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Sample records for blood pressure-lowering limb

  1. Timing of blood pressure lowering in acute ischemic stroke.

    Science.gov (United States)

    Carcel, Cheryl; Anderson, Craig S

    2015-08-01

    Whether there are any benefits without harm from early lowering of blood pressure (BP) in the setting of acute ischemic stroke (AIS) has been a longstanding controversy in medicine. Whilst most studies have consistently shown associations between elevated BP, particularly systolic BP, and poor outcome, some also report that very low BP (systolic <130 mmHg) and large reductions in systolic BP are associated with poor outcomes in AIS. However, despite these associations, the observed U- or J-shaped relationship between BP and outcome in these patients may not be causally related. Patients with more severe strokes may have a more prominent autonomic response and later lower BP as their condition worsens, often pre-terminally. Fortunately, substantial progress has been made in recent years with new evidence arising from well-conducted randomized trials. This review outlines new evidence and recommendations for clinical practice over BP management in AIS. PMID:26041479

  2. Blood Pressure-Lowering Mechanisms of the DASH Dietary Pattern

    Directory of Open Access Journals (Sweden)

    Pao-Hwa Lin

    2012-01-01

    Full Text Available Potential blood pressure- (BP- lowering mechanisms of the DASH dietary pattern were measured in 20 unmedicated hypertensive adults in a controlled feeding study. At screening, participants averaged 44.3±7.8 years, BMI 33.9±6.6 Kg/m2, and BP 144.2±9.38/88.5±6.03 mmHg. All consumed a control diet for one week, then were randomized to control or DASH for another two weeks (week one and two. With DASH, but not controls, SBP fell by 10.65±12.89 (=0.023 and 9.60±11.23 (=0.039 mmHg and DBP by 5.95±8.01 (=0.069 and 8.60±9.13 mmHg (=0.011 at the end of week one and two, respectively. Univariate regressions showed that changes in urinary sodium/potassium ratio (=1.99 and plasma renin activity (=−15.78 and percent change in plasma nitrite after hyperemia were associated with SBP changes at week one (all <0.05. Plasma nitrite following hyperemia showed a treatment effect (=0.014 and increased at week two (=0.001. Pulse wave velocity decreased over time with DASH (trend =0.019, and reached significance at week two (=0.026. This response may be mediated by an improvement in upregulation of nitric oxide bioavailability. Early natriuresis and reductions in oxidative stress cannot be ruled out. Future studies are needed to verify these findings, assess the possibility of earlier effects, and examine other potential mediators.

  3. Potential synergy between lipid-lowering and blood-pressure-lowering in the Anglo-Scandinavian Cardiac Outcomes Trial

    DEFF Research Database (Denmark)

    Sever, Peter; Dahlöf, Björn; Poulter, Neil; Wedel, Hans; Beevers, Gareth; Caulfield, Mark; Collins, Rory; Kjeldsen, Sverre; Kristinsson, Arni; McInnes, Gordon; Mehlsen, Jesper; Nieminem, Markku; O'Brien, Eoin; Ostergren, Jan

    2006-01-01

    A prespecified objective of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) was to assess whether any synergistic effects were apparent between the lipid-lowering and blood-pressure-lowering regimens in preventing cardiovascular events.......A prespecified objective of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) was to assess whether any synergistic effects were apparent between the lipid-lowering and blood-pressure-lowering regimens in preventing cardiovascular events....

  4. Blood Pressure Lowering Effect of Adenanthera pavonina Seed Extract on Normotensive Rats

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    Janet M. Makinde

    2009-03-01

    Full Text Available The effect of Adenanthera pavonina (AP seed extract on the blood pressure of normotensive rats wasevaluated. Twelve adult male Wistar rats divided into 3 groups of 4 animals each were used and were treatedorally with normal saline (control group, propanolol (positive control, and was given at 1mg/kg and 200mg/kgof AP seed extract over a 4- week period. Condon manometer was used to measure the mean arterial bloodpressure. The mean arterial blood pressure of the normal saline treated animal was 60mmHg, those of propanololtreated animals was 23mmHg while the 200mg/kg extract treated group was 30mmHg. Phytochemical screeningshowed that the extract contained cardiac glycosides, tannins, saponins, alkaloids and flavonoids. Cyanogeneticglycosides and anthraquinones were absent. The sodium level for the 200mg/kg group was significantly lowerthan that of control group. The total bilirubin, total protein and the globulin fraction were significantly higher inthe extract treated groups compared to the control group. Histopathological examination showed that the extractdid not cause any significant lesion changes in the liver, kidney and even the testes. The study showed thatAdenanthera pavonina seed extract have the potential to cause a blood pressure lowering effect. The serumbiochemistry changes may suggest that the extract has a tonic effect on the kidneys and the liver and theseorgans play central role in drug metabolism. Absence of significant lesion in the kidney, liver and testes mayindicate that the plant is safe for medicinal use.

  5. Blood pressure lowering effect of a pea protein hydrolysate in hypertensive rats and humans.

    Science.gov (United States)

    Li, Huan; Prairie, Natalie; Udenigwe, Chibuike C; Adebiyi, Abayomi P; Tappia, Paramjit S; Aukema, Harold M; Jones, Peter J H; Aluko, Rotimi E

    2011-09-28

    The blood pressure lowering effect of a pea protein hydrolysate (PPH) that contained isolated by membrane ultrafiltration from the thermolysin digest of pea protein isolate (PPI), was examined using different rat models of hypertension as well as hypertensive human subjects. The PPH showed weak in vitro activities against renin and angiotensin converting enzyme (ACE) with inhibitory activities of 17 and 19%, respectively, at 1 mg/mL test concentration. Oral administration of the PPH to spontaneously hypertensive rats (SHR) at doses of 100 and 200 mg/kg body weight led to a lowering of hourly systolic blood pressure (SBP), with a maximum reduction of 19 mmHg at 4 h. In contrast, orally administered unhydrolyzed PPI had no blood pressure reducing effect in SHR, suggesting that thermolysin hydrolysis may have been responsible for releasing bioactive peptides from the native protein. Oral administration of the PPH to the Han:SPRD-cy rat (a model of chronic kidney disease) over an 8-week period led to 29 and 25 mmHg reductions in SBP and diastolic blood pressure, respectively. The PPH-fed rats had lower plasma levels of angiotensin II, the major vasopressor involved in development of hypertension, but there was no effect on plasma activity or renal mRNA levels of ACE. However, renal expression of renin mRNA levels was reduced by approximately 50% in the PPH-fed rats, suggesting that reduced renin may be responsible for the reduced levels of angiotensin II. In a 3-week randomized double blind placebo-controlled crossover human intervention trial (7 volunteers), significant (p<0.05) reductions (over placebo) in SBP of 5 and 6 mmHg were obtained in the second and third weeks, respectively, for the PPH group. Therefore, thermolysin derived bioactive peptides from PPH reduced blood pressure in hypertensive rats and human subjects, likely via effects on the renal angiotensin system. PMID:21854068

  6. The blood pressure-lowering effect and safety of chlorogenic acid from green coffee bean extract in essential hypertension.

    Science.gov (United States)

    Watanabe, Takuya; Arai, Yoichi; Mitsui, Yuki; Kusaura, Tatsuya; Okawa, Wataru; Kajihara, Yasushi; Saito, Ikuo

    2006-07-01

    Chlorogenic acids (CGA) in green coffee bean extract (GCE) reduce blood pressure in spontaneously hypertensive rats and humans. The authors examined the blood pressure-lowering effect and safety of CGA in patients with mild hypertension through a placebo-controlled, randomized clinical trial. Subjects (n = 28) were randomized to receive treatment with CGA (140 mg/day) from GCE or placebo. Blood pressure, pulse rate, body mass index, routine blood test, hematochemistry, urinalysis, and subjective symptoms were recorded throughout the study. In the CGA group, but not the placebo group, blood pressure (systolic and diastolic) decreased significantly during the ingestion period. There was no difference in body mass index and pulse rate between groups, nor were there any apparent side effects. Thus, CGA from GCE is effective in decreasing blood pressure and safe for patients with mild hypertension. PMID:16820341

  7. Blood pressure lowering, fibrinolysis enhancing and antioxidant activities of cardamom (Elettaria cardamomum).

    Science.gov (United States)

    Verma, S K; Jain, Vartika; Katewa, S S

    2009-12-01

    Elettaria cardamomum (L.) Maton. (Small cardamom) fruit powder was evaluated for its antihypertensive potential and its effect on some of the cardiovascular risk factors in individuals with stage 1 hypertension. Twenty, newly diagnosed individuals with primary hypertension of stage 1 were administered 3 g of cardamom powder in two divided doses for 12 weeks. Blood pressure was recorded initially and at 4 weeks interval for 3 months. Blood samples were also collected initially and at 4 weeks interval for estimation of lipid profile, fibrinogen and fibrinolysis. Total antioxidant status, however, was assessed initially and at the end of the study. Administration of 3 g cardamom powder significantly (pcardamom effectively reduces blood pressure, enhances fibrinolysis and improves antioxidant status, without significantly altering blood lipids and fibrinogen levels in stage 1 hypertensive individuals. PMID:20361714

  8. Comparative review of the blood pressure-lowering and cardiovascular benefits of telmisartan and perindopril

    Directory of Open Access Journals (Sweden)

    Wang JG

    2014-04-01

    Full Text Available Ji-Guang Wang,1 Eduardo Pimenta,2 Frank Chwallek3 1Centre for Epidemiological Studies and Clinical Trials, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 2Boehringer Ingelheim, Sydney, NSW, Australia; 3Boehringer Ingelheim Pharma, Biberach an der Riss, Germany Abstract: Hypertension is a major cardiovascular (CV risk factor, and blood pressure (BP-lowering treatment substantially reduces the risk. This review compares the available clinical evidence from the BP-lowering and CV-outcome studies of telmisartan and perindopril, which are among the most intensively studied members of their respective classes. The PubMed database was searched for telmisartan and perindopril publications meeting the following criteria: 1 head-to-head comparison trials for BP lowering; and 2 CV-outcome studies (ie, ones with a CV event, mortality, or hospitalization outcome in patients with CV risk factors but without heart failure. In comparative trials, telmisartan treatment resulted in significantly higher reduction in trough BP and mean ambulatory diastolic BP for the last 8 hours of the dosing interval compared with perindopril. In mainly placebo-controlled CV-outcome studies in patients with hypertension, CV benefits with perindopril were associated with large reductions in BP. There were no CV outcome studies with telmisartan in patients with hypertension. The beyond-BP-lowering CV-protective benefits of telmisartan were demonstrated in the active-controlled ONTARGET (ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial trial, which included patients with controlled BP at baseline. In general, the trials discussed in this review reinforce the fact that perindopril and telmisartan are two long-acting antihypertensive drugs that reduce BP over 24 hours, and are the best-evidenced drugs in their class with proven CV protection. It is also clear

  9. Blood pressure-lowering peptides from neo-fermented buckwheat sprouts: a new approach to estimating ACE-inhibitory activity.

    Directory of Open Access Journals (Sweden)

    Masahiro Koyama

    Full Text Available Neo-fermented buckwheat sprouts (neo-FBS contain angiotensin-converting enzyme (ACE inhibitors and vasodilators with blood pressure-lowering (BPL properties in spontaneously hypertensive rats (SHRs. In this study, we investigated antihypertensive mechanisms of six BPL peptides isolated from neo-FBS (FBPs by a vasorelaxation assay and conventional in vitro, in vivo, and a new ex vivo ACE inhibitory assays. Some FBPs demonstrated moderate endothelium-dependent vasorelaxation in SHR thoracic aorta and all FBPs mildly inhibited ACE in vitro. Orally administered FBPs strongly inhibited ACE in SHR tissues. To investigate detailed ACE-inhibitory mechanism of FBPs in living body tissues, we performed the ex vivo assay by using endothelium-denuded thoracic aorta rings isolated from SHRs, which demonstrated that FBPs at low concentration effectively inhibited ACE in thoracic aorta tissue and suppressed angiotensin II-mediated vasoconstriction directly associated with BPL. These results indicate that the main BPL mechanism of FBP was ACE inhibition in living body tissues, suggesting that high FBP's bioavailability including absorption, tissue affinity, and tissue accumulation was responsible for the superior ACE inhibition in vivo. We propose that our ex vivo assay is an efficient and reliable method for evaluating ACE-inhibitory mechanism responsible for BPL activity in vivo.

  10. Blood Pressure Lowering Medication, Visit-to-Visit Blood Pressure Variability, and Cognitive Function in Old Age

    DEFF Research Database (Denmark)

    Wijsman, Liselotte W; de Craen, Anton J M; Muller, Majon; Sabayan, Behnam; Stott, David; Ford, Ian; Trompet, Stella; Jukema, J Wouter; Westendorp, Rudi G J; Mooijaart, Simon P

    2015-01-01

    BACKGROUND: Visit-to-visit blood pressure (BP) variability is associated with cognitive impairment. We assessed to what extent the association between BP variability and cognitive impairment is mediated by the association of BP lowering medication (BPLM) with both BP variability and cognition. ME...

  11. Risks of cardiovascular events and effects of routine blood pressure lowering among patients with type 2 diabetes and atrial fibrillation: results of the ADVANCE study.

    NARCIS (Netherlands)

    Du, X.; Ninomiya, T.; Galan, B.E. de; Abadir, E.; Chalmers, J.; Pillai, A.; Woodward, M.; Cooper, M.; Harrap, S.; Hamet, P.; Poulter, N.; Lip, G.Y.; Patel, A.

    2009-01-01

    AIMS: The aim of this study was to investigate serious clinical outcomes associated with atrial fibrillation (AF) and the effects of routine blood pressure lowering on such outcomes in the presence or absence of AF, among individuals with type 2 diabetes. METHODS AND RESULTS: About 11 140 patients w

  12. The effects of blood pressure reduction and of different blood pressure-lowering regimens on major cardiovascular events according to baseline blood pressure : meta-analysis of randomized trials

    NARCIS (Netherlands)

    Czernichow, Sebastien; Zanchetti, Alberto; Turnbull, Fiona; Barzi, Federica; Ninomiya, Toshiaru; Kengne, Andre-Pascal; Lambers Heerspink, Hiddo J.; Perkovic, Vlado; Huxley, Rachel; Arima, Hisatomi; Patel, Anushka; Chalmers, John; Woodward, Mark; MacMahon, Stephen; Neal, Bruce

    2011-01-01

    Background The benefits of reducing blood pressure are well established, but there remains uncertainty about whether the magnitude of the effect varies with the initial blood pressure level. The objective was to compare the risk reductions achieved by different blood pressure-lowering regimens among

  13. Pharmacological interventions into the renin-angiotensin system with ACE inhibitors and angiotensin II receptor antagonists: effects beyond blood pressure lowering.

    Science.gov (United States)

    Düsing, Rainer

    2016-06-01

    Hypertension is recognized as an important risk factor for cardiovascular morbidity and mortality. Lowering of blood pressure has been shown to minimize the risk of cardiovascular events, with the majority of antihypertensives demonstrating a similar ability to reduce coronary events and stroke for a given reduction in blood pressure. Agents that modify the activity of the renin-angiotensin system (RAS) have been proposed to exhibit additional effects that might go beyond simple blood pressure lowering. The RAS is a crucial system that regulates extracellular fluid volume and blood pressure. Proposed potential benefits of RAS blockade that go beyond blood pressure lowering include a reduction in platelet aggregation and thrombosis, blunting of cardiac and vascular remodeling, favorable metabolic effects and reno- and cerebro-protection. However, factors such as treatment adherence, duration of action of antihypertensive agents and differences in effects on central versus brachial blood pressure may also result in apparent differences in efficacy of different antihypertensives. The aim of this review article is to examine the available data from clinical studies of antihypertensive drugs for evidence of effects that might legitimately be claimed to go beyond simple blood pressure lowering. PMID:27122491

  14. Blood pressure-lowering effects of beetroot juice and novel beetroot-enriched bread products in normotensive male subjects

    OpenAIRE

    Hobbs, Ditte; Kaffa, Nedi; George, Trevor; Methven, Lisa; Lovegrove, Julie

    2012-01-01

    A number of vegetables have a high nitrate content which after ingestion can be reduced to nitrite by oral bacteria, and further to vasoprotectiveNO endogenously. In the present study, two separate randomly controlled, single-blind, cross-over, postprandial studies wereperformed in normotensive volunteers. Ambulatory blood pressure (BP) was measured over a 24 h period following consumption of eitherfour doses of beetroot juice (BJ), 0, 100, 250 and 500 g (n 18), or three bread products, contr...

  15. Reduced transcapillary escape of albumin during acute blood pressure-lowering in type 1 (insulin-dependent) diabetic patients with nephropathy

    DEFF Research Database (Denmark)

    Parving, H H; Kastrup, J; Smidt, U M

    1985-01-01

    The effect of acute arterial blood pressure lowering upon albumin extravasation was studied in 10 patients with nephropathy and retinopathy due to long-standing Type 1 (insulin-dependent) diabetes. The following variables were measured: transcapillary escape rate of albumin (initial disappearance...... injection induced the following changes: arterial blood pressure decreased from 134/87 to 107/73 mmHg (p less than 0.01), transcapillary escape rate of albumin declined from 8.1 to 6.7% of the intravascular mass of albumin/h (p less than 0.01), albuminuria diminished from 1434 to 815 micrograms/min (p less...... than 0.01), and plasma volume raised slightly from 2916 to 2995 ml (p less than 0.05). Our findings demonstrate that the enhanced albumin passage through the wall of the microvasculature characteristically found in long-term Type 1 diabetic patients with clinical microangiopathy is pressure...

  16. The Anglo-Scandinavian Cardiac Outcomes Trial: blood pressure-lowering limb: effects in patients with type II diabetes

    DEFF Research Database (Denmark)

    Ostergren, Jan; Poulter, Neil R; Sever, Peter S;

    2008-01-01

    . METHODS: Patients had either untreated hypertension or treated hypertension. For those with type II diabetes mellitus, inclusion criteria required at least two additional risk factors. Patients were randomized to amlodipine with addition of perindopril as required (amlodipine-based) or atenolol...

  17. Angiotensin Ⅱ receptor blocker provides pancreatic β-cell protection independent of blood pressure lowering in diabetic db/db mice

    Institute of Scientific and Technical Information of China (English)

    Jia-qing SHAO; Noseki IWASHITA; Hong DU; Yang-tian WANG; Yan-yan WANG; Ming ZHAO; Jian WANG; Hirotaka WATADA; Ryuzo KAWAMORI

    2007-01-01

    Aim: Several epidemiological studies have suggested that treatment with angiotensin Ⅱ type 1 receptor blocker provided a risk reduction of developing type 2 diabetes. The aim of this study was to investigate whether and how chronic candesartan treatment can attenuate the deleterious influence of the hyperactive local intra-islet renin-angiotensin system in the diabetes state. Methods: Eight-week-old db/db mice were randomized to candesartan 1 mg/kg, candesartan 10mg/kg, manidipine 10 mg/kg, or placebo via gavage for 6 weeks. Their age-matched nondiabetic littermates db/m mice were treated with placebo and acted as nondia-betic controls. After 6 weeks' treatment, an intraperitoneal glucose tolerance test, immunohistochemical staining of oxidative stress markers, insulin, CD31, azan staining and an electron microscopy observation were performed. Results: Chronic candesartan treatment provided an improvement of glucose tolerance, and greatly rescued islet β-cell mass. Candesartan treatment also notably decreased staining intensity of oxidative stress markers, as well as attenuating intra-islet fibrosis and improving blood supply in the islet. In the electron microscopy observation, candesartan-treated animals exhibited improved granulation and less remarkable endoplasmic reticulum and Golgi bodies; furthermore, candesartan treatment greatly relieved the swelling of mitochondria to nearly normal. Both the benefits of reducing oxidative stress and ultra structure protection were in a dose-dependent and blood pressure-independent manner. Conclusion: After diabetes was initiated, candesartan treatment could not reverse the state of diabetes, but it effectively improved glucose tolerance and protected β-cell function by attenuating oxidative stress, islet fibrosis, sparsity of blood supply and ultrastructure disruption in a dose-dependent and blood pressure-independent manner.

  18. Glucose and blood pressure lowering effects of Pycnogenol® are inefficient to prevent prolongation of QT interval in experimental diabetic cardiomyopathy.

    Science.gov (United States)

    Jankyova, Stanislava; Kmecova, Jana; Cernecka, Hana; Mesarosova, Lucia; Musil, Peter; Brnoliakova, Zuzana; Kyselovic, Jan; Babal, Pavel; Klimas, Jan

    2012-08-15

    Diabetic cardiomyopathy shows ECG alterations related to cardiac repolarization and manifested by increased duration of QT interval. Although the mechanism is unknown, it is widely believed that the reduction of hyperglycaemia might prevent such alterations. To test this hypothesis, we used the standardized extract of French pine bark - Pycnogenol(®) (PYC) with hypoglycaemic and antioxidant properties in 8-9 week old rats with experimentally (streptozotocin) induced diabetes mellitus (DM). PYC was administered orally for 6 weeks in three different doses (10, 20, and 50 mg/kg b.w., resp.). Experimental DM was manifested by hyperglycaemia (four to six-fold increase in plasma glucose concentration; p<0.05) and significantly increased mean arterial blood pressure (by 19%; p<0.05) measured using catheterization of carotid artery in vivo. Both abnormalities were dose-dependently reduced by PYC. In addition, diabetic cardiomyopathy was associated with a significant increase in left ventricular weight to body weight ratio (by 21%; p<0.05) and a significant decrease of the width of cardiomyocytes (by 23%; p<0.05) indicating cardiac edema on the one side, and hypotrophy of cardiomyocytes on the other. Both of these changes were not affected by PYC. Consequently to metabolic and hemodynamic alterations, significant prolongation of QT interval (by 20%; p<0.05) was present in diabetic rats, however, PYC failed to correct it. Conclusively, PYC fails to correct QT prolongation in spite of dose-dependent reduction of glycaemia and high blood pressure in streptozotocin-induced diabetic cardiomyopathy. PMID:22749577

  19. Systolic Blood Pressure Lower than Heart Rate upon Arrival at and Departure from the Emergency Department Indicates a Poor Outcome for Adult Trauma Patients

    Science.gov (United States)

    Lai, Wei-Hung; Wu, Shao-Chun; Rau, Cheng-Shyuan; Kuo, Pao-Jen; Hsu, Shiun-Yuan; Chen, Yi-Chun; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

    2016-01-01

    Background: Hemorrhage is a leading cause of preventable trauma death. In this study, we used the reverse shock index (RSI), a ratio of systolic blood pressure (SBP) to heart rate (HR), to evaluate the hemodynamic stability of trauma patients. As an SBP lower than the HR (RSI < 1) may indicate hemodynamic instability, the objective of this study was to assess the associated complications in trauma patients with an RSI < 1 upon arrival at the emergency department (ED) (indicated as (A)RSI) and at the time of departure from the ED (indicated as (L)RSI) to the operative room or for admission. Methods: Data obtained from all 16,548 hospitalized patients recorded in the trauma registry system at a Level I trauma center between January 2009 and December 2013 were retrospectively reviewed. A total of 10,234 adult trauma patients aged ≥20 were enrolled and subsequently divided into four groups: Group I, (A)RSI ≥ 1 and (L)RSI ≥ 1 (n = 9827); Group II, (A)RSI ≥ 1 and (L)RSI < 1 (n = 76); Group III, (A)RSI < 1 and (L)RSI ≥ 1 (n = 251); and Group IV, (A)RSI < 1 and (L)RSI < 1 (n = 80). Pearson’s χ2 test, Fisher’s exact test, or independent Student’s t-test was conducted to compare trauma patients in Groups II, III, and IV with those in Group I. Results: Patients in Groups II, III, and IV had a higher injury severity score and underwent a higher number of procedures, including intubation, chest tube insertion, and blood transfusion, than Group I patients. Additionally, patients of these groups had increased hospital length of stay (16.3 days, 14.9 days, and 22.0 days, respectively), proportion of patients admitted to the intensive care unit (ICU) (48.7%, 43.0%, and 62.5%, respectively), and in-hospital mortality (19.7%, 7.6%, and 27.5%, respectively). Although the trauma patients who had a SBP < 90 mmHg either upon arrival at or departure from the ED also present a more severe injury and poor outcome, those patients who had a SBP ≥ 90 mmHg but an RSI < 1 had

  20. Anti—inflammatory effect of cerivastatin in vascular injury independent of serum cholesterol and blood pressure lowering effects in mouse model

    Institute of Scientific and Technical Information of China (English)

    陈小东; 李震; 等

    2002-01-01

    Objective:To observe the anti-inflammatory effect of cerivastatin in a mouse model of vascular injury and its cholesterol-lowering effect.Methods:We developed a mouse model of vascular remodeling induced by polyethylene cuff placement and determined the anti-inflannatory effects of cerivastatin in wild mice.Cerivastatin was given by Alzet micro-osmotic minipumps implanted intraperitoneally at the same time as cuff placement at doses of 0.1mg/kg,0.5mg/kgand1mg/kgper day,respectively for 2weeks after cuff placement.The insufficient doses of Cerivastatin to lower serum cholesterol and systolic blood pressue through the neointimal formation and BrdUindex were investigated in mouse formation and BrdUindex were investigated in the 1mg/kg cerivastatin,but not in the 0.1mg/kgand0.5mg/kg cerivastatin,Furthermore,1mg/kg of cerivastatin significantly inhibited the expression of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)without lowering serum cholesterol.Conclusions:These results suggest that cerivastatin can inhitit vascular inflammation and ahe proliferation of vascular smooth muscle cells(VSMCs)through its lipid-lowering independent action.Such effects of cerivastatin may be an important mechanism,by which it prevents the development of atherosclerotic lesions.

  1. Anti-inflammatory effect of cerivastatin in vascular injury independent of serum cholesterol and blood pressure lowering effects in mouse model

    Institute of Scientific and Technical Information of China (English)

    陈小东; 李震; 李建文

    2002-01-01

    Objective: To observe the anti-inflammatory effect of cerivastatin in a mouse model of vascular injury and its cholesterol-lowering effect. Methods: We developed a mouse model of vascular remodeling induced by polyethylene cuff placement and determined the anti-inflammatory effects of cerivastatin in wild mice. Cerivastatin was given by Alzet micro-osmotic minipumps implanted intraperitoneally at the same time as cuff placement at doses of 0.1 mg/kg, 0.5 mg/kg and 1 mg/kg per day, respectively for 2 weeks after cuff placement. The insufficient doses of Cerivastatin to lower serum cholesterol and systolic blood pressure through the neointimal formation and BrdU index were investigated in mouse femoral injury artery induced by cuff-placement. Results: There was a little change in serum cholesterol by the treatment with cerivastatin, the cross-sectional area of intima of injured femoral artery was significantly increased, the neointima formation was significantly increased by the cuff-induced vascular injury at day 14. The neointimal formation and BrdU index were inhibited in the 1 mg/kg cerivastatin, but not in the 0.1 mg/kg and 0.5 mg/kg cerivastatin. Furthermore, 1 mg/kg of cerivastatin significantly inhibited the expression of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) without lowering serum cholesterol.Conclusions: These results suggest that cerivastatin can inhibit vascular inflammation and the proliferation of vascular smooth muscle cells (VSMCs) through its lipid-lowering independent action. Such effects of cerivastatin may be an important mechanism, by which it prevents the development of atherosclerotic lesions.

  2. Measurement of limb blood flow using technetium-labelled red blood cells

    Energy Technology Data Exchange (ETDEWEB)

    Parkin, A; Robinson, P.J.; Wiggins, P.A.; Leveson, S.H.; Salter, M.C.P.; Matthews, I.F.; Ware, F.M.

    1986-05-01

    A method for measuring blood flow below the knee during reactive hyperaemia induced by 3 min of arterial occlusion has been developed. Subjects are positioned with lower limbs within the field of view of a gamma camera and pneumatic cuffs are placed below the knees to isolate the blood and induce a hyperaemic response. The remaining blood pool is labelled with /sup 99/Tcsup(m)-labelled red cells. Blood flows have been derived from the initial gradients of time-activity curves and from equilibrium blood sampling. The technique has been validated using a tissue-equivalent leg phantom and peristaltic pump. The method has been applied to a small group of patients with peripheral vascular disease and to normal controls. The mean value (+-SD) of limb perfusion for normal controls was found to be 16.4 +- 3.0 ml/100 ml/min and for patients with intermittent claudication was 5.1 +- 2.6 ml/100 ml/min. Flow measurements are found to correlate with clinical findings and with symptoms. Reproducibility (established by repeated measurements) is high. The method is well tolerated even by patients suffering from rest pain.

  3. The measurement of limb blood flow using technetium-labelled red blood cells

    International Nuclear Information System (INIS)

    A method for measuring blood flow below the knee during reactive hyperaemia induced by 3 min of arterial occlusion has been developed. Subjects are positioned with lower limbs within the field of view of a gamma camera and pneumatic cuffs are placed below the knees to isolate the blood and induce a hyperaemic response. The remaining blood pool is labelled with 99Tcsup(m)-labelled red cells. Blood flows have been derived from the initial gradients of time-activity curves and from equilibrium blood sampling. The technique has been validated using a tissue-equivalent leg phantom and peristaltic pump. The method has been applied to a small group of patients with peripheral vascular disease and to normal controls. The mean value (+-SD) of limb perfusion for normal controls was found to be 16.4+-3.0 ml/100 ml/min and for patients with intermittent claudication was 5.1+-2.6 ml/100 ml/min. Flow measurements are found to correlate with clinical findings and with symptoms. Reproducibility (established by repeated measurements) is high. The method is well tolerated even by patients suffering from rest pain. (author)

  4. Limb blood flow - Rest and heavy exercise in sitting and supine positions in man

    Science.gov (United States)

    Greenleaf, J. E.; Montgomery, L. D.; Brock, P. J.; Van Beaumont, W.

    1979-01-01

    The objectives of the study were twofold: (1) to determine the effect of body position (hydrostatic pressure) on total blood flow in active and passive limbs at rest and after severe exercise; and (2) to further evaluate the impedance technique for measurement of blood flow. To this end, the effect of body position on the redistribution of total blood flow in active (leg) and passive (forearm) limbs during exercise was determined by measuring total limb impedance (blood flow) in five male and one female subjects in sitting and supine positions with a modified Beckman BR-100 rheograph. The results show that, at rest and after exercise, the supine position induces significantly greater flows in the leg but not in the forearm. With severe exercise, blood flows are increased in both passive and active limbs, so that there is probably no net transfer of blood volume from passive to active muscles. The advantages of the impedance technique over other methods are stressed.

  5. Blood temperature and perfusion to exercising and non-exercising human limbs

    DEFF Research Database (Denmark)

    González-Alonso, José; Calbet, José A L; Boushel, Robert; Helge, Jørn W; Søndergaard, Hans; Munch-Andersen, Thor; van Hall, Gerrit; Mortensen, Stefan P; Secher, Niels H

    2015-01-01

    NEW FINDINGS: What is the central question of this study? Temperature-sensitive mechanisms are thought to contribute to blood-flow regulation, but the relationship between exercising and non-exercising limb perfusion and blood temperature is not established. What is the main finding and its...... importance? The close coupling among perfusion, blood temperature and aerobic metabolism in exercising and non-exercising extremities across different exercise modalities and activity levels and the tight association between limb vasodilatation and increases in plasma ATP suggest that both temperature- and...... metabolism-sensitive mechanisms are important for the control of human limb perfusion, possibly by activating ATP release from the erythrocytes. Temperature-sensitive mechanisms may contribute to blood-flow regulation, but the influence of temperature on perfusion to exercising and non-exercising human limbs...

  6. Diagnostic value of blood pool imaging for limbs viability after electrical injury

    International Nuclear Information System (INIS)

    This study was undertaken to evaluate the clinical usefulness of 99mTc labelled red blood cell imaging in the detection of limbs viability after electrical injury. 8 patients were studied. There are two steps in the imaging process: artery perfusion and blood pool imaging. In the case of severe injury, in which muscles were necrotic and vessels are obstructed, no radioactivities appeared in those areas. The imaging results were proved by plastic surgery. This study shows that 99mTc-RBC blood pool imaging is a reliable method for the detection of limbs' viability after electrical injury

  7. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled

    DEFF Research Database (Denmark)

    Dahlöf, Björn; Sever, Peter S; Poulter, Neil R;

    2005-01-01

    The apparent shortfall in prevention of coronary heart disease (CHD) noted in early hypertension trials has been attributed to disadvantages of the diuretics and beta blockers used. For a given reduction in blood pressure, some suggested that newer agents would confer advantages over diuretics an...... and beta blockers. Our aim, therefore, was to compare the effect on non-fatal myocardial infarction and fatal CHD of combinations of atenolol with a thiazide versus amlodipine with perindopril....

  8. Limb Prosthetics

    Science.gov (United States)

    ... in the Residual Limb A prosthesis is an artificial device that replaces a missing body part. A limb may be amputated or missing because of a blood vessel disorder (such as atherosclerosis or damage due to ...

  9. Regional disturbances in blood flow and metabolism in equine limb wound healing with formation of exuberant granulation tissue

    DEFF Research Database (Denmark)

    Sørensen, Mette A.; Petersen, Lars; Bundgaard, Louise; Toft, Nils; Jacobsen, Stine

    2014-01-01

    As in other fibroproliferative disorders, hypoxia has been suggested to play a key role in the pathogenesis of exuberant granulation tissue (EGT). The purpose of this study was to investigate metabolism and blood flow locally in full-thickness wounds healing with (limb wounds) and without (body...... wounds) formation of EGT. Microdialysis was used to recover endogenous metabolites from the wounds, and laser Doppler flowmetry was used to measure blood flow. Measurements were performed before wounding and 1-28 days after wounding. Blood flow was consistently lower in limb wounds than in body wounds...... throughout the study period with no change over time. After wounding and throughout the study period, the glucose concentration was significantly lower in limb wounds than in body wounds, whereas the lactate level showed a significantly higher concentration in limb wounds. The lactate/glucose ratio displayed...

  10. Blood flow modeling for patient-specific bypass surgery in lower-limb arteries

    OpenAIRE

    Willemet, Marie

    2012-01-01

    Every day in Belgium, at least one or two people will undergo a bypass surgery in the lower-limb arteries. This medical procedure consists of replacing an occluded section of the leg arteries with an artificial vessel, in order to allow blood to flow downwards of this blockage. Even though this intervention is very common, failure of this treatment within five years reaches up to 60%. In order to improve our understanding of the causes of bypass failure, one approach is to study the local hem...

  11. Comparison of obstructing blood flow interventional embolectomy and simple interventional embolectomy for acute lower limb arterial embolism

    International Nuclear Information System (INIS)

    Objective: To evaluate the effects (mortality, amputation rate, the length and expense of hospital stay, etc)of the obstructing blood flow interventional embolectomy and simple interventional embolectomy for acute lower limb arterial embolism. Methods: 79 cases of acute lower limb arterial embolism including 23 cases of two sites puncturing and obstructing blood flow interventional embolectomy and 56 cases treated by simple interventional embolectomy were retrospectively analyzed and compared. Results: Embolisms were removed in all 79 cases and arteries were reopened successfully. The mortality and the amputation rates of the simple and the obstructing blood flow embolectomies were 5.36%, 19.6%, and 4.35%, 8.70% respectively. Conclusion: Two sites puncturing and obstructing blood flow interventional embolectomy for acute lower limb arterial embolism is simple, safe and effective, comparing with the simple interventional embolectomy, with lower amputation rate, quicker recovery and lower expense, however with no statistical significance in mortalities. (authors)

  12. Four-limb blood pressure as predictors of mortality in elderly Chinese.

    Science.gov (United States)

    Sheng, Chang-Sheng; Liu, Ming; Zeng, Wei-Fang; Huang, Qi-Fang; Li, Yan; Wang, Ji-Guang

    2013-06-01

    The predictive value of blood pressure (BP) for cardiovascular morbidity and mortality diminishes in the elderly, which may be confounded and compensated by the BP differences across the 4 limbs, markers of peripheral arterial disease. In a prospective elderly (≥60 years) Chinese study, we performed simultaneous 4-limb BP measurement using an oscillometric device in the supine position, and calculated BP differences between the 4 limbs. At baseline, the mean age of the 3133 participants (1383 men) was 69 years. During 4 years (median) of follow-up, all-cause and cardiovascular deaths occurred in 203 and 93 subjects, respectively. In multiple regression analyses, arm BPs on the higher arm side of systolic BP did not predict mortality (P≥0.06) except for a negative association between mean arterial pressure and total mortality (P=0.04). However, in adjusted analyses, the hazard ratios associated with a 1-SD decrease in ankle-brachial BP index or increase in interarm or interankle BP difference were 1.15 to 1.23 for total mortality (P≤0.01) and 1.17 to 1.24 for cardiovascular mortality (P≤0.04). In categorical analyses, similar results were observed for a decreased ankle-brachial index (≤0.90, ≤0.95, or ≤1.00) or increased interarm or interankle difference (≥15 mm Hg or ≥10 mm Hg). In conclusion, in the elderly, above and beyond arm BP level and together with ankle-brachial index, the interarm and interankle BP differences improve prediction of mortality. Simultaneous 4-limb BP measurement has become feasible with current technology and might be useful in cardiovascular prevention. PMID:23569084

  13. A pitfall in the measurement of arterial blood pressure in the ischaemic limb during elevation

    DEFF Research Database (Denmark)

    Bülow, J; Jelnes, Rolf

    1987-01-01

    In order to evaluate if elevation of the ischaemic limb above heart level is an alternative to the conventionally applied method with external counterpressure for estimation of skin perfusion pressure, femoral and popliteal artery pressures were measured directly in eight patients with occlusion of...... the superficial femoral artery. The measurements were done in the horizontal position and during elevation of the calf above heart level. During elevation relative blood flow, measured by arterio-venous oxygen saturation differences, decreased compared with the horizontal position. In contrast the...... lower extremity cannot be determined non-invasively by elevation of the extremity, probably due to collapse of segments of the vascular bed increasing the vascular resistance considerably....

  14. Limb venous compliance responses to lower body negative pressure in humans with high blood pressure.

    Science.gov (United States)

    Goulopoulou, S; Deruisseau, K C; Carhart, R; Kanaley, J A

    2012-05-01

    This study tested the hypothesis that limb venous responses to baroreceptor unloading are altered in individuals with high blood pressure (HBP) compared with normotensive (NT) controls. Calf venous compliance was assessed in 20 subjects with prehypertension and stage-1 hypertension (mean arterial pressure, MAP: 104±1 mm Hg) and 13 NT controls (MAP: 86±2 mm Hg) at baseline and during lower body negative pressure (LBNP), using venous occlusion plethysmography. Baroreflex sensitivity (BRS) was measured using the sequence technique and total peripheral resistance (TPR) was estimated from finger plethysmography. Baseline venous compliance was not different between groups, but the HBP group had lower baseline lnBRS (2.22±0.14 vs 2.7±0.18 ms mm Hg(-1)) and greater baseline TPR (3828±138 vs 3250±111 dyn sec(-1) cm(-5) m(2), Pcompliance was reduced in response to LBNP only in the NT group (Psec(-1) cm(-5) m(2), P<0.05). In conclusion, the early stages of hypertension are characterized by an attenuated venoconstrictor response to baroreceptor unloading, which may compensate for an exaggerated vasoconstrictor response and protect against further increases in blood pressure. PMID:21471995

  15. Therapeutic neovascularization by autologous transplantation with expanded endothelial progenitor cells from peripheral blood into ischemic hind limbs

    Institute of Scientific and Technical Information of China (English)

    Chun-ling FAN; Ping-jin GAO; Zai-qian CHE; Jian-jun LIU; Jian WEI; Ding-liang ZHU

    2005-01-01

    Aim: To investigate the hypothesis that transplantation with expanded autologous endothelial progenitor cells (EPC) could enhance neovascularization.Methods: Peripheral blood mononuclear cells (PB-MNC) isolated from New Zealand White rabbits were cultured in vitro. At d 7, the adherent cells were collected for autologous transplantation. Rabbits with severe unilateral hind limb ischemia were randomly assigned to receive phosphate-buffered saline or expanded EPC in phosphate-buffered saline, administered by intramuscular injection in 6 sites of the ischemic thigh at postoperative d 7. Neovascularization was monitored by using the calf blood pressure ratio to indicate tissue perfusion, digital subtraction angiography to identify collateral vessel development and histological analysis of capillary density in the ischemic limb at d 35 after surgery. Results: Autologous EPC transplantation produced significant amelioration in ischemic hind limbs,as indicated by a greater calf blood pressure ratio (0.52±0.04 vs 0.42±0.05, P<0.01),angiographic score (1.44±0.06 vs 0.98±0.08, P<0.01) and capillary density in muscle (195.2±5.4/mm2 vs 169.4±6.4/mm2, P<0.05), than controls. Conclusion: Transplantation of autologous expanded EPC can promote neovascularization in ischemic hindlimbs.

  16. Investigation of blood pulse PPG signal regulation on toe effect of body posture and lower limb height

    Institute of Scientific and Technical Information of China (English)

    XIN Shang-zhi; HU Sijung; CRABTREE Vincent P.; ZHENG Jia

    2007-01-01

    Objective: To study the regulation of blood pulse volume via photoplethysmography (PPG) signal detected from toe, while the lower limb is passively raised in different height positions. Methods: Use a modified non-invasive PPG technique to detect the blood pulse signal on toe with infrared (IR) photo sensor. A protocol consisting of two postures, i.e., supine and 45° reclining, was designed to conduct laboratory trial in this study. During the period of performing the protocol of these postures, the lower limb was passively raised from the heights of 10 cm to 60 cm randomly and individually with sponge blocks underneath the foot. Results: In the supine posture, the higher the foot was passively raised, the more the blood PPG signal decreased. In the 45° reclining posture, the blood PPG signal increased at the beginning and then decreased in the foot height position from 10 cm to 60 cm. In both postures the normalized AC signal changes significantly while the normalized DC signal changes little. Conclusion:The toe PPG signals can obviously indicate the regulated blood volume change with the designated postural procedures due to the heart level position.

  17. Diagnosis of deep vein thrombosis of the lower limbs with scintigraphy of red blood cells labelled with 99m technetium

    International Nuclear Information System (INIS)

    The clinical diagnosis of leg deep vein thrombosis (DVT) is notoriously unreliable. It must be supplemented by objective techniques which all have drawbacks. 99mTc-RBC venography also has its limitations, yet it is a simple, safe, and useful test for diagnosing DVT of the lower limb. When done carefully, it is a rewarding procedure with good sensitivity and specificity for the condition both in the calf and ilio-femoral regions. Blood pool venography is readily accessible to all nuclear medicine department for the diagnosis of thrombophlebitis and also the follow-up of treated patients

  18. Immunological indices of blood and interstitial fluid in estimation of a program of therapy of upper limb secondary edemas

    International Nuclear Information System (INIS)

    The efficacy of therapy of upper limb secondary edemas after 4 programs was compared among 83 patients. The methods were as follows: traditional method (TM) including routine conservative therapy, acupuncture (AP), He-Ne laser OKG-13 and semiconductor laser against a background of traditional therapy. A study was made of the time course of the extent of edema, total protein, IG, G, A and M and circulating immune complexes (CIC) during therapy of such patients. Blood serum and interstitial fluid indices were compared. It was shown that the application of both lasers led to increasing efficacy of TM and AP

  19. AG490 suppresses EPO-mediated activation of JAK2-STAT but enhances blood flow recovery in rats with critical limb ischemia

    OpenAIRE

    Chai, Han-Tan; Yip, Hon-Kan; Sun, Cheuk-Kwan; Hsu, Shu-Yuan; Leu, Steve

    2016-01-01

    Background Erythropoietin (EPO) has been demonstrated to enhance recovery in ischemic organs through enhancing angiogenesis. In this study, we used an experimental critical limb ischemia (CLI) rat model to reveal the underlying mechanisms and directly examine the benefits of the anti-apoptotic capacity of EPO in the acute phase of limb ischemia and following blood flow recovery. Methods To determine the role of the JAK2/STAT pathway in EPO-enhanced recovery after CLI, male Sprague-Dawley rats...

  20. Quantitative leakage control by radioactive labelled blood cells during isolated limb perfusion

    International Nuclear Information System (INIS)

    Quantitative leakage control is used during isolated limb perfusion in cases of high-dosage chemotherapy. By positioning scintillation probes across the heart and the extra-corporal circulatory system we can measure the distribution of the 111In-marked erythrocyte. The rate of the leakage can then be determined from the cyclical measurements given. This indicates the quantitative volume crossover from the introduction of the cytostatic substances into the perfusate, and is the basis for any further necessary interventions during the procedure. (orig.)

  1. Repeatability of popliteal blood flow and lower limb vascular conductance at rest and exercise during body tilt using Doppler ultrasound

    International Nuclear Information System (INIS)

    We tested the data repeatability for popliteal blood flow velocity (PBV), popliteal arterial diameter (ADpop), popliteal blood flow (PBF) and lower limb vascular conductance (VC) at rest and exercise in three body positions, two work rates and two inspired oxygen fractions. Fifteen, eleven and ten healthy volunteers participated in the three phases of the studies. Resting protocols were performed in horizontal (HOR), 35° head-down tilt (HDT) and 45° head-up tilt (HUT) for 5 min in each body position. Participants also exercised at lower and higher power outputs (repeated plantar flexion contractions at 20% and 30% maximal voluntary contraction, respectively) in HOR, HDT and HUT and in normoxia (21%O2) and hypoxia (14%O2) with the same work rates and body positions. PBV and ADpop were measured by ultrasound to determine PBF, and VC was estimated by dividing PBF by muscle perfusion pressure (MPP). PBV, ADpop, PBF and VC were not different, demonstrated good agreement and consistency between the two days of testing during both rest and exercise conditions regardless of body position. Therefore, these data support the utilization of Doppler and echo Doppler ultrasound as a reproducible method to measure PBV and ADpop and consequently estimate PBF and VC responses in such conditions. (paper)

  2. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial

    DEFF Research Database (Denmark)

    Dahlöf, Björn; Sever, Peter S; Poulter, Neil R;

    2005-01-01

    The apparent shortfall in prevention of coronary heart disease (CHD) noted in early hypertension trials has been attributed to disadvantages of the diuretics and beta blockers used. For a given reduction in blood pressure, some suggested that newer agents would confer advantages over diuretics an...

  3. Inspiratory loading and limb blood flow in COPD: The modulating effects of resting lung hyperinflation.

    Science.gov (United States)

    Berton, Danilo C; de Castro, Marina A; Merola, Pietro; Benedetto, Igor; Castilho, Mariah; Vieira, Paulo J C; Knorst, Marli M; Neder, J Alberto

    2016-07-01

    Inspiratory resistive loading (IRL) may have deleterious cardiocirculatory effects leading to poor peripheral perfusion in severely-hyperinflated patients with COPD. Nineteen patients (13 severely-hyperinflated with inspiratory capacity/total lung capacity ratio≤0.28) underwent calf blood flow (CBF) measurements by venous occlusion plethysmography at rest and during IRL at 60% maximal inspiratory pressure. Severely-hyperinflated patients had lower resting CBF and greater calf vascular resistance (CVR) than moderately-hyperinflated patients (phyperinflated patients had markedly reduced CBF (p=0.01). Opposite to our main hypothesis, however, IRL did not further reduce CBF in these patients (p>0.05). Conversely, it significantly decreased CBF and increased CVR in moderately-hyperinflated patients; in fact, end-trial CBF and CVR did not differ between the groups (p>0.05). In conclusion, marked impairments in resting appendicular blood flow in severely-hyperinflated patients with COPD were seen only after acute IRL in less hyperinflated patients. These findings set the stage for studies investigating the effects of lung deflation on peripheral hemodynamics in patients with severe hyperinflation. PMID:26965088

  4. Nutrition Coupled with High-Load Traditional or Low-Load Blood Flow Restricted Exercise During Human Limb Suspension

    Science.gov (United States)

    Hackney, K. J.; Everett, M.; Ploutz-Snyder, L. L.

    2011-01-01

    High-load resistance exercise (HRE) and low-load blood flow restricted (BFR) exercise have demonstrated efficacy for attenuating unloading related muscle atrophy and dysfunction. In recreational exercisers, protein consumption immediately before and/or after exercise has been shown to increase the skeletal muscle anabolic response to resistance training. PURPOSE: To compare the skeletal muscle adaptations when chocolate milk intake was coupled with HRE or low-load BFR exercise [3 d/wk] during simulated lower limb weightlessness. METHODS: Eleven subjects were counterbalanced [based on age and gender] to HRE (31 +/- 14 yr, 170 +/- 13 cm, 71 +/- 18 kg, 2M/3W) or low-load BFR exercise (31 +/- 12 yr, 169 +/- 13 cm, 66 +/- 14 kg, 2M/4W) during 30 days of unilateral lower limb suspension (ULLS). Both HRE and BFR completed 3 sets of single leg press and calf raise exercise during ULLS. BFR exercise intensity was 20% of repetition maximum (1RM) with a cuff inflation pressure of 1.3 systolic blood pressure (143 4 mmHg). Cuff pressure was maintained during all 3 sets including rest intervals (90s). HRE intensity was 75% 1RM and was performed without cuff inflation. Immediately (<10 min) before and after exercise 8 fl oz of chocolate milk (150 kcal, 2.5g total fat, 22g total carbohydrate, 8g protein) was consumed to optimize acute exercise responses in favor of muscle anabolism. ULLS analog compliance was assessed from leg skin temperature recordings and plantar accelerometry. Muscle cross-sectional area (CSA) for knee extensor and plantar flexor muscle groups were determined from analysis of magnetic resonance images using ImageJ software. 1RM strength for leg press and calf raise was assessed on the Agaton exercise system. Muscular endurance during leg press and calf raise was evaluated from the maximal number of repetitions performed to volitional fatigue using 40% of pre-ULLS 1RM. RESULTS: Steps detected by plantar acceleometry declined by 98.9% during ULLS relative to an

  5. 探讨生物反馈治疗对伴有焦虑症的难治性高血压的降血压作用%Study of Biofeedback Therapy on Anxiety Disorders Refractory Hypertension Blood Pressure Lowering Effect

    Institute of Scientific and Technical Information of China (English)

    盘德益; 石克梅

    2013-01-01

      目的:应用生物反馈方式对合并患有焦虑症的难治性高血压患者进行治疗的临床效果进行研究分析。方法:抽取92例合并患有焦虑症的难治性高血压患者,将其分为对照组和治疗组,平均每组46例。采用临床常规方式对对照组病情进行控制;采用生物反馈方法对治疗组进行治疗。结果:治疗组血压水平控制效果明显优于对照组;治疗前后SAS和HAMD评分的改善幅度明显大于对照组。结论:应用生物反馈方式对合并患有焦虑症的难治性高血压患者进行治疗的临床效果非常明显。%Objective:To application of biofeedback on combined with anxiety disorder in patients with refractory hypertension treatment clinical effect analysis. Method:Selected 92 cases with comorbid anxiety disorders in patients with refractory hypertension cases,divided into control group and treatment group,46 cases in each group the average. Using routine clinical methods on the patients of control group disease control;biofeedback methods on the patients in the treatment group were treated with. Result:The patients in the treatment group the level of blood pressure control effect is better than the control group;before and after treatment with SAS and HAMD score improved significantly greater than the control group. Conclusion:On Application of biofeedback combined with anxiety disorders in patients with refractory hypertension treatment clinical effect is very obvious.

  6. Orchidectomy attenuates high-salt diet-induced increases in blood pressure, renovascular resistance, and hind limb vascular dysfunction: role of testosterone.

    Science.gov (United States)

    Oloyo, Ahmed K; Sofola, Olusoga A; Yakubu, Momoh A

    2016-09-01

    Sex hormone-dependent vascular reactivity is an underlying factor contributing to sex differences in salt-dependent hypertension. This study evaluated the role of androgens (testosterone) in high salt-induced increase in blood pressure (BP) and altered vascular reactivity in renal blood flow and perfused hind limb preparation. Weanling male rats (8 weeks old, 180-200 g) were bilaterally orchidectomised or sham operated with or without testosterone replacement (Sustanon 250, 10 mg/kg intramuscularly once in 3 weeks) and placed on a normal (0.3%) or high (4.0%) NaCl diet for 6 weeks. The high-salt diet (HSD) increased arterial BP, renal vascular resistance (RVR) and positive fluid balance (FB). These changes were accompanied by decreased plasma nitric oxide levels. The increased BP, RVR and FB observed in the rats fed a HSD were reversed by orchidectomy while testosterone replacement prevented the reversal. Phenylephrine (PE)-induced increased vascular resistance in the perfused hind limb vascular bed was enhanced by HSD, the enhanced vascular resistance was prevented by orchidectomy and testosterone replacement reversed orchidectomy effect. Vasorelaxation responses to acetylcholine (ACh) and sodium nitroprusside (SNP) were impaired in HSD groups, orchidectomy attenuated the impairment, while testosterone replacement prevented the orchidectomy attenuation. These data suggested that eNOS-dependent and independently-mediated pathways were equally affected by HSD in vascular function impairment and this effect is testosterone-dependent in male Sprague-Dawley rats. PMID:27197589

  7. Radiation exposure to surgical staff during hyperthermic isolated limb perfusion with 99m Technetium labeled red blood cells

    DEFF Research Database (Denmark)

    Kristoffersen, Ulrik Sloth; Straalman, Kristina; Schmidt, Grethe;

    2009-01-01

    the limb circuit. This has made HILP safe for the patient. However, the radiation exposure to the surgical staff has never been measured and could be a limiting factor for the use of HILP. The purpose of the present study was to measure and evaluate the radiation exposure to the surgical staff...... dose monitoring of the staff or special precautions for fertile women are not necessary....

  8. Artificial Limbs

    Science.gov (United States)

    ... you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which ... activities such as walking, eating, or dressing. Some artificial limbs let you function nearly as well as ...

  9. Methodological assessment of skin and limb blood flows in the human forearm during thermal and baroreceptor provocations

    OpenAIRE

    Brothers, R. Matthew; Wingo, Jonathan E.; Hubing, Kimberly A.; Crandall, Craig G.

    2010-01-01

    Skin blood flow responses in the human forearm, assessed by three commonly used technologies—single-point laser-Doppler flowmetry, integrated laser-Doppler flowmetry, and laser-Doppler imaging—were compared in eight subjects during normothermic baseline, acute skin-surface cooling, and whole body heat stress (Δ internal temperature = 1.0 ± 0.2°C; P < 0.001). In addition, while normothermic and heat stressed, subjects were exposed to 30-mmHg lower-body negative pressure (LBNP). Skin blood flow...

  10. Vasodilators and Blood Pressure Lowering Medications and Age-Related Macular Degeneration: The Beaver Dam Eye Study

    Science.gov (United States)

    Klein, Ronald; Myers, Chelsea E.; Klein, Barbara E. K.

    2014-01-01

    Objective To examine the association of vasodilator and antihypertensive medication use to the incidence of age-related macular degeneration (AMD). Design A longitudinal population-based study. Participants Persons 43–86 years of age living in Beaver Dam, Wisconsin in 1988–1990. Methods Examinations were performed every 5 years over a 20-year period. There were 9676 total person-visits over the course of the study. Status of AMD was determined from grading retinal photographs. Main Outcome Measures Incidence of AMD. Results The 5-year incidence of early AMD over the 20-year period was 8.4%, for late AMD it was 1.4%, for pure geographic atrophy (GA) it was 0.6%, for exudative AMD it was 0.9%, and for progression of AMD it was 24.9%. While adjusting for age, sex, and other factors, using a vasodilator (hazard ratio [HR]=1.72; 95% confidence interval [CI] 1.25 – 2.38), particularly oral nitroglycerin (1.81, 1.14 – 2.90) was associated with an increased risk of early AMD. Using an oral beta blocker was associated with an increased hazard of incident exudative AMD (1.71, 1.04 – 2.82) but not pure GA (0.51, 0.20 – 1.29) or progression (0.92, 0.67 – 1.28) of AMD over the 20-year period. Conclusions Use of vasodilators is associated with a 72% increase in the hazard of incidence of early AMD and use of oral beta blockers is associated with a 71% increase in the hazard of incident exudative AMD. If these findings are replicated it may have implications for care of older adults as vasodilators and oral beta blockers are commonly used drugs by older persons. PMID:24793737

  11. Secondary limb edemas following irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Tsyb, A.F.; Bardychev, M.S.; Guseva, L.I.

    1981-09-01

    The results of clinical examination and treatment of 96 patients with secondary limb edemas, developed at late periods after radiation therapy of malignant tumors are discussed. The genesis of edema is accounted both for direct radiation injury of lymphatics and blood vessels (veins) and fibrous changes of tissue in irradiated areas.

  12. Secondary limb edemas following irradiation

    International Nuclear Information System (INIS)

    The results of clinical examination and treatment of 96 patients with secondary limb edemas, developed at late periods after radiation therapy of malignant tumors are discussed. The genesis of edema is accounted both for direct radiation injury of lymphatics and blood vessels (veins) and fibrous changes of tissue in irradiated areas. (orig.)

  13. Quantitative leakage control by radioactive labelled blood cells during isolated limb perfusion; Kontinuierliche quantitative Leckkontrolle mittels radioaktiv markierter Blutbestandteile bei isolierter Extremitaetenperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Schnorr, J.; Mischke, W.; Tunn, P.U.; Dresel, S. [Nuklearmedizinische Klinik, HELIOS Klinikum Berlin-Buch (Germany); Dept. Tumororthopaedie, HELIOS Klinikum Berlin-Buch (Germany)

    2009-03-15

    Quantitative leakage control is used during isolated limb perfusion in cases of high-dosage chemotherapy. By positioning scintillation probes across the heart and the extra-corporal circulatory system we can measure the distribution of the 111In-marked erythrocyte. The rate of the leakage can then be determined from the cyclical measurements given. This indicates the quantitative volume crossover from the introduction of the cytostatic substances into the perfusate, and is the basis for any further necessary interventions during the procedure. (orig.)

  14. Intraocular pressure-lowering effect of oral paracetamol and its in vitro corneal penetration properties

    Directory of Open Access Journals (Sweden)

    Mohamed N

    2013-01-01

    Full Text Available Nabiel Mohamed, David MeyerDivision of Ophthalmology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South AfricaBackground: Several studies have confirmed the ability of cannabinoids to reduce intraocular pressure. Experimental data recently demonstrated unequivocally that the analgesic effect of paracetamol is due to its indirect action on cannabinoid receptors. The question then arises as to whether paracetamol can reduce intraocular pressure via its effect on intraocular cannabinoid receptors.Methods: A 2-week, prospective, randomized, controlled, single-center, parallel-group pilot study was carried out to determine the efficacy and safety of paracetamol 1 g orally administered every 6 hours in adult patients with primary or secondary open angle glaucoma as compared with topical levobunolol 0.5% twice a day. Patient well-being was closely monitored throughout the study and focused on hepatic safety in accordance with Drug-Induced Liver Injury Network criteria. The in vitro diffusion kinetics of acetaminophen in a phosphate-buffered solution in rabbit and human corneas was also investigated, with the view to a topical application.Results: Eighteen adult patients were enrolled in the study, with nine in the topical levobunolol group and nine in the oral paracetamol group. In the levobunolol group, the mean reduction in intraocular pressure at day 7 was 7.5 mmHg (P < 0.008 and at day 14 was 9.1 mmHg (P < 0.005, from a mean baseline intraocular pressure of 29.6 mmHg. The corresponding figures for the paracetamol group were 8.8 mmHg (P < 0.0004 at day 7 and 6.5 mmHg (P < 0.004 at day 14, from a mean baseline intraocular pressure of 29.4 mmHg. Both study regimens were well tolerated. No serious treatment-related adverse events were reported in either of the treatment groups. Liver function tests, systolic/diastolic blood pressure, or heart rate remained unchanged in both groups during the 2 weeks of the study. In

  15. Endovascular interventional therapy for acute limb ischemia

    International Nuclear Information System (INIS)

    Acute limb ischemia is an urgent and common clinical condition which occurs when the blood flow to a certain extremity is suddenly blocked b either embolic agent or thrombotic vascular lesion. Prompt restoration of perfusion through early intervention can significantly decrease the incidence of amputation and mortality. The main therapeutic methods include surgical operation and endovascular interventional technique. For recent years, considerable progress in treating acute limb ischemia with endovascular interventional technique has been achieved. This article aims to make a comprehensive review in respect of the endovascular intervention therapy for acute limb ischemia. (authors)

  16. Phantom limb pain

    Science.gov (United States)

    ... shooting pain Achy pain Burning pain Cramping pain Phantom limb pain will lessen over time for most people. ... Elsevier; 2012:chap 44. Bang MS, Jung SH. Phantom limb pain. In: Frontera, WR, Silver JK, eds. Essentials ...

  17. Effectiveness of a New Exercise Program after Lower Limb Arterial Blood Flow Surgery in Patients with Peripheral Arterial Disease: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Edita Jakubsevičienė

    2014-08-01

    Full Text Available Objective: The aim of this study was to evaluate the effectiveness of a supervised exercise program (SEP plus at home nonsupervised exercise therapy (non-SET on functional status, quality of life (QoL and hemodynamic response in post-lower-limb bypass surgery patients. Results: One hundred and seventeen patients were randomized to an intervention (n = 57 or a control group (n = 60. A new individual SEP was designed for patients with peripheral arterial disease (PAD and applied to the studied subjects of the intervention group who also continued non-SET at home, whereas those assigned to the control group received just usual SEP according to a common cardiovascular program. The participants of the study were assessed by a 6-min walking test (6 MWT, an ankle-brachial index (ABI, and the Medical Outcomes Study Short Form-36 (SF-36 of QoL at baseline, at 1 and 6 months after surgery. A significant improvement was observed in the walked distance in the intervention group after 6 months compared with the control group (p < 0.001. The intervention group had significantly higher QoL score in the physical and mental component of SF-36 (p < 0.05. Conclusions: A 6-month application of the new SEP and non-SET at home has yielded significantly better results in walking distance and QoL in the intervention group than in the controls.

  18. Acupuncture Treatment for Low Back Pain and Lower Limb Symptoms-The Relation between Acupuncture or Electroacupuncture Stimulation and Sciatic Nerve Blood Flow.

    Science.gov (United States)

    Inoue, Motohiro; Kitakoji, Hiroshi; Yano, Tadashi; Ishizaki, Naoto; Itoi, Megumi; Katsumi, Yasukazu

    2008-06-01

    To investigate the clinical efficacy of acupuncture treatment for lumbar spinal canal stenosis and herniated lumbar disc and to clarify the mechanisms in an animal experiment that evaluated acupuncture on sciatic nerve blood flow. In the clinical trial, patients with lumbar spinal canal stenosis or herniated lumbar disc were divided into three treatment groups; (i) Ex-B2 (at the disordered level), (ii) electrical acupuncture (EA) on the pudendal nerve and (iii) EA at the nerve root. Primary outcome measurements were pain and dysesthesia [evaluated with a visual analogue scale (VAS)] and continuous walking distance. In the animal study, sciatic nerve blood flow was measured with laser-Doppler flowmetry at, before and during three kinds of stimulation (manual acupuncture on lumber muscle, electrical stimulation on the pudendal nerve and electrical stimulation on the sciatic nerve) in anesthetized rats. For the clinical trial, approximately half of the patients who received Ex-B2 revealed amelioration of the symptoms. EA on the pudendal nerve was effective for the symptoms which had not improved by Ex-B2. Considerable immediate and sustained relief was observed in patients who received EA at the nerve root. For the animal study, increase in sciatic nerve blood flow was observed in 56.9% of the trial with lumber muscle acupuncture, 100% with pudendal nerve stimulation and 100% with sciatic nerve stimulation. Sciatic nerve stimulation sustained the increase longer than pudendal nerve stimulation. One mechanism of action of acupuncture and electrical acupuncture stimulation could be that, in addition to its influence on the pain inhibitory system, it participates in causing a transient change in sciatic nerve blood blow, including circulation to the cauda equine and nerve root. PMID:18604251

  19. Acupuncture Treatment for Low Back Pain and Lower Limb Symptoms—The Relation between Acupuncture or Electroacupuncture Stimulation and Sciatic Nerve Blood Flow

    OpenAIRE

    Megumi Itoi; Naoto Ishizaki; Tadashi Yano; Hiroshi Kitakoji; Motohiro Inoue; Yasukazu Katsumi

    2007-01-01

    To investigate the clinical efficacy of acupuncture treatment for lumbar spinal canal stenosis and herniated lumbar disc and to clarify the mechanisms in an animal experiment that evaluated acupuncture on sciatic nerve blood flow. In the clinical trial, patients with lumbar spinal canal stenosis or herniated lumbar disc were divided into three treatment groups; (i) Ex-B2 (at the disordered level), (ii) electrical acupuncture (EA) on the pudendal nerve and (iii) EA at the nerve root. Primary o...

  20. Acupuncture Treatment for Low Back Pain and Lower Limb Symptoms—The Relation between Acupuncture or Electroacupuncture Stimulation and Sciatic Nerve Blood Flow

    Directory of Open Access Journals (Sweden)

    Motohiro Inoue

    2008-01-01

    Full Text Available To investigate the clinical efficacy of acupuncture treatment for lumbar spinal canal stenosis and herniated lumbar disc and to clarify the mechanisms in an animal experiment that evaluated acupuncture on sciatic nerve blood flow. In the clinical trial, patients with lumbar spinal canal stenosis or herniated lumbar disc were divided into three treatment groups; (i Ex-B2 (at the disordered level, (ii electrical acupuncture (EA on the pudendal nerve and (iii EA at the nerve root. Primary outcome measurements were pain and dysesthesia [evaluated with a visual analogue scale (VAS] and continuous walking distance. In the animal study, sciatic nerve blood flow was measured with laser-Doppler flowmetry at, before and during three kinds of stimulation (manual acupuncture on lumber muscle, electrical stimulation on the pudendal nerve and electrical stimulation on the sciatic nerve in anesthetized rats. For the clinical trial, approximately half of the patients who received Ex-B2 revealed amelioration of the symptoms. EA on the pudendal nerve was effective for the symptoms which had not improved by Ex-B2. Considerable immediate and sustained relief was observed in patients who received EA at the nerve root. For the animal study, increase in sciatic nerve blood flow was observed in 56.9% of the trial with lumber muscle acupuncture, 100% with pudendal nerve stimulation and 100% with sciatic nerve stimulation. Sciatic nerve stimulation sustained the increase longer than pudendal nerve stimulation. One mechanism of action of acupuncture and electrical acupuncture stimulation could be that, in addition to its influence on the pain inhibitory system, it participates in causing a transient change in sciatic nerve blood blow, including circulation to the cauda equine and nerve root.

  1. Development of limb volume measuring system

    Science.gov (United States)

    Bhagat, P. K.; Kadaba, P. K.

    1983-01-01

    The mechanisms underlying the reductions in orthostatic tolerance associated with weightlessness are not well established. Contradictory results from measurements of leg volume changes suggest that altered venomotor tone and reduced blood flow may not be the only contributors to orthostatic intolerance. It is felt that a more accurate limb volume system which is insensitive to environmental factors will aid in better quantification of the hemodynamics of the leg. Of the varous limb volume techniques presently available, the ultrasonic limb volume system has proven to be the best choice. The system as described herein is free from environmental effects, safe, simple to operate and causes negligible radio frequency interference problems. The segmental ultrasonic ultrasonic plethysmograph is expected to provide a better measurement of limb volume change since it is based on cross-sectional area measurements.

  2. LDTk: Limb Darkening Toolkit

    CERN Document Server

    Parviainen, Hannu

    2015-01-01

    We present a Python package LDTk that automates the calculation of custom stellar limb darkening (LD) profiles and model-specific limb darkening coefficients (LDC) using the library of PHOENIX-generated specific intensity spectra by Husser et al. (2013). The aim of the package is to facilitate analyses requiring custom generated limb darkening profiles, such as the studies of exoplanet transits--especially transmission spectroscopy, where the transit modelling is carried out for custom narrow passbands--eclipsing binaries (EBs), interferometry, and microlensing events. First, LDTk can be used to compute custom limb darkening profiles with uncertainties propagated from the uncertainties in the stellar parameter estimates. Second, LDTk can be used to estimate the limb-darkening-model specific coefficients with uncertainties for the most common limb-darkening models. Third, LDTk can be directly integrated into the log posterior computation of any pre-existing modelling code with minimal modifications. The last a...

  3. Comparison of intraocular pressure lowering effect of latanoprost and timolol combination versus latanoprost alone in primary open angle glaucoma

    International Nuclear Information System (INIS)

    To compare the intraocular pressure (IOP) lowering effect of topical drug combination (Latanoprost and Timolol) with Latanoprost alone in patients of Primary Open Angle Glaucoma (POAG). Study Design: Randomized controlled Trials (RCT). Place and Duration of Study: Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi from December 2009 to May 2011. Patients and Methods: A total of 240 eyes of 120 patients (68 males and 52 females) were included in the study. The patients were randomized into two groups of 60 each using random numbers table. Group A (60 patients, 120 eyes) were put on topical drug combination of Latanoprost and Timolol eye drops and Group B (60 patients, 120 eyes) were treated with topical Latanoprost eye drops alone. IOP assessments were done at baseline, 2 weeks, 4 weeks and 8 weeks intervals after initiation of treatment. Results: Both the groups were age matched with mean age in Group A was 56.39 ± 8.50 years and in Group B was 55.61 ± 8.95 years (p=0.09). Both groups showed significant IOP decrease from the baseline at each follow up interval. However after 8 weeks of start of treatment, pressure lowering effect in group A (14.73 ± 2.50 mmHg) was significantly more as compared to Group B (9.10 ± 2.51 mmHg) (p<0.001). Conclusion: Combination therapy of Latanoprost and Timolol is more effective as compared to monotherapy with Latanoprost in lowering IOP of patients with POAG. (author)

  4. Limb Salvage After Bone Cancer

    Science.gov (United States)

    ... Blog Donate Now Select Page Limb Salvage After Bone Cancer Home > Understanding Children’s Cancer > Late Effects of Treatment > Limb Salvage After Bone Cancer Limb salvage is a surgical procedure that replaces ...

  5. Out on a Limb: Investigating the Anatomy of Tree Limbs

    Science.gov (United States)

    Shaw, Edward L.

    2008-01-01

    The author presents several upper elementary science activities involving tree limbs that were collected after severe weather conditions. The activities involved 3rd-grade students arranging tree limb pieces in the correct order from the trunk to the tip of the limb, measuring the pieces, determining the age of a tree limb by its rings,…

  6. [Phantom limb pains].

    Science.gov (United States)

    Giraux, Pascal

    2015-03-01

    With the radical experience of an amputation, the adaptation of body image is often incomplete. Some people experience phantom body perceptions, often painful and difficult to treat, after the amputation of a limb. PMID:26145132

  7. Hemodynamic study of ischemic limb by velocity measurement in foot

    International Nuclear Information System (INIS)

    By means of a tracer technique with 99mTc-pertechnetate, provided with seven zonal regions of interest, 6 mm in width, placed at equal spaces of 18 mm, from the toe tip to the midfoot at a right angle to the long axis of the foot, arterial flow velocity in the foot during reactive hyperemia was measured. The mean velocity in the foot was 5.66 +/- 1.78 cm/sec in 14 normal limbs, 1.58 +/- 1.07 cm/sec in 29 limbs with distal thromboangiitis obliterans (TAO), 0.89 +/- 0.61 cm/sec in 13 limbs with proximal TAO, and 0.97 +/- 0.85 cm/sec in 15 limbs with arteriosclerosis obliterans (ASO). The velocity returned to normal in all 12 limbs after successful arterial reconstruction, whereas the foot or toe blood pressure remained pathologic in 9 of the 12 limbs postoperatively; the velocity reverted to normal in 4 of 13 limbs after lumbar sympathectomy. When the velocity was normalized after operation, the ulceration healed favorably, and the ischemic limb was salvaged. The most characteristic feature of peripheral arterial occlusive disease of the lower extremity was a stagnation of arterial circulation in the foot, and the flow velocity in the foot was a sensitive predictive index of limb salvage

  8. Comparison between the in vivo rate of metabolism of prostaglandin I2 and its blood-pressure-lowering response after intravenous administration in the rat.

    Science.gov (United States)

    Pace-Asciak, C R; Rosenthal, A; Domazet, Z

    1979-07-27

    Intravenous bolus injection of prostaglandin I2 in the Inactin-anaesthetised rat produces a slow dose-dependant vasodepression which reaches maximum approximately 15 s. after injection. Administration of 9 beta-[3H1]-prostaglandin I2 by the same route followed by serial arterial sampling and TLC analysis revealed a slow conversion into one less polar metabolite starting after 20 s and reaching 40% by two minutes in the circulation. These experiments indicate that prostaglandin I2 survives pulmonary transit for a sufficiently long time to elicit a biological action. Thus its continuous systemic vascular synthesis could play an important role in the control of hypertension. PMID:383157

  9. Effect of lower limb preference on local muscular and vascular function

    International Nuclear Information System (INIS)

    Unilateral physical training can enhance muscular size and function as well as vascular function in the trained limb. In non-athletes, the preferred arm for use during unilateral tasks may exhibit greater muscular strength compared to the non-preferred arm. It is unclear if lower limb preference affects lower limb vascular function or muscular endurance and power in recreationally active adults. To examine the effect of lower limb preference on quadriceps muscle size and function and on lower limb vascular function in middle-aged adults. Twenty (13 men, 7 women) recreationally-active middle-aged (55 ± 7 yrs) adults underwent measurements of quadriceps muscle thickness, strength, mean power, endurance, and arterial stiffness, calf venous compliance, and calf blood flow in the preferred and non-preferred lower limb. The preferred limb exhibited greater calf vascular conductance (31.6 ± 15.5 versus 25.8 ± 13.0 units flow/mmHg; p = 0.011) compared to the non-preferred limb. The interlimb difference in calf vascular conductance was negatively related to weekly aerobic activity (hrs/week) (r = −0.521; p = 0.019). Lower limb preference affects calf blood flow but not quadriceps muscle size or function. Studies involving unilateral lower limb testing procedures in middle-aged individuals should consider standardizing the testing to either the preferred or non-preferred limb rather than the right or left limb. (paper)

  10. Trade-offs in relative limb length among Peruvian children: extending the thrifty phenotype hypothesis to limb proportions.

    Directory of Open Access Journals (Sweden)

    Emma Pomeroy

    Full Text Available BACKGROUND AND METHODS: Both the concept of 'brain-sparing' growth and associations between relative lower limb length, childhood environment and adult disease risk are well established. Furthermore, tibia length is suggested to be particularly plastic under conditions of environmental stress. The mechanisms responsible are uncertain, but three hypotheses may be relevant. The 'thrifty phenotype' assumes that some components of growth are selectively sacrificed to preserve more critical outcomes, like the brain. The 'distal blood flow' hypothesis assumes that blood nutrients decline with distance from the heart, and hence may affect limbs in relation to basic body geometry. Temperature adaptation predicts a gradient of decreased size along the limbs reflecting decreasing tissue temperature/blood flow. We examined these questions by comparing the size of body segments among Peruvian children born and raised in differentially stressful environments. In a cross-sectional sample of children aged 6 months to 14 years (n = 447 we measured head circumference, head-trunk height, total upper and lower limb lengths, and zeugopod (ulna and tibia and autopod (hand and foot lengths. RESULTS: Highland children (exposed to greater stress had significantly shorter limbs and zeugopod and autopod elements than lowland children, while differences in head-trunk height were smaller. Zeugopod elements appeared most sensitive to environmental conditions, as they were relatively shorter among highland children than their respective autopod elements. DISCUSSION: The results suggest that functional traits (hand, foot, and head may be partially protected at the expense of the tibia and ulna. The results do not fit the predictions of the distal blood flow and temperature adaptation models as explanations for relative limb segment growth under stress conditions. Rather, our data support the extension of the thrifty phenotype hypothesis to limb growth, and suggest that

  11. Leakage measurement during selective limb perfusion using a gamma probe

    International Nuclear Information System (INIS)

    The objective of this study was to establish a probe system for intraoperative quantitative leakage measurement during selective limb perfusion for adjuvant high-dose chemotherapy in patients with malignant melanomas. We used a portable gamma probe with digital display and investigated the physical properties in a phantom study simulating blood pool activity at different angles of the probe to the surface and different distances. In 20 patients the limb circulation was surgically separated from the systemic blood circulation, and the limb was then selectively perfused (cytostatics added) for 60 min. Initially, 15 MBq technetium-99m labelled autologous red blood cells was injected into the limb circulation, and an equal amount was kept as a standard. Every 10 min, blood samples were drawn from the body circulation and count rates were simultaneously measured by the probe system at the lower end of the sternal body. At the end of perfusion, the circulation of the limb was reconnected, the standard injected into the systemic circulation, and a blood sample drawn after 10 min. All blood samples were counted for calculation of leakage in terms of percent of the injected dose, and the results compared with the intraoperative count rates of the probe system. In the range of leakage observed in this study (0%-86%), the count rate of the probe system (corrected for blood volume, i.e. for body surface) correlated with the results of conventional measurement (r=0.92) according to the equation: %leakage=counts per s x 1.2 x body surface (m2)-1.19 In conclusion, the use of the described probe system is a feasible approach for leakage quantification which continuously yields data during selective limb perfusion. (orig.)

  12. Effect of different oxygen concentrations on blood oxygen pressure in the system of in vitro physiological environment foster limbs%不同氧体积分数气体对体外模拟体内生理环境寄养断肢系统血氧分压的影响

    Institute of Scientific and Technical Information of China (English)

    王江宁; 尹叶锋; 高磊; 王德成; 左有为; 苏才培

    2012-01-01

    BACKGROUND:Limb replantation success rate with limb preservation method is directly related to conduct in vitro simulated physiological environment foster limbs, which can extend saved time of the limbs.OBJECTIVE: To investigate the effects of different oxygen concentrations on blood oxygen pressure in the system of in vitrophysiological environment foster limbs.METHODS: Totally nine New Zealand sheep with a total of 36 limbs underwent in vitro limb perfusion experiments with blood andwere randomly divided into six groups according to different concentrations of oxygen gas (100%, 60%, 50%, 40%, 20%, 10%)into the membrane lung.RESULTS AND CONCLUSION: Comparison of blood oxygen pressure in each group, the arterial oxygen values in experimentalgroup 6 was in the normal range (80-100 mm Hg), and with the oxygen concentration decreases, arterial oxygen pressure valuesdecreases. It is indicated that in vitro simulation of physiological environment in the foster care system, different concentrations ofoxygen gas into the membrane lung may have an impact on the arterial partial pressure of oxygen; through reducing the oxygenconcentration, the arterial oxygen pressure can be close to the normal range.%背景:断肢再植成功率与断肢的保存方法有直接关系,开展体外模拟体内生理环境寄养断肢的研究,可以延长肢体保存时间.目的:探讨不同氧体积分数对体外模拟体内生理环境寄养断肢系统血氧分压的影响.方法:健康的新西兰绵羊9头,共计36只肢体,行体外断肢同型血液循环灌注实验.36只肢体按照进入膜肺的气体氧体积分数的不同随机数字表均分成氧体积分数100%,60%,50%,40%,20%,10%组进行观察.结果与结论:各组血氧分压数据相比较,氧体积分数10%的动脉血氧分压数值在正常值范围(10.64~13.33 kPa),而且动脉血氧分压的数值随氧体积分数的减小而减小.提示在体外模拟体内生理环境寄养断肢系统中,不同氧体积分

  13. Lower limb vascular dysfunction in cyclists

    Directory of Open Access Journals (Sweden)

    Thiago Ayala Melo Di Alencar

    2013-06-01

    Full Text Available Sports-related vascular insufficiency affecting the lower limbs is uncommon, and early signs and symptoms can be confused with musculoskeletal injuries. This is also the case among professional cyclists, who are always at the threshold between endurance and excess training. The aim of this review was to analyze the occurrence of vascular disorders in the lower limbs of cyclists and to discuss possible etiologies. Eighty-five texts, including papers and books, published from 1950 to 2012, were used. According to the literature reviewed, some cyclists receive a late diagnosis of vascular dysfunction due to a lack of familiarity of the medical team with this type of dysfunction. Data revealed that a reduced blood flow in the external iliac artery, especially on the left, is much more common than in the femoral and popliteal arteries, and that vascular impairment is responsible for the occurrence of early fatigue and reduced performance in cycling.

  14. [Therapy of phantom limb pain].

    Science.gov (United States)

    Schwarzer, Andreas; Zenz, Michael; Maier, Christoph

    2009-03-01

    About 80 % of all extremity amputations suffer from phantom limb pain following the operation. In this context, it is important to differentiate between painful phantom limb sensations, non-painful phantom limb sensations and residual limb pain. The pathophysiology of phantom limb pain is not fully understood. Current research findings ascribe a major pathophysiological role to cortical changes as well as a disturbed body perception. Peripheral and spinal mechanisms appear less relevant in the development of phantom limb pain. An essential part of the therapy is the pharmacological treatment with antidepressants, anticonvulsives and opioids. Another significant aspect of therapy is senso-motory training, important to mention here would be mirror therapy, lateralisation and motor imaging. In case of an elective amputation, an epidural or axiliar plexus catheter should be considered prior to the amputation. The perioperative treatment with ketamine is debated. PMID:19266417

  15. Limb lengthening in achondroplasia

    Directory of Open Access Journals (Sweden)

    Sanjay K Chilbule

    2016-01-01

    Full Text Available Background: Stature lengthening in skeletal dysplasia is a contentious issue. Specific guidelines regarding the age and sequence of surgery, methods and extent of lengthening at each stage are not uniform around the world. Despite the need for multiple surgeries, with their attendant complications, parents demanding stature lengthening are not rare, due to the social bias and psychological effects experienced by these patients. This study describes the outcome and complications of extensive stature lengthening performed at our center. Materials and Methods: Eight achondroplasic and one hypochondroplasic patient underwent bilateral transverse lengthening for tibiae, humeri and femora. Tibia lengthening was carried out using a ring fixator and bifocal corticotomy, while a monolateral pediatric limb reconstruction system with unifocal corticotomy was used for the femur and humerus. Lengthening of each bone segment, height gain, healing index and complications were assessed. Subgroup analysis was carried out to assess the effect of age and bone segment on the healing index. Results: Nine patients aged five to 25 years (mean age 10.2 years underwent limb lengthening procedures for 18 tibiae, 10 femora and 8 humeri. Four patients underwent bilateral lengthening of all three segments. The mean length gain for the tibia, femur and humerus was 15.4 cm (100.7%, 9.9 cm (52.8% and 9.6 cm (77.9%, respectively. Healing index was 25.7, 25.6 and 20.6 days/cm, respectively, for the tibia, femur and humerus. An average of 33.3% height gain was attained. Lengthening of both tibia and femur added to projected height achieved as the 3 rd percentile of standard height in three out of four patients. In all, 33 complications were encountered (0.9 complications per segment. Healing index was not affected by age or bone segment. Conclusion: Extensive limb lengthening (more than 50% over initial length carries significant risk and should be undertaken only after due

  16. Exsanguination of lower limbs in healthy male subjects

    DEFF Research Database (Denmark)

    Blond, Lars; Kirketerp-Møller, Klaus; Sonne-Holm, Stig; Madsen, Jan L

    2002-01-01

    times spent on use of these methods were: Esmarch 85 sec, gauze 104 sec, and Pomidor roll-cuff 18 sec. The various exsanguination methods caused a median percentage reduction in regional blood volume of the lower limbs: elevation 1/2 minute 45%, 1 minute 45%, 2 minutes 42%, 4 minutes 44%, 6 minutes 43...

  17. Spontaneous arteriorrhexis in affected lower limb following total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ya-feng; JIANG Qing; WANG Jun-fei

    2008-01-01

    @@ Total knee arthroplasty ( TKA) is now a standard treatment for serious osteoarthritis all over the world. Although it is a standard treatment, it has many complications, among which deep vein thrombosis ( DVT) is the exclusive blood vessel complication that has been reported.1,2 However, we found a new blood vessel complication of TKA in this study, which is spontaneous arteriorrhexis in the affected lower limb.

  18. Supernumerary phantom limb after stroke

    OpenAIRE

    Bakheit, A; Roundhill, S

    2005-01-01

    The perception of a phantom limb is commonly reported after amputations. However, only a few cases have been described after a stroke. This article presents a patient who reported a supernumerary phantom limb (pseudopolymelia) after spontaneous intracerebral haemorrhage and discusses the possible underlying mechanisms for this rare phenomenon.

  19. Arterial mapping of lower limbs

    International Nuclear Information System (INIS)

    A bibliographic review is realized in the arterial mapping of lower limbs by ultrasonographic. The physical properties of the Doppler effect applied to diagnostic ultrasound are described. The anatomical characteristics of the general arterial system and specifically of the lower limbs arterial system are mentioned. Pathologies of the ischemic arterial disease of lower limbs are explained. The study characteristics of lower limbs arterial mapping are documented to determine its importance as appropriate method for the assessment of lower limb ischemia. An adequate arterial mapping of lower limbs is recognized in atherosclerotic ischemic disease as a reliable initial method alternative to arteriography. Arteriography is considered as reference pattern for therapeutic decision making in patients with critical ischemia of the lower limbs. Non-invasive methods to assess the arterial system of lower limbs has evidenced the advantages of the arterial mapping with Doppler, according to the consulted literature. The combination morphological and hemodynamic information has been possible and a map of the explored zone is made. The arterial mapping by ultrasonography has offered similar reliability to angiography

  20. Evaluation of Limb-Girdle Muscular Dystrophy

    Science.gov (United States)

    2014-03-06

    Becker Muscular Dystrophy; Limb-Girdle Muscular Dystrophy, Type 2A (Calpain-3 Deficiency); Limb-Girdle Muscular Dystrophy, Type 2B (Miyoshi Myopathy, Dysferlin Deficiency); Limb-Girdle Muscular Dystrophy, Type 2I (FKRP-deficiency)

  1. Comparative study on observing vascular crisis of rabbits with replanted limb by Na99TcmO4 trace imaging

    International Nuclear Information System (INIS)

    A method of observing the blood supply of rabbits with replanted limb by Na99TcmO4 trace imaging (TTI) is described and compared with clinical routine method (CRM). 40 healthy adult rabbits with replanted limb were divided into and A (n=25) and B(n=15) groups by 20 min after operation. Locally freezing (2=20.9, P<0.01). It is conclude that the blood supply of rabbits with replanted limb could be reported more accurately and directly by TTI than CRM. TTI could play an important role on early and no traumatic diagnosing VC in patients with replanted finger or limb. (authors)

  2. Vasoconstrictor responses in the upper and lower limbs to increases in transmural pressure

    OpenAIRE

    Lott, Mary E. J.; Hogeman, Cynthia; Herr, Michael; Bhagat, Monica; Kunselman, Allen; Sinoway, Lawrence I.

    2009-01-01

    The purpose of this study was to examine upper and lower limb vasoconstrictor responses to changes in transmural pressure in humans. Brachial and femoral blood mean blood velocity (MBV) and vessel diameter (Doppler ultrasound) were measured in 20 supine healthy subjects (10 men and 10 women; 27 ± 1 yr; mean ± SE) during four levels of limb suction at −25, −50, −75, and −100 mmHg, respectively. Limb suction led to an initial rise in MBV followed by a rapid fall in flow velocity to a level belo...

  3. Risk factors for lower limb swelling after primary total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    GAO Fu-qiang; LI Zi-jian; ZHANG Ke; David Huang; LIU Zhong-jun

    2011-01-01

    Background Total knee arthroplasty (TKA) is a successful surgical technique for patients with advanced knee osteoarthritis; however,some peri-operative complications can not be predicted or avoided completely.This study aimed to investigate the factors affecting limb swelling after primary total knee arthroplasty,to guide and improve patient rehabilitation.Methods Using a hospital database,we retroactively analyzed the mean changes in limb circumferences of 286 consecutive patients who underwent primary unilateral total knee arthroplasty between October 2007 and August 2009.The lower limb circumference change was calculated and analyzed statistically.The influence of age,gender,body mass index,the presence of deep vein thrombosis,methods of anti-coagulation,operation time,hidden blood loss,and type of prosthesis on post-operative lower limb swelling was studied.Results Swelling was most pronounced from the third to the fifth post-operative day and usually occurred in both lower limbs.Swelling was significantly more pronounced in the operated limb than in the non-operated limb.The swelling above the knee was also significantly greater than that below the knee.The change in limb circumference at 10 cm above the knee was significantly different between the patients with body mass index <25 kg/m2 and those with body mass index >25 kg/m2.However,the change in limb circumference at 10 cm below the knee was not significantly different between the two groups.There was no statistically significant difference in limb swelling between different age groups (P >0.05).Similarly,gender,methods of anti-coagulation,the presence of deep vein thrombosis,the type of prosthesis,and operation time did not significantly affect post-operative limb swelling.Multivariate linear regression showed that the factors affecting post-operative limb swelling were body mass index and hidden blood loss.Conclusions Lower limb swelling after total knee arthroplasty is related to early post

  4. Phantom limbs and neural plasticity.

    Science.gov (United States)

    Ramachandran, V S; Rogers-Ramachandran, D

    2000-03-01

    The study of phantom limbs has received tremendous impetus from recent studies linking changes in cortical topography with perceptual experience. Systematic psychophysical testing and functional imaging studies on patients with phantom limbs provide 2 unique opportunities. First, they allow us to demonstrate neural plasticity in the adult human brain. Second, by tracking perceptual changes (such as referred sensations) and changes in cortical topography in individual patients, we can begin to explore how the activity of sensory maps gives rise to conscious experience. Finally, phantom limbs also allow us to explore intersensory effects and the manner in which the brain constructs and updates a "body image" throughout life. PMID:10714655

  5. Prevalence and Characteristics of Phantom Limb Pain and Residual Limb Pain in the Long Term after Upper Limb Amputation

    Science.gov (United States)

    Desmond, Deirdre M.; MacLachlan, Malcolm

    2010-01-01

    This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence…

  6. Limb and hemispatial hypometria.

    Science.gov (United States)

    Meador, K J; Moore, E E; Martin, R C; Loring, D W; Hess, D C; Heilman, K M

    2000-01-01

    In a previous study, we demonstrated that unilateral cerebral lesions produce hypometric limb movements of the contralateral arm and hemispatial (i.e., directional) hypometria for movements towards contralateral hemispace. In the present study, we investigated 10 patients with right cerebral lesions and 25 healthy controls using a task to uncouple deficits in sensory perceptual systems and motor-action output systems on directional hypometria. This task required participants, with their eyes closed, to reproduce lateral and medial horizontal displacements (15-27 cm) with each arm. Each participant was seated at a waist high table and had their hand placed at an origin point aligned with the axillary fold on the same side. Their hand was moved by the investigator from the origin point to a target point and brought back to the point of origin (input displacement). The participant was then asked to return their hand to either the same target point or to an equidistant target point in the opposite direction. Healthy dextral participants were significantly more hypometric with their right arm, but patients with right cerebral lesions exhibited an opposite pattern with overall left arm hypometria. In addition, patients were significantly more hypometric for movements when output displacements were toward left hemispace. No effect was found for direction of sensory input. The results suggest that the directional hypometria is predominantly produced by hemispatial output deficits. PMID:10761369

  7. Endograft Limb Occlusion in EVAR

    DEFF Research Database (Denmark)

    Taudorf, M; Jensen, L P; Vogt, K C;

    2014-01-01

    OBJECTIVE: To assess the incidence and outcome of graft limb occlusions after endovascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA) in a high volume single centre. To quantify iliac artery tortuosity in patients with AAA and correlate this with limb occlusion. DESIGN: Data were......, subsequently, duplex ultrasound imaging was performed. Patients with limb occlusions were identified. For each index patient, two controls were obtained, one immediately preceding and one following the index patient in the consecutive cohort of EVAR patients. METHODS: Demographics and CTA data on limb graft...... occlusions were recorded and compared with a defined control group. Three different indices were used to describe the tortuosity of the iliac vessels based on preoperative CTA: pelvic artery index of tortuosity (PAI), common iliac artery index of tortuosity (CAI), and a visual description of vessel...

  8. Intermittent pneumatic compression: effect on the lower limb bone uptake of Tc99m MDP

    International Nuclear Information System (INIS)

    Introduction: Venous compression of the lower limbs will obstruct outflow through deep and superficial veins, yet inflow will continue without continual swelling of the limb. It is hypothesized that venous channels in the long bones will act as collateral channels to restore outflow, and therefore general blood flow through bone will increase. Such a hemodynamic change should affect the uptake of radiopharmaceuticals by the bone. The purpose of this study therefore was to determine whether bone uptake in the lower limb would be affected by intermittent venous compression, with any mechanism. Materials and Methods: The effect of intermittent pneumatic compression of the thigh and calf on uptake of 99Tcm methylene diphosphonate (MDP) was studied in twenty-four patients. All were undergoing routine bone imaging for medical conditions that were not focussed on their lower limbs, and received 1 hour of the therapy at 60 mmHg on one limb only, after injection of the radiopharmaceutical. Three hours after injection the relative difference in uptake (net counts per pixel) between the two limbs was calculated. Results: The median differences in uptake in the intermittently compressed limb, compared to the contralateral limb, were +7.6% (interquartile range +3.9% to +16.0%, p99Tcm MDP in long bones by probably affected the blood flowing through the bones. (authors)

  9. Psychophysical correlates of phantom limb experience.

    OpenAIRE

    Katz, J

    1992-01-01

    Phantom limb phenomena were correlated with psychophysiological measures of peripheral sympathetic nervous system activity measured at the amputation stump and contralateral limb. Amputees were assigned to one of three groups depending on whether they reported phantom limb pain, non-painful phantom limb sensations, or no phantom limb at all. Skin conductance and skin temperature were recorded continuously during two 30 minute sessions while subjects continuously monitored and rated the intens...

  10. Eficácia da compressão pneumática intermitente (CPI nos membros inferiores sobre o fluxo sanguíneo das veias femorais comuns Efficacy of intermittent pneumatic compression (IPC in lower limbs on the blood flow of common femoral veins

    Directory of Open Access Journals (Sweden)

    Marcondes Figueiredo

    2008-12-01

    Full Text Available CONTEXTO: A profilaxia do tromboembolismo venoso pode ser feita por métodos farmacológicos ou de forma mecânica, com o uso de meias antitrombo e compressão pneumática (CPI. A CPI é um método mecânico de profilaxia que merece melhor atenção da comunidade médica. OBJETIVO: Avaliar o efeito do uso de compressão pneumática intermitente (CPI nos pés, pernas e coxas de adultos saudáveis sobre o fluxo sanguíneo nas veias femorais comuns. MÉTODOS: A amostra foi constituída de 10 voluntários (sete mulheres e três homens adultos (20-40 anos, sem antecedente de tromboembolismo venoso. Após repouso (10 min em decúbito dorsal, o fluxo sanguíneo era medido (três vezes por ultra-sonografia vascular na veia femoral, a 1 cm acima da junção safeno-femoral, em ambos os membros, sem controle e com CPI no pé, perna e na coxa. A compressão (130 mmHg no pé e 45 mmHg na perna e na coxa foi aplicada em ciclos de 11 segundos de compressão e 20-60 segundos de esvaziamento. As aferições de fluxo foram realizadas no pico de fluxo do ciclo de compressão. Os valores foram comparados por análise de variância (teste de Tukey, com p BACKGROUND: Prophylaxis of venous thromboembolism, a very common post-surgical complication, can be made pharmacologically or via mechanical methods, such as the use of anti-thrombosis socks and intermittent pneumatic compression (IPC. IPC is a mechanical method of prophylaxis that deserves the attention of the medical community. OBJECTIVE: To evaluate the effect of IPC on the blood flow of common femoral veins in feet, legs and thighs of healthy adults. METHODS: The sample was comprised of 10 volunteers (seven females and three males, adults (20-40 years, without history of venous thromboembolism. After a rest period (10 min, with the patient in the supine position, blood flow was measured (three times via vascular ultrasonography at the femoral vein, 1 cm above of the saphenofemoral junction, in both limbs

  11. Prevalence and characteristics of phantom limb pain and residual limb pain in the long term following upper limb amputation

    OpenAIRE

    Desmond, Deirdre M.; MacLachlan, Malcolm

    2010-01-01

    This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain following upper limb amputation. Methods: One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Results: Prevalence of phantom limb pain during the week preceding assessment was 42.6% (60/141). Prevalence of residual limb pain was 43.3% (61/1...

  12. Radionuclide lymphoscintigraphy in limb edemas

    International Nuclear Information System (INIS)

    Indirect radionuclide lymphoscintigraphy is a safe, non-invasive and physiological method for the assessment of the limb lymphatic system. Colloids as antimony or rhenium sulphide labeled with 99m technetium have been widely used for morphological studies. Quantitative studies involving a continuous count rate monitoring of the injection sites followed by a computer analysis of dynamic image sequences have been a new promising step for an objective measurement of the peripheral lymphatic function. The injection site is always bilateral on the first web space of either the hand or the foot using a small volume (<0.2 mL) of the radiocolloid. This method has been validated on 30 young healthy volunteers and normal values established from a group of 125 upper and 141 lower limbs (normal subjects). The normal results showed a slight but continuous decrease in lymphatic function depending on the age of the subject. In pathological situations, we observed dysfunction of the lymphatic system in pure lymphoedemas or so-called lympho-venous edemas as demonstrated on the 1,182 upper and 2,463 lower limbs tested. The radionuclide lymphoscintigraphy may be helpful in cases of unilateral swollen limbs demonstrating a lymphatic dysfunction on a clinically normal contralateral limb at the first stage of a distal edema which appears within a few weeks or days, in a transient edema phase when normal status and oedema alternate. The lymphoscintigraphy gives objective and reproducible parameters necessary to assess the lymphatic variation under therapy (decongestive physiotherapy, surgery, drugs) and may be useful in the selection of new lympho-tonic treatments. This method is only reflecting the lymphatic function and is unable to appreciate the total lymphatic flow of the limb. Its results only reflect what happens at the injection site and it may be necessary to add a second test using a proximal injection in order to assess the occurrence of lymph nodes not visualized by the

  13. TRENDS IN REVASCULARIZATION FOR CRITICAL LIMB ISCHEMIA OF LOWER LIMBS

    Directory of Open Access Journals (Sweden)

    Ravikumar

    2014-07-01

    Full Text Available OBJECTIVE: To study the trends in revascularization procedures done for critical limb ischemia (CLI of lower limbs. MATERIALS AND METHODS: Total of 166 revascularization procedures done for CLI by a single vascular surgeon between June 2010 and May 2014 at Kempegowda Institute of Medical Sciences Bangalore. Both endovascular and open bypass procedures for lower limb ischemia were included. This retrospective study was conducted to evaluate the outcomes of the procedures and to see the trends in the management of CLI of lower limb. Only elective cases were included in the study. Emergency revascularization procedures for acute limb ischemia and those below 45 years suspected to be thromboangiitis obliterans were excluded STUDY PERIOD: Review of 4 year experience from June 2010 to May 2014. Follow up period was 24 months. Patients were predominantly male (94%, of the 5th and 7th decade of life (Median age 60 years.All patients presented with chronic lower limb ischemia with critical limb ischemia. Commonest presentation was disabling claudication, rest pain with ulcerations and digital gangrene. Co morbid conditions included diabetes mellitus, smoking history, hypertension, hyperlipidemia, cardiac disease. Total procedures done: Open- 104, Endovascular- 62. Open procedures: Aorto-femoral (21 femoro-femoral (33 femoropopliteal (50. Primary endovascular revascularization procedures angioplasty alone (53 % angioplasty + stenting (47 %. Complication rate was significantly higher and the mean hospital stay was significantly longer with open surgery (15%, 10 days compared with endovascular surgery (0.08%, 4days (P < 0.05. Furthermore the number of endovascular revascularization procedures done significantly increased from6% in the first period (June 2010-May 2011 to 61% in the last period (June2013-May2014. CONCLUSIONS: Endovascular procedures for CLI have largely replaced open surgical procedures. Angioplasty is a feasible, safe, and effective

  14. Limb-girdle muscular dystrophies

    Science.gov (United States)

    ... it may involve other muscles. Causes Limb-girdle muscular dystrophies are a large group of genetic diseases in which there is muscle weakness and ... or a family member has been diagnosed with muscular dystrophy and you are planning a pregnancy. ... Genetic counseling may help some couples and families learn ...

  15. Observation of limb movements reduces phantom limb pain in bilateral amputees

    OpenAIRE

    Tung, Monica L; Murphy, Ian C; Griffin, Sarah C; Alphonso, Aimee L.; Hussey-Anderson, Lindsey; Hughes, Katie E; Weeks, Sharon R; Merritt, Victoria; Yetto, Joseph M; Pasquina, Paul F.; Tsao, Jack W.

    2014-01-01

    Background Mirror therapy has been demonstrated to reduce phantom limb pain (PLP) experienced by unilateral limb amputees. Research suggests that the visual feedback of observing a limb moving in the mirror is critical for therapeutic efficacy. Objective Since mirror therapy is not an option for bilateral lower limb amputees, the purpose of this study was to determine if direct observation of another person’s limbs could be used to relieve PLP. Methods We randomly assigned 20 bilateral lower ...

  16. Blood Clots

    Science.gov (United States)

    ... Index A-Z Blood Clots Blood clots are semi-solid masses of blood that can be stationary (thrombosis) ... treated? What are blood clots? Blood clots are semi-solid masses of blood. Normally, blood flows freely through ...

  17. Limb edemas in cancer patients

    International Nuclear Information System (INIS)

    Diagnostic radiology in cancer patients suffering from limb edemas serves two main purposes: to detect or to rule out lymph node metastases, recurrent cancer, or secondary malignancies, and to differentiate venous edema from lymphedema. The authors suggest an algorithmic pathway where the non-invasive imaging modalities, real-time ultrasonography and computed tomography are recommended as the initial diagnostic step. Both techniques are equally well suited to detect enlarged lymph nodes with high accuracy. In addition, computed tomography allows to a certain degree to separate venous from lymphedema. Phlebography is rarely needed in these patients. Lymphography should only be considered in patients undergoing microsurgical reconstructive operations of the lymphatics (e.g. lymphovenous anastomoses) because this invasive study carries the risk of deteriorating the edematous limb. (orig.)

  18. Limb edemas in cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Peters, P.E.; Groth, W.

    1983-06-20

    Diagnostic radiology in cancer patients suffering from limb edemas serves two main purposes: to detect or to rule out lymph node metastases, recurrent cancer, or secondary malignancies, and to differentiate venous edema from lymphedema. The authors suggest an algorithmic pathway where the non-invasive imaging modalities, real-time ultrasonography and computed tomography are recommended as the initial diagnostic step. Both techniques are equally well suited to detect enlarged lymph nodes with high accuracy. In addition, computed tomography allows to a certain degree to separate venous from lymphedema. Phlebography is rarely needed in these patients. Lymphography should only be considered in patients undergoing microsurgical reconstructive operations of the lymphatics (e.g. lymphovenous anastomoses) because this invasive study carries the risk of deteriorating the edematous limb.

  19. Regenerative Engineering and Bionic Limbs

    OpenAIRE

    James, Roshan; Laurencin, Cato T.

    2015-01-01

    Amputations of the upper extremity are severely debilitating, current treatments support very basic limb movement, and patients undergo extensive physiotherapy and psychological counselling. There is no prosthesis that allows the amputees near-normal function. With increasing number of amputees due to injuries sustained in accidents, natural calamities and international conflicts, there is a growing requirement for novel strategies and new discoveries. Advances have been mad...

  20. The formation of skeletal muscle: from somite to limb.

    Science.gov (United States)

    Buckingham, Margaret; Bajard, Lola; Chang, Ted; Daubas, Philippe; Hadchouel, Juliette; Meilhac, Sigolène; Montarras, Didier; Rocancourt, Didier; Relaix, Frédéric

    2003-01-01

    During embryogenesis, skeletal muscle forms in the vertebrate limb from progenitor cells originating in the somites. These cells delaminate from the hypaxial edge of the dorsal part of the somite, the dermomyotome, and migrate into the limb bud, where they proliferate, express myogenic determination factors and subsequently differentiate into skeletal muscle. A number of regulatory factors involved in these different steps have been identified. These include Pax3 with its target c-met, Lbx1 and Mox2 as well as the myogenic determination factors Myf5 and MyoD and factors required for differentiation such as Myogenin, Mrf4 and Mef2 isoforms. Mutants for genes such as Lbx1 and Mox2, expressed uniformly in limb muscle progenitors, reveal unexpected differences between fore and hind limb muscles, also indicated by the differential expression of Tbx genes. As development proceeds, a secondary wave of myogenesis takes place, and, postnatally, satellite cells become located under the basal lamina of adult muscle fibres. Satellite cells are thought to be the progenitor cells for adult muscle regeneration, during which similar genes to those which regulate myogenesis in the embryo also play a role. In particular, Pax3 as well as its orthologue Pax7 are important. The origin of secondary/fetal myoblasts and of adult satellite cells is unclear, as is the relation of the latter to so-called SP or stem cell populations, or indeed to potential mesangioblast progenitors, present in blood vessels. The oligoclonal origin of postnatal muscles points to a small number of founder cells, whether or not these have additional origins to the progenitor cells of the somite which form the first skeletal muscles, as discussed here for the embryonic limb. PMID:12587921

  1. Gremlin1 induces anterior-posterior limb bifurcations in developing Xenopus limbs but does not enhance limb regeneration.

    Science.gov (United States)

    Wang, Yi-Hsuan; Keenan, Samuel R; Lynn, Jeremy; McEwan, James C; Beck, Caroline W

    2015-11-01

    Gremlin1 (grem1) has been previously identified as being significantly up-regulated during regeneration of Xenopus laevis limbs. Grem1 is an antagonist of bone morphogenetic proteins (BMPs) with a known role in limb development in amniotes. It forms part of a self-regulating feedback loop linking epithelial (FGF) and mesenchymal (shh) signalling centres, thereby controlling outgrowth, anterior posterior and proximal distal patterning. Spatiotemporal regulation of the same genes in developing and regenerating Xenopus limb buds supports conservation of this mechanism. Using a heat shock inducible grem1 (G) transgene to created temperature regulated stable lines, we have shown that despite being upregulated in regeneration, grem1 overexpression does not enhance regeneration of tadpole hindlimbs. However, both the regenerating and contralateral, developing limb of G transgenics developed skeletal defects, suggesting that overexpressing grem1 negatively affects limb patterning. When grem1 expression was targeted earlier in limb bud development, we saw dramatic bifurcations of the limbs resulting in duplication of anterior posterior (AP) pattern, forming a phenotypic continuum ranging from duplications arising at the level of the femoral head to digit bifurcations, but never involving the pelvis. Intriguingly, the original limbs have AP pattern inversion due to de-restricted Shh signalling. We discuss a possible role for Grem1 regulation of limb BMPs in regulation of branching pattern in the limbs. PMID:26527308

  2. Use of a virtual integrated environment in prosthetic limb development and phantom limb pain.

    Science.gov (United States)

    Alphonso, Aimee L; Monson, Brett T; Zeher, Michael J; Armiger, Robert S; Weeks, Sharon R; Burck, J M; Moran, C; Davoodie, R; Loeb, G; Pasquina, Paul F; Tsao, Jack W

    2012-01-01

    Patients face two major difficulties following limb loss: phantom limb pain (PLP) in the residual limb and limited functionality in the prosthetic limb. Many studies have focused on decreasing PLP with mirror therapy, yet few have examined the same visual ameliorating effect with a virtual or prosthetic limb. Our study addresses the following key questions: (1) does PLP decrease through observation of a 3D limb in a virtual integration environment (VIE) and (2) can consistent surface electromyography (sEMG) signals from the VIE drive an advanced modular prosthetic limb (MPL)? Recorded signals from the residual limb were correlated to the desired motion of the phantom limb, and changes in PLP were scored during each VIE session. Preliminary results show an overall reduction in PLP and a trend toward improvement in signal-to-motion accuracy over time. These signals allowed MPL users to perform a wide range of hand motions. PMID:22954877

  3. Unusual Cause of Swelling in the Upper Limb: Kimura Disease

    Directory of Open Access Journals (Sweden)

    Kabilan Chokkappan

    2015-09-01

    Full Text Available Kimura disease is a rare chronic inflammatory disease of unknown etiology. The disease typically presents in young Asian males with single or multiple slowly progressing painless subcutaneous lumps in the head and neck region; regional lymphadenopathy is commonly accompanied. The disease is associated with peripheral blood eosinophilia and elevated serum immunoglobulin E levels. This gives an important clinical clue to the diagnosis and implies a possible immune-mediated pathophysiology. Although the disease commonly affects the head and neck region, it may also affect the extremities, axilla, groin, and abdomen. Upper limb involvement in Kimura’s disease is rare and few cases have been reported in the literature. We describe the case of a man who presented with a history of progressive upper limb swelling. He was diagnosed with Kimura’s disease based on concordant clinical, laboratory, radiological, and histopathological grounds. Although rare in the upper limb, the possibility of Kimura’s disease has to be considered in young males presenting with painless swelling in the medial epitrochlear region with compatible imaging appearance, particularly if associated with lymph node enlargement and increased blood eosinophils. Characteristic imaging findings of Kimura’s disease of the upper limb include specific location along the neuro-lymphovascular structures, the absence of necrosis or calcification, mutliple flow voids representing vascular structures, a varying amount of edema of subcutaneous fat plane overlying the lesion; displacement of adjacent muscles; and neurovascular structures without signs of direct invasion. Clinicians should be aware of this distinct entity in order to avoid misdiagnosis and to tailor appropriate management.

  4. Heterogeneous responses of human limbs to infused adrenergic agonists: a gravitational effect?

    Science.gov (United States)

    Pawelczyk, James A.; Levine, Benjamin D.

    2002-01-01

    Unlike quadrupeds, the legs of humans are regularly exposed to elevated pressures relative to the arms. We hypothesized that this "dependent hypertension" would be associated with altered adrenergic responsiveness. Isoproterenol (0.75-24 ng x 100 ml limb volume-1 x min-1) and phenylephrine (0.025-0.8 microg x 100 ml limb volume-1 x min-1) were infused incrementally in the brachial and femoral arteries of 12 normal volunteers; changes in limb blood flow were quantified by using strain-gauge plethysmography. Compared with the forearm, baseline calf vascular resistance was greater (38.8 +/- 2.5 vs. 26.9 +/- 2.0 mmHg x 100 ml x min x ml-1; P forearm during phenylephrine infusions (P forearm (P blood pooling and capillary filtration in the legs during standing.

  5. Bilateral hind limb hypoplasia in a foal

    International Nuclear Information System (INIS)

    Hypoplasia affecting both hind limbs was observed in a neonatal foal. Scintigraphy aided in establishing diagnosis and prognosis. Radiography revealed an abnormally shaped middle phalanx and lack of the distalphalanx and navicular bone in the right hind limb, with an abnormally shaped distal phalanx and navicular bone in the left hind limb. Scintigraphic findings were closely correlated with the radiographic findings. Radiographic and scintigraphic findings were confirmed at postmortem examination

  6. Risk indicators of reduction limb defects.

    OpenAIRE

    Aro, T.; Heinonen, O P; Saxén, L

    1983-01-01

    The birth of a child with a reduction limb defect (RLD) was evaluated in relation to vaginal bleeding, threatened abortion, and other complications of pregnancy, placental weight, birth weight, family history, parental age, and the outcome of previous pregnancies. The material consisted of 453 cases of reduction limb defect and an equal number of non-malformed controls matched for time and place. The children were born in Finland during 1964-77. The cases with reduction limb defect without ad...

  7. Extracellular Control of Limb Regeneration

    Science.gov (United States)

    Calve, S.; Simon, H.-G.

    Adult newts possess the ability to completely regenerate organs and appendages. Immediately after limb loss, the extracellular matrix (ECM) undergoes dramatic changes that may provide mechanical and biochemical cues to guide the formation of the blastema, which is comprised of uncommitted stem-like cells that proliferate to replace the lost structure. Skeletal muscle is a known reservoir for blastema cells but the mechanism by which it contributes progenitor cells is still unclear. To create physiologically relevant culture conditions for the testing of primary newt muscle cells in vitro, the spatio-temporal distribution of ECM components and the mechanical properties of newt muscle were analyzed. Tenascin-C and hyaluronic acid (HA) were found to be dramatically upregulated in the amputated limb and were co-expressed around regenerating skeletal muscle. The transverse stiffness of muscle measured in situ was used as a guide to generate silicone-based substrates of physiological stiffness. Culturing newt muscle cells under different conditions revealed that the cells are sensitive to both matrix coating and substrate stiffness: Myoblasts on HA-coated soft substrates display a rounded morphology and become more elongated as the stiffness of the substrate increases. Coating of soft substrates with matrigel or fibronectin enhanced cell spreading and eventual cell fusion.

  8. Free anterolateral thigh flap harvesting from paralytic limbs in post-polio syndrome.

    Science.gov (United States)

    Changchien, Chih-Hsuan; Chen, Wei-Chen; Su, Yu-Min

    2016-01-01

    We report two cases of poliomyelitis in which an anterolateral thigh myocutaneous free flap was harvested from the paralytic limb for oral reconstruction. We observed a decrease in the pedicle diameter of the anterolateral thigh flap, but the blood supply to the skin paddle was adequate. PMID:27583272

  9. 21 CFR 890.3475 - Limb orthosis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Limb orthosis. 890.3475 Section 890.3475 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3475 Limb orthosis. (a)...

  10. Genetics Home Reference: limb-girdle muscular dystrophy

    Science.gov (United States)

    ... Health Conditions limb-girdle muscular dystrophy limb-girdle muscular dystrophy Enable Javascript to view the expand/collapse boxes. ... All Open All Close All Description Limb-girdle muscular dystrophy is a term for a group of diseases ...

  11. Cross-limb Interference during motor learning

    DEFF Research Database (Denmark)

    Lauber, Benedikt; Jensen, Jesper Lundbye; Keller, Martin;

    2013-01-01

    It is well known that following skill learning, improvements in motor performance may transfer to the untrained contralateral limb. It is also well known that retention of a newly learned task A can be degraded when learning a competing task B that takes place directly after learning A. Here we...... investigate if this interference effect can also be observed in the limb contralateral to the trained one. Therefore, five different groups practiced a ballistic finger flexion task followed by an interfering visuomotor accuracy task with the same limb. Performance in the ballistic task was tested before the...... training, after the training and in an immediate retention test after the practice of the interference task for both the trained and the untrained hand. After training, subjects showed not only significant learning and interference effects for the trained limb but also for the contralateral untrained limb...

  12. [Psychological adjustment following lower limb amputation].

    Science.gov (United States)

    Panyi, Lilla Krisztina; Lábadi, Beatrix

    2015-09-27

    Rehabilitation of lower limb amputees and the fitting of their prosthesis depend highly on the psychological adjustment process and motivational state of the patient. The loss of a limb is extremely challenging and can cause various physical and psychological problems. Depression, anxiety, decreased well-being and quality of life, body image dissatisfaction and changes in self-concept and identity are frequent after lower limb amputation. In the interest of adjustment patients have to cope with the emerging changes and difficulties in their lifes as well as the problems in psychological functioning. It is important for them to accept the alterations in their body and identity, and integrate them in a new self-concept in which process motivation is a fundamental issue. The aim of this article is to review the literature on psychological consequences of lower limb amputation, and to propose an integrative way of rehabilitation for lower limb amputees. PMID:26550913

  13. Slow Movements of Bio-Inspired Limbs

    Science.gov (United States)

    Babikian, Sarine; Valero-Cuevas, Francisco J.; Kanso, Eva

    2016-05-01

    Slow and accurate finger and limb movements are essential to daily activities, but the underlying mechanics is relatively unexplored. Here, we develop a mathematical framework to examine slow movements of tendon-driven limbs that are produced by modulating the tendons' stiffness parameters. Slow limb movements are driftless in the sense that movement stops when actuations stop. We demonstrate, in the context of a planar tendon-driven system representing a finger, that the control of stiffness suffices to produce stable and accurate limb postures and quasi-static (slow) transitions among them. We prove, however, that stable postures are achievable only when tendons are pretensioned, i.e., they cannot become slack. Our results further indicate that a non-smoothness in slow movements arises because the precision with which individual stiffnesses need to be altered changes substantially throughout the limb's motion.

  14. Lunar western limb pyroclastic deposits

    Science.gov (United States)

    Coombs, Cassandra R.; Hawke, B. Ray

    1991-01-01

    It has become increasingly evident that the lunar pyroclastic volcanism played an important role in the formation and resurfacing of many areas of the Moon. On-going analysis of lunar Orbiter and Apollo photographs continues to locate and identify pyroclastic deposits and suggests that they just may be more ubiquitous than once thought. Located near mare/highland boundaries, many of these deposits formed contemporaneously with effusive mare volcanism. The mantling deposits formed as products of fire-fountaining. Probable source vents for these deposits include irregular depressions at the head of associated sinuous rilles and/or along irregular fractures in the floors of ancient craters. Here, researchers provide a brief synopsis of the nature of the dark mantling deposits and briefly discuss several newly identified deposits on the western limb.

  15. One of the most urgent vascular circumstances: Acute limb ischemia

    OpenAIRE

    Acar, Rezzan D; Sahin, Muslum; Kirma, Cevat

    2013-01-01

    Acute limb ischemia is a sudden decrease in limb perfusion that threatens limb viability and requires urgent evaluation and management. Most of the causes of acute limb ischemia are thrombosis of a limb artery or bypass graft, embolism from the heart or a disease artery, dissection, and trauma. Assessment determines whether the limb is viable or irreversibly damaged. Prompt diagnosis and revascularization by means of catheter-based thrombolysis or thrombectomy and by surgery reduce the risk o...

  16. Effects of L-alanyl-glutamine upon the blood and kidney biochemical parameters in the rat hind limb model of ischemia/reperfusion Efeitos da L-alanil-glutamina sobre os parâmetros bioquímicos do sangue e do rim no rato submetido à isquemia/reperfusão do membro pélvico

    Directory of Open Access Journals (Sweden)

    Marcos Antonio Alves

    2005-12-01

    Full Text Available PURPOSE: To investigate the effects of l-alanyl-glutamine (Ala-Gln intragastric administration upon blood and kidney metabolic parameters alterations in rats subjected to ischemia/reperfusion of hind limb. METHODS: Forty-eight male rats were randomized in 2 groups offered via gavage either saline 2.0 mL (G-1 or Ala-Gln solution 0.75 mgKg-1(G-2 once a day at 7 AM during 7 days. One-hour after the last gavage (Day 7 all rats were submitted to ether anesthesia, laparotomy and clamping of the left iliac artery for 3 h. Kidney and blood samples were collected at the end of ischemic period (3h and at 1-3-6h during reperfusion period for metabolites (pyruvate, lactate, glucose and ketone bodies enzymatic analysis. ATP was also assayed in kidney samples. RESULTS: Lactacemia and ketonemia were significantly increased in Ala-Gln treated rats during reperfusion. Kidney pyruvate concentrations were significantly decreased and tissue lactate concentrations were significantly increased during reperfusion (1h and 3h in G-2 rats compared with respective controls. Glucose, ATP and ketone bodies concentrations were significantly increased in the kidney in L-Ala-Gln treated rats at 3 hours after reperfusion as compared to respective controls. CONCLUSIONS: Unilateral hind limb ischemia in L-Ala-Gln pre-treated rats may induce increased lactacemia and increased kidney lactate concentrations, indicating increased glycolytic activity in renal medulla and in other peripheral tissues. Higher ketonemia during reperfusion may reflect a possible increase in ketogenesis due to lower insulin plasma concentration hepatic signaling as a result of increased glucose oxidation in peripheral tissues, caused by the intra-gastric administration of glutamine dipeptide, suggesting also decreased insulin resistance.OBJETIVO: Investigar alterações dos parâmetros metabólicos no sangue e rim de ratos submetidos à isquemia/reperfusão do membro pélvico. MÉTODOS: Quarenta e oito

  17. Combination of cilostazol and clopidogrel attenuates Rat critical limb ischemia

    Directory of Open Access Journals (Sweden)

    Sheu Jiunn-Jye

    2012-08-01

    Full Text Available Abstract Background and aim Procedural failure and untoward clinical outcomes after surgery remain problematic in critical limb ischemia (CLI patients. This study tested a clopidogrel-cilostazol combination treatment compared with either treatment alone in attenuating CLI and improving CLI-region blood flow in rats. Methods Male Sprague–Dawley rats (n = 40 were equally divided into five groups: control, CLI induction only, CL I + cilostazol (12.0 mg/day/kg, CLI + clopidogrel (8.0 mg/kg/day and CLI + combined cilostazol-clopidogrel. After treatment for 21 days, Laser Doppler imaging was performed. Results On day 21, the untreated CLI group had the lowest ratio of ischemic/normal blood flow (p  Conclusion Combined cilostazol-clopidogrel therapy is superior to either agent alone in improving ischemia in rodent CLI.

  18. Predictors of atherosclerotic lesions of limb arteries according to cardioangiological screening of the adult population

    Directory of Open Access Journals (Sweden)

    R. A. Khokhlov

    2015-11-01

    Full Text Available Aim. To study the predictors of atherosclerotic lesions of arteries identified through a multi-channel volume sphygmography (MCVS. Material and methods. Simultaneous survey of 441 rural residents over 40 years old was performed. Synchronous registration of blood pressure (BP on four limbs using MCVS was fulfilled, and differences in systolic BP between arms (ΔSBParm and legs (ΔSBPleg were calculated. Ankle-brachial index (ABI was also evaluated. │ΔSBParm│≥15 mm Hg or │ΔSBPleg│≥15 mm Hg or ABI≤0.9 were considered as the markers of atherosclerotic arterial disease. Results. A significant asymmetry of SBP (≥15 mmHg was found in 7.7% [95% confidence interval (CI 5.5-10.6%] of patients in the upper limbs and in 6.8% (95 % CI 4.89.6% of patients in the lower extremities. The relative risk of asymmetry of SBP (≥15 mm Hg in the upper limbs increased in hypertension and obesity, and in the lower limbs in men and diabetes. Various quantitative risk factors of the onset and progression of atherosclerosis (age, body mass index, waist circumference, blood glucose, BP level had a positive correlation with the level of asymmetry of SBP on the limbs. Using MCVS and the appropriate combinations of features (SBP asymmetry or ABI≤0.9 allowed us at the stage of screening to find out blood flow disturbances in the arteries of the extremities in 14.7% (95% CI 11.7-18.4% of patients. This detection frequency was significantly higher than that when using only ABI. Conclusion. Identification of significant SBP asymmetry (≥15 mm Hg in the limbs may improve the diagnosis of atherosclerotic arterial disease at the stage of screening.

  19. Blood pressure reduction, persistence and costs in the evaluation of antihypertensive drug treatment – a review

    Directory of Open Access Journals (Sweden)

    Hasford Joerg

    2009-03-01

    Full Text Available Abstract Background Blood pressure lowering drugs are usually evaluated in short term trials determining the absolute blood pressure reduction during trough and the duration of the antihypertensive effect after single or multiple dosing. A lack of persistence with treatment has however been shown to be linked to a worse cardiovascular prognosis. This review explores the blood pressure reduction and persistence with treatment of antihypertensive drugs and the cost consequences of poor persistence with pharmaceutical interventions in arterial hypertension. Methods We have searched the literature for data on blood pressure lowering effects of different antihypertensive drug classes and agents, on persistence with treatment, and on related costs. Persistence was measured as patients' medication possession rate. Results are presented in the form of a systematic review. Results Angiotensin II receptor blocker (ARBs have a competitive blood pressure lowering efficacy compared with ACE-inhibitors (ACEi and calcium channel blockers (CCBs, beta-blockers (BBs and diuretics. 8 studies describing the persistence with treatment were identified. Patients were more persistent on ARBs than on ACEi and CCBs, BBs and diuretics. Thus the product of blood pressure lowering and persistence was higher on ARBs than on any other drug class. Although the price per tablet of more recently developed drugs (ACEi, ARBs is higher than that of older ones (diuretics and BBs, the newer drugs result in a more favourable cost to effect ratio when direct drug costs and indirect costs are also considered. Conclusion To evaluate drugs for the treatment of hypertension several key variables including the blood pressure lowering effect, side effects, compliance/persistence with treatment, as well as drug costs and direct and indirect costs of medical care have to be considered. ARBs, while nominally more expensive when drug costs are considered only, provide substantial cost savings

  20. Cross-limb interference during motor learning.

    Directory of Open Access Journals (Sweden)

    Benedikt Lauber

    Full Text Available It is well known that following skill learning, improvements in motor performance may transfer to the untrained contralateral limb. It is also well known that retention of a newly learned task A can be degraded when learning a competing task B that takes place directly after learning A. Here we investigate if this interference effect can also be observed in the limb contralateral to the trained one. Therefore, five different groups practiced a ballistic finger flexion task followed by an interfering visuomotor accuracy task with the same limb. Performance in the ballistic task was tested before the training, after the training and in an immediate retention test after the practice of the interference task for both the trained and the untrained hand. After training, subjects showed not only significant learning and interference effects for the trained limb but also for the contralateral untrained limb. Importantly, the interference effect in the untrained limb was dependent on the level of skill acquisition in the interfering motor task. These behavioural results of the untrained limb were accompanied by training specific changes in corticospinal excitability, which increased for the hemisphere ipsilateral to the trained hand following ballistic training and decreased during accuracy training of the ipsilateral hand. The results demonstrate that contralateral interference effects may occur, and that interference depends on the level of skill acquisition in the interfering motor task. This finding might be particularly relevant for rehabilitation.

  1. Customizable Rehabilitation Lower Limb Exoskeleton System

    Directory of Open Access Journals (Sweden)

    Riaan Stopforth

    2012-10-01

    Full Text Available Disabled people require assistance with the motion of their lower limbs to improve rehabilitation. Exoskeletons used for lower limb rehabilitation are highly priced and are not affordable to the lowerincome sector of the population. This paper describes an exoskeleton lower limb system that was designed keeping in mind that the cost must be as low as possible. The forward kinematic system that is used must be a simplified model to decrease computational time, yet allow the exoskeleton to be adjustable according to the patient’s leg dimensions.

  2. A comparison of blood pressure measurements in newborns.

    LENUS (Irish Health Repository)

    O'Shea, Joyce

    2012-02-01

    Blood pressure monitoring is an essential component of neonatal intensive care. We compared invasive and noninvasive (Dinamap, Marquette, and Dash) recordings in newborns and also noninvasive values obtained from upper and lower limbs. Infants\\' blood pressure was recorded every 6 hours for 72 hours using three noninvasive devices and compared with invasive readings taken simultaneously. Twenty-five babies were enrolled in the study, with birth weights of 560 to 4500 g and gestation 24 + 1 to 40 + 5 weeks. Three hundred thirty-two recordings were obtained. Comparison between invasive and noninvasive readings revealed that all three noninvasive monitors overread mean blood pressure. There was no significant difference between the cuff recordings obtained from the upper or lower limbs. All three noninvasive devices overestimated mean blood pressure values compared with invasive monitoring. Clinicians may be falsely reassured by noninvasive monitoring. Mean blood pressure values obtained from the upper and lower limb are similar.

  3. Blood pressure

    Science.gov (United States)

    ... the walls of the arteries is called blood pressure. Blood pressure is measured both as the heart contracts, which ... as it relaxes, which is called diastole. Normal blood pressure is considered to be a systolic blood pressure ...

  4. Blood transfusions

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000431.htm Blood transfusions To use the sharing features on this ... several sources of blood which are described below. Blood From the Public (Volunteer Blood Donation) The most ...

  5. Blood Basics

    Science.gov (United States)

    ... Patient Group Links Advocacy Toolkit Home For Patients Blood Basics Blood is a specialized body fluid. It ... about 9 pints. Jump To: The Components of Blood and Their Importance Many people have undergone blood ...

  6. Blood Thinners

    Science.gov (United States)

    If you have some kinds of heart or blood vessel disease, or if you have poor blood flow to your brain, your doctor may recommend that you take a blood thinner. Blood thinners reduce the risk of heart ...

  7. Blood culture

    Science.gov (United States)

    Culture - blood ... A blood sample is needed . The site where blood will be drawn is first cleaned with an antiseptic such ... organism from the skin getting into (contaminating) the blood sample and causing a false-positive result (see ...

  8. Heart Allograft Tolerance Induced and Maintained by Vascularized Hind-Limb Transplant in Rats

    Directory of Open Access Journals (Sweden)

    Quan Liu

    2013-01-01

    Full Text Available Organ/tissue transplantation has become an effective therapy for end-stage diseases. However, immunosuppression after transplantation may cause severe side effects. Donor-specific transplant tolerance was proposed to solve this problem. In this study, we report a novel method for inducing and maintaining heart allograft tolerance rats. First, we induced indefinite vascularized hind-limb allograft survival with a short-term antilymphocyte serum + Cyclosporine A treatment. Peripheral blood chimerism disappeared 6-7 weeks after immunosuppression was withdrawn. Then the recipients accepted secondary donor-strain skin and heart transplantation 200 days following vascularized hind-limb transplantation without any immunosuppression, but rejected third party skin allografts, a status of donor-specific tolerance. The ELISPOT results suggested a mechanism of clone deletion. These findings open new perspectives for the role of vascularized hind-limb transplant in the induction and maintenance of organ transplantation tolerance.

  9. Acute lower limb compartment syndrome after Cesarean section: a case report

    Directory of Open Access Journals (Sweden)

    Sütterlin Marc

    2011-04-01

    Full Text Available Abstract Introduction Acute compartment syndrome of the lower limb is a rare but severe intra- and post-partum complication. Prompt diagnosis is essential to avoid permanent functional restriction or even the loss of the affected limb. Clinical signs and symptoms might be nonspecific, especially in the early stages; therefore, knowledge of predisposing risk factors can be helpful. Case presentation We present the case of a 32-year-old Caucasian woman with acute post-partum compartment syndrome. Conclusion Acute compartment syndrome is an important differential diagnosis for the sudden onset of intra- or post-partum lower-limb pain. Predisposing factors for the manifestation of acute compartment syndrome in an obstetric environment are augmented intra-partum blood loss, prolonged hypotensive episodes and the use of oxytocin to support or induce labor because of its vasoconstrictive properties. Treatment is prompt surgical decompression by performing fasciotomy in any affected muscular compartments.

  10. Atypical Supernumerary Phantom Limb and Phantom Limb Pain in Two Patients with Pontine Hemorrhage

    OpenAIRE

    Yoo, Seung Don; Kim, Dong Hwan; Jeong, Yong Seol; Chon, Jinmann; Bark, Jihea

    2011-01-01

    Phantom limbs are usually observed after amputation of extremities. In patients after a stroke, a similar but rarely occurring phenomenon consisting of the patient experiencing the presence of an additional limb has been described. This phenomenon, generally called supernumerary phantom limb (SPL), may be caused by lesions in the right or left cerebral hemisphere, but has been predominantly reported in patients who have had a right hemispheric stroke. We report two cases of atypical SPL and p...

  11. Obstacle crossing in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A.H.; van Keeken, H.G.; Schoppen, Tanneke; Otten, Egbert; Halbertsma, J.P.; Hof, A.L.; Postema, K.

    2007-01-01

    Objective: To study limitations in function and adjustment strategies in lower limb amputees during obstacle crossing. Design: Observational cohort study. Subjects: Transfemoral and transtibial amputees and able-bodied control subjects. Methods: In a motion analysis laboratory unimpeded and obstacle

  12. Tips for Taking Care of Your Limb

    Science.gov (United States)

    ... knee and hip; this makes walking, and even lying in bed, more comfortable. Skin Care Wash your ... for your prosthesis or your alignment will be wrong, putting a strain on your residual limb and ...

  13. Mirror Therapy for Phantom Limb Pain

    OpenAIRE

    Kim, Sae Young; Kim, Yun Young

    2012-01-01

    Phantom limb pain is a painful sensation that is perceived in a body part that no longer exists. To control this pain, many methods have been used such as medication, physical treatment, nerve block, neuromodulation, surgical treatment and mirror therapy. However, until now, there effects have been uncertain. We report the successful reduction of phantom limb pain using mirror therapy when other treatments initially failed to control the pain.

  14. Phantom Limb Pain: Mechanisms and Treatment Approaches

    OpenAIRE

    Bishnu Subedi; George T. Grossberg

    2011-01-01

    The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of preamputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral and central neural changes involving cortical reorganization. More recently, the role of mirror neuron...

  15. Collagen gene expression during limb cartilage differentiation

    OpenAIRE

    1986-01-01

    As limb mesenchymal cells differentiate into chondrocytes, they initiate the synthesis of type II collagen and cease synthesizing type I collagen. Changes in the cytoplasmic levels of type I and type II collagen mRNAs during the course of limb chondrogenesis in vivo and in vitro were examined using cloned cDNA probes. A striking increase in cytoplasmic type II collagen mRNA occurs coincident with the crucial condensation stage of chondrogenesis in vitro, in which prechondrogenic mesenchymal c...

  16. Acupuncture treatment of phantom limb pain and phantom limb sensation in a primary care setting.

    Science.gov (United States)

    Davies, Arwel

    2013-03-01

    A 45-year-old man presented with phantom limb pain and phantom limb sensation 12 weeks after an above-elbow amputation of his right arm. He underwent seven sessions of acupuncture at weekly intervals carried out by his general practitioner on his intact left arm, with complete relief of the phantom limb pain and considerable improvement of the phantom limb sensation of his right arm. This case demonstrates the possible benefits from the use of short acupuncture sessions for a potentially chronic condition undertaken within the constraints of a busy general medical practice. PMID:23220713

  17. 21 CFR 890.3500 - External assembled lower limb prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External assembled lower limb prosthesis. 890.3500... External assembled lower limb prosthesis. (a) Identification. An external assembled lower limb prosthesis... the lower extremity. Examples of external assembled lower limb prostheses are the following:...

  18. LIMB Demonstration Project Extension and Coolside Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Goots, T.R.; DePero, M.J.; Nolan, P.S.

    1992-11-10

    This report presents results from the limestone Injection Multistage Burner (LIMB) Demonstration Project Extension. LIMB is a furnace sorbent injection technology designed for the reduction of sulfur dioxide (SO[sub 2]) and nitrogen oxides (NO[sub x]) emissions from coal-fired utility boilers. The testing was conducted on the 105 Mwe, coal-fired, Unit 4 boiler at Ohio Edison's Edgewater Station in Lorain, Ohio. In addition to the LIMB Extension activities, the overall project included demonstration of the Coolside process for S0[sub 2] removal for which a separate report has been issued. The primary purpose of the DOE LIMB Extension testing, was to demonstrate the generic applicability of LIMB technology. The program sought to characterize the S0[sub 2] emissions that result when various calcium-based sorbents are injected into the furnace, while burning coals having sulfur content ranging from 1.6 to 3.8 weight percent. The four sorbents used included calcitic limestone, dolomitic hydrated lime, calcitic hydrated lime, and calcitic hydrated lime with a small amount of added calcium lignosulfonate. The results include those obtained for the various coal/sorbent combinations and the effects of the LIMB process on boiler and plant operations.

  19. Myokymia of lower limbs for over one year

    Directory of Open Access Journals (Sweden)

    Jing ZHAO

    2015-09-01

    Full Text Available A 51-year-old man came to our outpatient for one-year history of progressive myokymia in both legs. He had initially noted a “continuous muscle-fiber activity” of lower limbs in July 2013. Two months later, similar symptoms progressively affected muscles in both thighs and fundament, which was persistent during sleep. The frequency, duration and severity were gradually increased. He suffered from a feeling of tiredness and fatigue in both legs after long-time walking. In the local hospital, spinal MRI showed protrusion of C5-6, L4-5, L5-S1 intervertebral disc. One day in Oct 2013, his legs subsequently became generally stiff and painful to the point of a stiff paralysis and presented excessive sweating after drunk. This attack lasted for 30 min. Then he came to our clinic. Routine blood tests were normal. Electromyographic examination showed neurogenic damages of left thoracic paraspinal muscles. Abnormal F wave of left lower limb and discrete waveform of four limbs could be seen. Nerve conduction velocity (NCV and sympathetic skin response (SSR were unremarkable. Treatments with oral phenytoin sodium and carbamazepine were all ineffective. The attack occurred only a few times a year, especially after drunk, as well as the frequency, duration and severity roughly similar. He was admitted in our hospital in Oct 2014. The patient had a 9-year history of high blood pressure and the family history was normal. Neurological examination revealed generalized leg muscle hypertrophy, especially the gastrocnemius muscle, despite lack of physical exercise. Cranial nerves were intact. Hyperhidrosis was noted along with abundant myokymia that were evident in lower limbs. Muscle bulk and strength of upper limbs were normal. The deep tendon reflexes of lower limbs were unobtainable. Sensory and cerebellar examination revealed no dysfunction. Laboratory records showed that serum A type Sjögren's syndrome antibody (SSA and Ro52 antibody was positive

  20. Basic characteristics of duplexsonographyin the assessment of lower limb arterial circulation

    Directory of Open Access Journals (Sweden)

    Vučaj-Ćirilović Viktorija

    2006-01-01

    Full Text Available Introduction. Dulpex and color duplex ultrasonography of lower limb arteries are valuable non-invasive diagnostic methods in the pathology of vascular diseases and a major step in diagnostics and in follow-up of hemodynamic and morphologic characteristics. Color Duplex Sonography. The method consists of image analysis and analysis of Doppler information. Real-time-B mode is used to visualize the anatomy of blood vessels and other pathological lesions. Doppler information based on the Doppler effect determine the pulse wave i.e. the shape of flow velocity - hemodynamic characteristics. Spectral analysis is the most important element ofDoppler examination of the lower limb peripheral arteries. Based on the spectral analysis, there are four stages of lower limb arterial disease: normal findings - 1%-19% diameter reduction; medium stenosis - artery diameter reduction of 20%-49%; high level stenosis - artery diameter reduction of 50%-100%; occlusion - no flow detected within the imaged arterial segment. In the first place, both iliac arteries are examined, which is followed with femoral, popliteal and crural arteries. The examination of iliac arteries is carried out with a 3.5 MHz transducer, and other peripheral arteries of the lower limbs are examined with a 7,5 or 5 MHz transducer. Conclusion. Color Doppler is an extremely valuable diagnostic method in detecting pathology of the lower limb arteries. With high reliability level arterial insufficiency and pathological arterial segments are diagnosed by a duplex-Doppler. .

  1. Structured movement representations of a phantom limb associated with phantom limb pain.

    Science.gov (United States)

    Osumi, Michihiro; Sumitani, Masahiko; Wake, Naoki; Sano, Yuko; Ichinose, Akimichi; Kumagaya, Shin-Ichiro; Kuniyoshi, Yasuo; Morioka, Shu

    2015-09-25

    The relation between phantom limb pain (PLP) and the movement representation of a phantom limb remains controversial in several areas of neurorehabilitation, although there are a few studies in which the representation of phantom limb movement was precisely evaluated. We evaluated the structured movement representation of a phantom limb objectively using a bimanual circle-line coordination task. We then investigated the relation between PLP and the structured movement representation. Nine patients with a brachial plexus avulsion injury were enrolled who perceived a phantom limb and had neuropathic pain. While blindfolded, the participants repeatedly drew vertical lines using the intact hand and intended to draw circles using the phantom limb simultaneously. "Drawing of circles" by the phantom limb resulted in an oval transfiguration of the vertical lines ("bimanual coupling" effect). We used an arbitrary ovalization index (OI) to quantify the oval transfiguration. When the OI neared 100%, the trajectory changed toward becoming more circular. A significant negative correlation was observed between the intensity of PLP and the OI (r=-0.66, pphantom limb are necessary for alleviating PLP. PMID:26272300

  2. Effect of upper limb, lower limb and combined training on health-related quality of life in COPD

    OpenAIRE

    Subin,; Rao Vaishali; Prem V; Sahoo

    2010-01-01

    Objectives: To study the effect of unsupported upper limb and lower limb exercise training and their combined influence on the exercise performance and health-related quality of life in COPD patients. Materials and Methods: Thirty patients were randomly assigned to one of the three groups, through block randomization. Of the three groups, group A received upper limb training, group B received lower limb training, and group C received both upper and lower limb training. Patients in group A,...

  3. Temporal changes in clinic and ambulatory blood pressure during cyclic post-menopausal hormone replacement therapy

    DEFF Research Database (Denmark)

    Sørensen, M B; Rasmussen, Verner; Jensen, Gorm Boje;

    2000-01-01

    OBJECTIVE: Post-menopausal hormone replacement (HRT) might protect against cardiovascular disease, possibly by arterial vasodilation and reduced blood pressure. Progestogens are needed to avoid endometrial disease but vascular effects are controversial. The objective was to assess temporal change...... but the reduction varies with the HRT regimen, which might explain the diversity in previous BP findings during HRT. Norethisterone acetate might possess additive blood pressure-lowering effects in postmenopausal women....

  4. Radionuclide lympho- and venography in the diagnosis of radiation edema of the lower limbs

    International Nuclear Information System (INIS)

    Lymphography and venography were used for diagnosis of radiation edemas of the lower limbs in patients receiving radiation or combined therapy for malignant tumors of the female genital organs. It was established that sup(99m)Tc-lymphocys could be used to detect lymphostasis, to determine the level and nature of the lymphatic trochlea. An additional study of the venous blood flow made it possible to determine the type of disorder of the lymph flow. Radionuclide methods of the investigation of the lymph flow and venous blood flow are easy to use, atraumatic and quite informative, therefore they should be recommended for the investigation of patients with radiation edemas of the limbs to determine indications for surgery

  5. Phantom limb pain: mechanisms and treatment approaches.

    Science.gov (United States)

    Subedi, Bishnu; Grossberg, George T

    2011-01-01

    The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of preamputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral and central neural changes involving cortical reorganization. More recently, the role of mirror neurons in the brain has been proposed in the generation of phantom pain. A wide variety of treatment approaches have been employed, but mechanism-based specific treatment guidelines are yet to evolve. Phantom limb pain is considered a neuropathic pain, and most treatment recommendations are based on recommendations for neuropathic pain syndromes. Mirror therapy, a relatively recently proposed therapy for phantom limb pain, has mixed results in randomized controlled trials. Most successful treatment outcomes include multidisciplinary measures. This paper attempts to review and summarize recent research relative to the proposed mechanisms of and treatments for phantom limb pain. PMID:22110933

  6. Phantom Limb Pain: Mechanisms and Treatment Approaches

    Science.gov (United States)

    Subedi, Bishnu; Grossberg, George T.

    2011-01-01

    The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of preamputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral and central neural changes involving cortical reorganization. More recently, the role of mirror neurons in the brain has been proposed in the generation of phantom pain. A wide variety of treatment approaches have been employed, but mechanism-based specific treatment guidelines are yet to evolve. Phantom limb pain is considered a neuropathic pain, and most treatment recommendations are based on recommendations for neuropathic pain syndromes. Mirror therapy, a relatively recently proposed therapy for phantom limb pain, has mixed results in randomized controlled trials. Most successful treatment outcomes include multidisciplinary measures. This paper attempts to review and summarize recent research relative to the proposed mechanisms of and treatments for phantom limb pain. PMID:22110933

  7. Phantom Limb Pain: Mechanisms and Treatment Approaches

    Directory of Open Access Journals (Sweden)

    Bishnu Subedi

    2011-01-01

    Full Text Available The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of preamputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral and central neural changes involving cortical reorganization. More recently, the role of mirror neurons in the brain has been proposed in the generation of phantom pain. A wide variety of treatment approaches have been employed, but mechanism-based specific treatment guidelines are yet to evolve. Phantom limb pain is considered a neuropathic pain, and most treatment recommendations are based on recommendations for neuropathic pain syndromes. Mirror therapy, a relatively recently proposed therapy for phantom limb pain, has mixed results in randomized controlled trials. Most successful treatment outcomes include multidisciplinary measures. This paper attempts to review and summarize recent research relative to the proposed mechanisms of and treatments for phantom limb pain.

  8. Pharmacological interventions for phantom limb pain

    Institute of Scientific and Technical Information of China (English)

    FANG Jun; LIAN Yan-hong; XIE Kang-jie; CAI Shu-nü

    2013-01-01

    Objective To review the mechanisms and current clinical application of pharmacological interventions for phantom limb pain.Data sources Both Chinese and English language literatures were searched using MEDLINE (1982-2011),Pubmed (1982-2011) and the Index of Chinese Language Literature (1982-2011).Study selection Data from published articles about pharmacological management of phantom limb pain in recent domestic and foreign literature were selected.Data extraction Data were mainly extracted from 96 articles which are listed in the reference section of this review.Results By reviewing the mechanisms and current clinical application of pharmacological interventions for phantom limb pain,including anticonvulsants,antidepressants,local anaesthetics,N-methyl-D-aspartate receptor antagonists,non-steroidal anti-inflammatory drugs,tramadol,opioids,calcitonin,capsaicin,beta-adrenergic blockers,clonidine,muscle relaxants,and emerging drugs,we examined the efficacy and safety of these medications,outlined the limitations and future directions.Conclusions Although there is lack of evidence-based consensus guidelines for the pharmacological management of phantom limb pain,we recommend tricyclic antidepressants,gabapentin,tramadol,opioids,local anaesthetics and N-methyl-D-aspartate receptor antagonists as the rational options for the treatment of phantom limb pain.

  9. Cell Therapy in Patients with Critical Limb Ischemia

    Directory of Open Access Journals (Sweden)

    Rita Compagna

    2015-01-01

    Full Text Available Critical limb ischemia (CLI represents the most advanced stage of peripheral arterial obstructive disease (PAOD with a severe obstruction of the arteries which markedly reduces blood flow to the extremities and has progressed to the point of severe rest pain and/or even tissue loss. Recent therapeutic strategies have focused on restoring this balance in favor of tissue survival using exogenous molecular and cellular agents to promote regeneration of the vasculature. These are based on stimulation of angiogenesis by extracellular and cellular components. This review article carries out a systematic analysis of the most recent scientific literature on the application of stem cells in patients with CLI. The results obtained from the detailed analysis of the recent literature data have confirmed the beneficial role of cell therapy in reducing the rate of major amputations in patients with CLI and improving their quality of life.

  10. Blood Types

    Science.gov (United States)

    ... How Can I Help a Friend Who Cuts? Blood Types KidsHealth > For Teens > Blood Types Print A A ... or straight hair instead of curly. ...Make Eight Blood Types The different markers that can be found in ...

  11. Blood Types

    Science.gov (United States)

    ... confidence to respond in emergency situations with the skills that can help to save a life. Learn more » Red Cross Information Donating Blood Learn About Blood Hosting a Blood Drive For Hospitals Engage with Us About Us Media ...

  12. Limb Regeneration is Impaired in an Adult Zebrafish Model of Diabetes Mellitus

    OpenAIRE

    Olsen, Ansgar S.; Sarras, Michael P.; Intine, Robert V.

    2010-01-01

    The zebrafish (Danio Rerio) is an established model organism for the study of developmental processes, human disease and tissue regeneration. We report that limb regeneration is severely impaired in our newly developed adult zebrafish model of type I diabetes. Intraperitoneal streptozocin injection of adult, wild type zebrafish results in a sustained hyperglycemic state as determined by elevated fasting blood glucose values and increased glycation of serum protein. Serum insulin levels are al...

  13. Pneumococcal sepsis presenting as acute compartment syndrome of the lower limbs: a case report

    OpenAIRE

    Doddi Sudeendra; Singhal Tarun; Sinha Prakash

    2009-01-01

    Abstract Introduction Acute compartment syndrome is a surgical emergency requiring immediate fasciotomy. Spontaneous onset of acute compartment syndrome of the lower limbs is rare. We present a very rare case of pneumococcal sepsis leading to spontaneous acute compartment syndrome. Case presentation A 40-year-old Caucasian man presented as an emergency with spontaneous onset of pain in both legs and signs of compartment syndrome. This was confirmed on fasciotomy. Blood culture grew Streptococ...

  14. Comparison of three skin-stretching devices for closing skin defects on the limbs of dogs

    OpenAIRE

    Tsioli, Vassiliki; Papazoglou, Lysimachos G.; Papaioannou, Nikolaos; PSALLA, Dimitra; SAVVAS, Ioannis; Pavlidis, Leonidas; Karayannopoulpou, Maria

    2015-01-01

    Our objective was to evaluate the effectiveness of skin-stretching devices for closing defects on the extremities of dogs. Antebrachial skin defects were created on the limbs of 24 dogs randomly divided into three groups. Skin stretchers included staples and sutures passing through them (group A), sutures and hypodermic needles (group B), and Pavletic device (group C). Wounds on the left were further undermined in all groups. Tension and blood perfusion were assessed. After removing the stret...

  15. Radionuclide assessment of lower limb perfusion using 99mTc-MIBI in early stages of atherosclerosis

    International Nuclear Information System (INIS)

    The aim of the work was a scintigraphic evaluation of regional blood supply of thigh and calf muscles using 99mTc-MIBI as a radiopharmaceutical, in early stages of atherosclerosis revealed during ultrasonographic examination of lower limbs, in patients without typical clinical symptoms of chronic ischaemia of lower limbs and with preserved normal Doppler spectrum of blood flow. Moreover, basic relations between early signs of lower limb atherosclerosis and abnormal myocardial perfusion, as well as asymptomatic hypoperfusion of lower limbs, were analysed. Stress and rest radionuclide study of lower limb muscles and myocardium using 99mTc-MIBI was performed in 47 men, who were divided into two groups based on ultrasonography results. The first group (group I) comprised 22 patients with early atherosclerotic changes in peripheral vessels and the second (group II) comprised 25 people with normal arteries. For the purposes of quantification of study results normal values of regional blood supply and indices of asymmetry at levels of thighs and calves, as proposed by Segall et al., were applied. Myocardial scintigrams were evaluated according to widely accepted rules (visual and semi quantitative ? normative analysis). Mean values of stress and rest perfusion indices of thighs as well as calves in gr. I were statistically significantly lower (p < 0.001) than in gr. II. Incidence of asymmetry in the stress perfusion of calves and thighs was statistically significantly higher (p = 0.04) in patients with atherosclerotic changes as compared with the control group. Abnormal myocardial perfusion was found in 77% of patients from group I and in 28% from group II (p = 0.001). Reversible, stress induced ischaemia was found in 59% and 16%, resp. (p = 0.01). 1. Radionuclide study revealed a reduced stress as well as rest perfusion of lower limb muscles in clinically asymptomatic patients with atherosclerotic changes of lower limb vessels of low degree and a preserved normal Doppler

  16. Phantom limb pain: a nursing perspective.

    Science.gov (United States)

    Virani, Anila; Green, Theresa; Turin, Tanvir C

    2014-09-01

    Phantom limb pain (PLP) is a neuropathic pain condition occurring after amputation of a limb. PLP affects amputees' quality of life and results in loss of productivity and psychological distress. The origin of pain from a non-existing limb creates a challenging situation for both patients and nurses. It is imperative to provide patients and nurses with the knowledge that PLP is a real phenomenon that requires care and treatment. This knowledge will lead to reduced problems for patients by allowing them to talk about PLP and ask for help when needed. Understanding of this phenomenon will enable nurses to appreciate the unique features of this form of neuropathic pain and apply appropriate techniques to promote effective pain management. Performing accurate and frequent assessments to understand the unique characteristics of PLP, displaying a non-judgemental attitude towards patients and teaching throughout the peri-operative process are significant nursing interventions. PMID:25182922

  17. Limb Girdle Muscular Dystrophy (LGMD): Case Report

    Science.gov (United States)

    Kalyan, Meenakshi; Gaikwad, Anu N.; Makadia, Ankit; Shah, Harshad

    2015-01-01

    We report a young male of autosomal recessive limb girdle muscular dystrophy (LGMD) with positive family history presented with gradual onset proximal muscle weakness in all four limbs since eight years and thinning of shoulders, arms and thighs. Neurological examination revealed atrophy of both shoulders with wasting of both deltoids thinning of thighs and pseudo hypertrophy of both calves, hypotonia in all four limbs. Gower’s sign was positive. Winging of scapula was present. Power was 3/5 at both shoulders, 4/5 at both elbows, 5/5 at both wrists, 3/5 at both hip joints, 3/5 at both knees, 5/5 at both ankles. All deep tendon reflexes and superficial reflexes were present with plantars bilateral flexors. Electromyography (EMG) showed myopathic pattern. He had elevated creatinine phosphokinase levels and muscle biopsy findings consistent with muscular dystrophy. PMID:25738022

  18. Immunoelectrophoresis - blood

    Science.gov (United States)

    IEP - serum; Immunoglobulin electrophoresis - blood; Gamma globulin electrophoresis; Serum immunoglobulin electrophoresis ... A blood sample is needed. For information on how this is done, see: Venipuncture

  19. Review of the Relationship of Restless Legs Syndrome and Periodic Limb Movements in Sleep to Hypertension, Heart Disease, and Stroke

    OpenAIRE

    Walters, Arthur S.; Rye, David B.

    2009-01-01

    Evidence is reviewed documenting an intimate relationship among restless legs syndrome (RLS) / periodic limb movements in sleep (PLMS) and hypertension and cardiovascular and cerebrovascular disease. Sympathetic overactivity is associated with RLS/PLMS, as manifested by increased pulse rate and blood pressure coincident with PLMS. Causality is far from definitive. Mechanisms are explored as to how RLS/PLMS may lead to high blood pressure, heart disease, and stroke: (a) the sympathetic hyperac...

  20. [Phantom limb pain. Psychological treatment strategies].

    Science.gov (United States)

    Diers, M; Flor, H

    2013-04-01

    Similar to other pain syndromes phantom limb pain is characterized by learning and memory processes that maintain the pain and increase maladaptive plastic changes of the brain: therefore, psychological interventions that change maladaptive memory processes are useful. In addition to traditional psychological interventions, such as pain management training and biofeedback, more recent developments that involve sensory discrimination training, mirror treatment, graded motor imagery, prosthesis training and training in virtual reality are interesting. These interventions not only reduce phantom limb pain but also reverse the associated maladaptive brain changes. PMID:23588803

  1. Creation of distal canine limb lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Chen, H.C.; Pribaz, J.J.; O' Brien, B.M.; Knight, K.R.; Morrison, W.A.

    1989-06-01

    A canine model of distal limb lymphedema was established in order to study the treatment of this condition by lymph node transfer. This model was more difficult to establish than whole-limb lymphedema. Significant edema was achieved by a combination of preoperative irradiation and circumferential removal of skin from the irradiated areas followed by removal of the contents of the popliteal fossa. Despite these measures, it was not possible to produce lymphedema in every case, possibly because of the presence of lymphaticovenous shunts and panvascular compensation mechanisms.

  2. Myoelectric signal features for upper limb prostheses

    OpenAIRE

    Bach, Per Ferdinand

    2009-01-01

    In the last couple of years The Institute of Cybernetics at NTNU, Norway, has based its research on the SVEN work carried out in Sweden in the late 1970’s. The SVEN hand was an on/off-controlled upper limb prosthesis based on electromyographic (EMG) signals. This master thesis is a part of the renewed and continuing research. This study will try to identify signal features that are beneficial in a proportional control of a multi-function upper limb prosthesis. The intent is to identify a set ...

  3. Cocaine-associated lower limb ischemia.

    LENUS (Irish Health Repository)

    Collins, Chris G

    2011-07-25

    Cocaine-associated thrombosis has been reported in the literature with reports of vascular injuries to cardiac, pulmonary, intestinal, placental, and musculoskeletal vessels; however, injury of the pedal vessels is rare. We report on a 31-year-old man who presented 2 months following a cocaine binge with limb-threatening ischemia without an otherwise identifiable embolic source. Angiography confirmed extensive occlusive disease of the tibioperoneal vessels. The patient improved following therapy with heparin and a prostacyclin analogue. Cocaine-induced thrombosis should be considered in patients presenting with acute arterial insufficiency in the lower limb without any other identifiable cause.

  4. Phantom limb perception interferes with motor imagery after unilateral upper-limb amputation.

    Science.gov (United States)

    Lyu, Yuanyuan; Guo, Xiaoli; Bekrater-Bodmann, Robin; Flor, Herta; Tong, Shanbao

    2016-01-01

    A potential contributor to impaired motor imagery in amputees is an alteration of the body schema as a result of the presence of a phantom limb. However, the nature of the relationship between motor imagery and phantom experiences remains unknown. In this study, the influence of phantom limb perception on motor imagery was investigated using a hand mental rotation task by means of behavioral and electrophysiological measures. Compared with healthy controls, significantly prolonged response time for both the intact and missing hand were observed specifically in amputees who perceived a phantom limb during the task but not in amputees without phantom limb perception. Event-related desynchronization of EEG in the beta band (beta-ERD) in central and parietal areas showed an angular disparity specifically in amputees with phantom limb perception, with its source localized in the right inferior parietal lobule. The response time as well as the beta-ERD values were significantly positively correlated with phantom vividness. Our results suggest that phantom limb perception during the task is an important interferential factor for motor imagery after amputation and the interference might be related to a change of the body representation resulting from an unnatural posture of the phantom limb. PMID:26879749

  5. Limb suction evoked during arterial occlusion causes systemic sympathetic activity in humans.

    Science.gov (United States)

    Cui, Jian; Blaha, Cheryl; Herr, Michael D; Drew, Rachel C; Muller, Matthew D; Sinoway, Lawrence I

    2015-09-01

    Venous saline infusions in an arterially occluded forearm evokes reflex increases in muscle sympathetic nerve activity (MSNA) and blood pressure (BP). We hypothesized that the application of suction to the human limbs would activate this venous distension reflex and raise sympathetic outflow. We placed airtight pressure tanks and applied 100 mmHg negative pressure to an arterially occluded limb (occlusion and suction, O&S) to induce tissue deformation without fluid translocation. BP, heart rate (HR), and MSNA were assessed in 19 healthy subjects during 2 min of arm or leg O&S. Occlusion without suction served as a control. During a separate visit, saline (5% forearm volume) was infused into veins of the arterially occluded arm (n = 13). The O&S increased limb circumference, MSNA burst rate (arm: Δ6.7 ± 0.7; leg: Δ6.8 ± 0.7 bursts/min), and total activity (arm: Δ199 ± 14; leg: Δ172 ± 22 units/min) and BP (arm: Δ4.3 ± 0.3; leg: Δ9.4 ± 1.4 mmHg) from the baseline. The MSNA and BP responses during arm O&S correlated with those during leg O&S. Occlusion alone had no effect on MSNA and BP. MSNA (r = 0.607) responses during arm O&S correlated with those evoked by the saline infusion into the arm. These correlations suggest that sympathetic activation during limb O&S is likely, at least partially, to be evoked via the venous distension reflex. These data suggest that suction of an occluded limb evokes sympathetic activation and that the limb venous distension reflex exists in arms and legs of normal humans. PMID:26136530

  6. Modelling of oedemous limbs and venous ulcers using partial differential equations

    Directory of Open Access Journals (Sweden)

    Wilson Michael J

    2005-08-01

    Full Text Available Abstract Background Oedema, commonly known as tissue swelling, occurs mainly on the leg and the arm. The condition may be associated with a range of causes such as venous diseases, trauma, infection, joint disease and orthopaedic surgery. Oedema is caused by both lymphatic and chronic venous insufficiency, which leads to pooling of blood and fluid in the extremities. This results in swelling, mild redness and scaling of the skin, all of which can culminate in ulceration. Methods We present a method to model a wide variety of geometries of limbs affected by oedema and venous ulcers. The shape modelling is based on the PDE method where a set of boundary curves are extracted from 3D scan data and are utilised as boundary conditions to solve a PDE, which provides the geometry of an affected limb. For this work we utilise a mixture of fourth order and sixth order PDEs, the solutions of which enable us to obtain a good representative shape of the limb and associated ulcers in question. Results A series of examples are discussed demonstrating the capability of the method to produce good representative shapes of limbs by utilising a series of curves extracted from the scan data. In particular we show how the method could be used to model the shape of an arm and a leg with an associated ulcer. Conclusion We show how PDE based shape modelling techniques can be utilised to generate a variety of limb shapes and associated ulcers by means of a series of curves extracted from scan data. We also discuss how the method could be used to manipulate a generic shape of a limb and an associated wound so that the model could be fine-tuned for a particular patient.

  7. The experimental research of isolated limb perfusion on rabbit model

    International Nuclear Information System (INIS)

    Objective: To set up an isolated limb perfusion (LIP) model of rabbit approximately physiological state. Methods: Measuring and calculating the average speed of blood circulation in rabbit's femoral artery with ultrasound, building up an isolated limb of perfusion system with a mini-membrane-oxygenator and a mini pump. Observing the values of blood analysis (pH, PO2 and PCO2) at prior-, mid- and post-operation with differential exchanging speeds of oxygen, and probabilities of circulation failure with differential blood flow speeds, and the glucose change at several points of time and the difference between the groups with and without compensating glucose, and the dimensions of hind leg prior-and post-operation. Results: Results of ultrasound showed that there was no difference in parameter between bilateral femoral arteries giving no effect on the results of differential groups. Total average flow speed was (12.0 +- 1.8) ml/min. Blood analysis; the perfusion without oxygen exchange showed pH was lower than pre-perfusion and physiological low threshold. PO2 was below the normal standard, PCO2 was higher than pre-perfusion and physiological upper threshold. 100 ml/min of oxygen exchange showed pH, PO2 and PCO2 were nearly normal post-perfusion and 200 ml/min group showed pH and PO2 obviously higher than the normal physiological value. The glucose was lower than the normal at 30 min after perfusion, but could be recovered under the compensation of glucose. There was significant difference between the groups processing with and without glucose. There was no circulation failure when the flow speed was in 10 ml ≤ V ≤ 12 ml. No difference of dimension of hind legs appeared prior-and post-procedure. Conclusions: According to the flow speed offered by ultrasound adhered with adjustment during perfusion. The selection of 100 ml/min oxygen-exchange speed and compensation with glucose could set up an ILP model of rabbit, approximately as in the physiological state

  8. Monitoring system for isolated limb perfusion based on a portable gamma camera

    Energy Technology Data Exchange (ETDEWEB)

    Orero, A.; Muxi, A.; Rubi, S.; Duch, J. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); Vidal-Sicart, S.; Pons, F. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); Inst. d' Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona (Spain); Red Tematica de Investigacion Cooperativa en Cancer (RTICC), Barcelona (Spain); Roe, N. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); CIBER de Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona (Spain); Rull, R. [Servei de Cirurgia, Hospital Clinic, Barcelona (Spain); Pavon, N. [Inst. de Fisica Corpuscular, CSIC - UV, Valencia (Spain); Pavia, J. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); Inst. d' Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona (Spain); CIBER de Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona (Spain)

    2009-07-01

    Background: The treatment of malignant melanoma or sarcomas on a limb using extremity perfusion with tumour necrosis factor (TNF-{alpha}) and melphalan can result in a high degree of systemic toxicity if there is any leakage from the isolated blood territory of the limb into the systemic vascular territory. Leakage is currently controlled by using radiotracers and heavy external probes in a procedure that requires continuous manual calculations. The aim of this work was to develop a light, easily transportable system to monitor limb perfusion leakage by controlling systemic blood pool radioactivity with a portable gamma camera adapted for intraoperative use as an external probe, and to initiate its application in the treatment of MM patients. Methods: A special collimator was built for maximal sensitivity. Software for acquisition and data processing in real time was developed. After testing the adequacy of the system, it was used to monitor limb perfusion leakage in 16 patients with malignant melanoma to be treated with perfusion of TNF-{alpha} and melphalan. Results: The field of view of the detector system was 13.8 cm, which is appropriate for the monitoring, since the area to be controlled was the precordial zone. The sensitivity of the system was 257 cps/MBq. When the percentage of leakage reaches 10% the associated absolute error is {+-}1%. After a mean follow-up period of 12 months, no patients have shown any significant or lasting side-effects. Partial or complete remission of lesions was seen in 9 out of 16 patients (56%) after HILP with TNF-{alpha} and melphalan. Conclusion: The detector system together with specially developed software provides a suitable automatic continuous monitoring system of any leakage that may occur during limb perfusion. This technique has been successfully implemented in patients for whom perfusion with TNF-{alpha} and melphalan has been indicated. (orig.)

  9. Reliability of pressure cuff induced transient limb ischemia in conscious rabbits

    Institute of Scientific and Technical Information of China (English)

    Zhang Nanrong; Zheng Wanjun; Wen Yi; Hu Qiongyu; Jin Sanqing

    2014-01-01

    Background The protective effects of transient limb ischemia (TLI) induced by several cycles of intermittent pressure cuff inflation and deflation for a period have been widely investigated,however the reliability of this protocol has not been clearly verified.Our study aimed to investigate the reliability of pressure cuff induced TLI in conscious rabbits.Methods Eight New Zealand rabbits were subjected to TLI without anesthesia.TLI consisted of 3 cycles of ischemia and reperfusion induced by inflating the cuff placed on the left lower limb to 200 mmHg for 5 minutes followed by deflating the cuff for 5 minutes.Skin color,pulse oxygen saturation (SpO2),pulse rate (PR),plethysmogram waveform (Pleth),and ultrasound detection of the blood flow in the extremity distal to the ischemic segment were observed to confirm ischemia and reperfusion during TLI.The frequency of severe limb movement during TLI was also recorded to assess the amenability of this protocol in conscious rabbits.Results The skin color of the extremity distal to the ischemic segment changed from bright red to dark purple after inflating the cuff to 200 mmHg,and returned to normal after cuff deflation.Pleth,PR and SpO2 disappeared during ischemia and restored during reperfusion in the monitor.Blood flow of the left posterior tibial artery was completely blocked by a pressure of 200 mmHg during ischemia,and recovered immediately after cuff deflation.The frequency of severe limb movement in supine position was higher than that in prone position (P<0.05),but there was no severe limb movement that could result in disturbance to ischemia when the rabbits were placed in prone position.Conclusion Pressure cuff inflating to 200 mmHg for 5 minutes and deflating for 5 minutes is a reliable regimen to induce TLI in conscious rabbits.

  10. HST observations of the limb polarization of Titan

    CERN Document Server

    Bazzon, Andreas; Buenzli, Esther

    2014-01-01

    Titan is an excellent test case for detailed studies of the scattering polarization from thick hazy atmospheres. We present the first limb polarization measurements of Titan, which are compared as a test to our limb polarization models. Previously unpublished imaging polarimetry from the HST archive is presented which resolves the disk of Titan. We determine flux-weighted averages of the limb polarization and radial limb polarization profiles, and investigate the degradation and cancelation effects in the polarization signal due to the limited spatial resolution of our observations. Taking this into account we derive corrected values for the limb polarization in Titan. The results are compared with limb polarization models, using atmosphere and haze scattering parameters from the literature. In the wavelength bands between 250 nm and 2000 nm a strong limb polarization of about 2-7 % is detected with a position angle perpendicular to the limb. The fractional polarization is highest around 1 micron. As a first ...

  11. Infantile lipofibromatosis of the upper limb

    Energy Technology Data Exchange (ETDEWEB)

    Teo, Harvey E.L.; Peh, Wilfred C.G. [KK Women' s and Children' s Hospital, Department of Diagnostic Imaging, Singapore (Singapore); Chan, Mei-Yoke [KK Women' s and Children' s Hospital, Department of Paediatric Medicine, Singapore (Singapore); Walford, Norman [Tan Tock Seng Hospital, Department of Pathology, Singapore (Singapore)

    2005-12-01

    The imaging features of extensive lipofibromatosis presenting in a 1-day-old female infant are reported. This lesion involved her entire right upper limb, extending from the axilla to the palm of the hand. Radiographs showed marked deformity and thinning of all the right upper-limb bones due to pressure effect of soft-tissue enlargement, especially affecting the distal humerus and proximal forearm bones. Magnetic resonance imaging showed a huge soft-tissue mass infiltrating most of the muscles of the entire upper limb, with bony erosion. The mass was largely T1-isointense, moderately T2-hyperintense and showed marked enhancement. There were intra-lesional signal changes consistent with fatty elements. A lesion debulking procedure was performed and the histology was that of lipofibromatosis. The limb was found to be non-viable after the procedure and a subsequent above-elbow amputation was performed. Although the resection margins were not clear, she had no further recurrence over a subsequent 3-year follow-up period. (orig.)

  12. Interhemispheric sensorimotor integration; an upper limb phenomenon?

    Science.gov (United States)

    Ruddy, Kathy L; Jaspers, Ellen; Keller, Martin; Wenderoth, Nicole

    2016-10-01

    Somatosensory information from the limbs reaches the contralateral Primary Sensory Cortex (S1) with a delay of 23ms for finger, and 40ms for leg (somatosensory N20/N40). Upon arrival of this input in the cortex, motor evoked potentials (MEPs) elicited by Transcranial Magnetic Stimulation (TMS) are momentarily inhibited. This phenomenon is called 'short latency afferent inhibition (SAI)' and can be used as a tool for investigating sensorimotor interactions in the brain. We used SAI to investigate the process of sensorimotor integration in the hemisphere ipsilateral to the stimulated limb. We hypothesized that ipsilateral SAI would occur with a delay following the onset of contralateral SAI, to allow for transcallosal conduction of the signal. We electrically stimulated the limb either contralateral or ipsilateral to the hemisphere receiving TMS, using a range of different interstimulus intervals (ISI). We tested the First Dorsal Interosseous (FDI) muscle in the hand, and Tibialis Anterior (TA) in the lower leg, in three separate experiments. Ipsilateral SAI was elicited in the upper limb (FDI) at all ISIs that were greater than N20+18ms (all pintegration. PMID:27425210

  13. 49 CFR 572.35 - Limbs.

    Science.gov (United States)

    2010-10-01

    ... OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Hybrid III Test Dummy § 572.35 Limbs. (a..., revision A, and arm assemblies 78051-123, revision D and -124, revision D, and shall conform to the.... (2) Test procedure. (i) The test material consists of leg assemblies (86-5001-001, revision A)...

  14. Running With an Elastic Lower Limb Exoskeleton.

    Science.gov (United States)

    Cherry, Michael S; Kota, Sridhar; Young, Aaron; Ferris, Daniel P

    2016-06-01

    Although there have been many lower limb robotic exoskeletons that have been tested for human walking, few devices have been tested for assisting running. It is possible that a pseudo-passive elastic exoskeleton could benefit human running without the addition of electrical motors due to the spring-like behavior of the human leg. We developed an elastic lower limb exoskeleton that added stiffness in parallel with the entire lower limb. Six healthy, young subjects ran on a treadmill at 2.3 m/s with and without the exoskeleton. Although the exoskeleton was designed to provide ~50% of normal leg stiffness during running, it only provided 24% of leg stiffness during testing. The difference in added leg stiffness was primarily due to soft tissue compression and harness compliance decreasing exoskeleton displacement during stance. As a result, the exoskeleton only supported about 7% of the peak vertical ground reaction force. There was a significant increase in metabolic cost when running with the exoskeleton compared with running without the exoskeleton (ANOVA, P exoskeletons for human running are human-machine interface compliance and the extra lower limb inertia from the exoskeleton. PMID:26694976

  15. Gadolinium and ruthenium red attenuate remote hind limb preconditioning-induced cardioprotection: possible role of TRP and especially TRPV channels.

    Science.gov (United States)

    Randhawa, Puneet Kaur; Jaggi, Amteshwar Singh

    2016-08-01

    Remote ischemic preconditioning is a well reported therapeutic strategy that induces cardioprotective effects but the underlying intracellular mechanisms have not been widely explored. The current study was designed to investigate the involvement of TRP and especially TRPV channels in remote hind limb preconditioning-induced cardioprotection. Remote hind limb preconditioning stimulus (4 alternate cycles of inflation and deflation of 5 min each) was delivered using a blood pressure cuff tied on the hind limb of the anesthetized rat. Using Langendorff's system, the heart was perfused and subjected to 30-min ischemia and 120-min reperfusion. The myocardial injury was assessed by measuring infarct size, lactate dehydrogenase (LDH), creatine kinase (CK), LVDP, +dp/dtmax, -dp/dtmin, heart rate, and coronary flow rate. Gadolinium, TRP blocker, and ruthenium red, TRPV channel blocker, were employed as pharmacological tools. Remote hind limb preconditioning significantly reduced the infarct size, LDH release, CK release and improved coronary flow rate, hemodynamic parameters including LVDP, +dp/dtmax, -dp/dtmin, and heart rate. However, gadolinium (7.5 and 15 mg kg(-1)) and ruthenium red (4 and 8 mg kg(-1)) significantly attenuated the cardioprotective effects suggesting the involvement of TRP especially TRPV channels in mediating remote hind limb preconditioning-induced cardioprotection. Remote hind limb preconditioning stimulus possibly activates TRPV channels on the heart or sensory nerve fibers innervating the heart to induce cardioprotective effects. Alternatively, remote hind limb preconditioning stimulus may also activate the mechanosensitive TRP and especially TRPV channels on the sensory nerve fibers innervating the skeletal muscles to trigger cardioprotective neurogenic signaling cascade. The cardioprotective effects of remote hind limb preconditioning may be mediated via activation of mechanosensitive TRP and especially TRPV channels. PMID:27118661

  16. Atypical supernumerary phantom limb and phantom limb pain in two patients with pontine hemorrhage.

    Science.gov (United States)

    Yoo, Seung Don; Kim, Dong Hwan; Jeong, Yong Seol; Chon, Jinmann; Bark, Jihea

    2011-06-01

    Phantom limbs are usually observed after amputation of extremities. In patients after a stroke, a similar but rarely occurring phenomenon consisting of the patient experiencing the presence of an additional limb has been described. This phenomenon, generally called supernumerary phantom limb (SPL), may be caused by lesions in the right or left cerebral hemisphere, but has been predominantly reported in patients who have had a right hemispheric stroke. We report two cases of atypical SPL and phantom limb pain (PLP) after pontine hemorrhage. The patients were treated conservatively and their symptoms lasted more than 1 month. This is the first report of SPLs after left pontine hemorrhage, and phantom perception and pain lasted longer than those in previously observed cases. Our results indicate that SPL may be more common than reported; therefore, thorough examinations are essential for the care of stroke patients. PMID:21655076

  17. Phantom limb perception interferes with motor imagery after unilateral upper-limb amputation

    OpenAIRE

    Yuanyuan Lyu; Xiaoli Guo; Robin Bekrater-Bodmann; Herta Flor; Shanbao Tong

    2016-01-01

    A potential contributor to impaired motor imagery in amputees is an alteration of the body schema as a result of the presence of a phantom limb. However, the nature of the relationship between motor imagery and phantom experiences remains unknown. In this study, the influence of phantom limb perception on motor imagery was investigated using a hand mental rotation task by means of behavioral and electrophysiological measures. Compared with healthy controls, significantly prolonged response ti...

  18. Spinal Cord Stimulation Therapy for the Treatment of Concomitant Phantom Limb Pain and Critical Limb Ischemia.

    Science.gov (United States)

    De Caridi, Giovanni; Massara, Mafalda; Serra, Raffaele; Risitano, Claudia; Giardina, Massimiliano; Acri, Ignazio Eduardo; Volpe, Pietro; David, Antonio

    2016-04-01

    Phantom limb pain (PLP) is a chronic condition experienced by about 80% of patients who have undergone amputation. In most patients, both the frequency and the intensity of pain attacks diminish with time, but severe pain persists in about 5-10%. Probably, factors in both the peripheral and central nervous system play a role in the occurrence and persistence of pain in the amputated lower limb. The classical treatment of PLP can be divided into pharmacologic, surgical, anesthetic, and psychological modalities. Spinal cord stimulation (SCS) does not represent a new method of treatment for this condition. However, the concomitant treatment of PLP and critical lower limb ischemia by using SCS therapy has not yet been described in the current literature. The aim of the present article is to highlight the possibility of apply SCS for the simultaneous treatment of PLP and critical lower limb ischemia on the contralateral lower limb after failure of medical therapy in a group of 3 patients, obtaining pain relief in both lower limbs, delaying an endovascular or surgical revascularization. After SCS implantation and test stimulation, the pain was reduced by 50% on both the right and the left side in all our patients. The main indications for permanent SCS therapy after 1 week of test stimulation were represented by transcutaneous oxygen (TcPO2) increase >75%, decrease of opioids analgesics use of at least 50% and a pain maintained to within 20-30/100 mm on visual analog scale. PMID:26802307

  19. Artificial blood

    Directory of Open Access Journals (Sweden)

    Sarkar Suman

    2008-01-01

    Full Text Available Artificial blood is a product made to act as a substitute for red blood cells. While true blood serves many different functions, artificial blood is designed for the sole purpose of transporting oxygen and carbon dioxide throughout the body. Depending on the type of artificial blood, it can be produced in different ways using synthetic production, chemical isolation, or recombinant biochemical technology. Development of the first blood substitutes dates back to the early 1600s, and the search for the ideal blood substitute continues. Various manufacturers have products in clinical trials; however, no truly safe and effective artificial blood product is currently marketed. It is anticipated that when an artificial blood product is available, it will have annual sales of over $7.6 billion in the United States alone.

  20. Endovascular diagnostics and treatment of stenosis, acute thrombosis and chronic occlusion of arteries and upper limbs

    International Nuclear Information System (INIS)

    Full text: Diseases of the upper limb arteries are significantly rarer than those of the lower limbs but they are not causes and due to the lack of diagnostic algorithms are often missed. the symptoms are not typical except for those in acute thrombosis. The complaints in acute thrombosis is strong, sudden pain in the limb or part of it, bruising or paleness of the ischemic area and a lack of pulsation. Diagnosis is fairly easy – clinical events, difference in blood pressure or a lack of blood pressure in the affected limb, a total lack of blood pressure or a difference in the pressure in the left and right arm. Then complaints in stenosis and chronic occlusions is significantly less pronounced and is expressed as weakness in the affected limb, heaviness, bluish or paleness. If the proximal segments are affected Still’s syndrome is often observed. The complaints is not decisive for diagnosis. A difference in blood pressure of more than 20 mm Hg and an echodoppler examination of the arteries are the main criteria for directing the patients for angiography. Contrast CT and MRT are not used often. treatment is vascular surgery and endovascular. In acute thrombosis priority takes vascular surgery through extraction of the thrombi with Fogerty catheters, and in chronical stenosis and occlusions – dilation and stenting. Clinical cases: Case 1 – Revascularization of artery brachialis, radialis and ulnaris after acute occlusion L.Y., 77 years old. Complains of sharp pain and bruising of right forearm since two hours before hospitalization. A lack of blood flow was identified using palpation and echodoppler. After a diagnostic angiography , thrombaspiration was undertaken, through a leading catheter, recovering blood flow in both arteries and stenting of the proximal segment of artery radialis. Case 2: Revascularization of Trunkus brachiocefalicus K.P., 65 years old. Suffering from bradypsychia for several months. Bradypsychia becomes worse after manual labor

  1. Removing Blood-stasis and Activating Collateral Therapy Combining Repeating Lidocaine Injection Treating 30 Cases of Lower Limb Spasticity%祛淤通络法结合重复利多卡因神经阻滞治疗下肢痉挛30例

    Institute of Scientific and Technical Information of China (English)

    黄格朗; 郭礼; 周德文; 周凯; 卢燕

    2014-01-01

    目的:观察运用祛淤通络法拟定方剂结合重复利多卡因神经阻滞治疗下肢痉挛的效果。方法:选择60例中风下肢痉挛患者,治疗组30例予运用祛淤通络法拟定的痉挛1号汤及利多卡因注射,对照组30例予利多卡因注射同时口服巴氯芬,两组患者均予常规康复治疗,在治疗前、治疗后2周、4周、12周分别运用改良 Ashworth 量表(MAS)、简易 Fugl‐Meyer 评定(FMA)下肢部分、改良 Barthel 指数(MBI)进行康复评定。结果:两组治疗前 MAS 、FMA 、MBI 评分比较无统计学差异(P>0.05),治疗后2周、4周 MAS 、FMA 、MBI 评分比较有统计学差异(P<0.05),治疗后12周MAS 评分比较无统计学差异(P>0.05),而 FMA 、MBI 评分比较有统计学差异(P<0.05)。结论:运用祛淤通络法拟定方剂结合重复利多卡因神经阻滞治疗下肢痉挛疗效显著。%Objective :To investigate the effect of removing blood‐stasis and activating collateral therapy tisane combi‐ning repeating lidocaine injection on lower limb spasticity .Methods :60 cases with lower limb spasticity after stroke were divided into the treatment group (n= 30) and the control group (n= 30) .The treatment group was treated with No 1 Spasticity Tisane and repeating lidocaine injection .The control group was treated with lidocaine injection and oral ba‐clofen .Both groups accepted the regular rehabilitation treatment .They were assessed with modified Ashworth Scale (MAS) ,Fugl‐Meyer Lower Limb Assessment (FMA ) ,Modified Barthel Index (MBI) before each treatment ,and 2 weeks ,4 weeks ,12 weeks after each treatment or the same time for the controls .Results :Before treatment ,there was no difference in scores of MAS ,FMA ,MBI between the two groups(P> 0 .05) ,but significant difference in all scores 2 weeks ,4 weeks after the treatment (P 0 .05) .Conclusion :Removing blood‐stasis and activating collateral

  2. A Clinical Evaluation of Postamputation Phenomena Including Phantom Limb Pain after Lower Limb Amputation in Dysvascular Patients.

    Science.gov (United States)

    Richardson, Cliff; Crawford, Kath; Milnes, Karen; Bouch, Elizabeth; Kulkarni, Jai

    2015-08-01

    To explore the effects of phantom phenomena on a group of dysvascular lower limb amputees. This was a cross-sectional study of dysvascular lower limb amputees. A modified version of the phantom phenomena questionnaire was used to measure the prevalence of phantom phenomena and the effects of those phenomena on daily life. Eighty-nine amputees were recruited. The majority were inpatients (72%) and male (72%). Most had pain before amputation (83%). Sixty-three percent had phantom limb pain. No associations were found between phantom limb pain and preamputation pain (p = .397). Phantom limb pain was present immediately on waking from amputation in 23%. Phantom limb pain is highly fluctuant. It is more likely that phantom limb pain was present with more time passed since amputation (p = .002). Outpatients with unhealed wounds were less likely to have phantom limb pain (p = .007). The effects of postamputation phenomena include sleep loss and social restrictions. These results challenge the belief that phantom limb pain reduces over time as more outpatients reported phantom limb pain than inpatients. Preamputation pain is not linked to the presence of phantom limb pain. The fluctuant nature of phantom limb pain makes its treatment complex. Some may wish intensity to reduce, whereas others may prefer to reduce the number of episodes or duration of each episode instead. More research is needed to clarify the needs of amputees in relation to the postamputation phenomena. PMID:26092194

  3. Patterns of presentation and outcome in critical limb ischemia

    International Nuclear Information System (INIS)

    Introduction: The threatened limb due to peripheral occlusive arterial disease, embolism or trauma requires early recognition and urgent treatment if the limb is to be saved. Objective: To determine the pattern of presentation and outcome of surgery in cases of critical limb ischemia. Study Design: Descriptive study. Place and Duration of Study: This study was conducted at surgical ward, Combined Military Hospital, Rawalpindi, from Dec 2006 to Dec 2007. Subject and Methods: A sample size of 30 patients was taken by convenience sampling. Informed written consent was obtained from all patients. Patients suffering from rest pain with ischemia features, trophic lesions, extensive gangrene , ulcers and demonstrable presence of occlusive arterial disease were included in the study. Moribund patients, extensive cardiopulmonary disease or advanced malignancy were not included in the study. Results: Thirty patients were included in the study. The mean age was 56 +-13. There were 28 males (93.3%) and 2 females (6.7%). They were all married and belonged to middle and low middle social economic class. Out of 30, there were 2 (6.7%) cases of trauma while 28 (93.3%) had peripheral vascular involvement secondary to thromboembolism. Vessels involved were femoral artery in 9 (30%) cases, popliteal artery in 18 (60%) cases and brachial artery in 2 (6.7%) cases. Rest pain was present as a primary feature in all the patients (100%), while tissue loss or gangrene was seen in 22 (73.33%) cases. A total of 14 (46.7%) amputations, 6 (20%) bypass procedures, 4 (13.3%) lumbar sympathectomies, and 2 (6.7 %) embolectomies, were carried out, whereas 4 (13.3%) patients were managed conservatively. Of the patients having rest pain 46.7 % were amputated, whereas of patients having ischemic tissue loss 73.3% were amputated. 13 patients who underwent primary amputation had ankle brachial pressure index (ABPI less than 0.4 (86.7%). ABPI was more than 0.4 in 4 (13.3%) patients whereas it was less

  4. Analysis of temporal dynamics in imagery during acute limb ischemia and reperfusion

    Science.gov (United States)

    Irvine, John M.; Regan, John; Spain, Tammy A.; Caruso, Joseph D.; Rodriquez, Maricela; Luthra, Rajiv; Forsberg, Jonathon; Crane, Nicole J.; Elster, Eric

    2014-03-01

    Ischemia and reperfusion injuries present major challenges for both military and civilian medicine. Improved methods for assessing the effects and predicting outcome could guide treatment decisions. Specific issues related to ischemia and reperfusion injury can include complications arising from tourniquet use, such as microvascular leakage in the limb, loss of muscle strength and systemic failures leading to hypotension and cardiac failure. Better methods for assessing the viability of limbs/tissues during ischemia and reducing complications arising from reperfusion are critical to improving clinical outcomes for at-risk patients. The purpose of this research is to develop and assess possible prediction models of outcome for acute limb ischemia using a pre-clinical model. Our model relies only on non-invasive imaging data acquired from an animal study. Outcome is measured by pathology and functional scores. We explore color, texture, and temporal features derived from both color and thermal motion imagery acquired during ischemia and reperfusion. The imagery features form the explanatory variables in a model for predicting outcome. Comparing model performance to outcome prediction based on direct observation of blood chemistry, blood gas, urinalysis, and physiological measurements provides a reference standard. Initial results show excellent performance for the imagery-base model, compared to predictions based direct measurements. This paper will present the models and supporting analysis, followed by recommendations for future investigations.

  5. Blood smear

    Science.gov (United States)

    ... osmotic fragility ) Deficiency of an enzyme called lecithin cholesterol acyl transferase Abnormalities of hemoglobin , the protein in ... sickle and Pappenheimer Red blood cells, target cells Formed elements of blood References Bain BJ. The peripheral ...

  6. Study of L-arginine-nitric oxide pathway in ischemia-reperfusion injured limbs in rats

    Institute of Scientific and Technical Information of China (English)

    朱立军; 黄耀添; 裴国献

    2002-01-01

    Objective: To observe the change of nitric oxide (NO) levels in the blood and the morphological change of the muscles in the limbs of rats during the (IR) injury and after being intervened by L-arginine (L-Arg) and L-nitroarginine (L-NNA).   Methods: Sixty-six male Sprague-Dawley (SD) rats were used and grouped into the normal controls, the sham injury controls, the IR injury group and the intervention groups (L-Arg group and L-NNA group). After 6 hours of ischemia, followed by reperfusion for 3, 12 or 24 hours, the samples in the IR injury group were obtained. The rats in the intervention groups were given L-Arg (100 mmol/L) and L-NNA (10 mmol/L), respectively, through the abdominal cavity. Then the anterior tibial muscle in the right limb was obtained for histological examination, the anterior tibial muscle in the left limb for ultrastructure observation and the blood for assay of NO in all the rats. NO was assayed by indirect measurement of NO2/NO3 with Griess method.   Results: There was no significant difference of NO between the normal controls and the sham injury controls (P>0.05). But NO significantly decreased in the IR injury group (P0.05). In the L-NNA group, NO decreased to the undetectable level (P<0.01). Histological examination and ultrastructure observation showed the muscles were normal in the control groups. After 6 hours of ischemia, the skeletal muscles displayed injuries, and they were most severely injured after 12 hours of reperfusion. In the L-Arg group, the skeletal muscles were less injured, while in the L-NNA group, the injury was similar to that in the IR injury group.   Conclusions: When the limbs of the rats sustain IR, NO in the blood decreases. Meanwhile, the muscles in the limbs are injured. When L-Arg is given, NO in the blood is restored and the muscles are protected. When L-NNA completely inhibits NO, no protection of the muscles is shown.

  7. Phantom limb pain from spinal sarcoma: a case report.

    Science.gov (United States)

    Cruz, Ernesto; Dangaria, Harsh T

    2013-07-01

    Phantom limb pain is a frequent sequela of amputation. A high prevalence of residual limb pain and back pain also exists among amputees. We present a case of a new-onset severe phantom limb pain resulting from a metastatic spinal mass in an 81-year-old patient with a history of malignant sarcoma and an old hip disarticulation amputation. The metastatic lesion, upon imaging, was found to involve the L3 vertebra and caused moderate compression of the thecal sac on the right and severe right lateral recess stenosis. After the mass was resected, the patient's phantom limb pain resolved. Our case report demonstrates that spinal metastatic pathologies may be a cause of phantom limb pain and should be included in the differential diagnosis of new-onset phantom limb pain or a change in phantom limb pain. PMID:23880049

  8. Measurements of protein in limbs by IVNAA

    International Nuclear Information System (INIS)

    A method for the determination of protein in human limbs by in vivo neutron activation analysis of their nitrogen content is described. The neutron flux is provided by a collimated 740 GBq (20 Ci) Pu-Be source. The 10.83 MeV thermal neutron capture gamma-rays from 14N are detected by a 12.7 cm by 10.2 cm NaI(TI) detector. The nitrogen and hydrogen in an arm, the lower and the upper legs of two volunteers were measured with a statistical error around 3.6%-18% and 0.26%-0.56%, respectively. Also, the ratio of nitrogen to hydrogen in the limbs was compared. For a 1.000 s irradiation the dose equivalent was 0.3 mSv (30 mrem). (author) 5 refs.; 2 figs.; 3 tabs

  9. Can neural blocks prevent phantom limb pain?

    Science.gov (United States)

    Borghi, Battista; D'Addabbo, Marco; Borghi, Raffaele

    2014-07-01

    Phantom limb syndrome (PLS) is a syndrome including stump pain, phantom limb pain and not-painful phantom sensations, which involves a large part of amputee patients and often has devastating effects on their quality of life. The efficacy of standard therapies is very poor. Nerve blocks have been investigated for the treatment and prevention of PLS. Epidural and peripheral blocks limited to the first three postamputation days can only reduce acute pain but cannot prevent the later development of PLS. Recent studies have shown that ambulatory prolonged peripheral nerve block (up to 30 days postamputation) may represent a new possible option to treat phantom pain and prevent the development of PLS and chronic pain. PMID:25300383

  10. The upper limb of Australopithecus sediba.

    Science.gov (United States)

    Churchill, Steven E; Holliday, Trenton W; Carlson, Kristian J; Jashashvili, Tea; Macias, Marisa E; Mathews, Sandra; Sparling, Tawnee L; Schmid, Peter; de Ruiter, Darryl J; Berger, Lee R

    2013-04-12

    The evolution of the human upper limb involved a change in function from its use for both locomotion and prehension (as in apes) to a predominantly prehensile and manipulative role. Well-preserved forelimb remains of 1.98-million-year-old Australopithecus sediba from Malapa, South Africa, contribute to our understanding of this evolutionary transition. Whereas other aspects of their postcranial anatomy evince mosaic combinations of primitive (australopith-like) and derived (Homo-like) features, the upper limbs (excluding the hand and wrist) of the Malapa hominins are predominantly primitive and suggest the retention of substantial climbing and suspensory ability. The use of the forelimb primarily for prehension and manipulation appears to arise later, likely with the emergence of Homo erectus. PMID:23580536

  11. Endovascular Management of Acute Limb Ischemia.

    LENUS (Irish Health Repository)

    Hynes, Brian G

    2011-09-14

    Despite major advances in pharmacologic and endovascular therapies, acute limb ischemia (ALI) continues to result in significant morbidity and mortality. The incidence of ALI may be as high as 13-17 cases per 100,000 people per year, with mortality rates approaching 18% in some series. This review will address the contemporary endovascular management of ALI encompassing pharmacologic and percutaneous interventional treatment strategies.

  12. Vertebrates Limb Geometry in the Simplex space

    OpenAIRE

    Daunis i Estadella, Josep; Mateu i Figueras, Glòria; Thió i Fernández de Henestrosa, Santiago; Rodrigues, L

    2008-01-01

    A novel metric comparison of the appendicular skeleton (fore and hind limb) of different vertebrates using the Compositional Data Analysis (CDA) methodological approach it’s presented. 355 specimens belonging in various taxa of Dinosauria (Sauropodomorpha, Theropoda, Ornithischia and Aves) and Mammalia (Prothotheria, Metatheria and Eutheria) were analyzed with CDA. A special focus has been put on Sauropodomorpha dinosaurs and the Aitchinson distance has been used as a mea...

  13. Omphalocele Major with Absent Lower Limb

    OpenAIRE

    Kundal, Vijay Kumar; Gajdhar, Mufique; Kundal, Raksha; Ahmed, Reyaz; Agrawal, Leela Dhar

    2013-01-01

    A newborn delivered by Caesarian section presented with an absent anterior abdominal wall and visible bowel loops and liver. The defect was covered by a thin membrane. The patient had associated absent left lower limb and right foot fusion defect. The patient was haemodynamically stable; general condition was average. No genito-urinary abnormality was detected. The anal opening was present normally, and the patient passed meconium immediately after birth. A diagnosis of omphalocele major with...

  14. Critical Limb Ischemia: Advanced Medical Therapy

    OpenAIRE

    Davies, Mark G.

    2012-01-01

    Systemic atherosclerosis and its risk factors are present in the majority of patients with critical limb ischemia. Aggressive medical therapy is an immediate and necessary part of the work-up and management of these patients and will involve a multidisciplinary approach. Risk stratification based on a patient’s current clinical cardiovascular condition is important in determining the most appropriate and safe intervention and will allow both the patient and physician to make an informed decis...

  15. Limb Lengthening in Patients with Achondroplasia

    OpenAIRE

    Park, Kwang-Won; Garcia, Rey-an Niño; Rejuso, Chastity Amor; Choi, Jung-Woo; Song, Hae-Ryong

    2015-01-01

    Purpose Although bilateral lower-limb lengthening has been performed on patients with achondroplasia, the outcomes for the tibia and femur in terms of radiographic parameters, clinical results, and complications have not been compared with each other. We proposed 1) to compare the radiological outcomes of femoral and tibial lengthening and 2) to investigate the differences of complications related to lengthening. Materials and Methods We retrospectively reviewed 28 patients (average age, 14 y...

  16. The assessment of the range of normal values of lower limb perfusion indicators at rest stress with the own radio isotopic method and program

    International Nuclear Information System (INIS)

    Introduction: In this study, we took on the trial to elaborate the radioisotopic method and program allowing for defining the range of normal values of muscle perfusion. Aim: Elaborating the method and program allowing for half quantitative evaluation and defining the range of normal values of lower limbs perfusion indicators at rest and stress allowing for their clinical application. Material and Methods: 74 patients, age 21-45 without the lower limbs muscle perfusion disturbances. Basic tests biochemical blood tests, USG-Doppler, ankle-brachial, pulsation and resistance indexes and maximal blood flow in the lower limbs. Perfusion scintigraphy (Tc99m MIBI) of rest and stress. Data analysis with the own ALLP program. Results: Basic and biochemical examination and USG Doppler didn't show any deviation from the norm. The range of normal values of the lower limbs perfusion indexes was defined: calves: at rest - 5,28-8.02, at stress - 4.29-6.32; thighs, at rest - 4.54-7.08 and at stress - 4.00-5.66. Conclusions: The elaborated radioisotopes method and program allow for half quantitative assessment of lower limb perfusion at rest and stress. Established normal ranges of lower limb perfusion values at rest and stress allow for clinical assessment of perfusion in healthy patients and diagnostics of dysfunctions of muscle perfusion. They also monitor the effects in conservative and operative treatment and other factors that influence muscle perfusion. (author)

  17. Hyperglycemia (High Blood Glucose)

    Medline Plus

    Full Text Available ... Events Wellness Lives Here Drive to Stop Diabetes Awareness Programs Hispanic Heritage Month African American Programs Latino ... device. Living W/ Diabetes: April is Limb Loss Awareness Month - 2016-04-limb-loss.html Living W/ ...

  18. Tendon vibration attenuates superficial venous vessel response of the resting limb during static arm exercise

    Directory of Open Access Journals (Sweden)

    Ooue Anna

    2012-11-01

    Full Text Available Abstract Background The superficial vein of the resting limb constricts sympathetically during exercise. Central command is the one of the neural mechanisms that controls the cardiovascular response to exercise. However, it is not clear whether central command contributes to venous vessel response during exercise. Tendon vibration during static elbow flexion causes primary muscle spindle afferents, such that a lower central command is required to achieve a given force without altering muscle force. The purpose of this study was therefore to investigate whether a reduction in central command during static exercise with tendon vibration influences the superficial venous vessel response in the resting limb. Methods Eleven subjects performed static elbow flexion at 35% of maximal voluntary contraction with (EX + VIB and without (EX vibration of the biceps brachii tendon. The heart rate, mean arterial pressure, and rating of perceived exertion (RPE in overall and exercising muscle were measured. The cross-sectional area (CSAvein and blood velocity of the basilic vein in the resting upper arm were assessed by ultrasound, and blood flow (BFvein was calculated using both variables. Results Muscle tension during exercise was similar between EX and EX + VIB. However, RPEs at EX + VIB were lower than those at EX (P P vein in the resting limb at EX decreased during exercise from baseline (P vein at EX + VIB did not change during exercise. CSAvein during exercise at EX was smaller than that at EX + VIB (P vein did not change during the protocol under either condition. The decreases in circulatory response and RPEs during EX + VIB, despite identical muscle tension, showed that activation of central command was less during EX + VIB than during EX. Abolishment of the decrease in CSAvein during exercise at EX + VIB may thus have been caused by a lower level of central command at EX + VIB rather than EX. Conclusion Diminished central command induced by tendon

  19. Cord Blood

    Directory of Open Access Journals (Sweden)

    Saeed Abroun

    2014-05-01

    Full Text Available   Stem cells are naïve or master cells. This means they can transform into special 200 cell types as needed by body, and each of these cells has just one function. Stem cells are found in many parts of the human body, although some sources have richer concentrations than others. Some excellent sources of stem cells, such as bone marrow, peripheral blood, cord blood, other tissue stem cells and human embryos, which last one are controversial and their use can be illegal in some countries. Cord blood is a sample of blood taken from a newborn baby's umbilical cord. It is a rich source of stem cells, umbilical cord blood and tissue are collected from material that normally has no use following a child’s birth. Umbilical cord blood and tissue cells are rich sources of stem cells, which have been used in the treatment of over 80 diseases including leukemia, lymphoma and anemia as bone marrow stem cell potency.  The most common disease category has been leukemia. The next largest group is inherited diseases. Patients with lymphoma, myelodysplasia and severe aplastic anemia have also been successfully transplanted with cord blood. Cord blood is obtained by syringing out the placenta through the umbilical cord at the time of childbirth, after the cord has been detached from the newborn. Collecting stem cells from umbilical blood and tissue is ethical, pain-free, safe and simple. When they are needed to treat your child later in life, there will be no rejection or incompatibility issues, as the procedure will be using their own cells. In contrast, stem cells from donors do have these potential problems. By consider about cord blood potency, cord blood banks (familial or public were established. In IRAN, four cord blood banks has activity, Shariati BMT center cord blood bank, Royan familial cord blood banks, Royan public cord blood banks and Iranian Blood Transfusion Organ cord blood banks. Despite 50,000 sample which storage in these banks, but the

  20. Using multimodal imaging techniques to monitor limb ischemia: a rapid noninvasive method for assessing extremity wounds

    Science.gov (United States)

    Luthra, Rajiv; Caruso, Joseph D.; Radowsky, Jason S.; Rodriguez, Maricela; Forsberg, Jonathan; Elster, Eric A.; Crane, Nicole J.

    2013-03-01

    Over 70% of military casualties resulting from the current conflicts sustain major extremity injuries. Of these the majority are caused by blasts from improvised explosive devices. The resulting injuries include traumatic amputations, open fractures, crush injuries, and acute vascular disruption. Critical tissue ischemia—the point at which ischemic tissues lose the capacity to recover—is therefore a major concern, as lack of blood flow to tissues rapidly leads to tissue deoxygenation and necrosis. If left undetected or unaddressed, a potentially salvageable limb may require more extensive debridement or, more commonly, amputation. Predicting wound outcome during the initial management of blast wounds remains a significant challenge, as wounds continue to "evolve" during the debridement process and our ability to assess wound viability remains subjectively based. Better means of identifying critical ischemia are needed. We developed a swine limb ischemia model in which two imaging modalities were combined to produce an objective and quantitative assessment of wound perfusion and tissue viability. By using 3 Charge-Coupled Device (3CCD) and Infrared (IR) cameras, both surface tissue oxygenation as well as overall limb perfusion could be depicted. We observed a change in mean 3CCD and IR values at peak ischemia and during reperfusion correlate well with clinically observed indicators for limb function and vitality. After correcting for baseline mean R-B values, the 3CCD values correlate with surface tissue oxygenation and the IR values with changes in perfusion. This study aims to not only increase fundamental understanding of the processes involved with limb ischemia and reperfusion, but also to develop tools to monitor overall limb perfusion and tissue oxygenation in a clinical setting. A rapid and objective diagnostic for extent of ischemic damage and overall limb viability could provide surgeons with a more accurate indication of tissue viability. This may

  1. Epigenetic drug 5-azacytidine impairs proliferation of rat limb buds in an organotypic model-system in vitro

    Science.gov (United States)

    Mužić, Vedrana; Katušić Bojanac, Ana; Jurić-Lekić, Gordana; Himelreich, Marta; Tupek, Katarina; Šerman, Ljiljana; Marn, Nina; Sinčić, Nino; Vlahović, Maja; Bulić-Jakuš, Floriana

    2013-01-01

    Aim To establish an organotypic in vitro model of limb bud development to verify whether epigenetic drug and teratogen 5-azacytidine (5azaC) has an effect on limb buds independent of its effects on the placenta. Methods Fischer strain rat fore- and hindlimb buds were microsurgically isolated from 13 days old embryos and cultivated in vitro for two weeks at the air-liquid interface in Eagle's minimum essential medium (MEM) with 50% rat serum. 30 µmol of 5azaC was added to the fresh medium. Overall growth was measured by an ocular micrometer. Routine histology, immunohistochemical detection of the proliferating cell nuclear antigen (PCNA), and stereological quantification of PCNA expression were performed. Results At four time points, significantly lower overall growth was detected for fore- and hindlimb bud explants cultivated with 5azaC in comparison to controls. After the culture period, numerical density of the PCNA signal for both types of limb buds was lower than for controls (P < 0.001). Limb buds were initially covered by immature epithelium and contained mesenchyme, myotubes, single hemangioblasts, hemangioblast aggregates, blood islands, and capillaries. Regardless of the treatment, cartilage and epidermis differentiated, but cells and structures typical for vasculogenesis disappeared. Conclusion Our findings, obtained outside of the maternal organism, stress the importance of compromised cell proliferation for 5azaC impact on limb buds. This investigation points to the necessity to establish alternatives to in vivo research on animals using teratogenic agents. PMID:24170728

  2. Altering blood flow does not reveal differences between nitrogen and helium kinetics in brain or in skeletal miracle in sheep.

    Science.gov (United States)

    Doolette, David J; Upton, Richard N; Grant, Cliff

    2015-03-01

    In underwater diving, decompression schedules are based on compartmental models of nitrogen and helium tissue kinetics. However, these models are not based on direct measurements of nitrogen and helium kinetics. In isoflurane-anesthetized sheep, nitrogen and helium kinetics in the hind limb (n = 5) and brain (n = 5) were determined during helium-oxygen breathing and after return to nitrogen-oxygen breathing. Nitrogen and helium concentrations in arterial, femoral vein, and sagittal sinus blood samples were determined using headspace gas chromatography, and venous blood flows were monitored continuously using ultrasonic Doppler. The experiment was repeated at different states of hind limb blood flow and cerebral blood flow. Using arterial blood gas concentrations and blood flows as input, parameters and model selection criteria of various compartmental models of hind limb and brain were estimated by fitting to the observed venous gas concentrations. In both the hind limb and brain, nitrogen and helium kinetics were best fit by models with multiexponential kinetics. In the brain, there were no differences in nitrogen and helium kinetics. Hind limb models fit separately to the two gases indicated that nitrogen kinetics were slightly faster than helium, but models with the same kinetics for both gases fit the data well. In the hind limb and brain, the blood:tissue exchange of nitrogen is similar to that of helium. On the basis of these results, it is inappropriate to assign substantially different time constants for nitrogen and helium in all compartments in decompression algorithms. PMID:25525213

  3. Blood / Money

    OpenAIRE

    Strong, Thomas

    1997-01-01

    Marilyn Strathern has argued that "nature" in Euro-American culture has appeared as constraint; it has figured the givens of existence on which human artifice is seen to construct "society" or "culture."(5) Among those givens is the notion that human beings are naturally individuals. And blood, too, images individuality: "The very thought of blood, individual blood, touches the deepest feelings in man about life and death" ([RIchard Titmuss] 16.) Transfusion medicine, then, draws on a series ...

  4. The effects of flosequinan on regional blood flow in normal man.

    OpenAIRE

    Scott, R. A.; Woods, K. L.; Barnett, D B

    1991-01-01

    1. The effects of 100 mg and 200 mg flosequinan on limb, hepatic and renal blood flow were investigated in 14 healthy male volunteers in a placebo controlled double-blind randomised three-way crossover study. 2. Heart rate, blood pressure, forearm blood flow and venous capacitance measured by volume plethysmography, were recorded sequentially over 4 h, after oral dosing. 3. Apparent hepatic and renal blood flows were estimated 2 h post-dose by indocyanine green dye clearance and clearance of ...

  5. Understanding Blood Counts

    Science.gov (United States)

    ... Lab and Imaging Tests Understanding Blood Counts Understanding Blood Counts Understanding Blood Counts SHARE: Print Glossary Blood cell counts give ... your blood that's occupied by red cells. Normal Blood Counts Normal blood counts fall within a range ...

  6. Other limb-girdle muscular dystrophies.

    Science.gov (United States)

    Amato, Anthony A

    2011-01-01

    The secondary α-dystroglycanopathies usually present in infancy as congenital muscular dystrophies but may manifest later in childhood or adult life (limb-girdle muscular dystrophy (LGMD) 2I, LGMD2K, LGMD2M, LGMD2N, and LGMD2O). Patients with telethoninopathy (LGMD2B) may present with mainly proximal or distal lower extremity weakness, and notably the muscle biopsies may demonstrate rimmed vacuoles. LGMD2L is caused by newly described mutations in ANO5 and can sometimes present with distal weakness resembling Miyoshi myopathy. PMID:21496628

  7. UPPER LIMB PROSTHETIC FOR STROKE AFFECTED PATIENTS

    Directory of Open Access Journals (Sweden)

    DEBIKA KHANRA,

    2011-04-01

    Full Text Available Paralysis causes loss of muscle function and loss of feeling in the affected area. The main problem faced by the patients after paralysis is muscle atrophy caused due to non-functionality of the stump. Orthotics is an orthopedic device which supports the function of the arm, leg or torso. This paper deals with the design of an upper limb orthotic device which has a hollow shell/ braces structure and can be used by paralyzed patients to bring about simple hand movements independently by the patient.

  8. Acupuncture for Limb Conditions: Pinpointing the Evidence.

    Science.gov (United States)

    2016-06-01

    Acupuncture therapies include a range of interventions and are commonly used for managing musculoskeletal disorders of the extremities; however, their use is still controversial. A study published in the June 2016 issue of JOSPT conducted a systematic review of randomized clinical trials on the effectiveness of various acupuncture therapies for any musculoskeletal condition affecting the limbs. Importantly, the review critically appraised the quality of the evidence to reveal risks of bias. In this Perspectives for Practice, the authors explain the impact of their findings for clinicians treating patients with such musculoskeletal conditions. J Orthop Sports Phys Ther 2016;46(6):430. doi:10.2519/jospt.2016.0502. PMID:27245489

  9. [Quantification and monitoring of vascular resistance in the lower limbs by the Doppler method (animal model)

    Science.gov (United States)

    Arbeille, P.; Berson, M.; Blondeau, B.; Durand, A.; Bodard, S.; Locatelli, A.; Fox, G. E. (Principal Investigator)

    1995-01-01

    The object of this study was to define and validate a non-invasive method of evaluation and monitoring of vascular resistances in the leg. Blood flow velocity was measured by Doppler ultrasound in an animal model (ewe) with similar blood flow characteristics in the lower limb as man and allowing access to the required invasive measurements for validation of the method (pressure and flow). Vascular resistances distal to the measuring point (femoral, for example) were assessed using the resistance index R = D/S, S being the peak systolic deflection and D that of diastolic reflux of the Doppler spectral analysis of flow in the femoral artery. The values and variations of this resistance index were compared with the vascular resistances calculated from measurements of pressure and flow at the point of Doppler sampling and expressed in mmHg/ml/min. Femoral flow was measured by Doppler ultrasound (Doppler-echo), and mean pressure by an arterial catheter introduced into the abdominal aorta. Compression of the lower limb veins induced a venous return resulting in a reduction of cardiac output and femoral flow. During compression, femoral flow decreased by an average of 29% (p vasoconstriction with an increase in blood pressure and a decrease in heart rate and femoral flow.(ABSTRACT TRUNCATED AT 250 WORDS).

  10. [Quantification and monitoring of vascular resistance in the lower limbs by the Doppler method (animal model)

    Science.gov (United States)

    Arbeille, P.; Berson, M.; Blondeau, B.; Durand, A.; Bodard, S.; Locatelli, A.; Fox, G. E. (Principal Investigator)

    1995-01-01

    The object of this study was to define and validate a non-invasive method of evaluation and monitoring of vascular resistances in the leg. Blood flow velocity was measured by Doppler ultrasound in an animal model (ewe) with similar blood flow characteristics in the lower limb as man and allowing access to the required invasive measurements for validation of the method (pressure and flow). Vascular resistances distal to the measuring point (femoral, for example) were assessed using the resistance index R = D/S, S being the peak systolic deflection and D that of diastolic reflux of the Doppler spectral analysis of flow in the femoral artery. The values and variations of this resistance index were compared with the vascular resistances calculated from measurements of pressure and flow at the point of Doppler sampling and expressed in mmHg/ml/min. Femoral flow was measured by Doppler ultrasound (Doppler-echo), and mean pressure by an arterial catheter introduced into the abdominal aorta. Compression of the lower limb veins induced a venous return resulting in a reduction of cardiac output and femoral flow. During compression, femoral flow decreased by an average of 29% (p pressure and heart rate did not change significantly. The femoral resistance index (Rf) increased by an average of 37.5% (p blood pressure and a decrease in heart rate and femoral flow.(ABSTRACT TRUNCATED AT 250 WORDS).

  11. Limb polarization of Uranus and Neptune. II Spectropolarimetric observations

    OpenAIRE

    Joos, F.; Schmid, H. M.

    2006-01-01

    We have detected a strong limb polarization for Uranus and Neptune. With spectropolarimetric observations we characterize the spectral dependence of this limb polarization and explore the diagnostic potential for investigating the distribution and properties of the scattering particles. We present disk resolved spectropolarimetry of Uranus and Neptune covering the wavelength range from 530nm to 930nm and compare the spectropolarimetric signal for different limb sections and the center of the ...

  12. Prenatal imaging of distal limb abnormalities using OCT in mice

    Science.gov (United States)

    Larina, Irina V.; Syed, Saba H.; Dickinson, Mary E.; Overbeek, Paul; Larin, Kirill V.

    2012-01-01

    Congenital abnormalities of the limbs are common birth defects. These include missing or extra fingers or toes, abnormal limb length, and abnormalities in patterning of bones, cartilage or muscles. Optical Coherence Tomography (OCT) is a 3-D imaging modality, which can produce high-resolution (~8 μm) images of developing embryos with an imaging depth of a few millimeters. Here we demonstrate the capability of OCT to perform 3D imaging of limb development in normal embryos and a mouse model with congenital abnormalities. Our results suggest that OCT is a promising tool to analyze embryonic limb development in mammalian models of congenital defects.

  13. Blood donation

    CERN Multimedia

    GS Department

    2009-01-01

    A blood donation is organised by the Cantonal Hospital of Geneva On Thursday 19 March 2009 from 9 a.m. to 5 p.m. CERN RESTAURANT 2 Number of donations during the last blood donations :135 donors in July 2008 122 donors in November 2008 Let’s do better in 2009 !!! Give 30 minutes of your time to save lives...

  14. BLOOD DONATION

    CERN Multimedia

    SC Unit

    2008-01-01

    A blood donation, organized by EFS (Etablissement Français du Sang) of Annemasse will take place On Wednesday 12 November 2008, from 8:30 to 16:00, at CERN Restaurant 2 If possible, please, bring your blood group Card.

  15. Pneumococcal sepsis presenting as acute compartment syndrome of the lower limbs: a case report

    Directory of Open Access Journals (Sweden)

    Doddi Sudeendra

    2009-02-01

    Full Text Available Abstract Introduction Acute compartment syndrome is a surgical emergency requiring immediate fasciotomy. Spontaneous onset of acute compartment syndrome of the lower limbs is rare. We present a very rare case of pneumococcal sepsis leading to spontaneous acute compartment syndrome. Case presentation A 40-year-old Caucasian man presented as an emergency with spontaneous onset of pain in both legs and signs of compartment syndrome. This was confirmed on fasciotomy. Blood culture grew Streptococcus pneumoniae. Conclusion Sepsis should be strongly suspected in bilateral acute compartment syndrome of spontaneous onset.

  16. Effect of demedullation on freezing injury in hind limbs of rats

    Science.gov (United States)

    Dhingra, Shashi; Bhatia, B.; Chhina, G. S.; Singh, Baldev

    1987-09-01

    Freezing incidence and tissue loss on exposure of hind limbs of female Wistar rats to freezing mixture was reduced by demedullation 6 days prior to cold exposure (pNoradrenaline (1 mg/kg i.p.) 5 min before exposure increased the freezing incidence in intact (pAdrenaline (500 mg/kg i.p.) had no effect on either. A sustained fall in plasma adrenaline after demedullation leading to reduced reactivity of the blood vessels to some vasoactive agents is postulated.

  17. Radioimmunoassay of serrum ferritin in patients with soft tissue malignant tumors of limbs and torso

    International Nuclear Information System (INIS)

    The change of ferritin level in the blood serum of patients with benign and malignant tumors of soft tissues of body and limbs, inflammabory processes of a given localization, is studied. The increase in the level of ferritin in the case of malignant tumors with regional and remote metastases is found. The conclusion is made on the possibility of using the given test to find metastases in the preclinical stage of their manifestation, to control the course of postoperative period, radical nature of operative treatment. 6 refs.; 2 tabs

  18. Tainted blood

    DEFF Research Database (Denmark)

    Deleuran, Ida; Sheikh, Zainab Afshan; Hoeyer, Klaus

    2015-01-01

    study of the historical rise and current workings of safety practices in the Danish blood system. Here, we identify a strong focus on contamination in order to avoid 'tainted blood', at the expense of working with risks that could be avoided through enhanced blood monitoring practices. Of further...... significance to this focus are the social dynamics found at the heart of safety practices aimed at avoiding contamination. We argue that such dynamics need more attention, in order to achieve good health outcomes in transfusion medicine. Thus, we conclude that, to ensure continuously safe blood systems, we...... need to move beyond the bifurcation of the social and medical aspects of blood supply as two separate issues and approach social dynamics as key medical safety questions....

  19. Tactile, thermal, and electrical thresholds in patients with and without phantom limb pain after traumatic lower limb amputation

    OpenAIRE

    Melton DH; Li S

    2015-01-01

    Shengai Li,1,2 Danielle H Melton,1,2 Sheng Li1,2 1Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX, USA; 2Neurorehabilitation Research Laboratory, TIRR Memorial Hermann Research Center, Houston, TX, USA Purpose: To examine whether there is central sensitization in patients with phantom limb pain (PLP) after traumatic limb amputation. Methods: Seventeen patients after unilateral lower limb amputation secondary to trauma were...

  20. Acupuncture for the treatment of phantom limb pain in lower limb amputees: study protocol for a randomized controlled feasibility trial

    OpenAIRE

    Trevelyan, Esmé G; Turner, Warren A; Robinson, Nicola

    2015-01-01

    Background Phantom limb pain is a prevalent condition that is difficult to manage, with a lack of robust evidence to support the use of many adjunctive treatments. Acupuncture can be effective in the management of many painful conditions but little is known about its effectiveness in treating phantom limb pain. The aim of this study is to explore the feasibility of conducting a randomized controlled trial comparing acupuncture and routine care in a group of lower limb amputees with phantom li...

  1. The Effect of Core and Lower Limb Exercises on Trunk Strength and Lower Limb Stability on Australian Soldiers

    OpenAIRE

    Rolf Sellentin; Rhondda Jones

    2012-01-01

    Study Design: A before and after design in the collection of data and using analyses of variance to examine the changes in each test score. Objectives: The objectives and hypotheses of this study are: (1) Do specific core exercises, incorporating the lower limbs improve lower limb stability and trunk core muscle strength?; (2) Can the Star Excursion Balance Test be used as a measure of ankle and lower limb stability without a history of ankle instability?; (3) Can static core test...

  2. Upper limb lymphedema after breast cancer treatment

    International Nuclear Information System (INIS)

    Purpose. - To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer. Patients and methods. - It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51 years (27-92 years). Tumour was T2 in 59% of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80% of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68 months (12-120). Results. - Lymphedema appeared in 23% of cases (51 patients), 14 months after surgery (mean period). Lymphedema affected the brachium in 17% of cases, the forearm in 12% of cases and all upper limb in 71% of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema. Conclusion. - Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10. (authors)

  3. Radiogrammetric analysis of upper limb long bones

    Directory of Open Access Journals (Sweden)

    Stojanović Zlatan

    2011-01-01

    Full Text Available Radiogrammetry is radiological method of bone mineral density quantification. Besides giving an insight in diagnostics and evolution of metabolic bone disorders (osteoporosis, osteomalacia, osteitis deformans- Paget's disease, it can also explain some specific biomechanical characteristics of bone structures. The aim of this study is to evaluate the significance and perspectives of radiogrammetry as a scientific model for further inquiry of skeletal system. The work demonstrates mathematical parameters (Ca-Cortical area, CI- Cortical index, GI- Garn's index, ESI- Exton Smith's index of upper limb long bones (humerus, radius, ulna. Two standard radiological projections of bones were taken: antero-posterior (AP and latero-lateral (LL. Correlation with metacarpal and lower limb bones was also performed. The value of the cortical area of humerus is significantly higher comparing with the two other examined bones (Xmean 2,2443 cm2, p < 0.01. Radial bone has the highest values of the relational mathematical parameters, which implicates its higher strength by volumetric unit concerning humerus and ulna. Despite the development of contemporary osteometric procedures (ultrasound densitometry, dual X-ray absorptiometry, digital X-ray radiogrammetry, the classical radiogrammetry sustains its important role in diagnostics of metabolic bone disorders and it can be successfully used for biomechanical inquiry of skeletal system.

  4. Comparative evaluation between ascorbic acid and N-acetyl cysteine for preventing tourniquet induced ischaemic reperfusion injury during lower limb surgery, a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mahmoud Hassan Mohamed

    2016-01-01

    Conclusion: Both N-acetyl cysteine and ascorbic acid reduce post-deflation increase in blood levels of markers of oxidative stress and markers of systemic inflammation and thus both are beneficial in preventing post-tourniquet deflation ischemic reperfusion injury in lower limb surgery.

  5. Heart Rate Variability and Hemodynamic Change in the Superior Mesenteric Artery by Acupuncture Stimulation of Lower Limb Points: A Randomized Crossover Trial

    OpenAIRE

    Soichiro Kaneko; Masashi Watanabe; Shin Takayama; Takehiro Numata; Takashi Seki; Junichi Tanaka; Seiki Kanemura; Yutaka Kagaya; Tadashi Ishii; Yoshitaka Kimura; Nobuo Yaegashi

    2013-01-01

    Objective. We investigated the relationship between superior mesenteric artery blood flow volume (SMA BFV) and autonomic nerve activity in acupuncture stimulation of lower limb points through heart rate variability (HRV) evaluations. Methods. Twenty-six healthy volunteers underwent crossover applications of bilateral manual acupuncture stimulation at ST36 or LR3 or no stimulation. Heart rate, blood pressure, cardiac index, systemic vascular resistance index, SMA BFV, and HRV at rest and 30 mi...

  6. Cell therapy in critical limb ischemia: current developments and future progress.

    Science.gov (United States)

    Mamidi, Murali Krishna; Pal, Rajarshi; Dey, Sovan; Bin Abdullah, Basri Johan Jeet; Zakaria, Zubaidah; Rao, Mahendra S; Das, Anjan Kumar

    2012-09-01

    Critical limb ischemia (CLI) is a syndrome manifested by ischemic rest pain, non-healing ulcers and tissue loss. CLI patients are at very high risk of amputation and experience poor physical function, leading to severe morbidity and mortality. The fundamental goal for CLI treatment is to relieve ischemic rest pain, heal ulcers, prevent limb loss and improve the quality of life, thereby extending the survival of the patient. Surgical or endovascular revascularization aimed at increasing blood flow is currently available for limb salvage in CLI. However, up to 30% of CLI patients are not suitable for such interventions because of high operative risk or unfavorable vascular anatomy. Therefore exploring new and more effective strategies for revascularization of ischemic limbs is imperative for the establishment of a viable therapeutic alternative. With the emergence of new approaches, this review describes up-to-date progress and developments in cell-based therapy as a novel and promising alternative for CLI treatment. Preliminary clinical data have established the safety, feasibility and efficacy of stem cells, and numerous studies are underway to consolidate this evidence further. However, significant hurdles remain to be addressed before this research can be responsibly translated to the bedside. In particular, we need better understanding of the behavior of cells post-transplantation and to learn how to control their survival and migration proliferation/differentiation in the hostile pathologic environment. Future research should focus on methods of isolation, optimal dosage, appropriate cell type, route of administration, role of tissue-derived factors and supportive endogenous stimulation. PMID:22731756

  7. VA paradigm shift in care of veterans with limb loss

    Directory of Open Access Journals (Sweden)

    Gayle E. Reiber, PhD, MPH

    2010-08-01

    Full Text Available Traumatic limb loss results in pain and discomfort in addition to the loss of an important part of the body and its function. The mental health challengesaccompanying limb loss include issues of frustration and body image, role in life, and feelings of not being whole. Many servicemembers and veteranswith limb loss need to prove to themselves that they can still accomplishphysical feats, such as those with lower-limb loss returning to running or those with upper-limb loss working with tools. If our servicemembers and veterans let these activities go, they again feel a loss. Therefore, Department of Veterans Affairs (VA services are available to help individuals meet their physical and recreational goals, whether they be running, walking, or masteringcomplex upper-limb activities. Veterans with limb loss need ongoing clinical care, prosthetic devices, and mobility assistance. As their prosthetic devices are repaired, replaced, and updated, they need corresponding educationand training. Too often in the past, the VA has taken a narrow view of amputation care, focusing only on managing prosthetic devices. Prosthetic care is one small but important aspect of the complex rehabilitation partnershipbetween the veteran with limb loss and the VA.

  8. Usefulness of milnacipran in treating phantom limb pain

    Directory of Open Access Journals (Sweden)

    Matsumoto Y

    2012-11-01

    Full Text Available Yasuhide Nagoshi,1 Akira Watanabe,1 Saiko Inoue,1 Tomoki Kuroda,2 Mitsuo Nakamura,3 Yoshitake Matsumoto,4 Kenji Fukui31Department of Psychiatry (Psychosomatic Medicine, Kyoto First Red Cross Hospital, Kyoto, Japan; 2Gojouyama Hospital, Nara, Japan; 3Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; 4Matsumoto Clinic, Kyoto, JapanBackground: Amputation of an extremity often results in the sensation of a “phantom limb” where the patient feels that the limb that has been amputated is still present. This is frequently accompanied by “phantom limb pain”. We report here the use of milnacipran, a serotonin and norepinephrine reuptake inhibitor, to treat phantom limb pain after amputation of injured or diseased limbs in three patients.Methods and results: The severity of phantom pain before and during treatment was quantified using a visual analog scale. In one case, phantom limb pain responded partially to treatment with high doses of paroxetine, and then replacement with milnacipran further improved the pain relief and long-term full pain relief was achieved. In the two other cases, milnacipran was used as first-line treatment and phantom limb pain responded rapidly.Conclusion: These results suggest that milnacipran administration may be useful in phantom limb pain, possibly as a first-line treatment.Keywords: milnacipran, paroxetine, phantom limb pain, selective serotonin reuptake inhibitor (SSRI, serotonin and norepinephrine reuptake inhibitor (SNRI

  9. Transient alien limb phenomenon in right frontoparietal infarction

    OpenAIRE

    Panda Samhita

    2010-01-01

    Alien limb phenomenon is associated with different neurological disorders, such as stroke and corticobasal degeneration. It is usually caused by involvement of the corpus callosum, with or without the frontal regions. Rarely, it can result from insult in the posterior cerebral artery territory. Alien limb phenomenon is generally persistent. Here, an unusual case of transient alien hand phenomenon is reported.

  10. Phantom limb pain--a phenomenon of proprioceptive memory?

    Science.gov (United States)

    Anderson-Barnes, Victoria C; McAuliffe, Caitlin; Swanberg, Kelley M; Tsao, Jack W

    2009-10-01

    Despite the amount of research that has been conducted on phantom limb pain (PLP), the etiology of the condition remains unknown, and treatment options are limited. After an individual loses a limb, the brain continues to detect the presence of the missing limb even though it is no longer attached to the body, likely through proprioceptive signals. The majority of patients with amputations either report the feeling of volitional control over their phantom or a phantom limb that is frozen in a specific position. Many patients also experience PLP. Here we propose a new theory, termed "proprioceptive memory," which may explain some of the unique experiences amputees encounter. We also suggest that memories of the limb's position prior to amputation remain embedded within an individual's subconscious, and pain memories that may be associated with each limb position contribute not only to PLP, but to the experience of a fixed or frozen limb. We suspect that there are memory networks for pain--and other sensations, either positive or negative--that are associated with each limb position, and propose that these memories evolved to protect our bodies from repeated injury. A discussion of mirror therapy as a treatment option for PLP is also provided, as well as an explanation for the efficacy of mirror therapy. The paper offers a unique insight into how and why amputees experience these unusual phenomena. PMID:19556069

  11. A feasibility study of limb volume measuring systems

    Science.gov (United States)

    Lafferty, J. F.; Carter, W. M.

    1974-01-01

    Evaluation of the various techniques by which limb volume can be measured indicates that the odometric (electromechanical) method and the reflective scanner (optical) have a high probability of meeting the specifications of the LBNP experiments. Both of these methods provide segmental measurements from which the cross sectional area of the limb can be determined.

  12. Transient alien limb phenomenon in right frontoparietal infarction

    Directory of Open Access Journals (Sweden)

    Panda Samhita

    2010-01-01

    Full Text Available Alien limb phenomenon is associated with different neurological disorders, such as stroke and corticobasal degeneration. It is usually caused by involvement of the corpus callosum, with or without the frontal regions. Rarely, it can result from insult in the posterior cerebral artery territory. Alien limb phenomenon is generally persistent. Here, an unusual case of transient alien hand phenomenon is reported.

  13. Experimental investigation of crustacean swimming with variation of limb structures

    Science.gov (United States)

    Lai, Hong Kuan; Samaee, Milad; Donnell, Geoffrey; Santhanakrishnan, Arvind; Guy, Robert; Lewis, Timothy

    2015-11-01

    Crustaceans such as crayfish and krill swim by rhythmically paddling a set of four to five limbs (known as swimmerets or pleopods) originating from their abdomen. The limb motion in these animals has been observed to follow tail-to-head metachronal wave pattern with an approximate quarter-period inter-limb phase difference. The goal of this study is to investigate the hydrodynamics of this swimming mechanism as a function of inter-limb phase difference, inclusion of hinges in the limbs, and Reynolds number (Re). 2D PIV measurements were conducted on a scaled robotic model of metachronal paddling, consisting of a rectangular tank fitted with stepper motors coupled to a four-bar linkage that actuated four paddles immersed in water-glycerin fluid medium. The inter-limb phase difference was varied from 0% (synchronous paddling) through 50% across Re range of O(10-1000). Two types of limb models were used, including a simple flat plate and a `split-paddle' structure with two flat plates connected halfway with hinges. The results of the study show that limb models with hinges generated increased horizontal (thrust-producing direction) fluid velocity compared to the simple flat plate paddles, suggesting that asymmetry between power and return strokes is important to augment thrust.

  14. A morpho-etiological description of congenital limb anomalies.

    Directory of Open Access Journals (Sweden)

    Tayel S

    2005-01-01

    Full Text Available Background: Limb anomalies rank behind congenital heart disease as the most common birth defects observed in infants. More than 50 classifications for limb anomalies based on morphology and osseous anatomy have been drafted over the past 150 years. The present work aims to provide a concise summary of the most common congenital limb anomalies on a morpho-etiological basis. Patients and Methods: In a retrospective study, 70 newborns with anomalies of the upper and/or lower limbs were ascertained through clinical examination, chromosomal analysis, skeletal surveys and other relevant investigations. Results: Fetal causes of limb anomalies represented 55.8% of the cases in the form of 9 cases (12.9% with chromosomal aberrations (trisomy 13, 18 and 21, duplication 13q and deletion 22q and 30 cases (42.9% with single gene disorders. An environmental etiology for limb anomalies was diagnosed in 11 cases (15.7% as amniotic band disruption, monozygotic twin with abnormal circulation, vascular disruption (Poland sequence, sirenomelia and general vascular disruption and an infant with a diabetic mother. Twenty cases (28.5% had limb anomalies as part of sporadic syndromes of unknown etiology. Conclusions: The morpho-etiological work-up of limb anomalies adopted in the present study is valuable for detecting the cause of the anomaly and is crucial for its prevention. Prevention can be achieved by proper genetic counseling, which includes recurrence risk estimation and prenatal diagnosis.

  15. Prenatal MRI evaluation of limb-body wall complex

    Energy Technology Data Exchange (ETDEWEB)

    Aguirre-Pascual, Elisa [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Hospital Universitario Doce de Octubre, Department of Radiology, Madrid (Spain); Epelman, Monica [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Nemours Children' s Hospital, Department of Medical Imaging, Orlando, FL (United States); Johnson, Ann M.; Chauvin, Nancy A.; Coleman, Beverly G.; Victoria, Teresa [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States)

    2014-11-15

    The sonographic (US) features of limb-body wall complex have been well documented; however the literature regarding the findings on MRI in limb-body wall complex is scant. To characterize the prenatal MRI features of limb-body wall complex. We performed a retrospective review of all MRI scans of fetuses diagnosed with limb-body wall complex at our institution from 2001 to 2011. Fetuses without correlating US scans or follow-up information were excluded. Three pediatric radiologists blinded to the specific US findings reviewed the prenatal MRIs. Images were evaluated for the organ location and attachment, the body part affected, characterization of the body wall defect, and spinal, limb and umbilical cord abnormalities. Ten subjects met inclusion criteria. MRI was able to detect and characterize the body part affected and associated abnormalities. All fetuses had ventral wall defects, a small thorax and herniated liver and bowel. The kidneys were extracorporeal in three cases. The extruded organs were attached to the placenta or the uterine wall in all cases. Abnormal spinal curvatures of various degrees of severity were present in all cases. Eight cases had a short, uncoiled cord. Limb anomalies were present in 6 of the 10 cases. We illustrate the common fetal MRI findings of limb-body wall complex. The prenatal diagnosis of limb-body wall complex and the differentiation of this defect from treatable abdominal wall defects are crucial to providing appropriate guidance for patient counseling and management. (orig.)

  16. Treatment of Critical Limb Ischemia: A shifting paradigm

    NARCIS (Netherlands)

    Teraa, M.

    2013-01-01

    Critical limb ischemia (CLI), the most advanced stage of peripheral artery disease (PAD), is characterized by severely impaired perfusion of the lower limbs, which results in rest pain and/or tissue loss. It is associated with high risk for major amputation and cardiovascular events resulting in 6-m

  17. Sex Differences in Limb and Joint Stiffness in Recreational Runners

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2015-09-01

    Full Text Available Purpose. Female runners are known to be at greater risk from chronic running injuries than age-matched males, although the exact mechanisms are often poorly understood. The aim of the current investigation was to determine if female recreational runners exhibit distinct limb and joint stiffness characteristics in relation to their male counterparts. Methods. Fourteen male and fourteen female runners ran over a force platform at 4.0 m · s-1. Lower limb kinematics were collected using an eight-camera optoelectric motion capture system operating at 250 Hz. Measures of limb and joint stiffness were calculated as a function of limb length and joint moments divided by the extent of limb and joint excursion. All stiffness and joint moment parameters were normalized to body mass. Sex differences in normalized limb and knee and ankle joint stiffness were examined statistically using independent samples t tests. Results. The results indicate that normalized limb (male = 0.18 ± 0.07, female = 0.37 ± 0.10 kN · kg · m-1 and knee stiffness (male = 5.59 ± 2.02, female = 7.34 ± 1.78 Nm · kg · rad-1 were significantly greater in female runners. Conclusions. On the basis that normalized knee and limb stiffness were shown to be significantly greater in female runners, the findings from the current investigation may provide further insight into the aetiology of the distinct injury patterns observed between sexes.

  18. Navicular bone fracture in the pelvic limb in two horses

    International Nuclear Information System (INIS)

    The case history, radiographic and scintigraphic findings of two horses with pelvic limb navicular bone fractures are presented. In both cases the fractures were of traumatic origin. One horse had a bilateral fracture of the navicular bone, distal border, the other horse had a fracture of the proximal articular border in one pelvic limb navicular bone

  19. Donating Blood

    Science.gov (United States)

    ... And be sure to drink plenty of water, milk, or other liquids. Before donating, you'll need to answer some questions about your medical history, and have your temperature, pulse, blood pressure, and ...

  20. Blood smear

    Science.gov (United States)

    ... of RBCs due to body destroying them ( immune hemolytic anemia ) Low number of RBCs due to some red ... of Heinz bodies may indicate: Alpha thalassemia Congenital hemolytic anemia Disorder in which red blood cells break down ...

  1. Amylase - blood

    Science.gov (United States)

    Amylase is an enzyme that helps digest carbohydrates. It is made in the pancreas and the glands ... saliva. When the pancreas is diseased or inflamed, amylase releases into the blood. A test can be ...

  2. Moving blood.

    Science.gov (United States)

    Pelis, K

    1997-01-01

    Our internationally acclaimed journalist Sanguinia has returned safely from her historic assignment. Travelling from Homeric Greece to British Romanticism, she was witness to blood drinking, letting, bathing, and transfusion. In this report, she explores connections between the symbolic and the sadistic; the mythic and the medical--all in an effort to appreciate the layered meanings our culture has given to the movement of blood between our bodies. PMID:9407636

  3. Pyroclastic deposits on the western limb of the moon

    Science.gov (United States)

    Coombs, Cassandra R.; Hawke, B. R.

    1992-01-01

    A geologic characterization is presented of 17 newly identified localized pyroclastic deposits on the western limb of the moon. The results show that lunar pyroclastic deposits are more pervasive on the western limb of the moon than once thought. The western limb dark-mantle deposits in the proximal zone are probably related to faults and fractures associated with the Cordillera ring of Orientale Basin. All the localized pyroclastic deposits on the western limb for which near-infrared reflectance spectra have been obtained exhibit parameter that allowed them to be assigned to the three spectral groups described elsewhere. Western limb pyroclastic deposits appear to represent various stages in a formational sequence in which an initial explosive phase is followed by varying amounts of mare flooding. In view of their sequential formation, both the pyroclastic and mare materials associated with individual volcanic complexes may be the products of the same parent magmas and have very similar compositions.

  4. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... Blood Basics Blood Disorders Anemia Bleeding Disorders Blood Cancers Blood Clots Blood Clotting and Pregnancy Clots and ... Increased maternal age Other medical illness (e.g., cancer, infection) back to top How are Blood Clots ...

  5. Biology of Blood

    Science.gov (United States)

    ... Mail Facebook TwitterTitle Google+ LinkedIn Home Blood Disorders Biology of Blood Overview of Blood Medical Dictionary Also ... Version. DOCTORS: Click here for the Professional Version Biology of Blood Overview of Blood Components of Blood ...

  6. Blood (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Blood KidsHealth > For Parents > Blood Print A A A ... about the mysterious, life-sustaining fluid called blood. Blood Basics Two types of blood vessels carry blood ...

  7. Blood Facts and Statistics

    Science.gov (United States)

    ... About Blood > Blood Facts and Statistics Printable Version Blood Facts and Statistics Facts about blood needs Facts ... about American Red Cross Blood Services Facts about blood needs Every two seconds someone in the U.S. ...

  8. Catecholamine blood test

    Science.gov (United States)

    Norepinephrine -- blood; Epinephrine -- blood; Adrenalin -- blood; Dopamine -- blood ... A blood sample is needed. ... the test. This is especially true if both blood and urine catecholamines are to be measured. You ...

  9. Omphalocele major with absent lower limb.

    Science.gov (United States)

    Kundal, Vijay Kumar; Gajdhar, Mufique; Kundal, Raksha; Ahmed, Reyaz; Agrawal, Leela Dhar

    2015-02-01

    A newborn delivered by Caesarian section presented with an absent anterior abdominal wall and visible bowel loops and liver. The defect was covered by a thin membrane. The patient had associated absent left lower limb and right foot fusion defect. The patient was haemodynamically stable; general condition was average. No genito-urinary abnormality was detected. The anal opening was present normally, and the patient passed meconium immediately after birth. A diagnosis of omphalocele major with amelia was made. The patient was initially managed by topical application of povidone-iodine for eschar formation and epithelisation of the sac. The patient was discharged after 1 week with advice for regular follow-up. PMID:25829718

  10. Interventional musculoskeletal ultrasonography of the lower limb.

    Science.gov (United States)

    Morvan, G; Vuillemin, V; Guerini, H

    2012-09-01

    In this case series, out of 823 ultrasound-guided injections carried out over a period of one and a half years, 60% were of the lower limb (LL). In the hip (61% of LL injections), the main indications were pathologies of the gluteal tendons and bursae (80%) and pathologies of periprosthetic soft tissue; in the knee (15% of LL punctures), these procedures were for cysts (51%), tendinopathies and bursopathies (18%), and joint aspirations (7%); in the calf, haematoma drainage; in the foot and the ankle (24% of LL punctures), Morton's neuroma (47%), tenosynovitis (22%), pathologies of the plantar fascia (13%), cysts (7%), joint aspirations (5%), and bursopathies. For each of these indications, we will detail the specific technique and equipment used, useful tips, and post-procedure care. PMID:22921690

  11. Microwave limb sounder for stratospheric measurements

    International Nuclear Information System (INIS)

    The balloon-borne Microwave Limb Sounder (BMLS) measures atmospheric thermal emission from millimeter wavelength spectral lines to determine vertical profiles of stratospheric species. The instrument flown to data operates at 205 BHz to measure ClO, O3, and H2O2. A 63 GHz radiometer is added to test the technique for determining tangent point pressure from the MLS experiment on the Upper Atmosphere Research Satellite (UARS). Many additional species is also measured by the BLMS. A radiometer at 270 GHz would provide measurements of HO2, NO2, HNO3, N2O, 16O18O16O, and HCN. With this addition the BMLS can test the current theory of O3 heavy ozone photochemical balance in the upper stratosphere

  12. Music related upper limb pain in schoolchildren.

    Science.gov (United States)

    Fry, H J; Rowley, G L

    1989-12-01

    Two British secondary schools (one a specialist music school) were surveyed to assess the prevalence of upper limb pain among specialist music students compared with students in a regular school setting. Female students tended to report pain more often than male students, but for both significantly higher prevalence was found in the music school. Pain in the regular school was most often attributed to writing, whereas in the music school it was associated with the playing of all instruments, but most particularly with cello, clarinet, and flute. Music students reported long hours of practice, but it appeared that the intensity of practice may be more important as a determinant of pain than the total hours spent practising. The results of the study are in substantial agreement with those previously published from Australia and North America. On the balance of probabilities the pain is due to overuse syndrome, which is very common in musicians and well known in writers. PMID:2619360

  13. How x rays inhibit amphibian limb regeneration

    Energy Technology Data Exchange (ETDEWEB)

    Maden, M.; Wallace, H.

    1976-07-01

    The effects of an inhibiting dose of 2,000 rad of x-rays on the regenerating limbs of axolotl larvae have been examined in a histological and cytological study. Particular attention was paid to the mitotic indices of normal and irradiated epidermal and blastemal cells. Both the characteristic pattern of epidermal mitotic stimulation which normally follows amputation and the later increase in blastemal mitoses are suppressed by irradiation. In most cells the effects are permanent, but in a small proportion a mitotic delay is induced and upon subsequent division chromosome damage in the form of micronuclei is revealed. Thus irradiated cells which do divide almost certainly die. These results are discussed in relation to other theories of x-ray inhibition of regeneration with particular reference to the view that irradiated cells can be reactivated.

  14. Near-Limb Zeeman and Hanle Diagnostics

    CERN Document Server

    Kim, I S; Bugaenko, O I; Popov, V V; Suyunova, E Z

    2013-01-01

    "Weak" magnetic-field diagnostics in faint objects near the bright solar disk are discussed in terms of the level of non-object signatures, in particular, of the stray light in telescopes. Calculated dependencies of the stray light caused by diffraction at the 0.5-, 1.6-, and 4-meter entrance aperture are presented. The requirements for micro-roughness of refractive and reflective primary optics are compared. Several methods for reducing the stray light (the Lyot coronagraphic technique, multiple stages of apodizing in the focal and exit pupil planes, apodizing in the entrance aperture plane with a special mask), and reducing the random and systematic errors are noted. An acceptable level of stray light in telescopes is estimated for the V-profile recording with a signal-to-noise ratio greater than three. Prospects for the limb chromosphere magnetic measurements are indicated.

  15. The role of lymphography in limb meloma

    International Nuclear Information System (INIS)

    The autors report the results of the lymphographic examinations performed on 123 patients affected with melanoma of the limbs. The patients were divided into 2 groups according to the different clinical stages; they all had pathologic conformation. The following lymphographic parameters were considered: sensitivity, specificity, efficacy and positive/negative predictive value. The results obtained in the first group of patients (Clinical stage: I) demonstrated lymphography to have low sensitivity, specificity and efficacy in the staging of melanomas (37%, 50% and 45%, respectively). On the contrary, lymphography could be trusted in the study of stage II melanomas thanks to its high sensitivity. As for stage II, the methodology had a clinical indication only in the follow-up of melanomas treated with radio-chemotherapy

  16. MR imaging in congenital lower limb deformities

    Energy Technology Data Exchange (ETDEWEB)

    Laor, T. [Dept. of Radiology, Children`s Hospital and Harvard Medical School, Boston, MA (United States); Jaramillo, D. [Dept. of Radiology, Children`s Hospital and Harvard Medical School, Boston, MA (United States); Hoffer, F.A. [Dept. of Radiology, Children`s Hospital and Harvard Medical School, Boston, MA (United States); Kasser, J.R. [Dept. of Orthopedics, Children`s Hospital and Harvard Medical School, Boston, MA (United States)

    1996-06-01

    Treatment for children with cogenital deformities of the lower extremities may vary, depending on the state of the unossified skeletal structures and surrounding soft tissues. The purpose of our study was to demonstrate the spectrum of the osteochondral and extrasosseous abnormalities as depicted with MR imaging. We retrospectively reviewed MR examinations of 13 limbs of ten children (aged 1 month-9 years, mean 2.1 years) with longitudinal and transverse deformities of the lower extremities. The lesions imaged were fibular hemimelia (n=5), tibial hemimelia (n=5), and congenital constriction bands (n=3). Each examination was assessed for abnormalities in the osteocartilaginous and extraosseous (articular or periarticular components such as ligaments, tendons, and menisci; the muscles and the arteries) structures. Abnormalities were seen in all patients. Osteocartilaginous abnormalities in the patients with longitudinal deformities included abnormal distal femoral epiphyses, abnormal proximal tribial physes, hypertrophied and dislocated proximal fibular epiphyses, unsuspected fibular and tibial remnants, and absence or coalition of the tarsal bones. No osteocartilaginous abnormalities were seen in the patients with congential constriction bands. Articular abormalities in patients with either form of hemimelia included absent cruciate ligaments and menisci, dislocated or absent cartilaginous patellae, absent patellar tendons, and abnormal collateral ligaments. All but one limb imaged had absent or attenuated muscle groups. Of the nine MR arteriograms performed at the level of the knee, eight were abnormal. The normal popliteal trifurcation was absent or in an abnormal location. We conclude that MR imaging of children with congenital lower extremity deformities shows many osteochondral and extraosseous abnormalities that are not depicted by conventional radiogrpahy. This information can help to plan early surgical intervention and prosthetic rehabilitation. (orig.)

  17. Assimilation of the Microwave Limb Sounder Radiances

    Science.gov (United States)

    Wargan, K.; Read, W.; Livesey, N.; Wagner, P.; Nguyen. H.; Pawson, S.

    2012-01-01

    It has been shown that the assimilation of limb-sounder data can significantly improve the representation of ozone in NASA's GEOS Data Assimilation Systems (GEOS-DAS), particularly in the stratosphere. The studies conducted so far utilized retrieved data from the MIPAS, POAM, ILAS and EOS Microwave Limb Sounder (EOS MLS) instruments. Direct assimilation of the radiance data can be seen as the natural next step to those studies. The motivation behind working with radiances is twofold. First, retrieval algorithms use a priori data which are either climatological or are obtained from previous analyses. This introduces additional uncertainty and, in some cases, may lead to "self-contamination"- when the a priori is taken from the same assimilation system in which subsequently ingests the retrieved observations. Second, radiances can be available in near real time thus providing an opportunity for operational assimilation, which could help improve the use of infrared radiance instruments from operational satellite instruments. In this presentation we summarize our ongoing work on an implementation of the assimilation of EOS MLS radiances into the GEOS-5 DAS. This work focuses on assimilation of band 7 brightness temperatures which are sensitive to ozone. Our implementation uses the MLS Callable Forward Model developed by the MLS team at NASA JPL as the observation operator. We will describe our approach and recent results which are not yet final. In particular, we will demonstrate that this approach has a potential to improve the vertical structure of ozone in the lower tropical stratosphere as compared with the retrieved MLS product. We will discuss the computational efficiency of this implementation.

  18. Lower limb joint replacement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Clement Nicholas D

    2012-06-01

    Full Text Available Abstract Introduction There is limited literature regarding the peri-operative and surgical management of patients with rheumatoid disease undergoing lower limb arthroplasty. This review article summarises factors involved in the peri-operative management of major lower limb arthroplasty surgery for patients with rheumatoid arthritis. Methods We performed a search of the medical literature, using the PubMed search engine (http://www.pubmed.gov. We used the following terms: ‘rheumatoid’ ‘replacement’ ‘arthroplasty’ and ‘outcome’. Findings The patient should be optimised pre-operatively using a multidisciplinary approach. The continued use of methotrexate does not increase infection risk, and aids recovery. Biologic agents should be stopped pre-operatively due the increased infection rate. Patients should be made aware of the increased risk of infection and periprosthetic fracture rates associated with their disease. The surgical sequence is commonly hip, knee and then ankle. Cemented total hip replacement (THR and total knee replacement (TKR have superior survival rates over uncemented components. The evidence is not clear regarding a cruciate sacrificing versus retaining in TKR, but a cruciate sacrificing component limits the risk early instability and potential revision. Patella resurfacing as part of a TKR is associated with improved outcomes. The results of total ankle replacement remain inferior to THR and TKR. RA patients achieve equivalent pain relief, but their rehabilitation is slower and their functional outcome is not as good. However, the key to managing these complicated patients is to work as part of a multidisciplinary team to optimise their outcome.

  19. Geographic variation in gorilla limb bones.

    Science.gov (United States)

    Jabbour, Rebecca S; Pearman, Tessa L

    2016-06-01

    Gorilla systematics has received increased attention over recent decades from primatologists, conservationists, and paleontologists. Studies of geographic variation in DNA, skulls, and teeth have led to new taxonomic proposals, such as recognition of two gorilla species, Gorilla gorilla (western gorilla) and Gorilla beringei (eastern gorilla). Postcranial differences between mountain gorillas (G. beringei beringei) and western lowland gorillas (G. g. gorilla) have a long history of study, but differences between the limb bones of the eastern and western species have not yet been examined with an emphasis on geographic variation within each species. In addition, proposals for recognition of the Cross River gorilla as Gorilla gorilla diehli and gorillas from Tshiaberimu and Kahuzi as G. b. rex-pymaeorum have not been evaluated in the context of geographic variation in the forelimb and hindlimb skeletons. Forty-three linear measurements were collected from limb bones of 266 adult gorillas representing populations of G. b. beringei, Gorilla beringei graueri, G. g. gorilla, and G. g. diehli in order to investigate geographic diversity. Skeletal elements included the humerus, radius, third metacarpal, third proximal hand phalanx, femur, tibia, calcaneus, first metatarsal, third metatarsal, and third proximal foot phalanx. Comparisons of means and principal components analyses clearly differentiate eastern and western gorillas, indicating that eastern gorillas have absolutely and relatively smaller hands and feet, among other differences. Gorilla subspecies and populations cluster consistently by species, although G. g. diehli may be similar to the eastern gorillas in having small hands and feet. The subspecies of G. beringei are distinguished less strongly and by different variables than the two gorilla species. Populations of G. b. graueri are variable, and Kahuzi and Tshiaberimu specimens do not cluster together. Results support the possible influence of

  20. Structure design of lower limb exoskeletons for gait training

    Science.gov (United States)

    Li, Jianfeng; Zhang, Ziqiang; Tao, Chunjing; Ji, Run

    2015-09-01

    Due to the close physical interaction between human and machine in process of gait training, lower limb exoskeletons should be safe, comfortable and able to smoothly transfer desired driving force/moments to the patients. Correlatively, in kinematics the exoskeletons are required to be compatible with human lower limbs and thereby to avoid the uncontrollable interactional loads at the human-machine interfaces. Such requirement makes the structure design of exoskeletons very difficult because the human-machine closed chains are complicated. In addition, both the axis misalignments and the kinematic character difference between the exoskeleton and human joints should be taken into account. By analyzing the DOF(degree of freedom) of the whole human-machine closed chain, the human-machine kinematic incompatibility of lower limb exoskeletons is studied. An effective method for the structure design of lower limb exoskeletons, which are kinematically compatible with human lower limb, is proposed. Applying this method, the structure synthesis of the lower limb exoskeletons containing only one-DOF revolute and prismatic joints is investigated; the feasible basic structures of exoskeletons are developed and classified into three different categories. With the consideration of quasi-anthropopathic feature, structural simplicity and wearable comfort of lower limb exoskeletons, a joint replacement and structure comparison based approach to select the ideal structures of lower limb exoskeletons is proposed, by which three optimal exoskeleton structures are obtained. This paper indicates that the human-machine closed chain formed by the exoskeleton and human lower limb should be an even-constrained kinematic system in order to avoid the uncontrollable human-machine interactional loads. The presented method for the structure design of lower limb exoskeletons is universal and simple, and hence can be applied to other kinds of wearable exoskeletons.

  1. The Treatment of Phantom Limb Pain Using Immersive Virtual Reality : Three Case Studies.

    OpenAIRE

    Murray, Craig; Pettifer, Stephen; Howard, Toby; Patchick, Emma; Caillette, Fabrice; Kulkarni, Jai; Bamford, Candy

    2007-01-01

    Purpose: This paper describes the design and implementation of a case-study based investigation using immersive virtual reality as a treatment for phantom limb pain. Method: Three participants who experienced phantom limb pain (two with an upper-limb amputation, and one with a lower-limb amputation) took part in between 2-5 Immersive Virtual Reality (IVR) sessions over a three week period. The movements of participants’ anatomical limbs were transposed into the movements of a virtual limb, pr...

  2. Comparative lower limb hemodynamics using neuromuscular electrical stimulation (NMES) versus intermittent pneumatic compression (IPC)

    International Nuclear Information System (INIS)

    Deep Vein Thrombosis (DVT) is a life threatening condition and a serious concern among hospitalised patients, with death occurring in approximately 6% of cases. Intermittent pneumatic compression (IPC) is commonly used for DVT prevention, however suffers from low compliance and issues of usability and portability. Neuromuscular electrical stimulation (NMES) has been shown to improve lower limb hemodynamics but direct comparison with IPC in terms of hemodynamics is rare but very important to determine the potential effectiveness of NMES in DVT prevention. Lower limb IPC was compared to calf NMES, in 30 healthy volunteers (18–23 years). Each intervention was carried out on each leg, on the popliteal vein measured using Doppler ultrasound. All interventions produced significantly greater haemodynamic responses compared to baseline. Calf-IPC and NMES produced significant increases in venous blood velocity (cm/s) and volume of blood ejected per cycle (1 cycle of NMES expels 23.22 ml compared to the baseline ejected volume of 2.52 ml, measured over 1 s (p < 0.001 versues baseline). Improving lower limb hemodynamics is vital in preventing DVT. NMES resulted in larger ejected volumes compared to IPC (x3 greater than foot-IPC and x1.7 greater than calf-IPC) more effectively emptying the veins and soleal sinuses. This is an important finding as DVT occurs predominantly in the soleal sinuses. NMES is silent and portable and thus does not suffer many of the issues associated with IPC. This work supports the potential widespread application of NMES in hospital and home settings where the risk of DVT formation is high. (paper)

  3. The effect of limb dominance on lower limb functional performance--a systematic review.

    Science.gov (United States)

    McGrath, Timothy M; Waddington, Gordon; Scarvell, Jennie M; Ball, Nick B; Creer, Rob; Woods, Kevin; Smith, Damian

    2016-01-01

    Lower limb dominance (or lateral preference) could potentially effect functional performance. Clinicians are often asked to make judgements as to when a patient has sufficiently "recovered" from an injury, typically using strength and dynamic performance outcome measures. The primary purpose of this study was to systematically review the literature in relation to limb dominance within active adult populations and discuss some limitations to current methods and relate this to current clinical practice. A search of MEDLINE and CINAHL and EMBASE databases and reference lists of those articles identified was performed. Eleven articles were selected for meta-analysis. There was no statistical effect of limb dominance for any of the functional tests: isokinetic quadriceps and hamstring tests, hamstring:quadriceps ratios, single-leg hop for distance, single-leg vertical jump and vertical ground reaction force following a single-leg vertical jump. Pooled symmetry values varied from 94.6% to 99.6% across the tests, above the clinically accepted benchmark of 90% used in clinical practice. Although the results of this study must be used with discretion, asymmetries in the tasks described in this analysis should be viewed as undesirable and remedied accordingly. Further research is needed to quantify asymmetries, particularly in relation to sport-specific contexts. PMID:26055387

  4. Limb lengthening in Africa: tibial lengthening indicated for limb length discrepancy and postosteomyelitis pseudarthrosis

    Directory of Open Access Journals (Sweden)

    Ibrahima F

    2014-05-01

    Full Text Available Farikou Ibrahima,1,2 Pius Fokam,2 Félicien Faustin Mouafo Tambo11Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, 2Department of Surgery, Douala General Hospital, Douala, CameroonBackground: We present a case of lengthening of a tibia to treat postosteomyelitis pseudarthrosis and limb length discrepancy by the Ilizarov device.Objective: The objective was to treat the pseudarthrosis and correct the consequent limb length discrepancy of 50 mm.Materials and methods: The patient was a 5-year-old boy. Osteotomy of the tibia, excision of fibrosis, and decortications were carried out. After a latency period of 5 days, the lengthening started at a rate of 1 mm per day.Results: The pseudarthrosis healed and the gained correction was 21.73%. The index consolidation was 49 days/cm. Minor complications were reported.Discussion: Osteomyelitis of long bones is a common poverty-related disease in Africa. The disease usually is diagnosed at an advanced stage with complications. In these conditions, treatment is much more difficult. Most surgical procedures treating this condition use the Ilizarov device. The most common reported surgical complications are refractures and recurrence of infection.Conclusion: This technique should be popularized in countries with limited resources because it would be an attractive alternative to the amputations that are sometimes performed.Keywords: Limb length discrepancy (LLD, bone gap, Ilizarov device

  5. Bone dosimetry and scintigraphy in post-traumatic reflex sympathetic dystrophy syndrome (RSDS) with upper limb involvement

    International Nuclear Information System (INIS)

    In 24 patients affected with post-traumatic reflex sympathetic dystrophy syndrome (RSDS) with upper limb involvement following humeral fractures, bone mineral density (BMD, mg/cm2) was measured by means of dual-photon absorptiometry in the distal radius of both the affected and the normal contralateral limbs. Subsequently, all patients underwent dynamic and static scintigraphic exams after i.v. injection of 99mTc-MDP (20 mCi), with gamma camera collimator centered in both limbs. BMD values were significantly lower in the affected sides than in the normal contralateral ones. Time-activity curves with MDP showed increased flow in the involved limbs. Significant increase in blood pool and in bone uptake was also oserved. After carbocalcin treatment (80 U/q.d.i.m. in 12 cases and 40 U/q.d.i.m. in the other 12 cases for month) all the patients presented improved clinical symptoms and significant increase in BMD, that was restored to normal values in 7 of the patients who had a longer treatment (40 U/q.d.i.m. for 2 months). Both local blood flow and bone up-take in the affected side significantly decreased after carbocalcitonin therapy while bone avidity index increased in those patients in whom this parameter had been measured. Results confirmed the usefulness of radioisotopic procedures in post-traumatic RSDS for both diagnosis (by demonstrating increased local blood flow and early bone demineralization) and monitoring response to treatment with carbocalcitonin, which seems to play an important role in this condition

  6. 四肢脱套伤的处理%Management of degloving injuries of limbs

    Institute of Scientific and Technical Information of China (English)

    戴亚辉; 梅炯

    2015-01-01

    Degloving injuries of limbs occur relatively rarely but pose extreme challenges to surgeons, which are usually caused by trafifc accidents or industrial trauma. The key point that differentiates this kind of injury from others is that certain arteries will get damaged due to the separation of the skin and subcutaneous soft tissues from muscles, tendons and fascias, leading to the block of blood lfow. Loss of blood supply means the degloving skin and other soft tissues can hardly live. Mismanagement of such kind of injuries may result in delayed full-thickness necrosis of the avulsed skin lfap, higher complication rate, increased hospitalization and rehabilitation cost, even greater risk of amputation and death. By reviewing past scholars’ management of different types of degloving injuries, it is found that although there are many options available for the management, it is still disputed on how to choose effective treatment strategies and techniques. Some traditional methods are efficient and can be easily put into use in clinic. With the development of science and technology in recent years, new technologies and materials like microsurgical techniques and vaccum sealing drainage ( VSD )/vaccum assisted closure ( VAC ) can provide new options for these injuries, which could greatly reduce the heavy nursing care burden after surgery and decrease the postoperative infection rate. This article is introducing the classification of degloving injuries of limbs, storage methods of degloved skin and discussing the treatment strategies, surgical techniques and prognosis of this kind of injury, aiming to provide some recommendations to surgeons who will face these injuries.

  7. High-resolution dynamic angiography using flat-panel volume CT: feasibility demonstration for neuro and lower limb vascular applications

    Energy Technology Data Exchange (ETDEWEB)

    Mehndiratta, Amit [Massachusetts General Hospital, Department of Radiology, Harvard Medical School, Boston, MA (United States); University of Oxford, Institute of Biomedical Engineering and Keble College, Oxford (United Kingdom); Indian Institute of Technology Delhi and All India Institute of Medical Science, Centre for Biomedical Engineering, New Delhi (India); Rabinov, James D. [Massachusetts General Hospital, Interventional Neuroradiology, Harvard Medical School, Boston, MA (United States); Grasruck, Michael [Siemens Medical Solutions, Forchheim (Germany); Liao, Eric C. [Massachusetts General Hospital, Department of Plastic and Reconstructive Surgery and Center for Regenerative Medicine, Harvard Medical School, Boston, MA (United States); Crandell, David [Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA (United States); Gupta, Rajiv [Massachusetts General Hospital, Department of Radiology, Harvard Medical School, Boston, MA (United States)

    2015-07-15

    This paper evaluates a prototype flat-panel volume CT (fpVCT) for dynamic in vivo imaging in a variety of neurovascular and lower limb applications. Dynamic CTA was performed on 12 patients (neuro = 8, lower limb = 4) using an fpVCT with 120 kVp, 50 mA, rotation time varying from 8 to 19 s, and field of view of 25 x 25 x 18 cm{sup 3}. Four-dimensional data sets (i.e. 3D images over time) were reconstructed and reviewed. Dynamic CTA demonstrated sufficient spatio-temporal resolution to elucidate first-pass and recirculation dynamics of contrast bolus through neurovasclar pathologies and phasic blood flow though lower-limb vasculature and grafts. The high spatial resolution of fpVCT resulted in reduced partial volume and metal beam-hardening artefacts. This facilitated assessment of vascular lumen in the presence of calcified plaque and evaluation of fractures, especially in the presence of fixation hardware. Evaluation of arteriovenous malformation using dynamic fpVCT angiography was of limited utility. Dynamic CTA using fpVCT can visualize time-varying phenomena in neuro and lower limb vascular applications and has sufficient diagnostic imaging quality to evaluate a number of pathologies affecting these regions. (orig.)

  8. Multiple bilateral lower limb fractures in a 2-year-old child: previously unreported injury with a unique mechanism

    Directory of Open Access Journals (Sweden)

    Anuj Jain

    2014-10-01

    Full Text Available 【Abstract】Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason. A child fell from a height of around 15 feet after toppling from a alcony. He developed multiple fractures involving the right femoral shaft, right distal femoral epiphysis (Salter Harris type 2, right distal metaphysis of the tibia and fi bula, and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia. There were no head, abdominal or spinal injuries. The patient was taken into emergency operation theatre after initial management which consisted of intravenous fl uids, blood transfusion, and splintage of both lower limbs. Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails. Distal femoral physeal injury required open eduction and fixation with K wires. Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs. All the fractures united in four weeks. At the last follow-up, the child had no disability and was able to perform daily ctivities comfortably. We also proposed the unique mechanism of injury in this report. Key words: Multiple bilateral lower limb fractures; Fall; Child

  9. High-resolution dynamic angiography using flat-panel volume CT: feasibility demonstration for neuro and lower limb vascular applications

    International Nuclear Information System (INIS)

    This paper evaluates a prototype flat-panel volume CT (fpVCT) for dynamic in vivo imaging in a variety of neurovascular and lower limb applications. Dynamic CTA was performed on 12 patients (neuro = 8, lower limb = 4) using an fpVCT with 120 kVp, 50 mA, rotation time varying from 8 to 19 s, and field of view of 25 x 25 x 18 cm3. Four-dimensional data sets (i.e. 3D images over time) were reconstructed and reviewed. Dynamic CTA demonstrated sufficient spatio-temporal resolution to elucidate first-pass and recirculation dynamics of contrast bolus through neurovasclar pathologies and phasic blood flow though lower-limb vasculature and grafts. The high spatial resolution of fpVCT resulted in reduced partial volume and metal beam-hardening artefacts. This facilitated assessment of vascular lumen in the presence of calcified plaque and evaluation of fractures, especially in the presence of fixation hardware. Evaluation of arteriovenous malformation using dynamic fpVCT angiography was of limited utility. Dynamic CTA using fpVCT can visualize time-varying phenomena in neuro and lower limb vascular applications and has sufficient diagnostic imaging quality to evaluate a number of pathologies affecting these regions. (orig.)

  10. 踝肱压指数与趾肱压指数在评估糖尿病患者下肢血供中的意义%The significance of ABPI and TBPI in evaluating blood supply of lower limb in type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    王彦; 陈兵

    2004-01-01

    目的测量踝动脉收缩压(ankle systolic blood pressures, ASBP)和计算踝肱压指数(ankle brachial pressure indices,ABPI)是评估下肢血供的一项操作简便的非侵入性检查方法.但在糖尿病下肢动脉钙化时,ASBP会异常升高.有学者推荐使用趾动脉收缩压(toe systolic blood pressures,TSBP)和趾肱压指数(toe brachial pressure indices,TBPI).本研究旨在发现趾压和踝压的关系以指导临床医生在什么时候更应该测量趾血管指数而不是踝血管指数.方法 41例2型糖尿病患者和23例正常对照者用多普勒仪测量肱动脉收缩压、ASBP和TSBP,并分别计算ABPI、TBPI,根据ABPI值对所有下肢进一步分组,作统计学分析.结果各组ASBP与TSBP相关很微弱.当下肢血管钙化因素对ASBP及ABPI影响很明显时,TSBP和TBPI的测量值受其影响不明显.结论对于大部分糖尿病患者测量TBPI不比ABPI更有优势.只要ABPI不是明显的假性增高(例如>1.3),它就和TBPI一样能为临床诊断提供可信的参考.但当患者有明显的动脉中膜钙化(ABPI≥1.3)时,趾压指数因受其影响不显著而更有诊断价值.同时测量TSBP和计算TBPI,可减少因ABPI造成的糖尿病足漏诊率.

  11. Tactile, thermal, and electrical thresholds in patients with and without phantom limb pain after traumatic lower limb amputation

    Directory of Open Access Journals (Sweden)

    Li S

    2015-04-01

    Full Text Available Shengai Li,1,2 Danielle H Melton,1,2 Sheng Li1,2 1Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX, USA; 2Neurorehabilitation Research Laboratory, TIRR Memorial Hermann Research Center, Houston, TX, USA Purpose: To examine whether there is central sensitization in patients with phantom limb pain (PLP after traumatic limb amputation. Methods: Seventeen patients after unilateral lower limb amputation secondary to trauma were enrolled. Ten patients had chronic PLP, while the other seven patients had no PLP. Tactile-sensation threshold, cold- and warm-sensation thresholds, cold- and heat-pain thresholds, electrical-sensation threshold (EST, and electrical-pain threshold on the distal residual limb and the symmetrical site on the sound limb were measured in all tested patients. Their thresholds were compared within the PLP and non-PLP group, and between the groups. Results: The novel findings included: 1 electrical-pain threshold was only decreased in the sound limb in the PLP group and there was no difference between two limbs in the non-PLP group, suggesting central sensitization in patients with PLP; and 2 EST was increased on the affected limb as compared to the sound limb within the PLP group, but there were no significant differences in EST between the PLP and non-PLP group. There were in general no significant differences in other tested thresholds within the groups and between groups. Conclusion: Our results demonstrate central sensitization in the patients with PLP after traumatic limb amputation. Keywords: central sensitization, pain threshold, human

  12. Rehabilitation and return to running after lower limb stress fractures.

    Science.gov (United States)

    Liem, Brian C; Truswell, Hallie J; Harrast, Mark A

    2013-01-01

    Lower limb stress fractures are common injuries in runners. In terms of treatment, much of the medical literature has focused primarily on rest and cessation of running, but little has been written about the rehabilitation and functional progression of runners following a lower limb stress fracture. This article reviews the scientific evidence behind common rehabilitation concepts used for runners recovering from these injuries and also discusses sport-specific training modalities such as deep water running and antigravity treadmill training. Overall this article is intended to be a practical resource for clinicians to guide runners in functional rehabilitation and return to running following lower limb stress injury. PMID:23669091

  13. Solar limb darkening function and solar diameter with eclipses observations

    CERN Document Server

    Raponi, Andrea; Guhl, Konrad; Nugent, Richard; Tegtmeier, Andreas

    2012-01-01

    We introduce a new method to perform high resolution astrometry of the solar diameter from the ground, through the observations of eclipses. A discussion of the solar diameter and its variations is linked to the Limb Darkening Function (LDF) using the luminosity evolution of a Baily's Bead and the profile of the lunar limb available from satellite data. The inflexion point of the LDF is defined as the solar limb. The method proposed is applied for the videos of the eclipse in January, 15, 2010 recorded by Richard Nugent in Uganda and Andreas Tegtmeier in India. An upper limit for the inflexion point position has been set for that eclipse.

  14. Limb anomalies in DiGeorge and CHARGE syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Prasad, C.; Quackenbush, E.J.; Whiteman, D.; Korf, B. [Harvard Medical School, Boston, MA (United States)

    1997-01-20

    Limb anomalies are not common in the DiGeorge or CHARGE syndromes. We describe limb anomalies in two children, one with DiGeorge and the other with CHARGE syndrome. Our first patient had a bifid left thumb, Tetralogy of Fallot, absent thymus, right facial palsy, and a reduced number of T-cells. A deletion of 22q11 was detected by fluorescence in situ hybridization (FISH). The second patient, with CHARGE syndrome, had asymmetric findings that included right fifth finger clinodactyly, camptodactyly, tibial hemimelia and dimpling, and severe club-foot. The expanded spectrum of the DiGeorge and CHARGE syndromes includes limb anomalies. 14 refs., 4 figs.

  15. Validation of NIRS in measuring tissue hemoglobin concentration and oxygen saturation on ex vivo and isolated limb models

    Science.gov (United States)

    Xu, Xiaorong; Zhu, Wen; Padival, Vikram; Xia, Mengna; Cheng, Xuefeng; Bush, Robin; Christenson, Linda; Chan, Tim; Doherty, Tim; Iatridis, Angelo

    2003-07-01

    Photonify"s tissue spectrometer uses Near-Infrared Spectroscopy for real-time, noninvasive measurement of hemoglobin concentration and oxygen saturation [SO2] of biological tissues. The technology was validated by a series of ex vivo and animal studies. In the ex vivo experiment, a close loop blood circulation system was built, precisely controlling the oxygen saturation and the hemoglobin concentration of a liquid phantom. Photonify"s tissue spectrometer was placed on the surface of the liquid phantom for real time measurement and compared with a gas analyzer, considered the gold standard to measure oxygen saturation and hemoglobin concentration. In the animal experiment, the right hind limb of each dog accepted onto the study was surgically removed. The limb was kept viable by connecting the femoral vein and artery to a blood-primed extracorporeal circuit. Different concentrations of hemoglobin were obtained by adding designated amount of saline solution into the perfusion circuit. Photonify"s tissue spectrometers measured oxygen saturation and hemoglobin concentration at various locations on the limb and compared with gas analyzer results. The test results demonstrated that Photonify"s tissue spectrometers were able to detect the relative changes in tissue oxygen saturation and hemoglobin concentration with a high linear correlation compared to the gas analyzer

  16. Cellular proliferation in the skin of X-rayed newt limbs (with a note on x-ray-induced limb regression)

    International Nuclear Information System (INIS)

    Left hind limbs, including the pelvis, of adult newts (Notophthalmus viridescens) were locally irradiated with a dose of x-rays that inhibited regeneration (2,000 R). This x-ray dose and other doses (700-2,000 R) capable of inhibiting limb regeneration also cause limb regression prior to amputation. Before limb regression occurred, there was a latent period of 3 to 6 weeks. Limb regression was characterized by necrotic wasting and resorption of distal elements. The degree of loss was variable and dependent upon dosage. After this further degenerative changes were not noted. Proliferation of epidermal cells was examined 4 days after irradiation prior to limb regression or after x-ray-induced degeneration of the limbs had ended. Proliferative activity in x-rayed limbs was also compared at various stages of contralateral control limb regeneration. Limbs examined after x-ray-induced limb regression had ended showed levels of [3H]-thymidine incorporation into DNA comparable to normal epidermis. In contrast, limbs examined 4 days after irradiation had lower levels of DNA synthesis (P much less than 0.01). Amputation of limbs in both groups caused an increase in DNA synthesis (P much less than 0.01). Histological examination showed that cellular proliferation was associated primarily with the epidermis. These results indicate that epidermal cell proliferation was not resistant to x-rays. However, levels of normal cell division were observed after amputation of after cessation of x-ray-induced limb regression

  17. Bone marrow stem cell injection for the treatment of critical limb ischemia

    Directory of Open Access Journals (Sweden)

    Shunya Shindo

    2007-01-01

    Full Text Available Vascular reconstruction remains a treatment of choice for critical limb ischemia. Bypass surgery has been accepted as the most effective therapy to achieve increase of blood flow and cure the ischemic symptoms. On the other hand, continuous increase of the patients suffering diabetes mellitus enhances the increase of the number of the patients with peripheral arterial disease (PAD. This tendency is also observed in Japan and expected to continue from now on. The reports of the Ministry of Health, Labor and Welfare of Japan indicated that more than 6% of population was treated for diabetes mellitus and more than 12% of population was supposed to be diabetic in 2002.1 This report also gave a warning for rapid and continuous increase of the diabetic patients at present and in the future.? As is well known, diabetes mellitus is one of the strong risk factors to cause an arteriosclerosis obliterans (ASO. Therefore, the patients with PAD will increase continuously and more severe ischemic limb will need to be treated. Moreover, diabetic macroangiopathy is characterized as showing diffuse stenosis and occlusion down to the foot arteries.2 Monckeberg’s medial calcification is also frequently observed in the ASO with diabetes mellitus.3 Therefore, along with the increase of the patients with PAD, the vascular reconstruction becomes technically demanding due to co-morbid diabetes with diffuse lesion and severe calcification. The patients, who show critical limb ischemia but are excluded from the operative candidate, are eventually performed major amputation. To prevent this disastrous sequel, therapeutic angiogenesis has been investigated.In 1996, Isner reported a new therapy to treat ischemic limb by using angiogenetic gene; vascular endothelial growth factor (VEGF.4 Since then, angiogenetic therapy started to be investigated by using gene transfer with VEGF, fibroblast growth factor (FGF5 or hepatic growth factor (HGF.6 Animal study showed increase of

  18. Chronic effects of metoprolol and methyldopa on calf blood flow in intermittent claudication.

    OpenAIRE

    Lepäntalo, M

    1984-01-01

    In a placebo-controlled double-blind study 14 hypertensive patients with intermittent claudication were treated with metoprolol (100-200 mg daily) and methyldopa (500-1000 mg daily) for 3 weeks and their effects on heart rate, blood pressure as well as on resting and hyperaemic calf blood flow and vascular resistance were compared. In their antihypertensive effect metoprolol and methyldopa did not differ significantly. In 23 diseased limbs the calf blood flow and vascular resistance remained ...

  19. Blood Transfusion

    Science.gov (United States)

    ... to infections including those we develop from our vaccinations (such as poliovirus antibodies, which are made by ... the Transfusion Medicine Unit, Blood Bank, and Stem Cell Storage Facility University of Rochester Medical ... and health educators who are available by phone Monday through Friday, 9 am to 9 pm ( ...

  20. Limb girdle muscular dystrophies: The clinicopathological viewpoint

    Directory of Open Access Journals (Sweden)

    Urtizberea J

    2007-01-01

    Full Text Available Limb girdle muscular dystrophies (LGMD are characterized by involvement of the pelvic and shoulder girdles, classically with an onset in the second or third decade and a slow progression as opposed to Duchenne muscular dystrophy. In fact, there are many clinical variants that are related to this broad definition. For the past 13 years and since the discovery of calpain-3 as the underlying defect in LGMD 2A in 1995, a number of different genes have been found to cause LGMD; some of whose encoding proteins are located either in the sarcolemma, nucleus, cytosol or in the extra-cellular matrix. Very little is known regarding a possible common pathogenesis between all these entities. The current nomenclature of LGMDs, although a bit confusing, is still necessary to continue the establishment of homogeneous cohorts of patients and to look for unknown genes. The diagnosis of LGMD is nowadays based on a complementary clinical, immunocytochemical and genetic approach that is best achieved in specialized myology centers. In this context, India can make a significant contribution to improve the routine diagnosis in LGMD patients and to find new LGMD genes in genetic isolates. Therapeutic prospects in LGMD, although quite exciting, remain at a preliminary stage, especially those with gene-therapy orientation.

  1. Thrombolytic therapy in acute lower limb ischemia.

    Science.gov (United States)

    Pilger, E

    1996-01-01

    Surgical revascularization as the initial therapy in acute lower limb ischemia (ALLI) is associated with a high cumulative mortality and amputation rate. Catheter-directed delivery of low-dose thrombolytic agents (intra-arterial thrombolysis, IAT) offers the possibility for a gentle revascularization with a minimum of stress for the patients. In two randomized studies, the primary rates of revascularization, amputation, and mortality did not differ significantly between IAT and surgical revascularization. However, in one study the 6-month event-free survival rate was 85% in the IAT group, and 63% in the surgical group. Also in the second study the 12-month results were significantly better in the IAT group (event-free survival 75%) than in the surgical group (event free survival 52%). The high-dose urokinase regimen recommended by some authors in IAT is associated with an unacceptable cerebral bleeding rate of up to 2%. Low-dose recombinant tissue-type plasminogen activator (rt-PA) (0.02 to 0.05 mg/h) is the most suitable agent in IAT because of rapid lysis and low bleeding complications. Patients with ALLI, classified as viable or threatened without neurologic deficit, benefit most from the IAT as the initial therapy in ALLI. When IAT is performed as the initial therapy in ALLI, surgical intervention becomes unnecessary in approximately one-third of the patients. In another third the subsequent correction of the cause of the ALLI can be performed electively, which reduces mortality and morbidity rates. PMID:8711491

  2. Blood Culture (For Parents)

    Science.gov (United States)

    ... KidsHealth in the Classroom What Other Parents Are Reading Upsetting News Reports? What to Say Vaccines: Which ... BMP) Blood Test: Complete Blood Count Basic Blood Chemistry Tests Getting a Blood Test (Video) Blood Test: ...

  3. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... your doctor prescribes it, medicine. What Is Blood Pressure? Blood pressure is the force of blood flow inside ... Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you won't ...

  4. Blood Pressure Quiz

    Science.gov (United States)

    ... page please turn Javascript on. Feature: High Blood Pressure Blood Pressure Quiz Past Issues / Fall 2011 Table of Contents ... About High Blood Pressure / Treatment: Types of Blood Pressure Medications / Blood Pressure Quiz Fall 2011 Issue: Volume 6 Number ...

  5. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... right away. continue How Do Doctors Measure Blood Pressure? Blood pressure readings are fast and painless. Blood pressure ... same age, height, and gender have lower blood pressure. Blood pressure between 90% and 95% of the normal ...

  6. Blood pressure measurement

    Science.gov (United States)

    Diastolic blood pressure; Systolic blood pressure; Blood pressure reading; Measuring blood pressure ... or your health care provider will wrap the blood pressure cuff snugly around your upper arm. The ...

  7. Blood Transfusions (For Teens)

    Science.gov (United States)

    ... How Can I Help a Friend Who Cuts? Blood Transfusions KidsHealth > For Teens > Blood Transfusions Print A ... United States get blood transfusions. A Bit About Blood As blood moves throughout the body, it carries ...

  8. Blood Count Tests

    Science.gov (United States)

    Your blood contains red blood cells (RBC), white blood cells (WBC), and platelets. Blood count tests measure the number and types of cells in your blood. This helps doctors check on your overall health. ...

  9. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... About Awards Membership ASH Foundation Global Programs Newsroom facebook twitter youtube linkedin Research In This Section Agenda ... View all publications For Patients Blood Basics Blood Disorders Anemia Bleeding Disorders Blood Cancers Blood Clots Blood ...

  10. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... For Patients Blood Disorders Blood Clots Blood Clotting & Pregnancy If you are pregnant, or you have just ... The risk of developing a blood clot during pregnancy is increased by the following: Previous blood clots ...

  11. Myoelectric control of artificial limb inspired by quantum information processing

    International Nuclear Information System (INIS)

    Precise and elegant coordination of a prosthesis across many degrees of freedom represents a significant challenge to efficient rehabilitation of people with limb deficiency. Processing the electrical neural signals collected from the surface of the remnant muscles of the stump is a common way to initiate and control the different movements available to the artificial limb. Based on the assumption that there are distinguishable and repeatable signal patterns among different types of muscular activation, the problem of prosthesis control reduces to one of pattern recognition. Widely accepted classical methods for pattern recognition, however, cannot provide simultaneous and proportional control of the artificial limb. Here we show that, in principle, quantum information processing of the neural signals allows us to overcome the above-mentioned difficulties, suggesting a very simple scheme for myoelectric control of artificial limb with advanced functionalities. (paper)

  12. Freezing Technique May Ease 'Phantom Limb' Pain for Amputees

    Science.gov (United States)

    ... news/fullstory_158216.html Freezing Technique May Ease 'Phantom Limb' Pain for Amputees Targeted treatment of nerve and scar tissue found to improve symptoms in small study To use the sharing features ...

  13. Lunar topography and the limb compression source regions

    International Nuclear Information System (INIS)

    Data from the Apollo 15, 16, and 17 laser altimeters has been used to study slopes, elevations and roughness in the identifiable regions on the Moon which sporadically produce plasma compressions and magnetic field enhancements in the solar wind/lunar void boundary, when those regions are at a flow limb. It is found that occurrence rates for such ''limb compressions'' derived from Explorer 35 satellite measurements are significantly correlated with peak, average and rms slopes in the source regions, whereas rates derived from Apollo 15 and 16 subsatellite data are not correlated with topography. This suggests that two or more mechanisms operate in the source regions to produce limb compressions. Together with the known correlation between limb compressions and local surface remanent magnetic fields, the results indicate that lunar magnetization is not strongly related to surface features

  14. TES/Aura L1B Spectra Limb V002

    Data.gov (United States)

    National Aeronautics and Space Administration — The L1B Limb granule consists of radiometrically calibrated spectra & associated NESR, observed at 0.025 cm-1 resolution for an entire Global Survey &...

  15. Myoelectric Control of Artificial Limb by Quantum Information Processing

    CERN Document Server

    Siomau, Michael

    2013-01-01

    Precise and elegant coordination of a prosthesis across many degrees of freedom is highly desired for rehabilitation of people with limb deficiency. Processing the electrical neural signals, collected from the surface of the remnant muscles of the stump, is a common way to activate certain function of the artificial limb. Based on the assumption that there are distinguishable and repeatable signal patterns among different types of muscular activation, the problem of the prosthesis control reduces to the pattern recognition. Widely accepted classical methods for pattern recognition, however, can not provide simultaneous and proportional control of the artificial limb. Here we show that quantum information processing of the neural signals allows us to overcome above difficulties suggesting a very simple scheme for myoelectric control of artificial limb with advanced functionalities.

  16. Apples, oranges, and angles: Comparative kinematic analysis of disparate limbs.

    Science.gov (United States)

    Gatesy, Stephen M; Pollard, Nancy S

    2011-08-01

    Tetrapod limbs exhibit diverse postures and movements during terrestrial locomotion. As with morphological traits, the history of kinematic evolution should be accessible to reconstruction through analysis of limb motion patterns in a phylogenetic framework. However, the angular data comprising most kinematic descriptions appear to suffer from limitations that preclude meaningful comparison among disparate species. Using simple planar models, we discuss how geometric constraints render joint and elevation angles independent of neither morphology, degree of crouch, nor one another during the stance phase of locomotion. The implicit null hypothesis of potential similarity is invalidated because angular data are not viably transferable among limbs of dissimilar proportion and/or degree of crouch. Overlooking or dismissing the effect of constraints on angular parameterization hampers efforts to quantitatively elucidate the evolution of locomotion. We advocate a search for alternative methods of measuring limb movement that can decouple intersegmental coordination from morphology and posture. PMID:21600220

  17. Reflections on the present and future of upper limb prostheses.

    Science.gov (United States)

    Farina, Dario; Amsüss, Sebastian

    2016-04-01

    Despite progress in research and media attention on active upper limb prostheses, presently the most common commercial upper limb prosthetic devices are not fundamentally different from solutions offered almost one century ago. Limited information transfer for both control and sensory-motor integration and challenges in socket technology have been major obstacles. By analysing the present state-of-the-art and academic achievements, we provide our opinion on the future of upper limb prostheses. We believe that surgical procedures for muscle reinnervation and osseointegration will become increasingly clinically relevant; muscle electrical signals will remain the main clinical means for prosthetic control; and chronic electrode implants, first in muscles (control), then in nerves (sensory feedback), will become viable clinical solutions. After decades of suspended clinically relevant progress, it is foreseeable that a new generation of upper limb prostheses will enter the market in the near future based on such advances, thereby offering substantial clinical benefit for patients. PMID:26924191

  18. Action potentials of curved nerves in finite limbs.

    Science.gov (United States)

    Xiao, S; McGill, K C; Hentz, V R

    1995-06-01

    Previous simulations of volume-conducted nerve-fiber action-potentials have modeled the limb as semi-infinite or circularly cylindrical, and the fibers as straight lines parallel to the limb surface. The geometry of actual nerves and limbs, however, can be considerably more complicated. This paper presents a general method for computing the potentials of fibers with arbitrary paths in arbitrary finite limbs. It involves computing the propagating point-source response (PPSR), which is the potential arising from a single point source (dipole or tripole) travelling along the fiber. The PPSR can be applied to fibers of different conduction velocities by simple dilation or compression. The method is illustrated for oblique and spiralling nerve fibers. Potentials from oblique fibers are shown to be different for orthodromic and antidromic propagation. Such results show that the straight-line models are not always adequate for nerves with anatomical amounts of curvature. PMID:7790016

  19. Infrapopliteal angioplasty in the treatment of ischaemic diabetic lower limbs

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical effect of infrapopliteal arterial balloon angioplasty in the treatment of ischaemic diabetic lower limbs. Methods: 53 cases of ischaemic diabetic lower limb containing 64 ischemic limbs were treated with infrapopliteal angioplasty by Amphirion Deep Balloon. Observation of clinical remission including the ulcers was carried out before and after the procedure. Results: 119 ateries of the 53 cases were chosen for PTA and 101 PTA in 50 cases were accomplished, with technical success rate of 84.9%. All the 50 patients got clinical remission including the shrinkage of ulcers and none amputation. Conclusin: Infrapopliteal arterial angioplasty is effective, minimal invasive and safe for the ischaemic diabetic lower limbs. (authors)

  20. The center-to-limb. [in solar photosphere

    Science.gov (United States)

    1978-01-01

    Center-to-limb measurements of the Ca I 6573 intercombination line and the Ca II 7324 forbidden line are compared with synthetic profiles based on a simple representation of the non-LTE Ca-Ca(+) ionization equilibrium. The effects of photoionizations from low lying excited states of neutral calcium are found to reduce the sensitivity of the 6573 center-to-limb behavior as a thermal structure diagnostic. The synthetic center-to-limb behavior is also sensitive to uncertainties in the nonthermal broadening. Nevertheless, the measured center-to-limb behavior of 6573 favors a 'cool' photospheric model over hotter models based on the Ca II K wings. The non-LTE calcium abundance obtained from the disk center equivalent widths of 6573 and 7324 using the best fit model is A(Ca) = 2.1 plus or minus 0.2 x 10 to the -6th (by number relative to hydrogen).

  1. Image Processing for Planetary Limb/Terminator Extraction

    Science.gov (United States)

    Udomkesmalee, S.; Zhu, D. Q.; Chu, C. -C.

    1995-01-01

    A novel image segmentation technique for extracting limb and terminator of planetary bodies is proposed. Conventional edge- based histogramming approaches are used to trace object boundaries. The limb and terminator bifurcation is achieved by locating the harmonized segment in the two equations representing the 2-D parameterized boundary curve. Real planetary images from Voyager 1 and 2 served as representative test cases to verify the proposed methodology.

  2. Lower limb control and mobility following exercise training

    OpenAIRE

    Kim Sukwon; Lockhart Thurmon

    2012-01-01

    Abstract The objective of the present study was to evaluate the effects of 8-week balance or weight training on ankle joint stiffness and limb stability for older adults, furthermore, on outcomes of slips while walking. Eighteen older adults volunteered for the study and randomly were assigned to the three groups, such as, weight, balance, or control group. While walking on a walking track, three-dimensional posture data were sampled and ankle joint stiffness and limb stability were computed ...

  3. Autosomal recessive limb girdle myasthenia in two sisters.

    Directory of Open Access Journals (Sweden)

    Shankar A

    2002-10-01

    Full Text Available Limb girdle myasthenic syndromes are rare genetic disorders described under the broad heterogeneous group known as congenital myasthenic syndromes and present with mixed features of myasthenia and myopathy. The familial limb girdle myasthenia has been described as one with selective weakness of pectoral and pelvic girdles, showing a positive response to edrophonium chloride. A report of two sisters affected by this disorder is presented.

  4. Musculoskeletal anatomical changes that accompany limb reduction in lizards.

    Science.gov (United States)

    Abdala, Virginia; Grizante, Mariana B; Diogo, Rui; Molnar, Julia; Kohlsdorf, Tiana

    2015-11-01

    Muscles, bones, and tendons in the adult tetrapod limb are intimately integrated, both spatially and functionally. However, muscle and bone evolution do not always occur hand in hand. We asked, how does the loss of limb bones affect limb muscle anatomy, and do these effects vary among different lineages? To answer these questions, we compared limb muscular and skeletal anatomy among gymnophthalmid lizards, which exhibit a remarkable variation in limb morphology and different grades of digit and limb reduction. We mapped the characters onto a phylogeny of the group to assess the likelihood that they were acquired independently. Our results reveal patterns of reduction of muscle and bone elements that did not always coincide and examples of both, convergent and lineage-specific non-pentadactyl musculoskeletal morphologies. Among lineages in which non-pentadactyly evolved independently, the degree of convergence seems to depend on the number of digits still present. Most tetradactyl and tridactyl limbs exhibited profound differences in pattern and degree of muscle loss/reduction, and recognizable morphological convergence occurred only in extremely reduced morphologies (e.g., spike-like appendix). We also found examples of muscles that persisted although the bones to which they plesiomorphically attach had been lost, and examples of muscles that had been lost although their normal bony attachments persisted. Our results demonstrate that muscle anatomy in reduced limbs cannot be predicted from bone anatomy alone, meaning that filling the gap between osteological and myological data is an important step toward understanding this recurrent phenomenon in the evolution of tetrapods. PMID:26251347

  5. Limb circumference and performance in junior tennis players

    OpenAIRE

    Nuhmani, Shibili; Shaphe, MD Abu; Waseem, MD

    2013-01-01

    Objective: To find out the correlation of limb circumference with functional performance of junior tennis players Design: correlation design Setting: Tennis academies all over Delhi and National Capital Region Subjects: 100 junior tennis players Measurement: The limb circumferences (thigh circumference and calf circumference) of each athlete have measured and have been correlated with all the three functional performance tests. Result and conclusion: Pearson's correlation test was used to cor...

  6. Surveillance case definitions for work related upper limb pain syndromes

    OpenAIRE

    Harrington, J. M.; Carter, J T; Birrell, L.; Gompertz, D

    1998-01-01

    OBJECTIVES: To establish consensus case definitions for several common work related upper limb pain syndromes for use in surveillance or studies of the aetiology of these conditions. METHODS: A group of healthcare professionals from the disciplines interested in the prevention and management of upper limb disorders were recruited for a Delphi exercise. A questionnaire was used to establish case definitions from the participants, followed by a consensus conference involving the core grou...

  7. LIMB Demonstration Project Extension and Coolside Demonstration. [Final report

    Energy Technology Data Exchange (ETDEWEB)

    Goots, T.R.; DePero, M.J.; Nolan, P.S.

    1992-11-10

    This report presents results from the limestone Injection Multistage Burner (LIMB) Demonstration Project Extension. LIMB is a furnace sorbent injection technology designed for the reduction of sulfur dioxide (SO{sub 2}) and nitrogen oxides (NO{sub x}) emissions from coal-fired utility boilers. The testing was conducted on the 105 Mwe, coal-fired, Unit 4 boiler at Ohio Edison`s Edgewater Station in Lorain, Ohio. In addition to the LIMB Extension activities, the overall project included demonstration of the Coolside process for S0{sub 2} removal for which a separate report has been issued. The primary purpose of the DOE LIMB Extension testing, was to demonstrate the generic applicability of LIMB technology. The program sought to characterize the S0{sub 2} emissions that result when various calcium-based sorbents are injected into the furnace, while burning coals having sulfur content ranging from 1.6 to 3.8 weight percent. The four sorbents used included calcitic limestone, dolomitic hydrated lime, calcitic hydrated lime, and calcitic hydrated lime with a small amount of added calcium lignosulfonate. The results include those obtained for the various coal/sorbent combinations and the effects of the LIMB process on boiler and plant operations.

  8. Proximity to pollution sources and risk of amphibian limb malformation.

    Science.gov (United States)

    Taylor, Brynn; Skelly, David; Demarchis, Livia K; Slade, Martin D; Galusha, Deron; Rabinowitz, Peter M

    2005-11-01

    The cause of limb deformities in wild amphibian populations remains unclear, even though the apparent increase in prevalence of this condition may have implications for human health. Few studies have simultaneously assessed the effect of multiple exposures on the risk of limb deformities. In a cross-sectional survey of 5,264 hylid and ranid metamorphs in 42 Vermont wetlands, we assessed independent risk factors for nontraumatic limb malformation. The rate of nontraumatic limb malformation varied by location from 0 to 10.2%. Analysis of a subsample did not demonstrate any evidence of infection with the parasite Ribeiroia. We used geographic information system (GIS) land-use/land-cover data to validate field observations of land use in the proximity of study wetlands. In a multiple logistic regression model that included land use as well as developmental stage, genus, and water-quality measures, proximity to agricultural land use was associated with an increased risk of limb malformation (odds ratio = 2.26; 95% confidence interval, 1.42-3.58; p < 0.001). The overall discriminant power of the statistical model was high (C = 0.79). These findings from one of the largest systematic surveys to date provide support for the role of chemical toxicants in the development of amphibian limb malformation and demonstrate the value of an epidemiologic approach to this problem. PMID:16263502

  9. Pediatric Traumatic Limb Amputation: The Principles of Management and Optimal Residual Limb Lengths.

    Science.gov (United States)

    Khan, Muhammad Adil Abbas; Javed, Ammar Asrar; Rao, Dominic Jordan; Corner, J Antony; Rosenfield, Peter

    2016-01-01

    Pediatric traumatic limb amputations are rare and their acute and long term management can be challenging in this subgroup of patients. The lengthy and costly hospital stays, and resulting physical and psychological implications leads to significant morbidity. We present a summary of treatment principles and the evidence base supporting the management options for this entity. The initial management focuses on resuscitating and stabilization of the patients, administration of appropriate and adequate analgesics, and broad spectrum antibiotics. The patient should ideally be managed by an orthopedic or a plastic surgeon and when an amputation is warranted, the surgical team should aim to conserve as much of the viable physis as possible aimed at allowing bone development in a growing child. A subsequent wound inspection should be performed to assess for signs of ischemia or non-viability of tissue. Depending on the child's age, approximations of the ideal residual limb length can be calculated using our guidelines, allowing an ideal stump length at skeletal maturity for a well-fitting and appropriate prosthesis. Myodesis and myoplasties can be performed according to the nature of the amputation. Removable rigid dressings are safe and cost effective offering better protection of the stump. Complications such as necrosis and exostosis, on subsequent examination, warrant further revisions. Other complications such as neuromas can be prevented by proximal division of the nerves. Successful rehabilitation can be accomplished with a multidisciplinary approach, involving physiotherapist, play therapist and a child psychiatrist, in addition to the surgeon and primary care providers. PMID:27308235

  10. Modified Vertical Rectus Abdominis Musculocutaneous Flap for Limb Salvage Procedures in Proximal Lower Limb Musculoskeletal Sarcomas

    Directory of Open Access Journals (Sweden)

    Tarek Mahboub

    2008-03-01

    Full Text Available Introduction and aim. Management of complicated wounds after tumor extipiration of pelvic and proximal lower limb musculoskeletal sarcoma represents an essential component in the outcome of these patients. The authors present modified vertical rectus abdominis musculocutaneous (VRAM flap techniques to reconstruct extensive defects after debridment of these complicated wounds. Material and Methods. Over a period of 4 years (2002–2005, 5 men and 2 women were managed. Median age was 21 years (range 15–49. The patients were managed for complicated lower trunk, groin, and upper thigh wounds after resection of three pelvic chondrosarcomas as well as two pelvic and two proximal femur osteosarcomas. The modifications included a VRAM flap with lateral and tongue-like extension design of the skin paddle (5 cases or a delayed extended VRAM flap (2 cases. Results. All flaps showed complete survival and healing with no ischemic events providing stable coverage. All patients were ambulant with good limb functions in terms of walking and gait after adequate rehabilitation, 2 needed support with crutches. Conclusion. The modified VRAM flaps offer reliable reconstructive tools for coverage of complex groin and thigh defects by providing larger well-vascularized soft tissue with acceptable donor site.

  11. Bioimpedance profiling of the limbs: Update

    Science.gov (United States)

    Ward, L. C.; Essex, T.; Bartlett, M.; Kilbreath, S.; Brookes, D.

    2010-04-01

    Bioelectrical impedance spectroscopy (BIS) is now commonly used to assess breast cancer-related lymphoedema. Typically, the ratio of impedances of the two arms, determined at zero frequency (Z0), is used as a quantitative index of the presence of excess lymph. Measurement uses skin electrodes spanning the whole limb. However, lymphoedema may be highly localised and may involve changes other than simple fluid accumulation, e.g. increased fat and fibrosis, that also give rise to changes in impedance-related parameters such as capacitance. We have previously reported (13th ICEBI, Graz, 2007) a prototype mobile electrode probe that replaces the distal sense electrode which, when moved proximally along the arm, provides an impedance profile. We report here the further development of this technology to incorporate real-time measurement of impedance integrated with a digital measuring wheel. This allows exact synchronisation of impedance with position on the arm. A commercial BIS instrument (ImpediMed SFB7) was modified to collect impedance (R and Xc) data every msec and the mean impedance computed for each 10-mm slice. The apparent resistivity values for arm tissue were used to calculate slice volumes. These computed volumes were compared to equivalent slice volumes from perometry and DXA. The system is being further validated by correlating slice impedance parameters with lean tissue volume determined by pQCT (StraTec XCT 3000), for multiple positions along the arm. Ultimately, it is hoped that such measurements will not only allow localised tissue volume measurement but will also provide information of tissue composition in conditions such as lymphoedema.

  12. Atypical Supernumerary Phantom Limb and Phantom Limb Pain in a Patient With Spinal Cord Injury: Case Report

    OpenAIRE

    Choi, Ja Young; Kim, Hyo In; Lee, Kil Chan; Han, Zee-A

    2013-01-01

    Supernumerary phantom limb (SPL) resulting from spinal cord lesions are very rare, with only sporadic and brief descriptions in the literature. Furthermore, the reported cases of SPL typically occurred in neurologically incomplete spinal cord patients. Here, we report a rare case of SPL with phantom limb pain that occurred after traumatic spinal cord injury in a neurologically complete patient. After a traffic accident, a 43-year-old man suffered a complete spinal cord injury with a C6 neurol...

  13. EFFECTS OF BURN ON THE MOBILITY OF UPPER LIMB/S, FUNCTIONS OF HAND /S & ACTIVITIES OF DAILY LIVING

    OpenAIRE

    Perera M M N; Nanayakkarawasam P P; Katulanda P

    2015-01-01

    Background: Burn is an injury cause destruction of skin and underling tissue. Post burns complications are severe. Objective of this study is to identify the effects on the Active Range of Motion (AROM) of upper limb/s, hand functions and Activities of Daily Living (ADL) who attend the physical therapy department of burns unit. Methodology: It was a descriptive cross sectional study carried out at out-patient physical therapy department of burns unit of National Hospital of SriLanka (NHS...

  14. Musculoskeletal modelling of an ostrich (Struthio camelus) pelvic limb: influence of limb orientation on muscular capacity during locomotion

    OpenAIRE

    Hutchinson, John R.; Rankin, Jeffery W.; Jonas Rubenson; Kate H. Rosenbluth; Siston, Robert A.; Scott L. Delp

    2015-01-01

    We developed a three-dimensional, biomechanical computer model of the 36 major pelvic limb muscle groups in an ostrich (Struthio camelus) to investigate muscle function in this, the largest of extant birds and model organism for many studies of locomotor mechanics, body size, anatomy and evolution. Combined with experimental data, we use this model to test two main hypotheses. We first query whether ostriches use limb orientations (joint angles) that optimize the moment-generating capacities ...

  15. Combined mirror visual and auditory feedback therapy for upper limb phantom pain: a case report

    OpenAIRE

    Yan Kun; Chernev Ivan; Wilcher Delia G

    2011-01-01

    Abstract Introduction Phantom limb sensation and phantom limb pain is a very common issue after amputations. In recent years there has been accumulating data implicating 'mirror visual feedback' or 'mirror therapy' as helpful in the treatment of phantom limb sensation and phantom limb pain. Case presentation We present the case of a 24-year-old Caucasian man, a left upper limb amputee, treated with mirror visual feedback combined with auditory feedback with improved pain relief. Conclusion Th...

  16. [Mirror, mirror of the wall: mirror therapy in the treatment of phantom limbs and phantom limb pain].

    Science.gov (United States)

    Casale, Roberto; Furnari, Anna; Lamberti, Raul Coelho; Kouloulas, Efthimios; Hagenberg, Annegret; Mallik, Maryam

    2015-01-01

    Phantom limb and phantom limb pain control are pivotal points in the sequence of intervention to bring the amputee to functional autonomy. The alterations of perception and sensation, the pain of the residual limb and the phantom limb are therefore aspects of amputation that should be taken into account in the "prise en charge" of these patients. Within the more advanced physical therapies to control phantom and phantom limb pain there is the use of mirrors (mirror therapy). This article willfocus on its use and on the possible side effects induced by the lack of patient selection and a conflict of body schema restoration through mirror therapy with concurrent prosthetic training and trauma acceptance. Advice on the need to select patients before treatment decisions, with regard to their psychological as well as clinical profile (including time since amputation and clinical setting), and the need to be aware of the possible adverse effects matching different and somehow conflicting therapeutic approaches, are put forward. Thus a coordinated sequence of diagnostic, prognostic and therapeutic procedures carried out by an interdisciplinary rehabilitation team that works globally on all patients' problems is fundamental in the management of amputees and phantom limb pain. Further studies and the development of a multidisciplinary network to study this and other applications of mirror therapy are needed. PMID:26731959

  17. Major limb amputations: A tertiary hospital experience in northwestern Tanzania

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2012-05-01

    Full Text Available Abstract Background Major limb amputation is reported to be a major but preventable public health problem that is associated with profound economic, social and psychological effects on the patient and family especially in developing countries where the prosthetic services are poor. The purpose of this study was to outline the patterns, indications and short term complications of major limb amputations and to compare our experience with that of other published data. Methods This was a descriptive cross-sectional study that was conducted at Bugando Medical Centre between March 2008 and February 2010. All patients who underwent major limb amputation were, after informed consent for the study, enrolled into the study. Data were collected using a pre-tested, coded questionnaire and analyzed using SPSS version 11.5 computer software. Results A total of 162 patients were entered into the study. Their ages ranged between 2–78 years (mean 28.30 ± 13.72 days. Males outnumbered females by a ratio of 2:1. The majority of patients (76.5% had primary or no formal education. One hundred and twelve (69.1% patients were unemployed. The most common indication for major limb amputation was diabetic foot complications in 41.9%, followed by trauma in 38.4% and vascular disease in 8.6% respectively. Lower limbs were involved in 86.4% of cases and upper limbs in 13.6% of cases giving a lower limb to upper limb ratio of 6.4:1 Below knee amputation was the most common procedure performed in 46.3%. There was no bilateral limb amputation. The most common additional procedures performed were wound debridement, secondary suture and skin grafting in 42.3%, 34.5% and 23.2% respectively. Two-stage operation was required in 45.4% of patients. Revision amputation rate was 29.6%. Post-operative complication rate was 33.3% and surgical site infection was the most common complication accounting for 21.0%. The mean length of hospital stay was 22.4 days and mortality

  18. Second-Generation Six-Limbed Experimental Robot

    Science.gov (United States)

    Kennedy, Brett; Okon, Avi; Aghazarian, Hrand; Robinson, Matthew; Garrett, Michael; Magnone, Lee

    2004-01-01

    The figure shows the LEMUR II - the second generation of the Limbed Excursion Mechanical Utility Robot (LEMUR), which was described in "Six-Legged Experimental Robot" (NPO-20897), NASA Tech Briefs, Vol. 25, No. 12 (December 2001), page 58. The LEMUR II incorporates a number of improvements, including new features, that extend its capabilities beyond those of its predecessor, which is now denoted the LEMUR I. To recapitulate: the LEMUR I was a six-limbed robot for demonstrating robotic capabilities for assembly, maintenance, and inspection. The LEMUR I was designed to be capable of walking autonomously along a truss structure toward a mechanical assembly at a prescribed location and to perform other operations. The LEMUR I was equipped with stereoscopic video cameras and image-data-processing circuitry for navigation and mechanical operations. It was also equipped with a wireless modem, through which it could be commanded remotely. Upon arrival at a mechanical assembly, the LEMUR I would perform simple mechanical operations with one or both of its front limbs. It could also transmit images to a host computer. Each of the six limbs of the LEMUR I was operated independently. Each of the four rear limbs had three degrees of freedom (DOFs), while each of the front two limbs had four DOFs. The front two limbs were designed to hold, operate, and/or be integrated with tools. The LEMUR I included an onboard computer equipped with an assortment of digital control circuits, digital input/output circuits, analog-to-digital converters for input, and digital-to-analog (D/A) converters for output. Feedback from optical encoders in the limb actuators was utilized for closed-loop microcomputer control of the positions and velocities of the actuators. The LEMUR II incorporates the following improvements over the LEMUR I: a) The drive trains for the joints of the LEMUR II are more sophisticated, providing greater torque and accuracy. b) The six limbs are arranged symmetrically about

  19. Managing your blood sugar

    Science.gov (United States)

    Hyperglycemia - control; Hypoglycemia - control; Diabetes - blood sugar control ... Know how to: Recognize and treat low blood sugar (hypoglycemia) Recognize and treat high blood sugar (hyperglycemia) ...

  20. Revascularization Surgery: Its Efficacy for Limb Salvage in Diabetic Foot.

    Science.gov (United States)

    Chang, Tzu-Yen; Shieh, Shyh-Jou

    2016-03-01

    The estimated prevalence of diabetes is 9.78% in Taiwan. The lifetime risk for patients with diabetes to have foot ulcers might be as high as 25%. About 15% of these patients require major limb amputation because of ischemia and infection. Peripheral artery disease is still a major problem involved in diabetic foot disease and the cause for major amputation despite an increase in the prevalence of revascularization surgery and new revascularization techniques over the past 20 years. We investigated the major limb amputation rates in patients with diabetic foot and critical limb ischemia who had undergone revascularization surgery in our hospital. The records of 42 patients who had undergone revascularization surgery for diabetic foot were retrospectively reviewed. Nineteen patients (45%) required major limb amputation despite revascularization. The affected limbs of only 15 patients (36%) were salvaged. Four patients died soon after surgery because of comorbidities, and another 4 were lost to follow-up. Two patients died from procedure-related sepsis, and overall perioperative mortality was 4.8%. Ten predictive risk factors (duration of diabetes, history of smoking, coronary artery disease, congestive heart failure, cerebral vascular accident, contralateral amputation, end-stage renal disease, fever episode, wound infection severity score, and arterial obstruction level) were included for analysis. Although none was significant, long-duration diabetes (OR: 1.13), end-stage renal disease (OR: 10.02), wound infection (OR: 1.56), and infrapopliteal lesions (OR: 3.00) tended to be unfavorable predictive risk factors of limb amputation. Revascularization surgery is still potentially beneficial for these patients-eg, it decreases the contralateral limb amputation rate by 7.5%-if done early in high-risk patients. PMID:26808765

  1. A New Limb Movement Detector Enabling People with Multiple Disabilities to Control Environmental Stimulation through Limb Swing with a Gyration Air Mouse

    Science.gov (United States)

    Shih, Ching-Hsiang; Chang, Man-Ling; Shih, Ching-Tien

    2010-01-01

    This study assessed whether two persons with multiple disabilities would be able to control environmental stimulation using limb swing with a gyration air mouse and a newly developed limb movement detection program (LMDP, i.e., a new software program that turns a gyration air mouse into a precise limb movement detector). The study was performed…

  2. A Limb Action Detector Enabling People with Multiple Disabilities to Control Environmental Stimulation through Limb Action with a Nintendo Wii Remote Controller

    Science.gov (United States)

    Shih, Ching-Hsiang; Chang, Man-Ling; Shih, Ching-Tien

    2010-01-01

    This study assessed whether two persons with multiple disabilities would be able to control environmental stimulation using limb action with a Nintendo Wii Remote Controller and a newly developed limb action detection program (LADP, i.e., a new software program that turns a Wii Remote Controller into a precise limb action detector). This study was…

  3. Midazolam with Bupivacaine for Improving Analgesia Quality in Brachial Plexus Block for Upper Limb Surgeries

    International Nuclear Information System (INIS)

    To compare the onset, duration and postoperative pain scores of supraclavicular block with bupivacaine alone and bupivacaine-midazolam combination. A randomized controlled clinical trial was conducted on 50 ASA-I or II adult patients undergoing upper limb surgeries under supraclavicular brachial plexus block. Patients were randomly allocated into two groups of 25 each. Patients in group A were administered 30 ml of 0.5% bupivacaine with midazolam 50 micro g kg/sup -1/. Hemodynamic variables (heart rate, noninvasive blood pressure, oxygen saturation), pain scores, rescue analgesic requirements and sedation score were recorded for 24 hours postoperatively, and compared using ANOVA with significance at p <0.05. The onset and duration of sensory and motor block was significantly faster and longer in group B compared to group A (p < 0.001). Pain scores were significantly lower in group B for 24 hours postoperatively (p < 0.001). Demand for rescue analgesic were significantly less in group B. Hemodynamics and sedation scores did not differ between the groups in the studied period. Bupivacaine (0.5%) in combination with Midazolam (50 micro g kg/sup -1/) quickened the onset as well as prolonged the duration of sensory and motor blockade of the brachial plexus for upper limb surgery. It improved postoperative analgesia without producing any adverse events compared to plain bupivacaine (0.5%) in equal volume. (author)

  4. Diabetic Muscle Infarction: A Rare Cause of Acute Limb Pain in Dialysis Patients

    Directory of Open Access Journals (Sweden)

    G. De Vlieger

    2013-01-01

    Full Text Available Diabetic muscle infarction is a rare microangiopathic complication occurring in patients with advanced diabetes mellitus. Diabetic patients with chronic kidney disease stage Vd are prone to develop this complication. The presenting symptom is a localized painful swelling of the affected limb. Symptoms usually resolve spontaneously during the following weeks, but frequent relapse can occur and in some cases swelling may lead to compartment syndrome. Biochemical blood analyses show an elevated C-reactive protein, but creatine kinase is often normal. Diagnosis can be made on clinical presentation and imaging, with magnetic resonance imaging as the gold standard. Histology is often not contributive. Treatment consists of rest, analgesics, rigorous glycemic control and low-dose aspirin. Severe cases of compartment syndrome require fasciotomy. In the current paper, we present two diabetic patients with cystic fibrosis, who are treated with automated peritoneal dialysis and suffered from episodic lower limb infarction. We subsequently review 48 episodes of diabetic muscle infarction previously reported in the literature in patients with end-stage renal disease.

  5. An upper limb robot model of children limb for cerebral palsy neurorehabilitation.

    Science.gov (United States)

    Pathak, Yagna; Johnson, Michelle

    2012-01-01

    Robot therapy has emerged in the last few decades as a tool to help patients with neurological injuries relearn motor tasks and improve their quality of life. The main goal of this study was to develop a simple model of the human arm for children affected with cerebral palsy (CP). The Simulink based model presented here shows a comparison for children with and without disabilities (ages 6-15) with normal and reduced range of motion in the upper limb. The model incorporates kinematic and dynamic considerations required for activities of daily living. The simulation was conducted using Matlab/Simulink and will eventually be integrated with a robotic counterpart to develop a physical robot that will provide assistance in activities of daily life (ADLs) to children with CP while also aiming to improve motor recovery. PMID:23366294

  6. Critical Limb Ischemia in Association with Charcot Neuroarthropathy: Complex Endovascular Therapy for Limb Salvage

    Energy Technology Data Exchange (ETDEWEB)

    Palena, Luis Mariano, E-mail: marianopalena@hotmail.com [Policlinico Abano Terme, Interventional Radiology Unit (Italy); Brocco, Enrico [Policlinico Abano Terme, Diabetic Foot Department, Foot and Ankle Clinic (Italy); Manzi, Marco [Policlinico Abano Terme, Interventional Radiology Unit (Italy)

    2013-05-09

    Charcot neuroarthropathy is a low-incidence complication of diabetic foot and is associated with ankle and hind foot deformity. Patients who have not developed deep ulcers are managed with offloading and supportive bracing or orthopedic arthrodesis. In patients who have developed ulcers and severe ankle instability and deformity, below-the-knee amputation is often indicated, especially when deformity and cutaneous involvement result in osteomyelitis. Ischemic association has not been described but can be present as a part of peripheral arterial disease in the diabetic population. In this extreme and advanced stage of combined neuroischemic diabetic foot disease, revascularization strategies can support surgical and orthopedic therapy, thus preventing osteomyelitis and leading to limb and foot salvage.

  7. Limb venous distension evokes sympathetic activation via stimulation of the limb afferents in humans

    OpenAIRE

    Cui, Jian; McQuillan, Patrick M.; Blaha, Cheryl; Kunselman, Allen R.; Sinoway, Lawrence I.

    2012-01-01

    We have recently shown that a saline infusion in the veins of an arterially occluded human forearm evokes a systemic response with increases in muscle sympathetic nerve activity (MSNA) and blood pressure. In this report, we examined whether this response was a reflex that was due to venous distension. Blood pressure (Finometer), heart rate, and MSNA (microneurography) were assessed in 14 young healthy subjects. In the saline trial (n = 14), 5% forearm volume normal saline was infused in an ar...

  8. Lower-limb valgus deformity associated with developmental hip dysplasia

    Institute of Scientific and Technical Information of China (English)

    GUO Sheng-jie; ZHOU Yi-xin; YANG De-jin; YANG Xu-cheng

    2012-01-01

    Background Treating developmental dysplasia of the hip is often challenging.The difficulties include not only the hip surgery itself but also the treatment of the associated lower-limb valgus deformity However,there have been very few studies on such deformity in patients with developmental hip dysplasia.In this study,we investigated the prevalence and severity of lower-limb valgus deformity,along with the relationship between the severity ef valgus deformity and mechanical alterations of the hip or the ipsilateral knee.Methods Two hundred and six affected lower limbs of 116 adult patients with untreated developmental dysplasia of the hip were included in the study,grouped according to the severity of hip dysplasia.Each study participant's radiographs were measured to quantitatively evaluate the mechanical axis deviation of the lower limb,and further to evaluate the prevalence and severity of the lower-limb valgus deformity.Some mechanical alterations of the hip and the ipsilateral knee were also measured on the radiographs.Results Of the affected lower limbs,14.1% had valgus deformities.Study participants with Crowe typeⅢ?hip dysplasiahad the most severe deformity and the highest prevalence of deformity.Severity of valgus deformity had a strong positive correlation with the lateral migration of the femoral head but not with the superior migration.A decreased lateral distal femoral angle contributed to the lower-limb valgus deformity,and the lateral distal femoral angle had a strong negative correlation with the severity of valgus deformity.Conclusions Hip dysplasia is commonly associated with lower-limb valgus deformity,and the severity of the lower-limb valgus deformity is mostly affected by lateral migration but not superior migration of the femoral head.The valgus deformity may originate mainly in the distal femur,in addition to the hip joint itself.These findings can be taken into account when planning to treat the patients with hip dysplasia.

  9. The perception of phantom limbs. The D. O. Hebb lecture.

    Science.gov (United States)

    Ramachandran, V S; Hirstein, W

    1998-09-01

    Almost everyone who has a limb amputated will experience a phantom limb--the vivid impression that the limb is not only still present, but in some cases, painful. There is now a wealth of empirical evidence demonstrating changes in cortical topography in primates following deafferentation or amputation, and this review will attempt to relate these in a systematic way to the clinical phenomenology of phantom limbs. With the advent of non-invasive imaging techniques such as MEG (magnetoencephalogram) and functional MRI, topographical reorganization can also be demonstrated in humans, so that it is now possible to track perceptual changes and changes in cortical topography in individual patients. We suggest, therefore, that these patients provide a valuable opportunity not only for exploring neural plasticity in the adult human brain but also for understanding the relationship between the activity of sensory neurons and conscious experience. We conclude with a theory of phantom limbs, some striking demonstrations of phantoms induced in normal subjects, and some remarks about the relevance of these phenomena to the question of how the brain constructs a 'body image.' PMID:9762952

  10. Optimal walking speed following changes in limb geometry.

    Science.gov (United States)

    Leurs, Françoise; Ivanenko, Yuri P; Bengoetxea, Ana; Cebolla, Ana-Maria; Dan, Bernard; Lacquaniti, Francesco; Cheron, Guy A

    2011-07-01

    The principle of dynamic similarity states that the optimal walking speeds of geometrically similar animals are independent of size when speed is normalized to the dimensionless Froude number (Fr). Furthermore, various studies have shown similar dimensionless optimal speed (Fr ∼0.25) for animals with quite different limb geometries. Here, we wondered whether the optimal walking speed of humans depends solely on total limb length or whether limb segment proportions play an essential role. If optimal walking speed solely depends on the limb length then, when subjects walk on stilts, they should consume less metabolic energy at a faster optimal speed than when they walk without stilts. To test this prediction, we compared kinematics, electromyographic activity and oxygen consumption in adults walking on a treadmill at different speeds with and without articulated stilts that artificially elongated the shank segment by 40 cm. Walking on stilts involved a non-linear reorganization of kinematic and electromyography patterns. In particular, we found a significant increase in the alternating activity of proximal flexors-extensors during the swing phase, despite significantly shorter normalized stride lengths. The minimal metabolic cost per unit distance walked with stilts occurred at roughly the same absolute speed, corresponding to a lower Fr number (Fr ∼0.17) than in normal walking (Fr ∼0.25). These findings are consistent with an important role of limb geometry optimization and kinematic coordination strategies in minimizing the energy expenditure of human walking. PMID:21653821

  11. Lower limb control and mobility following exercise training

    Directory of Open Access Journals (Sweden)

    Kim Sukwon

    2012-02-01

    Full Text Available Abstract The objective of the present study was to evaluate the effects of 8-week balance or weight training on ankle joint stiffness and limb stability for older adults, furthermore, on outcomes of slips while walking. Eighteen older adults volunteered for the study and randomly were assigned to the three groups, such as, weight, balance, or control group. While walking on a walking track, three-dimensional posture data were sampled and ankle joint stiffness and limb stability were computed to evaluate the effects of training. 2 (pre and post × 3 (weight, balance, and control × 2 (dominant and non-dominant legs mixed factor repeated ANOVA was performed. The results indicated that only balance training group showed an improvement in joint stiffness and both the training groups showed improvements in limb stability. Also, fall frequency results suggested that joint stiffness and limb stability had an effect on the likelihood of slip-induced falls. In conclusion, training can facilitate improvements in joint and limb control mechanism for older adults contributing to an improvement in the likelihood of slip-induced falls.

  12. Regeneration of limb joints in the axolotl (Ambystoma mexicanum.

    Directory of Open Access Journals (Sweden)

    Jangwoo Lee

    Full Text Available In spite of numerous investigations of regenerating salamander limbs, little attention has been paid to the details of how joints are reformed. An understanding of the process and mechanisms of joint regeneration in this model system for tetrapod limb regeneration would provide insights into developing novel therapies for inducing joint regeneration in humans. To this end, we have used the axolotl (Mexican Salamander model of limb regeneration to describe the morphology and the expression patterns of marker genes during joint regeneration in response to limb amputation. These data are consistent with the hypothesis that the mechanisms of joint formation whether it be development or regeneration are conserved. We also have determined that defects in the epiphyseal region of both forelimbs and hind limbs in the axolotl are regenerated only when the defect is small. As is the case with defects in the diaphysis, there is a critical size above which the endogenous regenerative response is not sufficient to regenerate the joint. This non-regenerative response in an animal that has the ability to regenerate perfectly provides the opportunity to screen for the signaling pathways to induce regeneration of articular cartilage and joints.

  13. Radionuclide venography of lower limbs by subcutaneous injection

    International Nuclear Information System (INIS)

    We have proved that subcutaneous injection (SC) of a small dose of Tc-99m pertechnetate (1 to 2 mCi: 37 to 74 MBq) at acupuncture points (K-3 and B-60) may offer an alternative method of radionuclide venography (RNV) of the lower limbs. In this study, we compared intravenous (IV) RNV and SC-RNV in 22 consecutive cases with typical signs and symptoms suggesting venous abnormality of the lower limb(s) from March to May 1988. They are 11 male and 11 female, aged 47.7±15.7 years. Among the 44 limbs of the 22 cases, 4 were normal, 12 (27.3%) were found to have varicose veins in the legs only, 18 (40.9%) had partial stenosis of the deep veins (14 poplito-tibial and 4 superficial femoral), and 13 (29.6%) had complete stenosis of the deep veins (4 poplito-tibial, 1 superficial femoral and 8 ilio-femoral. SC-RNV showed almost the same results as IV-RNV in 21 (47.7%), superior to IV-RNV in 22 (50%) (including 4.6% failure of IV-RNV), and inferior to IV-RNV in 1 (2.3%). We conclude that SC-RNV is definitely an alternative method of lower-limb venography. Since it is in most cases superior to IV-RNV, we suggest that it can take the place of IV-RNV in routine work. (author) 62 refs

  14. Great Toe Necrosis Predicts an Unfavorable Limb Salvage Prognosis

    Directory of Open Access Journals (Sweden)

    Hitomi Sano, MD, PhD

    2014-09-01

    Full Text Available Summary: The initial location of necrosis may affect the limb salvage rate. This study of 130 patients with chronic toe ulcers or gangrene was performed to assess whether the location of initial necrosis in the toes affected limb salvage prognosis. The patients were divided into 2 groups according to whether the initial necrosis was in the great toe or in other toes. Limb salvage prognosis was determined retrospectively. In the great toe group, the rates of total toe loss and major amputation were 50.0% and 24.4%, respectively. When the initial necrosis was in other toes, these rates were 27.3% and 9.3%, respectively. Great toe necrosis is associated with significantly higher rates of total toe loss (odds ratio = 3.10; P = 0.003; 95% confidence interval, 1.43−6.68 and major amputation (odds ratio = 3.66; P = 0.007; 95% confidence interval, 1.37−9.79. The great toe is supplied by 3 source arteries, whereas the lesser toes are fed by 1 or 2 arteries. Therefore, necrosis initiating from the great toe may reflect the presence of severe vascular disorders. The great toe is also anatomically connected to much of the foot via the tendons. Infection is more likely to spread along these tendons, which may reduce limb prognosis. Thus, the initial location of necrosis may be predictive of limb prognosis.

  15. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... 6, 2016, San Diego, CA Abstracts Registration Housing Travel Information Government Concierge View all meetings Publications Blood ... Blood Clots Blood Clotting and Pregnancy Clots and Travel DVT Myths vs. Facts Blood Detectives Find a ...

  16. Types of Blood Donations

    Science.gov (United States)

    ... Double Red Cell Plasma Platelets Red Cells What blood donation type is best for me? **If you do not ... blood type, a whole blood donation is recommended** Blood Donation Types: Volunteer Donations The standard or most common type ...

  17. Blood Type Game

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    ... Donor Community > Games > Blood Type Game Printable Version Blood Type Game This feature requires version 6 or later ... many points as possible by matching the appropriate blood type of a donor to the blood type of ...

  18. Understanding Blood Pressure Readings

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    ... What is the AHA recommendation for healthy blood pressure? This blood pressure chart reflects categories defined by the American ... unusually low blood pressure readings. How is high blood pressure diagnosed? Your healthcare providers will want to get ...

  19. Blood Clotting and Pregnancy

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    Full Text Available ... Research Programs and Awards View all Blood Current Issue First Edition Abstracts Collections Submit to Blood View ... Government Concierge View all meetings Publications Blood Current Issue First Edition Abstracts Blood: How I Treat A ...

  20. High Blood Pressure

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    ... Connected Home » High Blood Pressure Heath and Aging High Blood Pressure What Is Blood Pressure? Do ... high blood pressure increases as you get older. Gender. Before age 55, men have a greater chance ...

  1. Blood donation before surgery

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000367.htm Blood donation before surgery To use the sharing features ... vessels. Several sources of blood are described here. Blood From the Public (Volunteer Blood Donation) The most ...

  2. Blood Transfusion (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Blood Transfusions KidsHealth > For Parents > Blood Transfusions Print A ... and help put your child at ease. About Blood Transfusions Blood is like the body's transportation system. ...

  3. Blood donation before surgery

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    ... choose to use a method called autologous blood donation. Autologous blood is blood donated by you, which you later receive if you need a transfusion during or after surgery. You can have blood ...

  4. High blood pressure

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    ... you are at risk for: Bleeding from the aorta, the large blood vessel that supplies blood to ... tests Blood pressure check Blood pressure References American Diabetes Association. Standards of medical care in diabetes-2015 ...

  5. Blood Clotting and Pregnancy

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    Full Text Available ... raise public awareness of these blood conditions and increase research on the causes, prevention, and treatment. Blood ... of developing a blood clot during pregnancy is increased by the following: Previous blood clots A genetic ...

  6. Blood Clotting and Pregnancy

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    Full Text Available ... Housing Travel Information Government Concierge View all meetings Publications Blood Current Issue First Edition Abstracts Blood Advances ... reflect the most recent scientific research View all publications For Patients Blood Basics Blood Disorders Anemia Bleeding ...

  7. Abnormal access of axial vibrotactile input to deafferented somatosensory cortex in human upper limb amputees.

    Science.gov (United States)

    Kew, J J; Halligan, P W; Marshall, J C; Passingham, R E; Rothwell, J C; Ridding, M C; Marsden, C D; Brooks, D J

    1997-05-01

    We studied two human subjects with total deafferentation of one upper limb secondary to traumatic multiple cervical root avulsions. Both subjects developed a phantom limb and underwent elective amputation of the paralyzed, deafferentated limb. Psychophysical study revealed in each subject an area of skin in the pectoral region ipsilateral to the amputation where vibrotactile stimulation (VS) elicited referred sensations (RS) in the phantom limb. Positron emission tomography was then used to measure regional cerebral blood flow changes during VS of the pectoral region ipsilateral to the amputation with RS and during VS of a homologous part of the pectoral region adjacent to the intact arm without RS. A voxel-based correlation analysis was subsequently used to study functional connectivity. VS of the pectoral region adjacent to the intact arm was associated with activation of the dorsal part of the contralateral primary somatosensory cortex (S1) in a position consistent with the S1 trunk area. In contrast, VS of the pectoral region ipsilateral to the amputation with RS was associated with activation of the contralateral S1 that extended from the level of the trunk representation ventrally over distances of 20 and 12 mm, respectively, in the two subjects. The area of S1 activated during VS of the digits in a normal control subject was coextensive with the ventral S1 region abnormally activated during VS of the ectopic phantom representation in the two amputees, suggesting that the deafferented digit or hand/arm area had been activated by sensory input from the pectoral region. Correlation analysis showed an abnormal pattern of intrinsic connectivity within the deafferented S1 hand/arm area of both amputees. In one subject, the deafferented S1 was functionally connected with 3 times as many S1 voxels as the normally afferented S1. This abnormal functional connectivity extended in both the rostrocaudal and ventrodorsal dimensions. The results demonstrate that sensory

  8. Hemodynamic Changes in the Brachial Artery Induced by Acupuncture Stimulation on the Lower Limbs: A Single-Blind Randomized Controlled Trial

    OpenAIRE

    Masashi Watanabe; Shin Takayama; Atsushi Hirano; Takashi Seki; Nobuo Yaegashi

    2012-01-01

    Acupuncture is commonly performed at acupoints. No comparisons of quantitative physiological alterations in the brachial artery (BA) induced by the stimulation of different acupoints in the lower limbs have been performed in humans. Therefore, we investigated changes in blood flow volume (BFV) in the BA as an indicator of the physiological effects induced by stimulation at 3 points. Seventy-five healthy participants aged 33 ± 9 years (mean ± SD) were enrolled and randomly assigned to 3 groups...

  9. Failure by congestion of pedicled and free flaps for reconstruction of lower limbs after trauma: the role of negative-pressure wound therapy

    OpenAIRE

    L. Vaienti; Gazzola, R.; E. Benanti; Leone, F.; Marchesi, A.; Parodi, P; Riccio, M.

    2013-01-01

    Lower limb reconstruction with pedicled or free flaps can be commonly compromised by venous insufficiency. This complication often leads to partial/complete flap necrosis and increases the risk of superinfection. Negative-pressure wound therapy (NPWT) is known to increase local blood flow, decrease edema, promote tissue granulation, and reduce the likelihood of soft tissue infection. This study aims to evaluate the effectiveness of NPWT in the treatment of congested pedicled and free flaps of...

  10. Significance of the determination of doppler sonography haemodynamic indices for the assessment of distal perfusion in patients with critical ischemia of lower limbs

    OpenAIRE

    Čizmić Milica; Kronja Goran; Ajdinović Boris; Pucar Dragan

    2006-01-01

    Background/Aim: The perfusion of tissue, especially the muscles of the lower limbs (LL), implies the blood flow that carries enough nutrition, energy materials and oxygen. The aim of this study was to determine whether the decreased Doppler sonography parameters, resistance index (RI), and pulsatility index (PI) were significant as indicators of irreversible ischemia of LL. Methods. In 40 patients (mean age 66±14.9 years, 21% women and 79% men) with the signs of critical ischemia of LL, Laric...

  11. The comparison between lateral spinal anesthesia and sitting positions in lower limb vascular surgery

    Directory of Open Access Journals (Sweden)

    Mohajer MR

    2011-10-01

    Full Text Available "nBackground: Patients who require surgery on the lower extremities are considered to be a high risk group from the point of anesthesia. This study was performed to compare sitting and lateral positions in spinal anesthesia method with hyperbaric bupivacaine 0.5% for hemodynamic status and analgesic period in patients under vascular surgery of the lower limbs in Imam-Khomeini Hospital Complex affiliated to Tehran University of Medical Sciences in 2009."n "nMethods: In this study 40 patients were divided into two groups of 20 to undergo spinal anesthesia with 3 ml of hyperbaric bupivacaine 0.5% injected into the subarachnoid space in sitting or lateral positions. The anesthesia was performed at T10 level and the hemodynamic status and analgesic periods were compared in the two groups."n "nResults: The changes in mean arterial blood pressure and systolic and diastolic blood pressures were different between the two groups (P<0.05. Except in the first and thirtieth minutes, the changes in heart rate (HR were significantly different throughout the study between the two groups (P<0.04 and they were higher in sitting position. The duration of analgesia was significantly longer in lateral position (P<0.04 and the use of fluid was significantly larger in the sitting group (P<0.05."n "nConclusion: According to the obtained results, the changes in hemodynamic variables were significantly lower in the group in lateral versus sitting position in patients undergoing spinal anesthesia with bupivacaine for vascular surgery of the lower limb.

  12. Types of Blood Transfusions

    Science.gov (United States)

    ... Home » Health Information for the Public » Health Topics » Blood Transfusion » Types of Blood Transfusions Explore Blood Transfusion What Is... ... Share this page from the NHLBI on Twitter. Types of Blood Transfusions Blood is transfused either as whole blood ( ...

  13. Cord blood testing

    Science.gov (United States)

    ... to evaluate the oxygen, carbon dioxide, and pH levels) Blood sugar level Blood type and Rh Complete blood count ( ... means you have a blood infection (septicemia). High levels of blood sugar (glucose) in the cord blood may be found ...

  14. Blood and Diversity

    Science.gov (United States)

    ... The Process Risks and Complications History of Blood Transfusion Iron and Blood Donation Iron Info. for All Donors Iron Info. for ... Donation Student Donors Donation Process Eligibility Blood FAQs Blood Donor ... of Blood Transfusion Hosting a Blood Drive What to Expect Hosting ...

  15. Evaluation of Frequency and Risk Factors of Soft Tissue Rheumatism of Upper Limbs in Diabetic Patients in Kerman in 2001

    Directory of Open Access Journals (Sweden)

    M.R. Shakibi

    2003-10-01

    Full Text Available Diabetes mellitus is a metabolic disorder that affect different systems in human. Wide range of musculoskeletal syndromes have been described in association with diabetes. To determine the prevalence of upper limb soft tissue rheumatism in diabetes patients. In a cross sectional study 300 diabetic patients was examined by COPCORD questionnaire. The examination was performed by internist and rheumatologist . Data was analyzed by logistic regression. 73.3% of patients were female. Average age of cases was 51.2±13.7 years and mean of duration of disease was 7±6.4 years. 152 cases (50.7% had soft tissue rheumatism in upper limbs. 66 cases had carpal tannel syndrome, 23 cases with Dupuytren’s disease, 23 cases with Flexortenosynovitis, 91 cases with shoulder periarthritis, 4 cases had limited joint mobility and 12 had Elbow Epicandititis. Logestic regression analysis showed that type 2 diabetes, weak control of blood sugur and duration of disease>5years were risk factors for incidence of soft tissue rheumatism in upper limbs. Results have showed the high prevalence of soft tissue rheumatism in diabetic patients.

  16. Multiple bilateral lower limb fractures in a 2-year-old child: previously unreported injury with a unique mechanism

    Institute of Scientific and Technical Information of China (English)

    Basant Repswal; Anuj Jain; Sunil Gupta; Aditya Aggarwal; Tushar Kohli; Devendra Pathrot

    2014-01-01

    Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths,usually from head injury.We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason.A child fell from a height of around 15 feet after toppling from a balcony.He developed multiple fractures involving the right femoral shaft,right distal femoral epiphysis (Salter Harris type 2),right distal metaphysis of the tibia and fibula,and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia.There were no head,abdominal or spinal injuries.The patient was taken into emergency operation theatre after initial management which consisted of intravenous fluids,blood transfusion,and splintage of both lower limbs.Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails.Distal femoral physeal injury required open reduction and fixation with K wires.Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs.All the fractures united in four weeks.At the last follow-up,the child had no disability and was able to perform daily activities comfortably.We also proposed the unique mechanism of injury in this report.

  17. Multiple bilateral lower limb fractures in a 2-year-old child: previously unreported injury with a unique mechanism.

    Science.gov (United States)

    Repswal, Basant; Jain, Anuj; Gupta, Sunil; Aggarwal, Aditya; Kohli, Tushar; Pathrot, Devendra

    2014-01-01

    Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason. A child fell from a height of around 15 feet after toppling from a balcony. He developed multiple fractures involving the right femoral shaft, right distal femoral epiphysis (Salter Harris type 2), right distal metaphysis of the tibia and fibula, and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia. There were no head, abdominal or spinal injuries. The patient was taken into emergency operation theatre after initial management which consisted of intravenous fluids, blood transfusion, and splintage of both lower limbs. Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails. Distal femoral physeal injury required open reduction and fixation with K wires. Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs. All the fractures united in four weeks. At the last follow-up, the child had no disability and was able to perform daily activities comfortably. We also proposed the unique mechanism of injury in this report. PMID:25293902

  18. Autologous Stem Cell Transplantation in Patient with Critical Limb Ischemia

    International Nuclear Information System (INIS)

    Critical limb ischemia (CLI) is clinical manifestation of an end-stage peripheral arterial obstruction disease. Progressive ischemia leads to development of ischemic rest pain and skin defects. Early recognition, medicamentous treatment and revascularisation are standard treatment practise in these patients. However, up to 30% of patients are not eligible for endovascular or surgical revascularisation. Remaining patients are threatened with disease progression and high risk for leg amputation. Some clinical studies demonstrated, that therapeutic angio genesis with autologous stem cells therapy may be effective in ulcer healing and prevention of limb amputation. This case report describes a 47-year old male with history of one year non-healing ulcer after the third and fifth finger amputation without option of endovascular or surgical revascularisation. Patient was successfully treated with intramuscular autologous bone marrow therapy with ulcer healing and limb salvage after 12-month follow-up. (author)

  19. Personal Identification Based on Vectorcardiogram Derived from Limb Leads Electrocardiogram

    Directory of Open Access Journals (Sweden)

    Jongshill Lee

    2012-01-01

    Full Text Available We propose a new method for personal identification using the derived vectorcardiogram (dVCG, which is derived from the limb leads electrocardiogram (ECG. The dVCG was calculated from the standard limb leads ECG using the precalculated inverse transform matrix. Twenty-one features were extracted from the dVCG, and some or all of these 21 features were used in support vector machine (SVM learning and in tests. The classification accuracy was 99.53%, which is similar to the previous dVCG analysis using the standard 12-lead ECG. Our experimental results show that it is possible to identify a person by features extracted from a dVCG derived from limb leads only. Hence, only three electrodes have to be attached to the person to be identified, which can reduce the effort required to connect electrodes and calculate the dVCG.

  20. Development of phantom limb pain after femoral nerve block.

    Science.gov (United States)

    Siddiqui, Sadiah; Sifonios, Anthony N; Le, Vanny; Martinez, Marc E; Eloy, Jean D; Kaufman, Andrew G

    2014-01-01

    Historically, phantom limb pain (PLP) develops in 50-80% of amputees and may arise within days following an amputation for reasons presently not well understood. Our case involves a 29-year-old male with previous surgical amputation who develops PLP after the performance of a femoral nerve block. Although there have been documented cases of reactivation of PLP in amputees after neuraxial technique, there have been no reported events associated with femoral nerve blockade. We base our discussion on the theory that symptoms of phantom limb pain are of neuropathic origin and attempt to elaborate the link between regional anesthesia and PLP. Further investigation and understanding of PLP itself will hopefully uncover a relationship between peripheral nerve blocks targeting an affected limb and the subsequent development of this phenomenon, allowing physicians to take appropriate steps in prevention and treatment. PMID:24872817

  1. Solar Limb Darkening Function from Baily's Beads Observations

    CERN Document Server

    Raponi, Andrea

    2011-01-01

    We introduce a method to measure with high resolution the solar diameter from the ground, through the eclipse observations by reconsidering the definition of the solar edge. The outer part of the Limb Darkening Function (LDF) is recovered using the luminosity evolution of a Baily's Bead and the profile of the lunar limb available from the Kaguya satellite. The method proposed is applied for the videos of the eclipse in January, 15, 2010 recorded by Richard Nugent in Uganda and Andreas Tegtmeier in India. The result shows light from solar limb detected at least 0.65 arcsec beyond the LDF inflection point, and this fact may suggest to reconsider the evaluations of the historical eclipses made with naked eye.

  2. Intraocular pressure-lowering combination therapies with prostaglandin analogues.

    Science.gov (United States)

    Aptel, Florent; Chiquet, Christophe; Romanet, Jean-Paul

    2012-07-01

    Intraocular pressure (IOP) reduction is currently the only therapeutic approach demonstrated to preserve visual function in patients with glaucoma. The first line of glaucoma treatment consists of topical IOP-lowering medications, usually initiated as monotherapy. A significant proportion of patients require more than one medication to reach a target IOP at which optic nerve damage will not progress. As prostaglandin analogues (PGAs) are the most effective class for reducing IOP, one of the other commonly used classes (β-adrenoceptor antagonist [β-blocker], carbonic anhydrase inhibitor or α(2)-adrenoceptor agonist) is frequently combined with a PGA. In the last decade, the use of fixed combinations containing two medications in a single bottle has steadily increased. Fixed combinations have the potential to simplify the dosing regimen, increase patient adherence, avoid the washout effect of the second drop on the first medication instilled, decrease exposure to preservatives and, sometimes, reduce the cost of treatment. Clinical trials have evaluated PGA-based fixed combinations versus unfixed combinations (individual components administered concomitantly) or versus individual monotherapies; however, any advantage that the fixed combinations may have in terms of IOP-lowering efficacy is still debated. For these reasons, the PGA-based fixed combinations are not approved by regulatory authorities in some countries, such as the US. We review the published studies evaluating the efficacy and tolerability of the IOP-lowering unfixed and fixed combination therapies with PGAs. Regarding unfixed combinations, the review shows that α(2)-adrenergic agonists-PGA and carbonic anhydrase inhibitor-PGA combinations seem to be at least as effective at reducing IOP as the β-blocker-PGA combinations. As for the fixed combinations, the review shows that the three PGA-timolol fixed combinations are more effective than their component medications used separately as monotherapy and are better tolerated than the three respective prostaglandins. The three PGA-timolol fixed combinations are less effective at reducing IOP than the unfixed combinations but are better tolerated. The advantage of the fixed combinations in terms of patient adherence and persistence is supported by a very small number of studies and remains to be more accurately determined. Most studies, but not all, seem to show that PGA-timolol fixed combinations are more effective than other available β-blocker fixed combinations (dorzolamide-timolol fixed combinations) at reducing IOP and are similarly tolerated. PMID:22686588

  3. Effects of physical training on endothelial function and limb blood flow in type 2 diabetes

    DEFF Research Database (Denmark)

    Sonne, Mette Paulli; Scheede-Bergdahl, Celena; Olsen, David Benee;

    2007-01-01

    physical training - or the opposite, inactivity - on endothelial function is not fully elucidated. Some studies have shown positive effects of physical training, whereas others have not. In general, physical training can improve endothelial function when this is impaired. However, physical training does...... not seem to have any effect on endothelial function when this is normal....

  4. Immersive virtual reality as a rehabilitative technology for phantom limb experience: a protocol.

    Science.gov (United States)

    Murray, Craig D; Patchick, Emma; Pettifer, Stephen; Caillette, Fabrice; Howard, Toby

    2006-04-01

    This paper describes a study protocol to investigate the use of immersive virtual reality as a treatment for amputees' phantom limb pain. This work builds upon prior research using mirror box therapy to induce vivid sensations of movement originating from the muscles and joints of amputees' phantom limbs. The present project transposes movements of amputees' anatomical limbs into movements of a virtual limb presented in the phenomenal space of their phantom limb. It is anticipated that the protocol described here will help reduce phantom limb pain. PMID:16640472

  5. The Diterpene Glycoside, Rebaudioside A, Does not Improve Glycemic Control or Affect Blood Pressure After Eight Weeks Treatment in the Goto-Kakizaki Rat

    OpenAIRE

    Dyrskog, Stig E.U.; Jeppesen, Per B.; Chen, Jianguo; Christensen, Lars P.; Hermansen, Kjeld

    2005-01-01

    The plant, Stevia rebaudiana Bertoni (SrB), has been used for the treatment of diabetes in traditional medicine. Previously, we have demonstrated that long-term administration of the glycoside stevioside has insulinotropic, glucagonostatic, anti-hyperglycemic and blood pressure-lowering effects in type 2 diabetic animal models. The aim of this study was to elucidate if long-term administration of rebaudioside A, another glycoside isolated from the plant SrB, could improve glycemic control and...

  6. Change and role of heme oxygenase-1 in injured lungs following limb ischemia/reperfusion in rats

    Institute of Scientific and Technical Information of China (English)

    周君琳; 朱晓光; 林源; 凌亦凌; 邵新中; 张桂生

    2004-01-01

    Objective: To study the change and role of hemeoxygenase-1 (HO-1) in injured lungs following limbischemia/reperfusion in rats.Methods: A total of 96 healthy male Sprague-Dawley rats, weighing 250-300 g, were used in this study. Hind limb ischemia was made on 40 rats through clamping the infrarenal aorta for 2 hours with a microvascular clip, then limb reperfusion for 0, 4, 8,16 and 24 hours(n =8 in each time point)was performed, respectively. Other 8 rats undergoing full surgical operation including isolation of the infrarenal aorta without occlusion were taken as the sham operation group. Lung tissues were obtained from the 48animals and Northern blotting and Western blotting were employed to measure the changes of HO-1 mRNA and protein expression, respectively. Immunohistochemistry technique was used to determine the cell types responsible for HO-1 expression after limb ischemia/reperfusion. Then hind limb ischemia was made on other 12 rats through clamping the infrarenal aorta for 2 hours with a microvascular clip, among whom, 6 rats were given zinc protoporphyrin (ZnPP), an inhibitor of HO. Then limb reperfusion for 16 hours was performed on all the 12 rats.And other 12 rats underwent full surgical operation including isolation of the infrarenal aorta without occlusion,among whom, 6 rats were then given ZnPP. Then lung tissues were obtained from the 24 animals and lung injury markers, lung histology, polymorphonuclear leukocyte (PMN) count and malondialdehyde (MDA) content were detected, respectively. HO activity was determined through measuring the carboxyhemoglobin (COHb) level in artery blood with a CO-oximeter after limb ischemia/reperfusion.And the animal mortality was observed on the other 24rats.Results: Northern blotting analysis showed that HO-1mRNA increased significantly at 4 hours after reperfusion,peaked at 16 hours, and began to decrease at 24 hours. In contrast, no positive signal was observed in the sham and simple ischemia animals. Increased HO

  7. Pattern of Limb Malformations in Mice Induced by Methoxyacetic Acid

    OpenAIRE

    Rasjad, Chairuddin; Yamashita, Keisuke; Datu, Abdul Razak; Yasuda, Mineo

    1991-01-01

    The present study investigated the pattern of limb malformations induced in mice by methoxyacetic acid (MAA), one of di(2-methoxyethyl) phthalate (DMEP) metabolites. Pregnant Jcl:ICR mice were given orally at gestational day (gd) 10.5, 11.0, or 11.5 (vaginal plug = gd 0) a single dose of MAA 10 mmol/kg of body weight. Fetuses were examined at gd 15.5 for external and skeletal malformations. Limb defects were maximum in frequency and severity after administration at gd 11.5. Forelimbs had grea...

  8. Personal Identification Based on Vectorcardiogram Derived from Limb Leads Electrocardiogram

    OpenAIRE

    Jongshill Lee; Youngjoon Chee; Inyoung Kim

    2012-01-01

    We propose a new method for personal identification using the derived vectorcardiogram (dVCG), which is derived from the limb leads electrocardiogram (ECG). The dVCG was calculated from the standard limb leads ECG using the precalculated inverse transform matrix. Twenty-one features were extracted from the dVCG, and some or all of these 21 features were used in support vector machine (SVM) learning and in tests. The classification accuracy was 99.53%, which is similar to the...

  9. Pain in traumatic upper limb amputees in Sierra Leone.

    OpenAIRE

    Lacoux, Philippe A; Crombie, Iain K; MacRae, William A

    2002-01-01

    Data on 40 upper limb amputees (11 bilateral) with regard to stump pain, phantom sensation and phantom pain is presented. All the patients lost their limbs as a result of violent injuries intended to terrorise the population and were assessed 10-48 months after the injury. All amputees reported stump pain in the month prior to interview and ten of the 11 bilateral amputees had bilateral pain. Phantom sensation was common (92.5%), but phantom pain was only present in 32.5% of amputees. Problem...

  10. Amputated Lower Limb Fixation to the Fracture Table.

    Science.gov (United States)

    Gamulin, Axel; Farshad, Mazda

    2015-11-01

    Fractures of the proximal and diaphyseal femur are frequently internally fixed using a fracture table with fracture reduction obtained by traction and adequate rotation exerted on the slightly abducted extremity. Although rare, these fractures may occur on an amputated limb. If so, standard use of a fracture table is not possible. To address this situation, the authors describe a simple novel technique allowing rigid fixation of the amputated limb to the traction device of the fracture table that provides accurate control of reduction in all planes. PMID:26558660

  11. Stellate ganglion blockade for analgesia following upper limb surgery.

    LENUS (Irish Health Repository)

    McDonnell, J G

    2012-01-31

    We report the successful use of a stellate ganglion block as part of a multi-modal postoperative analgesic regimen. Four patients scheduled for orthopaedic surgery following upper limb trauma underwent blockade of the stellate ganglion pre-operatively under ultrasound guidance. Patients reported excellent postoperative analgesia, with postoperative VAS pain scores between 0 and 2, and consumption of morphine in the first 24 h ranging from 0 to 14 mg. While these are preliminary findings, and must be confirmed in a clinical trial, they highlight the potential for stellate ganglion blockade to provide analgesia following major upper limb surgery.

  12. Work-related upper limb “overuse” syndromes

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis

    2016-01-01

    A previous review of historical descriptions and theories about the character and pathogenesis of writer’s cramp and other comparable chronic upper limb “overuse” work-related pain syndromes has indicated that somatic dysfunctions explain symptoms and findings. The first case studies and case...... series suggested that these conditions were caused by pathology affecting the peripheral nerves. The general perception gradually changed, however, with symptoms becoming attributed to central nervous system dysfunction and ultimately to represent a psychiatric condition. Work-related upper limb......” conditions that have occurred sporadically and epidemically, and reviews interpretations from the nineteenth century that relate symptoms to psychogenic conditions....

  13. Network based transcription factor analysis of regenerating axolotl limbs

    Directory of Open Access Journals (Sweden)

    Cameron Jo Ann

    2011-03-01

    Full Text Available Abstract Background Studies on amphibian limb regeneration began in the early 1700's but we still do not completely understand the cellular and molecular events of this unique process. Understanding a complex biological process such as limb regeneration is more complicated than the knowledge of the individual genes or proteins involved. Here we followed a systems biology approach in an effort to construct the networks and pathways of protein interactions involved in formation of the accumulation blastema in regenerating axolotl limbs. Results We used the human orthologs of proteins previously identified by our research team as bait to identify the transcription factor (TF pathways and networks that regulate blastema formation in amputated axolotl limbs. The five most connected factors, c-Myc, SP1, HNF4A, ESR1 and p53 regulate ~50% of the proteins in our data. Among these, c-Myc and SP1 regulate 36.2% of the proteins. c-Myc was the most highly connected TF (71 targets. Network analysis showed that TGF-β1 and fibronectin (FN lead to the activation of these TFs. We found that other TFs known to be involved in epigenetic reprogramming, such as Klf4, Oct4, and Lin28 are also connected to c-Myc and SP1. Conclusions Our study provides a systems biology approach to how different molecular entities inter-connect with each other during the formation of an accumulation blastema in regenerating axolotl limbs. This approach provides an in silico methodology to identify proteins that are not detected by experimental methods such as proteomics but are potentially important to blastema formation. We found that the TFs, c-Myc and SP1 and their target genes could potentially play a central role in limb regeneration. Systems biology has the potential to map out numerous other pathways that are crucial to blastema formation in regeneration-competent limbs, to compare these to the pathways that characterize regeneration-deficient limbs and finally, to identify stem

  14. Primary motor cortex changes after amputation correlate with phantom limb pain and the ability to move the phantom limb.

    Science.gov (United States)

    Raffin, Estelle; Richard, Nathalie; Giraux, Pascal; Reilly, Karen T

    2016-04-15

    A substantial body of evidence documents massive reorganization of primary sensory and motor cortices following hand amputation, the extent of which is correlated with phantom limb pain. Many therapies for phantom limb pain are based upon the idea that plastic changes after amputation are maladaptive and attempt to normalize representations of cortical areas adjacent to the hand area. Recent data suggest, however, that higher levels of phantom pain are associated with stronger local activity and more structural integrity in the missing hand area rather than with reorganization of neighbouring body parts. While these models appear to be mutually exclusive they could co-exist, and one reason for the apparent discrepancy between them might be that no single study has examined the organisation of lip, elbow, and hand movements in the same participants. In this study we thoroughly examined the 3D anatomy of the central sulcus and BOLD responses during movements of the hand, elbow, and lips using MRI techniques in 11 upper-limb amputees and 17 healthy control subjects. We observed different reorganizational patterns for all three body parts as the former hand area showed few signs of reorganization, but the lip and elbow representations reorganized and shifted towards the hand area. We also found that poorer voluntary control and higher levels of pain in the phantom limb were powerful drivers of the lip and elbow topological changes. In addition to providing further support for the maladaptative plasticity model, we demonstrate for the first time that motor capacities of the phantom limb correlate with post-amputation reorganization, and that this reorganization is not limited to the face and hand representations but also includes the proximal upper-limb. PMID:26854561

  15. Nonoperative active management of critical limb ischemia: initial experience using a sequential compression biomechanical device for limb salvage.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2008-01-01

    Critical limb ischemia (CLI) patients are at high risk of primary amputation. Using a sequential compression biomechanical device (SCBD) represents a nonoperative option in threatened limbs. We aimed to determine the outcome of using SCBD in amputation-bound nonreconstructable CLI patients regarding limb salvage and 90-day mortality. Thirty-five patients with 39 critically ischemic limbs (rest pain = 12, tissue loss = 27) presented over 24 months. Thirty patients had nonreconstructable arterial outflow vessels, and five were inoperable owing to severe comorbidity scores. All were Rutherford classification 4 or 5 with multilevel disease. All underwent a 12-week treatment protocol and received the best medical treatment. The mean follow-up was 10 months (SD +\\/- 6 months). There were four amputations, with an 18-month cumulative limb salvage rate of 88% (standard error [SE] +\\/- 7.62%). Ninety-day mortality was zero. Mean toe pressures increased from 38.2 to 67 mm Hg (SD +\\/- 33.7, 95% confidence interval [CI] 55-79). Popliteal artery flow velocity increased from 45 to 47.9 cm\\/s (95% CI 35.9-59.7). Cumulative survival at 12 months was 81.2% (SE +\\/- 11.1) for SCBD, compared with 69.2% in the control group (SE +\\/- 12.8%) (p = .4, hazards ratio = 0.58, 95% CI 0.15-2.32). The mean total cost of primary amputation per patient is euro29,815 ($44,000) in comparison with euro13,900 ($20,515) for SCBD patients. SCBD enhances limb salvage and reduces length of hospital stay, nonoperatively, in patients with nonreconstructable vessels.

  16. Autologous blood donation

    OpenAIRE

    Goodnough, Lawrence T

    2004-01-01

    Although preoperative autologous blood donation is employed in elective surgery, this is declining because of the increasingly safe allogeneic blood supply. However, it continues to be used because of the public's perception of allogeneic blood risks and increasing blood shortages. Patients may donate a unit of blood (450 ± 45 ml) as often as twice weekly, up to 72 hours before surgery. Preoperative autologous blood is most beneficial in procedures that cause significant blood loss. It has be...

  17. Low-Load Resistance Training with Blood Flow Occlusion as a Countermeasure to Disuse Atrophy

    Science.gov (United States)

    Ploutz-Snyder, L. L.; Cook, S. B.

    2009-01-01

    Decreases in strength and neuromuscular function are observed following prolonged disuse. Exercise countermeasures to prevent muscle dysfunction during disuse typically involve high intensity resistance training. The purpose of the study is to evaluate the effectiveness of low-load resistance training with a blood flow occlusion to mitigate muscle loss and dysfunction during 30 days of unilateral lower limb suspension (ULLS).

  18. ENHANCED ABSORPTION OF MILLIMETER WAVE ENERGY IN MURINE SUBCUTANEOUS BLOOD VESSELS

    OpenAIRE

    Alekseev, Stanislav I.; Ziskin, Marvin C.

    2011-01-01

    The aim of the present study was to determine millimeter wave (MMW) absorption by blood vessels traversing the subcutaneous fat layer of murine skin. Most calculations were performed using the finite-difference time-domain (FDTD) technique. We used two types of models: (1) a rectangular block of multilayer tissue with blood vessels traversing the fat layer and (2) cylindrical models with circular and elliptical cross sections simulating the real geometry of murine limbs. We found that the spe...

  19. EFFECTS OF ETHANOL AND HYDROGEN PEROXIDE ON MOUSE LIMB BUD MESENCHYME DIFFERENTIATION AND CELL DEATH

    Science.gov (United States)

    Many of the morphological defects associated with embryonic alcohol exposure are a result of cell death. During limb development, ethanol administration produces cell death in the limb and digital defects, including postaxial ectrodactyly. Because an accumulation of reactive oxyg...

  20. Limb trauma in a university teaching hospital setting

    Directory of Open Access Journals (Sweden)

    I C Nwagbara

    2011-01-01

    Conclusion Majority of the limb trauma cases were as a result of road traffic crashes; thus efforts should be directed at improving safety on our roads to reduce the burden of trauma on the health care system. There is also a need to create awareness in the community on the role of orthodox medicine in the management of fractures.

  1. Peripheral nervous system origin of phantom limb pain.

    Science.gov (United States)

    Vaso, Apostol; Adahan, Haim-Moshe; Gjika, Artan; Zahaj, Skerdi; Zhurda, Tefik; Vyshka, Gentian; Devor, Marshall

    2014-07-01

    Nearly all amputees continue to feel their missing limb as if it still existed, and many experience chronic phantom limb pain (PLP). What is the origin of these sensations? There is currently a broad consensus among investigators that PLP is a top-down phenomenon, triggered by loss of sensory input and caused by maladaptive cortical plasticity. We tested the alternative hypothesis that PLP is primarily a bottom-up process, due not to the loss of input but rather to exaggerated input, generated ectopically in axotomized primary afferent neurons in the dorsal root ganglia (DRGs) that used to innervate the limb. In 31 amputees, the local anesthetic lidocaine was applied intrathecally and/or to the DRG surface (intraforaminal epidural block). This rapidly and reversibly extinguished PLP and also nonpainful phantom limb sensation (npPLS). Control injections were ineffective. For intraforaminal block, the effect was topographically appropriate. The suppression of PLP and npPLS could also be demonstrated using dilute lidocaine concentrations that are sufficient to suppress DRG ectopia but not to block the propagation of impulses generated further distally in the nerve. PLP is driven primarily by activity generated within the DRG. We recommend the DRG as a target for treatment of PLP and perhaps also other types of regional neuropathic pain. PMID:24769187

  2. Pain Management in Four-Limb Amputation: A Case Report.

    Science.gov (United States)

    Warner, Nafisseh S; Warner, Matthew A; Moeschler, Susan M; Hoelzer, Bryan C

    2015-09-01

    Acute pain following amputation can be challenging to treat due to multiple underlying mechanisms and variable clinical responses to treatment. Furthermore, poorly controlled preoperative pain is a risk factor for developing chronic pain. Evidence suggests that epidural analgesia and peripheral nerve blockade may decrease the severity of residual limb pain and the prevalence of phantom pain after lower extremity amputation. We present the perioperative analgesic management of a patient with gangrene of the bilateral upper and lower extremities as a result of septic shock and prolonged vasopressor administration who underwent four-limb amputation in a single procedure. A multimodal analgesic regimen was utilized, including titration of preoperative opioid and neuropathic pain agents, perioperative intravenous, epidural and peripheral nerve catheter infusions, and postoperative oral medication titration. More than 8 months postoperatively, the patient has satisfactory pain control with no evidence for phantom limb pain. To our knowledge, there have been no publications to date concerning analgesic regimens in four-limb amputation. PMID:26011696

  3. In situ saphenous vein bypass for limb salvage.

    Science.gov (United States)

    Sarcina, A; Carlesi, R; Bellosta, R; Agrifoglio, G

    1993-02-01

    A total of 130 infrapopliteal in situ saphenous vein bypasses were performed in 128 patients between January 1980 and June 1991. The indication for surgery was critical ischaemia with impending limb loss in 121 patients; seven suffered from severe claudication. The distal anastomosis was to the popliteal artery below the knee in 60 cases (46.2%) and in 70 (53.8%) to the tibioperoneal arteries. The results, in terms of secondary patency and limb salvage rates, of the first 68 procedures (1980-1985) and subsequent 62 (1986-June 1991) were compared. In the first period, a secondary patency rate of 42.6% and a limb salvage rate of 67.0% were obtained, compared with 71.3 and 80.8% respectively in the second. These differences are significant for patency (P < 0.005) and limb salvage (P < 0.01). These results show that the in situ technique can give acceptable results but a learning period with a high percentage of early failures is to be expected. PMID:8075993

  4. Diagnosis of fetal congenital limb deformities by MRI

    International Nuclear Information System (INIS)

    Objective: To explore the diagnostic value of MRI on fetal congenital limb deformities. Methods: Sixteen pregnant women, aged from 22 to 40 years (average 29 years) and with gestation from 22 to 39 weeks (average 29 weeks) were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound studies. Acquisitions consisted of coronal, sagittal, and axial slices relative to the fetal brain, spine, thorax, abdomen, especially limbs using 2D FIESTA sequences. Prenatal US and MR imaging findings were compared with postnatal diagnoses (4 fetuses) or autopsy (12 pregnant women, 13 fetuses). Postnatal evaluation included US, MR imaging, computed tomography, and physical examination. Results: Of the sixteen pregnant women (15 with a single fetus and 1 with twin fetuses), 17 fetuses were found. Those limb deformities of sixteen pregnant women included congenital both upper extremities amelia (1 case), sirenomelia sequence (1 case), micromelia (5 cases, 1 of which were twins), bilateral clenched hands (2 cases), right polydactyly (1 case), simple right ectrodactyly (1 case), right dactylolysis(1 case), simple club foot (2 cases), hydrocele spinalis with club foot (2 cases), 1 of the 2 cases with bilateral clinodactyly. In 14 of 16 cases, the diagnoses established by MR imaging were correct when compared with postnatal diagnosis, and prenatal MR diagnosis was inaccurate in 2 cases. Conclusion: Prenatal MRI is effective in the assessment of congenital limb deformities of fetuses, it can yield information additional to that obtained with US, and further correct US diagnosis. (authors)

  5. Popliteo-pedal bypass surgery for critical limb ischemia.

    LENUS (Irish Health Repository)

    Good, D W

    2011-12-01

    Critical limb ischaemia due to distal arterial disease represents a significant challenge. Randomised controlled evidence suggests that open surgery may be superior to endovascular intervention but there is limited data on the specific clinical cohort with exclusively infra-popliteal disease.

  6. Gestural Imitation and Limb Apraxia in Corticobasal Degeneration

    Science.gov (United States)

    Salter, Jennifer E.; Roy, Eric A.; Black, Sandra E.; Joshi, Anish; Almeida, Quincy

    2004-01-01

    Limb apraxia is a common symptom of corticobasal degeneration (CBD). While previous research has shown that individuals with CBD have difficulty imitating transitive (tool-use actions) and intransitive non-representational gestures (nonsense actions), intransitive representational gestures (actions without a tool) have not been examined. In the…

  7. Nuclear medicine and articulation prosthesis of the lower limbs

    International Nuclear Information System (INIS)

    Several nuclear medicine procedures can help the surgeons in the diagnosis of the complications of articulations prosthesis of the lower limbs, in particular in case of torpid infection. Even if the diagnosis remains uncertain, the indications and the interpretation of these procedures benefit of a close collaboration between nuclear medicine specialist and clinicians. (author)

  8. Somatic and movement inductions phantom limb in non-amputees

    Science.gov (United States)

    Casas, D. M.; Gentiletti, G. G.; Braidot, A. A.

    2016-04-01

    The illusion of the mirror box is a tool for phantom limb pain treatment; this article proposes the induction of phantom limb syndrome on non-amputees upper limb, with a neurological trick of the mirror box. With two study situations: a) Somatic Induction is a test of the literature reports qualitatively, and novel proposal b) Motor Induction, which is an objective report by recording surface EEG. There are 3 cases proposed for Motor illusion, for which grasped movement is used: 1) Control: movement is made, 2) illusion: the mirror box is used, and 3) Imagination: no movement is executed; the subject only imagines its execution. Three different tasks are registered for each one of them (left hand, right hand, and both of them). In 64% of the subjects for somatic experience, a clear response to the illusion was observed. In the experience of motor illusion, cortical activation is detected in both hemispheres of the primary motor cortex during the illusion, where the hidden hand remains motionless. These preliminary findings in phantom limb on non-amputees can be a tool for neuro-rehabilitation and neuro-prosthesis control training.

  9. Work-Related Upper Limb Disorders: A Case Report

    Directory of Open Access Journals (Sweden)

    Zlatka Borisova Stoyneva

    2015-03-01

    Full Text Available In this study the complex interrelationship between physical factors, job stress, lifestyle and genetic factors on symptoms of work-related musculoskeletal disorders of the upper limbs is demonstrated by a case report and discussion of the literature. A 58 year old woman with long lasting complaints of the upper limbs with increasing intensity and duration, generalisation, combined with skin thickness, Raynaud’s phenomenon, joint disorders, arterial and pulmonary hypertension, metabolic lipid dysfunctions is presented. Occupational history proves continuous duration of service at a job with occupational physical static load with numerous repetitive monotonous systematic motions of fingers and hands as a weaver of Persian rugs followed by work at an automated loom and variable labour activities. Though the complaints dated since the time she was a manual weaver, the manifestations of generalized joint degenerative changes, system sclerosis with Raynaud’s phenomenon with similar upper extremities signs and symptoms discount upper limbs musculoskeletal disorder as caused only or mainly by occupational risk factors. The main principles and criteria for occupational diagnosis of musculoskeletal upper limb disorders and legislative requirements for their reglamentation are discussed.

  10. Functional protein networks unifying limb girdle muscular dystrophy

    NARCIS (Netherlands)

    Morrée, Antoine de

    2011-01-01

    Limb Girdle Muscular Dystrophy (LGMD) is a rare progressive heterogeneous disorder that can be caused by mutations in at least 21 different genes. These genes are often widely expressed and encode proteins with highly differing functions. And yet mutations in all of them give rise to a similar clini

  11. Tropospheric Ozone from limb nadir matching of MIPAS and SCIAMACHY

    Science.gov (United States)

    Rahpoe, Nabiz; Ebojie, Felix; Jia, Jia; Weber, Mark; Rozanov, Alexei; Bovensmann, Heinrich; Burrows, John P.; von Clarmann, Thomas; Stiller, Gabriele; Laeng, Alexandra; Lossow, Stefan

    2016-04-01

    The tropospheric total ozone column (TTOC) is retrieved by applying the limb nadir matching method (LNM) for two different sensors on board the Envisat satellite. Each sensor provides independent information of the total ozone column (TOC, nadir) and stratospheric ozone column (SOC, limb). The latter is derived from the limb viewing geometry of MIPAS (Michelson Interferometer for Passive Atmospheric Sounding), while total ozone column (TOC) from the nadir viewing SCIAMACHY (SCanning Imaging spectrometer for AtMospheric CHartrographY) measurements. The residual ozone column or tropospheric total ozone column (TTOC) is then derived by subtraction of the SOC from the collocated TOC. Although this method is straightforward, the underlying difficulties are the exact knowledge of the tropopause height, matching/collocation of the two measurements, and instrumental differences between two sensors. Our results are compared with available tropospheric ozone columns derived from the SCIAMACHY - SCIAMACHY limb-nadir combination in order to understand the differences and the potential of LNM method for different sensor combination.

  12. Making sense-data-based simulations of vertebrate limb development.

    Science.gov (United States)

    Iber, Dagmar; Zeller, Rolf

    2012-12-01

    Limb bud development has been studied for decades and contributed a wealth of knowledge to our understanding of the molecular and cellular mechanisms that govern organogenesis in vertebrate embryos. However, the general regulatory paradigms that underlie the functional and structural organization of complex systems such as developing limb buds have remained largely elusive. A significant number of mathematical theories have been proposed to explain these developmental processes, but have rarely been validated by experimental analysis. In the age of systems biology, experimental and mathematical approaches have become interlinked and enable the experimental validation of computational models by molecular and genetic analysis. This in turn allows refinement of the mathematical simulations such that simulating limb bud development becomes increasingly more realistic. The resulting models not only detect inconsistencies in the interpretation of experimental data, but their predictive power facilitates identification of key regulatory interactions and definition of so-called core and accessory mechanisms. The ongoing integrative analysis of vertebrate limb organogenesis indicates that these network simulations may be suitable for in silico genetics, that is the computational modeling of complex loss-of-functions and gain-of-functions states. Such in silico genetic approaches will permit the simulation of complex mutant phenotypes tedious or impossible to generate using mouse molecular genetics. PMID:23266216

  13. Effect of WNT5a on chondrogenesis and limb development

    Czech Academy of Sciences Publication Activity Database

    Killinger, Michael; Veselá, Iva; Buchtová, Marcela

    2015-01-01

    Roč. 159, Suppl 1 (2015), S17-S17. ISSN 1213-8118. [Morphology 2015. International Congress of the Czech Anatomical Society /49./. Lojda Symposium on Histochemistry /52./. 06.09.2015-08.09.2015, Olomouc] R&D Projects: GA ČR(CZ) GA14-31540S Institutional support: RVO:67985904 Keywords : limb development Subject RIV: EA - Cell Biology

  14. Diagnostic distribution of non-traumatic upper limb disorders

    DEFF Research Database (Denmark)

    Laursen, Lise H; Sjøgaard, Gisela; Hagert, C G;

    2007-01-01

    BACKGROUND: Upper limb disorders (ULDs) are common, and so are the difficulties in specific diagnoses of these disorders. Prior studies have shed light on the nerves in the diagnostic approach beside disorders related to muscles, tendons and joints (MCDs). OBJECTIVE: The study aimed to compare th...

  15. Thermographic Patterns of the Upper and Lower Limbs: Baseline Data

    Science.gov (United States)

    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

  16. Short-Term Limb Immobilization Affects Cognitive Motor Processes

    Science.gov (United States)

    Toussaint, Lucette; Meugnot, Aurore

    2013-01-01

    We examined the effects of a brief period of limb immobilization on the cognitive level of action control. A splint placed on the participants' left hand was used as a means of immobilization. We used a hand mental rotation task to investigate the immobilization-induced effects on motor imagery performance (Experiments 1 and 2) and a number mental…

  17. Lower limb length and offset in total hip arthroplasty.

    Science.gov (United States)

    Flecher, X; Ollivier, M; Argenson, J N

    2016-02-01

    Restoration of normal hip biomechanics is a key goal of total hip arthroplasty (THA) and favorably affects functional recovery. Furthermore, a major concern for both the surgeon and the patient is preservation or restoration of limb length equality, which must be achieved without compromising the stability of the prosthesis. Here, definitions are given for anatomic and functional limb length discrepancies and for femoral and hip offset, determined taking anteversion into account. Data on the influence of operated-limb length and offset on patient satisfaction, hip function, and prosthesis survival after THA are reviewed. Errors may adversely impact function, quality of life, and prosthetic survival and may also generate conflicts between the surgeon and patient. Surgeons rely on two- or three-dimensional preoperative templating and on intraoperative landmarks to manage offset and length. Accuracy can be improved by using computer-assisted planning or surgery and the more recently introduced EOS imaging system. The prosthetic's armamentarium now includes varus-aligned and lateralized implants, as well as implants with modular or custom-made necks, which allow restoration of the normal hip geometry, most notably in patients with coxa vara or coxa valga. Femoral anteversion must also receive careful attention. The most common errors are limb lengthening and a decrease in hip offset. When symptoms are caused by an error in length and/or offset, revision arthroplasty may deserve consideration. PMID:26797005

  18. Effect of radiation on mouse embryonic limb development

    International Nuclear Information System (INIS)

    Extracellular matrix and molecules on the cell surface may play a role in regulating differentiation during chondrogenesis. These regulatory mechanisms are not well understood. Perturbation of developing embryonic limb buds in organ culture may provide a system for the study of intercellular interactions and regulatory mechanism. In this study, organ cultures were used to define a range of radiation doses that would induce abnormal limb development. Histochemical stains were used to detect any cellular and molecular changes. Forelimb buds of mouse embryos were explanted at 11 and 12 days of gestation (dg). One of the limb buds was irradiated with 1, 2, or 3 Gy of gamma rays, and the contralateral bud was used as a control. Both groups were incubated for 1, 2, or 3 days in center-well dishes, using BJG6 medium with 25% fetal bovine serum. Subtle effects were detectable at 1 Gy, but irradiation with 2 or 3 Gy at 11 dg led to pyknosis of the majority of nuclei in the nonchondrocytic population. At 12 dg, there was a delay of mesenchymal differentiation, and a less-well organized arrangement of chondrocytes. The authors observations demonstrate that irradiation of such cultures with doses in the range of 1 Gy and below will provide an appropriate system for studies on the normal and abnormal regulatory mechanisms involved in prenatal limb development

  19. Use of calcitonin in recalcitrant phantom limb pain complicated by heterotopic ossification

    OpenAIRE

    2015-01-01

    A common complication following amputation is phantom sensation, which may include experiencing pain in the phantom limb. This study details the management of phantom limb pain in a 72-year-old man, in whom comorbid heterotopic ossification was present. In addition, the authors provide a review of the literature regarding phantom limb pain management, and summarize the current understanding of heterotopic ossification and its possible link to peripheral nerve injury.BACKGROUND: Phantom limb p...

  20. Use of Calcitonin in Recalcitrant Phantom Limb Pain Complicated by Heterotopic Ossification

    OpenAIRE

    Ricardo Viana; Michael WC Payne

    2015-01-01

    A common complication following amputation is phantom sensation, which may include experiencing pain in the phantom limb. This study details the management of phantom limb pain in a 72-year-old man, in whom comorbid heterotopic ossification was present. In addition, the authors provide a review of the literature regarding phantom limb pain management, and summarize the current understanding of heterotopic ossification and its possible link to peripheral nerve injury.BACKGROUND: Phantom limb p...

  1. Environmental monitoring for the DOE coolside and LIMB demonstration extension projects

    Energy Technology Data Exchange (ETDEWEB)

    White, T.; Contos, L.; Adams, L. (Radian Corp., Research Triangle Park, NC (United States). Progress Center)

    1992-02-01

    The purpose of this document is to present environmental monitoring data collected during the US DOE Limestone Injection Multistage Burner (LIMB) Demonstration Project Extension. The objective of the LIMB program is to demonstrate the sulfur dioxide (SO{sub 2}) and nitrogen oxide (NO{sub x}) emission reduction capabilities of the LIMB system. The LIMB system is a retrofit technology to be used for existing coal-fired boilers equipped with electrostatic precipitators. (VC)

  2. Medications and Blood Pressure

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More Medications and Blood Pressure Updated:Jul 6,2016 When your blood pressure ... was last reviewed on 08/04/2014. High Blood Pressure • Home • About High Blood Pressure (HBP) • Why HBP ...

  3. Alternatives to Blood Transfusion

    Science.gov (United States)

    ... saved articles window. My Saved Articles » My ACS » Blood Transfusion and Donation + - Text Size Download Printable Version [PDF] » TOPICS Document ... Possible risks of blood transfusions Alternatives to blood transfusions Donating blood Blood donation by cancer survivors To learn more References Previous ...

  4. Disorders of Upper Limb Movements in Ataxia-Telangiectasia.

    Directory of Open Access Journals (Sweden)

    Aasef G Shaikh

    Full Text Available Ataxia-telangiectasia is known for cerebellar degeneration, but clinical descriptions of abnormal tone, posture, and movements suggest involvement of the network between cerebellum and basal ganglia. We quantitatively assessed the nature of upper-limb movement disorders in ataxia-telangiectasia. We used a three-axis accelerometer to assess the natural history and severity of abnormal upper-limb movements in 80 ataxia-telangiectasia and 19 healthy subjects. Recordings were made during goal-directed movements of upper limb (kinetic task, while arms were outstretched (postural task, and at rest. Almost all ataxia-telangiectasia subjects (79/80 had abnormal involuntary movements, such as rhythmic oscillations (tremor, slow drifts (dystonia or athetosis, and isolated rapid movements (dystonic jerks or myoclonus. All patients with involuntary movements had both kinetic and postural tremor, while 48 (61% also had resting tremor. The tremor was present in transient episodes lasting several seconds during two-minute recording sessions of all three conditions. Percent time during which episodic tremor was present was greater for postural and kinetic tasks compared to rest. Resting tremor had higher frequency but smaller amplitude than postural and kinetic tremor. Rapid non-rhythmic movements were minimal during rest, but were triggered during sustained arm postures and goal directed arm movements suggesting they are best considered a form of dystonic jerks or action myoclonus. Advancing age did not correlate with the severity of involuntary limb movements. Abnormal upper-limb movements in ataxia-telangiectasia feature classic cerebellar impairment, but also suggest involvement of the network between the cerebellum and basal ganglia.

  5. Reoperations for occluded arterial bypasses in the lower limbs

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background We reviewed the outcomes of reoperations for 29 patients (30 limbs) who had undergone occluded arterial bypass in the lower limbs from May 1996 to September 2005. Methods The 30 lower limbs of the 29 patients with arteriosclerotic obstruction received 44 reoperations, including thrombectomy alone (group T, 27) and inflow or outflow reconstruction plus thrombectomy (group C, 17). Among the 17 operations in group C, 17.6% (3/17) were inflow reconstructions involving the axillary-femoral (1), aorta-iliac (1) and aorta-femoral (1) arteries, and 76.4% (13/17) outflow reconstructions involving the femoral-popliteal bypass-tibial (8), femoral-tibial (1), femoral-popliteal bypass-popliteal arteries below the knee (2), and the femoral-popliteal bypass-tibial-peroneal trunk (2). One patient (1 limb) underwent both inflow and outflow reconstructions with an iliac arterial stent and a graft-popliteal anastomosis patch. Polytetrafluoroethylene (PTFE) grafts were used in the inflow or outflow reconstructions abve the knee. Autovenous grafts or autovenously combined PTFE grafts were used in the outflow reconstructions below the knee. Results The percentages of Fontaine stage III and IV before primary operation and reoperation were 60% (18/30) and 86.7% (26/30), respectively (P0.05). Among 42 reoperations, 19 failed within 1 month in groups T (16) and C (3) (P0.05). The rate of limb salvage was 64.29% (18/28). Conclusions The percentages of Fontaine stage III and IV before reoperation may be much higher than those before primary operation. Thrombectomy plus inflow/outflow reconstruction creates patency better than thrombectomy alone for re-occluded bypass.

  6. Quality of Life of Nigerians with Unilateral Lower Limb Amputation

    Directory of Open Access Journals (Sweden)

    Christopher Olusanjo Akosile

    2013-02-01

    Full Text Available Purpose: The aims of this study were to determine the QoL of Nigerians with lower limb amputation and to investigate the influence of some clinical and socio-demographic variables on it. Method: Forty-seven individuals with lower limb amputation participated in this study. Participants’ age, gender, marital status, occupation, time since amputation, level of amputation, affected limb and use of prosthesis were recorded. Quality of life was then measured using the WHO QOL-BREF. Data were analysed using mean and standard deviation, Mann-Whitney U test and Kruskal-Wallis test at 0.05 alpha levels. Results: Participants’ overall health and QoL scores were 3.6(SD 0.9 and 3.9(SD 0.7 respectively. Male subjects had significantly higher scores than females in the domains of physical health (p = 0.007, social relationships (p = 0.024 and overall health (p = 0.012. Prosthesis-wearing subjects scored significantly higher in the domains of physical health (p = 0.015, psychological health (p = 0.008 and environment (p = 0.011 and overall health (0.033, than those not wearing prosthesis. Level of amputation, leg dominance and pre-amputation occupational category had no significant influence on participants’ QoL. Conclusion: The findings of this study suggest that the QoL of individuals with lower limb amputation in Nigeria is moderate. The only factors which have significant influence on some QoL domains are gender and use of prosthesis.Implications: Individuals with lower limb amputation, particularly females and those not wearing prosthesis, require special attention. Clinicians should identify barriers to the use of prosthesis so as to enhance their quality of life.

  7. Lower Limb Neuromuscular Asymmetry in Volleyball and Basketball Players

    Directory of Open Access Journals (Sweden)

    Fort-Vanmeerhaeghe Azahara

    2016-04-01

    Full Text Available The primary objective of the present study was to evaluate the agreement between the dominant leg (DL (determined subjectively and the stronger leg (SL (determined via a functional test in a group of basketball and volleyball players. The secondary objective was to calculate lower limb neuromuscular asymmetry when comparing the DL vs the non-dominant leg (NDL and the SL vs the weaker (WL leg in the whole group and when differentiating by sex. Seventy-nine male and female volleyball and basketball players (age: 23.7 ± 4.5 years performed three single-leg vertical countermovement jumps (SLVCJ on a contact mat. Vertical jump height and an inter-limb asymmetry index (ASI were determined. Only 32 (40% of the subjects had a concordance between the perception of their dominant leg and the limb reaching the highest jump height. Using the DL as the discriminating variable, significant (p<0.05 inter-limb differences were found in the total group of players. When comparing between sexes, significant differences (p<0.05 arose in the female group only. With regard to the WL vs. the SL, significant (p<0.05 differences were noted in the whole group and when stratified into males and females. The mean ASI ranged from 9.31% (males to 12.84% (females and from 10.49% (males to 14.26% (females, when comparing the DL vs. the NDL and the SL vs. the WL, respectively. Subjective expression of leg dominance cannot be used as a predictor of limb jump performance. Vertical jump asymmetry of 10-15% exists and this can be considered as a reference value for male and female basketball and volleyball players.

  8. Development of an implantable transverse intrafascicular multichannel electrode (TIME) system for relieving phantom limb pain

    OpenAIRE

    Jensen W.; Micera S.; Navarro X.; Stieglitz T.; Guiraud D.; Divoux J.L.; Rossini P.M.; Yoshida K.

    2010-01-01

    Phantom limb pain frequently follows amputation. Currently there is no fully effective treatment available. Our aim is to develop an innovative Human Machine Interface (HMI) where we apply multi-channel microstimulation to the nerve stump of an amputee subject to manipulate the phantom limb sensations and explore the possibility of using microstimulation as a treatment for phantom limb pain.

  9. Motor Impairment Evaluation for Upper Limb in Stroke Patients on the Basis of a Microsensor

    Science.gov (United States)

    Huang, Shuai; Luo, Chun; Ye, Shiwei; Liu, Fei; Xie, Bin; Wang, Caifeng; Yang, Li; Huang, Zhen; Wu, Jiankang

    2012-01-01

    There has been an urgent need for an effective and efficient upper limb rehabilitation method for poststroke patients. We present a Micro-Sensor-based Upper Limb rehabilitation System for poststroke patients. The wearable motion capture units are attached to upper limb segments embedded in the fabric of garments. The body segment orientation…

  10. Brain abnormalities underlying limb apraxia in corticobasal degeneration: an fMRI study

    OpenAIRE

    Beauchet, Olivier; Giraux, Pascal; Schneider, Fabien; Peyron, Roland; Barral, Fabrice; Laurent, Bernard

    2001-01-01

    Corticobasal degeneration is a neurodegenerative disease characterized, by cortical dysfunction and extrapyramidal signs. The most consistent symptom is a unilateral limb apraxia, which consists of an isolated disorder of gestural production involving primarily the upper limb. The objective of this study is to investigate the functional abnormalities that may underlie motor dysfunction, and those which might correlate to the severity of limb apraxia.

  11. The application of hybrid technique in treating arterial embolism of limbs

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical effect of the hybrid technique, i.e. arteriotomic thrombectomy together with endovascular therapy, in treating arterial embolism of limbs. Methods: During the period from June 2011 to June 2013 at authors' hospital, hybrid operation was carried out in 82 patients with arterial embolism of limbs. A total of 91 diseased limbs, including 8 upper limbs and 83 lower limbs, were treated. Arterial angiography of the extremity was routinely performed first, which was followed by catheterization. After the guild-wire passed through the clot a Fogarty catheter was inserted along the guild- wire, and under DSA monitoring embolectomy or balloon-assisted thrombectomy was performed. Based on the postoperative angiography findings, transcatheter thrombolysis, balloon angioplasty and/or stenting were employed. All the patients were followed up for 3-36 months. The improvement of limb ischemia and the limb salvage rate were analyzed. Results: Hybrid operation was successfully performed in all patients. The procedures included balloon-assisted embolectomy (n=6), transcatheter thrombolysis following embolectomy (n=24), balloon angioplasty following embolectomy (n=11) and stenting following embolectomy (n=4). Limb salvage rate was 83.5% (76/91), leaving dysfunction in 11 limbs. Complete recovery was obtained in 65 limbs (71.4%), and 7 patients died during perioperative period. During the follow-up period, the previously diseased arteries remained patent. Conclusion: For the treatment of limb arterial embolism, the hybrid operation has higher limb salvage rate and cure rate. (authors)

  12. Molecular mechanism of limbs' postischemic revascularization improved by perindopril in diabetic rats

    Institute of Scientific and Technical Information of China (English)

    GAO Lu; YU De-min

    2008-01-01

    Background Currently,there are still divergent opinions about the mechanisms of the impaired neovascularization in diabetic subjects.Due to the remarkable therapeutic effect of angiotensin-converting enzyme inhibititors (ACEIs) on the reduction of blood pressure and the protection of target organs,the clinical application of this kind of drugs is very widespread.However,it is still not clear about the role and related molecular pathway of this kind of drugs in the limbs'postischemic revascularization.It is of major therapeutic importance to resolve these questions.This study aimed to investigate the reasons of the impaired angiogenesis in the hind limbs of rats with diabetic ischemia,the role and related molecular mechanisms of ACEI in postischemic revascularization.Methods Hind limbs ischemia was induced in diabetic rats by right femoral artery excision.Diabetic rats were randomly allocated to one of the following treatments for 4 weeks:ACEI by perindopril;perindopril in combination with a nitric oxide synthase (NOS) inhibitor;perindopril in combination with bradykinin (BK)-B1 receptor (B1R) antagonist or saline.The differences of angiogenesis,the mRNA and protein expression of endothelial nitric oxide synthase (eNOS),vascular endothelial growth factor (VEGF) and basic fibroblast (bFGF),constitutive nitric oxide synthase (cNOS) activity and nitric oxide (NO) content were observed after treatment.Results In non-ischemic hind limbs,no significant changes in capillary density,or the mRNA and protein expression of eNOS,VEGF and bFGF,or the NO content and the cNOS activity were observed among all groups.On the contrary,in ischemic hind limbs,the capillary density in diabetic rats decreased by 27% when compared with the control rats,so did the mRNA and protein expression of eNOS,VEGF and bFGF,or the NO content and the cNOS activity (P<0.05).The capillary density was increased by 1.65-fold in the perindopril treatment group in reference to untreared diabetic rats

  13. High Blood Pressure

    Science.gov (United States)

    ... normal blood pressure 140/90 or higher is high blood pressure Between 120 and 139 for the top number, ... prehypertension. Prehypertension means you may end up with high blood pressure, unless you take steps to prevent it. High ...

  14. Postpartum Blood Clots

    Science.gov (United States)

    ... Infection Postpartum Blood Clots Postpartum Thyroid Disorders Postpartum Depression The risk of developing blood clots (thrombophlebitis) is increased for about 6 to 8 weeks after delivery (see Thromboembolic Disorders During Pregnancy ). Typically, blood clots occur in the deep veins ...

  15. Blood Type Puzzle.

    Science.gov (United States)

    Kelly, Janet

    1997-01-01

    Presents a blood type puzzle that provides a visual, hands-on mechanism by which students can examine blood group reactions. Offers students an opportunity to construct their own knowledge about blood types. (JRH)

  16. High blood pressure - infants

    Science.gov (United States)

    National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics . ...

  17. Low Blood Glucose (Hypoglycemia)

    Science.gov (United States)

    ... Other Dental Problems Diabetic Eye Disease Low Blood Glucose (Hypoglycemia) What is hypoglycemia? Hypoglycemia, also called low ... actions can also help prevent hypoglycemia: Check blood glucose levels Knowing your blood glucose level can help ...

  18. What Is Blood?

    Science.gov (United States)

    ... Our Member Blood Centers Our Partners What is blood? PUBLICATIONS EDUCATION PRESS ROOM BLOG CAREERS CONTACT ABC ... for patients who need it. One unit of blood can be separated into the following components: Nearly ...

  19. Ketones blood test

    Science.gov (United States)

    ... Ketones - serum; Nitroprusside test; Ketone bodies - serum; Ketones - blood ... A blood sample is needed. ... When the needle is inserted to draw blood, some people feel slight ... there may be some throbbing or a slight bruise. This soon ...

  20. Magnesium blood test

    Science.gov (United States)

    Magnesium - blood ... A blood sample is needed. ... When the needle is inserted to draw blood, some people feel slight pain. Others feel a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon ...

  1. High Blood Pressure Facts

    Science.gov (United States)

    ... Heart Disease Cholesterol Salt Million Hearts® WISEWOMAN High Blood Pressure Facts Recommend on Facebook Tweet Share Compartir ... facts about high blood pressure [PDF-255K] . High Blood Pressure in the United States About 70 million ...

  2. Managing your blood sugar

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000086.htm Managing your blood sugar To use the sharing features on this page, ... way your doctor or nurse recommends. Check your Blood Sugar Often Checking your blood sugar levels often and ...

  3. High blood sugar

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000332.htm High blood sugar To use the sharing features on this page, ... later when energy is needed. Symptoms of High Blood Sugar Symptoms of high blood sugar can include: Being ...

  4. Home blood sugar testing

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000324.htm Home blood sugar testing To use the sharing features on this ... with their nutrition and activity plans. Check Your Blood Sugar Often Usual times to test your blood sugar ...

  5. Hyperglycemia (High Blood Glucose)

    Medline Plus

    Full Text Available ... Blood Pressure Physical Activity High Blood Glucose My Health Advisor Tools To Know Your Risk Alert Day ... DKA (Ketoacidosis) & Ketones Kidney Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing ...

  6. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... back to top How are Blood Clots in Pregnant Women Treated? Typically, blood clots are treated with ... you think you have one. If you are pregnant and have concerns about blood clots, talk with ...

  7. Hyperglycemia (High Blood Glucose)

    Medline Plus

    Full Text Available ... symptoms include the following: High blood glucose High levels of sugar in the urine Frequent urination Increased ... you should check and what your blood glucose levels should be. Checking your blood and then treating ...

  8. High Blood Pressure

    Science.gov (United States)

    ... pressure and should be taken seriously. Over time, consistently high blood pressure weakens and damages ... of landmark NIH blood pressure study confirm that lower blood pressure target can reduce ...

  9. Comparison of three skin-stretching devices for closing skin defects on the limbs of dogs.

    Science.gov (United States)

    Tsioli, Vassiliki; Papazoglou, Lysimachos G; Papaioannou, Nikolaos; Psalla, Dimitra; Savvas, Ioannis; Pavlidis, Leonidas; Karayannopoulpou, Maria

    2015-01-01

    Our objective was to evaluate the effectiveness of skin-stretching devices for closing defects on the extremities of dogs. Antebrachial skin defects were created on the limbs of 24 dogs randomly divided into three groups. Skin stretchers included staples and sutures passing through them (group A), sutures and hypodermic needles (group B), and Pavletic device (group C). Wounds on the left were further undermined in all groups. Tension and blood perfusion were assessed. After removing the stretchers on day 3, the defects were sutured and wound healing was clinically scored. Histological variables evaluated were cellular infiltration, edema, collagen orientation, and thickness of epidermis. Significant differences in tension were found among groups (p 0.0005) and between measurement times for undermined (p = 0.001) or non-undermined (p wounds. In contrast, blood perfusion values did not differ significantly. Clinical scores for group B seemed to be better than those for groups A and C, but differences were not significant. Primary wound closure using the Pavletic device was not feasible. No significant differences in histological variables were found between groups. Skin stretching with staples or hypodermic needles resulted in successful wound management with minor side effects on skin histology and circulation. PMID:25269717

  10. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... these blood conditions and increase research on the causes, prevention, and treatment. Blood clots are also potentially ... immobility (e.g., bedrest, long distance travel) ...

  11. Early and effective use of ketamine for treatment of phantom limb pain

    Directory of Open Access Journals (Sweden)

    Harsha Shanthanna

    2010-01-01

    Full Text Available Treatment for phantom limb pain is difficult and challenging. There is often suboptimum treatment with fewer than 10% receiving lasting relief. Treatments based broadly on other neuropathic pains may not be appropriate for a clinical success. We report a case of phantom limb pain, which proved resistant to multiple analgesics, including opioids and continuous epidural blockade. Treatment with intravenous (IV ketamine as an alternate day infusion, gave complete remission of phantom limb pain. This demonstrates an early and effective use of a potent NMDA antagonist for treatment of phantom limb pain. Mechanisms underlying phantom limb pain are briefly discussed.

  12. Motor cortex changes after amputation are modulated by phantom limb motor control rather than pain

    DEFF Research Database (Denmark)

    Raffin, Estelle E.; Pascal, Giraux,; Karen, Reilly,; Nathalie, Richard,

    retains a residual M1-c activity when amputees perform phantom limb movements (4-5). Except a correlation between phantom limb pain and M1-c expansion of the face (2-3), the relationship between the ability to voluntary move the phantom hand, the level of phantom limb pain, the degree of M1-c......Amputation of a limb induces reorganization within the contralateral primary motor cortex (M1-c) (1-3). In the case of hand amputation, M1-c areas evoking movements in the face and the remaining part of the upper-limb expand toward the hand area. Despite this expansion, the amputated hand still...

  13. The phantom and the supernumerary phantom limb: historical review and new case.

    Science.gov (United States)

    Cipriani, Gabriele; Picchi, Lucia; Vedovello, Marcella; Nuti, Angelo; Fiorino, Mario Di

    2011-12-01

    The way we experience the world is determined by the way our brain works. The phantom limb phenomenon, which is a delusional belief of the presence of a non-existent limb, has a particular fascination in neurology. This positive phenomenon of the phantom limb raises theoretical questions about its nature. After a stroke, some patients experience the perception of an extra limb in addition to the regular set of two arms and two legs. This complex cognitive and perceptual distortion is called supernumerary phantom limb. Here, we review the pathogenesis and historical aspects, and report a new case. PMID:22108813

  14. Interventional treatment of diabetic ischemic diseases of lower limb:a therapeutic observation

    International Nuclear Information System (INIS)

    Objective: To assess the clinical effects of endovascular interventional treatment for diabetic ischemic diseases of lower limb. Methods: Endovascular interventional management was performed in 47 patients with diabetic ischemic diseases of lower limb. The ankle-to-brachial index and the diameter of lower limb vessel were estimated both before the treatment and 3, 30 days after the treatment. The results were compared and analyzed. Results: Obvious improvement in ankle-to-brachial index and the diameter of lower limb vessel were observed after the treatment. Conclusion: Endovascular interventional treatment is very effective and reliable for diabetic ischemic diseases of lower limb. (authors)

  15. Soft-tissue inflammatory myofibroblastic tumors (IMTs) of the limbs: potential and limits of diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Masciocchi, Carlo; Lanni, Giuseppe; Conti, Laura; Conchiglia, Armando; Fascetti, Eva; Barile, Antonio [University of L' Aquila, S. Salvatore Hospital, Department of Radiology, Coppito, L' Aquila (Italy); Flamini, Stefano [S. Salvatore Hospital, Department of Orthopaedic Surgery, Coppito, L' Aquila (Italy); Coletti, Gino [S. Salvatore Hospital, Department of Pathology, Coppito, L' Aquila (Italy)

    2012-06-15

    The objective of this work was to evaluate the potential of diagnostic imaging in the identification, localization, and characterization of soft-tissue inflammatory myofibroblastic tumors (IMTs) of limbs with correlation to differential diagnosis and therapy. From a retrospective analysis of 324 histologically verified soft-tissue lesions of limbs and extremities diagnosed in our institute from January 2002 to July 2010, we selected seven cases of histologically proven IMT. These included six males and one female, aged between 28 and 81 years (mean age, 57 years). Lesions were localized in three cases to the thigh, in two cases to the popliteal space, and in the remaining two cases, to the shoulder girdle. All patients were evaluated on the basis of US, CT, and MRI. Ultrasound detected the presence of a non-homogeneous solid formation in all cases and calcifications in three cases. CT showed the presence and type of calcification/ossification and bone reaction. On MRI, all cases had low signal intensity on SE T1-weighted sequences and an intermediate-low signal intensity on SE and FSE T2-weighted sequences in six of them; only one case had an intermediate-high signal intensity on SE and FSE T2-weighted sequences. Both contrast-enhanced CT and MRI showed precocious enhancement in association with multiple peripheral hypertrophic blood vessels. On the basis of integrated imaging data obtained by US, CT, and MRI, it is possible to evaluate the lesion extension to provide a loco-regional staging, to characterize IMTs, and to allow an optimal therapeutical planning. (orig.)

  16. Flow-mediated dilation in the inactive limb following acute hypoxic exercise.

    Science.gov (United States)

    Katayama, Keisho; Yamashita, Shin; Iwamoto, Erika; Ishida, Koji

    2016-01-01

    The purpose of this study was to elucidate the effect of acute aerobic exercise performed under hypoxic conditions on flow-mediated dilation (FMD) in the inactive limb. Seven males participated in the study. The subjects performed two submaximal leg cycling on a semirecumbent ergometer at the same relative intensity (60% peak oxygen uptake) in normoxia [inspired oxygen fraction (FIO2) = 0·21] and hypoxia (FIO2 = 0·12-0·13) for 30 min. The brachial artery diameter and blood velocity during exercise were measured via ultrasound, and the antegrade and retrograde shear rates were calculated. Before and 5, 30 and 60 min after exercise, brachial artery FMD was measured in normoxia. FMD was estimated as the percentage increase in peak diameter from the baseline diameter at prior occlusion (%FMD) and as the controlling changes in baseline diameter (the corrected-%FMD). No difference in antegrade shear rate during exercise was detected between the normoxic and hypoxic conditions, whereas the retrograde shear rate was larger during hypoxic exercise. The %FMD decreased significantly at 5 min after exercise in both normoxia and hypoxia, and it returned to pre-exercise levels within 60 min of recovery. Significant decreases in FMD at 5 min after exercise had disappeared when the baseline diameter was controlled using an analysis of covariance (the corrected-%FMD). No significant differences were observed between the normoxic and hypoxic trials in the %FMD and corrected-%FMD following exercise. These results suggest that hypoxia has no impact on endothelial function in the inactive limb following acute aerobic exercise. PMID:25257848

  17. Soft-tissue inflammatory myofibroblastic tumors (IMTs) of the limbs: potential and limits of diagnostic imaging

    International Nuclear Information System (INIS)

    The objective of this work was to evaluate the potential of diagnostic imaging in the identification, localization, and characterization of soft-tissue inflammatory myofibroblastic tumors (IMTs) of limbs with correlation to differential diagnosis and therapy. From a retrospective analysis of 324 histologically verified soft-tissue lesions of limbs and extremities diagnosed in our institute from January 2002 to July 2010, we selected seven cases of histologically proven IMT. These included six males and one female, aged between 28 and 81 years (mean age, 57 years). Lesions were localized in three cases to the thigh, in two cases to the popliteal space, and in the remaining two cases, to the shoulder girdle. All patients were evaluated on the basis of US, CT, and MRI. Ultrasound detected the presence of a non-homogeneous solid formation in all cases and calcifications in three cases. CT showed the presence and type of calcification/ossification and bone reaction. On MRI, all cases had low signal intensity on SE T1-weighted sequences and an intermediate-low signal intensity on SE and FSE T2-weighted sequences in six of them; only one case had an intermediate-high signal intensity on SE and FSE T2-weighted sequences. Both contrast-enhanced CT and MRI showed precocious enhancement in association with multiple peripheral hypertrophic blood vessels. On the basis of integrated imaging data obtained by US, CT, and MRI, it is possible to evaluate the lesion extension to provide a loco-regional staging, to characterize IMTs, and to allow an optimal therapeutical planning. (orig.)

  18. Repetitive training for ameliorating upper limbs spasm of hemiplegic patients

    Institute of Scientific and Technical Information of China (English)

    Lin Zhu; Lin Liu; Weiqun Song

    2006-01-01

    BACKGROUND:The main aim of rehabilitation is to ameliorate motor function and use the damaged limbs in the activities of daily living.Several factors are needed in the self-recovery of the patients,and the most important one is to reduce spasm.Some mechanical repetitive movements can affect and change the excitability of motor neurons.OBJECTIVE:To observe the effect of repetitive training on ameliorating spasm of upper limbs of hemiplegic patients.DESIGN:A self-controlled observation before and after training.SETTING:Department of Rehabilitation,Xuanwu Hospital of Capital Medical University.PARTICI PANTS: Seven hemiplegic patients induced by brain injury were selected from the Department of Rehabilitation,Xuanwu Hospital,Capital Medical University from March to June in 2005.Inclusive criteria:①Agreed and able to participate in the 30-minute training of hand function; ②Without disturbance of understanding.The patients with aphasia or apraxia,manifestation of shoulder pain,and severe neurological or mental defects.For the 7 patients,the Rivermead motor assessment(RMA)scores ranged 0-10 points,the Rivermead mobility index(RMI)ranged 1-3,and modified Ashworth scale(MAS)was grade 2-4.Their horizontal extension of shoulder joint was 0°-30°,anteflextion was 0°-50°,internal rotation was 50°-90°,external rotation was 0°-10°:and the elbow joint could extend for 15°-135°.METHODS:The viva 2 serial MOTOmed exerciser(Reck Company,Germany)was used.There were three phases of A-B-A.①The phase A lasted for 1 week.The patient sat on a chair facting to the MOTOmed screen.and did the circumduction of upper limbs forwardly,30 minutes a day and 5 days a week.②The phase B lasted for 3 weeks.The training consisted of forward circumduction of upper limbs for 15 minutes.followed by backward ones for 15 minutes and 5-minute rest.③The training in the phase A was performed again for 2 weeks.The extensions of upper limbs were recorded at phase A,the extension and flexion of

  19. Knee functional recovery and limb-to-limb symmetry restoration after anterior cruciate ligament (ACL) rupture and ACL reconstruction

    Science.gov (United States)

    Nawasreh, Zakariya Hussein

    Anterior cruciate ligament (ACL) rupture is a common sport injury of young athletes who participate in jumping, cutting, and pivoting activities. Although ACL reconstruction (ACLR) surgery has the goal of enabling athletes to return to preinjury activity levels, treatment results often fall short of this goal. The outcomes after ACLR are variable and less than optimal with low rate of return to preinjury activity level and high risk for second ACL injury. Factors related to the knee functional limitations, strength deficits, and limb-to-limb movement asymmetry may be associated with poor outcomes after ACLR. Additionally, the criteria that are used to determine a patient's readiness to return to the preinjury activity level are undefined which may also be associated with poor outcomes after ACLR. The clinical decision-making to clear patients' for safe and successful return to high physical activities should be based on a universal comprehensive set of objective criteria that ensure normal knee function and limb-to-limb symmetry. A battery of return to activity criteria (RTAC) that emphases normal knee function and limb-to-limb movement symmetry has been constituted to better ensure safe and successful return to preinjury activity level. Yet, only variables related to patients' demographics, concomitant injuries, and treatment measures have been used to predict return to preinjury activity levels after ACLR. However, the ability of RTAC variables that ensure normal knee function and limb movement symmetry to predict the return to participate in the same preinjury activity level after ACLR has not been investigated. In light of this background, the first aim of the present study was to compare functional knee performance-based and patient-reported measures of those who PASS and who FAIL on RTAC at 6 months (6-M) following ACLR with those at 12 months (12-M) and 24 months (24-M) following ACLR and to determine how performance-based and patient-reported measures

  20. Automatic limb identification and sleeping parameters assessment for pressure ulcer prevention.

    Science.gov (United States)

    Baran Pouyan, Maziyar; Birjandtalab, Javad; Nourani, Mehrdad; Matthew Pompeo, M D

    2016-08-01

    Pressure ulcers (PUs) are common among vulnerable patients such as elderly, bedridden and diabetic. PUs are very painful for patients and costly for hospitals and nursing homes. Assessment of sleeping parameters on at-risk limbs is critical for ulcer prevention. An effective assessment depends on automatic identification and tracking of at-risk limbs. An accurate limb identification can be used to analyze the pressure distribution and assess risk for each limb. In this paper, we propose a graph-based clustering approach to extract the body limbs from the pressure data collected by a commercial pressure map system. A robust signature-based technique is employed to automatically label each limb. Finally, an assessment technique is applied to evaluate the experienced stress by each limb over time. The experimental results indicate high performance and more than 94% average accuracy of the proposed approach. PMID:27268736

  1. Scintigraphic method for evaluating reductions in local blood volumes in human extremities

    DEFF Research Database (Denmark)

    Blønd, L; Madsen, Jan Lysgård

    2000-01-01

    experiment. Evaluation of one versus two scintigraphic projections, trials for assessment of the reproducibility, a comparison of the scintigraphic method with a water-plethysmographic method and registration of the fractional reduction in blood volume caused by exsanguination as a result of simple elevation...... were carried out. No significant differences between results obtained by the use of one or two scintigraphic projections were found. The between-subject coefficient of variation was 14% in the lower limb experiment and 11% in the upper limb experiment. The within-subject coefficient of variation was 6...

  2. Phantom limb pain: an energy/trauma model.

    Science.gov (United States)

    Leskowitz, Eric

    2014-01-01

    Phantom limb pain (PLP) is a form of chronic neuropathic pain that responds poorly to treatment interventions derived from the neuroanatomic understanding of pain and analgesia. Several new psychological and behavioral treatments that have proven more effective have been explained by invoking neural plasticity as their mechanism of action. Other novel treatments that are based on an "energy medicine" model also appear to be quite effective, especially when addressing the psychological trauma of the amputation itself, a factor that is generally overlooked in the standard surgical approach to limb amputation. A speculative trauma/energy model for the etiology of PLP is proposed. This model is developed in some detail, and its utility in explaining several anomalous aspects of PLP, as well as the clinical efficacy of energy therapies, is outlined. This model is proposed as a step in the development of simple and effective energy/trauma treatment protocols for this widespread and largely treatment-resistant disorder. PMID:25264368

  3. Dynamics of skeletal pattern formation in developing chick limb.

    Science.gov (United States)

    Newman, S A; Frisch, H L

    1979-08-17

    During development of the embryonic chick limb the skeletal pattern is laid out as cartilaginous primordia, which emerge in a proximodistal sequence over a period of 4 days. The differentiation of cartilage is preceded by changes in cellular contacts at specific locations in the precartilage mesenchyme. Under realistic assumptions, the biosynthesis and diffusion through the extracellular matrix of a cell surface protein, such as fibronectin, will lead to spatial patterns of this molecule that could be the basis of the emergent primordia. As cellular differentiation proceeds, the size of the mesenchymal diffusion chamber is reduced in descrete steps, leading to sequential reorganizations of the morphogen pattern. The successive patterns correspond to observed rows of skeletal elements, whose emergence, in theory and in practice, depends on the maintenance of a unique boundary condition at the limb bud apex. PMID:462174

  4. Ocular, bulbar, limb, and cardiopulmonary involvement in oculopharyngeal muscular dystrophy

    DEFF Research Database (Denmark)

    Witting, N; Mensah, A; Køber, L;

    2014-01-01

    OBJECTIVES: To assess skeletal muscle weakness and progression as well as the cardiopulmonary involvement in oculopharyngeal muscular dystrophy (OPMD). MATERIALS AND METHODS: Cross-sectional study including symptomatic patients with genetically confirmed OPMD. Patients were assessed by medical...... history, ptosis, ophthalmoplegia, facial and limb strength, and swallowing capability. Cardiopulmonary function was evaluated using forced expiratory capacity in 1 s (FEV1), electrocardiogram (ECG), Holter monitoring, and echocardiography. RESULTS: We included 13 symptomatic patients (six males, mean age......; 64 years (41-80) from 8 families. Ptosis was the first symptom in 8/13 patients followed by limb weakness in the remaining 5 patients Dysphagia was never the presenting symptom. At the time of examination, all affected patients had ptosis or had previously been operated for ptosis, while...

  5. Unilateral linear pansclerotic morphea affecting face and limbs.

    Science.gov (United States)

    Padmavathy, L; Rao, Lakshmana L

    2005-01-01

    Disabling pansclerotic morphea is a rare atrophying and sclerosing disorder of the subcutaneous tissue, muscle and bone. It is characterized by atrophy of the skin, subcutaneous fat, muscle and bone involving half of the face. In some patients the atrophic lesions extend to involve the ipsilateral or contralateral upper and lower limbs with radiological evidence of hemiatrophy. The patients may present with arthralgia, convulsions or cramps. We report a case of a woman with deformity of face, and left upper and lower limbs that had started as an indurated plaque on the left half of forehead at the age of 5 years and had gradually enlarged, followed by the development of atrophic changes in left eye. The case is being reported in view of its rare occurrence. PMID:16394411

  6. Unilateral linear pansclerotic morphea affecting face and limbs

    Directory of Open Access Journals (Sweden)

    Padmavathy L

    2005-01-01

    Full Text Available Disabling pansclerotic morphea is a rare atrophying and sclerosing disorder of the subcutaneous tissue, muscle and bone. It is characterized by atrophy of the skin, subcutaneous fat, muscle and bone involving half of the face. In some patients the atrophic lesions extend to involve the ipsilateral or contralateral upper and lower limbs with radiological evidence of hemiatrophy. The patients may present with arthralgia, convulsions or cramps. We report a case of a woman with deformity of face, and left upper and lower limbs that had started as an indurated plaque on the left half of forehead at the age of 5 years and had gradually enlarged, followed by the development of atrophic changes in left eye. The case is being reported in view of its rare occurrence.

  7. Three-dimensional imaging of lower limb neuropathies.

    Science.gov (United States)

    Ahlawat, Shivani; Carrino, John A

    2015-04-01

    Peripheral nerve pathology can be detected on high-resolution MRI on the basis of primary or secondary findings. Primary findings of nerve pathology include alterations in signal, course, and caliber; secondary findings include skeletal muscle denervation. Although two-dimensional (2D) MRI sequences comprised of a combination of fluid-sensitive and non-fat-suppressed anatomical sequences can detect changes in nerve size, signal, course, and architecture, three-dimensional (3D) imaging can play an important role in the detection and characterization of nerve pathology including caliber changes at typical compression sites, anomalous course, and nerve discontinuity. This article discusses the benefits of 3D MRI with respect to lower limb neuropathies. The article also reviews the normal anatomy of the nerves in the lower extremity from the hip joint to the foot, and it illustrates common causes and the imaging appearance of lower limb peripheral neuropathy. PMID:25764241

  8. Computer assisted surgery for malunited fractures in upper limb

    International Nuclear Information System (INIS)

    Our objective was to evaluate the usefulness of computer-assisted preoperative simulation of malunited fractures in the upper limb. Ten patients with malunited fractures underwent multislice computed tomography of both upper limbs with reconstruction of three-dimensional bone models using three-dimensional (3D) software. Preoperative simulation was comprised of four main procedures: performance of virtual corrective osteotomy, matching of reposition with a mirror-image model of the unaffected side, creating new data for the bone defect, and machining of an hydroxyapatite block as bone graft. In addition, we used full-sized three-dimensional virtual reality modeling with a rapid prototyping molding device, and performed preoperative rehearsals of osteotomies using plaster models. All patients tolerated the surgical procedure well. This technique permits the surgeon to recognize and correct three-dimensional deformities of malunited fracture with both accuracy and precision. (author)

  9. Radiographic imaging for Ilizarov limb lengthening in children

    International Nuclear Information System (INIS)

    The Ilizarov method for limb lengthening is rapidly gaining popularity in North America. Use of this new technique has necessitated modifications in radiographic protocol. Initial imaging problems gained from our experience with twenty children are detailed including accurate centering for the plain films, correcting for magnification to accurately measure the distraction gap and the expected radiographic appearance of the regenerate bone. Ultrasonography has potential value in accurately measuring the distraction gap and in imaging the new bone prior to radiographic appearance. Since overly fast distraction inhibits bone formation and overly slow distraction leads to premature consolidation, ultrasound may serve a useful role in the qualitative evaluation of new bone formation in Ilizarov limb lengthening, enabling the orthopedic surgeon to tailor the distraction rate to the particular child. (orig.)

  10. The Retrieval of Ozone Profiles from Limb Scatter Measurements: Theory

    Science.gov (United States)

    Flittner, D. E.; Herman, B. M.; Bhartia, P. K.; McPeters, R. D.; Hilsenrath, E.

    1999-01-01

    An algorithm is presented for retrieving vertical profiles of O3 concentration using measurements of UV and visible light scattered from the limb of the atmosphere. The UV measurements provide information about the O3 profile in the upper and middle stratosphere, while only visible wavelengths are capable of probing the lower stratospheric O3 profile. Sensitivity to the underlying scene reflectance is greatly reduced by normalizing measurements at a tangent height high in the atmosphere (approximately 55 km), and relating measurements taken at lower altitudes to this normalization point. To decrease the effect of scattering by thin aerosols/clouds that may be present in the field of view, these normalized measurements are then combined by pairing wavelengths with strong and weak O3 absorption. We conclude that limb scatter can be used to measure O3 between 15 km and 50 km with 2-3 km vertical resolution and better than 10% accuracy.

  11. Musculoskeletal modelling of an ostrich (Struthio camelus) pelvic limb: influence of limb orientation on muscular capacity during locomotion.

    Science.gov (United States)

    Hutchinson, John R; Rankin, Jeffery W; Rubenson, Jonas; Rosenbluth, Kate H; Siston, Robert A; Delp, Scott L

    2015-01-01

    We developed a three-dimensional, biomechanical computer model of the 36 major pelvic limb muscle groups in an ostrich (Struthio camelus) to investigate muscle function in this, the largest of extant birds and model organism for many studies of locomotor mechanics, body size, anatomy and evolution. Combined with experimental data, we use this model to test two main hypotheses. We first query whether ostriches use limb orientations (joint angles) that optimize the moment-generating capacities of their muscles during walking or running. Next, we test whether ostriches use limb orientations at mid-stance that keep their extensor muscles near maximal, and flexor muscles near minimal, moment arms. Our two hypotheses relate to the control priorities that a large bipedal animal might evolve under biomechanical constraints to achieve more effective static weight support. We find that ostriches do not use limb orientations to optimize the moment-generating capacities or moment arms of their muscles. We infer that dynamic properties of muscles or tendons might be better candidates for locomotor optimization. Regardless, general principles explaining why species choose particular joint orientations during locomotion are lacking, raising the question of whether such general principles exist or if clades evolve different patterns (e.g., weighting of muscle force-length or force-velocity properties in selecting postures). This leaves theoretical studies of muscle moment arms estimated for extinct animals at an impasse until studies of extant taxa answer these questions. Finally, we compare our model's results against those of two prior studies of ostrich limb muscle moment arms, finding general agreement for many muscles. Some flexor and extensor muscles exhibit self-stabilization patterns (posture-dependent switches between flexor/extensor action) that ostriches may use to coordinate their locomotion. However, some conspicuous areas of disagreement in our results illustrate

  12. Lymphedema of the lower limbs - a lymphoscintigraphic approach

    International Nuclear Information System (INIS)

    Patients with lymphedema of the lower limbs (LLL) are usually affected by recurrent erysipelas. This bacterial infection is usually admitted as an aetiological factor, but it can be a consequence of some previous lymphatic abnormality. Classically, the commonest causative factors of LLL are bacterial infection, venous ulcers, trauma (leading to secondary lymphedema) and congenital disorders of the lymphatic system (primary lymphedema praecox or tarda. To identify previous lymphatics abnormalities in patients with LLL, admitted as having secondary lymphatic lymphedema - as consequences of infection, trauma or other factors -, by using lymphoscintigraphic method. To observe advantages of this approach in practical assistance and evaluation of LLL cases. Twelve patients with LLL, supposed to have primary (congenital) or secondary disorder affecting one or both lower extremities were submitted to lymphoscintigraphy at the Escola Paulista de Medicina of Sao Paulo, Brazil. Each patient received an intra dermal injection of labelled Dextran (Dx99m Tc) at the first interdigital space of each foot and , after one to three hours, images of lower extremities, pelvic and abdominal areas were obtained with Gammatome CGR. Examination of all 24 lower extremities disclosed clinical diagnosis of lymphedema in 17 (70.8%), being five (41.6%) with clinical signs of lymphedema of both lower limbs and seven (58.3%) of a single one. The lymphoscintigraphic images revealed lymphatic disordersin 22 of the 24 extremities (91.7%). Lymphoscintigraphic abnormalities in clinically normal lower extremities were observed in five cases (41.3%). Lymphoscintigraphy is a non-invasive useful method to study LLL, with involvement of one or both limbs. It does not differentiate between primary and secondary lymphedema, but makes possible to detect cases of normal appearance of the limbs with previous lymphatic defect(s), changing aetiological diagnosis. Some cases that appear to be secondary lymphedema

  13. Staging of upper limb lymphedema from routine lymphoscintigraphic examinations

    Czech Academy of Sciences Publication Activity Database

    Gebouský, Petr; Kárný, Miroslav; Křížová, H.; Wald, M.

    2009-01-01

    Roč. 39, č. 1 (2009), s. 1-7. ISSN 0010-4825 R&D Projects: GA MŠk 1M0572; GA MŠk 2C06001 Institutional research plan: CEZ:AV0Z10750506 Keywords : Quantitative lymphoscintigraphy * Secondary lymphedema of upper limbs * Staging * Bayesian evaluation * Probabilistic mixtures Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.269, year: 2009 http://library.utia.cas.cz/separaty/2009/AS/karny-0320214.pdf

  14. Comparative Study of Mechanical Stresses in Human Limb Bones

    OpenAIRE

    Doina Drăgulescu; Lucian Rusu; Vlad Morcovescu; Cris Precup

    2004-01-01

    This research studies the upper and lower limb bones of elderly persons. The measurements of compressive, tensile and bending forces were performed on 147 specimens: 72 in a compression trial, 21 in a tensile trial and 54 in a bending trial. Bones were extracted from 38 cadavers (60–70-years-old at the time of death). Experimental protocols were developed to minimise the possible errors in obtaining the data. All results were statistically processed. There was a significant difference between...

  15. Development of Phantom Limb Pain after Femoral Nerve Block

    OpenAIRE

    Sadiah Siddiqui; Anthony N. Sifonios; Vanny Le; Martinez, Marc E.; Eloy, Jean D.; Andrew G. Kaufman

    2014-01-01

    Historically, phantom limb pain (PLP) develops in 50–80% of amputees and may arise within days following an amputation for reasons presently not well understood. Our case involves a 29-year-old male with previous surgical amputation who develops PLP after the performance of a femoral nerve block. Although there have been documented cases of reactivation of PLP in amputees after neuraxial technique, there have been no reported events associated with femoral nerve blockade. We base our discussi...

  16. Functional protein networks unifying limb girdle muscular dystrophy

    OpenAIRE

    de Morrée, Antoine

    2011-01-01

    Limb Girdle Muscular Dystrophy (LGMD) is a rare progressive heterogeneous disorder that can be caused by mutations in at least 21 different genes. These genes are often widely expressed and encode proteins with highly differing functions. And yet mutations in all of them give rise to a similar clinical presentation: adult onset muscle weakness, with muscles of the pelvic and shoulder girdle as predominantly affected muscle groups. This thesis explores a potential molecular mechanism that unif...

  17. Unilateral linear pansclerotic morphea affecting face and limbs

    OpenAIRE

    Padmavathy L; Rao Lakshmana

    2005-01-01

    Disabling pansclerotic morphea is a rare atrophying and sclerosing disorder of the subcutaneous tissue, muscle and bone. It is characterized by atrophy of the skin, subcutaneous fat, muscle and bone involving half of the face. In some patients the atrophic lesions extend to involve the ipsilateral or contralateral upper and lower limbs with radiological evidence of hemiatrophy. The patients may present with arthralgia, convulsions or cramps. We report a case of a woman with deformity of face,...

  18. Thick Ascending Limb of the Loop of Henle

    OpenAIRE

    Mount, David B.

    2014-01-01

    The thick ascending limb occupies a central anatomic and functional position in human renal physiology, with critical roles in the defense of the extracellular fluid volume, the urinary concentrating mechanism, calcium and magnesium homeostasis, bicarbonate and ammonium homeostasis, and urinary protein composition. The last decade has witnessed tremendous progress in the understanding of the molecular physiology and pathophysiology of this nephron segment. These advances are the subject of th...

  19. Upper-limb activity in adults: Referent values using accelerometry

    OpenAIRE

    Ryan R. Bailey, MSOT, OTR/L; Catherine E. Lang, PT, PhD

    2013-01-01

    The goal of physical rehabilitation following upper-limb (UL) impairment is functional restoration of the UL for use in daily activities. Because capacity for UL function may not translate into real-world activity, it is important that assessment of real-world UL activity be used in conjunction with clinical measures of capacity. Accelerometry can be used to quantify duration of UL activity outside of the clinic. The purpose of this study was to characterize hours of UL activity and potential...

  20. Physiological effects of selective tibial neurotomy on lower limb spasticity

    OpenAIRE

    Feve, A; Decq, P; Filipetti, P; Verroust, J; Harf, A; N'Guyen, J; Keravel, Y

    1997-01-01

    OBJECTIVES—To assess by electrophysiology the effect of tibial selective neurotomy on muscle imbalance of the spastic ankle.
METHOD—The amplitudes of the H reflexes, M responses (muscle contractions recorded after stimulation of the tibial nerve), and Hmax:Mmax ratio were recorded in 12 patients with chronic lower limb spasticity, before and one month after tibial selective neurotomy. Recordings were done on medial and lateral gastrocnemius and soleus muscles.
 Clinical eva...

  1. Cellulitis of the lower limbs: incidence, diagnosis and management

    OpenAIRE

    Atkin, Leanne

    2016-01-01

    Cellulitis is a common clinical condition that is often inaccurately diagnosed. Risk factors for the development of cellulitis include obesity, lymphoedema and lower limb ulceration. It is important to accurately diagnose and effectively treat cellulitis in order to provide cost effective care and reduce patient suffering. This article will deliver an overview on the burden of cellulitis, provide information that will aid accurate diagnosis and summarise current treatment options.

  2. An open source lower limb model: Hip joint validation.

    Science.gov (United States)

    Modenese, L; Phillips, A T M; Bull, A M J

    2011-08-11

    Musculoskeletal lower limb models have been shown to be able to predict hip contact forces (HCFs) that are comparable to in vivo measurements obtained from instrumented prostheses. However, the muscle recruitment predicted by these models does not necessarily compare well to measured electromyographic (EMG) signals. In order to verify if it is possible to accurately estimate HCFs from muscle force patterns consistent with EMG measurements, a lower limb model based on a published anatomical dataset (Klein Horsman et al., 2007. Clinical Biomechanics. 22, 239-247) has been implemented in the open source software OpenSim. A cycle-to-cycle hip joint validation was conducted against HCFs recorded during gait and stair climbing trials of four arthroplasty patients (Bergmann et al., 2001. Journal of Biomechanics. 34, 859-871). Hip joint muscle tensions were estimated by minimizing a polynomial function of the muscle forces. The resulting muscle activation patterns obtained by assessing multiple powers of the objective function were compared against EMG profiles from the literature. Calculated HCFs denoted a tendency to monotonically increase their magnitude when raising the power of the objective function; the best estimation obtained from muscle forces consistent with experimental EMG profiles was found when a quadratic objective function was minimized (average overestimation at experimental peak frame: 10.1% for walking, 7.8% for stair climbing). The lower limb model can produce appropriate balanced sets of muscle forces and joint contact forces that can be used in a range of applications requiring accurate quantification of both. The developed model is available at the website https://simtk.org/home/low_limb_london. PMID:21742331

  3. The role of skeletal sonography in limb lengthening procedures.

    OpenAIRE

    Malde H; Hemmadi S; Chadda D; Parihar M; Bhosale P; Kedar R

    1993-01-01

    Eleven patients (8 males, 3 females) undergoing limb-lengthening procedures were subjected to weekly conventional radiography along with fortnightly skeletal sonography of the distraction site, to assess the rate of new bone production and complications. The radiographs were assessed for: (i) distance between the distracted bone ends, (ii) presence of new bone formation at the distraction site, (iii) regeneration of the cortical outline and (iv) overlaying soft tissue abnormality. The sonogra...

  4. Acute limb ischemia in cancer patients: should we surgically intervene?

    LENUS (Irish Health Repository)

    Tsang, Julian S

    2012-02-01

    BACKGROUND: Cancer patients have an increased risk of venous thromboembolic events. Certain chemotherapeutic agents have also been associated with the development of thrombosis. Reported cases of acute arterial ischemic episodes in cancer patients are rare. METHODS: Patients who underwent surgery for acute limb ischemia associated with malignancy in a university teaching hospital over a 10-year period were identified. Patient demographics, cancer type, chemotherapy use, site of thromboembolism, treatment and outcome were recorded. RESULTS: Four hundred nineteen patients underwent surgical intervention for acute arterial ischemia, 16 of these patients (3.8%) had associated cancer. Commonest cancer sites were the urogenital tract (n = 5) and the lungs (n = 5). Eight patients (50%) had been recently diagnosed with cancer, and four (25%) of these cancers were incidental findings after presentation with acute limb ischemia. Four patients (25%) developed acute ischemia during chemotherapy. The superficial femoral artery was the most frequent site of occlusion (50%), followed by the brachial (18%) and popliteal (12%) arteries. All patients underwent thromboembolectomy, but two (12%) patients subsequently required a bypass procedure. Six patients (37%) had limb loss, and in-patient mortality was 12%. Histology revealed that all occlusions were due to thromboembolism, with no tumor cells identified. At follow-up, 44% of patients were found to be alive after 1 year. CONCLUSION: Cancer and chemotherapy can predispose patients to acute arterial ischemia. Unlike other reports that view this finding as a preterminal event most appropriately treated by palliative measures, in this series, early diagnosis and surgical intervention enabled limb salvage and patient survival.

  5. The association of gegenhalten in the upper limbs with dyspraxia.

    OpenAIRE

    Tyrrell, P.; Rossor, M

    1988-01-01

    Ten patients with gegenhalten of the upper limb of mixed aetiology were studied, in nine of whom an association with dyspraxia was found. In four of the patients, the rigidity became more pronounced after the instruction to relax, and only one patient showed improvement after this instruction. In these patients, the resistance to movement, evident as gegenhalten, may be a direct consequence of the dyspraxia.

  6. The association of gegenhalten in the upper limbs with dyspraxia.

    Science.gov (United States)

    Tyrrell, P; Rossor, M

    1988-01-01

    Ten patients with gegenhalten of the upper limb of mixed aetiology were studied, in nine of whom an association with dyspraxia was found. In four of the patients, the rigidity became more pronounced after the instruction to relax, and only one patient showed improvement after this instruction. In these patients, the resistance to movement, evident as gegenhalten, may be a direct consequence of the dyspraxia. PMID:3204407

  7. Validation of Aura Microwave Limb Sounder HCl measurements

    OpenAIRE

    L. Froidevaux; Jiang, Y.B.; Lambert, A.; Livesey, N.J.; Read, W. G.; Waters, J. W.; Fuller, R. A.; Marcy, T. P.; Popp, P. J.; R. S. Gao; Fahey, D. W.; Jucks, K. W.; Stachnik, R. A.; Toon, G. C.; Christensen, L. E.

    2008-01-01

    The Earth Observing System (EOS) Microwave Limb Sounder (MLS) aboard the Aura satellite has provided daily global HCl profiles since August 2004. We provide a characterization of the resolution, random and systematic uncertainties, and known issues for the version 2.2 MLS HCl data. The MLS sampling allows for comparisons with many (similar to 1500 to more than 3000) closely matched profiles from the Halogen Occultation Experiment (HALOE) and Atmospheric Chemistry Experiment Fourier Transform ...

  8. Muscle exercise in limb girdle muscular dystrophies: pitfall and advantages

    OpenAIRE

    Siciliano, Gabriele; Simoncini, Costanza; Giannotti, Stefano; Zampa, Virna; Angelini, Corrado; Ricci, Giulia

    2015-01-01

    Different genetic mutations underlying distinct pathogenic mechanisms have been identified as cause of muscle fibers degeneration and strength loss in limb girdle muscular dystrophies (LGMD). As a consequence, exercise tolerance is affected in patients with LGMD, either as a direct consequence of the loss of muscle fibers or secondary to the sedentary lifestyle due to the motor impairment. It has been debated for many years whether or not muscle exercise is beneficial or harmful for patients ...

  9. Acupuncture in the Treatment of Upper-Limb Lymphedema

    OpenAIRE

    Cassileth, Barrie R.; Van Zee, Kimberly J.; Yeung, K. Simon; Coleton, Marci I.; Cohen, Sara; Chan, Yi H; Andrew J Vickers; Sjoberg, Daniel D.; Hudis, Clifford A.

    2013-01-01

    BACKGROUND Current treatments for lymphedema after breast cancer treatment are expensive and require ongoing intervention. Clinical experience and our preliminary published results suggest that acupuncture is safe and potentially useful. This study evaluates the safety and potential efficacy of acupuncture on upper-limb circumference in women with lymphedema. METHODS Women with a clinical diagnosis of breast cancer−related lymphedema (BCRL) for 0.5-5 years and with affected arm circumference ...

  10. Body image and prosthesis satisfaction in the lower limb amputee.

    OpenAIRE

    Murray, Craig; Fox, Jezz

    2002-01-01

    Purpose: This study examines the relationship between prosthesis satisfaction and body image in lower limb prosthesis users, and the gendered variations within these relationships. Method: A total of 44 valid responses were obtained to an Internet survey regarding prosthesis satisfaction, body image, and phantom pain. Spearman Rho correlations were calculated for these three domains. Results: Moderate to high negative correlations were observed between Body Image Disturbance and Prosthesis Sa...

  11. Literature Review on Needs of Upper Limb Prosthesis Users

    OpenAIRE

    Cordella, Francesca; Ciancio, Anna Lisa; Sacchetti, Rinaldo; Davalli, Angelo; Cutti, Andrea Giovanni; Guglielmelli, Eugenio; Zollo, Loredana

    2016-01-01

    The loss of one hand can significantly affect the level of autonomy and the capability of performing daily living, working and social activities. The current prosthetic solutions contribute in a poor way to overcome these problems due to limitations in the interfaces adopted for controlling the prosthesis and to the lack of force or tactile feedback, thus limiting hand grasp capabilities. This paper presents a literature review on needs analysis of upper limb prosthesis users, and points out ...

  12. The Chemokine System in Arteriogenesis and Hind Limb Ischemia

    OpenAIRE

    Shireman, Paula K.

    2007-01-01

    Chemokines (chemotactic cytokines) are important in the recruitment of leukocytes to injured tissues and as such, play a pivotal role in arteriogenesis and the tissue response to ischemia. Hind limb ischemia represents a complex model with arteriogenesis (collateral artery formation) occurring in tissues with normal perfusion while areas exhibiting ischemic necrosis undergo angiogenesis and skeletal muscle regeneration; monocytes/macrophages play an important role in all three of these proces...

  13. Effects of passive limb movement on pulmonary ventilation.

    OpenAIRE

    Waisbren, S. J.; Whiting, C. S.; Nadel, E R

    1990-01-01

    This study was undertaken to determine if the observed increase in ventilation during passive limb movement was a reflex hyperventilation or a response to an increased metabolic need for oxygen. Experiments on human volunteers were designed to test the hypothesis that the rapid increase of ventilation at the onset of exercise was due to stimulation of the joints. Results of these studies showed significant increases in ventilation, oxygen consumption, carbon dioxide production, ventilation/ox...

  14. Proteomic analysis of blastema formation in regenerating axolotl limbs

    Directory of Open Access Journals (Sweden)

    Nye Holly LD

    2009-11-01

    Full Text Available Abstract Background Following amputation, urodele salamander limbs reprogram somatic cells to form a blastema that self-organizes into the missing limb parts to restore the structure and function of the limb. To help understand the molecular basis of blastema formation, we used quantitative label-free liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS-based methods to analyze changes in the proteome that occurred 1, 4 and 7 days post amputation (dpa through the mid-tibia/fibula of axolotl hind limbs. Results We identified 309 unique proteins with significant fold change relative to controls (0 dpa, representing 10 biological process categories: (1 signaling, (2 Ca2+ binding and translocation, (3 transcription, (4 translation, (5 cytoskeleton, (6 extracellular matrix (ECM, (7 metabolism, (8 cell protection, (9 degradation, and (10 cell cycle. In all, 43 proteins exhibited exceptionally high fold changes. Of these, the ecotropic viral integrative factor 5 (EVI5, a cell cycle-related oncoprotein that prevents cells from entering the mitotic phase of the cell cycle prematurely, was of special interest because its fold change was exceptionally high throughout blastema formation. Conclusion Our data were consistent with previous studies indicating the importance of inositol triphosphate and Ca2+ signaling in initiating the ECM and cytoskeletal remodeling characteristic of histolysis and cell dedifferentiation. In addition, the data suggested that blastema formation requires several mechanisms to avoid apoptosis, including reduced metabolism, differential regulation of proapoptotic and antiapoptotic proteins, and initiation of an unfolded protein response (UPR. Since there is virtually no mitosis during blastema formation, we propose that high levels of EVI5 function to arrest dedifferentiated cells somewhere in the G1/S/G2 phases of the cell cycle until they have accumulated under the wound epidermis and enter mitosis in response to

  15. Functional Reorganization of the Primary Somatosensory Cortex of a Phantom Limb Pain Patient.

    Science.gov (United States)

    Zhao, Jia; Guo, Xiaoli; Xia, Xiaolei; Peng, Weiwei; Wang, Wuchao; Li, Shulin; Zhang, Ya; Hu, Li

    2016-07-01

    Functional reorganization of the somatosensory system was widely observed in phantom limb pain patients. Whereas some studies demonstrated that the primary somatosensory cortex (S1) of the amputated limb was engaged with the regions around it, others showed that phantom limb pain was associated with preserved structure and functional organization in the former brain region. However, according to the law of use and disuse, the sensitivity of S1 of the amputated limb to pain-related context should be enhanced due to the adaptation to the long-lasting phantom limb pain experience. Here, we collected neurophysiological data from a patient with 21-year phantom limb pain using electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) techniques. EEG data showed that both laser-evoked potentials (LEPs) and tactile-evoked potentials (TEPs) were clearly presented only when radiant-heat laser pulses and electrical pulses were delivered to the shoulder of the healthy limb, but not of the amputated limb. This observation suggested the functional deficit of somatosensory pathways at the amputated side. FMRI data showed that significant larger brain activations by painful rather than non-painful stimuli in video clips were observed not only at visual-related brain areas and anterior/mid-cingulate cortex, but also at S1 contralateral to the amputated limb. This observation suggested the increased sensitivity of S1 of the amputated limb to the pain-related context. In addition, such increase of sensitivity was significantly larger if the context was associated with the amputated limb of the patient. In summary, our findings provided novel evidence for a possible neuroplasticity of S1 of the amputated limb: in an amputee with long-lasting phantom limb pain, the sensitivity of S1 to pain-related and amputated-limb-related context was greatly enhanced. PMID:27389122

  16. Gene expression patterns specific to the regenerating limb of the Mexican axolotl

    Directory of Open Access Journals (Sweden)

    James R. Monaghan

    2012-07-01

    Salamander limb regeneration is dependent upon tissue interactions that are local to the amputation site. Communication among limb epidermis, peripheral nerves, and mesenchyme coordinate cell migration, cell proliferation, and tissue patterning to generate a blastema, which will form missing limb structures. An outstanding question is how cross-talk between these tissues gives rise to the regeneration blastema. To identify genes associated with epidermis-nerve-mesenchymal interactions during limb regeneration, we examined histological and transcriptional changes during the first week following injury in the wound epidermis and subjacent cells between three injury types; 1 a flank wound on the side of the animal that will not regenerate a limb, 2 a denervated limb that will not regenerate a limb, and 3 an innervated limb that will regenerate a limb. Early, histological and transcriptional changes were similar between the injury types, presumably because a common wound-healing program is employed across anatomical locations. However, some transcripts were enriched in limbs compared to the flank and are associated with vertebrate limb development. Many of these genes were activated before blastema outgrowth and expressed in specific tissue types including the epidermis, peripheral nerve, and mesenchyme. We also identified a relatively small group of transcripts that were more highly expressed in innervated limbs versus denervated limbs. These transcripts encode for proteins involved in myelination of peripheral nerves, epidermal cell function, and proliferation of mesenchymal cells. Overall, our study identifies limb-specific and nerve-dependent genes that are upstream of regenerative growth, and thus promising candidates for the regulation of blastema formation.

  17. Angiogenic factor AGGF1 promotes therapeutic angiogenesis in a mouse limb ischemia model.

    Directory of Open Access Journals (Sweden)

    Qiulun Lu

    Full Text Available BACKGROUND: Peripheral arterial disease (PAD is a common disease accounting for about 12% of the adult population, and causes significant morbidity and mortality. Therapeutic angiogenesis using angiogenic factors has been considered to be a potential treatment option for PAD patients. In this study, we assessed the potential of a new angiogenic factor AGGF1 for therapeutic angiogenesis in a critical limb ischemia model in mice for PAD. METHODS AND RESULTS: We generated a unilateral hindlimb ischemia model in mice by ligation of the right common iliac artery and femoral artery. Ischemic mice with intrasmuscular administration of DNA for an expression plasmid for human AGGF1 (AGGF1 group resulted in increased expression of both AGGF1 mRNA and protein after the administration compared with control mice with injection of the empty vector (control group. Color PW Doppler echocardiography showed that the blood flow in ischemic hindlimbs was significantly increased in the AGGF1 group compared to control mice at time points of 7, 14, and 28 days after DNA administration (n = 9/group, P = 0.049, 0.001, and 0.001, respectively. Increased blood flow in the AGGF1 group was correlated to increased density of CD31-positive vessels and decreased necrosis in muscle tissues injected with AGGF1 DNA compared with the control tissue injected with the empty vector. Ambulatory impairment was significantly reduced in the AGGF1 group compared to the control group (P = 0.004. The effect of AGGF1 was dose-dependent. At day 28 after gene transfer, AGGF1 was significantly better in increasing blood flow than FGF-2 (P = 0.034, although no difference was found for tissue necrosis and ambulatory impairment. CONCLUSIONS: These data establish AGGF1 as a candidate therapeutic agent for therapeutic angiogenesis to treat PAD.

  18. Tracking upper limbs fatigue by means of electronic dynamometry

    Directory of Open Access Journals (Sweden)

    Fernando Max Lima

    2015-06-01

    Full Text Available This study aimed to identify useful electronic grip dynamometry parameters to track differences between trained (TR and untrained (UT participants, and between dominant (DO and non-dominant (ND limbs as a consequence of upper limbs muscle fatigue following 10 RM tests of the brachial biceps. This experimental study with transversal design involved 18 young adult males, of whom 9 were untrained and 9 were experienced in resistance training.Isometric grip force was evaluated (30 seconds long previous and after 10RM tests by means of a G200 Model grip dynamometer with precision load cell (Biometrics(r. Significant differences between initial and final measurements were found only for trained participants: Peak force for TR-DO (67.1 vs 55.5 kgf, p = .0277; Raw average for TR-DO (46.96 vs 42.22 kgf, p = .0464, and for TR-ND (40.34 vs 36.13 kgf, p = .0277. Electronic grip dynamometry efficiently identified upper limbs fatigue in trained participants, being raw average measurements the best parameter.

  19. Morphology of the thoracic limb bones in the giant anteater

    Directory of Open Access Journals (Sweden)

    Fabrício Singaretti de Oliveira

    2013-11-01

    Full Text Available The giant anteater has a grayish-brown pelage with white and black tones, its skull is elongated, cylindrical, and there are no teeth. Its tail is long, with thick and long bristles, resembling a flag. This is an endangered species, due to the constant degradation of its habitat, in addition to deaths caused by fires and roadkills. Thus, this paper aimed to describe the morphology of the thoracic limb bones in Myrmecophaga tridactyla, focusing on its main bone accidents. We used two specimens of giant anteater collected on highways in the state of Minas Gerais, Brazil, after death due to being run over. The scapula, humerus, radius, ulna, and the hand bones showed particular characteristics adapted to the species’ lifestyle and habits. In general, the scapula resembles that in human beings and the humerus is similar to that in armadillo, the radius and ulna exhibit articular surfaces which enable a wide range of rotational movements in the forearm, the carpal bones are also similar in number and shape to those in human beings, and the fingers are well developed in the giant anteater, having long, strong and sharp claws, especially in the third finger. Thus, the anatomical description of the thoracic limb bones in the giant anteater showed to be important, providing a deeper understanding both of the functional aspects of the thoracic limb and the comparative anatomy of wild animals.

  20. Thoracodorsal artery perforator flap for upper limb reconstruction

    International Nuclear Information System (INIS)

    Thoracodorsal artery perforator flap (TAP) is a feasible option to reconstruct defects in upper limb where only skin and subcutaneous tissue is required. Methods: This case series was carried out at department of Plastic and Reconstructive Surgery Combined Military Hospital Rawalpindi. A total of 5 patients with upper limb defects were reconstructed with thoracodorsal artery musculocutaneous perforator flaps. Among them, 3 were pedicled and two free TAP flaps. All flaps except one pedicled flap were raised on a single perforator pedicle. Recipient sites were one axilla, two shoulder regions and two hands. The soft tissue defects in the patients had resulted from burns, trauma, wide local excision of synovial sarcoma and surgery for hidradenitis suppurativa. Preoperative hand held Doppler ultrasound was used to locate and mark the perforator. Results: All flaps survived without significant complications. All flaps were hyperemic in the immediate postoperative period. We designed and raised all the five flaps on eccentrically placed perforators. All the raised perforators originated from the descending branch of the thoracodorsal artery. The donor sites were closed primarily with linear scars in all cases except one, in which partial closure was accomplished with split thickness skin grafting (STSG). Conclusion: The thoracodorsal artery perforator flap has great potential for reconstructing large, relatively shallow, defects of upper limb because of its suitable skin quality, texture and appropriate thickness, as well as hidden donor site, a reliable pedicle and sparing of muscle unit. (author)

  1. ERYSIPELAS OF UPPER LIMB: A COMPLICATION OF BREAST CANCER SURGERY

    Directory of Open Access Journals (Sweden)

    Natalia Cireap

    2010-05-01

    Full Text Available Erysipelas of upper limb is a well-known complication following breast cancer therapy, but few cases are reported in the literature. We undertook a 5-year retrospective study at the Department I of Infectious Diseases. For each patient we recorded the age, past medical history, clinical findings, laboratory parameters, treatment, outcome and recommended prophylaxis. From 145 erysipelas identified, 12 cases were erysipelas of upper limb. All patients had a breast surgery and lymphadectomy. The erysipelas appeared with an average of 5.5 years after cancer treatment. Associated pathology: obesity (5 cases, diabetes (6 cases and thrombophlebitis (1 case. Lymphedema was noticed in 9 patients and the site of involvement was the homolateral upper limb of the treated breast. The diagnosis of erysipelas was essentially clinical. The clinical aspect was an inflammatory plaque with raised edges in 7 cases, blisters, cellulitis and purpura in one case, respectively. The portal of entry was not found in 6 cases. Laboratory parameters: increased leucocytes with predominance of neutrophils (4; normal white count (5 and leucopenia (3; the erythrocyte sedimentation rate and fibrinogen elevated in 5 cases; CRP levels elevated in 8 cases. The most commonly used antibiotic was penicillin G intravenous route of administration. The outcome was favorable for all the patients. At discharge, prophylactic treatment was recommended for all the patients. In three of our patient, despite the prophylaxis, recurrences occurred with a frequency of 3-6 episodes in 5 years. All these patients displayed an immune suppressive status with decreased CD4+.

  2. Multi-limbed locomotion systems for space construction and maintenance

    Science.gov (United States)

    Waldron, K. J.; Klein, C. A.

    1987-01-01

    A well developed technology of coordination of multi-limbed locomotory systems is now available. Results from a NASA sponsored study of several years ago are presented. This was a simulation study of a three-limbed locomotion/manipulation system. Each limb had six degrees of freedom and could be used either as a locomotory grasping hand-holds, or as a manipulator. The focus of the study was kinematic coordination algorithms. The presentation will also include very recent results from the Adaptive Suspension Vehicle Project. The Adaptive Suspension Vehicle (ASV) is a legged locomotion system designed for terrestrial use which is capable of operating in completely unstructured terrain in either a teleoperated or operator-on-board mode. Future development may include autonomous operation. The ASV features a very advanced coordination and control system which could readily be adapted to operation in space. An inertial package with a vertical gyro, and rate gyros and accelerometers on three orthogonal axes provides body position information at high bandwidth. This is compared to the operator's commands, injected via a joystick to provide a commanded force system on the vehicle's body. This system is, in turn, decomposed by a coordination algorithm into force commands to those legs which are in contact with the ground.

  3. Our experience of application of Autologous Bone Marrow Stem Cells in critical limb ischemia in six diabetic patients – A five-year follow-up

    Directory of Open Access Journals (Sweden)

    Subrammaniyan R

    2011-01-01

    Full Text Available Background: Numerous Clinical studies have reported the safety and efficacy of injection of one Marrow and Peripheral Blood Mononuclear cells in patients with lower limb ischemia. Earlier we have reported the six months follow-up of successful application of autologous bone marrow mononuclear cells in patients with Fontaine Stage IV critical limb ischemia due to diabetes. As a continuation of the previous study, herein we report the long term results of the six patients after a follow-up for five years.Materials and Methods: Six Diabetic patients with Fontaine Stage IV critical limb ischemia with ulcers were given intra-lesional injections of their autologous bone marrow mononuclear cells (BMMNC, isolated following the cGMP protocols. The patients have been followed up at regular intervals for five years after the treatment with all relevant clinical investigations. Results: Six months follow-up results revealed that all the patients showed improvements with appearance of healthy granulation tissue and uniform revascularization. Complete healing was reported at a mean duration of nine months in five patients and one patient died due to a complication of renal failure, peritoneal dialysis and cardiac failure, which were unrelated to the BMMNC injection. Five year continuous follow-up revealed that the healed tissue with or without skin grafting remained healthy in all the five patients and two of the patients are able to walk without support with a pain free walking distance of greater than 100m.There were no adverse effects in any of the patients. Conclusion: Autologous bone marrow stem cell therapy has been found to be salvaging the affected limb in patients with Fontaine Stage IV Critical Limb ischemia patients where revascularization was not feasible. Hence with our experience of six patients we recommend that the same should be considered in patients of similar clinical parameters before considering an amputation.

  4. Conditional Deletion of Indian Hedgehog in Limb Mesenchyme Results in Complete Loss of Growth Plate Formation but Allows Mature Osteoblast Differentiation.

    Science.gov (United States)

    Amano, Katsuhiko; Densmore, Michael J; Lanske, Beate

    2015-12-01

    Indian hedgehog (Ihh) is widely recognized as an essential factor for proper skeletal development. Previous in vivo studies using mutant Ihh mouse models were limited by perinatal lethality or carried out after a growth plate formed. Thus the important role of Ihh in mesenchymal cell differentiation has not been investigated. In this study, we established Prx1-Cre;Ihh(fl/fl) mice to ablate Ihh specifically in limb mesenchyme to allow us to observe the phenotype continuously from prenatal development to 3 weeks of age. Mutant mice displayed severe limb abnormalities characterized by complete lack of secondary ossification center and growth plate, indicating an essential role for Ihh in the development of these structures. Interestingly, we discovered that osteoblast differentiation and bone formation could occur in conditions of deficient Ihh. This is a novel finding that has not been observed because of the early lethality of previous Ihh mutants. Mature osteoblasts expressing osteocalcin could be detected in the center of mutant bones at postnatal day 10 (P10). Osteoclasts and blood vessel formation were also present, suggesting active bone remodeling. Histomorphometric analyses show a significant increase in osteoclast number with no major changes in bone formation rate at 3 weeks of age. Mutant long bones in the limbs were deformed, with cortices comprised of irregular woven bone. Also, there was a marked decrease in gene expression of osteoblastic and osteocytic markers. Moreover, mutant long bones displayed bone dysplasia in which we observed increased osteoclast activity and partially reduced osteoblastic and osteocytic differentiation that lead ultimately to loss of bone structures at 3 weeks of age. In summary, our data show for the first time, the presence of mature osteoblasts in long bones of the limbs despite the complete loss of growth plate formation due to Ihh deficiency. These data indicate an important function for Ihh in regulating limb

  5. Expression of Endothelial Nitric Oxide Synthase and Endothelin-1 in Skin Tissue from Amputated Limbs of Patients with Complex Regional Pain Syndrome

    Directory of Open Access Journals (Sweden)

    J. George Groeneweg

    2008-07-01

    Full Text Available Background and Objectives. Impaired microcirculation during the chronic stage of complex regional pain syndrome (CRPS is related to increased vasoconstriction, tissue hypoxia, and metabolic tissue acidosis in the affected limb. Endothelial dysfunction is suggested to be the main cause of diminished blood flow. The aim of this study was to examine the distribution of endothelial nitric oxide synthase (eNOS and endothelin-1(ET-1 relative to vascular density represented by the endothelial marker CD31-immunoreactivity in the skin tissue of patients with chronic CRPS. Methods. We performed immunohistochemical staining on sections of skin specimens obtained from the amputated limbs (one arm and one leg of two patients with CRPS. Results. In comparison to proximal specimens we found an increased number of migrated endothelial cells as well as an increase of eNOS activity in distal dermis specimens. Conclusions. We found indications that endothelial dysfunction plays a role in chronic CRPS.

  6. Hyperglycemia (High Blood Glucose)

    Medline Plus

    Full Text Available ... how often you should check and what your blood glucose levels should be. Checking your blood and then treating ... I Treat Hyperglycemia? You can often lower your blood glucose level by exercising. However, if your blood glucose is ...

  7. BUN - blood test

    Science.gov (United States)

    Blood urea nitrogen ... A blood sample is needed. Most of the time blood is drawn from a vein located on the inside ... Many medicines can interfere with blood test results. Your health ... if you need to stop taking any medicines before you have this ...

  8. Effect of glycemic status on peripheral nerve conduction in lower limbs in type 2 diabetes mellitus patients

    Directory of Open Access Journals (Sweden)

    Pranali P. Sonawane

    2015-06-01

    Full Text Available Background: Diabetes mellitus (DM is one of the most common chronic diseases globally. Diabetic neuropathy is the most common and troublesome complication. But exact pathogenesis is not yet known. Comparatively there are few studies showing relation between glycemic status and diabetic neuropathy. Hence present study was conducted, which was aimed to assess the same in lower limbs in type 2 DM. Methods: 60 type 2 diabetes mellitus male patients were selected from diabetic OPD. 30 were having glycated hemoglobin (HbA1c 6%-9% (group B, 30 were having HbA1c > 9% (group C. They were compared with age and sex matched 30 normal healthy controls (group A. Conduction velocity and amplitude of bilateral sural sensory nerve action potential (SNAP and peroneal compound muscle action potential (CMAP were recorded. Glycated hemoglobin was measured using ion exchange resin method. Results: Group B and group C had significantly lesser means of conduction velocity and amplitude of sural SNAP (p<0.001 and peroneal CMAP (p<0.05 as compared to group A. Hb A1c had statistically significant negative correlation with conduction velocity and amplitude of sural SNAP (p<0.001 as well as peroneal CMAP (p<0.001. Conclusions: This study shows that diabetic patients with higher blood glucose levels are at increased risk of diabetic neuropathy. Diabetic neuropathy in lower limbs worsens with increasing blood glucose levels. Hence stringent action has to be taken at an early stage to control blood glucose levels. Also, patients should be encouraged for regular follow up and strict glycemic control. [Int J Res Med Sci 2015; 3(6.000: 1505-1510

  9. Effects of regional limb perfusion volume on concentrations of amikacin sulfate in synovial and interstitial fluid samples from anesthetized horses.

    Science.gov (United States)

    Godfrey, Jennifer L; Hardy, Joanne; Cohen, Noah D

    2016-06-01

    OBJECTIVE To evaluate the effect of volume of IV regional limb perfusion (IVRLP) on amikacin concentrations in synovial and interstitial fluid of horses. ANIMALS 8 healthy adult horses. PROCEDURES Each forelimb was randomly assigned to receive IVRLP with 4 mL of amikacin sulfate solution (250 mg/mL) plus 56 mL (total volume, 60 mL) or 6 mL (total volume, 10 mL) of lactated Ringer solution. Horses were anesthetized, and baseline synovial and interstitial fluid samples were collected. A tourniquet was placed, and the assigned treatment was administered via the lateral palmar digital vein. Venous blood pressure in the distal portion of the limb was recorded. Additional synovial fluid samples were collected 30 minutes (just before tourniquet removal) and 24 hours after IVRLP began; additional interstitial fluid samples were collected 6 and 24 hours after IVRLP began. RESULTS 30 minutes after IVRLP began, mean amikacin concentration in synovial fluid was significantly greater for the large-volume (459 μg/mL) versus small-volume (70 μg/mL) treatment. Six hours after IVRLP, mean concentration in interstitial fluid was greater for the large-volume (723 μg/mL) versus small-volume (21 μg/mL) treatment. Peak venous blood pressure after large-volume IVRLP was significantly higher than after small-volume IVRLP, with no difference between treatments in time required for pressure to return to baseline. CONCLUSIONS AND CLINICAL RELEVANCE Study findings suggested that large-volume IVRLP would deliver more amikacin to metacarpophalangeal joints of horses than would small-volume IVRLP, without a clinically relevant effect on local venous blood pressure, potentially increasing treatment efficacy. PMID:27227495

  10. FILAR I AL LYMPHEDEMA LOWER LIMB DEBULKING 34 CASES

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    Baburao

    2015-10-01

    Full Text Available There are various treatment options in the management of filarial lymphedema of the lower extremities. The end point, regardless of the method adopted is a reduction of the girth of the limb, prevention of future increases in limb girth, prevention of recurrent episodes of streptococcal cellulitis; more important the treatment method used should not lead to any secondary problems that may far out shadow the primary co Majority of the methods adopted are mainly of the secondary prevention kind; very few of the procedures to date cure the disease condition. A few of the methods have been historically found to be more effective than the others; this may be real or apparent as the methodology of - reporting swelling in the lower limb may not have been consistent and there are too many variables to consider. This study seeks to evaluate the efficacy of one such treatment protocol for the management of filarial lymphedema of the lower limb 80 patients were admitted for filarial lymphedema of the lower limbs from 2005 to 2015 Of these 42 patients underwent surgical treatment; operative records for 8 of these patients was insufficient to analyse; among the remaining 34 patients 19 patients were unavailable for review. This left us a patient population of 15 for the final analysis . The surgical treatment of all of the 15 patients was identical, after preop preparation by using compression ba n dages to soften the edema along with a period of bed rest debulking of excess skin and subcutaneous tissue and primary closure was done. The intro operative application of Esmarch bandages helped in expelling fluid from the tissues and this ensured that closure was obtained with no tension at the margins. Patients were kept for at least 5 days post op before discharge; the routine use of compression crepe bandages postop along with bed rest ensured that we did not have a single case of skin necrosis or wound disruption in the postop period. All patients were given

  11. Bone transplantation in limb saving surgeries: Philippine experience

    International Nuclear Information System (INIS)

    Until the turn of the decade, Filipino patients afflicted with malignant and aggressive extremity tumors were almost uniformly treated with mutilating amputations. Limb saving surgery only recently became an option locally - this resulting not only from a better comprehension of surgical oncologic principles but also from the development and refinement of reconstructive procedures following such surgeries. Foremost among the latter is the use of long bone transplants, otherwise known as large segment bone allografts. Large segment allografts are available from the Tissue and Bone Bank of the University of the Philippines- the only bank of its kind in the country. All allografts are harvested from appropriate donors (both cadaveric and live), processed at the bank, radiation-sterilized at the Philippine Nuclear Research Institute (PNRI), and finally brought back to and stored in a -80 degrees centigrade deep freezer at the Bank. This paper presents our 4-year experience with large-segment allografts for extensive defects of limbs salvage surgery in musculoskeletal tumors. All patients included in this presentation had : (1) malignant or aggressive extremity tumors; (2) surgery performed by the University of the Philippines-Musculoskeletal Tumor Unit (UP-MuST Unit); (3) follow-up at least one year or until death; and (4) available pre-and post-operative radiographs for review. Over a period of 4 years (January 1993-January 1997), 63 patients with malignant or aggressive extremity tumors (who formerly would have been amputated) underwent limb salvage surgery by the UP-MuST Unit. Twenty (20) of these patients had reconstructions utilizing irradiated large-segment allografts and fulfilled the above criteria for inclusion in this review. Limb saving surgery for Filipino patients with musculoskeletal tumors continues to be a challenge because of both tumor size and the size of the defect requiring reconstruction. Large-segment allografts from the UP-Tissue and Bone Bank

  12. Staying in dynamic balance on a prosthetic limb: A leg to stand on?

    Science.gov (United States)

    Curtze, Carolin; Hof, At L; Postema, Klaas; Otten, Bert

    2016-06-01

    With the loss of a lower limb, amputees lack the active muscle empowered control of the ankle that is important for balance control. We examined single-leg stance on prosthesis vs. sound limb balancing on narrow ridges in transtibial amputees. When balancing on the prosthetic limb, the lateral displacement of the center of pressure was reduced and was compensated by an increase in counter-rotation. We show that single-leg stance on a prosthetic limb can be compared to balancing on a narrow ridge. Standing on a prosthetic limb involves the same balance mechanisms as balancing on narrow ridges of 40-mm to 20-mm width. Yet, the ability to balance on a narrow ridge with the sound limb was only a weak predictor for an amputee's ability to stand on the prosthetic limb. Balancing in single-leg stance on a prosthetic limb is not a common activity. The ability to compensate with the sound limb may therefore be functionally more important than the ability to stay in dynamic balance on the prosthetic limb. PMID:27052518

  13. Limb-Sparing Surgery with Vascular Reconstruction for Extremity Soft Tissue Sarcomas: Surgical, Oncological and Functional Outcomes

    International Nuclear Information System (INIS)

    The indications of limb-sparing surgery (LSS) for extremity soft tissue sarcoma (ESTS) can be extended by excision with simultaneous reconstruction of major blood vessels without adding significant risk. Methods: From January 2005 to January 2009, 12 patients with (ESTS) underwent LSS with major vascular reconstruction. Patients with metastatic disease and those with cardiopulmonary restraints were excluded. Arterial repair was mandatory whilst venous repair was selective according to selected protocol. Data were collected regarding the method of treatment, complications and tumor recurrence. Results: All tumors could be resected without amputation. In spite of the large tumor size 10 (83.3%) patients were resected with negative margins. Vascular complications occurred in eight patients: 4 cases of DVT, edema in 3 patients and one patient developed secondary hemorrhage that ended up by limb amputation. Nonvascular complications occurred in nine patients: Partial necrosis of the flap (n=2), wound infection (n=3), Wound dehiscence (n=2) hematoma (n=1) and seroma (n=1). The 2-year overall survival rates were 53.9%. Cumulative local recurrence free survival was 64.2%. Cumulative distant metastasis-free survival was 58.3%. Survival was significantly longer for surgical margin >10 mm (p<0.027). During a median follow-up period of 20 months, 4 (33.3%) developed local recurrence and 6 (50%) developed Distant metastases. Conclusion: Limb-sparing surgery with vascular reconstruction for extremity soft tissue sarcomas achieves good local control and functional results in the majority of extremity sarcomas for which amputation is infrequently indicated.

  14. Analysis of Risk Factors for Lower-limb Deep Venous Thrombosis in Old Patients after Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Jian Kang

    2015-01-01

    Full Text Available Background: Deep venous thrombosis (DVT is a common complication of arthroplasty in old patients. We analyzed risk factors for lower-limb DVT after arthroplasty in patients aged over 70 years to determine controllable risk factors. Methods: This was a retrospective study of 1,025 patients aged >70 years treated with knee arthroplasty at our hospital between January 2009 and December 2013. Of 1,025 patients, 175 had postoperative lower-limb DVT. We compared medical history, body mass index (BMI, ambulatory blood pressure, preoperative and postoperative fasting blood glucose (FBG, preoperative blood total cholesterol, triglyceride, high- and low-density lipoprotein cholesterol, and preoperative homocysteine (Hcy between thrombus and non-thrombus groups. B-mode ultrasonography was used to detect lower-limb DVT before the operation and 7 days after the operation in all patients. Logistic regression analysis was used to determine risk factors for DVT. Results: Incidence of diabetes (P = 0.014, BMI (P = 0.003, preoperative FBG (P = 0.004, postoperative FBG (P = 0.012, and preoperative Hcy (P < 0.001 were significantly higher in the thrombus group. A significantly greater proportion of patients in the non-thrombus group had early postoperative activity (P < 0.001 and used a foot pump (P < 0.001. Operative duration was significantly longer in the thrombus group (P = 0.012. Within the thrombus group, significantly more patients had bilateral than unilateral knee arthroplasty (P < 0.01. Multivariate logistic analysis revealed BMI, preoperative Hcy, postoperative FBG, long operative duration, bilateral knee arthroplasty, and time to the activity after the operation to be predictive factors of DVT. At 6-month follow-up of the thrombus group, 4.7% of patients had pulmonary embolism and 18.8% had recurrent DVT; there were no deaths. Conclusions: Obesity, inactivity after operation, elevated preoperative Hcy and postoperative FBG, long operative duration, and

  15. Analysis of Risk Factors for Lower-limb Deep Venous Thrombosis in Old Patients after Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Jian Kang; Xu Jiang; Bo Wu

    2015-01-01

    Background:Deep venous thrombosis (DVT) is a common complication of arthroplasty in old patients.We analyzed risk factors for lower-limb DVT after arthroplasty in patients aged over 70 years to determine controllable risk factors.Methods:This was a retrospective study of 1,025 patients aged >70 years treated with knee arthroplasty at our hospital between January 2009 and December 2013.Of 1,025 patients,175 had postoperative lower-limb DVT.We compared medical history,body mass index (BMI),ambulatory blood pressure,preoperative and postoperative fasting blood glucose (FBG),preoperative blood total cholesterol,triglyceride,high-and low-density lipoprotein cholesterol,and preoperative homocysteine (Hcy) between thrombus and non-thrombus groups.B-mode ultrasonography was used to detect lower-limb DVT before the operation and 7 days after the operation in all patients.Logistic regression analysis was used to determine risk factors for DVT.Results:Incidence of diabetes (P =0.014),BMI (P =0.003),preoperative FBG (P =0.004),postoperative FBG (P =0.012),and preoperative Hcy (P < 0.001) were significantly higher in the thrombus group.A significantly greater proportion of patients in the non-thrombus group had early postoperative activity (P < 0.001) and used a foot pump (P < 0.001).Operative duration was significantly longer in the thrombus group (P =0.012).Within the thrombus group,significantly more patients had bilateral than unilateral knee arthroplasty (P < 0.01).Multivariate logistic analysis revealed BMI,preoperative Hcy,postoperative FBG,long operative duration,bilateral knee arthroplasty,and time to the activity after the operation to be predictive factors of DVT.At 6-month follow-up of the thrombus group,4.7% of patients had pulmonary embolism and 18.8% had recurrent DVT;there were no deaths.Conclusions:Obesity,inactivity after operation,elevated preoperative Hey and postoperative FBG,long operative duration,and bilateral knee arthroplasty were risk

  16. Limb swinging in elephants and giraffes and implications for the reconstruction of limb movements and speed estimates in large dinosaurs

    Directory of Open Access Journals (Sweden)

    A. Christian

    1999-01-01

    Full Text Available Speeds of walking dinosaurs that left fossil trackways have been estimated using the stride length times natural pendulum frequency of the limbs. In a detailed analysis of limb movements in walking Asian elephants and giraffes, however, distinct differences between actual limb movements and the predicted limb movements using only gravity as driving force were observed. Additionally, stride frequency was highly variable. Swing time was fairly constant, but especially at high walking speeds, much shorter than half the natural pendulum period. An analysis of hip and shoulder movements during walking showed that limb swinging was influenced by accelerations of hip and shoulder joints especially at high walking speeds. These results suggest an economical fast walking mechanism that could have been utilised by large dinosaurs to increase maximum speeds of locomotion. These findings throw new light on the dynamics of large vertebrates and can be used to improve speed estimates in large dinosaurs. Geschwindigkeiten gehender Dinosaurier, die fossile Fährten hinterlassen haben, wurden als Produkt aus Schrittlänge und natürlicher Pendelfrequenz der Beine abgeschätzt. Eine detaillierte Analyse der Beinbewegungen von gehenden Asiatischen Elefanten und Giraffen offenbarte allerdings klare Unterschiede zwischen den tatsächlichen Extremitätenbewegungen und den Bewegungen, die zu erwarten wären, wenn die Gravitation die einzige treibende Kraft darstellte. Zudem erwies sich die Schrittfrequenz als hochgradig variabel. Die Schwingzeit der Gliedmaßen war recht konstant, aber besonders bei hohen Gehgeschwindigkeiten viel kürzer als die halbe natürliche Pendelperiode der Extremitäten. Eine Analyse der Bewegungen der Hüft- und Schultergelenke während des Gehens zeigte, daß das Schwingen der Gliedmaßen durch Beschleunigungen dieser Gelenke beeinflußt wurde, insbesondere bei hohen Gehgeschwindigkeiten. Die Resultate legen einen ökonomischen Mechanismus

  17. Short-limb dwarfism and hypertrophic cardiomyopathy in a patient with paternal isodisomy 14: 45,XYidic(14)(p11)

    Energy Technology Data Exchange (ETDEWEB)

    Walter, C.A.; Moore, C.M.; Kaye, C.I. [Univ. of Texas Health Science Center, San Antonio, TX (United States)] [and others

    1996-11-11

    Uniparental disomy (UPD) has been shown to result in specific disorders either due to imprinting and/or homozygosity of mutant alleles. Here we present the findings in a child with paternal UPD14. Ultrasound evaluation was performed at 30 weeks of gestation because of abnormally large uterine size. Pertinent ultrasound findings included polyhydramnios, short limbs, abnormal position of hands, small thorax, and nonvisualization of the fetal stomach. Postnatally the infant was found to have a low birth weight, short birth length, contractures, short limbs, and a small thorax with upslanting ribs. Assisted ventilation and gastrostomy were required. At age 6 months, the infant required hospitalization for hypertrophic cardiomyopathy which responded to Atenolol{reg_sign}. Initial cytogenetic studies demonstrated an apparently balanced de novo Robertsonian translocation involving chromosomes 14 and a karyotype designation of 45,XY,t(14q14q). No indication of mosaicism for trisomy 14 was observed in metaphase spreads prepared from peripheral blood lymphocytes or skin-derived fibroblasts. C-band and fluorescence in situ hybridization results demonstrated that the chromosome was dicentric. DNA analyses showed paternal uniparental isodisomy for chromosome 14. Based on the cytogenetic and DNA results a final karyotype designation of 45,XY,idic(14)(p11) was assigned to this infant with paternal isodisomy of chromosome 14. 41 refs., 5 figs., 2 tabs.

  18. Etiology of phantom limb syndrome: Insights from a 3D default space consciousness model.

    Science.gov (United States)

    Jerath, Ravinder; Crawford, Molly W; Jensen, Mike

    2015-08-01

    In this article, we examine phantom limb syndrome to gain insights into how the brain functions as the mind and how consciousness arises. We further explore our previously proposed consciousness model in which consciousness and body schema arise when information from throughout the body is processed by corticothalamic feedback loops and integrated by the thalamus. The parietal lobe spatially maps visual and non-visual information and the thalamus integrates and recreates this processed sensory information within a three-dimensional space termed the "3D default space." We propose that phantom limb syndrome and phantom limb pain arise when the afferent signaling from the amputated limb is lost but the neural circuits remain intact. In addition, integration of conflicting sensory information within the default 3D space and the loss of inhibitory afferent feedback to efferent motor activity from the amputated limb may underlie phantom limb pain. PMID:26003829

  19. Comparative Analysis of Cartilage Marker Gene Expression Patterns during Axolotl and Xenopus Limb Regeneration.

    Directory of Open Access Journals (Sweden)

    Kazumasa Mitogawa

    Full Text Available Axolotls (Ambystoma mexicanum can completely regenerate lost limbs, whereas Xenopus laevis frogs cannot. During limb regeneration, a blastema is first formed at the amputation plane. It is thought that this regeneration blastema forms a limb by mechanisms similar to those of a developing embryonic limb bud. Furthermore, Xenopus laevis frogs can form a blastema after amputation; however, the blastema results in a terminal cone-shaped cartilaginous structure called a "spike." The causes of this patterning defect in Xenopus frog limb regeneration were explored. We hypothesized that differences in chondrogenesis may underlie the patterning defect. Thus, we focused on chondrogenesis. Chondrogenesis marker genes, type I and type II collagen, were compared in regenerative and nonregenerative environments. There were marked differences between axolotls and Xenopus in the expression pattern of these chondrogenesis-associated genes. The relative deficit in the chondrogenic capacity of Xenopus blastema cells may account for the absence of total limb regenerative capacity.

  20. Phantom limbs: pain, embodiment, and scientific advances in integrative therapies.

    Science.gov (United States)

    Lenggenhager, Bigna; Arnold, Carolyn A; Giummarra, Melita J

    2014-03-01

    Research over the past two decades has begun to identify some of the key mechanisms underlying phantom limb pain and sensations; however, this continues to be a clinically challenging condition to manage. Treatment of phantom pain, like all chronic pain conditions, demands a holistic approach that takes into consideration peripheral, spinal, and central neuroplastic mechanisms. In this review, we focus on nonpharmacological treatments tailored to reverse the maladaptive neuroplasticity associated with phantom pain. Recent scientific advances emerging from interdisciplinary research between neuroscience, virtual reality, robotics, and prosthetics show the greatest promise for alternative embodiment and maintaining the integrity of the multifaceted representation of the body in the brain. Importantly, these advances have been found to prevent and reduce phantom limb pain. In particular, therapies that involve sensory and/or motor retraining, most naturally through the use of integrative prosthetic devices, as well as peripheral (e.g., transcutaneous electrical nerve stimulation) or central (e.g., transcranial magnetic stimulation or deep brain stimulation) stimulation techniques, have been found to both restore the neural representation of the missing limb and to reduce the intensity of phantom pain. While the evidence for the efficacy of these therapies is mounting, but well-controlled and large-scale studies are still needed. WIREs Cogn Sci 2014, 5:221-231. doi: 10.1002/wcs.1277 CONFLICT OF INTEREST: The authors have no financial or other relationship that might lead to a conflict of interest. For further resources related to this article, please visit the WIREs website. PMID:26304309