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Sample records for blood pressure-lowering limb

  1. 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

    OBJECTIVE: To compare the effects of two antihypertensive treatment strategies for the prevention of coronary heart disease and other cardiovascular events in the large subpopulation (n=5137) with diabetes mellitus in the blood pressure-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial...... by 48% (P=0.004) and noncoronary revascularization procedures by 57% (Pdeaths and nonfatal myocardial infarctions (the primary endpoint), which were reduced...... nonsignificantly by 8% (hazard ratio 0.92, confidence interval 0.74-1.15). CONCLUSION: In the large diabetic subgroup in the blood pressure-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial, the benefits of amlodipine-based treatment, compared with atenolol-based treatment, on the incidence of total...

  2. Blood Pressure-Lowering Diet May Help Treat Gout

    Science.gov (United States)

    ... blood pressure may also offer a non-drug treatment for gout -- a type of inflammatory arthritis, a new study ... risk for gout. A dietary approach to prevent gout should be considered first-line therapy," said study senior author Dr. Edgar Miller III. ...

  3. 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

  4. 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.

  5. More Versus Less Intensive Blood Pressure-Lowering Strategy: Cumulative Evidence and Trial Sequential Analysis.

    Science.gov (United States)

    Verdecchia, Paolo; Angeli, Fabio; Gentile, Giorgio; Reboldi, Gianpaolo

    2016-09-01

    Several randomized trials compared a more versus less intensive blood pressure-lowering strategy on the risk of major cardiovascular events and death. Cumulative meta-analyses and trial sequential analyses can establish whether and when firm evidence favoring a specific intervention has been reached from accrued literature. Therefore, we conducted a cumulative trial sequential analysis of 18 trials that randomly allocated 53 405 patients to a more or less intensive blood pressure-lowering strategy. We sought to ascertain the extent to which trial evidence added to previously accrued data. Outcome measures were stroke, myocardial infarction, heart failure, cardiovascular death, and all-cause death. Achieved blood pressure was 7.6/4.5 mm Hg lower with the more intensive than the less intensive blood pressure-lowering strategy. For stroke and myocardial infarction, the cumulative Z curve crossed the efficacy monitoring boundary solely after the SPRINT (Systolic Blood Pressure Intervention Trial) study, thereby providing firm evidence of superiority of a more intensive over a less intensive blood pressure-lowering strategy. For cardiovascular death and heart failure, the cumulative Z curve crossed the conventional significance boundary, but not the sequential monitoring boundary, after SPRINT. For all-cause death, the SPRINT trial pushed the cumulative Z curve away from the futility area, without reaching the conventional significance boundary. We conclude that evidence accrued to date strongly supports the superiority of a more intensive versus a less intensive blood pressure-lowering strategy for prevention of stroke and myocardial infarction. Cardiovascular death and heart failure are likely to be reduced by a more intensive blood pressure-lowering strategy, but evidence is not yet conclusive.

  6. Baseline albuminuria predicts the efficacy of blood pressure-lowering drugs in preventing cardiovascular events

    NARCIS (Netherlands)

    Boersma, C.; Postma, M.J.; Visser, S.T.; Atthobari, J.; de Jong, P.E.; de Jong-van den Berg, L.T.; Gansevoort, R.T.

    2008-01-01

    AIMS Albuminuria has been proven to be associated with cardiovascular (CV) events in specific patient populations, but also in the general population. This study aimed to investigate whether the efficacy of blood pressure-lowering agents in preventing CV events depends on baseline urinary albumin ex

  7. Blood pressure-lowering treatment based on cardiovascular risk : a meta-analysis of individual patient data

    NARCIS (Netherlands)

    Sundström, Johan; Arima, Hisatomi; Woodward, Mark; Jackson, Rod; Karmali, Kunal; Lloyd-Jones, Donald; Baigent, Colin; Emberson, Jonathan; Rahimi, Kazem; MacMahon, Stephen; Patel, Anushka; Perkovic, Vlado; Turnbull, Fiona; Neal, Bruce; de Zeeuw, Dick

    2014-01-01

    BACKGROUND: We aimed to investigate whether the benefits of blood pressure-lowering drugs are proportional to baseline cardiovascular risk, to establish whether absolute risk could be used to inform treatment decisions for blood pressure-lowering therapy, as is recommended for lipid-lowering therapy

  8. 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;

    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....

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Intensive blood pressure lowering increases cerebral blood flow in older subjects with hypertension.

    Science.gov (United States)

    Tryambake, Dinesh; He, Jiabao; Firbank, Michael J; O'Brien, John T; Blamire, Andrew M; Ford, Gary A

    2013-06-01

    Hypertension is associated with reduced cerebral blood flow (CBF). Intensive (blood pressure (BP) lowering in older people might give greater reduction in cardiovascular risk, but there are concerns that this might produce hypoperfusion which may precipitate falls and possibly stroke. We determined the effect of intensive compared with usual BP lowering on CBF in hypertensive older subjects. Individuals aged >70 years with a history of systolic hypertension on 1 or no BP lowering drugs were recruited from primary care (n=37; age, 75±4 years; systolic BP, >150 mm Hg) and randomized to receive intensive (target BP, treatment. Baseline BP (ambulatory or in clinic) and baseline gray matter CBF were not significantly different between the groups. After treatment, BP was reduced significantly in both groups but fell more in the intensive group (26/17 versus 15/5 mm Hg; Phypertension increases CBF, compared with BP lowering to usual target. These findings suggest hypertension in older people shifts the autoregulatory CBF curve rightward and downward and is reversible with BP lowering.

  11. Mechanisms for blood pressure lowering and metabolic effects of thiazide and thiazide-like diuretics

    Science.gov (United States)

    Duarte, Julio D; Cooper-DeHoff, Rhonda M

    2010-01-01

    Thiazide and thiazide-like diuretics are among the most commonly used antihypertensives and have been available for over 50 years. However, the mechanism by which these drugs chronically lower blood pressure is poorly understood. Possible mechanisms include direct endothelial- or vascular smooth muscle-mediated vasodilation and indirect compensation to acute decreases in cardiac output. In addition, thiazides are associated with adverse metabolic effects, particularly hyperglycemia, and the mechanistic underpinnings of these effects are also poorly understood. Thiazide-induced hypokalemia, as well as other theories to explain these metabolic disturbances, including increased visceral adiposity, hyperuricemia, decreased glucose metabolism and pancreatic β-cell hyperpolarization, may play a role. Understanding genetic variants with differential responses to thiazides could reveal new mechanistic candidates for future research to provide a more complete understanding of the blood pressure and metabolic response to thiazide diuretics. PMID:20528637

  12. Blood pressure lowering action of active principle from Trachyspermum ammi (L.) sprague.

    Science.gov (United States)

    Aftab, K; Atta-Ur-Rahman; Usmanghani, K

    1995-07-01

    Trachyspermum ammi (L.) Syn. Carum copticum (L.) Bth. (Apiaceae) is locally known as Ajowan. Bioassay-directed fractionation of Trachyspermum ammi has resulted in the isolation of thymol which is present in other plants as well. However, its action on blood pressure has not been studied so far. In anaesthetized rats, thymol (1-10mg/kg) produced dose-dependent fall in blood pressure and heart rate. These effects were not blocked by atropine (1 mg/kg) and thymol did not modify presser response of norepinepherine, which rules out the possibility of cholinergic stimulation or adrenergic blockade. In spontaneously beating atria, thymol caused decrease in force and rate of atrial contractions. These effects remained unaltered in the presence of atropine. In rabbit aorta, thymol caused relaxation of norepinepherine and potassium induced contractions in a concentration-dependent manner. These relaxant effects remained unchanged after the removal of endothelium. Moreover, atropine, propranolol, indomethacine and glibenclamide did not alter the vasorelaxation by thymol. These results suggest that Trachyspermum ammi contains a calcium channel blocker-like constituent (thymol) which may explain the hypotensive and bradycardiac effects observed in the in vivo studies.

  13. Future Treatment of Hypertension: Shifting the Focus from Blood Pressure Lowering to Arterial Stiffness Modulation?

    Science.gov (United States)

    Fok, Henry; Cruickshank, J Kennedy

    2015-08-01

    Isolated systolic hypertension is the commonest form of hypertension from middle age onwards. Achieving target systolic blood pressure (BP) control remains difficult in everyday clinical practice and even under clinical trial conditions. Most antihypertensive medicines were designed to lower peripheral vascular resistance, which was considered the haemodynamic determinant of hypertension; most are effective in reducing steady but not pulsatile components of BP. Arterial stiffness, defined via aortic length-specific pulse wave velocity (PWV), is thought to be an important determinant of pulse pressure widening through its effects on the timing and amplitude of pressure wave reflection, and/or the aorta's Windkessel function, or its excess 'reservoir' pressure. Whereas pulse pressure is neither an independent nor consistent cardiovascular risk factor, particularly below the age of about 60 years, PWV has become the most powerful predictor of cardiovascular outcomes including mortality, independent of systolic, pulse, mean or other BP components. PWV is therefore a more direct target for treatment. This review addresses the potential therapeutic options for targeting arterial stiffness and the role of pulse pressure.

  14. 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

  15. Effects of blood pressure lowering and intensive glucose control on the incidence and progression of retinopathy in patients with type 2 diabetes mellitus : a randomised controlled trial

    NARCIS (Netherlands)

    Beulens, J. W. J.; Patel, A.; Vingerling, J. R.; Cruickshank, J. K.; Hughes, A. D.; Stanton, A.; Lu, J.; Thom, S. A. McG; Grobbee, D. E.; Stolk, R. P.

    2009-01-01

    The aim of the present study was to investigate the effect of blood pressure lowering and intensive glucose control on the incidence and progression of retinopathy in type 2 diabetic patients. The Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) Reti

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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...... 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-dependent to a large extent...

  1. A new monoterpene glucoside and complete assignments of dihydroflavonols of Pulicaria jaubertii: potential cytotoxic and blood pressure lowering activity.

    Science.gov (United States)

    Ragab, Ehab A; Raafat, Mohamed

    2016-06-01

    One new monoterpene glucoside and five dihydroflavonols were isolated for the first time from the aerial parts of Pulicaria jaubertii and identified as p-menthane-2-O-β-D-glucopyranoside [1], dihydroquercetin (taxifolin) [2], 7,3'-di-O-methyltaxifolin [3], 3'-O-methyltaxifolin [4], 7-O-methyltaxifolin (padmatin) [5] and 7-O-methyl-dihydrokampferol (7-O-methylaromadenderin) [6]. The structures of these compounds were unambiguously assigned on the basis of NMR spectroscopic data ((1)H, (13)C, DEPT, HSQC, HMBC) and MS analysis. 2D-NMR methods required revision of assignments of H-6 and H-8 for dihydroflavonol compounds. Possible cytotoxic activity as well as blood pressure (BP) lowering activity were tested. The alcoholic extract showed cytotoxic activity against prostate carcinoma (PC-3), breast carcinoma (MCF-7) and hepatocellular carcinoma (HepG-2) human cell lines with IC50 19.1, 20.0 and 24.1 μg, respectively. The higher dose levels of the alcoholic extract significantly reduced normal BP of rats in a dose-dependent manner.

  2. ISH PRE-1 REDUCTION OF CARDIOVASCULAR MORTALITY IN HYPERTENSIVES WITH COMORBIDITIES: BEYOND BLOOD PRESSURE LOWERING - THE ROLE OF ARTERIAL AGING.

    Science.gov (United States)

    Safar, Michel E

    2016-09-01

    Mid-life elevated BP is classically associated with a raised systemic vascular resistance. A classical interpretation of the association between aortic stiffness and blood pressure (BP) invokes hypertension as a simple form of premature aging that increases stress on the arterial wall and accelerates age-related stiffening of the aorta. Recent clinical and experimental data have called into question the directionality of this sequence of events associating stiffness and hypertension.Therefore an initial abnormality in stiffness may antedate and contribute initially to the pathogenesis of hypertension, namely isolated systolic hypertension. This possibility is important to consider since it might affect the individual estimation of cardiovascular risk even in low risk prehypertensive subjects. Therefore, it might be essential to direct therapy of hypertension toward the reduction of both BP and aortic stiffness.Cardiovascular (CV) complications are dominant causes of death in severe hypertensive patients with comorbidities, especially diabetic hypertensive patients (DHS) and patients with end-stage renal disease (ESRD). Vascular calcifi cation and arterial stiffness are highly prevalent in such subjects, particularly in those with co-morbidities. Carotid-femoral pulse wave velocity (CFPWV) is the gold standard and simple, non-invasive and reproducible measure of large artery stiffness.This measurement have been frequently used as predictors for CV events and CV mortality in the general population, in specifi c populations such as in patients with DHS and ESRD. These fi ndings have been widely observed using conventional cross-sectional investigations. However, in such studies, it has been observed that the association between single measurements of CFPWV and CV events is frequently driven by the high incidence of late events, i.e. after 12 months of follow-up.New data from our prospective studies in DHS and ESRD evaluated the association between longitudinal changes

  3. Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA)

    DEFF Research Database (Denmark)

    Poulter, Neil R; Wedel, Hans; Dahlöf, Björn;

    2005-01-01

    Results of the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) show significantly lower rates of coronary and stroke events in individuals allocated an amlodipine-based combination drug regimen than in those allocated an atenolol-based combination drug regimen (HR...... 0.86 and 0.77, respectively). Our aim was to assess to what extent these differences were due to significant differences in blood pressures and in other variables noted after randomisation....

  4. Rationale and design of the AdRem study : Evaluating the effects of blood pressure lowering and intensive glucose control on vascular retinal disorders in patients with type 2 diabetes mellitus

    NARCIS (Netherlands)

    Stolk, Ronald P.; Vingerling, Johannes R.; Cruickshank, J. Kennedy; Hughes, Alun D.; Stanton, Alice; Lu Juming, [No Value; Patel, Anushka; Thom, Simon A. McG.; Grobbee, Diederick E.; Lu, J.M.

    2007-01-01

    The ADVANCE Retinal Measurements (AdRem) Study is a large intervention study evaluating the effects of target driven intensive glucose control and placebo controlled blood pressure lowering on retinal vascular changes. AdRem is a sub-study of the ADVANCE Study (Action in Diabetes and Vascular diseas

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. 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.

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

    DEFF Research Database (Denmark)

    González-Alonso, José; Calbet, José A. L.; Boushel, Robert;

    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......- 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...... 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...

  11. 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...

  12. O2-sulfonylethyl protected isopropylamine diazen-1-ium-1,2-diolates as nitroxyl (HNO) donors: synthesis, β-elimination fragmentation, HNO release, positive inotropic properties, and blood pressure lowering studies.

    Science.gov (United States)

    Huang, Zhangjian; Kaur, Jatinder; Bhardwaj, Atul; Alsaleh, Nasser; Reisz, Julie A; DuMond, Jenna F; King, S Bruce; Seubert, John M; Zhang, Yihua; Knaus, Edward E

    2012-11-26

    New types of nonexplosive O(2)-sulfonylethyl protected (-CH(2)CH(2)SO(2)R; R = OMe, NHOMe, NHOBn, Me) derivatives of isopropylamine diazen-1-ium-1,2-diolate (IPA/NO) (2-5) were developed that are designed to act as novel HNO donors. These compounds, with suitable half-lives (6.6-17.1 h) at pH 7.4, undergo a base-induced β-elimination reaction that releases a methyl vinyl sulfone product and the parent IPA/NO anion which subsequently preferentially releases HNO (46-61% range). Importantly, the O(2)-methylsulfonylethyl compound 5 exhibited a significant in vitro inotropic effect up to 283% of the baseline value and increased the rates of contraction and relaxation but did not induce a chronotropic effect. Furthermore, compound 5 (22.5 mg/kg po dose) provided a significant reduction in blood pressure up to 6 h after drug administration. All these data suggest that O(2)-sulfonylethyl protected derivatives of IPA/NO, which are efficient HNO donors, could have potential applications to treat cardiovascular disease(s) such as congestive heart failure.

  13. 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;

    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...... a significant difference between body and limb wounds. In conclusion, the metabolic disturbances may suggest an inadequate oxygen supply during the wound healing process in equine limb wounds healing with EGT. This may be related to the inherently decreased perfusion in the wound bed of limb wounds....... 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...

  14. 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 ...

  15. Efficacy of Micromobile Foot Compression Device in Increasing Lower Limb Venous Blood Flow

    Directory of Open Access Journals (Sweden)

    Thomas Charles

    2013-01-01

    Full Text Available Background. A novel, micromobile foot compression device (MMC has been developed to reduce the risk of venous thromboembolism associated with prolonged seated immobility. Objective. To compare the efficacy of the MMC with graduated compression stockings in augmenting lower limb venous blood flow. Patients/Methods. Twenty participants were randomised to wear the MMC or a graduated compression stocking (GCS on either the left or right leg while seated. Doppler ultrasound measurements of popliteal vein blood flow and leg circumference measurements were made -30 and -10 minutes (baseline and +30 and +60 minutes following application of the interventions. The primary outcome variable was peak systolic velocity. A mixed linear model was used, with covariates including baseline measurement, randomised side, time, and a time by interaction term. Results. The mean popliteal vein peak systolic velocity at 60 minutes with the MMC was 20.1 cm/s which was significantly higher than with the GCS (difference 14.1 cm/s 95% CI 12.1–16.2, representing a 3.8-fold increase from baseline. Conclusion. The MMC resulted in a marked increase in lower limb venous blood flow which suggests that it may have efficacy in reducing the risk of venous thromboembolism associated with prolonged seated immobility, such as long distance air travel.

  16. 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...

  17. Methods for axolotl blood collection, intravenous injection, and efficient leukocyte isolation from peripheral blood and the regenerating limb.

    Science.gov (United States)

    Debuque, Ryan J; Godwin, James W

    2015-01-01

    The vertebrate immune system comprises both adaptive and innate immune cells with distinct functions during the resolution of inflammation and wound healing after tissue injury. Recent evidence implicates a requirement for innate immune cells from the myeloid lineage during the early stages of limb regeneration in the Mexican axolotl. Understanding the functions of innate and adaptive immune cells in the axolotl has been hampered by a lack of approaches to isolate and analyze these cells. Here we describe a protocol to isolate myeloid cells from the regenerating axolotl limb that incorporates intravenous delivery of physiological labels. In addition we provide a protocol to enrich for leukocytes in the peripheral blood. These protocols produce single-cell suspensions that can be analyzed using flow cytometry or sorted into specific subsets using fluorescent-activated cell sorting (FACS). FACS is a routine approach to sort cells based on their physical characteristics as well as their cell surface antigen repertoire. Isolated cell populations can then be analyzed in a wide range of downstream assays to facilitate a greater understanding of leukocyte biology in the axolotl.

  18. 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

    kept at 10 mmHg during elevation. In these patients, the increase in vascular resistance was significantly less compared with the situation in which venous pressure was 0 mmHg during elevation. The arterial pressure still did not decrease. It is concluded that perfusion pressure in the ischaemic lower......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 popliteal...

  19. 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

  20. 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.

  1. 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.

  2. Growing blood vessels to treat limb ischemia : studie in mice and man

    NARCIS (Netherlands)

    Weel, Vincent van

    2008-01-01

    Summary This thesis describes the efforts of increasing our knowledge and insights into cellular and molecular mechanisms of vascular growth, especially collateral artery growth (arteriogenesis), in limb ischemia with the aim of developing new strategies for therapeutic angiogenesis and arteriogenes

  3. 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

  4. ROLE OF TRANEXAMIC ACID IN REDUCING POSTOPERATIVE BLOOD LOSS AND TRANSFUSION REQUIREMENT IN PATIENTS UNDERGOING LOWER LIMB ORTHOPEDIC SURGERIES

    Directory of Open Access Journals (Sweden)

    Yashwant

    2014-09-01

    Full Text Available AIM: Aim of our study to assess the effects of tranexamic acid (TA in patients undergoing lower limb orthopedic surgeries. OBJECTIVE: Assess the effects of tranexamic acid on prevention of bleeding and requirement of blood transfusion after major lower limb orthopedic surgeries. MATERIAL AND METHOD: 90 patients ASA grade I & II undergoing elective surgery for femoral fracture like open reduction internal fixation, hemiarthroplasty, total hip replacement (THR under anaesthesia were taken. Patients were classified randomly into 2 groups (forty five patients in each group. Group T: Patients received inj. TA 10 mg/kg body weight. Group P: Patients received normal saline 1 ml/kg body weight 15 min before surgery. Postoperative hemoglobin concentration (on day 0 and day 2 and volume of blood in the drain were measured. The number of units of packed red cells transfused during the hospital stay was recorded and any thromboembolic and other complications were documented. RESULT: Analysis revealed that there were no significant differences between the patients with respect to age, sex, duration and type of surgery and preoperative mean hemoglobin concentration. Neither heart rate nor MABP has statistically significant difference or results (P>0.05. The drains were removed in the evening of the first postoperative day. Mean volume of blood in the drain compared to placebo group showing a highly significant reduction in postoperative blood loss (P=0.01. Mean fall in hemoglobin at day 0 and day 2 was 2 less in the study group as compared to the placebo that has P value 0.01 making it significant finding. CONCLUSION: the present paired study demonstrated that the administration of TA given preoperatively reduces the blood loss in the first 24 h by a highly significant degree as well it causes a significant reduction in postoperative anemia and need for transfusion among these patients.

  5. The Effects of Chinese Medicines on Micro-circulation of Nail Folds and Blood Flow Velocity of Limbs in the Patients with Arteriosclerotic Obliteration

    Institute of Scientific and Technical Information of China (English)

    葛辛; 葛芃; 彭玉清; 陈云翔

    2003-01-01

    The effects of Chinese medicines on micro-circulation and blood flow velocity in arteries of the lower limbs were observed in 33 patients with arteriosclerotic obliteration (ASO). The results showed that the integral values of micro-circulation after treatment were obviously higher than those before treatment (P<0.05 or P<0.01). Blood flow velocity in arteries of the lower limbs determined with the color Doppler ultrasound detecting method after treatment were also obviously higher than those before treatment (P<0.05 or P<0.01). In this series of 33 ASO patients, the markedly effective rate was 36.36%, and the total effective rate was 63.64%. The observation indicates that the recipe prescribed according to the principle of supplementing qi and activating blood circulation can effectively improve micro-circulation in ASO patients, and accelerate blood flow in arteries of the lower limbs.

  6. 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...

  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 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...

  8. 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.

  9. 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

  10. 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

  11. 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

    procedure to the finger pulp of 16.2 microSv, to the ring area of 8.5 microSv, and to the abdominal wall of 4.2 +/- 0.6 microSv. CONCLUSIONS: HILP with (99m)technetium-labeled red blood cells does not constitute a safety risk to the operating team with respect to radioactive exposure. Routine dose...... to 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 performing...... pulp and to the ring area of the left fourth finger, as well as an electronic dosimeter attached to the anterior lining of the trousers. The anesthesiologist and perfusion technologist also carried electronic dosimeters. RESULTS: The surgeon had the highest radioactive exposure with an average dose per...

  12. 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.

  13. Comparison of blood pressurs-lowering efifcacy of 5 kinds of antihypertensive agents in the treatment of patients with hypertension in the community%比较社区五类抗高血压药物的降压疗效

    Institute of Scientific and Technical Information of China (English)

    王亚娟; 钱岳晟; 王彦

    2014-01-01

    Objective:To ifnd out the current situation of 5 kinds of antihypertensive agents in the treatment of patinets with hypertension in the community, and to compare their blood pressure(BP)-lowering efifcacy. Methods:The data of 5 594 hypertensive patients from the electrical health record system during 2007 to 2011 were collected, and BP-lowering efficay of 5 kinds of antihypertensive agents was analyzed. Results: ①The calcium channel blocker (CCB) was most used in the community.②There were no differences in the BP-lowering among 5 kinds of antihypertensive agents. However, the systolic BP was reduced more signiifcantly in the women taking angiotensin receptor II blockers (ARB), and in the middle-aged people taking CCB and diuretics. The CCB and angiotensin converting enzyme inhibitor (ACEI) had more advantages in lowering the diastolic BP for the elderly patients.③There was no signiifcant difference between the domestic and joint venture antihypertensive agents in lowering the BP. Conclusion:In the treatment of hypertension in the community, CCB and the domestic agents are used most. The use of ARB is related to the gender and CCB, and the use of ACEI and diuretics are related to the age.%目的:了解社区5类抗高血压药物的使用现状,比较不同类型抗高血压药物的降压疗效。方法:收集2007年至2011年本中心电子健康档案中5594例高血压患者的资料,分析使用每种抗高血压药物的降压幅度。结果:①社区使用的抗高血压药物中以钙通道拮抗剂(CCB)居首位。②各类抗高血压药物间的降压幅度差异无统计学意义(P>0.05),但服用血管紧张素Ⅱ受体拮抗剂(ARB)的女性、服用CCB和利尿剂的中年患者收缩压降压幅度更明显,服用CCB和血管紧张素转换酶抑制剂(ACEI)的老年患者舒张压降压幅度更有优势。③国产与合资药物间的降压幅度差异无统计学意义(P>0.05)。结论:社区高血压治

  14. Driving performance on the descending limb of blood alcohol concentration (BAC in undergraduate students: a pilot study.

    Directory of Open Access Journals (Sweden)

    Mathieu Tremblay

    Full Text Available Young drivers are overrepresented in collisions resulting in fatalities. It is not uncommon for young drivers to socially binge drink and decide to drive a vehicle a few hours after consumption. To better understand the risks that may be associated with this behaviour, the present study has examined the effects of a social drinking bout followed by a simulated drive in undergraduate students on the descending limb of their BAC (blood alcohol concentration curve. Two groups of eight undergraduate students (n = 16 took part in this study. Participants in the alcohol group were assessed before drinking, then at moderate and low BAC as well as 24 hours post-acute consumption. This group consumed an average of 5.3 ± 1.4 (mean ± SD drinks in an hour in a social context and were then submitted to a driving and a predicted crash risk assessment. The control group was assessed at the same time points without alcohol intake or social context.; at 8 a.m., noon, 3 p.m. and 8 a.m. the next morning. These multiple time points were used to measure any potential learning effects from the assessment tools (i.e. driving simulator and useful field of view test (UFOV. Diminished driving performance at moderate BAC was observed with no increases in predicted crash risk. Moderate correlations between driving variables were observed. No association exists between driving variables and UFOV variables. The control group improved measures of selective attention after the third assessment. No learning effect was observed from multiple sessions with the driving simulator. Our results show that a moderate BAC, although legal, increases the risky behaviour. Effects of alcohol expectancy could have been displayed by the experimental group. UFOV measures and predicted crash risk categories were not sensitive enough to predict crash risk for young drivers, even when intoxicated.

  15. 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

  16. 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 ...

  17. Limb anomalies

    DEFF Research Database (Denmark)

    Gurrieri, Fiorella; Kjær, Klaus Wilbrandt; Sangiorgi, Eugenio;

    2002-01-01

    of limb development has been conserved for more than 300 millions years, with all the necessary adaptive modifications occurring throughout evolution, we also take into consideration the evolutionary aspects of limb development in terms of genetic repertoire, molecular pathways, and morphogenetic events....

  18. Effect of acute inspiratory muscle exercise on blood flow of resting and exercising limbs and glucose levels in type 2 diabetes.

    Directory of Open Access Journals (Sweden)

    Ana Paula dos Santos Corrêa

    Full Text Available To evaluate the effects of inspiratory loading on blood flow of resting and exercising limbs in patients with diabetic autonomic neuropathy. Ten diabetic patients without cardiovascular autonomic neuropathy (DM, 10 patients with cardiovascular autonomic neuropathy (DM-CAN and 10 healthy controls (C were randomly assigned to inspiratory muscle load of 60% or 2% of maximal inspiratory pressure (PImax for approximately 5 min, while resting calf blood flow (CBF and exercising forearm blood flow (FBF were measured. Reactive hyperemia was also evaluated. From the 20 diabetic patients initially allocated, 6 wore a continuous glucose monitoring system to evaluate the glucose levels during these two sessions (2%, placebo or 60%, inspiratory muscle metaboreflex. Mean age was 58 ± 8 years, and mean HbA1c, 7.8% (62 mmol/mol (DM and DM-CAN. A PImax of 60% caused reduction of CBF in DM-CAN and DM (P<0.001, but not in C, whereas calf vascular resistance (CVR increased in DM-CAN and DM (P<0.001, but not in C. The increase in FBF during forearm exercise was blunted during 60% of PImax in DM-CAN and DM, and augmented in C (P<0.001. Glucose levels decreased by 40 ± 18.8% (P<0.001 at 60%, but not at 2%, of PImax. A negative correlation was observed between reactive hyperemia and changes in CVR (Beta coefficient = -0.44, P = 0.034. Inspiratory muscle loading caused an exacerbation of the inspiratory muscle metaboreflex in patients with diabetes, regardless of the presence of neuropathy, but influenced by endothelial dysfunction. High-intensity exercise that recruits the diaphragm can abruptly reduce glucose levels.

  19. A System for Simple Real-Time Anastomotic Failure Detection and Wireless Blood Flow Monitoring in the Lower Limbs

    Science.gov (United States)

    Rothfuss, Michael A.; Franconi, Nicholas G.; Unadkat, Jignesh V.; Gimbel, Michael L.; STAR, Alexander; Mickle, Marlin H.

    2016-01-01

    Current totally implantable wireless blood flow monitors are large and cannot operate alongside nearby monitors. To alleviate the problems with the current monitors, we developed a system to monitor blood flow wirelessly, with a simple and easily interpretable real-time output. To the best of our knowledge, the implanted electronics are the smallest in reported literature, which reduces bio-burden. Calibration was performed across realistic physiological flow ranges using a syringe pump. The device’s sensors connected directly to the bilateral femoral veins of swine. For each 1 min, blood flow was monitored, then, an occlusion was introduced, and then, the occlusion was removed to resume flow. Each vein of four pigs was monitored four times, totaling 32 data collections. The implant measured 1.70 cm3 without battery/encapsulation. Across its calibrated range, including equipment tolerances, the relative error is less than ±5% above 8 mL/min and between −0.8% and +1.2% at its largest calibrated flow rate, which to the best of our knowledge is the lowest reported in the literature across the measured calibration range. The average standard deviation of the flow waveform amplitude was three times greater than that of no-flow. Establishing the relative amplitude for the flow and no-flow waveforms was found necessary, particularly for noise modulated Doppler signals. Its size and accuracy, compared with other microcontroller-equipped totally implantable monitors, make it a good candidate for future tether-free free flap monitoring studies. PMID:27730016

  20. 活血通脉液内外并治动脉硬化性闭塞症患肢体麻木、溃疡40例%Management of limbs numb and ulcer in 40 patients with atherosclerotic occlusion by fluid promoting blood circulation to remove obstruction in channels externally and internally applied

    Institute of Scientific and Technical Information of China (English)

    杜振芳; 袁曙光

    2002-01-01

    Background:Atherosclerotic Occlusion(ASO) is common among middle aged and elderly population to which atherosclerosis of vital organs,disorder of blood supply in limbs,as well as limbs numb or ulcer are secondary.Rate of disbilitation and amputee is high.So,management and prevention of disbilation are very important.

  1. 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

  2. [Sequence of venous blood flow alterations in patients after recently endured acute thrombosis of lower-limb deep veins based on the findings of ultrasonographic duplex scanning].

    Science.gov (United States)

    Tarkovskiĭ, A A; Zudin, A M; Aleksandrova, E S

    2009-01-01

    This study was undertaken to investigate the sequence of alterations in the venous blood flow to have occurred within the time frame of one year after sustained acute thrombosis of the lower-limb deep veins, which was carried out using the standard technique of ultrasonographic duplex scanning. A total of thirty-two 24-to-62-year-old patients presenting with newly onset acute phlebothrombosis were followed up. All the patients were sequentially examined at 2 days, 3 weeks, 3 months, 6 months and 12 months after the manifestation of the initial clinical signs of the disease. Amongst the parameters to determine were the patency of the deep veins and the condition of the valvular apparatus of the deep, superficial and communicant veins. According to the obtained findings, it was as early as at the first stage of the phlebohaemodynamic alterations after the endured thrombosis, i. e., during the acute period of the disease, that seven (21.9%) patients were found to have developed valvular insufficiency of the communicant veins of the cms, manifesting itself in the formation of a horizontal veno-venous reflux, and 6 months later, these events were observed to have occurred in all the patients examined (100%). Afterwards, the second stage of the phlebohaemodynamic alterations was, simultaneously with the process of recanalization of the thrombotic masses in the deep veins, specifically characterized by the formation of valvular insufficiency of the latter, manifesting itself in the form of the development of a deep vertical veno-venous reflux, which was revealed at month six after the onset of the disease in 56.3% of the examined subjects, to be then observed after 12 months in 93.8% of the patients involved. Recanalization of thrombotic masses was noted to commence 3 months after the onset of thrombosis in twelve (37.5%) patients, and after 12 months it was seen to ensue in all the patients (100%), eventually ending in complete restoration of the patency of the affected

  3. 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

  4. Flap repair for vascular prosthesis exposure after artificial blood vessel bypass surgery for critical limb ischemia%皮瓣重建修复下肢动脉旁路移植术后人工血管外露

    Institute of Scientific and Technical Information of China (English)

    吴巍巍; 吴昊; 曾昂; 白明; 曾嵘; 陈宇; 刘昌伟

    2013-01-01

    Objective To investigate the effectiveness of flap repair for vascular prosthesis exposure after the artificial blood vessel bypass surgery for critical limb ischemia.Methods From August 2007 to December 2011,bypass surgery with vascular prosthetic grafts were performed in 192 patients with critical limb ischemia.Five patients among them (2.6%) suffered from vascular prosthesis exposure 6 to 13 days after the previous surgery,including 4 males and 1 female,with a median age of 68 years (arranged from 52 to 81 years).The surgical managements included surgical debridement and local flap or transferred muscle-cutaneous flap repair to preserve the prosthetic vascular grafts.Three patients underwent Z-plasty with local flap repair,while 2 patients underwent transferred rectus abdominis or rectus femoris muscle flap repair of the wounds.Results After the surgery,prosthetic vascular graft was successfully preserved in 4 of the 5 cases with first intention healing.At a median follow-up of 38 months (arranged from 5 to 57 months),all the 4 limbs were salvaged with patent of the prosthetic grafts.One flap failed to heal and the prosthetic graft had to be removed due to infection and hemorrhage.An above-knee-amputation was performed due to severe limb ischemia.Conclusions The vascular prosthesis exposure is often a disaster after artificial blood vessel bypass surgery for critical limb ischemia.Local flap or transferred muscle-cutaneous flap repair is an effective surgical management to salvage the exposed graft and the affected limb.%目的 探讨皮瓣重建技术修复因重症下肢缺血行人工血管旁路移植术后人工血管外露的可行性.方法 回顾性分析2007年8月至201 1年12月诊治的192例下肢人工血管旁路移植术后患者,其中5例(2.6%)在前次术后6~13d发生人工血管外露,包括男性4例,女性1例,年龄52~81岁,中位年龄68岁.外科处理主要包括局部清创及保留移植物的任意皮

  5. Micro-lightguide spectrophotometry for tissue perfusion in ischemic limbs

    DEFF Research Database (Denmark)

    Jørgensen, Lise Pyndt; Schroeder, Torben V

    2012-01-01

    To validate micro-lightguide spectrophotometry (O2C) in patients with lower limb ischemia and to compare results with those obtained from toe blood pressure.......To validate micro-lightguide spectrophotometry (O2C) in patients with lower limb ischemia and to compare results with those obtained from toe blood pressure....

  6. 脐血干细胞移植及血管成形治疗糖尿病下肢缺血性疾病%Umbilical cord blood stem cell transplantation and endovascular treatment of diabetic lower limb ischemic disease

    Institute of Scientific and Technical Information of China (English)

    马红芳; 王富军

    2015-01-01

    背景:近年来介入治疗因其成功率高、疗效好、创伤小已被广泛认可,但由介入治疗引起的血管内膜损伤尚无有效的治疗手段,致使术后远期发生严重再狭窄。干细胞移植技术的出现为促进受损血管内皮功能修复、再内皮化及辅助恢复缺血组织血供带来了新的曙光。目的:总结近年来有关脐血干细胞移植技术及腔内血管成形术治疗糖尿病下肢缺血性病变的研究进展。方法:使用计算机检索2000年1月至2015年3月PubMed、CNKI数据库中相关文章,检索词为“human umbilical cord blood stem cel transpltation,percutaneous transluminal angioplasty,diabetic lower limb ischemia, restenosis”及“人脐血干细胞移植、血管腔内成形术、糖尿病下肢缺血、再狭窄”。将符合研究目的的文献分类筛选并进行评价,初检获得216篇相关文献,最终纳入44篇文献进行分析。结果与结论:通过对人脐血干细胞移植及血管成形术这两种治疗方式的疗效及远期预后分析比较,得出脐血干细胞移植联合血管成形术疗效优于单纯干细胞移植或单纯介入治疗,能够促进侧支循环建立、改善受损内皮功能及降低介入治疗后再狭窄发生。%BACKGROUND:In recent years, interventional therapy because of its high success rate, good curative effect, little trauma has been widely recognized, but vascular intimal injury due to interventional therapy stil has no effective treatment, resulting in long-term postoperative severe restenosis. Stem cel transplantation has brought a new drawn for the repair of impaired endothelial function, reendothelialization and aided restoration of the blood supply to ischemic tissues. OBJECTIVE: To summarize the recent progress in umbilical cord blood stem cels transplantation and endovascular treatment for treatment of diabetic lower limb ischemic disease. METHODS: A computer-based search of PubMed and CNKI

  7. MR angiography of collateral arteries in a hind limb ischemia model: comparison between blood pool agent Gadomer and small contrast agent Gd-DTPA.

    Directory of Open Access Journals (Sweden)

    Karolien Jaspers

    Full Text Available The objective of this study was to compare the blood pool agent Gadomer with a small contrast agent for the visualization of ultra-small, collateral arteries (diameter0.10. Inter-observer variation was 24% and 18% for Gadomer and Gd-DTPA, respectively. In conclusion, blood pool agent Gadomer improved vessel conspicuity compared to Gd-DTPA. Steady-state MRA can be considered as an excellent non-invasive alternative to intra-arterial XRA for the visualization of ultra-small collateral arteries.

  8. 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.

  9. 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.

  10. 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...

  11. Effects on duration of post-operative ischemia and patterns of blood flow recovery in different conditions of mouse hind limb ischemia

    Directory of Open Access Journals (Sweden)

    Al-Mubarak Husain A

    2011-06-01

    Full Text Available Abstract Background Current limitations to the experimentation on patients with peripheral arterial disease push the development of different preclinical strategies. We investigated both duration of ischemia and blood flow recovery in mouse models of partial femoral artery ligation. Methods Male BALB/c mice were used. The ligation over needle method involved placing a suture needle over the femoral artery, ligating over it and then removing the needle. The transfixation method involved transfixing the approximate center of the femoral artery and then tying the suture. Laser Doppler Perfusion Imaging was used to assess perfusion every 3rd day until 42 days after the procedure. Results Ligation over needle method: Immediately post procedure, mean perfusion was -71.87% ± 4.43. Then mean difference in perfusion remained below the base line reading on days 3, 6, 9, and 12. From day 15 on wards mean perfusion progressively improved remaining near base line. Transfixation Method: Immediately post procedure mean perfusion was -70.82% ± 4.73. Mean perfusion improved following the procedure on days 3 and 6; a plateau followed this on days 9, 12 and 15. From day 15 onwards perfusion progressively improved remaining well below base line until crossing it on day 36. Conclusion The currently described models do not pose major improvements over previously described methods.

  12. Upper Limb Exoskeleton

    NARCIS (Netherlands)

    Rusak, Z.; Luijten, J.; Kooijman, A.

    2015-01-01

    The present invention relates a wearable exoskeleton for a user having a torso with an upper limb to support motion of the said upper limb. The wearable exoskeleton comprises a first fixed frame mountable to the torso, an upper arm brace and a first group of actuators for moving the upper arm brace

  13. 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 ...

  14. 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,…

  15. 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

  16. Should we prescribe blood pressure lowering drugs to every patient with advanced chronic kidney disease? A comment on two recent meta-analyses.

    Science.gov (United States)

    Gross, Peter; Schirutschke, Holger; Barnett, Kerstin

    2009-10-01

    Antihypertensive treatment is an essential, life-prolonging measure in primary hypertension. It prevents apoplexy, myocardial infarction, and hypertensive kidney failure. Chronic kidney failure is associated with hypertension and an accelerated form of arteriosclerosis. Demise from cardiovascular affliction is a leading cause of death in renal patients (chronic renal failure stages II-IV, renal failure requiring dialysis, renal transplantation). What, then, is the role of antihypertensive treatment in such patients, and, specifically, what is achieved by renin-angiotensin-aldosterone (RAA) system modifying agents? Two meta-analyses have recently investigated these issues. An article in The Lancet evaluated eight studies on dialysis patients (n = 1679). It concluded that antihypertensives are beneficial in reducing cardiovascular morbidity and mortality. However, we criticize these conclusions and show that the data are not convincingly in favor of antihypertensive treatment. A meta-analysis in the American Heart Journal assessed the role of antihypertensive agents and RAA system modifying drugs in 45,758 patients (from 25 studies), who were in stages I-III of renal failure, i.e., not (yet) requiring dialysis. The authors claim that angiotensin- -converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) significantly reduced cardiovascular outcomes. However, our analysis of the data is not consistent with their conclusions. It showed that the results were quite mixed, that the authors may have overemphasized the positive results, and that considering all the results, it should be concluded that antihypertensive treatments, including those with ACEI/ARB, may not be superior to placebo (sic!) in renal patients. Rather than doing meta-analyses, larger primary studies are needed to reveal the real role of antihypertensive treatments in renal patients.

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

    Science.gov (United States)

    Fahs, Christopher A; Thiebaud, Robert S; Rossow, Lindy M; Loenneke, Jeremy P; Kim, Daeyeol; Abe, Takashi; Bemben, Michael G

    2014-01-01

    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.

  18. 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)

  19. Limb salvage surgery.

    Science.gov (United States)

    Kadam, Dinesh

    2013-05-01

    The threat of lower limb loss is seen commonly in severe crush injury, cancer ablation, diabetes, peripheral vascular disease and neuropathy. The primary goal of limb salvage is to restore and maintain stability and ambulation. Reconstructive strategies differ in each condition such as: Meticulous debridement and early coverage in trauma, replacing lost functional units in cancer ablation, improving vascularity in ischaemic leg and providing stable walking surface for trophic ulcer. The decision to salvage the critically injured limb is multifactorial and should be individualised along with laid down definitive indications. Early cover remains the standard of care, delayed wound coverage not necessarily affect the final outcome. Limb salvage is more cost-effective than amputations in a long run. Limb salvage is the choice of procedure over amputation in 95% of limb sarcoma without affecting the survival. Compound flaps with different tissue components, skeletal reconstruction; tendon transfer/reconstruction helps to restore function. Adjuvant radiation alters tissue characters and calls for modification in reconstructive plan. Neuropathic ulcers are wide and deep often complicated by osteomyelitis. Free flap reconstruction aids in faster healing and provides superior surface for offloading. Diabetic wounds are primarily due to neuropathy and leads to six-fold increase in ulcerations. Control of infections, aggressive debridement and vascular cover are the mainstay of management. Endovascular procedures are gaining importance and have reduced extent of surgery and increased amputation free survival period. Though the standard approach remains utilising best option in the reconstruction ladder, the recent trend shows running down the ladder of reconstruction with newer reliable local flaps and negative wound pressure therapy.

  20. Limb salvage surgery

    Directory of Open Access Journals (Sweden)

    Dinesh Kadam

    2013-01-01

    Full Text Available The threat of lower limb loss is seen commonly in severe crush injury, cancer ablation, diabetes, peripheral vascular disease and neuropathy. The primary goal of limb salvage is to restore and maintain stability and ambulation. Reconstructive strategies differ in each condition such as: Meticulous debridement and early coverage in trauma, replacing lost functional units in cancer ablation, improving vascularity in ischaemic leg and providing stable walking surface for trophic ulcer. The decision to salvage the critically injured limb is multifactorial and should be individualised along with laid down definitive indications. Early cover remains the standard of care, delayed wound coverage not necessarily affect the final outcome. Limb salvage is more cost-effective than amputations in a long run. Limb salvage is the choice of procedure over amputation in 95% of limb sarcoma without affecting the survival. Compound flaps with different tissue components, skeletal reconstruction; tendon transfer/reconstruction helps to restore function. Adjuvant radiation alters tissue characters and calls for modification in reconstructive plan. Neuropathic ulcers are wide and deep often complicated by osteomyelitis. Free flap reconstruction aids in faster healing and provides superior surface for offloading. Diabetic wounds are primarily due to neuropathy and leads to six-fold increase in ulcerations. Control of infections, aggressive debridement and vascular cover are the mainstay of management. Endovascular procedures are gaining importance and have reduced extent of surgery and increased amputation free survival period. Though the standard approach remains utilising best option in the reconstruction ladder, the recent trend shows running down the ladder of reconstruction with newer reliable local flaps and negative wound pressure therapy.

  1. [Angiosome-directed revascularization of critical limb ischaemia].

    Science.gov (United States)

    Houlind, Kim

    2015-07-27

    Critical limb ischaemia is the major cause of amputation in the developed world. When performing revascularization of the lower limb, guidelines recommend grafting of the "least diseased distal artery with the best continuous run-off to the ankle/foot... regardless of location" often implying indirect perfusion of the ischaemic area through collaterals. An alter-native strategy, called the "angiosome model", advocates a strategy which provides blood supply directly to the ischaemic area. This paper reviews the current evidence of indirect versus angiosome-directed revascularization of the lower limb.

  2. 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

  3. 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

  4. Effect of blood pressure rhythm changes on lower limb vascular lesion for patients with type 2 diabetes mellitus%血压节律变化对2型糖尿病患者下肢血管病变的影响

    Institute of Scientific and Technical Information of China (English)

    林雪英; 叶志东; 陈晓; 高凤; 蔡云梅

    2014-01-01

    Objective To study the effect of blood pressure rhythm changes on lower limb vascular lesion for patients with type 2 diabetes mellitus (T2DM). Methods Choosing 120 T2DM patients in our hospital for observation, including 60 patients with lower extremity vascular lesions with patients as observation group (LEAD), the other 60 cases of limb vascular lesions in patients with type 2 diabetes was set to the control group (not LEAD group), two groups of patients with noninvasive 24 hours ambulatory blood pressure monitoring, rhythm changes on blood pressure in two groups of patients were analyzed. Results Compared with the LEAD group, LEAD group of 24 patients with HSBP, 24 HPP, nSBP, nPP increase, nighttime blood pressure decrease rate reduce blood pressure rhythm, such as change, comparing the two groups were statistically significant (P<0.05, 0.01);Not LEAD scoop type blood pressure group patients (68.33%), LEAD group of scoop type blood pressure accounted for 36.67%, two groups are statistically significant (P<0.01); LEAD group of patients before blood pressure and got up morning get up early morning peak blood pressure significantly higher than control group, P<0.05. Conclusion Circadian blood pressure variation of intensity of patients with T2DM and lower extremity vascular lesions is greater than the patients with lower extremity vascular lesions, nighttime blood pressure, blood pressure in patients with morning peak were higher than patients with lower extremity vascular lesions, increase the risk of lower limb vascular lesion.%目的:探讨血压节律变化对2型糖尿病(T2DM)患者下肢血管病变的影响。方法选取本院收治的120例T2DM患者进行观察,其中伴下肢血管病变患者60例设为观察组(LEAD组),另60例非下肢血管病变的2型糖尿病患者设为对照组(非LEAD组),两组患者实施24 h无创性动态血压监测,对两组患者的血压节律变化进行对比分析。结果与非LEAD组比较, LEAD

  5. 伤口急救保护剂对猪肢体创面的止血和抑菌研究%Hemostatic effects and antibacterial activity of aerosol dressing for blood oozing wounds of swine limbs

    Institute of Scientific and Technical Information of China (English)

    孙鸿涛; 李军; 刘必善; 裴国献

    2011-01-01

    [ Objective ] To evaluate hemostatic efects and antibacterial activity of the wound aerosol dressing (WAD) for blood oozing wounds of swine limbs. [Method] Three different models of blood oozing wounds were established by means of cutting in swine: concave wounds,lateral wounds in swine hips and wounds across the knee joint. After injury,the WAD was sprayed over the wound models for 5 to 10 seconds. The main indexes,including hemostatic time(HT) ,the formation time(FT) and thickness of WAD membrane after spraying were measured and the WAD membrane was observed to see if it would rupture within 12 hours. Histological study was peformed in three concave wounds at different time points respectively. Models of contaminated wounds were estahlished in swine . The WAD was sprayed over the wounds for 6 seconds to see the bacteriostatic effect. [ Result ] The spraying time, HT and the thickness of the WAD membrane showed no significent difference between the concave wounds and latetal wounds ( P > 0.05 ). However, the above indexes were significantly different from those of the the knee joint ( P < 0.05 ). The rates of hemostatic success were 100% in each of models. The HT was about 10 seconds after spraying,and there was no more bleeding within 12 hours. Histological examination showed that the soft tissue had normal inflammation response after spraying. The wounds treated with WAD had less edema or exudation. Within 24 hours the amount of bacteria in the WAD group was significantly lower than those in the gauze group. [ Conclusion] The WAD is a kind of promising hemostatic dressing with short HT,satisfactory hemostatic effects and antibacterial activity.%[目的]评价伤口急救保护剂对猪肢体创伤创面的止血和抑菌效果.[方法]采用切割法分别建立猪臀部凹陷性创面、侧面创面、膝关节处创面等模型.向每个创面喷洒伤口急救保护剂5~10 s,观察止血时间、保护剂膜形成时间、保护剂膜厚度以及保

  6. 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.

  7. 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

  8. 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.

  9. 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

  10. 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)

  11. Blood loss and limb circumference changes in patients undergoing unilateral total knee arthroplasty after intra-articular injection of tranexamic acid:a randomized controlled trial%关节腔注射氨甲环酸单侧全膝关节置换者的失血量及肢体周径变化:随机对照

    Institute of Scientific and Technical Information of China (English)

    马金辉; 孙伟; 高福强; 王云亭; 李子荣

    2014-01-01

    BACKGROUND:Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years. OBJECTIVE:To investigate the efficacy of intra-articular injection of tranexamic acid on postoperative blood loss and limb circumference changes in patients who received unilateral total knee arthroplasty. METHODS:From March to October 2013, clinical data of 90 patients undergoing primary unilateral total knee arthroplasty were randomized to the tranexamic acid group and the control group, including 19 males and 71 females. The 30 patients in the tranexamic acid group received 50 mL of 3%tranexamic acid dilute solution inside knee joint after capsule closure, and 60 patients in the control group received the same volume of physiological saline. No significant difference in age, height, body mass index, anticoagulation, the type of prosthesis, tourniquet time and preoperative diagnosis was detected between the two groups (P>0.05). The amounts of intraoperative and postoperative blood loss and blood transfusion, postoperative drainage volume, the preoperative and postoperative limb circumference 10 cm above the operated knee were recorded. Routine blood test was reviewed after the surgery. RESULTS AND CONCLUSION:There were no significant differences in total blood loss, postoperative drainage volume and limb circumference changes between tranexamic acid and control groups (P>0.05). The amount of postoperative hidden blood loss was significantly less in the tranexamic acid group than in the control group (t=-2.683, P0.05)。记录患者术中及术后失血量和输血量、术后第1天引流量,测量术前及术后术侧膝上10 cm肢体周径,术后连续复查血常规。结果与结论:氨甲环酸组和对照组手术总失血量、术后第1天引流量与术侧肢体周径变化情况比较差异均无显著性意义(P>0.05),术后隐性失

  12. 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

  13. 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

  14. Percutaneous isolated limb perfusion with thrombolytics for severe limb ischemia.

    Science.gov (United States)

    Ali, Ahsan T; Kalapatapu, Venkat R; Bledsoe, Shelly; Moursi, Mohammed M; Eidt, John F

    2005-01-01

    Patients with severe tibioperoneal disease are poor candidates for a distal bypass. Absence of a distal target, lack of conduit, or multiple medical problems can make these patients a prohibitive risk for revascularization. Acute on chronic ischemia in this group poses a greater challenge. Thrombolytic therapy for acute ischemia can be prolonged and carries a significant risk of bleeding if continued beyond 24 hours. However, if the ischemic limbs can be isolated from the systemic circulation, a higher dose of the lytic agent can be given with lower risk. These are the initial results of a series of 10 patients who underwent percutaneous isolated limb perfusion with a high dose of thrombolytics for severe ischemia. Ten patients (lower extremity 8 and upper extremity 2) presented with severe limb-threatening ischemia. Mean ankle/brachial index (ABI) was 0.15 for the lower extremity, and there were no recordable digital pressures in patients with upper extremity ischemia. No distal target was visible on the initial arteriogram. These patients were then taken to the operating room, and under anesthesia, catheters were placed in an antegrade fashion via femoral approach in the popliteal artery and vein percutaneously. For upper extremity, the catheters were placed in the brachial artery and vein. A proximal tourniquet was then applied. This isolated the limb from the systemic circulation. Heparinized saline was infused through the arterial catheter while the venous catheter was left open. A closed loop or an isolated limb perfusion was confirmed when effluent became clear coming out of the venous port. A high dose of thrombolytic agent (urokinase 500,000 to 1,000,000 U) was infused into the isolated limb via the arterial catheter and drained out of the venous catheter. After 45 minutes, arterial flow was reestablished. In 4 patients, Reopro((R)) was used in addition to thrombolytics. Postprocedure angiograms showed minimal changes, but patients exhibited marked

  15. Endograft Limb Occlusion in EVAR

    DEFF Research Database (Denmark)

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

    2014-01-01

    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......, 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......% at 3 years. Logistic regression showed that iliac artery tortuosity (DIS) (p = .001) and body mass index (p = .007) had a significant impact on graft patency. CONCLUSION: A tortuous vessel on the preoperative CTA is associated with an increased risk of limb occlusion after EVAR. Adjunctive stenting...

  16. Limb salvage procedure in occlusion of the infrapopliteal arteries

    Directory of Open Access Journals (Sweden)

    Mijailović Milan

    2007-01-01

    Full Text Available Background/Aim. Limb salvage is a procedure for treatment of the causes of ischemia in the peripheral arteries of the lower limbs. This procedure consists of percutaneous transluminal angioplasty (PTA of arteries of the infrapopliteal segment in the lower limbs, endovascular stents implantation and selective intraarterial thrombolytic therapy. The main PTA principle is balloon dilatation of a blood vessel and increasing blood flow in this zone. The aim of this study was to show the validity and benefits of applying this procedure in pathologically corrupted arteries of the infrapopliteal segment. Methods. A prospective study included 30 patients: 15 with PTA dilatations, 13 with stents implantations and five with thrombolytic therapy. The follow-up period was: immediately after the procedure, a month later, and six months later. Results. Of the 15 patients with balloon dilatation, three still suffered from artery stenosis, and they additionally underwent stents implantation. These three patients were in the group of 13 patients who had underwent stent implantation.. The last group consisted of five patients with thrombolytic therapy (urokinase, streptokinase, rt-PA - recombinant tissue plasminogen activator. Restenosis appeared only in the three patients from the first group (PTA immediately after the intervention. A month later, there was no restenosis or ischemia of the limbs. After six months, restenosis appeared in three patients from the first group (PTA, in one patient from the second group (stent, and in two patients from the third group (thrombolytic therapy. The best results were shown by the stent implantation method (successful in 92.3% of the cases, PTA (75%, and thrombolytic therapy (60%. Conclusion. On the basis of the obtained results it can be concluded that the limb salvage method in case of occluded arteries of infrapopliteal segment is fully justified, especially the stent implantation method being successful in 92.3% of the

  17. Focal skin defect, limb anomalies and microphthalmia.

    NARCIS (Netherlands)

    Jackson, K.E.; Andersson, H.C.

    2004-01-01

    We describe two unrelated female patients with congenital single focal skin defects, unilateral microphthalmia and limb anomalies. Growth and psychomotor development were normal and no brain malformation was detected. Although eye and limb anomalies are commonly associated, clinical anophthalmia and

  18. 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 ...

  19. Managing residual limb hyperhidrosis in wounded warriors.

    Science.gov (United States)

    Pace, Sarah; Kentosh, Joshua

    2016-06-01

    Residual limb dermatologic problems are a common concern among young active traumatic amputee patients who strive to maintain an active lifestyle. Hyperhidrosis of residual limbs is a recognized inciting factor that often contributes to residual limb dermatoses and is driven by the design of the prosthetic liner covering the residual limb. Treatment of hyperhidrosis in this population presents a unique challenge. Several accepted treatments of hyperhidrosis can offer some relief but have been limited by lack of results or side-effect profiles. Microwave thermal ablation has presented an enticing potential for residual limb hyperhidrosis. PMID:27416083

  20. 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 ...

  1. 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.)

  2. 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...

  3. 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.

  4. 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

  5. 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.

  6. Clinical effects of electroacupuncture stimulation on treatment of stroke-induced limb spasm

    Institute of Scientific and Technical Information of China (English)

    Yang Tian; Lianguo Kang

    2008-01-01

    OBJECTIVE: To summarize the development of electroacupuncture stimulation in the treatment of stroke-induced limb spasm, to provide research possibilities or clinical development, and to clarify the mechanism and therapeutic effects of electroacupuncture stimulation. DATA SOURCES: Articles relating to therapeutic effects of electroacupuncture stimulation on treatment of stroke-induced limb spasm, as well as clinical studies (which are not limited to age, sex and race), were retrieved from the China Journal Fulltext Database from January 2000 to December 2007. The key words were stroke, apoplexy, spasm, and electroacupuncture in Chinese. Other articles were obtained from specific journals or books.STUDY SELECTION: Data were first selected by title and abstract. Clinical and rehabilitative studies relating to the effects of electroacupuncture and acupuncture on the treatment of stroke-induced limb spasm were included. Clinical studies related to the rehabilitative treatment of limb spasm were excluded, unless the effects of electroacupuncture stimulation were recorded. DATA EXTRACTION: A total of 338 references were collected; however, 295 of these were excluded. Therefore, 43 articles were analyzed, comprising 40 in Chinese and 3 in English.DATA SYNTHESIS: At present, acupuncture is widely used at home to treat stroke-induced limb spasm; however, acupuncture at different acupoints might cause different clinical effects. Electroacupuncture, which is characterized by analgesia and relief of spasm, can preclude inflammatory edema, improve blood circulation and blood viscosity, inhibit platelet aggregation and adherence, relieve formation of atheromatous plaque in tunica intima of artery, and resist cerebral anoxia, so as to relieve stroke-induced limb spasm. Meanwhile, electroacupuncture combined with rehabilitation can effectively decrease the degree of spasm and improve motor function. CONCLUSION: Acupuncture and moxibustion therapy are superior in the rehabilitative

  7. Obstructive Sleep Apnea Syndrome, Periodic Limb Movements and Related Factors

    Directory of Open Access Journals (Sweden)

    Osman Özgür Yalın

    2015-09-01

    Full Text Available OBJECTIVE: Obstructive sleep apnea syndrome (OSAS is characterized by nocturnal repetitive apnea episodes. Periodic limb movements (PLMs is nocturnal, stereotypic, repetitive movements of the lower extremities. The aim of this study was to investigate the presence of periodic limb movements in OSAS patients and correlation of PLM with OSAS severity. METHODS: One hundred and forty one OSAS suspected patients was enrolled into the study. All subjects’ blood pressure, heart rate measurements and neurologic examinations were made by the same neurologist. Sociodemographic characteristics were recorded. One night polysomnography (PSG was performed to all patients and results were analyzed. Apnea Hypopnea Index (AHI ≥ 5 subjects were accepted as OSAS, and PLM Index (PLMI ≥ 5 subjects were accepted as having PLM. RESULTS: One hundred and two patients were diagnosed as OSAS. The control group consisted of 39 patients who had normal polysomnographic findings. OSAS patients’ were older and body mass index (BMI were higher than the control group. Systolic blood pressure was higher in OSAS group. Alcohol use was determined as a risk factor for OSAS. PLM were more common in OSAS group than the control group (% 30,3 - % 10,2. PLM frequency was associated with the severity of OSAS. CONCLUSION: In OSAS patients presence of PLM was related with OSAS severity, higher systolic and diastolic blood pressure and REM sleep depletion. PLM in OSAS patients could be regarded as an indicator of disease severity and also could aware clinician for increased complication rates.

  8. 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.

  9. 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

  10. Blood transfusions

    Science.gov (United States)

    ... called homologous blood donation. Many communities have a blood bank at which any healthy person can donate blood. ... need to arrange with your hospital or local blood bank before your surgery to have directed donor blood. ...

  11. Sports participation of Dutch lower limb amputees

    NARCIS (Netherlands)

    Bragaru, Mihail; Meulenbelt, Hendrik; Dijkstra, Pieter U.; Geertzen, Jan H.B.; Dekker, Rienk

    2013-01-01

    Objective: To analyze sports participation of Dutch lower limb amputees and factors influencing sports participation. Study design: A cross-sectional survey was performed. Dutch lower limb amputees (N = 2039) were invited to participate in a postal survey addressing personal and amputation character

  12. Claimed walking distance of lower limb amputees

    NARCIS (Netherlands)

    Geertzen, JHB; Bosmans, JC; Van der Schans, CP; Dijkstra, PU

    2005-01-01

    Purpose: Walking ability in general and specifically for lower limb amputees is of major importance for social mobility and ADL independence. Walking determines prosthesis prescription. The aim of this study was to mathematically analyse factors influencing claimed walking distance of lower limb amp

  13. Haemodynamic optimisation in lower limb arterial surgery

    DEFF Research Database (Denmark)

    Bisgaard, J; Gilsaa, T; Rønholm, E;

    2012-01-01

    -operative complications and shorten hospital length of stay after open elective lower limb arterial surgery. METHODS: Forty patients scheduled for open elective lower limb arterial surgery were prospectively randomised. The LiDCO™plus system was used for haemodynamic monitoring. In the intervention group, stroke volume...

  14. 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 p<.05) but never at any earlier timepoint. No ipsilateral SAI was detected in the lower limb (TA) at any of the tested ISIs. The delayed onset timing of ipsilateral SAI suggests that transcallosal communication mediates this inhibitory process for the upper limb. The complete absence of ipsilateral SAI in the lower limb warrants consideration of the potential limb-specific differences in demands for bilateral sensorimotor integration.

  15. The Floating Upper Limb: Multiple Injuries Involving Ipsilateral, Proximal, Humeral, Supracondylar, and Distal Radial Limb

    Science.gov (United States)

    Manaan, Qazi; Bashir, Adil; Zahoor, Adnan; Mokhdomi, Taseem A.

    2016-01-01

    Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation. PMID:27583121

  16. 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

  17. 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 ...

  18. [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

  19. Slow Movements of Bio-Inspired Limbs

    Science.gov (United States)

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

    2016-10-01

    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.

  20. 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.

  1. 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...

  2. 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

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    R. A. Khokhlov

    2015-01-01

    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.

  5. The functional anatomy of suggested limb paralysis.

    Science.gov (United States)

    Deeley, Quinton; Oakley, David A; Toone, Brian; Bell, Vaughan; Walsh, Eamonn; Marquand, Andre F; Giampietro, Vincent; Brammer, Michael J; Williams, Steven C R; Mehta, Mitul A; Halligan, Peter W

    2013-02-01

    Suggestions of limb paralysis in highly hypnotically suggestible subjects have been employed to successfully model conversion disorders, revealing similar patterns of brain activation associated with attempted movement of the affected limb. However, previous studies differ with regard to the executive regions involved during involuntary inhibition of the affected limb. This difference may have arisen as previous studies did not control for differences in hypnosis depth between conditions and/or include subjective measures to explore the experience of suggested paralysis. In the current study we employed functional magnetic resonance imaging (fMRI) to examine the functional anatomy of left and right upper limb movements in eight healthy subjects selected for high hypnotic suggestibility during (i) hypnosis (NORMAL) and (ii) attempted movement following additional left upper limb paralysis suggestions (PARALYSIS). Contrast of left upper limb motor function during NORMAL relative to PARALYSIS conditions revealed greater activation of contralateral M1/S1 and ipsilateral cerebellum, consistent with the engagement of these regions in the completion of movements. By contrast, two significant observations were noted in PARALYSIS relative to NORMAL conditions. In conjunction with reports of attempts to move the paralysed limb, greater supplementary motor area (SMA) activation was observed, a finding consistent with the role of SMA in motor intention and planning. The anterior cingulate cortex (ACC, BA 24) was also significantly more active in PARALYSIS relative to NORMAL conditions - suggesting that ACC (BA 24) may be implicated in involuntary, as well as voluntary inhibition of prepotent motor responses.

  6. 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.

  7. 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.

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. 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 ...

  12. 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.

  13. Transducers for ultrasonic limb plethysmography

    Science.gov (United States)

    Nickell, W. T.; Wu, V. C.; Bhagat, P. K.

    1983-01-01

    The design, construction, and performance characteristics of ultasonic transducers suitable for limb plethysmography are presented. Both 3-mm-diameter flat-plate and 12-mm-diameter hemispheric ceramic transducers operating at 2 MHz were fitted in 1-mm thick epoxy-resin lens/acoustic-coupling structures and mounted in exercie-EKG electrode housings for placement on the calf using adhesive collars. The effects of transducer directional characteristics on performance under off-axis rotation and the electrical impedances of the transducers were measured: The flat transducer was found to be sensitive to rotation and have an impedance of 800 ohms; the hemispheric transducer, to be unaffected by rotation and have an impedance of 80 ohms. The use of hemispheric transducers as both transmitter and receiver, or of a flat transducer as transmitter and a hemispheric transducer as receiver, was found to produce adequate dimensional measurements, with minimum care in transducer placement, in short-term physiological experiments and long-term (up to 7-day) attachment tests.

  14. 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.

  15. 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

  16. Gait initiation in lower limb amputees

    NARCIS (Netherlands)

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

    2008-01-01

    Objective: To study limitations in function and adjustment strategies in lower limb amputees during gait initiation. Design: Observational cohort study. Setting: University Medical Center. Participants: Amputees with a unilateral transfemoral or transtibial amputation, and able-bodied subjects. Main

  17. Gait termination in lower limb amputees

    NARCIS (Netherlands)

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

    2008-01-01

    Objective: To study the limitations in function and adjustment strategies of lower limb amputees in gait termination. Design: Observational cohort study. Setting: University Medical Centre. Participants: Unilateral transfemoral and transtibial amputees, and able-bodied control subjects. Main outcome

  18. A Cognitive Overview of Limb Apraxia.

    Science.gov (United States)

    Bartolo, Angela; Ham, Heidi Stieglitz

    2016-08-01

    Since the first studies on limb apraxia carried out by Hugo Liepmann more than a century ago, research interests focused on the way humans process manual gestures by assessing gesture production after patients suffered neurologic deficits. Recent reviews centered their attention on deficits in gesture imitation or processing object-related gestures, namely pantomimes and transitive gestures, thereby neglecting communicative/intransitive gestures. This review will attempt to reconcile limb apraxia in its entirety. To this end, the existing cognitive models of praxis processing that have been designed to account for the complexity of this disorder will be taken into account, with an attempt to integrate in these models the latest findings in the studies of limb apraxia, in particular on meaningful gestures. Finally, this overview questions the very nature of limb apraxia when other cognitive deficits are observed. PMID:27349561

  19. Upper limb prosthetic use in Slovenia.

    Science.gov (United States)

    Burger, H; Marincek, C

    1994-04-01

    The article deals with the use of different types of upper limb prostheses in Slovenia. Four hundred and fourteen upper limb amputees were sent a questionnaire on the type of their prosthesis, its use and reasons for non-use, respectively. The replies were subject to statistical analysis. Most of the questioned upper limb amputees (70%) wear a prosthesis only for cosmesis. The use of a prosthesis depends on the level of upper limb amputation, loss of the dominant hand, and time from amputation. Prosthetic success appears to be unrelated to age at the time of amputation and the rehabilitation programme. The most frequent reason for not wearing a prosthesis is heat and consequent sweating of the stump. More than a third of amputees are dissatisfied with their prostheses.

  20. Zika Linked to Deformed Limbs in Newborns

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160324.html Zika Linked to Deformed Limbs in Newborns Cause isn' ... 2016 TUESDAY, Aug. 9, 2016 (HealthDay News) -- The Zika virus has already been linked to serious birth ...

  1. 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...

  2. 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...

  3. 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:...

  4. 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.

  5. 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

  6. Limb apraxia in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Rapaić Dragan

    2014-01-01

    Full Text Available Background/Aim. There are almost no studies on apraxia in people with multiple sclerosis. Although the white matter is damaged in MS, it is not the only location in which the pathological changes are present. Demyelinated lesions in the cortex have recently been recognized as important components of multiple sclerosis pathology. The aim of this study was to determine whether apraxia is present among people with MS, and the importance of demographic characteristics and impairment of functional systems at conceptualization and execution of movements. Methods. The experimental group consisted of 30 patients, mean age 51.34 ± 7.70 years. The patients in the experimental group were diagnosed with MS according to the McDonald criteria. The control group consisted of 30 healthy subjects, mean age 50.30 ± 10.47 years. For research purposes, we used the following instruments: Questionnaire for Collecting Demographic Data, Kurtzke Functional Systems Scores, Waterloo-Sunnybrook Apraxia Battery (WatAB. Execution of motion tasks that are a part of the Watwere incorporated in the System for the Observation and Analysis of Motor Behavior. Results. Our study showed that limb apraxia was common in people with MS. Apraxia was present during pantomime in 26.70% of the patients, and during the imitation of movements in 44.80% of the patients. Gender, age, education level, duration of disease and a form of MS did not determine the quality of conceptualization and execution of movements. The time elapsed from the last exacerbation was a determinant of quality of executed movements. Impairments of functional systems predicted impairments of movement execution. The expanded disability scale score correlated with the severity of apraxia. Conclusion. Our study confirm the presence of apraxia in MS. It is necessary to carry out further studies using functional magnetic resonance imaging, as well as the conduct longitudinal studies to determine the precise structure of

  7. 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. .

  8. Cerebral blood flow autoregulation in hypertension and effects of antihypertensive drugs

    DEFF Research Database (Denmark)

    Barry, David; Lassen, N A

    1984-01-01

    If antihypertensive treatment, especially emergency blood pressure lowering, is always to be safe, more thought should be given to autoregulation of cerebral blood in the hypertensive patient. This topic is reviewed in the present article, in the hypertensive patient. This topic is reviewed...... in the present article, particular emphasis being placed on the resetting of the lower limit of autoregulation to higher pressure in hypertension and the effects of acute administration of anti-hypertensive drugs on CBF and CBF-autoregulation....

  9. Reorganization of gait after limb-saving surgery of the lower limb

    NARCIS (Netherlands)

    de Visser, E; Veth, RPH; Schreuder, HWB; Duysens, J; Mulder, T

    2003-01-01

    Objective: In this study, the concept of a cognitive dual-task performance and visual restriction during walking has been used to study the recovery of gait after limb-saving surgery in ten patients. Design: All patients were recovering from some form of treatment to tumors of the lower limbs. Patie

  10. Increased cardiovascular disease mortality rates in traumatic lower limb amputees.

    Science.gov (United States)

    Modan, M; Peles, E; Halkin, H; Nitzan, H; Azaria, M; Gitel, S; Dolfin, D; Modan, B

    1998-11-15

    We evaluated the 24-year mortality rates of male traumatic lower limb amputees (n = 201) of the Israeli army, wounded between 1948 and 1974 compared with a cohort sample representing the general population (n = 1,832). Mortality rates were significantly higher (21.9% vs 12.1%, p amputees than in controls. Cardiovascular disease (CVD) mortality was the main cause for this difference. The prevalence of selected risk factors for CVD was determined in 101 surviving amputees (aged 50 to 65 years) and a sample of the controls (n = 96) matched by age and ethnic origin. Amputees had higher plasma insulin levels (during fasting and in response to oral glucose loading) and increased blood coagulation activity. No differences were found in rates of current symptoms of ischemic heart disease or of cerebrovascular disease, obesity, hypertension, altered plasma lipoprotein profile, impaired physical activity, smoking, or nutritional habits. Traumatic lower limb amputees had increased mortality rates due to CVD. Surviving amputees had hyperinsulinemia, increased coagulability, and increased sympathetic and parasympathetic responses (described previously). These established CVD risk factors may explain the excess mortality due to CVD in traumatic amputees.

  11. Alignment of lower-limb prostheses.

    Science.gov (United States)

    Zahedi, M S; Spence, W D; Solomonidis, S E; Paul, J P

    1986-04-01

    Alignment of a prosthesis is defined as the position of the socket relative to the other prosthetic components of the limb. During dynamic alignment the prosthetist, using subjective judgment and feedback from the patient, aims to achieve the most suitable limb geometry for best function and comfort. Until recently it was generally believed that a patient could only be satisfied with a unique "optimum alignment." The purpose of this systematic study of lower-limb alignment parameters was to gain an understanding of the factors that make a limb configuration or optimum alignment, acceptable to the patient, and to obtain a measure of the variation of this alignment that would be acceptable to the amputee. In this paper, the acceptable range of alignments for 10 below- and 10 above-knee amputees are established. Three prosthetists were involved in the majority of the 183 below-knee and 100 above-knee fittings, although several other prosthetists were also involved. The effects of each different prosthetist on the established range of alignment for each patient are reported to be significant. It is now established that an amputee can tolerate several alignments ranging in some parameters by as much as 148 mm in shifts and 17 degrees in tilts. This paper describes the method of defining and measuring the alignment of lower-limb prostheses. It presents quantitatively established values for bench alignment position and the range of adjustment required for incorporation into the design of new alignment units.

  12. 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

  13. 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.

  14. 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.

  15. Obesity and metabolic disorders in adults with lower limb amputation.

    Science.gov (United States)

    Kurdibaylo, S F

    1996-10-01

    Anthropometric and biochemical research was conducted on 94 subjects with various levels of lower limb amputation. The purpose of the work was to investigate the features of obesity progression and disorders of cholesterin metabolism, as well as to develop adequate training exercises. Anthropometric research was conducted by calipermetry; the biochemical research was done by various methods to determine exempt and total cholesterin and triglycerides in the blood serum. The research establishes the frequency of obesity progression relative to the level of amputation, as well as the features of the excessive body mass. Type 11A hyperlipoproteidemia was evident. It is characterized by rapid progress of atherosclerotic vascular disease and coronary disease (CD). Cyclic and acyclic exercises were developed for prophylaxis and therapy. Anthropometric research on the determination of body fat mass was conducted on 68 subjects with various levels of lower limb amputation. The nondirect method of measuring skin folds of several parts of the body was used to determine the extent of lipogenesis. Biochemical research of cholesterin metabolism was conducted on 26 subjects with lower limb amputation (a different group). Anthropometric research revealed an increase of body fat mass directly related to the level of amputation. The largest amount of fat in the body mass was noted for the subjects with bilateral transfemoral (above-knee) amputation or transfemoral plus transtibial (below-knee) amputation. Both groups averaged 25.9%. The body fat mass increased chiefly in the subcutaneous fat. Increase of the internal fat mass was less noticeable. The frequency of obesity progression in subjects with unilateral transtibial amputation equaled 37.9%; in subjects with transfemoral amputation, 48.0%; and in subjects with bilateral transfemoral or transfemoral plus transtibial amputation, 64.2%. Young subjects demonstrated obesity progression during the first year after amputation

  16. 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.

  17. 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 ...

  18. Ischaemic distal limb necrosis and Klebsiella pneumoniae infection associated with arterial catheterisation in a cat.

    Science.gov (United States)

    Bowlt, Kelly L; Bortolami, Elisa; Harley, Ross; Murison, Pamela; Wallace, Adrian

    2013-12-01

    This case report describes dorsal pedal arterial thrombosis and infection with Klebsiella pneumoniae subsequent to arterial catheter placement in a cat. The complication led to avascular necrosis of the metatarsal and pedal soft tissue. The catheter was placed for blood pressure monitoring during surgery for correction of a peritoneopericardial diaphragmatic hernia. The exact mechanism of thrombosis was unclear. Amputation of the limb was required and the histopathological findings are presented. This is the first report of such a complication.

  19. 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...

  20. Goniometry and Limb Girth in Miniature Dachshunds

    Directory of Open Access Journals (Sweden)

    Stephanie A. Thomovsky

    2016-01-01

    Full Text Available Purpose. To report the mean and median pelvic limb joint angles and girth measurements in miniature Dachshunds presenting with varying degrees of pelvic limb weakness secondary to thoracolumbar intervertebral disc extrusion. Methods. 15 miniature Dachshunds who presented to WSU-VTH for thoracolumbar disc extrusion. Dachshunds varied in neurologic status from ambulatory paraparetic to paraplegic at the time of measurements. Results. There were no significant differences in joint angles or girth among the three groups (ambulatory paraparetic, nonambulatory paraparetic, or paraplegic (P>0.05. When group was disregarded and values for extension, flexion, and girth combined, no differences existed. Conclusions. Goniometry and limb girth measurements can successfully be made in the miniature Dachshund; however, the shape of the Dachshund leg makes obtaining these values challenging. There were no differences in joint angle or girth measurements between dogs with varying neurologic dysfunction at the time of measurement.

  1. Cross-limb Interference during motor learning

    DEFF Research Database (Denmark)

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

    2013-01-01

    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......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...... 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...

  2. 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

  3. 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.

  4. 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.

  5. Electrodiagnostic testing in diabetic neuropathy: Which limb?

    Science.gov (United States)

    Rota, E; Cocito, D

    2015-10-01

    Electrodiagnosis of subclinical diabetic neuropathies by nerve conduction studies remains challenging. The question arises about which nerves should be tested and what the best electrodiagnostic protocol to make an early diagnosis of diabetic neuropathies would be. On the basis of our findings and other evidence, which highlighted the remarkable prevalence of electrophysiological abnormalities in nerve conduction studies of the upper limbs, often in the presence of normal lower limb conduction parameters, we suggest that both ulnar and median nerves, in their motor and sensitive component, should be the two target nerves for electrodiagnostic protocols in diabetic neuropathies.

  6. 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

  7. 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.

  8. 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

  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. 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.)

  11. 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 ...

  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. Limb reconstruction with the Ilizarov method

    NARCIS (Netherlands)

    Oostenbroek, H.J.

    2014-01-01

    In chapter 1, the background and origins of this study are explained. The aims of the study are defined. In chapter 2, an analysis of the complications rate of limb reconstruction in a cohort of 37 consecutive growing children was done. Several patient and deformity factors were investigated by logi

  14. 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

  15. One-sided limb preference is linked to alternating-limb locomotion in anuran amphibians.

    Science.gov (United States)

    Malashichev, Yegor B

    2006-11-01

    Amphibians provide a unique opportunity for identifying possible links between lateralized behaviors, locomotion, and phylogeny and for addressing the origin of lateralized behaviors of higher vertebrates. Five anuran species with different locomotive habits were tested for forelimb and hind limb preferences during 2 stereotyped behavior sequences--wiping a foreign object off their snout and righting themselves from the overturned position. The experiments were analyzed in a broader context of previous findings on anuran lateralization involving 11 anuran species that were studied within the same experimental paradigms. This analysis shows that one-sided forelimb and hind limb motor lateralization in anurans is strongly associated with alternating-limb locomotion and other unilateral limb activity. Conclusions reached for anuran amphibians may be applicable to other vertebrates possessing paired appendages-the degree of lateralization in motor response depends on the mode of locomotion used by a species.

  16. Does lower limb exercise worsen renal artery hemodynamics in patients with abdominal aortic aneurysm?

    Directory of Open Access Journals (Sweden)

    Anqiang Sun

    Full Text Available Renal artery stenosis (RAS and renal complications emerge in some patients after endovascular aneurysm repair (EVAR to treat abdominal aorta aneurysm (AAA. The mechanisms for the causes of these problems are not clear. We hypothesized that for EVAR patients, lower limb exercise could negatively influence the physiology of the renal artery and the renal function, by decreasing the blood flow velocity and changing the hemodynamics in the renal arteries. To evaluate this hypothesis, pre- and post-operative models of the abdominal aorta were reconstructed based on CT images. The hemodynamic environment was numerically simulated under rest and lower limb exercise conditions. The results revealed that in the renal arteries, lower limb exercise decreased the wall shear stress (WSS, increased the oscillatory shear index (OSI and increased the relative residence time (RRT. EVAR further enhanced these effects. Because these parameters are related to artery stenosis and atherosclerosis, this preliminary study concluded that lower limb exercise may increase the potential risk of inducing renal artery stenosis and renal complications for AAA patients. This finding could help elucidate the mechanism of renal artery stenosis and renal complications after EVAR and warn us to reconsider the management and nursing care of AAA patients.

  17. 7 CFR 51.1220 - Leaf or limb rub injury.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Leaf or limb rub injury. 51.1220 Section 51.1220... STANDARDS) United States Standards for Grades of Peaches Definitions § 51.1220 Leaf or limb rub injury. “Leaf or limb rub injury” means that the scarring is not smooth, not light colored, or aggregates...

  18. 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.

  19. 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

  20. 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 ...

  1. 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.

  2. Reduction of residual limb volume in people with transtibial amputation

    Directory of Open Access Journals (Sweden)

    Audrey T. Tantua, MD

    2014-11-01

    Full Text Available The early postoperative phase after transtibial amputation is characterized by rapid residual limb volume reduction. Accurate measurement of residual limb volume is important for the timing of fitting a prosthesis. The aim of this study was to analyze the reduction of residual limb volume in people with transtibial amputation and to correlate residual limb volume with residual limb circumference. In a longitudinal cohort study of 21 people who had a transtibial amputation, residual limb volume was measured using a laser scanner and circumference was measured using a tape measure 1 wk postamputation and every 3 wk thereafter until 24 wk postamputation. A linear mixed model analysis was performed with weeks postamputation transformed according to the natural logarithm as predictor. Residual limb volume decreased significantly over time, with a large variation between patients. Residual limb volume did not correlate well with circumference. On average, residual limb volume decreased 200.5 mL (9.7% of the initial volume per natural logarithm of the weeks postamputation. The decrease in residual limb volume following a transtibial amputation was substantial in the early postamputation phase, followed by a leveling off. It was not possible to determine the specific moment at which the residual limb volume stabilized.

  3. Residual limb volume change: Systematic review of measurement and management

    Directory of Open Access Journals (Sweden)

    Joan E. Sanders, PhD

    2011-10-01

    Full Text Available Management of residual limb volume affects decisions regarding timing of fit of the first prosthesis, when a new prosthetic socket is needed, design of a prosthetic socket, and prescription of accommodation strategies for daily volume fluctuations. This systematic review assesses what is known about measurement and management of residual limb volume change in persons with lower-limb amputation. Publications that met inclusion criteria were grouped into three categories: group I: descriptions of residual limb volume measurement techniques; group II: studies investigating the effect of residual limb volume change on clinical care in people with lower-limb amputation; and group III: studies of residual limb volume management techniques or descriptions of techniques for accommodating or controlling residual limb volume. We found that many techniques for the measurement of residual limb volume have been described but clinical use is limited largely because current techniques lack adequate resolution and in-socket measurement capability. Overall, limited evidence exists regarding the management of residual limb volume, and the evidence available focuses primarily on adults with transtibial amputation in the early postoperative phase. While we can draw some insights from the available research about residual limb volume measurement and management, further research is required.

  4. Techniques for collecting blood from collared peccaries, Dicotyles tajacu (L.).

    Science.gov (United States)

    Lochmiller, R L; Hellgren, E C; Robinson, R M; Grant, W E

    1984-01-01

    Four methods are described for obtaining blood samples from the collared peccary. This animal lacks prominent superficial veins which makes the procedure of taking blood difficult for inexperienced persons. Large volumes of blood (greater than 20 ml) can be obtained easily via anterior vena cava venipuncture. Moderate amounts of blood (less than 20 ml) can be obtained from the orbital sinus. Lesser volumes of blood can be obtained from superficial veins located on the ear and the hind limb. The saphenous vein is distended easily due to its unique location across the cranial face of the tibia.

  5. Emulating Upper Limb Disorder for Therapy Education

    Directory of Open Access Journals (Sweden)

    Noor Ayuni binti Che Zakaria

    2014-11-01

    Full Text Available Robotics not only contributes to the invention of rehabilitation devices, it can also enhance the quality of medical education. In recent years, the use of patient simulators and part-task trainers in the medical education field has brought meaningful improvements in the training of medical practitioners. Nevertheless, in the context of therapy training for upper limb disorders, trainee therapists still have to engage directly with the patients to gain experience of the rehabilitation of physical diseases. In this work, a high-fidelity part-task trainer that is able to reproduce the stiffness of spasticity and rigidity symptoms of the upper limb, such as those observed in post-stroke patients and Parkinson’s disease patients, has been developed. Based on the evaluation carried out by two experienced therapists, the developed part-task trainer is able to simulate different patient cases and help trainee therapists gain pre- clinical experience in a safe and intuitive learning environment.

  6. 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

  7. Lower-Limb Rehabilitation Robot Design

    Science.gov (United States)

    Bouhabba, E. M.; Shafie, A. A.; Khan, M. R.; Ariffin, K.

    2013-12-01

    It is a general assumption that robotics will play an important role in therapy activities within rehabilitation treatment. In the last decade, the interest in the field has grown exponentially mainly due to the initial success of the early systems and the growing demand caused by increasing numbers of stroke patients and their associate rehabilitation costs. As a result, robot therapy systems have been developed worldwide for training of both the upper and lower extremities. This paper investigates and proposes a lower-limb rehabilitation robot that is used to help patients with lower-limb paralysis to improve and resume physical functions. The proposed rehabilitation robot features three rotary joints forced by electric motors providing linear motions. The paper covers mechanism design and optimization, kinematics analysis, trajectory planning, wearable sensors, and the control system design. The design and control system demonstrate that the proposed rehabilitation robot is safe and reliable with the effective design and better kinematic performance.

  8. Lethal neonatal short-limbed dwarfism

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ok Hwa; Yim, Chung Ik; Bahk, Yong Whee [Catholic Medical College, Seoul (Korea, Republic of)

    1986-02-15

    We have detailed our experiences on 6 cases of neonatal lethal short-limbed dwarfism and reviewed the articles. They include, achondrogenesis, thanatophoric dysplasia, asphyxiating thoracic dysplasia, osteogenesis imperfect a congenita, and hypophosphatasia lethals. Five babies were born alive but died soon after birth and one was a stillbirth. The main cause of failure to thrive was respiratory insufficiency. Each case was having quite characteristic radiologic findings, even if the general appearances were similar to the achondroplasts clinically. Precise diagnosis is very important for genetic counselling of the parents and alarm to them the possibility of bone dysplasias to the next offsprings. For this purpose, the radiologists play major role for the correct diagnosis. We stress that when the baby is born with short-limbed dwarfism, whole body radiogram should be taken including lateral view and postmortem radiogram is also very precious.

  9. 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.

  10. 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...

  11. Surgical treatment of traumatic lower limb pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    Pan Zhongjie; Zhang Hua; Li Li; Jia Yutao; Tian Rong

    2014-01-01

    Objective:To summarize our experience in surgical treatment of traumatic lower limb pseudoaneurysm.Methods:Twenty patients with traumatic lower limb pseudoaneurysm were surgically treated in our department from January 2007 to January 2012.The treatment protocols included interventional covered-stent placement (10 cases),spring coil embolization (2 cases),and surgical operation (8 cases).Surgical operations included pseudoaneurysm repair (2 cases),autologousvein transplantation (1 case),and artificial-vessel bypass graft (5 cases).Results:All the patients were successfully treated without aggravating lower limb ischemia.Pseudoaneurysm disappeared after treatment.A surgical operation is suitable to most pseudoaneurysms,but its damage is relatively obvious and usually leads to more bleeding.It also requires a longer operating time.Compared to a surgical operation,interventional therapy is less traumatic and patients usually have a quicker recovery (P<0.05).All patients were followed up once per month for 12-36 months by color Doppler ultrasound examination.There were no cases of pseudoaneurysm recurrence.Conclusion:Both surgical operation and interventional therapy are safe and effective in the treatment of pseudoaneurysm.

  12. Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems

    Science.gov (United States)

    Yusof, Nazri Mohd; Rahman, Jamalludin Ab; Zulkifly, Ahmad Hafiz; Che-Ahmad, Aminudin; Khalid, Kamarul Ariffin; Sulong, Ahmad Fadzli; Vijayasingham, Naveen

    2015-01-01

    INTRODUCTION Diabetes mellitus (DM) is the most common cause of amputations in Malaysia. This study aimed to identify the predictive factors for major lower limb amputation among patients with type 2 DM (T2DM) who were admitted to a hospital, in order to reduce its likelihood. METHODS This cross-sectional study involved 218 patients with T2DM who were admitted to Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, for diabetic foot problems from June 2011 to July 2012. A form was developed to document the patients’ profiles, comorbidities, complications, investigations, treatment and clinical outcomes. The predictors for major lower limb amputations were determined using univariate and stepwise logistic regression analysis. RESULTS A total of 31 patients underwent major lower limb amputations (25 transtibial, 6 transfemoral). The following factors were found to be associated with the incidence of major lower limb amputations: T2DM duration ≥ 10 years, diabetic neuropathy, diabetic nephropathy, presentation with gangrene, diabetic foot conditions of Wagner grade 4 or 5, and necrotising fasciitis. Patients who underwent major amputations had significantly lower haemoglobin and albumin levels, and higher total white blood cell counts, erythrocyte sedimentation rates, and C-reactive protein, urea and creatinine levels. However, only T2DM duration ≥ 10 years, positive bacterial culture and albumin levels were significant on stepwise logistic regression analysis. CONCLUSION T2DM duration ≥ 10 years, positive bacterial culture and low albumin levels were found to be significant predictive factors for major lower limb amputation among patients with T2DM admitted for diabetic foot problems. PMID:26668408

  13. Percutaneous transluminal angioplasty of iliac and femoral arteries in severe lower-limb ischaemia

    DEFF Research Database (Denmark)

    Jørgensen, B; Henriksen, L O; Karle, A;

    1988-01-01

    Percutaneous transluminal angioplasty was performed 92 times in 86 patients with severe lower-limb ischaemia (40% occlusion), giving rise to rest pain and/or gangrene. The patients were thereafter observed for periods up to 5 years. Criteria for success were appearance of normal groin pulse (iliac...... angioplasty) or persistent greater than or equal to 0.15 rise in arm/ankle blood pressure index (femoropopliteal angioplasty). The respective technical success rates were 82% and 64%. The complication rate was 10.9%, including 5.4% distal embolization. Patency rates were higher in iliac than...... in femoropopliteal lesions, in stenotic than occluded vessels, and also when the lesion was shorter than 5 cm and if there was good run-off. Limb salvage exceeded patency by 10% in the iliac procedures and by 15% in the femoropopliteal. Percutaneous transluminal angioplasty is recommended for selected cases...

  14. 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

  15. 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

  16. FEASIBILITY AND SAFETY OF CONTRAST-ENHANCED ULTRASOUND IN THE DISTAL LIMB OF SIX HORSES.

    Science.gov (United States)

    Seiler, Gabriela S; Campbell, Nigel; Nixon, Britton; Tsuruta, James K; Dayton, Paul A; Jennings, Samuel; Redding, W Rich; Lustgarten, Meghann

    2016-05-01

    Vascular alterations play important roles in many orthopedic diseases such as osteoarthritis, tendonitis, and synovitis in both human and equine athletes. Understanding these alterations could enhance diagnosis, prognosis, and treatment. Contrast-enhanced ultrasound (CEUS) could be a valuable method for evaluation of blood flow and perfusion of these processes in the equine distal limb, however no reports were found describing feasibility or safety of the technique. The goal of this prospective, experimental study was to describe the feasibility and safety of distal limb CEUS in a sample of six horses. For each horse, CEUS of the distal limb was performed after intravenous injections of 5 and 10 ml, as well as intra-arterial injections of 0.5 and 1 ml contrast medium. Vital parameters were monitored and CEUS images were assessed qualitatively and quantitatively for degree of contrast enhancement. None of the horses had clinically significant changes in their vital parameters after contrast medium injection. One horse had a transient increase in respiratory rate, and several horses had mild increases of systolic blood pressure of short duration after intravenous, but not after intra-arterial injections. Intra-arterial injection was possible in all horses and resulted in significantly improved contrast enhancement both quantitatively (P = 0.027) and qualitatively (P = 0.019). Findings from this study indicated that CEUS is a feasible and safe diagnostic test for evaluation of the equine distal limb. Future studies are needed to assess the clinical utility of this test for horses with musculoskeletal diseases. PMID:26765518

  17. [Lower limb varicose veins as a manifestation of undifferentiated connective tissue dysplasia].

    Science.gov (United States)

    Potapov, M P; Potapov, P P; Staver, E V; Mazepina, L S

    2016-01-01

    Analysed herein are the data of 737 patients (a total of 745 lower limbs) suffering from lower-limb varicose veins (LLVV) and subjected to treatment at the Surgical Department consisting of crossectomy, truncal and tributary phlebectomy, dissection of perforant veins exclusively in the basin of the great saphenous vein. Relapses during five-year follow up occurred in 13.8% (102/745) of cases. Based on clinical signs and laboratory findings we studied the effect of the factor of undifferentiated connective tissue dysplasia (UDCTD) on the development of lower-limb varicosity. We carried out comparative analysis in the groups with relapsing LLVV (n=43), without relapses (n=39) and control group comprising volunteers not suffering from LLVV (n=37). The median of blood serum total oxiprolin concentration in LLVV patients both with and without relapses was elevated and amounted to 18.4 (IR 14.9-19.65) and 14.3 (IR 13.1-16.5) versus 8.35 (5.75-9.75) μmol/l, respectively. The mode of the clinical parameter of UDCTD degree in accordance with the rating scale of Smolnova T.Yu. (2003) in the group of patients with LLVV relapses turned out to be higher (Mo=19) than in the group of patients without relapses (Mo=10, p=0.003). The lowest score was in the control group. In patients having immediate relatives with LLVV the level of blood serum total oxiprolin and clinical scores of LLVV turned out to be statistically significantly higher. Hence, based on the obtained during the study clinical and laboratory findings it may be supposed that undifferentiated connective tissue dysplasia plays an important part in the development of both lower limb varicosity and relapses thereof.

  18. 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

  19. 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

  20. 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

  1. 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 ...

  2. 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 ...

  3. 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 ...

  4. [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).

  5. Inter-limb differences in quadriceps strength and volitional activation.

    Science.gov (United States)

    Pietrosimone, Brian G; Park, Chang M; Gribble, Phillip A; Pfile, Kate R; Tevald, Michael A

    2012-01-01

    In this crossover study, we wished to determine if normalized inter-limb differences in strength differed from inter-limb differences in voluntary activation at 30°, 70°, and 90° of knee flexion. We also assessed the relationship between inter-limb differences in torque with the inter-limb differences in activation. Twenty-five healthy volunteers were used for final data analyses; the order of leg tested, joint angle, and measurement technique (isokinetic strength, voluntary activation) were randomly assigned. Quadriceps strength was measured isokinetically at 1.05 rad · s(-1), while quadriceps voluntary activation was assessed via the central activation ratio. Absolute values of inter-limb differences for both measures were calculated by subtracting the non-dominant leg values from those of the dominant leg. Inter-limb isokinetic strength differences were greater than inter-limb central activation ratio differences at all joint angles (P = 0.003). Interestingly, inter-limb deficits between measures were not strongly correlated, suggesting that these measurements may be evaluating completely different phenomena within the neuromuscular system. These measurement techniques may provide unique information regarding neuromuscular function, suggesting that researchers and clinicians must utilize information from both techniques to determine the true clinical nature of inter-limb deficits.

  6. 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.

  7. 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...

  8. BLOOD DONATION

    CERN Document Server

    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.

  9. 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....

  10. 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

  11. 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.

  12. 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)

  13. [Treatment of varicose veins and limb lymphedema].

    Science.gov (United States)

    Vignes, S

    2014-02-01

    Two questions arise when considering the treatment of varicose veins and the development of lymphedema: can the treatment cause lymphedema? Can it worsen it? Primary lymphedema is rarely associated with varicose veins except in the lymphedema-distichiasis syndrome. Data available in the literature is essentially based on surgical treatment. Stripping on a normal limb may induce chronic lymphedema in almost 0.1% of cases. The risk of lymphedema after stripping in patients with previous pelvic surgery including lymph node excision and/or radiotherapy remains unknown. In patients with lower limb lymphedema wearing strong elastic compression stockings, stripping provides little clinical improvement and can worsen volume. The main objective is also to avoid venous complications. Lymphatic lesions related to stripping can be evaluated by lymphography or lymphoscintigraphy. New techniques for treating varicose veins (sclerotherapy, endovenous laser treatment, radiofrequency ablation) seem to induce fewer lymphatic complications. Further studies are required to confirm these results. Indications for treatment should be unquestionable and patients must be alerted to the potential risk of lymphedema or its worsening. PMID:24315933

  14. Line Caustic Microlensing and Limb Darkening

    CERN Document Server

    Rhie, S H; Rhie, Sun Hong; Bennett, David P.

    1999-01-01

    In a line caustic crossing microlensing event, the caustic line moving across the surface of the source star provides a direct method to measure the integrated luminosity profile of the star. Combined with the enormous brightening at the caustic crossings, microlensing offers a promising tool for studying stellar luminosity profiles. We derive the amplification behavior of the two extra images that become partial images conjoined across the critical curve at a line caustic crossing. We identify the multiplicative factors that depend on the caustic crossing point and the relative size of the star, and the shape function that depends on the stellar luminosity profile. We examine the analytic limb-darkening models -- linear, square root, and square -- using the analytic form of the shape function. We find that the microlensing lightcurves must be determined to an accuracy of better than 0.3-0.8% in order to be able to determine the linear limb-darkening parameter $c_1$ with precision of binaries as reported by P...

  15. Limb Regeneration in Axolotl: Is It Superhealing?

    Directory of Open Access Journals (Sweden)

    Stéphane Roy

    2006-01-01

    Full Text Available The ability of axolotls to regenerate their limbs is almost legendary. In fact, urodeles such as the axolotl are the only vertebrates that can regenerate multiple structures like their limbs, jaws, tail, spinal cord, and skin (the list goes on throughout their lives. It is therefore surprising to realize, although we have known of their regenerative potential for over 200 years, how little we understand the mechanisms behind this achievement of adult tissue morphogenesis. Many observations can be drawn between regeneration and other disciplines such as development and wound healing. In this review, we present new developments in functional analysis that will help to address the role of specific genes during the process of regeneration. We also present an analysis of the resemblance between wound healing and regeneration, and discuss whether axolotls are superhealers. A better understanding of these animals' regenerative capacity could lead to major benefits by providing regenerative medicine with directions on how to develop therapeutic approaches leading to regeneration in humans.

  16. [Arterial surgery of the upper limb].

    Science.gov (United States)

    Perrault, L; Lassonde, J; Laurendeau, F

    1991-01-01

    Arterial surgery of the upper limb represents 2.5% of peripheral vascular procedures in our center. From 1976 to 1989, 58 procedures were performed in 45 patients. There were 26 men and 19 women with average age of 52 years, ranging from 6 to 92 years. These patients were grouped in three categories according to etiology: 1) trauma; 2) acute non traumatic ischemia and 3) chronic ischemia. Sixteen patients (35.5%) were operated on for arterial trauma including three false aneurysms. Blunt trauma was the cause in 9 patients, penetrating in 6 and iatrogenic in one. Angioplasty and primary end to end anastomosis were used in 6, bypass in 4, simple ligation in 3, thrombectomy in 3. The outcome was excellent in 15/16 (93%). Non traumatic acute ischemia occurred in 16 patients (35.5%) and was due to emboli of cardiac origin in 92%. All patients were treated by thromboembolectomy. This group had a high mortality (5/16, 31%) because of associated medical conditions. The third group of 13 patients (29%) underwent surgery for chronic ischemia of the upper limb localized to the subclavian artery in 92%. They were treated with carotid subclavian bypasses in 9, other types of bypass in 3 and endarterectomy in 1. Excellent results were obtained in 10/13 (78%). Overall, satisfactory results were obtained in 90% of surviving patients. Operative mortality was 11.1% and the amputation rate was 13%.

  17. 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.

  18. Limb-Shaking Transient Ischemic Attacks Successfully Treated with External Carotid Artery Stenting

    Directory of Open Access Journals (Sweden)

    George N. Kouvelos

    2012-01-01

    Full Text Available The external carotid artery (ECA is one of the most important extracranial-to-intracranial sources of collateral circulation, contributing significantly to the cerebral blood flow especially when perfusion through the internal carotid artery (ICA is compromised. Most of the endovascular studies so far have been dedicated to ICA, with little focus on the ECA. Limb-shaking transient ischemic attacks (TIAs are a relatively rare manifestation of carotid artery disease that may present with repetitive shaking movements of the affected limbs. We report a case of an 80-year-old male with bilateral internal and contralateral external carotid artery occlusion who developed limb-shaking TIAs as a result of significant stenosis of the right ECA. Percutaneous revascularization of the ECA was performed by angioplasty and stenting. At the follow-up 12 months later, the patient remained neurologically intact with complete resolution of his symptoms. Stenting of the ECA should be considered as a reasonable alternative to conventional open repair especially in patients with contralateral carotid stenosis, insufficient circle of Willis, and significant comorbidities.

  19. IMPAIRED ANGIOGENESIS FOLLOWING HIND-LIMB ISCHEMIA IN DIABETES MELLITUS MICE

    Institute of Scientific and Technical Information of China (English)

    Yong-jun Li; Heng Guan; Surovi Hazarika; Chang-wei Liu; Brain H Annex

    2007-01-01

    To investigate vascular endothelial growth factor (VEGF) and its signaling pathway spontaneous response in type 2 diabetes mellitus (T2DM) mice to surgery-induced hind-limb ischemia.Methods Sixty mice were randomly divided into two groups, one was fed with normal chow as control, and another was fed with high fat diet to induce T2DM. Fourteen weeks later, mice were surgically induced to hind-limb ischemia. Blood flow restoration was monitored with laser Doppler perfusion imaging. Tibialis anterior muscle was collected after 3 days of hind-limb ischemia. VEGF mRNA and protein expressions were analyzed using real-time PCR and ELISA; expressions of VEGF downstream signal molecules and receptors were analyzed using Western blotting and RTPCR, respectively.Results Perfusion recovery 10, 20, 30 days after ischemia was significantly attenuated in T2DM compared with control group ( P < 0.05 ). T2DM impaired VEGF signaling pathway although VEGF levels increased in T2DM group.After ischemia, T2DM group had a comparable increase in VEGF expression compared with control group, but still had an impaired VEGF signaling pathway.Conclusion VEGF signaling pathway is abnormal in T2DM mice, although VEGF had a response to the ischemic stimulation.

  20. Epidural spinal cord stimulation in chronic non-reconstructible limb ischemia.

    Science.gov (United States)

    Neuhauser; Greiner; Kofler; Perkmann

    2004-04-01

    For patients with chronic non-reconstructible limb ischemia (chronic CLI), spinal-cord stimulation (SCS) has been advocated for the treatment of ischemic pain and prevention of amputation. The present clinical report was performed to evaluate the long-term effects of SCS on limb survival. A retrospective review was performed of 21 patients who had undergone SCS between December 1997 and July 2002 due to chronic CLI. The impulse generator used was the Itrel device (Medtronic, Inc). All conventional methods for revascularization and improvement of microcirculatory blood flow had been performed prior to SCS treatment. Patient selection was performed by clinical examination, pulse volume records, Doppler ankle/brachial measurements, angiography, and thoracic spine and lumbar spine x-ray. Since July 2000, additional TcpO2 measurements at the dorsum of the foot have been performed. SCS implantation was performed as a one-stage procedure in all cases. Patients are followed up to 57 months. Of 21 patients with chronic CLI, 20 (95%) were available for follow-up investigations. Four patients died one to fifteen months after implantation due to acute renal failure or myocardial infarction (19%). Major amputation could be avoided in 15 (71%) of 21 patients. Two electrode dislocation, one pulse-generator dislocation, and one wire disconnection occurred; no other complications were observed. SCS represents a safe and effective therapy for patients with chronic non-reconstructible critical limb ischemia.

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

    DEFF Research Database (Denmark)

    Raffin, Estelle; Richard, Nathalie; Giraux, Pascal;

    2016-01-01

    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...... 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....

  2. 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...

  3. Upper limb function in adults with Duchenne muscular dystrophy

    NARCIS (Netherlands)

    B. Bartels (Bart); R.F. Pangalila; M.P. Bergen (Michael); N.A.M. Cobben (Nicolle); H.J. Stam (Henk); M.E. Roebroeck (Marij)

    2011-01-01

    textabstractTo determine upper limb function and associated factors in adults with Duchenne muscular dystrophy. Design: Cross-sectional study. Subjects: A sample of 70 men with Duchenne muscular dystrophy (age range 20-43 years). Methods: General motor function and, in particular, upper limb distal

  4. 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

  5. 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.)

  6. Additivity in perception of affect from limb motion.

    Science.gov (United States)

    Etemad, S Ali; Arya, Ali; Parush, Avi

    2014-01-13

    In this study, the notion of additivity in perception of affect from limb motion is investigated. Specifically, we examine whether the impact of multiple limbs in perception of affect is equal to the sum of the impacts of each individual limb. Several neutral, happy, and sad walking sequences are first aligned and averaged. Four distinct body regions or limbs are defined for this study: arms and hands, legs and feet, head and neck, and torso. The three average walks are used to create the stimuli. The motion of each limb and combination of limbs from the neutral sequence are replaced with those of the happy and sad sequences. Through collecting perceptual ratings for when individual limbs contain affective features, and comparing the sums of these ratings to instances where multiple limbs of the body simultaneously contain affective features, additivity is investigated. We find that while the results are highly correlated, additivity does not hold in the classical sense. Based on the results, a mathematical model is proposed for describing the observed relationship. PMID:24269980

  7. Fundamental ratios and logarithmic periodicity in human limb bones.

    Science.gov (United States)

    Pietak, Alexis; Ma, Siyan; Beck, Caroline W; Stringer, Mark D

    2013-05-01

    Fundamental mathematical relationships are widespread in biology yet there is little information on this topic with regard to human limb bone lengths and none related to human limb bone volumes. Forty-six sets of ipsilateral upper and lower limb long bones and third digit short bones were imaged by computed tomography. Maximum bone lengths were measured manually and individual bone volumes calculated from computed tomography images using a stereologic method. Length ratios of femur : tibia and humerus : ulna were remarkably similar (1.21 and 1.22, respectively) and varied little (bone volume ratios varied much more than upper limb ratios. The relationship between bone length and volume was found to be well described by power laws, with R(2) values ranging from 0.983 to 0.995. The most striking finding was a logarithmic periodicity in bone length moving from distal to proximal up the limb (upper limb λ = 0.72, lower limb λ = 0.93). These novel data suggest that human limb bone lengths and volumes follow fundamental and highly conserved mathematical relationships, which may contribute to our understanding of normal and disordered growth, stature estimation, and biomechanics.

  8. 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.

  9. 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.

  10. Lower limb deficient children in the Netherlands : epidemiological aspects

    NARCIS (Netherlands)

    Rijnders, LJM; Boonstra, AM; Groothoff, JW; Cornel, MC; Eisma, WH

    2000-01-01

    information on the characteristics of children with limb deficiencies and amputations in the Netherlands is largely lacking. The present study aimed to collect data about the prevalence of congenital deficiencies, the ratio of congenital to acquired limb deficiencies, types of lower leg deficiency o

  11. 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

  12. Limb-Darkening Coefficients for Eclipsing White Dwarfs

    CERN Document Server

    Gianninas, A; Kilic, Mukremin; Bergeron, P

    2013-01-01

    We present extensive calculations of linear and non-linear limb-darkening coefficients as well as complete intensity profiles appropriate for modeling the light-curves of eclipsing white dwarfs. We compute limb-darkening coefficients in the Johnson-Kron-Cousins UBVRI photometric system as well as the Large Synoptic Survey Telescope (LSST) ugrizy system using the most up-to-date model atmospheres available. In all, we provide the coefficients for seven different limb-darkening laws. We describe the variations of these coefficients as a function of the atmospheric parameters, including the effects of convection at low effective temperatures. Finally, we discuss the importance of having readily available limb-darkening coefficients in the context of present and future photometric surveys like the LSST, Palomar Transient Factory (PTF), and the Panoramic Survey Telescope and Rapid Response System (Pan-STARRS). The LSST, for example, may find ~10^5 eclipsing white dwarfs. The limb-darkening calculations presented h...

  13. 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 ...

  14. Blood donation before surgery

    Science.gov (United States)

    ... type of donor blood. Many communities have a blood bank where healthy people can donate blood. This blood ... need to arrange with your hospital or local blood bank before your surgery to have directed donor blood. ...

  15. 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 ...

  16. 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 ...

  17. 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 ...

  18. 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. ...

  19. Optimising Body Layout Design of Limbed Machines

    Institute of Scientific and Technical Information of China (English)

    Shu-jun Zhang; Jin Tong; Kevin Hapeshi; Dong-hui Chen

    2007-01-01

    This paper presents our efforts to explain why mammals have large thigh muscles while insects have small ones. After a discussion of this observation a definition of body foot ratio is defined which describes how animals stand and how their legs are arranged. To investigate the mechanics, we present a closed optimum solution of the body foot ratio for a 2D two-leg walking machine. A multi-walker is used as a case for 3D general analysis, and the numerical simulation is presented. Both 2D and 3D case studies can explain the above observations of mammals and insects. These findings can also be used as a guide for the design of man-made limbed machines.

  20. Magnetic Fields in Limb Solar Flares

    Science.gov (United States)

    Lozitsky, V. G.; Lozitska, N. I.; Botygina, O. A.

    2013-02-01

    Two limb solar flares, of 14 July 2005 and 19 July 2012, of importance X1.2 and M7.7, are analyzed at present work. Magnetic field strength in named flares are investigated by Stokes I±V profiles of Hα and D3 HeI lines. There are direct evidences to the magnetic field inhomogeneity in flares, in particular, non-paralelism of bisectors in I+V and I-V profiles. In some flare places, the local maximums of bisectors splitting were found in both lines. If these bisector splittings are interpreted as Zeeman effect manifestation, the following magnetic field strengths reach up to 2200 G in Hα and 1300 G in D3. According to calculations, the observed peculiarities of line profiles may indicate the existence of optically thick emissive small-scale elements with strong magnetic fields and lowered temperature.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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.)

  6. Limb bone morphology, bone strength, and cursoriality in lagomorphs.

    Science.gov (United States)

    Young, Jesse W; Danczak, Robert; Russo, Gabrielle A; Fellmann, Connie D

    2014-10-01

    The primary aim of this study is to broadly evaluate the relationship between cursoriality (i.e. anatomical and physiological specialization for running) and limb bone morphology in lagomorphs. Relative to most previous studies of cursoriality, our focus on a size-restricted, taxonomically narrow group of mammals permits us to evaluate the degree to which 'cursorial specialization' affects locomotor anatomy independently of broader allometric and phylogenetic trends that might obscure such a relationship. We collected linear morphometrics and μCT data on 737 limb bones covering three lagomorph species that differ in degree of cursoriality: pikas (Ochotona princeps, non-cursorial), jackrabbits (Lepus californicus, highly cursorial), and rabbits (Sylvilagus bachmani, level of cursoriality intermediate between pikas and jackrabbits). We evaluated two hypotheses: cursoriality should be associated with (i) lower limb joint mechanical advantage (i.e. high 'displacement advantage', permitting more cursorial species to cycle their limbs more quickly) and (ii) longer, more gracile limb bones, particularly at the distal segments (as a means of decreasing rotational inertia). As predicted, highly cursorial jackrabbits are typically marked by the lowest mechanical advantage and the longest distal segments, non-cursorial pikas display the highest mechanical advantage and the shortest distal segments, and rabbits generally display intermediate values for these variables. Variation in long bone robusticity followed a proximodistal gradient. Whereas proximal limb bone robusticity declined with cursoriality, distal limb bone robusticity generally remained constant across the three species. The association between long, structurally gracile limb bones and decreased maximal bending strength suggests that the more cursorial lagomorphs compromise proximal limb bone integrity to improve locomotor economy. In contrast, the integrity of distal limb bones is maintained with increasing

  7. 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

  8. Reflex sympathetic dystrophy: the significance of differing plasma catecholamine concentrations in affected and unaffected limbs.

    Science.gov (United States)

    Drummond, P D; Finch, P M; Smythe, G A

    1991-10-01

    In 26 patients with features of reflex sympathetic dystrophy, venous blood was collected from painful and unaffected limbs. Levels of plasma adrenaline, noradrenaline and its intracellular metabolite, 3,4-dihydroxyphenylethyleneglycol (DHPG), were measured by combined gas chromatography/mass spectrometry. Plasma DHPG was lower on the painful side. Concentration of plasma noradrenaline was also lower on the painful side in patients with widespread allodynia, and in those with hyperhidrosis in the affected hand or foot. These findings do not support the widely held view that autonomic disturbances in reflex sympathetic dystrophy are due to sympathetic overactivity. Rather, they suggest that sweating and changes in peripheral blood flow result from supersensitivity to sympathetic neurotransmitters. After injury, supersensitivity to noradrenaline may also contribute to spontaneous pain and allodynia by disrupting efferent sympathetic modulation of sensation. This would explain why pain and allodynia are relieved by sympathetic blockade, and why noradrenaline rekindles pain in sympathectomized skin. PMID:1933231

  9. Managing your blood sugar

    Science.gov (United States)

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

  10. 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

  11. 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.

  12. 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

  13. 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.)

  14. Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

    Science.gov (United States)

    Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

    2015-02-15

    During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents.

  15. 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.

  16. 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

    blood pressure was again reduced (-3.6 mmHg, P= 0.037). Mean 24 h ambulatory systolic and diastolic blood pressures were significantly lower than clinic measurements (-15.7 and -5.9 mmHg, P blood pressure is reduced during a cyclic HRT regimen...... 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.......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 changes...

  17. Capturing the Perceived Phantom Limb through Virtual Reality

    Directory of Open Access Journals (Sweden)

    Christian Rogers

    2016-01-01

    Full Text Available Phantom limb is the sensation amputees may feel when the missing limb is still attached to the body and is still moving as it would if it still existed. Despite there being between 50 and 80% of amputees who report neuropathic pain, also known as phantom limb pain (PLP, there is still little understanding of why PLP occurs. There are no fully effective long-term treatments available. One of the struggles with PLP is the difficulty for amputees to describe the sensations of their phantom limbs. The sensations may be of a limb that is in a position that is impossible for a normal limb to attain. The goal of this project was to treat those with PLP by developing a system to communicate the sensations those with PLP were experiencing accurately and easily through various hand positions using a model arm with a user friendly interface. The system was developed with Maya 3D animation software, the Leap Motion input device, and the Unity game engine. The 3D modeled arm was designed to mimic the phantom sensation being able to go beyond normal joint extensions of regular arms. The purpose in doing so was to obtain a true 3D visualization of the phantom limb.

  18. Individual limb mechanical analysis of gait following stroke.

    Science.gov (United States)

    Mahon, Caitlin E; Farris, Dominic J; Sawicki, Gregory S; Lewek, Michael D

    2015-04-13

    The step-to-step transition of walking requires significant mechanical and metabolic energy to redirect the center of mass. Inter-limb mechanical asymmetries during the step-to-step transition may increase overall energy demands and require compensation during single-support. The purpose of this study was to compare individual limb mechanical gait asymmetries during the step-to-step transitions, single-support and over a complete stride between two groups of individuals following stroke stratified by gait speed (≥0.8 m/s or phases of a stride, as well as over a complete stride. Robust inter-limb asymmetries in mechanical power existed during walking after stroke; for both groups, the non-paretic limb produced significantly more positive net mechanical power than the paretic limb during all phases of a stride and over a complete stride. Interestingly, no differences in inter-limb mechanical power asymmetry were noted between groups based on walking speed, during any phase or over a complete stride. Paretic propulsion, however, was different between speed-based groups. The fact that paretic propulsion (calculated from anterior-posterior forces) is different between groups, but our measure of mechanical work (calculated from all three directions) is not, suggests that limb power output may be dominated by vertical components, which are required for upright support.

  19. MONITORING OF LOWER LIMB COMFORT AND INJURY IN ELITE FOOTBALL

    Directory of Open Access Journals (Sweden)

    Michael Kinchington

    2010-12-01

    Full Text Available The aim of the study was to examine the relation between lower limb comfort scores and injury and to measure the responsiveness of a lower limb comfort index (LLCI to changes over time, in a cohort of professional footballers. Lower limb comfort was recorded for each individual using a comfort index which assessed the comfort status of five anatomical segments and footwear. Specifically we tested the extent to which comfort zones as measured by the LLCI were related to injury measured as time loss events. The hypothesis for the study was that poor lower limb comfort is related to time loss events (training or match day. A total of 3524 player weeks of data was collected from 182 professional athletes encompassing three codes of football (Australian Rules, Rugby league, Rugby Union. The study was conducted during football competition periods for the respective football leagues and included a period of pre- season training. The results of regression indicated that poor lower limb comfort was highly correlated to injury (R2 =0.77 and accounted for 43.5 time loss events/ 1000hrs football exposure. While poor comfort was predictive of injury 47% of all time loss events it was not statistically relevant (R2 =0.18. The results indicate lower limb comfort can be used to assess the well-being of the lower limb; poor comfort is associated with injury, and the LLCI has good face validity and high criterion-related validity for the relationship between comfort and injury

  20. Functional reconstruction of ischemic contracture in the lower limb

    Institute of Scientific and Technical Information of China (English)

    TANG Hao; ZHANG Shao-cheng; TAN Zhang-yong; ZHU Hong-wei; ZHANG Qiu-lin; LI Ming

    2011-01-01

    Objective: To discuss the method of functional reconstruction of ischemic contracture in the lower limb and propose a classification protocol for ischemic contracture in the lower limb based on its severity and prognosis.Methods: Atotal of 42 patients with ischemic contracture in the lower limb were included in this study. According to different types of disturbance and degrees of severity,surgical reconstructions consisting of nerve decompression,tendon lengthening or transfer, intrinsic foot muscle release and sural-tibial nerve anastomosis were performed in every patient.Results: Postoperatively, all patients were able to walk on flat ground. Drop foot was corrected in 10 patients,and 5 patients still felt some difficulty during stair activity.Split Achilles tendon transfer to flexor hallucis longus tendon was performed in 12 patients, and their walking stability was improved. Seven patients accepted ipsilateral suraltibial nerve anastomosis, and sensitivity recovery reached to S2 in 2 patients and S3 in 5 patients.Conclusions: Ischemic contracture in the lower limb is a devastating complication after lower limb trauma. The prevention of contracture is much more important than the treatment of an established contracture. Split Achilles tendon transfer to flexor hallucis longus tendon and sural-tibial nerve anastomosis, which was initially implemented by us, could improve the functional recovery of ischemic contracture in lower limbs, and thus provides a new alternative for functional reconstruction of ischemic contracture in the lower limb.

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

    Energy Technology Data Exchange (ETDEWEB)

    Wertz, R.L.

    1982-07-01

    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 (/sup 3/H)-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.

  2. 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 ( ...

  3. Protective effect of hemoglobin- induced heme oxygenase- 1on injured lungs caused by limb ischemia-reperfusion inrats

    Institute of Scientific and Technical Information of China (English)

    周君琳; 朱晓光; 张桂生; 凌彤

    2002-01-01

    Objective: To determine the role of hemoglobin(HB) -induced heme oxygenase- 1 ( HO- 1 ) in injured lungscaused by limb ischemia-reperfusion (I/R) in rats.Methods: A rat model of ischemia in the hind limbswas made by clamping the infrarenal aorta with amicrovascular clip, and lung injury occurred afterreperfusion. To induce the expression of HO-1 in the lungs,Hb was administrated intraperitoneally at 16 hours beforereperfusion. Northern blotting and Western blotting wereused to detect the expression of HO-1 in the lungs, and thecarboxyhemoglobin (COHb) level in arterial blood wasassayed. The effect of hemoglobin (Hb) on the injuredlungs after limb I/R was determined by measuring thechanges of lung histology, polymorphonuclear (PMN)count, malondialdehyde (MDA) content and wet-to-dryweight ratio (W/D). Zinc protoporphyrin (ZnPP), aninhibitor of HO, was used to determine whether HO-1 wasinduced by Hb after lung injury.Results: Hb led to a significant increase in HO-1mRNA and protein expression in the lungs, accompanied bythe increase of COHb level in arterial blood. Comparedwith the sham controls, the lung PMN count, MDA contentand W/D significantly increased at 4 hours after limb I/R,which reversed by the pretreatment with Hb at 16 hoursbefore reperfusion. ZnPP blocked this protective role of Hbin the injured lungs.Conclusions: Hb can induce the lung HO-1expression, which plays an important role in the defenseagainst I/R-induced lung injury in rats.

  4. 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

  5. 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.

  6. 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: ...

  7. 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 ...

  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 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 ...

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. New type of lethal short-limbed dwarfism

    Energy Technology Data Exchange (ETDEWEB)

    Nairn, E.R.; Chapman, S.

    1989-05-01

    Details are presented of a most unusual osteo-chondrodysplasia which presents with lethal neonatal short-limbed dwarfism, defective ossification and nodular calcification with cartilage. The features resemble one case previously described in the literature.

  15. 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).

  16. 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

  17. 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 &...

  18. 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.

  19. 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

  20. A pilot study to compare the cerebral hemodynamics between patients with obstructive sleep apnea syndrome (OSA) and periodic limb movement syndrome (PLMS) during nocturnal sleep with near-infrared spectroscopy (NIRS)

    Science.gov (United States)

    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Hügli, Gordana; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    Obstructive sleep apnea syndrome (OSA) and periodic limb movement in sleep syndrome (PLMS) are two common sleep disorders. Previous studies showed that OSA and PLMS share common features, such as increased cardio-vascular risk, both apnea events and limb movements occur periodically, they are usually associated with cortical arousals, and both of them can induce declines in peripheral oxygen saturation measured with pulse oximetry. However, the question whether apnea events and limb movements also show similar characteristics in cerebral hemodynamic and oxygenation has never been addressed. In this pilot study, we will first time compare the cerebral hemodynamic changes induced by apnea events and limb movements in patients with OSA (n=4) and PLMS (n=4) with NIRS. In patients with OSA, we found periodic oscillations in HbO2, HHb, and blood volume induced by apnea/hypopnea events, HbO2 and HHb showed reverse changing trends. By contrast, the periodic oscillations linked to limb movements were only found in HbO2 and blood volume in patients with PLMS. These findings of different cerebral hemodynamics patterns between apnea events and limb movements may indicate different regulations of nervous system between these two sleep disorders.

  1. Idiopathic unilateral lower limb gangrene in a neonate

    Directory of Open Access Journals (Sweden)

    Jagjit Singh

    2011-01-01

    Full Text Available We are reporting a very unusual case of unilateral lower limb gangrene in 12 days neonate, who was brought to us with bluish discoloration of left foot with gangrene of toes. A negative sepsis screen, normal Doppler study, normal magnetic resonance angiography and absence of evidence of hypercoagulable state prompted us to make the diagnosis of idiopathic unilateral lower limb gangrene in this newborn. Because of the rarity we are reporting this case with vide review of literature.

  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. 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.

  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. The fastest runner on artificial legs: different limbs, similar function?

    Science.gov (United States)

    Weyand, Peter G; Bundle, Matthew W; McGowan, Craig P; Grabowski, Alena; Brown, Mary Beth; Kram, Rodger; Herr, Hugh

    2009-09-01

    The recent competitive successes of a bilateral, transtibial amputee sprint runner who races with modern running prostheses has triggered an international controversy regarding the relative function provided by his artificial limbs. Here, we conducted three tests of functional similarity between this amputee sprinter and competitive male runners with intact limbs: the metabolic cost of running, sprinting endurance, and running mechanics. Metabolic and mechanical data, respectively, were acquired via indirect calorimetry and ground reaction force measurements during constant-speed, level treadmill running. First, we found that the mean gross metabolic cost of transport of our amputee sprint subject (174.9 ml O(2)*kg(-1)*km(-1); speeds: 2.5-4.1 m/s) was only 3.8% lower than mean values for intact-limb elite distance runners and 6.7% lower than for subelite distance runners but 17% lower than for intact-limb 400-m specialists [210.6 (SD 13.2) ml O(2)*kg(-1)*km(-1)]. Second, the speeds that our amputee sprinter maintained for six all-out, constant-speed trials to failure (speeds: 6.6-10.8 m/s; durations: 2-90 s) were within 2.2 (SD 0.6)% of those predicted for intact-limb sprinters. Third, at sprinting speeds of 8.0, 9.0, and 10.0 m/s, our amputee subject had longer foot-ground contact times [+14.7 (SD 4.2)%], shorter aerial [-26.4 (SD 9.9)%] and swing times [-15.2 (SD 6.9)%], and lower stance-averaged vertical forces [-19.3 (SD 3.1)%] than intact-limb sprinters [top speeds = 10.8 vs. 10.8 (SD 0.6) m/s]. We conclude that running on modern, lower-limb sprinting prostheses appears to be physiologically similar but mechanically different from running with intact limbs.

  7. Lower limb deficient children in the Netherlands: epidemiological aspects

    OpenAIRE

    Rijnders, LJM; Boonstra, AM; Groothoff, JW; Cornel, MC; Eisma, WH

    2000-01-01

    information on the characteristics of children with limb deficiencies and amputations in the Netherlands is largely lacking. The present study aimed to collect data about the prevalence of congenital deficiencies, the ratio of congenital to acquired limb deficiencies, types of lower leg deficiency or amputation and male/female ratios. Data were obtained from a regional birth defects registry for the northern parr. of the Netherlands (EUROCAT-NNL) and from a national survey, inclusion criteria...

  8. 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.

  9. 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

  10. Lower limb strength in sports-active transtibial amputees.

    Science.gov (United States)

    Nolan, Lee

    2009-09-01

    The aim of this study was to compare hip strength in sports-active transtibial (TT) amputees, sedentary TT amputees and sports-active non-amputees. Three 'active' (exercising recreationally at least three times per week) TT amputees, four 'inactive' or sedentary TT amputees and nine 'active' able-bodied persons (AB) underwent concentric and eccentric hip flexion and extension strength testing on both limbs on an isokinetic dynamometer at 60 and 120 degrees /s. Little strength asymmetry was noted between the limbs of the active TT amputees (8% and 14% at 60 and 120 degrees /s, respectively), their residual limb being slightly stronger. Inactive TT amputees demonstrated up to 49% strength asymmetry, their intact limb being the stronger. Active TT amputees demonstrated greater peak hip torques (Nm/kg) for all conditions and speeds compared to inactive TT amputees. Peak hip torques (Nm/kg), were greater in the active TT amputees' residual limb compared to AB. While inactive TT amputees and AB had similar flexion/extension ratios, active TT amputees exhibited a lower ratio indicating overdeveloped hip extensors with respect to their hip flexors. It is not known whether this is due to the demands of sport or exercise with a prosthetic limb, or remaining residual thigh atrophy.

  11. Three-body segment musculoskeletal model of the upper limb

    Directory of Open Access Journals (Sweden)

    Valdmanová L.

    2013-06-01

    Full Text Available The main aim is to create a computational three-body segment model of an upper limb of a human body for determination of muscle forces generated to keep a given loaded upper limb position. The model consists of three segments representing arm, forearm, hand and of all major muscles connected to the segments. Muscle origins and insertions determination corresponds to a real anatomy. Muscle behaviour is defined according to the Hill-type muscle model consisting of contractile and viscoelastic element. The upper limb is presented by a system of three rigid bars connected by rotational joints. The whole limb is fixed to the frame in the shoulder joint. A static balance problem is solved by principle of virtual work. The system of equation describing the musculoskeletal system is overdetermined because more muscles than necessary contribute to get the concrete upper limb position. Hence the mathematical problem is solved by an optimization method searching the least energetically-consuming solution. The upper limb computational model is verified by electromyography of the biceps brachii muscle.

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Haitham H. Khalil

    2008-01-01

    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.

  14. 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.

  15. 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...

  16. Hospital Readmissions Following Endovascular Therapy for Critical Limb Ischemia: Associations With Wound Healing, Major Adverse Limb Events, and Mortality

    OpenAIRE

    Reed, Grant W.; Raeisi‐Giglou, Pejman; Kafa, Rami; Malik, Umair; Salehi, Negar; Mehdi H Shishehbor

    2016-01-01

    Background The significance of hospital readmission after endovascular therapy for critical limb ischemia (CLI) is not well established. We sought to investigate the incidence, timing, and causes of readmissions after endovascular therapy for CLI and whether readmission is associated with major adverse limb events (MALE) or mortality. Methods and Results This was a retrospective study of 252 patients treated with endovascular therapy for CLI. During median follow‐up of 381 days (interquartile...

  17. Local temperature-sensitive mechanisms are important mediators of limb tissue hyperemia in the heat-stressed human at rest and during small muscle mass exercise.

    Science.gov (United States)

    Chiesa, Scott T; Trangmar, Steven J; Kalsi, Kameljit K; Rakobowchuk, Mark; Banker, Devendar S; Lotlikar, Makrand D; Ali, Leena; González-Alonso, José

    2015-07-15

    Limb tissue and systemic blood flow increases with heat stress, but the underlying mechanisms remain poorly understood. Here, we tested the hypothesis that heat stress-induced increases in limb tissue perfusion are primarily mediated by local temperature-sensitive mechanisms. Leg and systemic temperatures and hemodynamics were measured at rest and during incremental single-legged knee extensor exercise in 15 males exposed to 1 h of either systemic passive heat-stress with simultaneous cooling of a single leg (n = 8) or isolated leg heating or cooling (n = 7). Systemic heat stress increased core, skin and heated leg blood temperatures (Tb), cardiac output, and heated leg blood flow (LBF; 0.6 ± 0.1 l/min; P 0.05). Increased heated leg deep tissue blood flow was closely related to Tb (R(2) = 0.50; P 0.05), despite unchanged systemic temperatures and hemodynamics. During incremental exercise, heated LBF was consistently maintained ∼ 0.6 l/min higher than that in the cooled leg (P temperature-sensitive mechanisms are important mediators in limb tissue perfusion regulation both at rest and during small-muscle mass exercise in hyperthermic humans.

  18. 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

  19. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the american heart association.

    Science.gov (United States)

    Brook, Robert D; Appel, Lawrence J; Rubenfire, Melvyn; Ogedegbe, Gbenga; Bisognano, John D; Elliott, William J; Fuchs, Flavio D; Hughes, Joel W; Lackland, Daniel T; Staffileno, Beth A; Townsend, Raymond R; Rajagopalan, Sanjay

    2013-06-01

    Many antihypertensive medications and lifestyle changes are proven to reduce blood pressure. Over the past few decades, numerous additional modalities have been evaluated in regard to their potential blood pressure-lowering abilities. However, these nondietary, nondrug treatments, collectively called alternative approaches, have generally undergone fewer and less rigorous trials. This American Heart Association scientific statement aims to summarize the blood pressure-lowering efficacy of several alternative approaches and to provide a class of recommendation for their implementation in clinical practice based on the available level of evidence from the published literature. Among behavioral therapies, Transcendental Meditation (Class IIB, Level of Evidence B), other meditation techniques (Class III, Level of Evidence C), yoga (Class III, Level of Evidence C), other relaxation therapies (Class III, Level of Evidence B), and biofeedback approaches (Class IIB, Level of Evidence B) generally had modest, mixed, or no consistent evidence demonstrating their efficacy. Between the noninvasive procedures and devices evaluated, device-guided breathing (Class IIA, Level of Evidence B) had greater support than acupuncture (Class III, Level of Evidence B). Exercise-based regimens, including aerobic (Class I, Level of Evidence A), dynamic resistance (Class IIA, Level of Evidence B), and isometric handgrip (Class IIB, Level of Evidence C) modalities, had relatively stronger supporting evidence. It is the consensus of the writing group that it is reasonable for all individuals with blood pressure levels >120/80 mm Hg to consider trials of alternative approaches as adjuvant methods to help lower blood pressure when clinically appropriate. A suggested management algorithm is provided, along with recommendations for prioritizing the use of the individual approaches in clinical practice based on their level of evidence for blood pressure lowering, risk-to-benefit ratio, potential

  20. 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

  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. 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.

  4. Intercalary Reconstructions with Vascularised Fibula and Allograft after Tumour Resection in the Lower Limb

    Directory of Open Access Journals (Sweden)

    Katharina Rabitsch

    2013-01-01

    Full Text Available Reconstruction with massive bone allograft and autologous vascularised fibula combines the structural strength of the allograft and the advantages of fibula’s intrinsic blood supply. We retrospectively analysed the outcome of twelve patients (4 male, 8 female who received reconstruction with massive bone allograft and autologous vascularised fibula after tumour resection in lower limb. Mean age was 17.8 years (range 11–31 years, with following primaries: Ewing’s sarcoma (n=6, osteosarcoma (n=4, liposarcoma grade 2 (n=1, and adamantinoma (n=1. Mean followup was 38.7 months (median 25.7 months; range 2–88 months. Seven tumours were located in the femur and five in the tibia. The mean length of bone defect was 18.7 cm (range 15–25 cm. None of the grafts had to be removed, but there occurred four fractures, four nonunions, and two infections. Two patients developed donor side complication, in form of flexion deformity of the big toe. The event-free survival rate was 51% at two-year followup and 39% at three- and five-year followup. As the complications were manageable, and full weight bearing was achieved in all cases, we consider the combination of massive bone allograft and autologous vascularised fibula a stable and durable reconstruction method of the diaphysis of the lower limbs.

  5. 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.

  6. 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

  7. 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.

  8. Acute impact of intermittent pneumatic leg compression frequency on limb hemodynamics, vascular function, and skeletal muscle gene expression in humans.

    Science.gov (United States)

    Sheldon, Ryan D; Roseguini, Bruno T; Thyfault, John P; Crist, Brett D; Laughlin, M H; Newcomer, Sean C

    2012-06-01

    The mechanisms by which intermittent pneumatic leg compression (IPC) treatment effectively treats symptoms associated with peripheral artery disease remain speculative. With the aim of gaining mechanistic insight into IPC treatment, the purpose of this study was to investigate the effect of IPC frequency on limb hemodynamics, vascular function, and skeletal muscle gene expression. In this two study investigation, healthy male subjects underwent an hour of either high-frequency (HF; 2-s inflation/3-s deflation) or low-frequency (LF; 4-s inflation/16-s deflation) IPC treatment of the foot and calf. In study 1 (n = 11; 23.5 ± 4.7 yr), subjects underwent both HF and LF treatment on separate days. Doppler/ultrasonography was used to measure popliteal artery diameter and blood velocity at baseline and during IPC treatment. Flow-mediated dilation (FMD) and peak reactive hyperemia blood flow (RHBF) were determined before and after IPC treatment. In study 2 (n = 19; 22.0 ± 4.6 yr), skeletal muscle biopsies were taken from the lateral gastrocnemius of the treated and control limb at baseline and at 30- and 150-min posttreatment. Quantitative PCR was used to assess mRNA concentrations of genes associated with inflammation and vascular remodeling. No treatment effect on vascular function was observed. Cuff deflation resulted in increased blood flow (BF) and shear rate (SR) in both treatments at the onset of treatment compared with baseline (P inflation. IPC decreased the mRNA expression of cysteine-rich protein 61 from baseline and controls (P <0 .01) and connective tissue growth factor from baseline (P < 0.05) in a frequency-dependent manner. In conclusion, a single session of IPC acutely impacts limb hemodynamics and skeletal muscle gene expression in a frequency-dependent manner but does not impact vascular function.

  9. A computational clonal analysis of the developing mouse limb bud.

    Directory of Open Access Journals (Sweden)

    Luciano Marcon

    Full Text Available A comprehensive spatio-temporal description of the tissue movements underlying organogenesis would be an extremely useful resource to developmental biology. Clonal analysis and fate mappings are popular experiments to study tissue movement during morphogenesis. Such experiments allow cell populations to be labeled at an early stage of development and to follow their spatial evolution over time. However, disentangling the cumulative effects of the multiple events responsible for the expansion of the labeled cell population is not always straightforward. To overcome this problem, we develop a novel computational method that combines accurate quantification of 2D limb bud morphologies and growth modeling to analyze mouse clonal data of early limb development. Firstly, we explore various tissue movements that match experimental limb bud shape changes. Secondly, by comparing computational clones with newly generated mouse clonal data we are able to choose and characterize the tissue movement map that better matches experimental data. Our computational analysis produces for the first time a two dimensional model of limb growth based on experimental data that can be used to better characterize limb tissue movement in space and time. The model shows that the distribution and shapes of clones can be described as a combination of anisotropic growth with isotropic cell mixing, without the need for lineage compartmentalization along the AP and PD axis. Lastly, we show that this comprehensive description can be used to reassess spatio-temporal gene regulations taking tissue movement into account and to investigate PD patterning hypothesis.

  10. Hair patterns of the lower limb in Central Indian males.

    Science.gov (United States)

    Chaurasia, B D

    1977-08-01

    The distribution of hair of the right lower limb has been studied in a random sample of 220 healthy Central Indian males 17 to 45 years of age. The common hair patterns observed are the proximal phalangeal hair in all toes in 55.45%, the middle phalangeal hair in the third toe in 8.18%, the tibial on the dorsum of foot in 69.55%, and the pedo-cruro-femoral in the lower limb in 70.00% subjects. Comparison of these findings with those of the right upper limb shows that hairiness of the two limbs is correlated, that the dorsum of foot is less hairy than the dorsum of hand, and that the third and second toes are comparable with the fourth and third fingers, respectively, as regards their middle phalangeal hair. Comparison with the available literature shows that the Central Indian males resemble the Whites in having greater frequency of middle phalangeal hair than those of the Negroes, that the dorsum of feet of this population is less hairy than the White and more hairy than the Negroes, and that the general hairiness of the lower limb is more or less equal in the three groups of persons.

  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. Ubiquitous human upper-limb motion estimation using wearable sensors.

    Science.gov (United States)

    Zhang, Zhi-Qiang; Wong, Wai-Choong; Wu, Jian-Kang

    2011-07-01

    Human motion capture technologies have been widely used in a wide spectrum of applications, including interactive game and learning, animation, film special effects, health care, navigation, and so on. The existing human motion capture techniques, which use structured multiple high-resolution cameras in a dedicated studio, are complicated and expensive. With the rapid development of microsensors-on-chip, human motion capture using wearable microsensors has become an active research topic. Because of the agility in movement, upper-limb motion estimation has been regarded as the most difficult problem in human motion capture. In this paper, we take the upper limb as our research subject and propose a novel ubiquitous upper-limb motion estimation algorithm, which concentrates on modeling the relationship between upper-arm movement and forearm movement. A link structure with 5 degrees of freedom (DOF) is proposed to model the human upper-limb skeleton structure. Parameters are defined according to Denavit-Hartenberg convention, forward kinematics equations are derived, and an unscented Kalman filter is deployed to estimate the defined parameters. The experimental results have shown that the proposed upper-limb motion capture and analysis algorithm outperforms other fusion methods and provides accurate results in comparison to the BTS optical motion tracker.

  13. 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

  14. Regeneration of limb joints in the axolotl (Ambystoma mexicanum).

    Science.gov (United States)

    Lee, Jangwoo; Gardiner, David M

    2012-01-01

    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.

  15. 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.

  16. 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...

  17. 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 ...

  18. Where to Donate Blood

    Science.gov (United States)

    ... zip code using the Blood Bank Locator below: Blood Bank Locator City: State/Province: ZIP Code: Country: Show ... safety and care. The Association sets standards for blood banks and transfusion services, and accredits member blood banks ...

  19. High blood pressure

    Science.gov (United States)

    ... 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 ...

  20. Lead levels - blood

    Science.gov (United States)

    Blood lead levels ... A blood sample is needed. Most of the time blood is drawn from a vein located on the inside ... may be used to puncture the skin. The blood collects in a small glass tube called a ...

  1. 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 ...

  2. Blood Type Game

    Science.gov (United States)

    ... 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 ...

  3. Blood Transfusion and Donation

    Science.gov (United States)

    ... in the United States receive life-saving blood transfusions. During a transfusion, you receive whole blood or parts of blood ... liver failure or a severe infection. Most blood transfusions go very smoothly. Some infectious agents, such as ...

  4. 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. ...

  5. Understanding Blood Pressure Readings

    Science.gov (United States)

    ... 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 ...

  6. Blood Clotting and Pregnancy

    Medline Plus

    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. Increase in skin perfusion pressure after maggot debridement therapy for critical limb ischaemia.

    Science.gov (United States)

    Maeda, T M; Kimura, C K; Takahashi, K T; Ichimura, K I

    2014-12-01

    Skin perfusion pressure (SPP) is the perfusion pressure at the skin level, and it can serve as an index of peripheral circulation in the skin and subcutaneous tissue. We report a 78-year-old man with critical limb ischaemia who, despite having undergone several catheter interventions, still had severe ulcers with exposed bone on his right foot. We performed transmetatarsal amputation. The tissue around the surgical site became necrotic several days later, and did not respond to conservative therapy. Therefore, we opted for maggot debridement therapy (MDT), given that maggots favour necrotic tissue. After the therapy, SPP around the ulcer increased from 12 to 54 mmHg on the dorsal aspect, and from 17 to 44 mmHg on the plantar aspect. Wound healing was successfully activated by MDT, leading to complete healing within 2.5 months after MDT. We believe that MDT probably contributed to increase the blood supply to the ischaemic wound.

  9. TUMOR NECROSIS FACTOR ALPHA DECREASES NOS3 EXPRESSION PRIMARILY VIA RHO/RHO KINASE IN THE THICK ASCENDING LIMB

    OpenAIRE

    Ramseyer, Vanesa; Hong, Nancy; Garvin, Jeffrey L.

    2012-01-01

    Inappropriate Na+ reabsorption by thick ascending limbs (THALs) induces hypertension. Nitric oxide (NO) produced by NO synthase type 3 (NOS3 or eNOS) inhibits NaCl reabsorption by THALs. Tumor necrosis factor alpha (TNF-α) decreases NOS3 expression in endothelial cells and contributes to increases in blood pressure. However, the effects of TNF-α on THAL NOS3 and the signaling cascade are unknown. TNF-α activates several signaling pathways including Rho/Rho kinase (ROCK) which is known to redu...

  10. 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...

  11. 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...

  12. 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...

  13. 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 ( ...

  14. 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 ...

  15. 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

    The term "endothelial dysfunction" refers to the inability or attenuated effect of the endothelial cells in participating in the relaxation of the adjacent smooth muscle, thus causing less vasodilation. Although endothelial dysfunction is often seen in patients with type 2 diabetes, it does...... not necessarily follow that insulin resistance and (or) hyperglycemia is causing the inability to respond properly to vasodilatory stimuli. Rather, this could be related to the impact of concomitant cardiovascular risk factors that are almost invariably present in patients with type 2 diabetes. The impact...

  16. Expanded spectrum of limb anomalies in the VATER association

    Energy Technology Data Exchange (ETDEWEB)

    Fernbach, S.K.; Glass, R.B.J.

    1988-04-01

    The radiographs of 230 children who had undergone neonatal surgery for imperforate anus and/or esophageal atresia/tracheoesophageal fistula were reviewed. Of the 31 children with limb anomalies thus detected, the 24 who had no radiologic or laboratory evidence of chromosomal abnormality form the basis of this report. In 16 children the limb anomalies fell within the commonly described spectrum of the VATER association. In the other 8 children and in 3 of the children with typical VATER limb anomalies additional anomalies were encountered: Sprengel deformity (2), hypoplasia of the humerus (3), radioulnar synostosis (1), midline anomalies of the hand (1), absence of the pubis, femur, tibia, and fibula and two rays of the foot (1), and other foot deformities. Subtle anomalies of the hand were common and included: clinodactyly, syndactyly, shortening of the middle phalanx of the fifth digit, and rotary malposition of the digits.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. Shared Enhancer Activity in the Limbs and Phallus and Functional Divergence of a Limb-Genital cis-Regulatory Element in Snakes.

    Science.gov (United States)

    Infante, Carlos R; Mihala, Alexandra G; Park, Sungdae; Wang, Jialiang S; Johnson, Kenji K; Lauderdale, James D; Menke, Douglas B

    2015-10-12

    The amniote phallus and limbs differ dramatically in their morphologies but share patterns of signaling and gene expression in early development. Thus far, the extent to which genital and limb transcriptional networks also share cis-regulatory elements has remained unexplored. We show that many limb enhancers are retained in snake genomes, suggesting that these elements may function in non-limb tissues. Consistent with this, our analysis of cis-regulatory activity in mice and Anolis lizards reveals that patterns of enhancer activity in embryonic limbs and genitalia overlap heavily. In mice, deletion of HLEB, an enhancer of Tbx4, produces defects in hindlimbs and genitalia, establishing the importance of this limb-genital enhancer for development of these different appendages. Further analyses demonstrate that the HLEB of snakes has lost hindlimb enhancer function while retaining genital activity. Our findings identify roles for Tbx4 in genital development and highlight deep similarities in cis-regulatory activity between limbs and genitalia.

  2. Blood supply and vasculature of mycetoma.

    Science.gov (United States)

    Fahal, A H; el Hag, I A; Gadir, A F; el Lider, A R; el Hassan, A M; Baraka, O Z; Mahgoub, E S

    1997-01-01

    The blood supply to the mycetoma lesion and its vasculature were studied in patients with various types of mycetoma using histological, ultrastructural, angiographic and sonographic techniques. The mycetoma lesion proved to be well vascularized. However, certain vascular abnormalities were demonstrated. In histological sections, the small arteries and arterioles showed medial muscular hypertrophy in 83%, intimal fibrosis in 33%, arteritis in 7% and endarteritis obliterans with narrowed lumen in 7% of the patients. No vascular occlusion, ischaemic changes or arteriovenous shunts were observed. These changes were confirmed ultrastructurally. Angiography of the lesion showed a brisk pathological circulation which was more evident in eumycetoma. The vascular Doppler study showed normal blood flow pattern in the affected limb. Regional intra-arterial chemotherapy for mycetoma is suggested as a possible treatment modality. PMID:9147269

  3. Proteus syndrome: A rare cause of gigantic limb

    Directory of Open Access Journals (Sweden)

    Nandini Chakrabarti

    2014-01-01

    Full Text Available A congenital disorder with variable manifestations, including partial gigantism of the hands and feet with hypertrophy of soles, nevi, hemihypertrophy, gynecomastia, macrocephaly and other skull abnormalities, and abdominal lipomatosis. The cause is unknown, although a genetic origin, generally of autosomal-dominant transmission, has been conjectured. Symptoms can be treated, but there is no known cure. We present the case of a young male with grotesque overgrowth of the right lower limb, splenomegaly and multiple nevi. Angiography revealed venous malformation within the limb. The findings are in conformity to the criteria for the Proteus syndrome.

  4. Proteus syndrome: A rare cause of gigantic limb.

    Science.gov (United States)

    Chakrabarti, Nandini; Chattopadhyay, Chandan; Bhuban, Majhi; Pal, Salil Kumar

    2014-04-01

    A congenital disorder with variable manifestations, including partial gigantism of the hands and feet with hypertrophy of soles, nevi, hemihypertrophy, gynecomastia, macrocephaly and other skull abnormalities, and abdominal lipomatosis. The cause is unknown, although a genetic origin, generally of autosomal-dominant transmission, has been conjectured. Symptoms can be treated, but there is no known cure. We present the case of a young male with grotesque overgrowth of the right lower limb, splenomegaly and multiple nevi. Angiography revealed venous malformation within the limb. The findings are in conformity to the criteria for the Proteus syndrome. PMID:24860761

  5. 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...

  6. 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

  7. 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.

  8. 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....

  9. An assessment of skin preparation in upper limb surgery.

    Science.gov (United States)

    Sullivan, P J; Healy, C E; Hirpara, K M; Hussey, A J; Potter, S M; Kelly, J L

    2008-08-01

    Postoperative wound infections remain a major source of upper limb morbidity. The effectiveness of peri-operative human upper limb preparation was determined using a clear fluid antiseptic and an iodine-based solution over 60 and 90 seconds. Less area was missed using iodine over both times and increasing clear solution preparation time from 60 to 90 seconds improved coverage. Surgical experience had little outcome relevance and a 90-second preparation time with either solution was insufficient, with fingers being the sites most commonly missed.

  10. 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

  11. 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...

  12. 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

  13. Gastric inhibitory polypeptide (GIP is selectively decreased in the roux-limb of dietary obese mice after RYGB surgery.

    Directory of Open Access Journals (Sweden)

    Jiaqiang Zhou

    Full Text Available Gastric inhibitory polypeptide (GIP, glucose-dependent insulinotropic polypeptide is expressed by intestinal K cells to regulate glucose-induced insulin secretion. The impact of Roux-en Y bypass (RYGB surgery on blood GIP is highly contraversial. This study was conducted to address the mechanism of controversy. GIP mRNA was examined in the intestine, and serum GIP was determined using Luminex and ELISA in diet-induced obese (DIO mice. The assays were conducted in RYGB mice in fasting and fed conditions. Food preference, weight loss and insulin sensitivity were monitored in RYGB mice. In DIO mice, GIP mRNA was increased by 80% in all sections of the small intestine over the lean control. The increase was observed in both fasting and fed conditions. After RYGB surgery, the food-induced GIP expression was selectively reduced in the Roux-limb, but not in the biliopancreatic and common limbs of intestine in fed condition. Lack of stimulation by glucose or cholesterol contributed to the reduction. Jejunal mucosa of Roux-limb exhibited hypertrophy, but villous surface was decreased by the undigested food. Serum GIP (total was significantly higher in the fasting condition, but not in the fed condition due to attenuated GIP response to food intake in RYGB mice. The GIP alteration was associated with chow diet preference, sustained weight loss and insulin sensitization in RYGB mice. RYGB increased serum GIP in the fasting, but not in the fed conditions. The loss of food-induced GIP response in Roux-limb of intestine likely contributes to the attenuated serum GIP response to feeding.

  14. 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.

  15. 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.

  16. 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

  17. 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...

  18. 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).

  19. Collagen reconstitution is inversely correlated with induction of limb regeneration in Ambystoma mexicanum.

    Science.gov (United States)

    Satoh, Akira; Hirata, Ayako; Makanae, Aki

    2012-03-01

    Amphibians can regenerate missing body parts, including limbs. The regulation of collagen has been considered to be important in limb regeneration. Collagen deposition is suppressed during limb regeneration, so we investigated collagen deposition and apical epithelial cap (AEC) formation during axolotl limb regeneration. The accessory limb model (ALM) has been developed as an alternative model for studying limb regeneration. Using this model, we investigated the relationship between nerves, epidermis, and collagen deposition. We found that Sp-9, an AEC marker gene, was upregulated by direct interaction between nerves and epidermis. However, collagen deposition hindered this interaction, and resulted in the failure of limb regeneration. During wound healing, an increase in deposition of collagen caused a decrease in the blastema induction rate in ALM. Wound healing and limb regeneration are alternate processes.

  20. Functional recovery of the paretic upper limb after stroke: who regains hand capacity?

    NARCIS (Netherlands)

    Houwink, A.; Nijland, R.H.; Geurts, A.C.H.; Kwakkel, G.

    2013-01-01

    OBJECTIVE: To describe recovery of upper limb capacity after stroke during inpatient rehabilitation based on the Stroke Upper Limb Capacity Scale (SULCS). DESIGN: Prospective observational study. SETTING: Inpatient department of a rehabilitation center. PARTICIPANTS: Patients with stroke (N=299) adm

  1. 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...

  2. A short overview of upper limb rehabilitation devices

    Science.gov (United States)

    Macovei, S.; Doroftei, I.

    2016-08-01

    As some studies show, the number of people over 65 years old increases constantly, leading to the need of solution to provide services regarding patient mobility. Diseases, accidents and neurologic problems affect hundreds of people every day, causing pain and lost of motor functions. The ability of using the upper limb is indispensable for a human being in everyday activities, making easy tasks like drinking a glass of water a real challenge. We can agree that physiotherapy promotes recovery, but not at an optimal level, due to limited financial and human resources. Hence, the need of robot-assisted rehabilitation emerges. A robot for upper-limb exercises should have a design that can accurately control interaction forces and progressively adapt assistance to the patients’ abilities and also to record the patient's motion and evolution. In this paper a short overview of upper limb rehabilitation devices is presented. Our goal is to find the shortcomings of the current developed devices in terms of utility, ease of use and costs, for future development of a mechatronic system for upper limb rehabilitation.

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

    Directory of Open Access Journals (Sweden)

    Alfred Gatt

    2015-01-01

    Full Text Available 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.

  4. Improving energy efficiency in robot limbs through hydraulic dangle

    Science.gov (United States)

    Whitman, Julian S.; Meller, Mike; Garcia, Ephrahim

    2015-03-01

    Animals often allow their limbs to swing passively under their own inertia. For example, about 40% of a human walking gait consists of the primarily passive swing phase. Current hydraulic robots employ traditional actuation methods in which fluid power is expended for all limb movements, even when passive dynamics could be utilized. "Dangle" is the ability to allow a hydraulic actuator to freely sway in response to external loads, in which both sides of the actuator are disconnected from pressure and connected to the tank. Dangle offers the opportunity for efficiency gains by enabling the use of momentum, gravity, and external loads to move a limb without expending fluid power. To demonstrate these efficiency gains, this paper presents an experiment that compares the fluid power consumed to actuate a two degree of freedom hydraulic leg following a human walking gait cycle trajectory in both a traditional manner and utilizing dangle. It was shown that the use of dangle can decrease fluid power consumption by 20% by utilizing pendular dynamics during the swing phase. At speeds higher than the free dangling rate, more power must be used to maintain the desired trajectory due to damping inherent in the configuration. The use of dangle as a power saving method when driving hydraulic limbs could increase operation time for untethered hydraulic walking robots.

  5. 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

  6. 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.

  7. 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)

  8. Principles of obstacle avoidance with a transfemoral prosthetic limb

    NARCIS (Netherlands)

    van Keeken, Helco G.; Vrieling, Aline H.; Hof, At L.; Postema, Klaas; Otten, Bert

    2012-01-01

    In this study, conditions that enable a prosthetic knee flexion strategy in transfemoral amputee subjects during obstacle avoidance were investigated. This study explored the hip torque principle and the static ground principle as object avoidance strategies. A prosthetic limb simulator device was u

  9. 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.

  10. 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.

  11. 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

  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. 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.

  14. Lower limb pain in sympathetic-sensory coupling

    Institute of Scientific and Technical Information of China (English)

    Hongjun Yang; Kairun Peng; Sanjue Hu; Li Xuan

    2011-01-01

    Previous studies have shown that sympathetic nerves are related to certain types of pain, and this phenomenon is referred to as sympathetic-sensory coupling. Chronic pain resulting from nerve injury can be exacerbated by sympathetic stimulation or relieved by sympathetic inhibition. In the present study, the correlation between pain and sympathetic nerves was analyzed in patients with severe pain in lower limbs, as well as in a chronically compressed dorsal root ganglion (CCD) rat model (model of low back pain and sciatica). Patients with severe pain in the lower limbs underwent chemical lumbar sympathectomy (CLS), and the analgesic effects of CLS were compared with painkillers. Results demonstrated significantly relieved lower limb pain following CLS, and the analgesic effects of CLS were superior to those seen with painkillers. In the CCD rat model, dorsal root ganglion neuronal activity significantly increased as a result of electrical stimulation to the sympathetic nerves. These results suggest that sympathetic nerves are closely associated with pain and sympathetic-sensory coupling is likely in lower limb pain in both patients and rat models of CCD.

  15. 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.

  16. 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)

  17. 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

  18. 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

  19. A study on limb reduction defects in six European regions

    NARCIS (Netherlands)

    Stoll, C; Calzolari, E; Cornel, M; GarciaMinaur, S; Garne, E; Nevin, N

    1996-01-01

    Limb reduction defects (LRD) gained especial attention after the thalidomide tragedy in 1962, LRD are common congenital malformations which present as obvious congenital anomalies recognized at birth, Therefore it might be assumed that they are well documented, However classification of LRDs is disp

  20. 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...

  1. Stump sensibility in children with upper limb reduction deficiency

    NARCIS (Netherlands)

    Reinkingh, Marianne; Reinders-Messelink, Heleen A.; Dijkstra, Pieter U.; Maathuis, Karel G. B.; van der Sluis, Corry K.

    2014-01-01

    Objectives: To compare stump sensibility in children with upper limb reduction deficiency with sensibility of the unaffected arm and hand. In addition, to evaluate the associations between stump sensibility, stump length and activity level. Design: Cross-sectional study. Subjects: Children and young

  2. Revisions of endoprosthetic reconstructions after limb salvage in musculoskeletal oncology

    NARCIS (Netherlands)

    Renard, AJS; Veth, RPH; Schreuder, HWB; van Horn, J; Keller, A; Schraffordt Koops, H.

    1998-01-01

    Of 91 limb-salvage procedures using prosthetic reconstructions because of primary or metastatic bone and soft-tissue tumors 26 revisions were performed in 16 patients. Revision was due to polyethylene wear (9 cases), aseptic loosening (8 cases), recurrent hip dislocation (3 cases), prosthetic stem f

  3. Limb distribution, motor impairment, and functional classification of cerebral palsy

    NARCIS (Netherlands)

    J.A. Gorter; P.L. Rosenbaum

    2004-01-01

    This study explored the relationships between the Gross Motor Function Classification System (GMFCS), limb distribution, and type of motor impairment. Data used were collected in the Ontario Motor Growth study, a longitudinal cohort study with a population-based sample of children with cerebral pals

  4. 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...

  5. 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)

  6. 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 ...

  7. Limb Event Brightenings and Fast Ejection Using IRIS Mission Observations

    Science.gov (United States)

    Tavabi, E.; Koutchmy, S.; Golub, L.

    2015-10-01

    The Interface Region Imaging Spectrograph (IRIS) of the recently commissioned NASA small explorer mission provides significantly more complete and higher resolution spectral coverage of the dynamical conditions inside the chromosphere and transition region (TR) than has been available ever before. High temporal, spatial (0.3'') and spectral resolution observations from the ultraviolet IRIS spectra near the solar limb reveal high-energy limb event brightenings (LEBs) at low chromospheric heights at about 1 Mm above the limb. They can be characterized as explosive events producing jets. We selected two events showing spectra of a confined eruption just off or near the quiet-Sun limb, the jet part showing obvious moving material with short-duration large Doppler shifts in three directions that were identified as macrospicules on slit-jaw (SJ) images in Si iv and He ii 304 Å. The events were analyzed from a sequence of very close rasters taken near the central meridian and the South Pole limb. We analyzed the processed SJ images and the simultaneously observed fast spectral sequences, which have large Doppler shifts, with a pair of redshifted elements together with a faster blueshifted element from almost the same position. Shifts correspond to velocities of up to 100 km s^{-1} in projection on the plane of the sky. Erupting spicules and macrospicules from these regions are visible in images taken before and after the spectra. The cool low first ionization potential (FIP) element simultaneous line emissions of the Mg ii h and k resonance lines do not clearly show a similar signature because of optical thickness effects, but the Si iv broadband SJ images do. The bidirectional plasma jets ejected from a small reconnection site are interpreted to be the result of coronal loop-loop interactions that lead to reconnection in nearby sites.

  8. 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.

  9. 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.

  10. 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.

  11. Gait and electromyographic analysis of patients recovering after limb-saving surgery

    NARCIS (Netherlands)

    De Visser, E; Mulder, T; Schreuder, HWB; Veth, RPH; Duysens, J

    2000-01-01

    Objective. Control of gait after limb-saving surgery. Design. Case series study. Background. At the moment little is known about adaptations in patients' gait after limb-saving surgery. Methods. Nineteen patients who underwent limb-saving surgery at least 1 yr earlier and 10 normal subjects were stu

  12. File list: His.Emb.05.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Emb.05.AllAg.Embryonic_limb mm9 Histone Embryo Embryonic limb SRX804048,SRX8040...X083275 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Emb.05.AllAg.Embryonic_limb.bed ...

  13. File list: ALL.Emb.10.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Emb.10.AllAg.Embryonic_limb mm9 All antigens Embryo Embryonic limb SRX485267,SR...276,SRX083265,SRX083266,SRX083275 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Emb.10.AllAg.Embryonic_limb.bed ...

  14. File list: Unc.Emb.10.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Emb.10.AllAg.Embryonic_limb mm9 Unclassified Embryo Embryonic limb SRX205523,SR...SRX205520,SRX204325,SRX204323,SRX205519,SRX205526 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Emb.10.AllAg.Embryonic_limb.bed ...

  15. File list: Pol.Emb.50.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Emb.50.AllAg.Embryonic_limb mm9 RNA polymerase Embryo Embryonic limb SRX326429,...SRX112945,SRX143800,SRX378836 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Pol.Emb.50.AllAg.Embryonic_limb.bed ...

  16. File list: DNS.Emb.10.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available DNS.Emb.10.AllAg.Embryonic_limb mm9 DNase-seq Embryo Embryonic limb SRX191032,SRX19...1037 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Emb.10.AllAg.Embryonic_limb.bed ...

  17. File list: NoD.Emb.20.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Emb.20.AllAg.Embryonic_limb mm9 No description Embryo Embryonic limb SRX793524,...SRX597164,SRX002661 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Emb.20.AllAg.Embryonic_limb.bed ...

  18. File list: InP.Emb.50.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Emb.50.AllAg.Embryonic_limb mm9 Input control Embryo Embryonic limb SRX804047,S...69,SRX083262,SRX083272 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Emb.50.AllAg.Embryonic_limb.bed ...

  19. File list: ALL.Emb.20.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  20. File list: Pol.Emb.10.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Emb.10.AllAg.Embryonic_limb mm9 RNA polymerase Embryo Embryonic limb SRX326429,...SRX143800,SRX112945,SRX378836 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Pol.Emb.10.AllAg.Embryonic_limb.bed ...

  1. FGF8 and SHH substitute for anterior-posterior tissue interactions to induce limb regeneration.

    Science.gov (United States)

    Nacu, Eugeniu; Gromberg, Elena; Oliveira, Catarina R; Drechsel, David; Tanaka, Elly M

    2016-04-27

    In salamanders, grafting of a left limb blastema onto a right limb stump yields regeneration of three limbs, the normal limb and two 'supernumerary' limbs. This experiment and other research have shown that the juxtaposition of anterior and posterior limb tissue plus innervation are necessary and sufficient to induce complete limb regeneration in salamanders. However, the cellular and molecular basis of the requirement for anterior-posterior tissue interactions were unknown. Here we have clarified the molecular basis of the requirement for both anterior and posterior tissue during limb regeneration and supernumerary limb formation in axolotls (Ambystoma mexicanum). We show that the two tissues provide complementary cross-inductive signals that are required for limb outgrowth. A blastema composed solely of anterior tissue normally regresses rather than forming a limb, but activation of hedgehog (HH) signalling was sufficient to drive regeneration of an anterior blastema to completion owing to its ability to maintain fibroblast growth factor (FGF) expression, the key signalling activity responsible for blastema outgrowth. In blastemas composed solely of posterior tissue, HH signalling was not sufficient to drive regeneration; however, ectopic expression of FGF8 together with endogenous HH signalling was sufficient. In axolotls, FGF8 is expressed only in the anterior mesenchyme and maintenance of its expression depends on sonic hedgehog (SHH) signalling from posterior tissue. Together, our findings identify key anteriorly and posteriorly localized signals that promote limb regeneration and show that these single factors are sufficient to drive non-regenerating blastemas to complete regeneration with full elaboration of skeletal elements.

  2. 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,;

    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...

  3. Limb defects and congenital anomalies of the genitalia in an infant with homozygous alpha-thalassemia.

    Science.gov (United States)

    Abuelo, D N; Forman, E N; Rubin, L P

    1997-01-20

    We describe an infant with homozygous alpha-thalassemia, genital abnormalities, and terminal transverse limb defects, whose limbs demonstrate evidence of loss of tissue and abnormal morphogenesis. We propose these defects were due to either severe fetal anemia or to vascular occlusion by abnormal erythrocytes, resulting in hypoxia of the developing distal limbs and genitalia.

  4. File list: NoD.Emb.10.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Emb.10.AllAg.Embryonic_limb mm9 No description Embryo Embryonic limb SRX793524,...SRX597164,SRX002661 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Emb.10.AllAg.Embryonic_limb.bed ...

  5. File list: InP.Emb.10.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Emb.10.AllAg.Embryonic_limb mm9 Input control Embryo Embryonic limb SRX485267,S...62,SRX378838,SRX083272 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Emb.10.AllAg.Embryonic_limb.bed ...

  6. File list: InP.Emb.05.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Emb.05.AllAg.Embryonic_limb mm9 Input control Embryo Embryonic limb SRX485267,S...27,SRX195356,SRX083272 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Emb.05.AllAg.Embryonic_limb.bed ...

  7. File list: Unc.Emb.20.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Emb.20.AllAg.Embryonic_limb mm9 Unclassified Embryo Embryonic limb SRX112942,SR...SRX205518,SRX204325,SRX205521,SRX205520,SRX205525 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Emb.20.AllAg.Embryonic_limb.bed ...

  8. File list: Unc.Emb.50.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Emb.50.AllAg.Embryonic_limb mm9 Unclassified Embryo Embryonic limb SRX112942,SR...SRX204326,SRX204323,SRX205521,SRX205525,SRX205520 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Emb.50.AllAg.Embryonic_limb.bed ...

  9. File list: InP.Emb.20.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Emb.20.AllAg.Embryonic_limb mm9 Input control Embryo Embryonic limb SRX485267,S...31,SRX195358,SRX083272 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Emb.20.AllAg.Embryonic_limb.bed ...

  10. File list: DNS.Emb.20.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available DNS.Emb.20.AllAg.Embryonic_limb mm9 DNase-seq Embryo Embryonic limb SRX191032,SRX19...1037 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Emb.20.AllAg.Embryonic_limb.bed ...

  11. File list: His.Emb.50.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Emb.50.AllAg.Embryonic_limb mm9 Histone Embryo Embryonic limb SRX112944,SRX1858...X083266 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Emb.50.AllAg.Embryonic_limb.bed ...

  12. File list: His.Emb.20.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Emb.20.AllAg.Embryonic_limb mm9 Histone Embryo Embryonic limb SRX112944,SRX1858...X083266 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Emb.20.AllAg.Embryonic_limb.bed ...

  13. File list: Unc.Emb.05.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Emb.05.AllAg.Embryonic_limb mm9 Unclassified Embryo Embryonic limb SRX205523,SR...SRX205528,SRX204326,SRX204324,SRX205518,SRX204325 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Emb.05.AllAg.Embryonic_limb.bed ...

  14. File list: Pol.Emb.20.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Emb.20.AllAg.Embryonic_limb mm9 RNA polymerase Embryo Embryonic limb SRX326429,...SRX112945,SRX143800,SRX378836 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Pol.Emb.20.AllAg.Embryonic_limb.bed ...

  15. File list: NoD.Emb.50.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Emb.50.AllAg.Embryonic_limb mm9 No description Embryo Embryonic limb SRX793524,...SRX597164,SRX002661 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Emb.50.AllAg.Embryonic_limb.bed ...

  16. File list: His.Emb.10.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Emb.10.AllAg.Embryonic_limb mm9 Histone Embryo Embryonic limb SRX804048,SRX2548...X083275 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Emb.10.AllAg.Embryonic_limb.bed ...

  17. File list: DNS.Emb.50.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  18. File list: DNS.Emb.05.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  19. File list: ALL.Emb.05.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Emb.05.AllAg.Embryonic_limb mm9 All antigens Embryo Embryonic limb SRX663359,SR...356,SRX083272,SRX083266,SRX083275 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Emb.05.AllAg.Embryonic_limb.bed ...

  20. File list: NoD.Emb.05.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Emb.05.AllAg.Embryonic_limb mm9 No description Embryo Embryonic limb SRX002661,...SRX793524,SRX597164 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Emb.05.AllAg.Embryonic_limb.bed ...

  1. File list: ALL.Emb.50.AllAg.Embryonic_limb [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Emb.50.AllAg.Embryonic_limb mm9 All antigens Embryo Embryonic limb SRX804047,SR...262,SRX002661,SRX083266,SRX083272 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Emb.50.AllAg.Embryonic_limb.bed ...

  2. Blood vessels, circulation and blood pressure.

    Science.gov (United States)

    Hendry, Charles; Farley, Alistair; McLafferty, Ella

    This article, which forms part of the life sciences series, describes the vessels of the body's blood and lymphatic circulatory systems. Blood pressure and its regulatory systems are examined. The causes and management of hypertension are also explored. It is important that nurses and other healthcare professionals understand the various mechanisms involved in the regulation of blood pressure to prevent high blood pressure or ameliorate its damaging consequences.

  3. Prophylactic isolated limb perfusion for localized, high-risk limb melanoma : Results of a multicenter randomized phase III trial

    NARCIS (Netherlands)

    Vaglini, M; Suciu, S; Kroon, BBR; Thompson, JF; Gohl, J; Eggermont, AMM; Di Filippo, F; Krementz, ET; Ruiter, D; Lejeune, FJ; Schraffordt Koops, H.

    1998-01-01

    Purpose: Patients with primary cutaneous melanoma greater than or equal to 1.5 mm in thickness are at high risk of having regional micrometastases at the time of initial surgical treatment. A phase III international study was designed to evaluate whether prophylactic isolated limb perfusion (ILP) co

  4. 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 ...

  5. 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 ...

  6. Blood Clotting and Pregnancy

    Science.gov (United States)

    ... The risk of developing a blood clot during pregnancy is increased by the following: Previous blood clots A genetic predisposition to blood clots Obesity Prolonged immobility (e.g., bedrest, long distance travel) Multiple ...

  7. CEA blood test

    Science.gov (United States)

    Carcinoembryonic antigen blood test ... A blood sample is needed . ... When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing or a slight bruise. ...

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. 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)

  12. 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 . ...

  13. 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 ...

  14. 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 ...

  15. 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 ...

  16. 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 ...

  17. 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 ...

  18. 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

  19. Money for Blood and Markets for Blood.

    Science.gov (United States)

    Derpmann, Simon; Quante, Michael

    2015-12-01

    Ontario's Bill 178 proposing a Voluntary Blood Donations Act declares the offer or acceptance of payment for the donation of blood a legal offence and makes it subject to penalty. The bill reinvigorates a fundamental debate about the ethical problems associated with the payment of money for blood. Scarcity of blood donors is a recurring problem in most health systems, and monetary remuneration of the willingness to donate blood is regularly discussed--and sometimes practiced--as a means to overcome scarcity in blood. However, making blood an object of economic exchange has long aroused ethical concerns that often refer to the specific meaning of blood. From the perspective of a modern understanding of money as a metric of economic value, the exchange of money for blood--shed or given--is seen as ethically troubling, because it appears to imply a commensurability of the value of human life and economic wealth. In this paper, we begin with a general taxonomy of the types of arguments that speak in favour or against compensating donors for giving blood. We then describe the context in which the discussion about payment for blood arises, and of the specific aims and concerns that are brought forward in this context. This is used to reconstruct the normative background that supports the rejection of payment for blood as it is envisaged in Bill 178 and the aims of the proposal. We then argue that while a payment indeed changes the nature of a blood donation in an ethically considerable way, we do not believe that decisive arguments against the monetary remuneration of blood donations can be substantiated, at least not independently of assuming specific societal circumstances. Thus it may be possible to establish a stable and safe blood supply through just gratification while at the same time taking strong provisions against social disconnection, injustice, exploitation or heteronomy.

  20. 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.

  1. 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.)

  2. 3D reconstruction of digitized histological sections for vasculature quantification in the mouse hind limb

    Science.gov (United States)

    Xu, Yiwen; Pickering, J. Geoffrey; Nong, Zengxuan; Gibson, Eli; Ward, Aaron D.

    2014-03-01

    In contrast to imaging modalities such as magnetic resonance imaging and micro computed tomography, digital histology reveals multiple stained tissue features at high resolution (0.25μm/pixel). However, the two-dimensional (2D) nature of histology challenges three-dimensional (3D) quantification and visualization of the different tissue components, cellular structures, and subcellular elements. This limitation is particularly relevant to the vasculature, which has a complex and variable structure within tissues. The objective of this study was to perform a fully automated 3D reconstruction of histology tissue in the mouse hind limb preserving the accurate systemic orientation of the tissues, stained with hematoxylin and immunostained for smooth muscle α actin. We performed a 3D reconstruction using pairwise rigid registrations of 5μm thick, paraffin-embedded serial sections, digitized at 0.25μm/pixel. Each registration was performed using the iterative closest points algorithm on blood vessel landmarks. Landmarks were vessel centroids, determined according to a signed distance map of each pixel to a decision boundary in hue-saturation-value color space; this decision boundary was determined based on manual annotation of a separate training set. Cell nuclei were then automatically extracted and corresponded to refine the vessel landmark registration. Homologous nucleus landmark pairs appearing on not more than two adjacent slides were chosen to avoid registrations which force curved or non-sectionorthogonal structures to be straight and section-orthogonal. The median accumulated target registration errors ± interquartile ranges for the vessel landmark registration, and the nucleus landmark refinement were 43.4+/-42.8μm and 2.9+/-1.7μm, respectively (p<0.0001). Fully automatic and accurate 3D rigid reconstruction of mouse hind limb histology imaging is feasible based on extracted vasculature and nuclei.

  3. 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

  4. 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

  5. Conservation of position-specific gene expression in axolotl limb skin.

    Science.gov (United States)

    Satoh, Akira; Makanae, Aki

    2014-01-01

    Urodele amphibians can regenerate their limbs after amputation. After amputation, undifferentiated cells appear on the amputation plane and form regeneration blastema. A limb blastema recreates a complete replica of the original limb. It is well known that disturbance of the location of limb tissues prior to amputation perturbs limb patterning, suggesting that different intact limb tissues carry different location information despite their identical appearance. The cause of such differences in intact tissues remains unknown. In this study, we found that Lmx1b, Tbx2, and Tbx3 genes, which are expressed in developing limb in a region specific manner, remained detectable in a mature axolotl limb. Furthermore, those position-specific gene expression patterns were conserved in mature limbs. Treatment with retinoic acid (RA), which is known to have ventralizing activity, changed Lmx1b expression in intact dorsal skin and dorsal character to ventral, indicating that conserved Lmx1b expression was due to the dorsal character and not leaky gene expression. Furthermore, we found that such conserved gene expression was rewritable in regeneration blastemas. These results suggest that axolotl limb cells can recognize their locations and maintain limbness via conserved expression profiles of developmental genes.

  6. 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

  7. Role of the podiatrist in diabetic limb salvage.

    Science.gov (United States)

    Kim, Paul J; Attinger, Christopher E; Evans, Karen K; Steinberg, John S

    2012-10-01

    Podiatrists play an important role in the multidisciplinary team in diabetic limb salvage. Podiatry is a specialty that is licensed in the diagnoses and treatment of pathologies of the foot and ankle. The treatment includes both conservative and surgical modalities. Understanding the biomechanics of the lower extremity is principally emphasized in the education and training of a podiatrist. This is particularly important in the context of the diabetic foot where biomechanical abnormalities often precede ulcer development. Preventive ulcer development strategies employed by a podiatrist include regular monitoring, routine care of calluses, and insert/shoe recommendations. Further, clinic-based ulcer care as well as surgery that include prophylactic and acute intervention can translate to the preservation of a functional limb. Finally, continuous podiatric management can prevent ulcer recurrence through offloading strategies and diabetic foot education.

  8. Design and control of hybrid actuation lower limb exoskeleton

    Directory of Open Access Journals (Sweden)

    Hipolito Aguilar-Sierra

    2015-06-01

    Full Text Available In this article, two types of actuators are applied for a lower limb exoskeleton. They are DC motors with the harmonic drive and the pneumatic artificial muscles. This combination takes advantages of both the harmonic drive and the pneumatic artificial muscle. It provides both high accuracy position control and high ratio of strength and weight. The shortcomings of the two actuators are overcome by the hybrid actuation, for example, low control accuracy and modeling difficult of pneumatic artificial muscle, compactness, and structural flexibility of DC motors. The design and modeling processes are discussed to show the proposed exoskeleton can increase the strength of human lower limbs. Experiments and analysis of the exoskeleton are given to evaluate the effectiveness of the design and modeling.

  9. Core stability training on lower limb balance strength.

    Science.gov (United States)

    Dello Iacono, Antonio; Padulo, Johnny; Ayalon, Moshe

    2016-01-01

    This study aimed to assess the effects of core stability training on lower limbs' muscular asymmetries and imbalances in team sport. Twenty footballers were divided into two groups, either core stability or control group. Before each daily practice, core stability group (n = 10) performed a core stability training programme, while control group (n = 10) did a standard warm-up. The effects of the core stability training programme were assessed by performing isokinetic tests and single-leg countermovement jumps. Significant improvement was found for knee extensors peak torque at 3.14 rad · s(-1) (14%; P strength asymmetries in core stability group (-71.4%; P = 0.02) while a concurrent increase was seen in the control group (33.3%; P lower limbs strength balance development in young soccer players.

  10. 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.)

  11. 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.

  12. Valine partitioning and kinetics between the gastrointestinal tract and hind limbs in lambs with an adult Trichostrongylus colubriformis burden.

    Science.gov (United States)

    Bermingham, E N; McNabb, W C; Sinclair, B R; Tavendale, M H; Roy, N C

    2011-11-01

    Intestinal parasitic infection increases the demand for AA because of increased protein synthesis in the intestine and increased luminal losses of AA, and these increased demands may be supported by increased mobilization of AA from the skeletal muscles. Two experiments were conducted to determine the effects of parasitic infection on valine kinetics within the gastrointestinal tract and hind limbs of lambs fed fresh forages. On d 1, lambs were given 6,000 stage-3 Trichostrongylus colubriformis larvae per day for 6 d (n = 6) or kept as parasite-free controls (n = 6) and fed fresh lucerne (Medicago sativa; Exp. 1) or fresh sulla (Hedysarum coronarium; Exp. 2). On d 48, valine kinetics within the mesenteric- (MDV) and portal-drained viscera (PDV) and hind limbs were obtained by carrying out concurrent infusions of para-amminohippuric acid into the mesenteric vein and indocyanin green into the abdominal aorta (for blood flow), and [3,4-(3)H]valine into the jugular vein and [1-(13)C]valine into the abomasum for 8 h (for kinetics). During the infusions, blood was collected from the mesenteric and portal veins and from the mesenteric artery and vena cava, and plasma was harvested. After the 8-h infusion, lambs were euthanized, ileal digesta were collected, and tissues were sampled from the intestine and muscle (biceps femoris). Tissues, digesta, and plasma were analyzed for valine concentration, specific radioactivity, and isotopic enrichment. In both experiments, intestinal worm burdens on d 48 were greater in parasitized lambs (P = 0.0001 and 0.003). In Exp. 1, parasitic infection increased (P = 0.03) the total valine irreversible loss rate (ILR) in the MDV and PDV. In Exp. 2, luminal ILR of valine in the MDV was reduced (P = 0.01); however, ILR of valine in the PDV was unaffected. Despite these changes within the MDV and PDV, parasitic infection did not affect the ILR of valine within the hind limbs, and valine transport rates were largely unchanged. We suggest that

  13. 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 ...

  14. 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.

  15. 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...

  16. 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...

  17. 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

  18. 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...

  19. 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.

  20. 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

  1. Titan's aerosol optical properties with VIMS observations at the limb

    Science.gov (United States)

    Rannou, Pascal; Seignovert, Benoit; Le Mouelic, Stephane; Sotin, Christophe

    2016-06-01

    The study of Titan properties with remote sensing relies on a good knowledge of the atmosphere properties. The in-situ observations made by Huygens combined with recent advances in the definition of methane properties enable to model and interpret observations with a very good accuracy. Thanks to these progresses, we can analyze in this work the observations made at the limb of Titan in order to retrieve information on the haze properties as its vertical profiles but also the spectral behaviour between 0.88 and 5.2 µm. To study the haze layer and more generally the source of opacities in the stratosphere, we use some observation made at the limb of Titan by the VIMS instrument onboard Cassini. We used a model in spherical geometry and in single scattering, and we accounted for the multiple scattering with a parallel plane model that evaluate the multiple scattering source function at the plane of the limb. Our scope is to retrieve informations about the vertical distribution of the haze, its spectral properties, but also to obtain details about the shape of the methane windows to desantangle the role of the methane and of the aerosols. We started our study at the latitude of 55°N, with a image taken in 2006 with a relatively high spatial resolution (for VIMS). Our preliminary results shows the spectral properties of the aerosols are the same whatever the altitude. This is a consequence of the large scale mixing. From limb profile between 0.9 and 5.2 µm, we can probe the haze layer from about 500 km (at 0.9 µm) to the ground (at 5.2 µm). We find that the vertical profile of the haze layer shows three distinct scale heights with transitions around 250 km and 350 km. We also clearly a transition around 70-90 km that may be due to the top of a condensation layer.

  2. Lower-Limb Robotic Rehabilitation: Literature Review and Challenges

    Directory of Open Access Journals (Sweden)

    Iñaki Díaz

    2011-01-01

    been developed worldwide for training of both the upper and lower extremities. This work reviews all current robotic systems to date for lower-limb rehabilitation, as well as main clinical tests performed with them, with the aim of showing a clear starting point in the field. It also remarks some challenges that current systems still have to meet in order to obtain a broad clinical and market acceptance.

  3. 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 ...

  4. 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...

  5. 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

  6. Ilizarov Method: A Limb Salvage Device in a Child.

    Science.gov (United States)

    Faruque, M G; Mollah, M U; Siddiquee, T H; Bari, S

    2016-07-01

    Ilizarov method is the best weapon for the treatment of the limb length discrepancy, especially in traumatic or congenital shortening of long bones. Post burn bony defect can be corrected by osteosynthesis. Here we treated a 7 years old boy, suffering from 33% electric burn affecting face, trunk, left upper limb & both lower limbs with loss of soft tissue of medial side of right leg along with dead and exposed of some segment (about 14cm) of Left tibia . Initially the patient was managed by plastic surgeons in the form of surgical toileting, wound debridement and wound coverage by split thickness skin graft. After about 6 weeks, we applied Ilizarov fixator on the affected limb and maintained it for 7 days to increase vascularity. As there was minimum bone in the proximal part, we did corticotomy at the distal end. After 7 days further, we started distal to proximal bone transport at a rate of 1mm per day. Staged excision of about 2.5 to 3cm dead bone was done, after transporting the same length of bone each time. In 5 such sittings, a total of 14cm bone was excised. Thus the burned portion was replaced by new bone; bony union was achieved after applying compression. Now the patient is able to walk individually, without any difficulty. So, we found that, Ilizarov method is a good option for the management of post burn bone loss. To our knowledge, such an application of the Ilizarov external fixation device in post burn bone loss has yet to be reported. PMID:27612909

  7. 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...

  8. 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...

  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. 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.

  11. 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

  12. 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+.

  13. Advances in upper limb stroke rehabilitation: a technology push.

    Science.gov (United States)

    Loureiro, Rui C V; Harwin, William S; Nagai, Kiyoshi; Johnson, Michelle

    2011-10-01

    Strokes affect thousands of people worldwide leaving sufferers with severe disabilities affecting their daily activities. In recent years, new rehabilitation techniques have emerged such as constraint-induced therapy, biofeedback therapy and robot-aided therapy. In particular, robotic techniques allow precise recording of movements and application of forces to the affected limb, making it a valuable tool for motor rehabilitation. In addition, robot-aided therapy can utilise visual cues conveyed on a computer screen to convert repetitive movement practice into an engaging task such as a game. Visual cues can also be used to control the information sent to the patient about exercise performance and to potentially address psychosomatic variables influencing therapy. This paper overviews the current state-of-the-art on upper limb robot-mediated therapy with a focal point on the technical requirements of robotic therapy devices leading to the development of upper limb rehabilitation techniques that facilitate reach-to-touch, fine motor control, whole-arm movements and promote rehabilitation beyond hospital stay. The reviewed literature suggest that while there is evidence supporting the use of this technology to reduce functional impairment, besides the technological push, the challenge ahead lies on provision of effective assessment of outcome and modalities that have a stronger impact transferring functional gains into functional independence.

  14. 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)

  15. On the solar chromosphere observed at the limb with Hinode

    CERN Document Server

    Judge, Philip G

    2010-01-01

    Broad-band images in the Ca II H line, from the BFI instrument on the Hinode spacecraft, show emission from spicules emerging from and visible right down to the observed limb. Surprisingly, little absorption of spicule light is seen along their lengths. We present formal solutions to the transfer equation for given (ad-hoc) source functions, including a stratified chromosphere from which spicules emanate. The model parameters are broadly compatible with earlier studies of spicules. The visibility of Ca II spicules down to the limb in Hinode data seems to require that spicule emission be Doppler shifted relative to the stratified atmosphere, either by supersonic turbulent or organized spicular motion. The non-spicule component of the chromosphere is almost invisible in the broad band BFI data, but we predict that it will be clearly visible in high spectral resolution data. Broad band Ca II H limb images give the false impression that the chromosphere is dominated by spicules. Our analysis serves as a reminder ...

  16. 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.

  17. Lower-limb proprioceptive awareness in professional ballet dancers.

    Science.gov (United States)

    Kiefer, Adam W; Riley, Michael A; Shockley, Kevin; Sitton, Candace A; Hewett, Timothy E; Cummins-Sebree, Sarah; Haas, Jacqui G

    2013-09-01

    Enhanced proprioceptive feedback strengthens synergistic muscle groups and stabilizes the coordination of limbs, thus contributing to the movement efficiency of ballet dancers. The present study compared lower-limb proprioceptive awareness in professional ballet dancers to matched controls who had no dance training. Two assessment methods were used to test the hypothesis that ballet dancers would demonstrate increased proprioceptive awareness in the ankle, knee, and hip: 1. a joint-position matching task to assess static proprioceptive joint awareness, and 2. an eyes-closed, quiet standing task to assess both static and dynamic proprioceptive awareness through measures of center of pressure (COP) variability. Results of the matching task indicated that the dancers exhibited greater proprioceptive awareness than controls for all three joints (p 0.05), whereas controls were less aware of their ankle position compared to their knee and hip joints (p 0.05). This indicates that quiet stance may have limited value as a means for evaluating proprioception. These findings provide preliminary evidence that enhanced proprioceptive awareness of lower limb joints should be considered as an evaluative criterion for dancers' ability to learn complex ballet skills. They also indicate that quiet standing tasks may not provide sufficient challenge for dancers' enhanced proprioceptive awareness to manifest. PMID:24069947

  18. Predicting prosthetic prescription after major lower-limb amputation

    Directory of Open Access Journals (Sweden)

    Linda Resnik, PT, PhD, OCS

    2015-09-01

    Full Text Available We describe prosthetic limb prescription in the first year following lower-limb amputation and examine the relationship between amputation level, geographic region, and prosthetic prescription. We analyzed 2005 to 2010 Department of Veterans Affairs (VA Inpatient and Medical Encounters SAS data sets, Vital Status death data, and National Prosthetic Patient Database data for 9,994 Veterans who underwent lower-limb amputation at a VA hospital. Descriptive statistics and bivariates were examined. Cox proportional hazard models identified factors associated with prosthetic prescription. Analyses showed that amputation level was associated with prosthetic prescription. The hazard ratios (HRs were 1.41 for ankle amputation and 0.46 for transfemoral amputation compared with transtibial amputation. HRs for geographic region were Northeast = 1.49, Upper Midwest = 1.26, and West = 1.39 compared with the South (p < 0.001. African American race, longer length of hospital stay, older age, congestive heart failure, paralysis, other neurological disease, renal failure, and admission from a nursing facility were negatively associated with prosthetic prescription. Being married was positively associated. After adjusting for patient characteristics, people with ankle amputation were most likely to be prescribed a prosthesis and people with transfemoral amputation were least likely. Geographic variation in prosthetic prescription exists in the VA and further research is needed to explain why.

  19. Evaluation of new suspension system for limb prosthetics

    Science.gov (United States)

    2014-01-01

    Background Good prosthetic suspension system secures the residual limb inside the prosthetic socket and enables easy donning and doffing. This study aimed to introduce, evaluate and compare a newly designed prosthetic suspension system (HOLO) with the current suspension systems (suction, pin/lock and magnetic systems). Methods All the suspension systems were tested (tensile testing machine) in terms of the degree of the shear strength and the patient’s comfort. Nine transtibial amputees participated in this study. The patients were asked to use four different suspension systems. Afterwards, each participant completed a questionnaire for each system to evaluate their comfort. Furthermore, the systems were compared in terms of the cost. Results The maximum tensile load that the new system could bear was 490 N (SD, 5.5) before the system failed. Pin/lock, magnetic and suction suspension systems could tolerate loads of580 N (SD, 8.5), 350.9 (SD, 7) and 310 N (SD, 8.4), respectively. Our subjects were satisfied with the new hook and loop system, particularly in terms of easy donning and doffing. Furthermore, the new system is considerably cheaper (35 times) than the current locking systems in the market. Conclusions The new suspension system could successfully retain the prosthesis on the residual limb as a good alternative for lower limb amputees. In addition, the new system addresses some problems of the existing systems and is more cost effective than its counterparts. PMID:24410918

  20. 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.

  1. Predicting prosthetic prescription after major lower-limb amputation.

    Science.gov (United States)

    Resnik, Linda; Borgia, Matthew

    2015-01-01

    We describe prosthetic limb prescription in the first year following lower-limb amputation and examine the relationship between amputation level, geographic region, and prosthetic prescription. We analyzed 2005 to 2010 Department of Veterans Affairs (VA) Inpatient and Medical Encounters SAS data sets, Vital Status death data, and National Prosthetic Patient Database data for 9,994 Veterans who underwent lower-limb amputation at a VA hospital. Descriptive statistics and bivariates were examined. Cox proportional hazard models identified factors associated with prosthetic prescription. Analyses showed that amputation level was associated with prosthetic prescription. The hazard ratios (HRs) were 1.41 for ankle amputation and 0.46 for transfemoral amputation compared with transtibial amputation. HRs for geographic region were Northeast = 1.49, Upper Midwest = 1.26, and West = 1.39 compared with the South (p amputation were most likely to be prescribed a prosthesis and people with transfemoral amputation were least likely. Geographic variation in prosthetic prescription exists in the VA and further research is needed to explain why.

  2. Predicting prosthetic prescription after major lower-limb amputation.

    Science.gov (United States)

    Resnik, Linda; Borgia, Matthew

    2015-01-01

    We describe prosthetic limb prescription in the first year following lower-limb amputation and examine the relationship between amputation level, geographic region, and prosthetic prescription. We analyzed 2005 to 2010 Department of Veterans Affairs (VA) Inpatient and Medical Encounters SAS data sets, Vital Status death data, and National Prosthetic Patient Database data for 9,994 Veterans who underwent lower-limb amputation at a VA hospital. Descriptive statistics and bivariates were examined. Cox proportional hazard models identified factors associated with prosthetic prescription. Analyses showed that amputation level was associated with prosthetic prescription. The hazard ratios (HRs) were 1.41 for ankle amputation and 0.46 for transfemoral amputation compared with transtibial amputation. HRs for geographic region were Northeast = 1.49, Upper Midwest = 1.26, and West = 1.39 compared with the South (p length of hospital stay, older age, congestive heart failure, paralysis, other neurological disease, renal failure, and admission from a nursing facility were negatively associated with prosthetic prescription. Being married was positively associated. After adjusting for patient characteristics, people with ankle amputation were most likely to be prescribed a prosthesis and people with transfemoral amputation were least likely. Geographic variation in prosthetic prescription exists in the VA and further research is needed to explain why. PMID:26562228

  3. 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.

  4. 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 ...

  5. 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 ...

  6. 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.

  7. HV1 acts as a sodium sensor and promotes superoxide production in medullary thick ascending limb of Dahl salt-sensitive rats.

    Science.gov (United States)

    Jin, Chunhua; Sun, Jingping; Stilphen, Carly A; Smith, Susan M E; Ocasio, Hiram; Bermingham, Brent; Darji, Sandip; Guha, Avirup; Patel, Roshan; Geurts, Aron M; Jacob, Howard J; Lambert, Nevin A; O'Connor, Paul M

    2014-09-01

    We previously characterized a H(+) transport pathway in medullary thick ascending limb nephron segments that when activated stimulated the production of superoxide by nicotinamide adenine dinucleotide phosphate oxidase. Importantly, the activity of this pathway was greater in Dahl salt-sensitive rats than salt-resistant (SS.13(BN)) rats, and superoxide production was enhanced in low Na(+) media. The goal of this study was to determine the molecular identity of this pathway and its relationship to Na(+). We hypothesized that the voltage-gated proton channel, HV1, was the source of superoxide-stimulating H(+) currents. To test this hypothesis, we developed HV1(-/-) null mutant rats on the Dahl salt-sensitive rat genetic background using zinc-finger nuclease gene targeting. HV1 could be detected in medullary thick limb from wild-type rats. Intracellular acidification using an NH4Cl prepulse in 0 sodium/BaCl2 containing media resulted in superoxide production in thick limb from wild-type but not HV1(-/-) rats (Pthick limb and peritoneal macrophages only when HV1 was present. When fed a high-salt diet, blood pressure, outer medullary renal injury (tubular casts), and oxidative stress (4-hydroxynonenal staining) were significantly reduced in HV1(-/-) rats compared with wild-type Dahl salt-sensitive rats. We conclude that HV1 is expressed in medullary thick ascending limb and promotes superoxide production in this segment when intracellular Na(+) is low. HV1 contributes to the development of hypertension and renal disease in Dahl salt-sensitive rats.

  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. Emergency Application of Limb Salvage Treated with Vacuum Sealing Drainage in Traumatic Destructive Limb%负压封闭引流在肢体毁损伤保肢术的急诊应用

    Institute of Scientific and Technical Information of China (English)

    石波; 王伯通; 叶楠; 王军; 杨衡; 王陶; 唐诗天; 康斌; 刘都; 张定伟; 陈利江

    2011-01-01

    , 6 cases of > 7 points.In accordance with the principles of surgical debridement, repaired blood vessels, nerves, tendons, bone exposed in wound tissue coverage, be fixed to constructed physical stability of bone by external fixation, closed suction by VSD. Results 21 patients with VSD treatment form once to 5 times, 20 cases were successful of limb salvage, only 1 case with serious infection was amputated. Conclusion VSD could control infection, stimulated the growth of granulation tissue and provided good conditions for the second phase of wound repair. This treatment could be applied for limb salvage in traumatic destructive limb.

  10. FILAR I AL LYMPHEDEMA LOWER LIMB DEBULKING 34 CASES

    Directory of Open Access Journals (Sweden)

    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. Impact testing of the residual limb: System response to changes in prosthetic stiffness

    Directory of Open Access Journals (Sweden)

    Erin Boutwell, PhD

    2016-04-01

    Full Text Available Currently, it is unknown whether changing prosthetic limb stiffness affects total limb stiffness and/or influences the shock absorption of an individual with transtibial amputation. The hypotheses tested within this study are that a decrease in longitudinal prosthetic stiffness will produce (1 reduced total limb stiffness and (2 reduced magnitude of peak impact forces and increased time delay to peak force. Fourteen subjects with a transtibial amputation participated in this study. Prosthetic stiffness was modified by means of a shock-absorbing pylon that provides reduced longitudinal stiffness through compression of a helical spring within the pylon. A sudden loading evaluation device was built to examine changes in limb loading mechanics during a sudden impact event. No significant change was found in the peak force magnitude or timing of the peak force between prosthetic limb stiffness conditions. Total limb stiffness estimates ranged from 14.9 to 17.9 kN/m but were not significantly different between conditions. Thus, the prosthetic-side total limb stiffness was unaffected by changes in prosthetic limb stiffness. The insensitivity of the total limb stiffness to prosthetic stiffness may be explained by the mechanical characteristics (i.e., stiffness and damping of the anatomical tissue within the residual limb.

  12. Measures of frontal plane lower limb alignment obtained from static radiographs and dynamic gait analysis.

    Science.gov (United States)

    Hunt, Michael A; Birmingham, Trevor B; Jenkyn, Thomas R; Giffin, J Robert; Jones, Ian C

    2008-05-01

    Currently, lower limb alignment is measured statically from radiographs that may not accurately represent the condition of the limb when moving and weight-bearing. Thus, the purpose of the present study was to introduce and examine a novel measure of dynamic lower limb alignment obtained during walking in patients with knee OA. In this cross-sectional study, standing, full-length lower limb radiographs were acquired from 80 individuals with confirmed knee OA, who also underwent three-dimensional gait analyses with reflective markers placed on the segments of the lower limb. Frontal plane lower limb alignment was measured using the static radiographs (mechanical axis) and gait analyses (marker-based alignment) by identifying the centres of the hip, knee, and ankle from both methods. Simple linear regression indicated these measures were highly correlated (r=0.84), however, 30% of the variance in the marker-based measure of lower limb alignment was not explained by the mechanical axis despite using the same anatomical landmarks. Results from this study suggest that a valid measure of dynamic lower limb alignment can be obtained from a standard quantitative gait analysis and highlight the differences in measures of lower limb alignment obtained in static and dynamic situations. Future research into the clinical utility of measures of dynamic alignment in the treatment of OA may aid in the development of interventions specifically tailored to one's dynamic lower limb biomechanics during gait.

  13. Limb swinging in elephants and giraffes and implications for the reconstruction of limb movements and speed estimates in large dinosaurs

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    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

  14. Analysis of Risk Factors for Lower-limb Deep Venous Thrombosis in Old Patients after Knee Arthroplasty

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    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. 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

  17. Comparative Analysis of Cartilage Marker Gene Expression Patterns during Axolotl and Xenopus Limb Regeneration.

    Science.gov (United States)

    Mitogawa, Kazumasa; Makanae, Aki; Satoh, Ayano; Satoh, Akira

    2015-01-01

    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. PMID:26186213

  18. Comparative Analysis of Cartilage Marker Gene Expression Patterns during Axolotl and Xenopus Limb Regeneration.

    Science.gov (United States)

    Mitogawa, Kazumasa; Makanae, Aki; Satoh, Ayano; Satoh, Akira

    2015-01-01

    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.

  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. Short-limb dwarfism and hypertrophic cardiomyopathy in a patient with paternal isodisomy 14: 45,XYidic(14)(p11)

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    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.