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Copyright of Journal of Babylon Center for Humanities Studies is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tenosynovial Giant Cell Tumor (TSGCT) is a solitary, firm, and extra-articular localized benign soft tissue tumor that may present with painless swelling for many years. It usually involves the tiny joints of the extremities in the hands and feet. Here, we present the case of a male in his 20s who presented with a painful, stiff, slow-growing mass over the distal interphalangeal joint of the right-hand ring finger. Fine Needle Aspiration Cytology (FNAC) was performed and based on the microscopic features, it was reported as a case of Tenosynovial Giant Cell Tumor. Surgical excision of the swelling was performed and histopathological examination confirmed the diagnosis. The rarity of this case arises from the fact that the diagnosis of TSGCT was established on cytology, as TSGCT is very rarely reported on cytology.

We describe the case of a 6-year-old female who presented with tender nodules and fixed flexion of her thumbs, diagnosed as bilateral pediatric trigger thumb. Though present since infancy, her condition was not diagnosed in prior clinical visits. Pediatric trigger digit is a clinical diagnosis, often missed if the digit's range of motion is not assessed routinely. Given the duration, pain, and severity of her condition, conservative management was deferred, and she was referred for surgery. An approach to clinical management is discussed. Ultimately, further study is required to develop structured management guidelines for pediatric trigger digit. [ABSTRACT FROM AUTHOR]

Tenosynovial Giant Cell Tumor (TSGCT) is a solitary, firm, and extra-articular localized benign soft tissue tumor that may present with painless swelling for many years. It usually involves the tiny joints of the extremities in the hands and feet. Here, we present the case of a male in his 20s who presented with a painful, stiff, slow-growing mass over the distal interphalangeal joint of the right-hand ring finger. Fine Needle Aspiration Cytology (FNAC) was performed and based on the microscopic features, it was reported as a case of Tenosynovial Giant Cell Tumor. Surgical excision of the swelling was performed and histopathological examination confirmed the diagnosis. The rarity of this case arises from the fact that the diagnosis of TSGCTwas established on cytology, as TSGCTis very rarely reported on cytology. [ABSTRACT FROM AUTHOR]

Previous work using visually guided reaches to localize landmarks on a hidden hand has suggested that proprioceptive acuity for hand targets is low and representation of hand dimensions is highly distorted (e.g., hand width estimated to be 60% wider than actual hand width). We re-examined these issues using a pure proprioceptive task in which 20 blindfolded subjects reached in a single movement without terminal corrections to touch the right index-tip to landmarks of the left hand placed in various locations in 3D space. Subjects were also tested with vision allowed to estimate minimal errors. Based on previous reports of high proprioceptive acuity for some hand landmarks, we hypothesized that the proprioceptive representation of the hand was much less distorted than described previously and that errors were not correlated with target hand location. Mean distance errors in proprioceptively guided reaches to the landmarks averaged less than 3 cm and were only 0.5–1.3 cm larger than when vision was allowed. Errors were not correlated with hand location in most subjects. Distortions of hand width averaged less than 20% wider than actual width and were not correlated with hand location in most subjects. We conclude that relatively accurate proprioceptive awareness of locations of hand/digit structures and dimensions is available for use in control of hand movements, which are executed largely subconsciously. Studying acuity of proprioception using conscious perceptual tasks and involving vision may not provide accurate measures of proprioceptive acuity as used by the motor system. [ABSTRACT FROM AUTHOR]

Superficial acral fibromyxoma, also known as digital fibromyxoma, is a benign soft tissue tumor. The acral regions, including the palms, soles, fingers, toes, and nail units, are the commonly affected locations. The subungual region of the great toe is the most common site reported in current literature. The tumor is slowly progressive and benign in nature. Histology commonly reveals a fibromyxoid neoplasm with immunoreactivity to CD34 and CD99 markers. We present the case of a 39-year-old female with a nine-year history of repetitive digital trauma presenting with superficial acral fibromyxoma of the thumb-nail bed. Our case is unique due to the tumor location and the patient's prior long history of trauma to the tumor site. [ABSTRACT FROM AUTHOR]

Acquired digital fibrokeratoma is a benign fibrous tumor usually located on the toes and fingers. A 63-year-old man with an acquired giant plantar fibrokeratoma is described. He presented with an asymptomatic exophytic nodule of ten years duration; there is no history of trauma to the site. It measured 15x10x5mm and was located on the plantar foot proximal to the third toe. Excisional biopsy established the diagnosis of fibrokeratoma. Giant acquired fibrokeratoma,has been described in 16 patients including ours: three women and 13 men. They are located on either the upper extremity (one man) or the lower extremity (15 individuals). Acquired plantar fibrokeratoma is rare. Including our patient, it has been reported in 11 patients: one woman and ten men. The woman was 13 years of age and the men ranged from 15 to 77-years-old. Plantar acquired fibrokeratomas are located on either the plantar aspect of the toes, the sole of the foot, or the heel. An excisional biopsy provided adequate treatment without subsequent recurrence of both giant and plantar fibrokeratomas.

Both symbolic (digits) and non-symbolic (dots) numerals are spatially coded, with relatively small numbers being responded faster with a left key and large numbers being responded faster with a right key (spatial–numerical association of response codes [SNARC]). The idea of format independent SNARC seems to support the existence of a common system for symbolic and non-symbolic numerical representations, although evidence in the field is still mixed. The aim of the present study is to investigate whether symbolic and non-symbolic numerals interact in the SNARC effect when both information is simultaneously displayed. To do so, participants were presented with dice-like patterns, with digits being used instead of dots. In two separate magnitude classification tasks, participants had to respond either to the number of digits presented on the screen or to their numerical size. In the non-symbolic task, they had to judge whether the digits on the screen were more or less than three, irrespective of the numerical value of the digits. In the symbolic task, participants had to judge whether the digits on the screen were numerically smaller or larger than three, irrespective of the number of digits being present. The results show a consistent SNARC effect in the symbolic task and no effect in the non-symbolic one. Furthermore, congruency between symbolic and non-symbolic numerals did not modulate the response patterns, thus supporting the idea of independent representations and questioning some propositions of current theoretical accounts. [ABSTRACT FROM AUTHOR]

Background: The goal of surgery, when treating a patient with a traumatized hand, is to restore function. The importance of the aesthetics on a patient's psychological well-being should also be considered. The biomechanical ideals for creating a useful hand after digit amputation have been defined; however, ideal aesthetic levels for finger amputation have not been elucidated. The purpose of this study was to determine the general population's visual preferences for different levels of digit amputation in the hand. Methods: In all, 310 participants were surveyed to identify preferences of different levels of single digit amputations in dorsal and volar views. A normal hand was digitally manipulated to simulate various levels of digit amputation. The aesthetics of amputation at the distal interphalangeal (DIP) joint, proximal interphalangeal (PIP) joint, metacarpophalangeal (MCP) joint, and ray amputation were compared to one another via rank order. Average rank for each level of amputation for a digit was determined. Results: Amputation at the DIP was favored over all other levels; however, ray amputation was the second most aesthetic, particularly in the middle and ring fingers even when compared to amputation at the PIP level. Conclusion: When presented a choice at which level to perform a completion amputation or a primary amputation of a digit, and functionality at multiple levels of amputation is equivocal, aesthetic outcomes should be considered. Amputation at the DIP joint is preferable, but ray amputation is aesthetically more pleasing than amputation at the PIP or MCP joints in the index, middle, ring, and small fingers. [ABSTRACT FROM AUTHOR]

Introduction  Hand and digit replantations can be complicated by vascular insufficiency necessitating revision of the original replantation. To date, few studies have evaluated outcomes in secondary revascularizations following replantation. Therefore, the objective of this study was to evaluate the incidence, etiology, and survival rates following secondary revascularization after hand and digit replantations. Materials and Methods  A literature search was performed on NCBI for studies documenting secondary revascularization procedures following hand and digit replant. Studies were evaluated for the etiology of vascular failure, frequency of secondary revascularization, and survival rates following intervention. Statistical analysis was conducted across the pooled dataset. Results  A total of 16 studies including 1,192 amputations were analyzed. We found that 16.9% (201/1,192) of replants were complicated by vascular compromise. The frequency of vascular compromise was not statistically different between arterial and venous etiologies. The survival rate following secondary revascularization was 55.6%, with no significant difference between the arterial and venous groups. Secondary arterial revascularization was often treated with arterial revision (nine of nine studies) and/or with vein grafting (two of nine studies). Secondary revascularization for venous insufficiency resulted in different survival rates for nonsurgical modalities (58%) versus vein revision (37.5%) versus vein grafting (100%). Conclusion  Survival rates following secondary revascularization are lower; however, they may be improved using vein grafts following venous insufficiency. These data can be used to better understand the etiology of replant failure and guide decision-making.

Numerals participate in the expression of a wide range of operations, including mass, volume, degree, ordering, counting, and arithmetic calculations. This raises the questions of what they denote semantically and how they are derived morpho-syntactically. Although a number of theories have been advanced regarding their semantics, studies on the syntactic side are rather scarce. Further, the syntactic accounts of numerals date back to GB period, calling for a reinterpretation of their conclusions under Minimalist considerations. This study attempts to develop a syntactic account of numerals under Minimalist desiderata. It is proposed that numerals are number-denoting type n objects, derived from two primitives: saturated DIGITs of type n, and unsaturated BASEs of type , instrumental in the derivation of simplex and complex numerals, respectively. This view is demonstrated to account for a wide range of distributional and interpretive possibilities of numerals as well as provide principled reasons for why some plausible forms are consistently unattested across languages.

Simple Summary: In veterinary medicine, methods such as histological grading, immunohistochemistry and mutation analysis of the c-kit gene are tools to assess the prognosis and treatment of canine cutaneous mast cell tumours. These methods have not yet been applied and evaluated on a large scale for mast cell tumours of the dog's toe, as these digital mast cell tumours are considered a subset of the cutaneous forms. Mast cell tumours can be more aggressive at certain sites. Therefore, the aim of this study was to apply these methods to 68 dogs with digital mast cell tumours. Even though only a few digital mast cell tumours were histologically poorly differentiated, more than half had immunohistochemical findings that could indicate an unfavourable prognosis. Mutations in the c-kit gene were found as well. Moreover, French Bulldogs—a breed that tends to develop benign variants at other sites on the skin—were more likely to have poorly differentiated tumours. Although outcome data were not available, the results of this study may contribute to a better understanding of canine mast cell tumours of the toe. Grading, immunohistochemistry and c-kit mutation status are criteria for assessing the prognosis and therapeutic options of canine cutaneous mast cell tumours (MCTs). As a subset, canine digital MCTs have rarely been explored in this context. Therefore, in this retrospective study, 68 paraffin-embedded canine digital MCTs were analysed, and histological grading was assessed according to Patnaik and Kiupel. The immunohistochemical markers KIT and Ki67 were used, as well as polymerase chain reaction (PCR) for mutational screening in c-kit exons 8, 9, 11 and 14. Patnaik grading resulted in 22.1% grade I, 67.6% grade II and 10.3% grade III tumours. Some 86.8% of the digital MCTs were Kiupel low-grade. Aberrant KIT staining patterns II and III were found in 58.8%, and a count of more than 23 Ki67-positive cells in 52.3% of the cases. Both parameters were significantly associated with an internal tandem duplication (ITD) in c-kit exon 11 (12.7%). French Bulldogs, which tend to form well-differentiated cutaneous MCTs, had a higher proportion of digital high-grade MCTs and ITD in c-kit exon 11 compared with mongrels. Due to its retrospective nature, this study did not allow for an analysis of survival data. Nevertheless, it may contribute to the targeted characterisation of digital MCTs. [ABSTRACT FROM AUTHOR]

Abstract Background The 3D computed tomography produces detailed images of the digit bones in addition to the angiograph render volume 3D of the CT shows the relation between the arteries, bones, and tissues of the digit. Therefore, the present study used those imaging techniques to provide a complete description of the digit bones and arteries’ origin, distribution, and course and their relations with surrounding structures in the Dromedary Camel. Which would serve as a guide for surgeons and students in distinguishing normal digit structures. The study used eight hind limbs of four adult camels of both sexes (two males and two females), aged 9–15 years (Mean ± SD, 11.80 ± 2.59 years). The samples were injected with latex with lead oxide were undergone 3D render volume CT (128-slice multi-detector CT scanning protocol) and angiography x-rays. Results The blood vessels and correlated structures such as bones, tendons, and ligaments were examined using 3D CT in all directions, which was easier to view than angiography and dissected specimens. The arterial supply to the camel’s hind foot was the A. digitalis plantaris communis III. The angiography render volume 3D of CT explained the blood supply of the bones and joints of digital regions and showed a good visualization of the many digit arteries. The metatarsals, the phalanges, and the sesamoid bones were visualized. A. plantaris medialis superficialis, A. digitalis plantaris communis III, A. digitalis plantaris communis II and IV, A. interdigitalis, rami articularis medialis and lateralis to the fetlock joint, ramus medialis and ramus lateralis of the A. digitalis plantaris communis III, A. digitalis plantaris propriae III et IV abaxialis, A. digitalis plantaris propriae III et IV axialis, Ramus phalangis axialis and abaxialis of the first phalanx, Ramus phalangis axialis and abaxialis of the second and third phalanges, and A. metatarsae plantaris III were visualized. The study discovered new blood vessel sources in dromedary camels, such as the ramus articularis to the fetlock and the ramus plantaris phalangis abaxialis proximalis and distalis of the first phalanx. Conclusions The digital circulation angiography investigates the circulatory pattern of the camel hind digit, which can assist clinicians in diagnosing digit region affections. 3D CT explained improved visualization of bones and arteries, including many small branches in relation to surrounding structures, in some views better than others.

Abstract Background The success of digit replantation is mainly based on survival rates. The functional outcome as well as the recovery of sensibility are essential parameters for judging the outcome after digit replantation but have been poorly assessed in previous studies. Patients and methods Forty-eight patients with 56 complete traumatic digit amputations occurring between 2008 and 2013 returned for a follow-up examination, the earliest being 6 months postoperatively. Each patient’s range of motion, fingertip-to-table distance, fingertip-to-palm distance, grip and pinch strengths, static two-point discrimination (2-PD), and Semmes–Weinstein monofilament (SWM) test level were assessed in order to compare functional outcome and recovery of sensibility between successful replantation (n = 19) and primary or secondary amputation (n = 37). Subjective assessments of the pain level and function of the upper extremity were performed using the numerical rating scale and the DASH score, respectively. Results Replanted digits achieved 58% of the median total range of motion of the corresponding uninjured digits. Grip and pinch strength were not significantly different after thumb or finger replantation or amputation. Recovery of sensibility was excellent after replantation, with a median static 2-PD of 5 mm and a reduction of pressure sensibility of two levels of the SWM test compared to the contralateral side. After amputation, the median static 2-PD was also very good, with a median value of 6 mm and a reduction of pressure sensibility of only one level according to the SWM test. There was significantly less pain after replantation at rest (p = 0.012) and under strain (p = 0.012) compared to patients after amputation. No significant differences were observed in the DASH score between the two groups. Conclusion Comparable functional results and sensory recovery but significantly less pain at rest and under strain can be expected after digit replantation when compared to digit amputation. Level of evidence IV.

The sporting goods sector can serve as a proving ground for new technologies. We propose that climbing shoes are an excellent case study for showcasing a systematic approach to bio-inspired design. Foot adaptations to climbing have been described before in some animals and have even been incorporated into bio-inspired products. However, there has not yet been a systematic description of climbing adaptations in mammals, and especially in rock climbing species. We present a description of foot morphology in mammals and compare rock climbing species to those with other locomotion types. Our results show that rock climbing species in our sample had fewer digits and larger anterior pads than arboreal species. Rock climbing species often had hooves or, if they had foot pads, these were relatively smooth. These examples look a bit like current climbing shoe designs, perhaps suggesting convergent evolution. However, there was also variation, with rock climbing species having pads varying in shape, placement and texture. Much of this variation is likely to be dependent on the relatedness of species, with those that are more related having more similar feet. We suggest that incorporation of novel textures and compliant pads might be an interesting focus for future climbing shoe designs. [ABSTRACT FROM AUTHOR]

Humans and mice have the ability to regenerate the distal digit tip, the terminal phalanx (P3) in response to amputation. What distinguishes P3 regeneration from regenerative failure is formation of the blastema, a proliferative structure that undergoes morphogenesis to regenerate the amputated tissues. P3 regeneration is characterised by the phases of inflammation, tissue histolysis and expansive bone degradation with simultaneous blastema formation, wound closure and finally blastemal differentiation to restore the amputated structures. While each regenerating digit faithfully progresses through all phases of regeneration, phase progression has traditionally been delineated by time, that is, days postamputation (DPA), yet there is widespread variability in the timing of the individual phases. To diminish variability between digits during tissue histolysis and blastema formation, we have established an in‐vivo method using microcomputed tomography (micro CT) scanning to identify five distinct stages of the early regeneration response based on anatomical changes of the digit stump. We report that categorising the initial phases of digit regeneration by stage rather than time greatly diminishes the variability between digits with respect to changes in bone volume and length. Also, stages correlate with the levels of cell proliferation, osteoclast recruitment and osteoprogenitor cell recruitment. Importantly, micro CT staging provides a means to estimate open versus closed digit wounds. We demonstrate two spatially distinct and stage specific bone repair/regeneration responses that occur during P3 regeneration. Collectively, these studies showcase the utility of micro CT imaging to infer the composition of radiolucent soft tissues during P3 blastema formation. Specifically, the staging system identifies the onset of cell proliferation, osteoclastogenesis, osteoprogenitor recruitment, the spatial initiation of de novo bone formation and epidermal closure. [ABSTRACT FROM AUTHOR]

It has been recognized as early as the Victorian era that the apex of the distal phalanx has a distinct embryological development from the main shaft of the distal phalanx. Recent studies in regenerative medicine have placed an emphasis on the role of the apex of the distal phalanx in bone regrowth. Despite knowledge about the unique aspects of the distal phalanx, all phalanges are often treated as equivalent. Our morphological study reiterates and highlights the special anatomical and embryological properties of the apex of the distal phalanx, and names the apex "the bony cap" to distinguish it. We posit that the distal phalanx shaft is endochondral, while the bony cap is intramembranous and derived from the ectodermal wall. During development, the bony cap may be a separate structure that will fuse to the endochondral distal phalanx in the adult, as it ossifies well before the distal phalanges across taxa. Our study describes and revives the identity of the bony cap, and we identify it in three mammalian species: humans, cats, and horses (Homo sapiens, Felis catus domestica, and Equus caballus). During the embryonic period, we show the bony cap has a thimble-like shape that surrounds the proximal endochondral distal phalanx. The bony cap may thus play an inductive role in the differentiation of the corresponding nail, claw, or hoof (keratin structures) of the digit. When it is not present or develops erroneously, the corresponding keratin structures are affected, and regeneration is inhibited. By terming the bony cap, we hope to inspire more attention to its distinct identity and role in regeneration. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Ciências Veterinárias e Zoologia da Unipar is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Functional magnetic resonance imaging (fMRI) at Ultra-high field (UHF, ≥ 7 T) benefits from significant gains in the BOLD contrast-to-noise ratio (CNR) and temporal signal-to-noise ratio (tSNR) compared to conventional field strengths (3 T). Although these improvements enabled researchers to study the human brain to unprecedented spatial resolution, the blood pooling effect reduces the spatial specificity of the widely-used gradient-echo BOLD acquisitions. In this context, vascular space occupancy (VASO-CBV) imaging may be advantageous since it is proposed to have a higher spatial specificity than BOLD. We hypothesized that the assumed higher specificity of VASO-CBV imaging would translate to reduced overlap in fine-scale digit representation maps compared to BOLD-based digit maps. We used sub-millimeter resolution VASO fMRI at 7 T to map VASO-CBV and BOLD responses simultaneously in the motor and somatosensory cortices during individual finger movement tasks. We assessed the cortical overlap in different ways, first by calculating similarity coefficient metrics (DICE and Jaccard) and second by calculating selectivity measures. In addition, we demonstrate a consistent topographical organization of the targeted digit representations (thumb-index-little finger) in the motor areas. We show that the VASO-CBV responses yielded less overlap between the digit clusters than BOLD, and other selectivity measures were higher for VASO-CBV too. In summary, these results were consistent across metrics and participants, confirming the higher spatial specificity of VASO-CBV compared to BOLD. [ABSTRACT FROM AUTHOR]

We give a characterization for the integers $ n \geq 1 $ such that the Fibonomial coefficient $ {pn \choose n}_F $ is divisible by $ p $ for any prime $ p \neq 2, 5 $. Then we use it to calculate asymptotic formulas for the number of positive integers $ n \leq x $ such that $ p \mid {pn \choose n}_F $. This completes the study on this problem for all primes $ p $.

It has been recognized as early as the Victorian era that the apex of the distal phalanx has a distinct embryological development from the main shaft of the distal phalanx. Recent studies in regenerative medicine have placed an emphasis on the role of the apex of the distal phalanx in bone regrowth. Despite knowledge about the unique aspects of the distal phalanx, all phalanges are often treated as equivalent. Our morphological study reiterates and highlights the special anatomical and embryological properties of the apex of the distal phalanx, and names the apex “the bony cap” to distinguish it. We posit that the distal phalanx shaft is endochondral, while the bony cap is intramembranous and derived from the ectodermal wall. During development, the bony cap may be a separate structure that will fuse to the endochondral distal phalanx in the adult, as it ossifies well before the distal phalanges across taxa. Our study describes and revives the identity of the bony cap, and we identify it in three mammalian species: humans, cats, and horses (Homo sapiens, Felis catus domestica, and Equus caballus). During the embryonic period, we show the bony cap has a thimble-like shape that surrounds the proximal endochondral distal phalanx. The bony cap may thus play an inductive role in the differentiation of the corresponding nail, claw, or hoof (keratin structures) of the digit. When it is not present or develops erroneously, the corresponding keratin structures are affected, and regeneration is inhibited. By terming the bony cap, we hope to inspire more attention to its distinct identity and role in regeneration.

The Lesser Treeshrew, Tupaia minor Günther, 1876 , is a small mammal from Southeast Asia with four currently recognized subspecies: T. m. minor from Borneo; T. m. malaccana from the Malay Peninsula; T. m. humeralis from Sumatra; and T. m. sincepis from Singkep Island and Lingga Island. A fifth subspecies, T. m. caedis , was previously synonymized with T. m. minor ; it was thought to occur in northern Borneo and on the nearby islands of Banggi and Balambangan. These subspecies were originally differentiated based on pelage color, a plastic feature that has proven to be an unreliable indicator of taxonomic boundaries in treeshrews and other mammals. To explore infraspecific variation among T. minor populations across the Malay Peninsula, Borneo, Sumatra, and smaller islands, we conducted multivariate analyses of morphometric data collected from the hands and skulls of museum specimens. Principal component and discriminant function analyses reveal limited differentiation in manus and skull proportions among populations of T. minor from different islands. We find no morphometric support for the recognition of the four allopatric subspecies and no support for the recognition of T. m. caedis as a separate subspecies on Borneo. [ABSTRACT FROM AUTHOR]

Background: Finger amputations are the most commonly encountered amputation injury in the upper extremities. It is important to avoid shortening and to preserve the length of the finger in fingertip amputations in order not to lose the functions of the hand. The aim of this study was to evaluate the results of our patients who underwent reconstruction using V-Y pulp flap and artificial nail in order to avoid donor site morbidity in fingertip defects. Methods: The results of patients who underwent reparation with V-Y flap and polyethylene nails for exposed distal phalanx and partial nail bed defect after fingertip amputation were evaluated in this retrospective study. The data of 44 patients who underwent 44 V-Y advancement flap between January 2016 and January 2021 were retrospectively analysed. Results: A total of 44 patients, 5 females and 39 males, who were treated for fingertip amputation, with a mean follow-up period of 24.2 months (14-71) and a mean age of 34.75 (2-68) were included in the study. The mechanism of injury was guillotine-style, avulsion and crush injuries in 15 (34.1%), 11 (25%) and 18 (40.9%) patients, respectively. Among the patients, 25 (56.8%) had right hand injuries, while 19 (43.2%) had left hand injuries. The dominant hand was affected in 28 (63.6%) patients. In 5 patients, the distal phalanx was shortened to the level of the lost nail bed (shortening was maximum 5 mm). Nail formation had occurred in all patients and deformed nail structure was seen in 18 patients. Graft necrosis was seen in 2 patients. Conclusion: It is difficult for surgeons to decide on the treatment method because of the fact that there are multiple surgical techniques in the literature and the results are reported differently. Success rates are high in our technique. Each technique has its own advantages and disadvantages. [ABSTRACT FROM AUTHOR]

We report a case of systemic metastasis of malignant melanoma in a mini-Rex (Oryctolagus cuniculus). The animal presented with lameness of the right hind limb, swelling of popliteal lymph node, and a black mass on the first digit. Paralysis of hindlimbs and forelimbs, dysuria, and dysphagia progressed over time, and the rabbit died on day 35 from the first visit. At necropsy, many black lesions were observed in multiple organs including the marrow of most bones. Histopathologically, the tumor cells had highly atypical nuclei of various sizes and an abundant eosinophilic cytoplasm, and some cells contained melanin granules. These cells were positive for PNL2 and S-100, melanoma markers, by immunohistochemistry. This is the first report of malignant melanoma in a mini-Rex with severe malignancy and systemic metastasis including the bone marrow. [ABSTRACT FROM AUTHOR]

Subungual keratoacanthoma (SK) is a digital neoplasm that has rarely been reported in dogs and carries an excellent prognosis following surgical removal. Radiographic features of canine SK have only been briefly discussed in two prior case reports. Both articles described extensive distal phalangeal osteolysis, a feature more commonly associated with malignant digital neoplasms (e.g., subungual squamous cell carcinoma (SCC) or melanoma). This retrospective case series aimed to further characterize radiographic findings of histologically confirmed canine SK. Seven dogs met the inclusion criteria, with a total of seven affected digits. All seven digits (100%) had osteolysis of the distal phalanx's ungual process and crest, as well as regional soft tissue swelling. Osteolysis of the ungual process was severe in all cases, with complete destruction in six of seven digits (86%). Partial ungual crest geographic and expansile osteolysis was noted in four of seven digits (57%), while two digits (28%) had complete ungual crest destruction. Seven of seven digits (100%) had a radiographically thickened claw, and two of seven digits (28%) had associated lysis of the distal aspect of the middle phalanx. Based on these findings, an osteolytic subungual mass should not be considered pathognomonic for malignant neoplasia. Observing the imaging features previously described should prompt veterinarians to consider SK as a differential diagnosis. [ABSTRACT FROM AUTHOR]

There have been dwindling numbers of replantations in the United States. Despite the advocacy for centralization in hand trauma, the fundamental landscape and attitudes of surgeons toward replantation have remained lackluster. There is growing and substantial evidence to demonstrate the superior outcomes of replantation in comparison to revision amputation in most scenarios. This article aims to delve into the factors contributing to the decreasing numbers of replantations and proposes strategies to overcome this issue., Competing Interests: Disclosure The authors of this article declare that they have no financial interests or conflicts that could influence the views or conclusions presented in this article. No external funding or financial support was received for this study. The authors have no affiliations with organizations or entities that may have a direct or indirect interest in the subject matter discussed in this article. This work has not been previously published or submitted for publication elsewhere., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Gout is a chronic metabolic disorder secondary to hyperuricemia and is typically characterized initially by monoarticular arthritis starting at the distal extremities and may progress to tophaceous gout after several years of acute attacks of painful inflammatory arthropathy. Case presentation: We present a case of erosive polyarticular tophaceous gout with an atypical presentation of painless masses of both hands and severe osteolysis without periarticular osteopenia on radiographs. Laboratory examinations were requested, and the diagnosis was confirmed with a biopsy. She was started with pharmacologic therapy but due to the severity of the joint destruction and deformities, surgical debridement and arthrodesis was done for the distal interphalangeal joints of the right middle and ring finger, along with the metacarpophalangeal joint of the right thumb. Non-union and implant failure of the metacarpophalangeal arthrodesis occurred but there was noted improvement of her hand function. Conclusion: This case should be differentiated from multicentric reticular histiocytosis, rheumatoid arthritis, and psoriatic arthritis. Surgical treatment, such as joint fusion, may be effective in some cases of gouty nodules.

Background: The 3D computed tomography produces detailed images of the digit bones in addition to the angiograph render volume 3D of the CT shows the relation between the arteries, bones, and tissues of the digit. Therefore, the present study used those imaging techniques to provide a complete description of the digit bones and arteries' origin, distribution, and course and their relations with surrounding structures in the Dromedary Camel. Which would serve as a guide for surgeons and students in distinguishing normal digit structures. The study used eight hind limbs of four adult camels of both sexes (two males and two females), aged 9–15 years (Mean ± SD, 11.80 ± 2.59 years). The samples were injected with latex with lead oxide were undergone 3D render volume CT (128-slice multi-detector CT scanning protocol) and angiography x-rays. Results: The blood vessels and correlated structures such as bones, tendons, and ligaments were examined using 3D CT in all directions, which was easier to view than angiography and dissected specimens. The arterial supply to the camel's hind foot was the A. digitalis plantaris communis III. The angiography render volume 3D of CT explained the blood supply of the bones and joints of digital regions and showed a good visualization of the many digit arteries. The metatarsals, the phalanges, and the sesamoid bones were visualized. A. plantaris medialis superficialis, A. digitalis plantaris communis III, A. digitalis plantaris communis II and IV, A. interdigitalis, rami articularis medialis and lateralis to the fetlock joint, ramus medialis and ramus lateralis of the A. digitalis plantaris communis III, A. digitalis plantaris propriae III et IV abaxialis, A. digitalis plantaris propriae III et IV axialis, Ramus phalangis axialis and abaxialis of the first phalanx, Ramus phalangis axialis and abaxialis of the second and third phalanges, and A. metatarsae plantaris III were visualized. The study discovered new blood vessel sources in dromedary camels, such as the ramus articularis to the fetlock and the ramus plantaris phalangis abaxialis proximalis and distalis of the first phalanx. Conclusions: The digital circulation angiography investigates the circulatory pattern of the camel hind digit, which can assist clinicians in diagnosing digit region affections. 3D CT explained improved visualization of bones and arteries, including many small branches in relation to surrounding structures, in some views better than others. [ABSTRACT FROM AUTHOR]

Observations of the osteological features of malformations in lizards are currently limited. In examinations of ca. 1,300 Scincella specimens, one Scincella lateralis specimen and three S. boettgeri specimens were observed to have malformed digits, i.e., ectrodactyly. Each of these specimens had a malformation in only one limb. One S. lateralis specimen lacked digits I–III of manus, and three S. boettgeri specimens lacked digits I, II, or I and II of pedes. Micro-computed tomography scanning revealed that the phalanges and metacarpals of digits I–III were absent in the malformed S. lateralis specimen, whereas the malformed S. boettgeri specimens lacked all phalanges for externally absent toes but had five metatarsals, despite these being shorter in the absent toes than those in normal toes. Although malformed limbs have been reported previously in lizards, this is the first report based on osteological descriptions. Some genera of Scincidae include species that have undergone phylogenetic reduction of their digits. In such species, the developmental order of the phalanges and metacarpals/metatarsals is well-known from embryological studies. With reference to this developmental mechanism, we also discuss the assumed development of the malformed specimens observed in this study. [ABSTRACT FROM AUTHOR]

Background: The success of digit replantation is mainly based on survival rates. The functional outcome as well as the recovery of sensibility are essential parameters for judging the outcome after digit replantation but have been poorly assessed in previous studies.Patients and Methods: Forty-eight patients with 56 complete traumatic digit amputations occurring between 2008 and 2013 returned for a follow-up examination, the earliest being 6 months postoperatively. Each patient's range of motion, fingertip-to-table distance, fingertip-to-palm distance, grip and pinch strengths, static two-point discrimination (2-PD), and Semmes-Weinstein monofilament (SWM) test level were assessed in order to compare functional outcome and recovery of sensibility between successful replantation (n = 19) and primary or secondary amputation (n = 37). Subjective assessments of the pain level and function of the upper extremity were performed using the numerical rating scale and the DASH score, respectively.Results: Replanted digits achieved 58% of the median total range of motion of the corresponding uninjured digits. Grip and pinch strength were not significantly different after thumb or finger replantation or amputation. Recovery of sensibility was excellent after replantation, with a median static 2-PD of 5 mm and a reduction of pressure sensibility of two levels of the SWM test compared to the contralateral side. After amputation, the median static 2-PD was also very good, with a median value of 6 mm and a reduction of pressure sensibility of only one level according to the SWM test. There was significantly less pain after replantation at rest (p = 0.012) and under strain (p = 0.012) compared to patients after amputation. No significant differences were observed in the DASH score between the two groups.Conclusion: Comparable functional results and sensory recovery but significantly less pain at rest and under strain can be expected after digit replantation when compared to digit amputation.Level Of Evidence: IV. [ABSTRACT FROM AUTHOR]

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Grading, immunohistochemistry and c-kit mutation status are criteria for assessing the prognosis and therapeutic options of canine cutaneous mast cell tumours (MCTs). As a subset, canine digital MCTs have rarely been explored in this context. Therefore, in this retrospective study, 68 paraffin-embedded canine digital MCTs were analysed, and histological grading was assessed according to Patnaik and Kiupel. The immunohistochemical markers KIT and Ki67 were used, as well as polymerase chain reaction (PCR) for mutational screening in c-kit exons 8, 9, 11 and 14. Patnaik grading resulted in 22.1% grade I, 67.6% grade II and 10.3% grade III tumours. Some 86.8% of the digital MCTs were Kiupel low-grade. Aberrant KIT staining patterns II and III were found in 58.8%, and a count of more than 23 Ki67-positive cells in 52.3% of the cases. Both parameters were significantly associated with an internal tandem duplication (ITD) in c-kit exon 11 (12.7%). French Bulldogs, which tend to form well-differentiated cutaneous MCTs, had a higher proportion of digital high-grade MCTs and ITD in c-kit exon 11 compared with mongrels. Due to its retrospective nature, this study did not allow for an analysis of survival data. Nevertheless, it may contribute to the targeted characterisation of digital MCTs.

It is long-established that innervation-dependent production of neurotrophic factors is required for blastema formation and epimorphic regeneration of appendages in fish and amphibians. The regenerating mouse digit tip and the human fingertip are mammalian models for epimorphic regeneration, and limb denervation in mice inhibits this response. A complicating issue of limb denervation studies in terrestrial vertebrates is that the experimental models also cause severe paralysis therefore impairing appendage use and diminishing mechanical loading of the denervated tissues. Thus, it is unclear whether the limb denervation impairs regeneration via loss of neurotrophic signaling or loss of mechanical load, or both. Herein, we developed a novel surgical procedure in which individual digits were specifically denervated without impairing ambulation and mechanical loading. We demonstrate that digit specific denervation does not inhibit but attenuates digit tip regeneration, in part due to a delay in wound healing. However, treating denervated digits with a wound dressing that enhances closure results in a partial rescue of the regeneration response. Contrary to the current understanding of mammalian epimorphic regeneration, these studies demonstrate that mouse digit tip regeneration is not peripheral nerve dependent, an observation that should inform continued mammalian regenerative medicine approaches. [Display omitted] • Denervation delays, but does not inhibit, digit tip regeneration. • Wound healing is delayed by denervation. • Blastema formation and proliferation are not disturbed by denervation. • Dermabond treatment partially rescues regeneration after denervation. [ABSTRACT FROM AUTHOR]

Background: The anatomic location of primary melanoma is significantly associated with outcome. Objective: To evaluate the prognostic factors and survival outcomes associated with melanomas on hand and foot digits. Methods: The data of 106 patients with digit melanomas were analyzed retrospectively. Results: Median age of patients was 55 years, and male‐to‐female ratio was one. Majority of the patients had skin melanomas (74.5%); and 25.5% of them had ungual melanomas. The lesions slightly more frequently affected toes (53.8%) and thumbs (55.9%); and 57.4% of the lesions were right‐sided. Acral lentiginous melanoma was the major histological subtype (67.5%). Digit melanomas were associated with aggressive histological features, such as high Clark level (75%), thick Breslow depth (72.3%), presence of ulceration (74.3%), and high mitotic rate (58.3%). At admission, the rates of stage I‐II, stage III, and stage IV diseases were 57.6%, 33%, and 9.4%, respectively. The recurrence and mortality rates were 41.7% and 46.2%, respectively. The 5‐year RFS and OS rates were similar: 47%. Melanoma origins (skin vs. ungual), locations (finger vs. toe; first digit vs. others; and right vs. left), and histological subtypes (acral lentiginous melanoma vs. others) had no impact on survivals. The known poor prognostic histological factors, such as Clark level, Breslow thickness, mitotic rate, ulceration, and neurotropism, were found to be associated with both RFS and OS. Conclusion: Digit melanomas are associated with poor clinicopathological prognostic features, and they might predict unfavorable survivals. [ABSTRACT FROM AUTHOR]

The combinatorial expression of Hox genes along the body axes is a major determinant of cell fate and plays a pivotal role in generating the animal body plan. Loss of HOXA13 and HOXD13 transcription factors (HOX13) leads to digit agenesis in mice, but how HOX13 proteins regulate transcriptional outcomes and confer identity to the distal-most limb cells has remained elusive. Here, we report on the genome-wide profiling of HOXA13 and HOXD13 in vivo binding and changes of the transcriptome and chromatin state in the transition from the early to the late-distal limb developmental program, as well as in Hoxa13-/-; Hoxd13-/- limbs. Our results show that proper termination of the early limb transcriptional program and activation of the late-distal limb program are coordinated by the dual action of HOX13 on cis-regulatory modules.

Amputation of the mouse digit tip results in blastema‐mediated regeneration. In this model, new bone regenerates de novo to lengthen the amputated stump bone, resulting in a functional replacement of the terminal phalangeal element along with associated non‐skeletal tissues. Physiological examples of bone repair, such as distraction osteogenesis and fracture repair, are well known to require mechanical loading. However, the role of mechanical loading during mammalian digit tip regeneration is unknown. In this study, we demonstrate that reducing mechanical loading inhibits blastema formation by attenuating bone resorption and wound closure, resulting in the complete inhibition of digit regeneration. Mechanical unloading effects on wound healing and regeneration are completely reversible when mechanical loading is restored. Mechanical unloading after blastema formation results in a reduced rate of de novo bone formation, demonstrating mechanical load dependence of the bone regenerative response. Moreover, enhancing the wound‐healing response of mechanically unloaded digits with the cyanoacrylate tissue adhesive Dermabond improves wound closure and partially rescues digit tip regeneration. Taken together, these results demonstrate that mammalian digit tip regeneration is mechanical load‐dependent. Given that human fingertip regeneration shares many characteristics with the mouse digit tip, these results identify mechanical load as a previously unappreciated requirement for de novo bone regeneration in humans. © 2021 American Society for Bone and Mineral Research (ASBMR). [ABSTRACT FROM AUTHOR]

Amputation injuries in mammals are typically non-regenerative; however, joint regeneration is stimulated by BMP9 treatment, indicating the presence of latent articular chondrocyte progenitor cells. BMP9 induces a battery of chondrogenic genes in vivo, and a similar response is observed in cultures of amputation wound cells. Extended cultures of BMP9-treated cells results in differentiation of hyaline cartilage, and single cell RNAseq analysis identified wound fibroblasts as BMP9 responsive. This culture model was used to identify a BMP9-responsive adult fibroblast cell line and a culture strategy was developed to engineer hyaline cartilage for engraftment into an acutely damaged joint. Transplanted hyaline cartilage survived engraftment and maintained a hyaline cartilage phenotype, but did not form mature articular cartilage. In addition, individual hypertrophic chondrocytes were identified in some samples, indicating that the acute joint injury site can promote osteogenic progression of engrafted hyaline cartilage. The findings identify fibroblasts as a cell source for engineering articular cartilage and establish a novel experimental strategy that bridges the gap between regeneration biology and regenerative medicine. [ABSTRACT FROM AUTHOR]

Abstract Background Intraosseous epidermoid cyst (IEC) is a rare, non-neoplastic, pathology in animals and humans that most commonly affects the distal phalanx. In dogs, it is important to differentiate this lesion from malignant digital tumours causing bone lysis. In previous reports, IEC has been described to affect only a single digit at the time of diagnosis which is usually based on histopathology. This is the first case report to describe immunohistochemically confirmed IECs affecting simultaneously multiple digits. Case presentation A 4-and-a-half-year-old female spayed Great Dane was presented with a 2-month history of progressive swelling of the distal phalanx (PIII) of digits IV and V of the right pelvic limb. Eleven weeks prior to presentation, the dog had a low-grade cutaneous mast cell tumour completely excised from the craniolateral base of its left pinna. A history of trauma to 1 of the nails of the same pes 4 years prior to referral was also reported. Examination of the right pelvic limb identified firm non-painful swelling of PIII of digits IV and V, with concurrent deformation of the nails. Radiographs of the right pes obtained by the primary veterinarian identified an expansile lesion of PIII of digits IV and V. Computed tomography identified large expansile lesions of PIII of digits IV and V, with associated cortical thinning and soft tissue swelling. Neoplasia was considered the most likely radiographic diagnosis. Histopathology of Jamshidi bone biopsies was consistent with intraosseous epidermoid cyst, which was confirmed with immunohistochemistry. Amputation of PIII of digits IV and V at the level of mid-PII was performed as definitive treatment. No recurrence of the lesion occurred during the 10-month follow-up period. Conclusions Intraosseous epidermoid cysts should be included in the differential diagnosis for expansile lesions affecting the canine digit. It is important to differentiate them from other digital lesions, with bone involvement, such as malignant digital tumours, which often require more extensive surgery for definitive treatment. The case herein highlights that this lesion can affect simultaneously multiple digits. Definitive diagnosis can be achieved by identification of keratin-producing epithelial cells on histopathology and confirmed by pancytokeratin labelling.