath; Schnoering, Heike; Lotfi, Shahram; Goetzenich, Andreas; Hatam, Nima; Pott, Desiree; Zhong, Zhaoyang; Steinseifer, Ulrich; Zayat, Rachad; Autschbach, Ruediger

2018-05-17

Sutureless aortic valve prostheses are gaining popularity due to the substantial reduction in cross-clamp time. In this study, we report our observations on the cusp-fluttering phenomenon of the Perceval bioprosthesis (LivaNova, London, UK) using a combination of technical and medical perspectives. Between August 2014 and December 2016, a total of 108 patients (69% women) with a mean age of 78 years had aortic valve replacement using the Perceval bioprosthesis (34 combined procedures). All patients underwent transoesophageal echocardiography (TOE) intraoperatively. TOE was performed postoperatively to detect paravalvular leakage and to measure gradients, acceleration time, Doppler velocity indices (Vmax and LVOT/Vmax AV) and effective orifice area indices. In addition, a TOE examination was performed in 21 patients postoperatively. Data were collected retrospectively from our hospital database. The retrospective evaluation of the intraoperative TOE examinations revealed consistent fluttering in all patients with the Perceval bioprosthesis. The echocardiographic postoperative measurements showed a mean effective orifice area index of 0.91 ± 0.12 cm2/m2. The overall mean pressure and peak pressure gradients were in a higher range (13.5 ± 5.1 mmHg and 25.5 ± 8.6 mmHg, respectively), whereas acceleration time (62.8 ± 16.4 ms) and Doppler velocity indices (0.43 ± 0.11) were within the normal range according to the American Society of Echocardiography or european association of echocardiography (EAE) guidelines. The 2-dimensional TOE in Motion Mode (M-Mode) that was performed in patients with elevated lactate dehydrogenase (LDH) levels revealed remarkable fluttering of the cusps of the Perceval bioprosthesis. In our study cohort, we observed the fluttering phenomenon in all patients who received the Perceval bioprosthesis, which was correlated with elevated LDH levels and higher pressure gradients.

Playing Tic-Tac-Toe with a Sugar-Based Molecular Computer.

PubMed

Elstner, M; Schiller, A

2015-08-24

Today, molecules can perform Boolean operations and circuits at a level of higher complexity. However, concatenation of logic gates and inhomogeneous inputs and outputs are still challenging tasks. Novel approaches for logic gate integration are possible when chemical programming and software programming are combined. Here it is shown that a molecular finite automaton based on the concatenated implication function (IMP) of a fluorescent two-component sugar probe via a wiring algorithm is able to play tic-tac-toe.

Two-Dimensional (2-D) Acoustic Fish Tracking at River Mile 85, Sacramento River, California

DTIC Science & Technology

2013-06-01

on fish become known (USACE 2004). Levee repair and constructed habitat features included (1) protection of the toe and upper slopes of the bank...be recovered rather than being lost due to sediment dunes , large woody material floating downstream, and vandalism. The RM 85 site was a relatively...into the river channel. The addition of this material narrowed the channel and created a scour feature along the toe of the repair site. VPS array

Risks to Navigation at the Matagorda Ship Channel Entrance, Texas, Phase 2: Evaluation of Significant Risk Factors

DTIC Science & Technology

2011-08-01

jetties are deteriorating. As a result of this deterioration and lowered beach and dunes adjacent to the jetties, there are overwash occurrences during...the toe . An example slope stability analysis is presented in Figure 51. This figure shows a typical cross section or model properties (soil layers...depth caused by the ship passage. Any area of influence will be localized and, in light of a critical gradient analysis, near- toe scouring effects

Erosion Control and Environment Restoration Plan Development, Matagorda County, Texas. Phase 1: Preliminary Investigation

DTIC Science & Technology

2012-07-01

Matagorda Peninsula east of MCR where a thicker cover of sand with vegetated dunes can be observed. 2.8 Typical beach profile Beach profile shape is a...clay bluffs on the beach face o Small tidal range, defined in Chapter 2, tends to focus wave action on the bluff toe o Breaking waves propel shell...toward the bluff, abrading the bluff toe o Abrasion undercuts the bluff, causing large sections to fail  Slope failure o Cyclical wave loading on

Premature Growth Plate Closure in a Ballet Dancer en Pointe.

PubMed

Shah, Selina

2017-09-01

A 13-year-old ballet dancer who had been dancing en pointe (on the tips of the toes) since 10 years presented to the clinic with a shortened right second toe. She had no previous history of pain or trauma. She was diagnosed with premature growth arrest of the second metatarsal head physes resulting in a shortened metatarsal. This is the first reported case of premature growth arrest in a ballet dancer as a result of dancing en pointe.

Drop foot corrective device

NASA Technical Reports Server (NTRS)

Deis, B. C. (Inventor)

1986-01-01

A light weight, economical device to alleviate a plurality of difficulties encountered in walking by a victim suffering from a drop foot condition is discussed. A legband girdles the leg below the knee and above the calf providing an anchor point for the upper end of a ligament having its lower end attached to a toe of a shoe or a toe on the foot. The ligament is of such length that the foot is supported thereby and retained in a normal position during walking.

Detecting Gait Asymmetry with Wearable Accelerometers

DTIC Science & Technology

2015-03-18

swing time to stride duration is referred to as swing factor [24]. Some features used in the past relate to the gait subphases: the heel - strike , when the...used in the past include the peaks of the impulse of the heel - strike [28] and toe-off force and the integral of the force over the course of the...with high acceleration and high jerk. Heel - strike and toe-off times are determined by extending outward from the identified stance time into areas of

From Toes to Top-of-the-Atmosphere: Fowler Sneaker Index

NASA Technical Reports Server (NTRS)

Crooke, Ben A.; McKinna, Lachlan I W.; Cetinic, Ivona

2016-01-01

Fowler Sneaker Index (FSI), developed by a NASA summer intern, is a new Ocean Color application that facilitates continuous monitoring of environmental conditions in the Chesapeake Bay. It builds on three decades of citizen science data collected by former Maryland State Senator Bernie Fowler, during his yearly "Wade-ins in the Patuxent River". FSI demonstrates how NASA's Earth-observing tools, in combination with a concerned and engaged public, can take science from the tips of our toes-to-top-of the atmosphere and back.

A new species of Bachia (Squamata: Gymnophthalmidae) with pleisomorphic limb morphology

USGS Publications Warehouse

Kizirian, D.A.; McDiarmid, R.W.

1998-01-01

We describe a new species of Bachia from the upper Rio Negro drainage of southeastern Colombia and southern Venezuela. The new taxon is diagnosed by a complement of phalanges that is unique among gymnophthalmid lizards and intermediate relative to other Bachia and closely related genera. Variation in limb osteology among the species of Bachia and close relatives is reported. We discuss the distribution of B. panoplia and the taxonomic status of B. flavescens.

Intrafamilial phenotypic heterogeneity of the Poland complex: a case report.

PubMed

Parano, E; Falsaperla, R; Pavone, V; Toscano, A; Bolan, E A; Trifiletti, R R

1995-08-01

Three cases of familial unilateral gluteal hypoplasia are reported. The index case in addition to having gluteal hypoplasia also has unilateral pectoral muscle hypoplasia. Another relative has unilateral symbrachydactyly of the distal phalanges of one foot. All four affected individuals in our pedigree were female. We propose that our cases are best classified as part of the Poland complex of anomalies. Our cases emphasize that intrafamilial phenotypic heterogeneity is possible within the Poland complex.

Classification and identification of inherited brachydactylies

PubMed Central

Fitch, Naomi

1979-01-01

A search for patterns of malformation in the brachydactylies has resulted in new ways to identify the different types. Type A-1 can be characterised by a proportionate reduction of the middle phalanges. Type B is thought to be an amputation-like defect. In type C the fourth middle phalanx is usually the longest, and type E (Riccardi and Holmes, 1974) is characterised by short metacarpals and short distal phalanges. Short stature is usually present in type A-1 and type E brachydactyly (Riccardi and Holmes, 1974) and it may be present in some individuals with brachydactyly C. As short children have short hands, it is possible that in patients with very mild expressions of brachydactyly the cause of the short stature may be overlooked. It is suggested that in every child with proportionate short stature the hands should be carefully examined. If the hands are disproportionately short, if any distal creases are missing, if there is a shortening, however mild, of any finger, if any metacarpals are short, then it is important to have ϰ-rays to look for brachydactyly A-1, C, or E. Much information is still needed. It is important in future reports to have skeletal surveys, pattern profile analyses, and to note the height of children with brachydactyly C. Most interesting of all will be when fetal limbs of each type become available for study. Images PMID:469884

Osteosynthesis using plates and screws after removing a limited area of the periosteum in order to reduce misclassified during radiological assessment metacarpal shaft fractures

PubMed Central

Neagu, TP; Popescu, SA; Cobilinschi, C; Tincu, R; Tiglis, M; Lascar, I

2016-01-01

Hand fractures are one of the most common causes for presenting to the emergency room. Metacarpal fractures count about 18 to 44% of all hand fractures, and are most often standalone closed injuries, without misplacement, not needing operative treatment. We present a case in which osteosynthesis with plates and screws was used to reduce two metacarpal fractures in order to allow an early motion recovery, despite the fact that a small portion of the periosteum needed to be removed. The type of fractures were misclassified according to the radiological findings, therefore the correct diagnosis was established during surgery. The results according to the radiological aspects and to the DASH score were excellent with 95% function recovery at twelve months. In this case, the use of osteosynthesis with plates and screws led to a good fracture healing without any major complications. However, there are a series of complications related to this method that should be taken into consideration. Being misled by the radiological aspects of the fractures, the most certain way to classify a metacarpal shaft fracture is through exploratory surgery, even if in most of the cases the three radiological views are enough to establish the diagnosis. Abbreviations: DASH score = Disability of Arm, Shoulder and Hand score, TAM = Total Active Motion, MCP = metacarpal phalangeal joint, PIP = proximal inter phalangeal joint PMID:27974942

Computer-aided bone age assessment for ethnically diverse older children using integrated fuzzy logic system

NASA Astrophysics Data System (ADS)

Ma, Kevin; Moin, Paymann; Zhang, Aifeng; Liu, Brent

2010-03-01

Bone Age Assessment (BAA) of children is a clinical procedure frequently performed in pediatric radiology to evaluate the stage of skeletal maturation based on the left hand x-ray radiograph. The current BAA standard in the US is using the Greulich & Pyle (G&P) Hand Atlas, which was developed fifty years ago and was only based on Caucasian population from the Midwest US. To bring the BAA procedure up-to-date with today's population, a Digital Hand Atlas (DHA) consisting of 1400 hand images of normal children of different ethnicities, age, and gender. Based on the DHA and to solve inter- and intra-observer reading discrepancies, an automatic computer-aided bone age assessment system has been developed and tested in clinical environments. The algorithm utilizes features extracted from three regions of interests: phalanges, carpal, and radius. The features are aggregated into a fuzzy logic system, which outputs the calculated bone age. The previous BAA system only uses features from phalanges and carpal, thus BAA result for children over age of 15 is less accurate. In this project, the new radius features are incorporated into the overall BAA system. The bone age results, calculated from the new fuzzy logic system, are compared against radiologists' readings based on G&P atlas, and exhibits an improvement in reading accuracy for older children.

Rare case of Isolated Aspergillus Osteomyelitis of Toe: Presentation and Management.

PubMed

Pattanashetty, O B; B B, Dayanand; Bhavi, Shushrut B; Bami, Monish

2013-01-01

Fungal osteomyelitis is an uncommon diseases and generally present in an indolent fashion. Isolated bone affection due to fungi are rare and we present one such case with fungal osteomyelitis of terminal phalanx of second toe. We present a rare case of fungal osteomyelitis of right second toe in a 30 year old Indian female who presented with swelling of 8 months duration. Diagnosis was based on the histo-pathological report and culture showing Aspergillus growth. The patient was treated with surgical debridement and amphotericin-B was given for 6 weeks after debridement. There was no recurrence one year post surgery. Isolated Aspergillus osteomyelitis of the bone are very rare and mostly seen in immunocompromised patients and larger bones like spine, femur and tibia. Treatment with wound debridement and subsequently followed up with a course of Amphotericin-B for 6 weeks provided good results. There was no recurrence noted at 1 year follow up. Fungi should be kept in mind for differential diagnosis of osteomyelitis and culture should be appropriately ordered.

Effects of carrying a backpack in a symmetrical manner on the shape of the feet.

PubMed

Drzał-Grabiec, Justyna; Snela, Sławomir; Rachwał, Maciej; Rykała, Justyna; Podgórska, Justyna

2013-01-01

The aim of this study was to assess changes in the shape of the feet while carrying a backpack constituting 10% of a child's weight. It was an observational, cross-sectional study involving 118 primary school children aged 11-13 years. Selected parameters of foot shape were assessed in both a normal position and with a backpack using podoscopy and a CQ-ST examination device. The study revealed significant differences in the length and width of the right and left feet between assessments. Moreover, the longitudinal arch of the foot was significantly lowered and deformity of the great toe was reported. Carrying a backpack constituting 10% of a child's weight results in lowering of the longitudinal and traverse arches of the feet and advanced toe deformities. We performed an observational, cross-sectional study examining the effect of carrying a backpack constituting 10% of a child's weight on parameters of foot shape and observed significant lowering of the longitudinal and traverse arches of the feet and advanced toe deformities.

[Isolation of Sporothrix pallida complex in clinical and environmental samples from Chile].

PubMed

Cruz Choappa, Rodrigo M; Vieille Oyarzo, Peggy I; Carvajal Silva, Laura C

2014-01-01

The isolation of S. pallida complex from medical samples and home garden soil of a patient in Chile is here in reported. Fungi of the Sporothrix schenckii complex can cause various infections. In Chile, the medical and environmental isolates of these this complex are rare. The aim of this study was to identify an unusual agent in a case of onychomycosis and to detect its presence in the patient's home garden. For this purpose, clinical samples were obtained by scraping the patient's subungueal first right toe nail as well as by taking soil samples from different areas of her home garden. Species identification was performed by morphophysiology and one of the strains isolated from the patient's toe nail was sent to CBS for molecular confirmation (14.062). S. pallida complex was identified both from the patient's toe nail and samples taken from her home garden. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España. All rights reserved.

The first metatarsal web space: its applied anatomy and usage in tracing the first dorsal metatarsal artery in thumb reconstruction.

PubMed

Xu, Yong-Qing; Li, Jun; Zhong, Shi-Zhen; Xu, Da-Chuan; Xu, Xiao-Shan; Guo, Yuan-Fa; Wang, Xin-Min; Li, Zhu-Yi; Zhu, Yue-Liang

2004-12-01

To clarify the anatomical relationship of the structures in the first toe webbing space for better dissection of toes in thumb reconstruction. The first dorsal metatarsal artery, the first deep transverse metatarsal ligament and the extensor expansion were observed on 42 adult cadaveric lower extremities. Clinically the method of tracing the first dorsal metatarsal artery around the space of the extensor expansion was used in 36 cases of thumb reconstruction. The distal segments of the first dorsal metatarsal artery of Gilbert types I and II were located superficially to the extensor expansion. The harvesting time of a toe was shortened from 90 minutes to 50 minutes with 100% survival of reconstructed fingers. The distal segment of the first dorsal metatarsal artery lies constantly at the superficial layer of the extensor expansion. Most of the first metatarsal arteries of Gilbert types I and II can be easily located via the combined sequential and reverse dissection around the space of the extensor expansion.

Using Student-Produced Video to Validate Head-to-Toe Assessment Performance.

PubMed

Purpora, Christina; Prion, Susan

2018-03-01

This study explored third-semester baccalaureate nursing students' perceptions of the value of using student-produced video as an approach for learning head-to-toe assessment, an essential clinical nursing skill taught in the classroom. A cognitive apprenticeship model guided the study. The researchers developed a 34-item survey. A convenience sample of 72 students enrolled in an applied assessment and nursing fundamentals course at a university in the western United States provided the data. Most students reported a videotaping process that worked, supportive faculty, valuable faculty review of their work, confidence, a sense of performance independence, the ability to identify normal assessment findings, and few barriers to learning. The results suggested that a student-produced video approach to learning head-to-toe assessment was effective. Further, the study demonstrated how to leverage available instructional technology to provide meaningful, personalized instruction and feedback to students about an essential nursing skill. [J Nurs Educ. 2018;57(3):154-158.]. Copyright 2018, SLACK Incorporated.

Subungual Ewing sarcoma/PNET tumor family of the great toe: a case report

PubMed Central

Binesh, Fariba; Sobhanardekani, Mohammad; Zare, Saeedeh; Behniafard, Nasim

2016-01-01

Ewing’s sarcoma is seen mainly in patients less than 18. This aggressive tumor generally affects the axial skeleton and only rarely involves the acral regions. Ewing’s sarcoma in the foot is inordinately scarce. Clinical features are uncertain and can imitate other common diseases. This paper presents a case of 62-year-old malewith complaints of pain and swelling of the subungual area of his right great toe. The lesion was excised, and histopathological diagnosis of Ewing’s sarcoma was made. Histopathological examination, supported by immunochemical methods, remains the mainstay of diagnosis. Surgical ablation along with chemotherapy is the therapy of choice. To our knowledge, this is the first report of Ewing’s sarcoma involving the nail bed of the great toe without bone erosion. The key messages of this case report is “Subungual Ewing sarcoma is a rare case, and Ewing’s sarcoma must be kept in mind for acral lesions, especially in the adult population.” PMID:27279998

Pliocene shorelines and the deformation of passive margins.

NASA Astrophysics Data System (ADS)

Rovere, Alessio; Raymo, Maureen; Austermann, Jacqueline; Mitrovica, Jerry; Janßen, Alexander

2016-04-01

Characteristic geomorphology described from three Pliocene scarps in Rovere et al. [2014] was used to guide a global search for additional Pliocene age scarps that could be used to document former Pliocene shoreline locations. Each of the Rovere et al. [2014] paleo-shorelines was measured at the scarp toe abutting a flat coastal plain. In this study, nine additional such scarp-toe paleo-shorelines were identified. Each of these scarps has been independently dated to the Plio-Pleistocene; however, they were never unified by a single formation mechanism. Even when corrected for Glacial Isostatic Adjustment post-depositional effects, Post-Pliocene deformation of the inferred shorelines precludes a direct assessment of maximum Pliocene sea level height at the scarp toes. However, careful interpretation of the processes at the inferred paleo-shoreline suggests specific amplitudes of dynamic topography at each location, which could lead to a corrected maximum sea level height and provide a target dataset with which to compare dynamic topography model output.

Quantum Tic-Tac-Toe as Metaphor for Quantum Physics

NASA Astrophysics Data System (ADS)

Goff, Allan; Lehmann, Dale; Siegel, Joel

2004-02-01

Quantum Tic-Tac-Toe is presented as an abstract quantum system derived from the rules of Classical Tic-Tac-Toe. Abstract quantum systems can be constructed from classical systems by the addition of three types of rules; rules of Superposition, rules of Entanglement, and rules of Collapse. This is formally done for Quantum Tic-Tac-Toe. As a part of this construction it is shown that abstract quantum systems can be viewed as an ensemble of classical systems. That is, the state of a quantum game implies a set of simultaneous classical games. The number and evolution of the ensemble of classical games is driven by the superposition, entanglement, and collapse rules. Various aspects and play situations provide excellent metaphors for standard features of quantum mechanics. Several of the more significant metaphors are discussed, including a measurement mechanism, the correspondence principle, Everett's Many Worlds Hypothesis, an ascertainity principle, and spooky action at a distance. Abstract quantum systems also show the consistency of backwards-in-time causality, and the influence on the present of both pasts and futures that never happened. The strongest logical argument against faster-than-light (FTL) phenomena is that since FTL implies backwards-in-time causality, temporal paradox is an unavoidable consequence of FTL; hence FTL is impossible. Since abstract quantum systems support backwards-in-time causality but avoid temporal paradox through pruning of the classical ensemble, it may be that quantum based FTL schemes are possible allowing backwards-in-time causality, but prohibiting temporal paradox.

Neurodevelopment in preschool idiopathic toe-walkers.

PubMed

Martín-Casas, P; Ballestero-Pérez, R; Meneses-Monroy, A; Beneit-Montesinos, J V; Atín-Arratibel, M A; Portellano-Pérez, J A

2017-09-01

Idiopathic toe walking, a differential diagnosis for neurological and orthopaedic disorders, has been associated with neurodevelopmental alterations. Neurodevelopmental assessment at early ages using specific tests may improve management and follow-up of these patients. The aim of our study is to analyse the neurodevelopmental characteristics of preschool idiopathic toe-walkers (ITW) by comparing them to a control group. Our descriptive cross-sectional study compared possible risk factors, neurodevelopmental characteristics, and scores on the Child Neuropsychological Maturity Questionnaire (CUMANIN) between a group of 56 ITWs aged 3 to 6 and a control group including 40 children. The proportion of males was significantly higher in the ITW group (P=.008). The percentage of patients with a family history (P=.000) and biological risk factors during the perinatal period (P=.032) was also higher in this group. According to the parents' reports, motor coordination in ITWs was significantly poorer (59%; P=.009). ITWs scored significantly lower on CUMANIN subscales of psychomotricity (=0,001) and memory (P=.001), as well as in verbal development (P=.000), non-verbal development (P=.026), and overall development (P=.004). Foot preference was less marked in the ITW group (P=.047). The neurodevelopmental characteristics of our sample suggest that idiopathic toe walking is a marker of neurodevelopmental impairment. However, further studies are necessary to confirm these findings. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Estimation of blood haemoglobin concentration using the HemoCue during caesarean section: the effect of sampling site.

PubMed

Richards, N A; Boyce, H; Yentis, S M

2010-01-01

Haemoglobin concentration measured using the HemoCue is accurate for capillary and venous/arterial blood, provided the recommended sampling method is strictly observed. Analysis of blood, particularly of capillary samples, using the HemoCue is useful during caesarean section. The toe might be preferred to the thumb since it is numb during neuraxial anaesthesia, but whether sampling at either site is accurate in this situation, given the cardiovascular effects of anaesthesia and pregnancy, is not known. We aimed to compare haemoglobin values measured in venous and capillary samples (toe and thumb) during caesarean section under neuraxial anaesthesia. Fifty healthy women having caesarean section under spinal or combined spinal-epidural anaesthesia were included. At the end of surgery, the great toe and thumb (non-i.v. fluid side) were lanced as recommended for a HemoCue reading. A venous blood sample (non-i.v. fluid side) was also taken and sent for formal laboratory measurement and tested with the HemoCue. Bland-Altman analysis was applied to the haemoglobin values. Bias (mean difference) and precision +/- 2 SD were respectively 0.2 +/-1.6 for laboratory vs. toe, 0.1 +/-1.8 for laboratory vs. thumb, and 0.2 +/-1.6 laboratory vs. venous. Our results suggest that in terms of accuracy, the two sites are equally suitable for use during caesarean section under neuraxial anaesthesia. Copyright 2009 Elsevier Ltd. All rights reserved.

Factors influencing survival and mark retention in postmetamorphic boreal chorus frogs

USGS Publications Warehouse

Swanson, Jennifer E; Bailey, Larissa L.; Muths, Erin L.; Funk, W. Chris

2013-01-01

The ability to track individual animals is crucial in many field studies and often requires applying marks to captured individuals. Toe clipping has historically been a standard marking method for wild amphibian populations, but more recent marking methods include visual implant elastomer and photo identification. Unfortunately, few studies have investigated the influence and effectiveness of marking methods for recently metamorphosed individuals and as a result little is known about this life-history phase for most amphibians. Our focus was to explore survival probabilities, mark retention, and mark migration in postmetamorphic Boreal Chorus Frogs (Psuedacris maculata) in a laboratory setting. One hundred forty-seven individuals were assigned randomly to two treatment groups or a control group. Frogs in the first treatment group were marked with visual implant elastomer, while frogs in the second treatment group were toe clipped. Growth and mortality were recorded for one year and resulting data were analyzed using known-fate models in Program MARK. Model selection results suggested that survival probabilities of frogs varied with time and showed some variation among marking treatments. We found that frogs with multiple toes clipped on the same foot had lower survival probabilities than individuals in other treatments, but individuals can be marked by clipping a single toe on two different feet without any mark loss or negative survival effects. Individuals treated with visual implant elastomer had a mark migration rate of 4% and mark loss rate of 6%, and also showed very little negative survival impacts relative to control individuals.

[Fingers, toes and thumbs, correct digital nomenclature based on early Hebrew texts].

PubMed

Leibner, Efraim D; London, Eli; Elishoov, Ofer

2005-08-01

There is some dissonance as to the correct Hebrew terms for the digits of the extremities. Terms in common use include 'Etzba, 'Bohen' and 'Agudal'. While most agree that 'Etzba' in the singular represents the index finger, there is debate about the plural (Etzba'ot), whether it represents 'fingers' (upper extremity only) or 'digits' (upper and lower). The meaning of 'Bohen' is disputed as well, with proponents existing for it to represent: 'Toe', 'Big Toe' or 'Big Digit'. 'Agudal' is in the same predicament, with uses as 'Thumb' or 'Big Digit'. We undertook a computerized search of the Bible for these words and their derivatives in order to establish their correct use. The term 'Etzba' and its derivatives appeared numerous times in the scriptures both in singular and in plural. 'Bohen' appeared somewhat less, however, all appearances were in conjunction, viz" 'Bohen' of the hand" or " 'Bohen' of the foot". 'Agudal' was not found in our computerized search. According to the early Hebrew texts 'Etzba' in singular usually represents the index finger. However, the plural form 'Etzba'ot', corresponds to the term 'digits' and may be used both for fingers and toes. 'Bohen' is a term representing the large digit of all extremities, i.e. both 'Thumb' and 'Hallux'. Likewise, the term 'Agudal', while not appearing in the scriptures, appears in later contexts in early Hebrew texts, and also represents both the thumb and the hallux.

Skin diseases during floods in Thailand.

PubMed

Vachiramon, Vasanop; Busaracome, Ploysyne; Chongtrakool, Piriyaporn; Puavilai, Siripen

2008-04-01

Floods are natural disasters that occur occasionally in Thailand. The most common form skin diseases due to floods are infectious dermatoses especially superficial fungal infection. However the microbiologic evidences have not been evaluated. To evaluate the most common skin diseases during floods and identify the organism that causes skin maceration at web space(s) of toes (Hong Kong foot). Patients who complained of skin problems were evaluated at the temporary outpatient clinic during October 2006. Skin specimens from all patients who had itches and skin maceration at web space(s) of toes were cultured. Ninety-six patients were evaluated (38 males and 58 females). Eczema was the most prevalent dermatosis, which accounted for 34.5% of the total skin problems and the great majority of these cases were irritant contact dermatitis. Sixteen cases presented with itch and skin maceration at web space(s) of toes. All of them were colonized with various microorganisms. Gram-negative bacilli were the most prevalent ones and were found in 14 out of 16 specimens. Fungal culture was positive in only two specimens. Eczema is the most common dermatosis during floods. Skin maceration at web space(s) of toes, which were thought to be fungal infection, are chronic irritant dermatitis with secondary bacterial colonization. Only a few cases were fungal infection. Microbiologic investigation should be done in these patients. Unfortunately, it is not practical in such a situation. Topical medications that have the combination of antiinflammatory, antibacterial and antifungal properties are the most suitable medications.

Diagnosis and Management of Common Foot Fractures.

PubMed

Bica, David; Sprouse, Ryan A; Armen, Joseph

2016-02-01

Foot fractures are among the most common foot injuries evaluated by primary care physicians. They most often involve the metatarsals and toes. Patients typically present with varying signs and symptoms, the most common being pain and trouble with ambulation. Diagnosis requires radiographic evaluation, although emerging evidence demonstrates that ultrasonography may be just as accurate. Management is determined by the location of the fracture and its effect on balance and weight bearing. Metatarsal shaft fractures are initially treated with a posterior splint and avoidance of weight-bearing activities; subsequent treatment consists of a short leg walking cast or boot for four to six weeks. Proximal fifth metatarsal fractures have different treatments depending on the location of the fracture. A fifth metatarsal tuberosity avulsion fracture can be treated acutely with a compressive dressing, then the patient can be transitioned to a short leg walking boot for two weeks, with progressive mobility as tolerated after initial immobilization. A Jones fracture has a higher risk of nonunion and requires at least six to eight weeks in a short leg non-weight-bearing cast; healing time can be as long as 10 to 12 weeks. Great toe fractures are treated with a short leg walking boot or cast with toe plate for two to three weeks, then a rigid-sole shoe for an additional three to four weeks. Lesser toe fractures can be treated with buddy taping and a rigid-sole shoe for four to six weeks.

HypnosIS to faciLitate trans-Esophageal echocardiograPhy Tolerance: The I-SLEPT study.

PubMed

Corman, Isabelle; Bouchema, Yasmina; Miquel, Béatrice; Rousseau, Hélène; Bouvier, Dominique; Voilmy, Nicolas; Beauvais, Florence; Cohen-Solal, Alain; Vicaut, Eric; Logeart, Damien; Tournoux, François

2016-03-01

Trans-oesophageal echocardiography (TOE) is one of the major diagnostic tests in cardiovascular medicine, but the procedure is associated with some discomfort for the patient. To determine the additive value of hypnosis as a means of improving patient comfort during TOE. We randomly assigned 98 patients with non-emergency indications for TOE to a 30-minute hypnosis session combined with topical oropharyngeal anaesthesia (HYP group) or topical oropharyngeal anaesthesia only (CTRL group) before the procedure. The primary efficacy endpoint was the level of patient discomfort assessed using a visual analogue scale (VAS). The VAS score was significantly reduced in the HYP group compared with the CTRL group (6 [5; 8] vs. 7 [5; 9]; P=0.046). No statistically significant differences were observed in terms of procedure failure (HYP group 2.2% vs. CTRL group 3.9%; P=1.00) and procedure length (HYP group 7 [5; 11] minutes vs. CTRL group 8 [7; 11] minutes; P=0.29). However, the patients' subjective estimations of the length of the procedure were significantly shorter in the HYP group than in the CTRL group (8 [5; 10] vs. 10 [10; 20] minutes; P<0.0001). There were no major adverse events in either group. The reported minor events rate was lower in the HYP group (36% vs. 57%; P=0.04). Hypnosis is an efficient alternative or complementary method for improving patient comfort during TOE. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

[Double toe to hand transfer in children with symbrachydactyly].

PubMed

Rivas, S; López-Gutiérrez, J C; Lovic, A; Díaz, M; Andrés, A M; Ros, Z

2006-07-01

Symbrachydactyly is fairly frequent congenital malformation that appears during first weeks of pregnancy. The range of clinical presentations goes from hypoplastic fingers to true agenesis. Although it usually appears in a random fashion, sometimes it is associated to other systemic malformations. The aim of this study is to check the functional, cosmetic and psychological results of those patients affected of grade IV symbrachydactyly treated using a double second toe transfer. The method employed is a retrospective study of the clinical records from 6 patients (5 males and 1 female) operated in our Department during the last five years. The follow up period was from 3 months to five years. Transfer from the second toe to the first ray was performed during the first surgical period, while transfer to the fourth ray was done in a second procedure. The mean age for the first operation was 19 months, and 30 months for the second one. There were no flap failure or major surgical complications. Tenolysis and tenoplasty was done in two patients to improve flap function and position. Motion rehabilitation was installed during the postoperative period. Functional, opposing pinch, and cosmetic results were satisfactory. Parents "and patients" psychological acceptance was also good. No walk disturbance was observed. Double second toe to hand transfer is a good option for the symbrachydactyly treatment in cases of thumb agenesis. Rehabilitation is the key clue for functional recovery. Surgery improves social and family relationships.

Influence of filling-drawdown cycles of the Three Gorges reservoir on deformation and failure behaviors of anaclinal rock slopes in the Wu Gorge

NASA Astrophysics Data System (ADS)

Huang, Da; Gu, Dong Ming

2017-10-01

The upper Wu Gorge on the Yangtze River has been the site of tens of reservoir-induced landslides since the filling of the Three Gorges reservoir in 2003. These landslides have been occurring in heavily fractured carbonate rock materials along the rim of the reservoir in the Wu Gorge. A detailed investigation was carried out to examine the influence of reservoir operations (filling and drawdown) on slope stabilities in the upper Wu Gorge. Field investigations reveal many collapses of various types occurred at the toe of the anaclinal rock slopes, owing to the long-term intensive river erosion caused by periodic fluctuation of the reservoir level. Analysis of data from deformation monitoring suggests that the temporal movement of the slopes shows seasonal fluctuations that correlate with reservoir levels and drawdown conditions, with induced slope acceleration peaking when reservoir levels are lowest. This may illustrate that the main mechanism is the reservoir drawdown, which induces an episodic seepage force in the highly permeable materials at the slope toes, and thus leads to the episodic rockslides. The coupled hydraulic-mechanical (HM) modeling of the G2 landslide, which occurred in 2008, shows that collapse initiated at the submerged slope toe, which then caused the upper slope to collapse in a rock topple-rock slide pattern. The results imply that preventing water erosion at the slope toe might be an effective way for landslide prevention in the study area.

Color of the tarsi and toes of the black rail

USGS Publications Warehouse

Meanley, B.; Stewart, R.E.

1960-01-01

Examination of two fresh specimens of the Black Rail (Laterallus jamaicensis) has prompted us to call attention to the color of the tarsi and toes of this species, since our observations do not agree with published accounts. Audubon (Ornithological Biography, vol. IV; 361, 1838) and Friedmann (Birds of North and Middle America, U.S. Nat'l. Mus. Bull., 50: 154, 1941) state that the tarsi and toes are bright yellowish-green. Descriptions in other publications are similar. Prominent bird artists, including Fuertes, have depicted the color of these appendages as yellowish-green, yellow, or green; while Allan Brooks' illustration of this species (The Book of Birds, vol. I, National Geographic Society, p. 291, 1932) shows pink legs. An adult female specimen was collected by J. A. Hagar, C. S. Robbins, and R. E. Stewart near Elliott Island, Maryland, on 8 June 1958. A second adult Black Rail, presumed to be a female by its dull color and call, was caught alive by the authors in the same area on 17 June 1958, and is still held in captivity. The tarsi and toes of these two birds show no trace of yellow or green. They appear grayish, matching "Flint" (plate 56-1C) or "Gunmetal" (plate 48-2C) in Maerz and Paul's "A Dictionary of Color" (1930), and "blackish-brown" in the color charts provided with Palmer and Reilly's "A Concise Color Standard" (Am. Ornith. Union Handbook Fund, 1956). A grayed-off blackish-brown would seem to be an appropriate description.

Hepatoprotective effect of Taraxacum officinale leaf extract on sodium dichromate-induced liver injury in rats.

PubMed

Hfaiedh, Mbarka; Brahmi, Dalel; Zourgui, Lazhar

2016-03-01

Taraxacum officinale (L.) Weber, commonly known as Dandelion, has been widely used as a folkloric medicine for the treatment of liver and kidney disorders and some women diseases such as breast and uterus cancers. The main objective of the present study was to assess the efficiency of T. officinale leaf extract (TOE) in treating sodium dichromate hazards; it is a major environmental pollutant known for its wide toxic manifestations witch induced liver injury. TOE at a dose of 500 mg/kg b.w was orally administered once per day for 30 days consecutively, followed by 10 mg/kg b.w sodium dichromate was injected (intraperitoneal) for 10 days. Our results using Wistar rats showed that sodium dichromate significantly increased serum biochemical parameters. In the liver, it was found to induce an oxidative stress, evidenced from increase in lipid peroxidation and changes in antioxidative activities. In addition, histopathological observation revealed that sodium dichromate causes acute liver damage, necrosis of hepatocytes, as well as DNA fragmentation. Interestingly, animals that were pretreated with TOE, prior to sodium dichromate administration, showed a significant hepatoprotection, revealed by a significant reduction of sodium dichromate-induced oxidative damage for all tested markers. These finding powerfully supports that TOE was effective in the protection against sodium dichromate-induced hepatotoxicity and genotoxicity and, therefore, suggest a potential therapeutic use of this plant as an alternative medicine for patients with acute liver diseases. © 2014 Wiley Periodicals, Inc.

Effect of rocker shoes on pain, disability and activity limitation in patients with rheumatoid arthritis.

PubMed

Bagherzadeh Cham, Masumeh; Ghasemi, Mohammad Sadegh; Forogh, Bijan; Sanjari, Mohammad Ali; Zabihi Yeganeh, Mozdeh; Eshraghi, Arezoo

2014-08-01

Rheumatoid arthritis is a chronic inflammatory joint disease which affects the joints and soft tissues of the foot and ankle. Rocker shoes may be prescribed for the symptomatic foot in rheumatoid arthritis; however, there is a limited evidence base to support the use of rocker shoes in these patients. The aim of this study was to evaluate the effectiveness of heel-to-toe rocker shoes on pain, disability, and activity limitation in patients with rheumatoid arthritis. Clinical trial. Seventeen female patients with rheumatoid arthritis of 1 year or more duration, disease activity score of less than 2.6, and foot and ankle pain were recruited. Heel-to-toe rocker shoe was made according to each patient's foot size. All the patients were evaluated immediately, 7 and 30 days after their first visit. Foot Function Index values were recorded at each appointment. With the use of rocker shoes, Foot Function Index values decreased in all subscales. This reduction was noted in the first visit and was maintained throughout the trials. Rocker shoe can improve pain, disability, and activity limitation in patients with rheumatoid foot pain. All the subjects reported improved comfort levels. The results of this study showed that high-top, heel-to-toe rocker shoe with wide toe box was effective at reducing foot and ankle pain. It was also regarded as comfortable and acceptable footwear by the patients with rheumatoid foot problems. © The International Society for Prosthetics and Orthotics 2013.

Movement triggers and remediation in a fracture-dominated translational landslide at the Oregon coast

USGS Publications Warehouse

Priest, George R.; Allan, Jonathan; Niem, Alan; Niem, Wendy A.; Dickenson, Stephen E.

2009-01-01

The Johnson Creek landslide is a translational slide in seaward dipping Miocene siltstone and sandstone (Astoria Formation) and an overlying Quaternary marine terrace deposit. The slide terminates in a sea cliff and has a hummocky to nearly horizontal ground surface. The basal slide plane, however, slopes subparallel to the dip of the Miocene rocks, except beneath the back-tilted toe blocks where it curves upward. The siltstone and sandstone have low estimated permeability but cores and field mapping reveal an extensive fracture system within the slide mass. The slide mainly moves in response to groundwater pressure and coastal erosion of the toe. Limit-equilibrium stability analyses indicate that 3 m of erosion at the toe would destabilize the slide for most of the wet season, although no movement could be directly attributed to erosion in the 5 years of observation. Intense rainfall events raise pore-water pressure throughout the slide in the form of pulses of water pressure traveling from the headwall graben down the axis of the slide at rates of 1.4-2.5 m/hr in the upper part, and 3.5 m/hr to virtually instantaneous in the middle part. Infiltration of meteoric water was only ~50 mm/hr. Slope of the water table exceeds topographic slope from the head to the toe of the slide, so infiltration was too slow to directly raise head in 90 percent of the slide mass where the saturated zone is deeper than a few meters. Only at the headwall graben was the saturated zone shallow enough for rainfall events to trigger pulses of water pressure through the entire saturated zone. When a pressure pulse reached the threshold pressure for movement in the central part of the slide, the whole slide began slow, creeping movement. As head became larger and larger than the threshold for movement in more of the slide mass, movement accelerated and differential displacement between internal slide blocks became more pronounced. These findings suggest that dewatering the shallowest part of the saturated zone in this type of slide will stop these rapid pressure pulses, thereby stopping or greatly reducing seasonal movement. If slides are also subject to continual removal of material from the toe, especially where there are back-tilted toe blocks, then some type of buttress or tied-back shear pile wall may be the only effective long term remediation.

A rare presentation of flexor digitorum profundus type V avulsion injury with associated intra-articular fracture: A case report.

PubMed

Rizis, D; Mahoney, Jl

2011-01-01

Traumatic avulsions of the flexor digitorum profundus tendon are associated with young adults engaged in athletic activities such as football and rugby. The current report presents a case involving a 30-year-old man with traumatic avulsion of his flexor digitorum profundus and associated intra-articular distal phalangeal fracture secondary to injury during martial arts - an unusual cause of this injury. Increased attention to injuries acquired during this form of sporting activity is suggested.

The position of symbrachydactyly in the classification of congenital hand anomalies.

PubMed

Miura, T; Nakamura, R; Horii, E

1994-06-01

The clinical features of 53 cases of intercalated hypoplasia and 113 cases of distal aplasia are reviewed and compared with each other and with 129 cases of syndactyly. Tri-, di- and mono-phalangeal symbrachydactyly, and adactyly with nubbin digits are consecutive anomalies. Transverse deficiency may result if the mesenchyme is damaged severely, and if damage is mild and formation has continued, intercalated transverse deficiency may occur. Webbing in symbrachydactyly may result from failure of the apical ectodermal ridge under the influence of damaged mesenchyme.

Occupational acroosteolysis in a guitar player.

PubMed

Baran, R; Tosti, A

1993-02-01

A case of occupational acroosteolysis in a 24-year-old classical guitar player is reported. Nail tenderness was the only manifestation of initial acroosteolysis, which was due to mechanical stress on the fingers. Radiographs showed initial resorption of the 2nd, 3rd and 4th finger of the left hand. The authors review the clinical and radiological features of acroosteolysis. The pathogenesis of acroosteolysis is discussed as well as the different diseases that may cause destructive changes of the distal phalangeal bones.

Swan-neck sign of the big toe - association with hypocalcaemia.

PubMed

Agarwal, Kishore S; Baijal, Noopur; Tiwari, Lokesh; Verma, Neeraj; Sahni, Mohit; Puliyel, Jacob M

2007-10-01

The sensitivity and specificity of a new clinical sign of hypocalcaemia were evaluated. The Swan-neck sign, wherein infants with symptomatic hypocalcaemia keep their big toe hyperextended at the metatarsophalangeal joint and flexed at the interphalangeal joint, was looked for in 25 infants presenting with non-febrile seizures, alongside their serum calcium levels. The study showed that the sign had a sensitivity of 63.6% and specificity of 66.6%. (Predictive values of positive and negative tests were 93.3% and 20%, respectively.) This is compared with the standard Trousseau and Chvostek signs.

Systematic Review of Ultrasonic Impact Treatment Parameters on Residual Stresses of Welded Non-Sensitized Versus Sensitized Aluminum-Magnesium

DTIC Science & Technology

2015-03-01

during the treatment. The images of the toe region were taken in the same location, approximately 4 to 6 mm from the toe of the weld. The heat effected...Available: http://en.wikipedia.org/wiki/USS_Chosin_%28CG-65%29. Accessed Mar. 11, 2015. [ 6 ] HSV-2 Swift. (2003, Nov. 4 ). Wikipedia. Available: http...Leave blank) I 2. REPORT DATE I 3. REPORT TYPE AND DATES COVERED March 2015 Master ’s Thesis 4 . TITLE AND SUBTITLE 5. FUNDING NUMBERS SYSTEMATIC REVIEW

GUTs and TOEs

ScienceCinema

Lincoln, Don

2018-01-16

Albert Einstein said that what he wanted to know was “God’s thoughts,” which is a metaphor for the ultimate and most basic rules of the universe. Once known, all other phenomena would then be a consequence of these simple rules. While modern science is far from that goal, we have some thoughts on how this inquiry might unfold. In this video, Fermilab’s Dr. Don Lincoln tells what we know about GUTs (grand unified theories) and TOEs (theories of everything).

Wave Overtopping of a Barrier Beach

DTIC Science & Technology

2009-09-01

but can result in increased dune erosion along Scenic Road as occurred in 1993, 1997, and 2005 (James, 2005). Field data and observations for...factors are equal to 1. The equations for these run-up formulas are parameterized on significant wave height at the toe of the structure as measured in...3 exp C r SS RQ C D HgH γ ⎛ ⎞ = −⎜ ⎟ ⎝ ⎠ 2pξ > where the significant wave height at the toe of the structure, SH and pT are used. Again the