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Sample records for bones of lower extremity

  1. Quality of Life Following Amputation or Limb Preservation in Patients with Lower Extremity Bone Sarcoma

    OpenAIRE

    Gary E Mason; Lele eAung; Sarah eGall; Meyers, Paul A; Robert eButler; Sarah eKrug; Mimi eKim; Healey, John H.; Richard eGorlick

    2013-01-01

    PURPOSE: Although functional differences have been described between patients with lower extremity bone sarcoma with amputation and limb preservation surgery, differences have not clearly been shown between the two groups related to quality of life. The aim of the study was to determine if there is a difference in overall quality of life in lower extremity bone sarcoma survivors related to whether they had an amputation or a limb preservation procedure. PATIENTS AND METHODS: Eighty-two lon...

  2. EVALUATION OF RESULTS OF TITANIUM ELASTIC NAILING SYSTEM IN PAEDIATRIC LOWER EXTREMITY FRACTURES OF LONG BONES

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    Pradeep

    2014-12-01

    Full Text Available BACKGROUND: Flexible intramedullary nails have gained widespread popularity for stabilization of pediatric fractures of long bones of lower extremity. AIMS: Purpose of our study was to evaluate safety and efficacy of titanium elastic nailing system (TENS for paediatric lower extremity long bone fractures. METHODS: All children operated for lower extremity long bone fractures at our tertiary care centre (Sri Aurobindo Institute of Medical Sciences, Indore between Jan 2012 to Dec 2013 who underwent fixation with TENS were reviewed. Out of 57 cases identified, 4 cases were lost to follow-up. Of the 53 cases, 58.49 per cent were males (boys 31 and girls 22. The average age of patients was 10.8 years (range 6- 14 years. The mean weight was 28.8 kg (range 16 kg - 42 kg. All fractures were reduced by closed manipulation. Outcomes were classified as excellent, satisfactory or poor according to Flynn flexible nail fixation classification. RESULTS: As per Flynn classification, we had 36 excellent, 14 good and 1 poor result. All patients attained complete healing at mean of 11.2 weeks (Range 7 - 16 weeks. Mean duration of hospital stay was of 5 days (Range 3 - 16 days. CONCLUSION: On the basis of results obtained TENS is an effective method for management of unstable paediatric fractures of long bones of lower extremity allowing rapid mobilization with minimal complications.

  3. Quality of Life Following Amputation or Limb Preservation in Patients with Lower Extremity Bone Sarcoma

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    Gary E Mason

    2013-08-01

    Full Text Available PURPOSE: Although functional differences have been described between patients with lower extremity bone sarcoma with amputation and limb preservation surgery, differences have not clearly been shown between the two groups related to quality of life. The aim of the study was to determine if there is a difference in overall quality of life in lower extremity bone sarcoma survivors related to whether they had an amputation or a limb preservation procedure. PATIENTS AND METHODS: Eighty-two long-term survivors of lower extremity bone sarcoma were studied to make a comparison of the overall quality of life, pain assessment and psychological evaluations in limb preservation and amputation patients. Forty-eight patients with limb preservation and thirty-four patients with amputations were enrolled in the study. Validated psychometric measures including the Quality of Life Questionnaire, the Minnesota Multiphasic Personality Inventory and visual analog scales were utilized.RESULTS: The overall quality of life of patients with limb preservation was significantly higher than patients with amputation (p-value < 0.01. Significant differences were noted in the categories of material well being, job satisfiers and occupational relations. CONCLUSION: The overall quality of life of patients with limb preservation appears to be better than for those patients with amputation based on the quality of life questionnaire in patients surviving lower extremity bone sarcoma. Further analysis needs to verify the results and focus on the categories that significantly affect the overall quality of life.

  4. Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction

    International Nuclear Information System (INIS)

    Aim: To analyse the effect of dual-energy bone subtraction (DEBS) on the image quality of peripheral computed tomography (CT) angiograms. Materials and methods: Twenty patients underwent dual-energy CT angiography of the pelvic and lower extremity arteries using commercially available equipment. Two different methods of image processing were employed for each CT angiographic dataset: (1) DEBS, and (2) manual bone subtraction (MBS). Effects on vessel visibility and artificial vessel alterations were compared. Results: Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p = 0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p = 0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p < 0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p = 0.22). Conclusion: DEBS facilitates bone removal in peripheral CT angiography, but generates more vessel alterations, particularly in the presence of calcified plaque.

  5. Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction

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    Yamamoto, S., E-mail: syamamoto@gmail.co [David Geffen School of Medicine, Department of Radiology, University of California-Los Angeles, Los Angeles (United States); McWilliams, J.; Arellano, C.; Marfori, W.; Cheng, W.; Mcnamara, T.; Quinones-Baldrich, W.J.; Ruehm, S.G. [David Geffen School of Medicine, Department of Radiology, University of California-Los Angeles, Los Angeles (United States)

    2009-11-15

    Aim: To analyse the effect of dual-energy bone subtraction (DEBS) on the image quality of peripheral computed tomography (CT) angiograms. Materials and methods: Twenty patients underwent dual-energy CT angiography of the pelvic and lower extremity arteries using commercially available equipment. Two different methods of image processing were employed for each CT angiographic dataset: (1) DEBS, and (2) manual bone subtraction (MBS). Effects on vessel visibility and artificial vessel alterations were compared. Results: Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p = 0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p = 0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p < 0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p = 0.22). Conclusion: DEBS facilitates bone removal in peripheral CT angiography, but generates more vessel alterations, particularly in the presence of calcified plaque.

  6. Management of periarticular fractures of long bones of the lower extremity by hybrid external fixation

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    Natarajan Mayil

    2006-01-01

    Full Text Available Background : Management of periarticular fractures is associated with many complications. Hybrid fixators allows for early partial weight bearing and range of motion exercises at adjoining joints. Furthermore, it promotes callous formation by continuous axial micro movements in the fixation frame. Methods : We have prospectively analyzed the results of hybrid external fixation in the management of periarticular fractures of long bones of the lower extremity in 20 patients accounting for 22 limbs. We treated 19 fractures (18 compound and 1 closed and three fracture nonunions with this method. The mean age of the patients was 36.5 years. In 12 patients hybrid fixation was the primary procedure while in 8 patients hybrid fixation was done following initial emergency AO Uniplanar external fixation. Fourteen patients required subsequent surgeries such as bone grafting and soft tissue cover. Results : The mean follow up of our patients was 13.2 months (5 - 25 months. We achieved excellent results in 10 fractures, good in 4 fractures, fair in 3 fractures and poor results in 3 fractures. Two patients were lost to follow up. Bony union was achieved in 18 of the fractures. A short-term acceptable result was achieved in 17 cases. Conclusion : Hybrid external fixation is a very effective and useful treatment modality in the management of fractures close to a joint providing excellent to good results. It combines the advantages of both Ilizarov and AO external fixators. It is minimally invasive, modular and yet efficient in promoting massive new proliferative callus formation at the fracture site.

  7. Dynamic contrast-enhanced MR imaging in symptomatic bone stress of the pelvis and the lower extremity

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    Kiuru, M.J. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Pihlajamaeki, H.K. [Military Central Hospital, Helsinki (Finland). Dept. of Surgery; Perkioe, J.P [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Ahovuo, J.A. [Military Central Hospital, Helsinki (Finland). Dept. of Radiology

    2001-05-01

    Purpose: To assess the value of dynamic contrast-enhanced MR imaging in bone stress of the pelvis and the lower extremity. Material and Methods: Thirty patients (37 reactions; aged 17-25 years, mean 20.5 years) with MR findings of 37 bone stress reactions were examined using dynamic gadolinium contrast enhancement. The enhancement was evaluated with time-intensity curves. The highest slope and maximum enhancement values were calculated and compared with the different precontrast MR imaging signs of bone stress reactions. Results: There was a significant difference in the highest slope values between the site of the bone stress reaction and the reference points. In 24 of the 37 reactions the dynamic contrast enhancement was regarded as positive. A fracture line, callus, and muscle edema were the MR imaging signs which had significant correlation to the dynamic contrast enhancement. Neither periosteal nor marrow changes showed any significant correlation. A new MR grading system for bone stress reactions could be assessed. Conclusion: Increased tissue perfusion could be seen if precontrast MR imaging revealed callus, fracture line or muscle edema surrounding the bone stress reaction.

  8. Lower extremity alignment normogram of Turkish population

    OpenAIRE

    Sezen, Sedat; Kuyurtar, Fehmi; ERDOGAN, Murat; Karaoglanoglu, Mustafa

    2004-01-01

    Extremity alignment normogram is useful in planning arthroplasty, osteotomy and treatment of fracture and malunion. The aim of this study is to get a lower extremity alignment normogram of Turkish population. Lower extremity plain radiographs of a hundred healthy volunteer are obtained and 21 parameters are measured in each of them. Results are statistically analyzed. Mechanical factors depending on aging, alters lower extremity alignment normogram parameters in Turkish population. When lower...

  9. The structure of long tubular bones fractures of lower extremity by the data of the regional bureau of forensic-medical examination

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    Savka I.H.

    2013-10-01

    Full Text Available The main purpose of the research is carrying out forensic-medical analysis of cases from expert’s practice with fractures of the long bones based on the findings of the Regional Bureau of Forensic-Medical Examination over 2009-2012 years period. The research has been carried out using methods of statistical and comparative analysis. Their distribution by gender, age, localization, character and type of external influence, the conditions of their occurrence and participation of other persons has been outlined. Fractures of lower extremity bones make up from 15,8 to 22,5% of all the cases of mechanical trauma with lethal outcomes. Therewith male persons suffer more often from injury of the left extremity at different day time and season. The principal mechanism of their origin is injury resulting from road accidents in the countryside with the participation of other persons.

  10. Radiocirculography of the lower extremities

    International Nuclear Information System (INIS)

    The thesis describes the determination of the absolute values (ml per min) of blood flow in the extremities. The method is based on model experiments in elastic tubing system and on comparison with intraoperative electromagnetic flow-measurements. An eight-channel radiocirculograph was used for simultaneous measurement of flow in the two art. femoralis comm., the two art. poplitea and the two art. dors. pedis under different pathological conditions and after therapeutic interventions. Experiences and data on 1400 patients are summarized. (L.E.)

  11. Sports nuclear medicine. Bone imaging for lower extremity pain in athletes

    International Nuclear Information System (INIS)

    Increased participation in sports by the general public has led to an increase in sports-induced injuries, including stress fractures, shin splints, arthritis, and a host of musculotendinous maladies. Bone scintigraphy with Tc-99m MDP has been used with increasing frequency in detecting stress fractures, but this study can miss certain important conditions and detect other lesions of lesser clinical significance. This paper demonstrates the spectrum of findings on bone scanning in nonacute sports trauma and offers suggestions for the optimal use of Tc-99m MDP for detecting the causes of lower extremity pain in athletes

  12. Effects of Low-Impact Dance on Blood Biochemistry, Bone Mineral Density, the Joint Range of Motion of Lower Extremities, Knee Extension Torque, and Fall in Females.

    Science.gov (United States)

    Wu, Hui Ying; Tu, Jui Hung; Hsu, Chin Hsing; Tsao, Te Hung

    2016-01-01

    The effect of low-impact dance on blood metabolites, the joint range of motion (ROM) of the lower extremities, knee extension torque, bone mass density (BMD), the number of falls, and the confidence to perform daily activities (Modified Falls Efficacy Scale [MFES]) was examined in older sedentary women (age: 59 ± 4 years) before and after a 16-week intervention. Results showed that the average score for the MFES, some parameters of blood chemistry, and joint ROM were significantly improved after low-impact intervention. In addition to improvements in blood lipids and body fat percentages, the increases shown in the parameters regarding the lower extremities may contribute to confidence in performing common daily activities in older women, although the number of falls did not significantly differ between the two groups during the 16-week period. PMID:25642949

  13. A STUDY OF LOWER EXTREMITY RECONSTRUCTION

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    Mariappan

    2014-12-01

    Full Text Available BACKGROUND: The reconstruction of the lower extremity poses a great challenge because of the complexity of the injuries. Road traffic accidents are the most common cause of mortality and morbidity in patients. High speed traffic accidents result in a variety of associated life-threatening injuries. Lower extremity poses problems of wound healing and also the lack of suitable donor local flaps. The development of Microsurgical techniques in the past 25 years has changed the whole spectrum of reconstruction of the lower limbs. AIMS AND OBJECTIVES: The aim of this study is to evaluate the use of various flaps in the lower extremity reconstruction in a tertiary care center. The main objective is to study the process of rehabilitation with main focus on early return to normal activities following the reconstructive procedures. SETTINGS AND DESIGN: Seventy three patients between the ages 17 to 65 years (mean age-36.43 with an injury period of up to 4 weeks were included in the study. For the 73 patients, 74 flaps were used. Patients with collagen disorder, liver disease. HIV positive patients and patients with history peripheral vascular diseases were excluded from the study. METHODS AND MATERIAL: This study was conducted in a tertiary teaching hospital over a period of two years from July 2012 to July 2014.Flap surgery was done in 73 patients with a total of 74 flaps. Defects of various regions of the lower extremity were selected for the study. A variety of reconstructive options are available for the lower extremity. This study includes patients from my private practice also. OBSERVATION AND RESULT: The flap surgery was successful in a variety of indications like trauma, infected chronic wounds, tumor excision and bone infections. There was a total failure of reverse sural artery flap in one patient. There was a partial necrosis of small area of the tip of the flaps in two patients with transposition fasciocutaneous flaps which healed by secondary

  14. Vascular calcification of the lower extremities demonstrated by Tc-99m MDP bone scintigraphy in a patient with diabetes mellitus

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    Lim, Seok Tae; Sohn, Myung Hee [Chonbuk National University Medical School, Chonju, l (Korea, Republic of)

    2001-06-01

    The femoral vessels are sometimes visualized on bone scintigraphy. This is almost always caused by calcification of the femoral artery associated with atherosclerotic changes of the arterial wall. Vascular calcification is frequently seen in the elderly and in diabetics. A 78 year old woman was admitted for non-insulin dependent diabetes mellitus. In this patient with diabetes mellitus, tibial arteries as well as femoral arteries were visualized onTc-99m MDP bone scintigraphy in contrast with visualization of femoral artery alone observed in the elderly.

  15. Vascular calcification of the lower extremities demonstrated by Tc-99m MDP bone scintigraphy in a patient with diabetes mellitus

    International Nuclear Information System (INIS)

    The femoral vessels are sometimes visualized on bone scintigraphy. This is almost always caused by calcification of the femoral artery associated with atherosclerotic changes of the arterial wall. Vascular calcification is frequently seen in the elderly and in diabetics. A 78 year old woman was admitted for non-insulin dependent diabetes mellitus. In this patient with diabetes mellitus, tibial arteries as well as femoral arteries were visualized onTc-99m MDP bone scintigraphy in contrast with visualization of femoral artery alone observed in the elderly

  16. Muscles of the Lower Extremity

    Science.gov (United States)

    ... Thyroid & Parathyroid Glands Adrenal Gland Pancreas Gonads Other Endocrine Glands Review Quiz Cardiovascular System Heart Structure of the Heart Physiology of the Heart Blood Classification & Structure of Blood ...

  17. Treatment of large skeletal defects in the lower extremities using double-strut, free vascularized fibular bone grafting.

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    Chang, M C; Lo, W H; Chen, C M; Chen, T H

    1999-08-01

    This article reports on the use of double-strut, free vascularized fibular grafts to treat six patients with infected nonunion or traumatic bone loss in the femur or tibia after prolonged treatment and multiple operations. The defects were 6-13 cm long. Five patients achieved solid union within 6 months, and one patient required additional cancellous grafting to achieve union at the distal end of the fibula. One patient experienced a stress fracture due to strenuous exercise, and union was achieved 3 months after reapplying an external fixator. Although three patients had some restricted knee motion, all patients had a satisfactory outcome in regard to walking, and no limb-length discrepancies were noted in any patient. PMID:10465486

  18. Scintigraphic demonstration of lower extremity periostitis secondary to venous insufficiency

    International Nuclear Information System (INIS)

    The scintigraphic findings on bone imaging in two patients with extensive lower extremity periostitis secondary to venous insufficiency are presented. One of these patients had bilateral disease. The use of [67Ga]citrate scanning in an attempt to exclude concurrent osteomyelitis is also addressed

  19. Scintigraphic demonstration of lower extremity periostitis secondary to venous insufficiency

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    Gensburg, R.S.; Kawashima, A.; Sandler, C.M.

    1988-07-01

    The scintigraphic findings on bone imaging in two patients with extensive lower extremity periostitis secondary to venous insufficiency are presented. One of these patients had bilateral disease. The use of (/sup 67/Ga)citrate scanning in an attempt to exclude concurrent osteomyelitis is also addressed.

  20. Reliability of the mangled extremity severity score in combat-related upper and lower extremity injuries

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    Tolga Ege

    2015-01-01

    Full Text Available Background: Decision of limb salvage or amputation is generally aided with several trauma scoring systems such as the mangled extremity severity score (MESS. However, the reliability of the injury scores in the settling of open fractures due to explosives and missiles is challenging. Mortality and morbidity of the extremity trauma due to firearms are generally associated with time delay in revascularization, injury mechanism, anatomy of the injured site, associated injuries, age and the environmental circumstance. The purpose of the retrospective study was to evaluate the extent of extremity injuries due to ballistic missiles and to detect the reliability of mangled extremity severity score (MESS in both upper and lower extremities. Materials and Methods: Between 2004 and 2014, 139 Gustillo Anderson Type III open fractures of both the upper and lower extremities were enrolled in the study. Data for patient age, fire arm type, transporting time from the field to the hospital (and the method, injury severity scores, MESS scores, fracture types, amputation levels, bone fixation methods and postoperative infections and complications retrieved from the two level-2 trauma center's data base. Sensitivity, specificity, positive and negative predictive values of the MESS were calculated to detect the ability in deciding amputation in the mangled limb. Results: Amputation was performed in 39 extremities and limb salvage attempted in 100 extremities. The mean followup time was 14.6 months (range 6–32 months. In the amputated group, the mean MESS scores for upper and lower extremity were 8.8 (range 6–11 and 9.24 (range 6–11, respectively. In the limb salvage group, the mean MESS scores for upper and lower extremities were 5.29 (range 4–7 and 5.19 (range 3–8, respectively. Sensitivity of MESS in upper and lower extremities were calculated as 80% and 79.4% and positive predictive values detected as 55.55% and 83.3%, respectively. Specificity of MESS

  1. Bone Fractures Following External Beam Radiotherapy and Limb-Preservation Surgery for Lower Extremity Soft Tissue Sarcoma: Relationship to Irradiated Bone Length, Volume, Tumor Location and Dose

    International Nuclear Information System (INIS)

    Purpose: To examine the relationship between tumor location, bone dose, and irradiated bone length on the development of radiation-induced fractures for lower extremity soft tissue sarcoma (LE-STS) patients treated with limb-sparing surgery and radiotherapy (RT). Methods and Materials: Of 691 LE-STS patients treated from 1989 to 2005, 31 patients developed radiation-induced fractures. Analysis was limited to 21 fracture patients (24 fractures) who were matched based on tumor size and location, age, beam arrangement, and mean total cumulative RT dose to a random sample of 53 nonfracture patients and compared for fracture risk factors. Mean dose to bone, RT field size (FS), maximum dose to a 2-cc volume of bone, and volume of bone irradiated to ≥40 Gy (V40) were compared. Fracture site dose was determined by comparing radiographic images and surgical reports to fracture location on the dose distribution. Results: For fracture patients, mean dose to bone was 45 ± 8 Gy (mean dose at fracture site 59 ± 7 Gy), mean FS was 37 ± 8 cm, maximum dose was 64 ± 7 Gy, and V40 was 76 ± 17%, compared with 37 ± 11 Gy, 32 ± 9 cm, 59 ± 8 Gy, and 64 ± 22% for nonfracture patients. Differences in mean, maximum dose, and V40 were statistically significant (p = 0.01, p = 0.02, p = 0.01). Leg fractures were more common above the knee joint. Conclusions: The risk of radiation-induced fracture appears to be reduced if V40 <64%. Fracture incidence was lower when the mean dose to bone was <37 Gy or maximum dose anywhere along the length of bone was <59 Gy. There was a trend toward lower mean FS for nonfracture patients.

  2. A new method of lower extremity immobilization in radiotherapy

    International Nuclear Information System (INIS)

    We developed a new method for immobilization of the fix lower extremities by using a thermoplastic mask, a carbon fiber base plate, a customized headrest, and an adjustable angle holder. The lower extremities of 11 patients with lower extremity tumors were immobilized by this method. CT simulation was performed for each patient. For all 11 patients, the device fit was suitable and comfortable and had good reproducibility, which was proven in daily radiotherapy

  3. [Surgical treatment of lower extremity peripheral nerve injuries].

    Science.gov (United States)

    Kaiser, Radek

    2016-01-01

    Peripheral nerve injuries of the lower extremities are not frequent. The most common are traction injury of the peroneal nerve at the knee level or iatrogenic trauma of the pelvic nerves during abdominal surgery. Civil sharp injuries are rare.Indications for surgical revision follow the general rules of nerve surgery. Sharp injury should be treated as soon as possible, ideally within 72 hours. Closed lesions are indicated for surgery if a complete denervation remains unchanged three months after the injury. Best results can be achieved within six months from the injury. Irritations caused by bone fragments or scarring or by iatrogenic injury (clamps, cement, screws, etc.) may be revised later. However, the most important is early clinical examination in a specialized neurosurgical department. PMID:27256143

  4. Primary varicosis of the lower extremity

    International Nuclear Information System (INIS)

    Primary varicosis is due to congenital or acquired defects of the venous wall and valves. Subjective patient complaints are often different and even in contrast to clinical findings. The combination of insufficiency of the large superficial veins and insufficiency of the perforating veins often leads to chronic venous insufficiency with crural ulceration. Phlebography is indicated prior to surgery in order to evaluate the deep and the perforating veins and to check for variants. The recurrance rate for varicosis is low if all insufficient superficial and perforating veins are made functionless. (orig.)

  5. Prediction of Lower Extremity Movement by Cyclograms

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    P. Kutilek

    2012-01-01

    Full Text Available Human gait is nowadays undergoing extensive analysis. Predictions of leg movements can be used for orthosis and prosthesis programming, and also for rehabilitation. Our work focuses on predicting human gait with the use of angle-angle diagrams, also called cyclograms. In conjunction with artificial intelligence, cyclograms offer a wide area of medical applications. We have identified cyclogram characteristics such as the slope and the area of the cyclogram for a neural network learning algorithm. Neural networks learned by cyclograms offer wide applications in prosthesis control systems.

  6. Prevalence of Vitamin D Deficiency in Korean Children Presenting with Nonspecific Lower-Extremity Pain

    OpenAIRE

    Park, Min Jung; Lee, Juyeob; Lee, Jun Ku; Joo, Sun Young

    2015-01-01

    Purpose Although interest in the role played by vitamin D in bone health is increasing, little is known about the role of this vitamin in musculoskeletal pain in children. This study aimed to assess the prevalence of vitamin D deficiency in children presenting with nonspecific lower extremity pains. Materials and Methods From 2011 to 2012, 183 children underwent evaluation for nonspecific lower-extremity pains. Patients with valid causes, such as fractures or transient synovitis, were exclude...

  7. Varus deformity of the left lower extremity causing degenerative lesion of the posterior horn of the left medial meniscus in a patient with Paget’s disease of bone

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    Al Kaissi, Ali

    2014-09-01

    Full Text Available [english] We report on a 42-year-old woman who presented with persistent pain in her left knee with no history of trauma. Sagittal T1-weighted MRI of the left knee showed discontinuity between the anterior and posterior horns of the left medial meniscus, causing effectively the development of degenerative lesion of the posterior horn. The latter was correlated to varus deformity of the left lower extremity associated with subsequent narrowing of the medial knee joint. The unusual craniofacial contour of the patient, the skeletal survey and the elevated serum alkaline phosphatase were compatible with the diagnosis of Paget’s disease of the bone. To alleviate the adverse effect of the mal-alignment of the left femur onto the left knee, corrective osteotomy of the left femoral diaphysis by means of fixators was performed. To the best of our knowledge this is the first clinical report describing the management and the pathological correlation of a unilateral varus deformity of the femoral shaft and degenerative lesions of the left knee in a patient with Paget’s disease of the bone.

  8. Transplantation of bone-marrow stem cell on chronic lower extremity ischemia%骨髓于细胞移植治疗慢性下肢缺血性疾病

    Institute of Scientific and Technical Information of China (English)

    方青波; 戈小虎

    2008-01-01

    Atheroselerosis and thrombangiitis obliterans are the chief factors of chronic lower extremity ischemia. Usually we utilize intervcntional treatment which includs balloon dilatation and stent implantation or surgical revascularization for the patients who have good target vessels, but those methods are not suitable for the patients who have small target vessels. The transplantation of bone marrow stem cells is the new tech-nology for chronic lower extremity isehemia, which utilize the capacity of stem cells that have multiple differ-entiation activity and high self renewal potentiality. It can direetionally differentiated into endothelial cells. It has a good perspective in chronic lower extremity isehemia.%动脉粥样硬化及血栓闭塞性脉管炎所引起的慢性下肢缺血在临床上最常见,对于血管流出道好的采用血运重建或介入下球囊扩张及支架置入,但对于血管流出道差的严重慢性下肢缺血上述方法 则不适用.干细胞移植是近年来发展起来的新技术,它是利用于细胞多重分化括性及高度自我更新的潜能,定向分化为具有血管活性的内皮细胞,在治疗慢性下肢缺血性疾病中有很好的前景.

  9. Cutaneous Markers of Systemic Disease in the Lower Extremity.

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    Vella, Joseph

    2016-07-01

    The skin of the lower extremity can be a helpful diagnostic tool for systemic disease. Diabetes, renal disease, genetic disorders, and even cancer can have cutaneous manifestations in the legs and feet; moreover, proper diagnosis can facilitate earlier treatment of these diseases and not only clear up the skin symptoms but also bring about resolution of the systemic disease causing them. Although not comprehensive, this article discusses many of these disorders presenting with integumentary manifestations in the lower extremities. Where appropriate, it also enumerates the treatments involved, both systemic and localized. PMID:27215161

  10. Influence of gravitational therapy on reparative osteogenesis in patients with osteomyelitis of lower extremities

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    Kotelnikov G.P.

    2010-09-01

    Full Text Available The article provides a comparative analysis of reparative osteogenesis in 105 patients with diffuse osteomyelitis of lower extremities, covering bone in diameter totally or subtotally. In complex treatment 51 patients have experienced gravitational therapy (study group, 54 patients have been treated by standard methods (control group. The study was conducted in clinics of Samara State Medical University. Gravitational therapy is a new noninvasive method of physiotherapy, first used in the treatment of patients with osteomyelitis. It is noted that the inclusion of gravitational therapy in complex treatment contributes to the consolidation of bone fragments, accelerates о ste о reparative processes in the regenerate bone formed in the zone of the defect in osteosynthesis in apparatus for external fixation. Past radionuclide study of the skeleton showed that the gravitational therapy positively affects the blood supply to the area osteomyelitic defeat, activates and improves bone metabolism. Osteodensimetric studies have shown that under the influence of gravitational therapy there was an increase in bone mineral density of the lower extremities, especially with the affected side, which was not observed in patients of control group. Gravitational therapy is an effective method of influence on reparative osteogenesis in patients with osteomyelitis of lower extremities

  11. Malignant bone tumors of the pelvis and of the extremities

    International Nuclear Information System (INIS)

    Bone tumors of the extremities are usually diagnosed by conventional radiography. A good angiogram may render information not only about intra- and extraosseous extension of the tumor, but often also about the biological dignity. CT is usually not necessary, especially since it is sometimes difficult to define the extraosseous borders of these extremity tumors with this method. In bone tumors of the pelvis, however, neither conventional radiography nor angiography render reliable information about the extent of the tumor, which CT is very well able to do. Therefore CT is primarily indicated for evaluation of bone tumors in this region. Angiography is done only for preoperative evaluation of the vascular architecture or for potential therapeutic embolisation. (orig.)

  12. On the Limit Distribution of Lower Extreme Generalized Order Statistics

    Indian Academy of Sciences (India)

    H M Barakat; Magdy E El-Adll

    2012-05-01

    In a wide subclass of generalized order statistics $(gOs)$, which contains most of the known and important models of ordered random variables, weak convergence of lower extremes are developed. A recent result of extreme value theory of $m-gOs$ (as well as the classical extreme value theory of ordinary order statistics) yields three types of limit distributions that are possible in case of linear normalization. In this paper a similar classification of limit distributions holds for extreme $gOs$, where the parameters $_j,j=1,\\ldots,n$, are assumed to be pairwise different. Two illustrative examples are given to demonstrate the practical importance for some of the obtained results.

  13. Bolustherapy in the general chart of renewal of the lost functions of lower extremities for patients after the diaphyseal fracture of bones of shins

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    Zhelezniy A.D.

    2010-06-01

    Full Text Available The results of the use of medical clay are considered as a physical therapy mean in the general chart of physical rehabilitation of patients. The existent methods of treatment clay are adapted for the physical rehabilitation of patients. Considered chemical components of local clays. Presented recommendation to the use of clay with the dosage of procedures during the physical rehabilitation of patients. As a result of application of author method for patients on 1-3 weeks the terms of physical rehabilitation grew short.

  14. Reliability of a New Lower-Extremity Motor Coordination Test

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    Antosiak-Cyrak Katarzyna

    2015-12-01

    Full Text Available Introduction. Motor coordination is a basic motor ability necessary for daily life, which also allows athletes to win a sports rivalry and patients to assess their recovery progress after therapy and rehabilitation. The aim of the present study was to assess the reliability of a new lower-extremity rate of movements test and testing apparatus.

  15. Parameters of lower extremities alignment view in Iranian adult population.

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    Mahmoud Jabalameli

    2015-05-01

    Full Text Available Normal axial alignment restoration in lower extremities is crucial for surgeons performing reconstructive surgeries. Since reference normal values of axial alignment are affected by age, sex, and ethical issues, we tried to scrutinize these parameters in Iranian adults and compare them with normal values in literatures. Through a cross-sectional design, standing axial alignment views of lower extremities were surveyed from 100 volunteers (50 males and 50 females aged between 15-32 years. The lower extremities alignment variables were evaluated during two separate measurements. Total average values were used for comparison among genders. Tibiofemoral mechanical angle depicted mean varus of 1.5 degrees in an Iranian population that was significantly higher in male participants. The Mean angle between anatomical and mechanical axes of the femur was 5.7 ± 1.2º. The Knee joint was shown to be medially inclined 3.6 ± 1.7º in men comparing 2 ± 2º of women with a significant difference. Joint line congruence angle was medially inclined in all of the study participants with a mean of 1 ± 1.6º. To compare with anthropometric studies of western populations, Iranian participants had more varus lower limb alignment. It seemed mainly because of larger medially inclined knee joint (knee-joint obliquity. This finding along with more compensatory ankle valgus is similar to results of other Asian studies. Such racial variation should be considered in designing appropriate systems in reconstructive surgery.

  16. Treatment of lower extremity arterial occlusive through retrograde access

    International Nuclear Information System (INIS)

    Objective: To explore the clinical significance of retrograde access for the interventional treatment of lower extremity arterial occlusive diseases when the occluded segment of lower extremity artery could not be reached through antegrade access. Methods: Twenty-seven cases (male 17, female 10; age range 32-89 years) were retrospectively investigated, including 18 with lower limb arteriosclerosis obliterans, 7 with diabetic foot and 2 with thromboangiitis obliterans. According to the Fontaine staging, 6 cases were classified as Fontaine Ⅱ, 11 were classified as Fontaine Ⅲ and 10 were classified as Fontaine Ⅳ. All cases underwent endovascular operation through antegrade access first with an attempt to cross the occlusive segment, but in vain. So retrograde access was tried via puncture of pedis dorsalis or posterior tibial artery or exposure of lateral branches of posterior tibial artery, peroneal artery or dorsal artery by open surgery,which followed by Percutaneous transluminal angiography and (or) stenting. Results: The operation through retrograde access was successful in all cases with obvious improvement of ischemic symptoms. Hematoma at the puncture site occurred in 3 patients, and paresthesia of toes occurred in 1 after dorsalis pedis arteriotomy. No severe perioperative complication occurred. The average ankle brachial index increased from 0.37 ± 0.11 preoperatively to 0.85 ± 0.12 postoperatively. Conclusions: Retrograde access could be used as an alternative strategy in lower extremity arterial occlusive diseases when the occluded segment could not reach through antegrade access. (authors)

  17. Reconstruction of the Lower Extremity Using Free Flaps

    Directory of Open Access Journals (Sweden)

    Min Jo Kang

    2013-09-01

    Full Text Available Background The aim of lower-extremity reconstruction has focused on wound coverage andfunctional recovery. However, there are limitations in the use of a local flap in cases of extensivedefects of the lower-extremities. Therefore, free flap is a useful option in lower-extremityreconstruction.Methods We performed a retrospective review of 49 patients (52 cases who underwentlower-extremity reconstruction at our institution during a 10-year period. In these patients,we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis,survival rate, and complications.Results There were 42 men and 10 women with a mean age of 32.7 years (range, 3-72years. The sites of defects included the dorsum of the foot (19, pretibial area (17, ankle(7, heel (5 and other sites (4. The types of free flap included latissimus dorsi muscle flap(10, scapular fascial flap (6, anterolateral thigh flap (6, and other flaps (30. There werefour cases of vascular complications, out of which two flaps survived after intervention. Theoverall survival of the flaps was 96.2% (50/52. There were 19 cases of other complications atrecipient sites such as partial graft loss (8, partial flap necrosis (6 and infection (5. However,these complications were not notable and were resolved with skin grafts.Conclusions The free flap is an effective method of lower-extremity reconstruction. Goodoutcomes can be achieved with complete debridement and the selection of appropriaterecipient vessels and flaps according to the recipient site.

  18. Combined Lymphedema and Capillary Malformation of the Lower Extremity

    OpenAIRE

    Maclellan, Reid A.; Chaudry, Gulraiz; Greene, Arin K.

    2016-01-01

    Background: Primary lymphedema and capillary malformation are independent vascular malformations that can cause overgrowth of the lower extremity. We report a series of patients who had both types of malformations affecting the same leg. The condition is unique but may be confused with other types of vascular malformation overgrowth conditions (eg, Klippel–Trenaunay and Parkes Weber). Methods: Our Vascular Anomalies Center and Lymphedema Program databases were searched for patients with both ...

  19. MR imaging of peripheral nerve tumors of the lower extremity

    International Nuclear Information System (INIS)

    Objective: To evaluate MR imaging of peripheral nerve tumors of the lower extremity. Methods: MR imaging of peripheral nerve tumors of the lower extremity in five cases proved by surgery and pathology were retrospectively reviewed. In all patients, routine scanning was performed in axial, coronal, and sagittal planes, including T1-weighted and T2 -weighted images. In two patients (schwannomas), T1WI were obtained following intravenous injection of Gd-DTPA. Results: There were four schwannomas (three benign and one malignant) and one malignant neurofibroma. Tumors arose at the following sites: leg (n=2), popliteal region (n=1), thigh (n=1), and femoral region (n=1). On T1WI, tumors generally showed isointensity (two benign schwannomas) or lower-medium signal intensity to adjacent muscle with minimal inhomogeneity (one benign schwannoma, one malignant schwannoma, and one malignant neurofibroma). On T2WI, tumors demonstrated inhomogeneous high signal intensity in all five patients. The target sign with peripheral hyperintense rim and central low intensity was see in two benign schwannomas on T2WI. Conclusion: MRI is useful in defining the location and extent of a lesion and in assisting the surgical planning. The target pattern appears to be a useful sign in the diagnosis of peripheral nerve tumors

  20. Influence of gravitational therapy on reparative osteogenesis in patients with osteomyelitis of lower extremities

    OpenAIRE

    Kotelnikov G.P.; Sonis A.G.

    2010-01-01

    The article provides a comparative analysis of reparative osteogenesis in 105 patients with diffuse osteomyelitis of lower extremities, covering bone in diameter totally or subtotally. In complex treatment 51 patients have experienced gravitational therapy (study group), 54 patients have been treated by standard methods (control group). The study was conducted in clinics of Samara State Medical University. Gravitational therapy is a new noninvasive method of physiotherapy, first used in the t...

  1. CRPS of the upper or lower extremity: surgical treatment outcomes

    Directory of Open Access Journals (Sweden)

    Rosson Gedge D

    2009-02-01

    Full Text Available Abstract The hypothesis is explored that CRPS I (the "new" RSD persists due to undiagnosed injured joint afferents, and/or cutaneous neuromas, and/or nerve compressions, and is, therefore, a misdiagnosed form of CRPS II (the "new" causalgia. An IRB-approved, retrospective chart review on a series of 100 consecutive patients with "RSD" identified 40 upper and 30 lower extremity patients for surgery based upon their history, physical examination, neurosensory testing, and nerve blocks. Based upon decreased pain medication usage and recovery of function, outcome in the upper extremity, at a mean of 27.9 months follow-up (range of 9 to 81 months, gave results that were excellent in 40% (16 of 40 patients, good in 40% (16 of 40 patients and failure 20% (8 of 40 patients. In the lower extremity, at a mean of 23.0 months follow-up (range of 9 to 69 months the results were excellent in 47% (14 of 30 patients, good in 33% (10 of 30 patients and failure 20% (6 of 30 patients. It is concluded that most patients referred with a diagnosis of CRPS I have continuing pain input from injured joint or cutaneous afferents, and/or nerve compressions, and, therefore, similar to a patient with CRPS II, they can be treated successfully with an appropriate peripheral nerve surgical strategy.

  2. MR imaging findings of fatigue fractures of lower extremity in young soldiers

    International Nuclear Information System (INIS)

    To evaluate the MR imaging findings of fatigue fractures of the lower extremity in young soldiers. In 22 cases of fatigue fractures of the lower extremity in young soldiers proven by clinical findings and radiological follow up, the MRI findings were retrospectively evalvated. All patients were male and aged between 19 and 21 years. As seen on MRI, the bone marrow edema, intramedullary low signal intensity band, cortical fracture line, periosteal reaction, surrounding soft tissue edema, and enhancement pattern were analyzed and the site of involvement was determined in the axial plane. The locations of fatigue fractures of the lower extremity were the tibia (n=12), fibula (n=8), femur (n=1) and second metatarsus (n=1). All occurred in diaphyses: the junction of the proximal and middle (n=10), middle (n=9), proximal (n=2), and distal shaft (n=1). The sites of involvement were the posteromedial (n=6) and medial side (n=6) of the tibia, and the entire portion of the fibula(n=5) in the axial plane. MRI findings were bone marrow edema in 20 cases, intramedullary low signal intensity band in 14 (which were continuous with the cortex or cortical fracture line), cortical fracture line in 13, and periosteal reaction and surrounding soft tissue edema in all. On gadolinium-enhanced images, enhancement was seen in the bone marrow in 19 cases, in the subperiosteal region in 18, and in the surrounding soft tissue in 22. In fatigue fractures of the lower extremity in young soldiers, the main locations were the tibia and fibula, and characteristic MR imaging findings were intramedullary low signal intensity bands, which were continuous with the cortex or cortical fracture line and often accompanied by bone marrow edema, periosteal reaction, and surrounding soft tissue edema

  3. MR imaging findings of fatigue fractures of lower extremity in young soldiers

    Energy Technology Data Exchange (ETDEWEB)

    Mo, Jong Hyun; Moon, Sung Hee; Kim, Young Bok; Park, Yang Hee [National Police Hospital, Seoul (Korea, Republic of); Park, Jin Kyoon [Chonnam National Medical School, Kwangju (Korea, Republic of)

    1999-04-01

    To evaluate the MR imaging findings of fatigue fractures of the lower extremity in young soldiers. In 22 cases of fatigue fractures of the lower extremity in young soldiers proven by clinical findings and radiological follow up, the MRI findings were retrospectively evalvated. All patients were male and aged between 19 and 21 years. As seen on MRI, the bone marrow edema, intramedullary low signal intensity band, cortical fracture line, periosteal reaction, surrounding soft tissue edema, and enhancement pattern were analyzed and the site of involvement was determined in the axial plane. The locations of fatigue fractures of the lower extremity were the tibia (n=12), fibula (n=8), femur (n=1) and second metatarsus (n=1). All occurred in diaphyses: the junction of the proximal and middle (n=10), middle (n=9), proximal (n=2), and distal shaft (n=1). The sites of involvement were the posteromedial (n=6) and medial side (n=6) of the tibia, and the entire portion of the fibula(n=5) in the axial plane. MRI findings were bone marrow edema in 20 cases, intramedullary low signal intensity band in 14 (which were continuous with the cortex or cortical fracture line), cortical fracture line in 13, and periosteal reaction and surrounding soft tissue edema in all. On gadolinium-enhanced images, enhancement was seen in the bone marrow in 19 cases, in the subperiosteal region in 18, and in the surrounding soft tissue in 22. In fatigue fractures of the lower extremity in young soldiers, the main locations were the tibia and fibula, and characteristic MR imaging findings were intramedullary low signal intensity bands, which were continuous with the cortex or cortical fracture line and often accompanied by bone marrow edema, periosteal reaction, and surrounding soft tissue edema.

  4. Dermatologic Concerns of the Lower Extremity in the Pediatric Patient.

    Science.gov (United States)

    Vlahovic, Tracey C

    2016-07-01

    As the largest organ in the body, skin can prove the most daunting to diagnose and manage due to the large number of conditions and their uncanny ability to have similar qualities visually. Skin can reflect current trauma or infections or can be a harbinger of an underlying systemic disorder. With knowledge of the most common pediatric skin conditions, it is possible for practitioners to start a child on a basic treatment regimen and then refer to an appropriate specialist for more complex or rare disorders. This article covers the most common skin conditions seen on the lower extremity in the pediatric population. PMID:27215157

  5. Clinicopathological features and treatment of extremity bone metastasis in patients with endometrial carcinoma: a case report and review

    Institute of Scientific and Technical Information of China (English)

    JIANG Guo-qing; GAO Yu-nong; GAO Min; ZHENG Hong; YAN Xin; WANG Wen; AN Na; CAO Kun

    2011-01-01

    Unlike other non-gynecologic solid tumors, such as breast cancer, lung cancer, metastasis to bone from endometrial carcinoma is rare, metastasis to extremity is extremely rare. We report a 51-year-old multiparous woman with FIGO Stage IVb Grade 2 endometrial adenocarcinoma which metastasized to left lower extremity bone. She received an amputation of left lower extremity below the knees, and a total abdominal hysterectomy and bilateral salpingo-oophorectomy, and followed by systemic chemotherapy, radiation therapy to the pelvis and progestational agent. She had a complete response to above treatments, and disease-free survival for 10 months. After recurrence, she received chemotherapy, radiotherapy and progestational agent once again. She had lived 56 months and is still alive by the time of report. Metastasis of endometrial carcinoma to extremity bone can rarely occur and should be considered when the patient with endometrial carcinoma complained of unexplained pain and swelling associated with extremity bone.

  6. Wound size measurement of lower extremity ulcers using segmentation algorithms

    Science.gov (United States)

    Dadkhah, Arash; Pang, Xing; Solis, Elizabeth; Fang, Ruogu; Godavarty, Anuradha

    2016-03-01

    Lower extremity ulcers are one of the most common complications that not only affect many people around the world but also have huge impact on economy since a large amount of resources are spent for treatment and prevention of the diseases. Clinical studies have shown that reduction in the wound size of 40% within 4 weeks is an acceptable progress in the healing process. Quantification of the wound size plays a crucial role in assessing the extent of healing and determining the treatment process. To date, wound healing is visually inspected and the wound size is measured from surface images. The extent of wound healing internally may vary from the surface. A near-infrared (NIR) optical imaging approach has been developed for non-contact imaging of wounds internally and differentiating healing from non-healing wounds. Herein, quantitative wound size measurements from NIR and white light images are estimated using a graph cuts and region growing image segmentation algorithms. The extent of the wound healing from NIR imaging of lower extremity ulcers in diabetic subjects are quantified and compared across NIR and white light images. NIR imaging and wound size measurements can play a significant role in potentially predicting the extent of internal healing, thus allowing better treatment plans when implemented for periodic imaging in future.

  7. [Ligament ruptures of the lower extremity in the elderly].

    Science.gov (United States)

    Herbort, M; Raschke, M J

    2011-08-01

    There is an increasing incidence of ligament ruptures of the lower extremities in older patients. This higher incidence is caused by the typical current demographic changes in the population and the higher level of activity and athletic motivation of the older people in our society. In this review we address the most important ligament ruptures of the lower extremity in the old patient. Quadriceps tendon and Achilles tendon ruptures are mostly the result of degenerative and abrasion changes. The ACL rupture on the other hand occurs spontaneously after adequate trauma and without former degenerative changes especially in highly active patients. For a differentiated treatment of the older patient with tendon ruptures, secondary diseases, an increased risk and complication profile and a potentially decreased compliance during rehabilitation must be taken into consideration before indicating operative or conservative therapy. There are no strict age-related limitations for indication of an operative treatment of tendon ruptures in the older patient. In this patient group a differentiated treatment decision is recommended. PMID:21766204

  8. The treatment of venous ulcers of the lower extremities

    OpenAIRE

    Whiddon, Lonnie L.

    2007-01-01

    Venous hypertension from failure of proper venous valve function in the veins of thelower extremities causes changes over time in the microcirculation of the skin of the distal extremity. These changes set the stage for the development of a chronic nonhealing ulceration, which typically occurs at the ankle. The mainstay of treatment has been conservative, with compression dressings and elevation of the extremity. However, results have been less than satisfactory because of delay in healing an...

  9. Robot-aided assessment of lower extremity functions: a review.

    Science.gov (United States)

    Maggioni, Serena; Melendez-Calderon, Alejandro; van Asseldonk, Edwin; Klamroth-Marganska, Verena; Lünenburger, Lars; Riener, Robert; van der Kooij, Herman

    2016-01-01

    The assessment of sensorimotor functions is extremely important to understand the health status of a patient and its change over time. Assessments are necessary to plan and adjust the therapy in order to maximize the chances of individual recovery. Nowadays, however, assessments are seldom used in clinical practice due to administrative constraints or to inadequate validity, reliability and responsiveness. In clinical trials, more sensitive and reliable measurement scales could unmask changes in physiological variables that would not be visible with existing clinical scores.In the last decades robotic devices have become available for neurorehabilitation training in clinical centers. Besides training, robotic devices can overcome some of the limitations in traditional clinical assessments by providing more objective, sensitive, reliable and time-efficient measurements. However, it is necessary to understand the clinical needs to be able to develop novel robot-aided assessment methods that can be integrated in clinical practice.This paper aims at providing researchers and developers in the field of robotic neurorehabilitation with a comprehensive review of assessment methods for the lower extremities. Among the ICF domains, we included those related to lower extremities sensorimotor functions and walking; for each chapter we present and discuss existing assessments used in routine clinical practice and contrast those to state-of-the-art instrumented and robot-aided technologies. Based on the shortcomings of current assessments, on the identified clinical needs and on the opportunities offered by robotic devices, we propose future directions for research in rehabilitation robotics. The review and recommendations provided in this paper aim to guide the design of the next generation of robot-aided functional assessments, their validation and their translation to clinical practice. PMID:27485106

  10. [Amputation and prosthesis attachment of the lower extremities].

    Science.gov (United States)

    Matthes, I; Beirau, M; Ekkernkamp, A; Matthes, G

    2015-06-01

    Approximately 61,000 amputations are performed in Germany per year. In most cases the lower limbs are affected. The reasons for amputations are arteriosclerosis, diabetes mellitus, severe infections, tumors and complex trauma to the extremities. A decision must be made concerning whether a salvage procedure or amputation is appropriate, specially after trauma. In cases where the need for amputation is clear, the site of amputation needs to be planned in advance with the aim of creating a stump which allows sufficient prosthetic attachment. Adjuvant pain therapy is mandatory, especially in order to avoid subsequent phantom pain. The type of prosthetic restoration is influenced by the grade of mobility and personal requirements of patients. Moreover, aftercare and adjusted rehabilitation are recommended. PMID:26013390

  11. Detection of rheumatoid arthritis bone erosions by two different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer-Jensen, A.; Vestergaard, A.; Dohn, U.M.;

    2008-01-01

    Objectives: To compare the ability of two different dedicated extremity MRI (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints. Methods: CR and two MRI examinations (using 0.2 T Esaote Artoscan and 0...... 15.8% of large erosions in wrists. Conclusions: Both E-MRI units detected more erosions than CR, in particular due to a higher sensitivity in metacarpal heads and carpal bones. The MagneVu unit detected fewer erosions than the Artoscan unit due to a lower average image quality and a smaller.......2 T portable MagneVu MV1000 units) of 418 bones in the dominant wrist and second to fifth MCP joints of 15 patients with RA and 4 healthy controls were performed and evaluated blindly for bones being visible and for erosions. Results: In MCP joints, MagneVu visualised 18.5% of bones entirely and 71...

  12. Assessment and management of the lower extremity in myelodysplasia.

    Science.gov (United States)

    Carroll, N C

    1987-10-01

    The goal in managing the lower extremity in a child with spina bifida is to achieve a pattern of development as near normal as possible. Lower limb deformities are produced by muscle imbalance, weight-bearing, and the postural effects of gravity. At any point in time, the management of the lower extremities will depend on the child's general development. Lower limb paralysis, hydrocephalus, bladder infections, hydromyelia, and Arnold Chiari malformation, all contribute to developmental delay. A child's potential for mobility varies with the severity of the motor and sensory deficit. Surgery is done to correct deformity, provide joint stability, and improve joint mobility. The results of surgery will be compromised if the child is not neurologically stable, or if appropriate therapy and orthotic care are not available. Muscle imbalance produces the problem of deformity and instability of the hip. Deformity must be corrected if the child is to assume an upright posture. Instability is of concern only in those children with a strong quadriceps muscle. Hip surgery for instability should be limited to one procedure, which must achieve a stable concentric reduction and balance the muscle forces about the hip. The common deformities seen at the knee are recurvatum, knee flexion contractures, and genu valgum. Most knee deformities can be corrected by soft tissue procedures. Well-designed orthoses rocker sole shoes, and appropriate gait training help prevent knee deformities. The goal in managing foot deformities is to achieve a plantigrade foot with stable skin. Whenever there is a problem with sensation, concentrated pressure in one area of a deformed foot will lead to skin breakdown. Surgical procedures must completely correct deformity and restore muscle imbalance. After surgery, meticulous orthotic care is required to prevent skin breakdown and avoid loss of correction. The orthopedist has a significant role in helping a child with spina bifida to achieve a pattern of

  13. CT measurements of torsion and length in the lower extremities

    International Nuclear Information System (INIS)

    Complex corrective osteotomies in the lower extremities require precise preoperative planning. Fifty patients who had suffered fractures of the lower limbs and had been treated by osteosynthetic or conservative methods were studied, using a GE 9800 Quick CT; accurate and reproducible measurements of the angles of torsion of the femur and tibia were obtained. Digital images were produced to standardise the planes of measurement and to measure the length of the limb. The most important clinical measurement is the intra-individual difference of the torsional angles. Amongst normals this is 4.3 ± 2.3deg in the femur and 6.1 ± 4.5deg in the tibia. Radiation exposure was measured by a LiF-thermoluminescence dosimeter on an Alderson phantom. Skin dose was 6.3 ± 1.2 mGy and gonadal dose for females was 2.5 ± 0.3 mGy and for males 0.7 ± 0.1 mGy. (orig./GDG)

  14. Lower Extremity Radiography

    Science.gov (United States)

    ... images of the toes, feet, ankles, lower leg, knee, upper leg or hip. These types of examinations are performed to detect conditions such as fractures, soft tissue damage and arthritis. A physician will ...

  15. Assessment of dynamic balance via measurement of lower extremities tortuosity.

    Science.gov (United States)

    Eltoukhy, Moataz; Kuenze, Christopher; Jun, Hyung-Pil; Asfour, Shihab; Travascio, Francesco

    2015-03-01

    Tortuosity describes how twisted or how much curvature is present in an observed movement or path. The purpose of this study was to investigate the differences in segmental tortuosity between Star Excursion Balance Test (SEBT) reach directions. Fifteen healthy participants completed this study. Participants completed the modified three direction (anterior, posteromedial, posterolateral) SEBT with three-dimensional motion analysis using an 8 camera BTS Smart 7000DX motion analysis system. The tortuosity of stance limb retro-reflective markers was then calculated and compared between reach directions using a 1 × 3 ANOVA with repeated measures, while the relationship between SEBT performance and tortuosity was established using Pearson product moment correlations. Anterior superior iliac spine tortuosity was significantly greater (p < 0.001) and lateral knee tortuosity was lesser (p = 0.018) in the anterior direction compared to the posteromedial and posterolateral directions. In addition, second metatarsal tortuosity was greater in the anterior reach direction when compared to posteromedial direction (p = 0.024). Tortuosity is a novel biomechanical measurement technique that provides an assessment of segmental movement during common dynamic tasks such as the SEBT. This enhanced level of detail compared to more global measures of joint kinematic may provide insight into compensatory movement strategies adopted following lower extremity joint injury. PMID:25895607

  16. Treatment algorithms for high-energy traumas of lower extremities

    Directory of Open Access Journals (Sweden)

    Jovanović Mladen

    2002-01-01

    Full Text Available Introduction High-energy traumas are open or closed injuries caused by force (missile, traffic injuries, crush or blust injuries, falling from heights, affecting the body surface and transferring high amount of kinetic energy inducing great damage to the tissue. Management of such lower extremity injuries has evolved over past several decades, but still remains a difficult task for every surgical team. Specific anatomic and functional characteristics combined with extensive injuries demands specific treatment protocols. Multiple injuries In a multiple injured patient the first priority is management of life-threatening trauma. Despite other injuries, surgical treatment of limb-threatening injuries must start as soon as life-threatening condition has been managed. Treatment algorithms Algorithms are especially beneficial in management of severely injured, but salvageable extremities and in making decision on amputation. Insight into mechanisms of injury, as well as systematic examination of the affected limb, should help us understand the extensiveness of trauma and make an adequate management plan. Prevention of infection and surgical approach Prevention of wound infection and surgical approach to high- energy limb trauma, which includes wound extension, wound excision, skeletal stabilization and if necessary muscle compartment release, should be done in the first 6 hours after injury. Methods of soft tissue reconstruction Commonly used methods for soft tissue defects must provide wound coverage in less than five days following injury. Rehabilitation Early passive and active mobilization and verticalization of patients is very important for successful treatment. Conclusion Good and timely evaluation of the injured and collaboration between plastic and orthopedic surgeons from the beginning of treatment, are crucial for final outcome.

  17. Tissue mass ratios and the reporting of distal lower extremity injuries in varsity athletes at a Canadian University.

    Science.gov (United States)

    Burkhart, Timothy A; Schinkel-Ivy, Alison; Andrews, David M

    2013-01-01

    The purpose of this preliminary investigation was to determine the relative role of the distal lower extremity tissue masses of varsity athletes in predicting distal lower extremity injury sustained during a competitive season. One hundred male and female varsity athletes (basketball, volleyball, soccer, cross country) completed a questionnaire on general health, physiological, and psychosocial variables, during each sport's respective training camp. A series of anthropometric measurements were used as inputs to distal lower extremity tissue mass prediction equations to calculate lean mass, fat mass, bone mineral content and wobbling mass (lean mass + fat mass) and tissue mass ratios. Athletes were monitored throughout their respective seasons and were instructed to report any distal lower extremity injuries to a certified athletic therapist who was responsible for assessing and confirming the reports. Logistic regression analyses were performed to determine which variables significantly predicted distal lower extremity injury. Mean leg fat mass:bone mass (OR = 1.6, CI = 1.0 - 2.5), and competition surface (rubber OR = 8.5, CI = 1.5 - 47.7; artificial turf OR = 4.0, CI = 0.77 - 22.9) were identified as significant predictors of injury. Overall, tibia bone injuries were significantly associated with the ratio of fat mass:bone mineral content and the surface on which the athletes compete. PMID:23215824

  18. Epidemiological characteristics of lower extremity cellulitis after a typhoon flood.

    Directory of Open Access Journals (Sweden)

    Pei-Chen Lin

    Full Text Available OBJECTIVE: The flood after a typhoon may lead to increase in patients with cellulitis of lower limbs. However, the microbiological features of these cases are rarely reported. We conducted a study of patients with lower extremity cellulitis after a typhoon followed in southern Taiwan to study the risk factors of cellulitis and the bacteriological features of the patients. METHODS: We reviewed all the medical records of cellulitis at emergency departments of two teaching hospitals in southern Taiwan 30 days before and after the landing of Typhoon Morakot and collected data on the demographic and bacteriological characteristics. In addition, we evaluated the relationship between the daily number of patients and the rainfall in the Tainan area. RESULTS: The number of cellulitis patients increased from 183 to 344 during the 30-day period after the typhoon. The number peaked in the third and fourth days and lasted for 3 weeks. The proportion of patients with water immersion of the affected limb was higher after the typhoon (6% vs. 37%, odds ratio [OR]: 9.0, 95% Confidence interval [CI]: 4.7-17.2. We found cultures from the infected limbs with immersion had more polymicrobial (73% vs. 26%, OR: 7.8, 95% CI: 3.2-19.2 and Gram-negative bacilli infection (86% vs. 34%, OR: 11.8, 95% CI: 4.1-34.5. CONCLUSIONS: Flood arose from Typhoon Morakot caused increases in cellulitis patients, which lasted for 3 weeks. Antibiotic treatment that were effective to both Gram-positive cocci and Gram-negative bacilli are recommended for patients with limbs emerged in the water.

  19. Recent developments and challenges of lower extremity exoskeletons

    Directory of Open Access Journals (Sweden)

    Bing Chen

    2016-04-01

    Full Text Available The number of people with a mobility disorder caused by stroke, spinal cord injury, or other related diseases is increasing rapidly. To improve the quality of life of these people, devices that can assist them to regain the ability to walk are of great demand. Robotic devices that can release the burden of therapists and provide effective and repetitive gait training have been widely studied recently. By contrast, devices that can augment the physical abilities of able-bodied humans to enhance their performances in industrial and military work are needed as well. In the past decade, robotic assistive devices such as exoskeletons have undergone enormous progress, and some products have recently been commercialized. Exoskeletons are wearable robotic systems that integrate human intelligence and robot power. This paper first introduces the general concept of exoskeletons and reviews several typical lower extremity exoskeletons (LEEs in three main applications (i.e. gait rehabilitation, human locomotion assistance, and human strength augmentation, and provides a systemic review on the acquisition of a wearer's motion intention and control strategies for LEEs. The limitations of the currently developed LEEs and future research and development directions of LEEs for wider applications are discussed.

  20. The diagnostic value of indirect lower limb CT venography in the lower extremity deep venous thrombosis

    International Nuclear Information System (INIS)

    Objective: To evaluate indirect CT venography (CTV) in the diagnosis of deep venous thrombosis (DVT). Methods: A total of 516 acute pulmonary embolism patients proved by objective test were analyzed retrospectively. Using the results of lower limb compression sonography as reference standard, the sensitivity, specificity, positive predictive value and negative predictive value of indirect CTV were calculated. The agreement between lower extremity venous sonography and indirect CTV were assessed by Kappa analysis. Results: Among 516 patients with acute pulmonary thromboembolism (PTE), 110 patients underwent both CTV and CTPA and lower extremity sonography. DVT were detected by CTV and sonography simultaneously in 48 patients, while no DVT was detected in 39 patients by both examinations. Thirteen patients were diagnosed to have DVT by CTV without sonography detection, and DVT was detected in other 10 patients only by sonography. The sensitivity, specificity, positive predictive value and negative predictive value of indirect CTV was 82.8% (48/58), 75.0% (39/52), 78.7% (48/61) and 79.6% (39/49). The agreement between lower extremity venous sonography and indirect CTV was good for femoropopliteal vein (Kappa value range from 0.874 to 0.914, P=0.000). Thrombi detected by CTV were 62 and 52 respectively, and for sonography were 67 and 51 respectively. For calf veins, the agreement decreased (Kappa value range from 0.464 to 0.584, P=0.000). Thrombi detected by CTV were 6, 25 and 13 respectively, and for sonography were 13, 38 and 19 respectively. The agreement for external iliac vein was poor (Kappa value range from 0.230 to 0.262, P=0.067 and 0.004, respectively). Thrombi detected by CTV were 33, and for sonography were 17. Conclusions: The indirect CTV has high accuracy in the diagnosis of DVT. Combined CTPA and CTV can image pulmonary arteries and lower extremity veins in one examination. Indirect CTV can reveal thrombus in large pelvic veins, which has an advantage

  1. High-resolution Sonographic Measurements of Lower Extremity Bursae in Chinese Healthy Young Men

    Directory of Open Access Journals (Sweden)

    Yong-Yan Gao

    2016-01-01

    Conclusions: Using HR-US imaging, we were able to analyze lower extremity bursae with high detection rates in healthy young men. The normal ranges of lower extremity bursa dimensions in healthy young men measured by HR-US in this study could be used as reference values for evaluation of bursa abnormalities in the lower extremity.

  2. Early detection of asymptomatic carotid disease in patients with arteriosclerotic occlusive disease of the lower extremities

    Directory of Open Access Journals (Sweden)

    Rančić Zoran S.

    2002-01-01

    Full Text Available Prevalence of asymptomatic carotid artery stenosis in patients with lower extremities atherosclerosis is relatively high. Limiting screening of specific subgroups for any demographic or medical characteristics is ineffective. Screening for asymptomatic carotid artery stenosis is indicated in all patients with lower extremities atherosclerosis except in whom prophylactic carotid endarterectomy is not recommended because of comorbid disease or extreme age.

  3. Hemolymphangioma of the lower extremities in children: two case reports

    Directory of Open Access Journals (Sweden)

    Kosmidis Ilias

    2010-08-01

    Full Text Available Abstract Background and purpose Hemo-lymphangiomas are rare benign tumors that arise from congenital malformation of the vascular system. They are usually diagnosed at birth or early in childhood. The management of hemo-lymphangiomas in children remains challenging because complete resection is often difficult to be achieved and recurrences are common. Methods We present the case of two children with a mass on their left tibia. Imaging modalities, plain radiograph, Ultrasonography and Magnetic Resonance were used to investigate the nature of the mass, the anatomical relationship to the neighboring tissues and help planning the surgical resection. The dominant diagnosis was hemo-lymphangioma. Both lesions increased in size in a short period of follow-up thus we decided to proceed to surgical excision. The diagnosis of hemo-lymphangioma was confirmed by histological examination of the surgical specimen. Post-operatively, seroma was formed to the first patient, managed by placing a drainage and immobilizing the limb on a splint. The second patient experienced no complications post-operatively. After 12 months of follow-up both patients had no complications or recurrence. Conclusions Very few cases of hemo-lymphangiomas of the extremities have been reported in the literature. Those tumors can grow slowly and remain asymptomatic for a long period of time or may become aggressive and enlarge rapidly, without invasive ability though. Radical resection is the choice of treatment offering the lowest recurrence rates. Other therapeutic methods are: aspiration and drainage, cryotherapy, injection of sclerotic agents and radiotherapy; although none of those offers better results that the surgical excision.

  4. Penetrating injury of the lungs and multiple injuries of lower extremities caused by aircraft bombs splinters

    Directory of Open Access Journals (Sweden)

    Golubović Zoran

    2010-01-01

    Full Text Available Introduction. Injuries caused by aircraft bombs cause severe damages to the human body. They are characterized by massive destruction of injured tissues and organs, primary contamination by polymorph bacterial flora and modified reactivity of the body. Upon being wounded by aircraft bombs projectiles a victim simultaneously sustains severe damages of many organs and organ systems due to the fact that a large number of projectiles at the same time injure the chest, stomach, head and extremities. Case report. We presented a patient, 41 years of age, injured by aircraft bomb with hemo-pneumothorax and destruction of the bone and soft tissue structures of the foot, as well as the treatment result of such heavy injuries. After receiving thoracocentesis and short reanimation, the patient underwent surgical procedure. The team performed thoracotomy, primary treatment of the wound and atypical resection of the left lung. Thoracic drains were placed. The wounds on the lower leg and feet were treated primarily. Due to massive destruction of bone tissue of the right foot by cluster bomb splinters, and impossibility of reconstruction of the foot, guillotine amputation of the right lower leg was performed. Twelve days after the wounding caused by cluster bomb splinters, soft tissue of the left lower leg was covered by Tirsch free transplantant and the defect in the area of the left foot was covered by dorsalis pedis flap. The transplant and flap were accepted and the donor sites were epithelized. Twenty-six days following the wounding reamputation was performed and amputation stump of the right lower leg was closed. The patient was given a lower leg prosthesis with which he could move. Conclusion. Upon being wounded by aircraft bomb splinters, the injured person sustains severe wounds of multiple organs and organ systems due to simultaneous injuries caused by a large number of projectiles. It is necessary to take care of the vital organs first because they

  5. Radicular lower extremity pain as the first symptom of primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Mustonen, Antti O.T.; Kiuru, Martti J.; Koskinen, Seppo K. [Toolo Trauma Center, Helsinki University Central Hospital, Topeliuksenkatu 5, 00029, Helsinki (Finland); Stahls, Anders; Bohling, Tom [Department of Pathology, Haartman Institute, University of Helsinki, 00014, Helsinki (Finland); Kivioja, Aarne [Department of Orthopedics and Traumatology, Helsinki University Central Hospital, 00029, Helsinki (Finland)

    2004-08-01

    Clinical symptoms of hyperparathyroidism are generally nausea, vomiting, fatigue, constipation, and hypotonicity of the muscles and ligaments; bone pain and tenderness are also seen but are more common in secondary hyperparathyroidism. We report a histologically confirmed case of a 28-year-old man whose sole symptom of primary hyperparathyroidism was lower extremity radicular pain due to a vertebral brown tumor. Magnetic resonance imaging demonstrated brown tumor to be hyperintense on T2-weighted and slightly hypointense on T1-weighted sequences; it showed intense contrast enhancement with gadolinium. Because brown tumors usually contain hemosiderin a short T2 should have been expected, but this was not seen in our case. Healing resulted in decreasing contrast enhancement on T1-weighted sequences and increasingly short T2. To our knowledge, this is the first report of a lumbar vertebral brown tumor associated with primary hyperparathyroidism. (orig.)

  6. Radicular lower extremity pain as the first symptom of primary hyperparathyroidism

    International Nuclear Information System (INIS)

    Clinical symptoms of hyperparathyroidism are generally nausea, vomiting, fatigue, constipation, and hypotonicity of the muscles and ligaments; bone pain and tenderness are also seen but are more common in secondary hyperparathyroidism. We report a histologically confirmed case of a 28-year-old man whose sole symptom of primary hyperparathyroidism was lower extremity radicular pain due to a vertebral brown tumor. Magnetic resonance imaging demonstrated brown tumor to be hyperintense on T2-weighted and slightly hypointense on T1-weighted sequences; it showed intense contrast enhancement with gadolinium. Because brown tumors usually contain hemosiderin a short T2 should have been expected, but this was not seen in our case. Healing resulted in decreasing contrast enhancement on T1-weighted sequences and increasingly short T2. To our knowledge, this is the first report of a lumbar vertebral brown tumor associated with primary hyperparathyroidism. (orig.)

  7. Solid variant of aneurysmal bone cist on the distal extremity of the radius in a child.

    Science.gov (United States)

    Ferreira, Adriano Jander; de Almeida Leitão, Sebastião; Rocha, Murilo Antônio; Nascimento, Valdênia das Graças; Lima, Giovanni Bessa Pereira; de Meneses, Antonio Carlos Oliveira

    2016-01-01

    The solid variant of aneurismal bone cysts (ABC) is considered rare. It occurs with greater frequency in pediatric patients and in the tibia, femur, pelvis and humerus. We present a case of a metaphyseal lytic lesion on the distal extremity of the radius in a child whose radiograph was requested after low-energy trauma. The hypothesis of a pathological bone fracture secondary to an aneurysmal bone cyst was suggested. After biopsy, the child underwent intralesional excision without bone grafting and the histopathological findings were compatible with the solid variant of aneurysmal bone cyst. PMID:27274493

  8. Basal Cell Carcinoma Of The Lower Extremities - A Report Of Two Cases

    Directory of Open Access Journals (Sweden)

    Nada Ritambhra

    2001-01-01

    Full Text Available The most common malignancy of the skin is basal cell carcinoma (BCC, usually occurring in the head and neck. It can occur elsewhere as also in the lower extremity. We describe two patients with BCC in the lower extremities, which were nodular type and without any predisposing factors.

  9. Combined use of negative pressure wound therapy and Integra® to treat complex defects in lower extremities after burns

    OpenAIRE

    González Alaña, I.; J.V. Torrero López; Martín Playá, P.; F.J. Gabilondo Zubizarreta

    2013-01-01

    Deep and extensive burns of lower extremities present a difficult challenge to healthcare professionals. After debridement, bones, tendons or joints are frequently exposed and cannot be covered by simple autografts. Moreover, in the case of major burns, damage to the surrounding areas of skin and the severity of the patient’s overall condition, often count against using pedicled or microsurgical flaps. In dealing with such complex wounds, which are difficult to treat, several authors have rec...

  10. Functional adaptation of long bone extremities involves the localized ``tuning'' of the cortical bone composition; evidence from Raman spectroscopy

    Science.gov (United States)

    Buckley, Kevin; Kerns, Jemma G.; Birch, Helen L.; Gikas, Panagiotis D.; Parker, Anthony W.; Matousek, Pavel; Goodship, Allen E.

    2014-11-01

    In long bones, the functional adaptation of shape and structure occurs along the whole length of the organ. This study explores the hypothesis that adaptation of bone composition is also site-specific and that the mineral-to-collagen ratio of bone (and, thus, its mechanical properties) varies along the organ's length. Raman spectroscopy was used to map the chemical composition of long bones along their entire length in fine spatial resolution (1 mm), and then biochemical analysis was used to measure the mineral, collagen, water, and sulfated glycosaminoglycan content where site-specific differences were seen. The results show that the mineral-to-collagen ratio of the bone material in human tibiae varies by 10% toward the flared extremities of the bone. Comparisons with long bones from other large animals (horses, sheep, and deer) gave similar results with bone material composition changing across tens of centimeters. The composition of the bone apatite also varied with the phosphate-to-carbonate ratio decreasing toward the ends of the tibia. The data highlight the complexity of adaptive changes and raise interesting questions about the biochemical control mechanisms involved. In addition to their biological interest, the data provide timely information to researchers developing Raman spectroscopy as a noninvasive tool for measuring bone composition in vivo (particularly with regard to sampling and measurement protocol).

  11. Validation of the SF-6D Health State Utilities Measure in Lower Extremity Sarcoma

    OpenAIRE

    Gundle, Kenneth R.; Cizik, Amy M.; Punt, Stephanie E.W.; Conrad, Ernest U.; Davidson, Darin J.

    2014-01-01

    Aim. Health state utilities measures are preference-weighted patient-reported outcome (PRO) instruments that facilitate comparative effectiveness research. One such measure, the SF-6D, is generated from the Short Form 36 (SF-36). This report describes a psychometric evaluation of the SF-6D in a cross-sectional population of lower extremity sarcoma patients. Methods. Patients with lower extremity sarcoma from a prospective database who had completed the SF-36 and Toronto Extremity Salvage Scor...

  12. The Effects of Load Carriage and Muscle Fatigue on Lower-Extremity Joint Mechanics

    Science.gov (United States)

    Wang, He; Frame, Jeff; Ozimek, Elicia; Leib, Daniel; Dugan, Eric L.

    2013-01-01

    Military personnel are commonly afflicted by lower-extremity overuse injuries. Load carriage and muscular fatigue are major stressors during military basic training. Purpose: To examine effects of load carriage and muscular fatigue on lower-extremity joint mechanics during walking. Method: Eighteen men performed the following tasks: unloaded…

  13. Complex radionuclide diagnosis of lesions of lower extremities in patients with diabetes mellitus

    International Nuclear Information System (INIS)

    The authors worked out radionuclide technique for investigation of hemodynamics and the structure of lower extremities which included radionuclide angiography and scintigraphy. In patients with diabetes mellitus (DM) with stage II micro-macroangiopathy of the lower extremities, reduction of the blood velocity in the arterioles and capillaries of the feet was revealed. Slowing down the velocity of the blood flow in the large vessels, arterioles and capillaries was observed in DM with neuropathic ulcers. The most prominent disturbances of hemodynamics of the lower extremities were observed in DM with neuroischemic ulcers

  14. Bone Density Changes After Radiation for Extremity Sarcomas: Exploring the Etiology of Pathologic Fractures

    International Nuclear Information System (INIS)

    Purpose: The incidental irradiation (RT) of adjacent bone that takes place during treatment of soft tissue extremity sarcomas is generally presumed to 'weaken' the bone by decreasing its density, which subsequently increases the risk for pathologic fracture. This investigation intended to assess the relative effects on bone density of both RT and diminished mechanical loading secondary to tumor-induced and therapy-induced functional extremity impairment. Methods and Materials: 19 patients treated with surgical excision and RT for soft tissue extremity sarcomas had bone density measured using dual energy X-ray absorptiometry at four sites: the irradiated (A) and contralateral (B) bone, and an uninvolved bone (C) in the treated extremity and its contralateral counterpart (D). Analysis included (1) [A-B], (2) [C-D], (3) [(A-B), - (C-D)], and (4) [(A-B)/B - (C-D)/D]. Results: The mean bone density for all irradiated sites was increased 0.08 ± 0.22 g/cm2 (variance) compared to the contralateral unirradiated side when corrected for weight-bearing effects (3). An average increase in bone density of 9 ± 22% (p = 0.08) was also seen when the differences were divided by individual control densities to normalize variation in density of different anatomic sites (4). Conclusions: RT does not routinely decrease bone density when corrected for weight bearing or mechanical effects. The pathogenesis for the known increased risk of pathologic fracture in irradiated bones is likely multifactorial, including possible alterations in bone remodeling that can result in stable, or even increased, bone density. Further clinical and basic studies are needed to confirm our unexpected findings.

  15. [Phlebography in chronic venous insufficiency of the lower extremities. Technic and value of different tests].

    Science.gov (United States)

    Genevois, A; Bolot, J E; Michel, C

    1988-01-01

    Remainder of the various phlebographic procedures in chronic venous insufficiency of the lower extremities: peripheral phlebography, popliteal phlebography, femoral phlebography, varicography. The techniques and the informations they provide are presented for each one of these examinations. PMID:3043478

  16. Clinical Significance of Lymphoscintigraphy Findings in the Evaluation of Lower Extremity Lymphedema

    OpenAIRE

    Seyhan Karaçavuş; Yunus Keser Yılmaz; Hasan Ekim

    2015-01-01

    Objective: The purpose of this study was to investigate the clinical significance of lymphoscintigraphy imaging in the evaluation of lower extremity lymphedema. Methods: Technetium-99m-labeled nanocolloid was injected subcutaneously in the first web spaces of both feet of 123 patients (M/F: 43/80, mean age 57.5±13.1 years, range 16-78 years) who had clinical evidence of lower extremity swelling with suspicion of lymphedema, and were referred for routine lymphoscintigraphy. Lymphos...

  17. Body composition of the human lower extremity observed by computed tomography

    International Nuclear Information System (INIS)

    Using computed tomography image, the body composition on the lower extremity were observed in 24 adult human (10 male, 14 female). CT image were taken at proximal section (upper a third on thigh), distal section (lower a third on thigh) and leg section (upper a third on leg), and the quantities determind from the images included the area of total cross-section, muscle, subcutaneous fat, connective tissue and bone in the each cross-section. The ratios of the each components to total area were surveyed. The age related changes and the differences between the three body types, which were defined by Rohrer's index, were discussed in both sexes. The following results were obtained. 1. The ratio of the each component to total sectional area in the three section levels was the highest in the muscle following in order of subcutaneous fat, connective tissue and bone in man generally. On the other hand, in female, the subcutaneous fat was higher than the muscle in the proximal section by A and C body types, but the muscle was higher than the subcutaneous fat by D body type in this section and by all body types in distal and leg sections. 2. Concerning the correlationship between the ratios of the components in the section and Rohrer's index or ages, they were in positive relation on the ratios of the subcutaneous fat and the connective tissue, and were in negative relation on the ratio of the muscle in the femoral section by male. 3. Decreasing with age of muscular area were found at under 50 ages in extensor, at 50 age in adductor and at about 60 ages in flexor on the proximal section, and at 50 age in extensor, after 55 age in adductor and at about 60 age in flexor on the distal section in man respectively. On the leg section, the decreasing tendency with ages were predominant in flexor by man and were found after 50 age by female too. (author)

  18. Are levels of bone turnover related to lower bone mass of adolescents previously fed a macrobiotic diet?

    NARCIS (Netherlands)

    Parsons, T.J.; Dusseldorp, van M.; Seibel, M.J.; Staveren, van W.A.

    2001-01-01

    Dutch adolescents who consumed a macrobiotic (vegan-type) diet in early life, demonstrate a lower relative bone mass than their omnivorous counterparts. We investigated whether subjects from the macrobiotic group showed signs of catching up with controls in terms of relative bone mass, reflected by

  19. Recent developments and challenges of lower extremity exoskeletons

    OpenAIRE

    Bing Chen; Hao Ma; Lai-Yin Qin; Fei Gao; Kai-Ming Chan; Sheung-Wai Law; Ling Qin; Wei-Hsin Liao

    2016-01-01

    The number of people with a mobility disorder caused by stroke, spinal cord injury, or other related diseases is increasing rapidly. To improve the quality of life of these people, devices that can assist them to regain the ability to walk are of great demand. Robotic devices that can release the burden of therapists and provide effective and repetitive gait training have been widely studied recently. By contrast, devices that can augment the physical abilities of able-bodied humans to enhanc...

  20. Use of Innovative Technologies in Pediatric Lower Extremity Reconstruction

    Science.gov (United States)

    Mountziaris, Paschalia M.; Soteropulos, Carol E.; Rezak, Kristen M.

    2016-01-01

    Summary: The anterolateral thigh (ALT) free flap has proven to be a reliable option for the coverage of soft tissue defects in adults and more recently in the pediatric population. When considering the use of the ALT flap in the pediatric patient, there are few studies that detail techniques specific to pediatric free flap management. We present a unique case of a 14- × 8-cm ALT flap used for traumatic wound coverage in a distal tibial injury in a 6-year-old girl. This case highlights innovative techniques in pediatric perioperative free flap monitoring and the use of continuous external tissue expansion to achieve delayed primary closure of the donor site.

  1. Hemolymphangioma of the lower extremities in children: two case reports

    OpenAIRE

    Kosmidis Ilias; Vlachou Maria; Koutroufinis Anastasios; Filiopoulos Konstantinos

    2010-01-01

    Abstract Background and purpose Hemo-lymphangiomas are rare benign tumors that arise from congenital malformation of the vascular system. They are usually diagnosed at birth or early in childhood. The management of hemo-lymphangiomas in children remains challenging because complete resection is often difficult to be achieved and recurrences are common. Methods We present the case of two children with a mass on their left tibia. Imaging modalities, plain radiograph, Ultrasonography and Magneti...

  2. Guideline for interventional recanalizat ion of lower extremity artery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwn [Dept. of Radiology, Keimyung University College of Medicine, Daegu (Korea, Republic of); Bae, Jae Ik [Mint Radiologic Clinic, Seongnam (Korea, Republic of); Jeon, Yong Sun [Dept. of Radiology, Inha University College of Medicine, Incheon (Korea, Republic of); Kim, Chang Won [Dept. of Radiology, Pusan National University College of Medicine, Busan (Korea, Republic of); Jae, Hwan Jun [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Kwang Bo [Dept. of Radiology, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of); Jo, Young Kwon [Dept. of Radiology, Eulji University College of Medicine, Seoul (Korea, Republic of); Kim, Man Deuk [Dept. of Radiology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-11-15

    Peripheral arterial occlusive disease caused by atheroscleorsis can be presented with intermittent claudication or critical limb ischemia. The proper diagnosis and management is warranted to reduce symptoms and salvage the limbs. With the introduction of new technique and dedicated materials, endovascular recanalization has been widely performed for treatment of peripheral arterial occlusive disease because it is lesser invasive than surgery. However, there have been different opinions regarding the appropriate indications and procedure methods for interventional recanalization among operator and institution in Korea. Therefore, we intend to provide evidence based guidelines for interventional recanalization by multidisciplinary consensus. These guidelines are the result of a close collaboration between physicians from many different areas of expertise including interventional radiology, interventional cardiology, and vascular surgery. The goal of these guidelines is to ensure better treatment, to serve as a guide to the clinician, and consequently, to contribute for public health care.

  3. Development of HIFU Therapy System for Lower Extremity Varicose Veins

    International Nuclear Information System (INIS)

    High-intensity focused ultrasound (HIFU) treatment utilizing microbubbles was investigated in the present study. It is known that microbubbles have the potential to enhance the heating effects of an ultrasound field. In this study, the heat accompanying microbubble oscillation was used to occlude varicose veins. Alteration of veins was observed after ultrasound irradiation. Veins were resected by stripping. In this study, two vein conditions were adopted during HIFU irradiation; non-compressed and compressed. Compressing the vein was expected to improve occlusion by rubbing the altered intima under compressed conditions. The frequency of the ultrasound was 1.7 MHz, the intensity at the focus was 2800 W/cm2, and the irradiation time was 20 s. In this study, the contrast agent Levovist registered was chosen as a microbubble source, and the void fraction (ratio of total gas volume to liquid) in the vein was fixed at 10-5. Under non-compressed conditions, changes were observed only at the adventitia of the vein anterior wall. In contrast, under compressed conditions, changes were observed from the intima to the adventitia of both the anterior and posterior walls, and they were partly stuck together. In addition, more experiments with hematoxylin-eosin staining suggested that the changes in the vein were more substantial under the latter conditions. From these results, it was confirmed that the vein was occluded more easily with vein compression.

  4. Skeletal muscle CT of lower extremities in myotonic dystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Ryosuke; Imai, Terukuni; Sadashima, Hiromichi; Matsumoto, Sadayuki; Yamamoto, Toru; Kusaka, Hirofumi; Yamasaki, Masahiro; Maya, Kiyomi; Tanabe, Masaya

    1988-02-01

    We evaluated the leg and thigh muscles of 4 control subjects and 10 patients with myotonic dystrophy using computed tomography. Taking previous reports about the skeletal muscle CT of myotonic dystrophy into account, we concluded that the following 5 features are characteristic of myotonic dystrophy: 1. The main change is the appearance of low-density areas in muscles; these areas reflect fat tissue. In addition, the muscle mass decreases in size. 2. The leg is more severely affected than the thigh. 3. In the thigh, although the m. quadriceps femoris, especially the vastus muscles, tends to be affected, the m. adductor longus and magnus tend to be preserved. 4. In the leg, although the m. tibialis anterior and m. triceps surae tend to be affected, the m. peroneus longus, brevis, and m. tibialis posterior tend to be preserved. 5. Compensatory hypertrophy is often observed in the m. rectus femoris, m. adductor longus, m. adductor magnus, m. peroneus longus, and m. peroneus brevis, accompanied by the involvement of their agonist muscles.

  5. Skeletal muscle CT of lower extremities in myotonic dystrophy

    International Nuclear Information System (INIS)

    We evaluated the leg and thigh muscles of 4 control subjects and 10 patients with myotonic dystrophy using computed tomography. Taking previous reports about the skeletal muscle CT of myotonic dystrophy into account, we concluded that the following 5 features are characteristic of myotonic dystrophy: 1. The main change is the appearance of low-density areas in muscles; these areas reflect fat tissue. In addition, the muscle mass decreases in size. 2. The leg is more severely affected than the thigh. 3. In the thigh, although the m. quadriceps femoris, especially the vastus muscles, tends to be affected, the m. adductor longus and magnus tend to be preserved. 4. In the leg, although the m. tibialis anterior and m. triceps surae tend to be affected, the m. peroneus longus, brevis, and m. tibialis posterior tend to be preserved. 5. Compensatory hypertrophy is often observed in the m. rectus femoris, m. adductor longus, m. adductor magnus, m. peroneus longus, and m. peroneus brevis, accompanied by the involvement of their agonist muscles. (author)

  6. Stress fractures in the lower extremity

    International Nuclear Information System (INIS)

    Stress fractures are fatigue injuries of bone usually caused by changes in training regimen in the population of military recruits and both professional and recreational athletes. Raised levels of sporting activity in today's population and refined imaging technologies have caused a rise in reported incidence of stress fractures in the past decades, now making up more than 10% of cases in a typical sports medicine practice. Background information (including etiology, epidemiology, clinical presentation and treatment and prevention) as well as state of the art imaging of stress fractures will be discussed to increase awareness amongst radiologists, providing the tools to play an important role in diagnosis and prognosis of stress fractures. Specific fracture sites in the lower extremity will be addressed, covering the far majority of stress fracture incidence. Proper communication between treating physician, physical therapist and radiologist is needed to obtain a high index of suspicion for this easily overlooked entity. Radiographs are not reliable for detection of stress fractures and radiologist should not falsely be comforted by them, which could result in delayed diagnosis and possibly permanent consequences for the patient. Although radiographs are mandatory to rule out differentials, they should be followed through when negative, preferably by magnetic resonance imaging (MRI), as this technique has proven to be superior to bone scintigraphy. CT can be beneficial in a limited number of patients, but should not be used routinely

  7. Stress fractures in the lower extremity

    Energy Technology Data Exchange (ETDEWEB)

    Berger, Ferco H. [Academic Medical Center, University of Amsterdam, Department of Radiology, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Jonge, Milko C. de [Academic Medical Center, University of Amsterdam, Department of Radiology, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Maas, Mario [Academic Medical Center, University of Amsterdam, Department of Radiology, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)]. E-mail: m.maas@amc.uva.nl

    2007-04-15

    Stress fractures are fatigue injuries of bone usually caused by changes in training regimen in the population of military recruits and both professional and recreational athletes. Raised levels of sporting activity in today's population and refined imaging technologies have caused a rise in reported incidence of stress fractures in the past decades, now making up more than 10% of cases in a typical sports medicine practice. Background information (including etiology, epidemiology, clinical presentation and treatment and prevention) as well as state of the art imaging of stress fractures will be discussed to increase awareness amongst radiologists, providing the tools to play an important role in diagnosis and prognosis of stress fractures. Specific fracture sites in the lower extremity will be addressed, covering the far majority of stress fracture incidence. Proper communication between treating physician, physical therapist and radiologist is needed to obtain a high index of suspicion for this easily overlooked entity. Radiographs are not reliable for detection of stress fractures and radiologist should not falsely be comforted by them, which could result in delayed diagnosis and possibly permanent consequences for the patient. Although radiographs are mandatory to rule out differentials, they should be followed through when negative, preferably by magnetic resonance imaging (MRI), as this technique has proven to be superior to bone scintigraphy. CT can be beneficial in a limited number of patients, but should not be used routinely.

  8. MANAGEMENT OF COMMINUTED FRACTURES OF LOWER EXTREMITY WITH MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS

    Directory of Open Access Journals (Sweden)

    Kapil A

    2015-07-01

    Full Text Available Comminuted multi fragmentary periarticular fractures are always a challenge to manage even today. Results of conservative management and ORIF by traditional methods are associated with number of complications. This study evaluate the role of minimally invasive plate osteosynthesis in management of such fractures. Seventeen (17 multi fragmentary fractures of long bones of lower extremity (in 15 patients were treated in t he present prospective study using the technique of minimally invasive plate osteosynthesis (MIPO. There were 11 cases of supracondylar fracture femur, two intra articular, 3 cases of proximal tibial fractures, 2 cases of tibial shaft fractures and 1 cases of subtrochanteric fracture. Mean age of the patients was 45.6 years with 13 male and 2 female patients. Most fractures were caused by high velocity road traffic accidents. Average injury surgery interval was 8.64 days. Average operative time was 67.35 mi nutes. Average period of union was 19.17 weeks and average period for full weight bearing was 15 weeks. Average hospital stay was 18.41 days. All fractures went on to union. Incidence of complications was low. Range of motion at the proximal and distal joi nts was excellent. Overall 93.33% (16 of 17 cases had excellent to good results.

  9. Effect of combining music media therapy with lower extremity exercise on elderly patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Li Ji

    2015-09-01

    Conclusion: Music media treatment combined with lower extremity exercise can both significantly increase the extent of exercise compliance of elderly patients suffering from diabetes mellitus, as well as improve blood circulation in their feet.

  10. Reduced incidence of lower-extremity amputations in a Danish diabetes population from 2000 to 2011

    DEFF Research Database (Denmark)

    Jørgensen, M E; Almdal, T P; Faerch, K

    2014-01-01

    Diabetic foot disease and amputations severely reduce quality of life and have major economic consequences. The aim of this study was to estimate time trends in the incidence of lower-extremity amputations in Danish people with diabetes.......Diabetic foot disease and amputations severely reduce quality of life and have major economic consequences. The aim of this study was to estimate time trends in the incidence of lower-extremity amputations in Danish people with diabetes....

  11. Thallium bone imaging as an indicator of response and outcome in nonmetastatic primary extremity osteosarcoma

    International Nuclear Information System (INIS)

    Purpose. We investigated one 201Tl bone scintigraphy method as a predictor of histologic response and event-free survival (EFS) of nonmetastatic extremity osteosarcoma. Materials and methods. We evaluated images of the primary tumor to determine whether they exhibited a donut of avidity for 40 patients enrolled on a single institutional protocol. Participants underwent three serial 201Tl bone scintigraphy studies during preoperative neoadjuvant chemotherapy. Intra- and interobserver variability of the method was assessed, and the presence of the donut of avidity was examined as a predictor of EFS and histologic response. Results. Fifty-three percent of patients were female and 75 % were Caucasian; the median age at diagnosis was 13.5 years. Intraobserver agreement was moderate to very good, ranging from 0.595 to 0.865. Interobserver agreement was moderate to good for all time points, ranging from 0.576 to 0.708. There was a significant difference in EFS among patients with and without the donut-shape at any of the three time points (P = 0.049); patients whose tumors displayed a donutshape had inferior EFS. Conclusion. The pattern of donut avidity in extremity OS is a predictor of lower EFS, but does not correlate with histologic response to therapy (orig.)

  12. Effect of in-hospital physical activity on cardiovascular prognosis in lower extremity bypass for claudication

    OpenAIRE

    Matsuo, Tomohiro; Sakaguchi, Taichi; Ishida, Atsuhisa; Yuguchi, Satoshi; Saito, Kazuya; Nakajima, Masaharu; Ujikawa, Takuya; Morisawa, Tomoyuki; Chikazawa, Genta; Takahashi, Tetsuya

    2015-01-01

    [Purpose] This study aimed to evaluate the effect of in-hospital physical activity on patient prognosis after lower extremity bypass surgery for peripheral arterial disease. [Subjects and Methods] A total of 13 patients (16 limbs; 11 males and 2 females; mean age [standard deviation], 72.8 [5.9] years) who underwent lower extremity bypass surgery for Fontaine stage 2 peripheral arterial disease were included in this study and assigned to either an active group (n = 6) to perform increased phy...

  13. Prevalence and risk factor analysis of lower extremity abnormal alignment characteristics among rice farmers

    Directory of Open Access Journals (Sweden)

    Karukunchit U

    2015-06-01

    Full Text Available Usa Karukunchit,1,2 Rungthip Puntumetakul,1,3 Manida Swangnetr,1,4 Rose Boucaut5 1Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH, 2Faculty of Associated Medical Sciences, Khon Kaen University, 3School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, 4Department of Production Technology, Faculty of Technology, Khon Kaen University, Khon Kaen, Thailand; 5School of Health Sciences (Physiotherapy, iCAHE (International Centre for Allied Health Evidence, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia Background: Rice farming activities involve prolonged manual work and human–machine interaction. Prolonged farming risk-exposure may result in lower limb malalignment. This malalignment may increase the risk of lower extremity injury and physical disabilities. However, the prevalence and factors associated with lower extremity malalignment have not yet been reported. This study aimed to investigate the prevalence and risk factors of lower extremity malalignment among rice farmers.Methods: A cross-sectional survey was conducted with 249 rice farmers. Lower extremity alignment assessment included: pelvic tilt angle, limb length equality, femoral torsion, quadriceps (Q angle, tibiofemoral angle, genu recurvatum, rearfoot angle, and medial longitudinal arch angle. Descriptive statistics were used to analyze participant characteristics and prevalence of lower extremity malalignment. Logistic regression analysis was used to identify risk factors.Results: The highest prevalence of lower extremity malalignment was foot pronation (36.14%, followed by the abnormal Q angle (34.94%, tibiofemoral angle (31.73%, pelvic tilt angle (30.52%, femoral antetorsion (28.11%, limb length inequality (22.49%, tibial torsion (21.29%, and genu recurvatum (11.24%. In females, the risk factors were abnormal Q angle, tibiofemoral angle, and genu recurvatum. Being overweight

  14. An evaluation of the clinical utility of mangled extremity severity score in severely injured lower limbs

    OpenAIRE

    Vipul Agarwal; Sarina Agarwal; Abhishek Singh; Setu Satani; Shewtank Goel; Pooja Goyal; Rohit Jhamnani

    2016-01-01

    Background: The management of severe lower limb injury is one of the most controversial subjects in the field of Orthopedic surgery. While the advancement of sophisticated microsurgical reconstruction technique has created the possibility of successful limb salvage in even the most extreme cases, it has become painfully obvious that the technical possibilities are double-edged swords. The aim of study was to analyze and ascertain the clinical utility of mangled extremity severity score (MESS)...

  15. Risk assessment of dermatolymphangioadenitis by lymphoscintigraphy in patients with lower extremity lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Young; Hwang, Ji Hye; Park, Jung Mi; Lee, Kyung Han; Kim, Sang Eun; Kim, Dong Ik; Lee, Byung Boong; Kim, Byung Tae [College of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    1999-02-01

    Dermatolymphangioadenitis (DLA) is a common and serious complication of lymphedema which deteriorates lymphatic function. The purpose of this study was to assess the risk of DLA by lymphoscintigraphy in patients with lower extremity lymphedema. The subjects were 59 edematous lower extremities of 50 patients without previous episode of DLA and 12 lower extremities of 6 controls. Whole body images were acquired 1 min and 2 hr after subcutaneous injection of 37 MBq of Tc-99m-antimony sulfide colloid into interdigital spaces of both feet before therapy for lymphedema. The lymphoscintigrapic and clinical variables were compared between groups with or without occurrence of DLA during clinical follow up. There were 20 episodes of DLA in 12 extremities during clinical follow-up (19{+-}6 months). On univariate analysis, there were significant differences in ilioinguinal lymph node uptake, uptake pattern of main lymphatic vessel, clinical stage and therapy compliance between the two groups. After multivariate analysis, only the uptake pattern of main lymphatic vessel and therapy compliance were confirmed to be independent variables. In other words, non-visualized main lymphatic vessel and poor compliance to therapy were more frequent in extremities with subsequent occurrence of DLA. Lymphoscintigraphy can be used to predict the risk of DLA and may thus be helpful for determining the initial therapeutic plan in patients with lower extremity lymphedema.

  16. Technical refinements of composite thoracodorsal system free flaps for 1-stage lower extremity reconstruction resulting in reduced donor-site morbidity.

    Science.gov (United States)

    Bannasch, Holger; Strohm, Peter C; Al Awadi, Khalid; Stark, G Björn; Momeni, Arash

    2008-04-01

    A multitude of local flaps has been suggested for lower extremity reconstruction. However, the gold standard for defect coverage remains free tissue transfer. In this regard, the scapular vascular axis is a well-established source of expendable skin, fascia, muscle, and bone for use in free flap reconstruction of defects requiring bone and soft tissue in complex 3-dimensional relationships. Composite bone and soft-tissue flaps derived from the subscapular vascular axis include the osteocutaneous scapular flap, the "latissimus/bone flap," and the thoracodorsal artery perforator-scapular osteocutaneous flap.Patient outcome following reconstruction of lower extremity defects with composite free flaps from the thoracodorsal system were analyzed. Here, we demonstrate the execution of technical refinements on free composite flap transfers based on the thoracodorsal vascular axis, thus resulting in a stepwise reduction of donor-site morbidity. PMID:18362565

  17. Nursing care of catheter-directed thrombolysis therapy for acute arterial embolism of lower extremities

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical effect of nursing intervention for interventional catheter-directed thrombolysis therapy in patients with acute arterial embolism of lower extremities. Methods: The experience of nursing care for 48 cases with acute arterial embolism of lower extremities which was treated with interventional catheter-directed thrombolysis was retrospectively analyzed. Results: With the help of active nursing care and rational treatment the occluded arteries were completely reopened in 40 cases and partially reopened in 8 cases. Complete relief from the clinical symptoms was obtained in 42 cases and partial remission was seen in 6 cases. Conclusion: For getting a complete recovery and improving living quality after catheter-directed thrombolysis in patients with acute arterial embolism of lower extremities, the key points are sufficient preoperative preparation, perioperative painstaking nursing care as well as postoperative correct guidance of exercise program. (authors)

  18. Treatment of Aseptic Hypertrophic Nonunion of the Lower Extremity with Less Invasive Stabilization System (New Approach to Hypertrophic Nonunion Treatment

    Directory of Open Access Journals (Sweden)

    Metin Uzun

    2015-01-01

    Full Text Available Aim. To evaluate whether aseptic hypertrophic nonunion in the long bones of the lower extremity can be treated successfully with LISS applied with closed methods without grafting. Materials and Methods. The study included 7 tibias and 9 femurs of 16 patients. All cases had hypertrophic nonunion. Initial surgical treatment was with intramedullary nailing in 14 cases, 6 of which had required an exchange of intramedullary nail. All the patients were treated with LISS plate with closed methods. Results. Union was obtained at mean 7 months in all patients. No implant loosening or breakage of the implant was observed and there was no requirement for secondary surgery. Conclusion. Cases of hypertrophic nonunion have excellent blood supply and biological potential. Therefore, there is no need for bone grafting and the addition of fracture stability is enough to achieve full union. Using a limited approach and percutaneous screw insertion, LISS provides fracture stabilization with soft tissue protection.

  19. [Identification of male somatotype based on osteometric characteristics of the upper and lower extremities].

    Science.gov (United States)

    Zviagin, V N; Sineva, I M

    2009-01-01

    This osteologic study included examination of 101 skeletons from the collections of the Department of Anthropology, M. V. Lomonosov Moscow State University, and Peter the Great Museum of Anthropology and Ethnography (Sankt-Peterburg). The results were compared with the data obtained by examining materials excavated from grave sites of an Yoshkar-Ola cemetery and from the Isupovo necropole (Kostroma) to evaluate the possibility of identifying human somatotypes from bone remains. Multidimensional discriminative analysis demonstrated that the equation derived by comparing characteristic signs of all long tubular bones of the extremities was of highest diagnostic value for the purpose of the study. Diagnostic equations are proposed for the identification of individual somatotypes based on the analysis of skeletal remains for the use in practical forensic medical examination. PMID:20058841

  20. A finite element lower extremity and pelvis model for predicting bone injuries due to knee bolster loading

    NARCIS (Netherlands)

    Rooij, L. van; Hoof, J. van; Barbir, A.; Made, R. van der; Slaats, P.M.A.; McCann, M.J.; Ridella, S.A.; Rupp, J.D.

    2004-01-01

    Injuries to the knee-thigh-hip (KTH) complex in frontal motor vehicle crashes are of substantial concern because of their frequency and potential to result in long-term disability. Current frontal impact Anthropometric Test Dummies (ATDs) have been shown to respond differently than human cadavers un

  1. Validity and interobserver agreement of lower extremity local tissue water measurements in healthy women using tissue dielectric constant

    DEFF Research Database (Denmark)

    Jensen, Mads R; Birkballe, Susanne; Nørregaard, Susan;

    2012-01-01

    Tissue dielectric constant (TDC) measurement may become an important tool in the clinical evaluation of chronic lower extremity swelling in women; however, several factors are known to influence TDC measurements, and comparative data on healthy lower extremities are few....

  2. Medical and Social Aspects of High Amputations in Patients with Obliterating Atherosclerosis of Lower Extremities

    OpenAIRE

    Gudz, I. M.; Hnatyshchak, A. I.

    2014-01-01

    Obliterating atherosclerosis of the lower extremities is one of the main causes of limb ischemia, that can result in high amputation of the lower limb (HALL). Despite the large number of publications on this subject, medical and social effects of HALL on the patients’ life are studied insufficiently. In some studies a significant impact of financial situation, the level of education, and accessibility of qualified vascular surgery care on the HALL index was stated. As this intervention is con...

  3. The use of mechanotherapy means in basketball players recovery after the injuries of the lower extremities

    Directory of Open Access Journals (Sweden)

    Zheleznyj O.D.

    2013-05-01

    Full Text Available The aim is to develop methods of physical rehabilitation of basketball players with injuries of the lower extremities. Summarizes the experience of use of mechanical therapy for the recovery of athletes with injuries to the lower extremities. Analyzed the nature of lower extremity injuries and their consequences. The methods of application of mechanical therapy using a simulator developed universal and local fatty clay as a means of physical therapy. It is proved that the method developed by the authors provided a mechanotherapy achieve the required level of mobility in the joints and improve range of body functions. Found that in the process of applying the developed program of rehabilitation basketball players with injuries of the lower extremities most effective in complex physical rehabilitation was value: therapeutic physical training with mechanotherapy + physical therapy with curative mud + therapeutic massage. Technique introduced to the work of medical and health-improving establishments and educational institutions of Ukraine Ministry of Education and Science of Ukraine.

  4. A study on the relationship between deep vein thrombosis of lower extremities and pulmonary embolism

    International Nuclear Information System (INIS)

    Objective: To evaluate the relationship between deep vein thrombosis (DVT) and pulmonary embolism (PE) and the origin of PE. Methods: Fifty normal people and 200 patients with highly suspected PE and DVT of lower extremities underwent pulmonary perfusion/ventilation (P/V) imaging with 99Tcm-macroaggregated albumin (MAA) and 99Tcm-glucose phosphate (GP), 15 patients among them also underwent pulmonary artery angiography. Results: Fifty normal people gave normal images of P/V. Among 200 patients, 175 were with multiple PE, 25 were normal; among PE patients, 128 were with lower extremity venous disorders (73.14%), 25 cases without PE were all with extremity venous disorders; among 153 with lower extremity venous diseases, 128 were with PE (83.66%); 119 of them had DVT, 101 cases' PEs originated from iliofemoral vein thrombosis (84.87%). Conclusion: It is effective to diagnosis PE and its origin with combinative use of pulmonary perfusion/ventilation imaging and lower extremity vein imaging

  5. Kinematic analysis of flailing injuries of lower extremities in side impacts.

    Science.gov (United States)

    Yoganandan, Narayan; Humm, John R; Rinaldi, James; Pintar, Frank A; Maiman, Dennis J

    2012-01-01

    The objective of the study was to determine the biomechanics of post mortem human subjects (PMHS) in lateral impact with a focus on lower extremity trauma and aviation safety for side-facing seat applications. Four male three-point belted intact PMHS were seated upright with the Frankfurt plane horizontal on a custom seat, covered with aircraft cushion. The seat had an armrest. The change in velocity from the Federal Aviation FAR25.562 standards was input to two specimens, and a lower energy input was used in the other two specimens. Pre-test and posttest x-rays were obtained, and autopsies were conducted. Sled and pelvic acceleration signals were digitally gathered and processed according to the Society of Automotive Engineers specifications. A high-speed digital video camera was used to track the frontal plane kinematics with targets placed at appropriate lower extremity landmarks. Fractures of the left distal femur-knee complex in one and proximal sub-capital femur in the other specimen occurred in tests using the simulated FAR pulse. Tests at the lower energy input in the other specimens did not result in trauma. Coronal motions in PMHS occurred from initial flailing of the lower leg-knee-upper leg complex initiating after the onset of the side-impact pulse with the armrest acting as a limiting/boundary condition for the left femur-pelvis-region. These motions were attributed to be a causal agent for the observed lower extremity injuries. Although from a limited sample size, the present findings indicate that lower extremities may sustain trauma, and side-facing seats in aviation environments may need to be evaluated for occupant safety in the lateral mode. PMID:22846325

  6. Angiographic distribution of lower extremity atherosclerosis in patients with and without diabetes

    NARCIS (Netherlands)

    van der Feen, C; Neijens, FS; Kanters, SDJM; Mali, WRTM; Stolk, RP; Banga, JD

    2002-01-01

    Aims To determine differences in the anatomic site of atherosclerosis in the lower extremity between patients with and patients without diabetes. Design Cross-sectional study of patients who underwent angiography of both legs because of symptoms of intermittent claudication, rest and/or night pain,

  7. Lower extremity finite element model for crash simulation

    Energy Technology Data Exchange (ETDEWEB)

    Schauer, D.A.; Perfect, S.A.

    1996-03-01

    A lower extremity model has been developed to study occupant injury mechanisms of the major bones and ligamentous soft tissues resulting from vehicle collisions. The model is based on anatomically correct digitized bone surfaces of the pelvis, femur, patella and the tibia. Many muscles, tendons and ligaments were incrementally added to the basic bone model. We have simulated two types of occupant loading that occur in a crash environment using a non-linear large deformation finite element code. The modeling approach assumed that the leg was passive during its response to the excitation, that is, no active muscular contraction and therefore no active change in limb stiffness. The approach recognized that the most important contributions of the muscles to the lower extremity response are their ability to define and modify the impedance of the limb. When nonlinear material behavior in a component of the leg model was deemed important to response, a nonlinear constitutive model was incorporated. The accuracy of these assumptions can be verified only through a review of analysis results and careful comparison with test data. As currently defined, the model meets the objective for which it was created. Much work remains to be done, both from modeling and analysis perspectives, before the model can be considered complete. The model implements a modeling philosophy that can accurately capture both kinematic and kinetic response of the lower limb. We have demonstrated that the lower extremity model is a valuable tool for understanding the injury processes and mechanisms. We are now in a position to extend the computer simulation to investigate the clinical fracture patterns observed in actual crashes. Additional experience with this model will enable us to make a statement on what measures are needed to significantly reduce lower extremity injuries in vehicle crashes. 6 refs.

  8. Botulinum therapy for poststroke spasticity of the lower extremity (clinical cases

    Directory of Open Access Journals (Sweden)

    L. V. Krylova

    2014-01-01

    Full Text Available The paper deals with the topical problem – the medical rehabilitation of patients with poststroke spasticity. It describes clinical cases of patients with poststroke spasticity of the upper and lower extremities who have received combined therapy using botulinum toxin type A (Botox injections.

  9. Assessment of lower extremity muscle power in functionally-limited elders

    Science.gov (United States)

    The purpose of this study was to assess the reliability and concurrent validity of a new methodology to evaluate lower extremity muscle power in older, functionally limited men and women. A cross sectional evaluation was performed on 58 older men (n=27) and women (n=31) (74.2 + 0.9 years). Knee and ...

  10. A Retrospective Review from 2006 to 2011 of Lower Extremity Injuries in Badminton in New Zealand

    Directory of Open Access Journals (Sweden)

    Joanna Reeves

    2015-06-01

    Full Text Available Aim: To describe lower extremity injuries for badminton in New Zealand. Methods: Lower limb badminton injuries that resulted in claims accepted by the national insurance company Accident Compensation Corporation (ACC in New Zealand between 2006 and 2011 were reviewed. Results: The estimated national injury incidence for badminton injuries in New Zealand from 2006 to 2011 was 0.66%. There were 1909 lower limb badminton injury claims which cost NZ$2,014,337 (NZ$ value over 2006 to 2011. The age-bands frequently injured were 10–19 (22%, 40–49 (22%, 30–39 (14% and 50–59 (13% years. Sixty five percent of lower limb injuries were knee ligament sprains/tears. Males sustained more cruciate ligament sprains than females (75 vs. 39. Movements involving turning, changing direction, shifting weight, pivoting or twisting were responsible for 34% of lower extremity injuries. Conclusion: The knee was most frequently injured which could be due to multi-planar loading. Turning or cutting movements typically involve motion in the frontal and transverse planes that may place the knee at greater risk of injury than movement in the sagittal plane alone. Further research on badminton specific movements is warranted to better understand the mechanisms of lower extremity injuries in the sport. Sports medicine and support personnel should take into account the susceptibility of the knee to injury when designing training and injury prevention programmes given the large number of change of direction movements during badminton.

  11. Morphological and functional relationships with ultrasound measured muscle thickness of the lower extremity: a brief review.

    Science.gov (United States)

    Abe, Takashi; Loenneke, Jeremy P; Thiebaud, Robert S

    2015-08-01

    Ultrasound is a potential method for assessing muscle size of the extremity and trunk. In a large muscle, however, a single image from portable ultrasound measures only muscle thickness (MT), not anatomical muscle cross-sectional area (CSA) or muscle volume (MV). Thus, it is important to know whether MT is related to anatomical CSA and MV in an individual muscle of the extremity and trunk. In this review, we summarize previously published articles in the lower extremity demonstrating the relationships between ultrasound MT and muscle CSA or MV as measured by magnetic resonance imaging and computed tomography scans. The relationship between MT and isometric and isokinetic joint performance is also reviewed. A linear relationship is observed between MT and muscle CSA or MV in the quadriceps, adductor, tibialis anterior, and triceps surae muscles. Intrarater correlation coefficients range from 0.90 to 0.99, except for one study. It would appear that anterior upper-thigh MT, mid-thigh MT and posterior thigh MT are the best predictors for evaluating adductor, quadriceps, and hamstrings muscle size, respectively. Despite a limited number of studies, anterior as well as posterior lower leg MT appear to reflect muscle CSA and MV of the lower leg muscles. Based on previous studies, ultrasound measured anterior thigh MT may be a valuable predictor of knee extension strength. Nevertheless, more studies are needed to clarify the relationship between lower extremity function and MT. PMID:27433253

  12. Ankle fusion with a retrograde locked intramedullary nail for sequela of lower extremity compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    WANG Xu; MA Xin; ZHANG Chao; HUANG Jia-zhang; GU Xiang-jie; JIANG Jian-yuan

    2012-01-01

    Objective: To assess the value of ankle fusion with a retrograde locked intramedullary nail in the treatment of sequela of lower extremity compartment syndrome.Methods:Thirty-five cases of equinus deformity following tibiofibular compartment syndrome treated by means of ankle fusion with a retrograde locked intramedullary nail from January 2001 to December 2010 were retrospectively reviewed.The complications,the time needed for bony fusion of the ankle joint assessed by anteroposterior and lateral X-ray photographs as well as patients' subjective evaluation were recorded and analysed.Results: Among the 35 patients,15 had previously undergone surgical treatment twice on the same limb,13 had thrice and 7 had to be operated on four times before ankle fusion.An anterior midpoint approach to the ankle joint was adopted in 29 cases,while anterior midpoint approach plus a small incision on the posterior ankle joint was made in 17 cases,whereas lateral approach in 6 cases.Tarsus joint fusion was performed on 4 cases.The follow-up period ranged 6-124 months,averaged 40.6 months.Bone grafting was not performed in this series.Preoperative tibial shaft fracture occurred in one patient and was healed after conservative treatment.Incision dehiscence located at previous Achilles tendon incision was found in two patients.As a result,one received an intramedullary nail emplacement at calcaneoplantar part while the wound at anterosuperior part of the other one was healed by dressing change.Two patients failed to bony union 5 months postoperatively,in which one healed 10 weeks after retrieval of proximal tibial nail and another by iliac grafting.Terminal necrosis of the toe due to blood supply dysfunction was not found in this series.All the patients were satisfied with the ankle joint function postoperatively.The time for bony union on X-rays was 9.8 weeks on average.Except for one patient who demanded removal of intramedullary nail,all the intramedullary nails were not retrieved at

  13. A Canadian population-based description of the indications for lower-extremity amputations and outcomes

    Science.gov (United States)

    Kayssi, Ahmed; de Mestral, Charles; Forbes, Thomas L.; Roche-Nagle, Graham

    2016-01-01

    Background To our knowledge, there have been no previously published reports characterizing lower-extremity amputations in Canada. The objective of this study was to describe the indications and outcomes of lower-extremity amputations in the Canadian population. Methods We performed a retrospective cohort study of all adult patients who underwent lower-extremity amputation in Canada between 2006 and 2009. Patients were identified from the Canadian Institute for Health Information’s Discharge Abstract Database, which includes all hospital admissions across Canada with the exception of the province of Quebec. Pediatric, trauma, and outpatients were excluded. Results During the study period, 5342 patients underwent lower-extremity amputations in 207 Canadian hospitals. The mean age was 67 ± 13 years, and 68% were men. Amputations were most frequently indicated after admission for diabetic complications (81%), cardiovascular disease (6%), or cancer (3%). In total, 65% of patients were discharged to another inpatient or long-term care facility, and 26% were discharged home with or without extra support. Most patients were diabetic (96%) and most (65%) required a below-knee amputation. Predictors of prolonged (> 7 d) hospital stay included amputation performed by a general surgeon; cardiovascular risk factors, such as diabetes, hypertension, ischemic heart disease, congestive heart failure, or hyperlipidemia; and undergoing the amputation in the provinces of Newfoundland and Labrador, New Brunswick, or British Columbia. Conclusion There is variability in the delivery of lower-extremity amputations and postoperative hospital discharges among surgical specialists and regions across Canada. Future work is needed to investigate the reasons for this variability and to develop initiatives to shorten postoperative hospital stays. PMID:27007090

  14. Pathologic features of lower extremity arterial lesions in diabetes mellitus:an analysis of 162 patients

    International Nuclear Information System (INIS)

    Objective: To investigate the angiographic manifestations of lower extremity atherosclerotic occlusion in patients with diabetes mellitus. Methods: The angiographic findings of lower extremity in 162 patients with diabetes mellitus were retrospectively analyzed. (1) The arteries of lower extremity were divided into the following four segments: iliac, femoral, popliteal and crural artery. The involvements of these arteries were documented. (2) Based on the lesion's number, location, nature (stricture or occlusion) and length ( 5 cm), the diabetic arterial diseases were categorized. Results: (1) Of 162 diabetic lower limbs, multiple segmental lesions were seen in 131, superficial femoral arterial lesions in 130, and crural arterial lesions in 139, of which 130 arterial lesions had at least two below-the-knee arteries being involved. (2) Based on segmental angiographic classification, a total of 660 vascular lesions were detected, including stricture lesions (33.8%) and occlusive lesions (66.2%). Of the 437 occlusions, 70.5% were located in below-the-knee arteries, and most of which were longer than 10 cm and located in anterior and posterior tibial arteries, while only a few peroneal arteries were involved (P < 0.0001). One hundred and fifty-two lesions were detected in superficial femoral arteries, of which 49 (31.2%) were located at the origin of the superficial femoral artery and 56 (35.7) were in the adductor canal hiatus. Conclusion: The main feature of peripheral arterial disease of lower extremity caused by diabetes mellitus is multi-level atherosclerotic occlusion, the superficial femoral and the crural arteries are most likely to be involved. The lesions of superficial femoral artery are often located at the arterial origin and in the adductor canal hiatus, while the deep femoral artery and the femoral artery are less involved. Long occlusive lesions are more prevalent in crural arteries, especially in anterior and posterior tibial arteries. (J Intervent

  15. LOWER EXTREMITY MANIFESTATIONS OF PERIPHERAL ARTERY DISEASE: THE PATHOPHYSIOLOGIC AND FUNCTIONAL IMPLICATIONS OF LEG ISCHEMIA

    OpenAIRE

    McDermott, Mary McGrae

    2015-01-01

    Lower extremity peripheral artery disease (PAD) is frequently under-diagnosed, in part because of the wide variety of leg symptoms manifested by patients with PAD and in part because of the high prevalence of asymptomatic PAD. In primary care medical practices, 30% to 60% of PAD patients report no exertional leg symptoms and approximately 45–50% report exertional leg symptoms that are not consistent with classic intermittent claudication. The prevalence and extent of functional impairment and...

  16. Rap System of Stress Stimulation Can Promote Bone Union after Lower Tibial Bone Fracture: A Clinical Research

    Directory of Open Access Journals (Sweden)

    Jian-fei YAO, Jia-zuo SHEN, Da-kun LI, Da-sheng LIN, Lin Li, Qiang LI, Peng Qi, Ke-jian LIAN, Zhen-qi DING

    2012-01-01

    Full Text Available Background Lower tibial bone fracture may easily cause bone delayed union or nonunion because of lacking of dynamic mechanical load.Objective Research Group would design a new instrument as Rap System of Stress Stimulation (RSSS to provide dynamic mechanical load which would promote lower tibial bone union postoperatively.Methods This clinical research was conducted from January 2008 to December 2010, 92 patients(male 61/female 31, age 16-70years, mean 36.3years who suffered lower tibial bone closed fracture were given intramedullary nail fixation and randomly averagely separated into experimental group and control group(according to the successively order when patients went for the admission procedure. Then researchers analysed the clinical healing time, full weight bearing time, VAS (Visual Analogue Scales score and callus growth score of Lane-Sandhu in 3,6,12 months postoperatively. The delayed union and nonunion rates were compared at 6 and 12 months separately.Results All the 92 patients had been followed up (mean 14 months. Clinical bone healing time in experimental group was 88.78±8.80 days but control group was 107.91±9.03days. Full weight bearing time in experimental group was 94.07±9.81 days but control group was 113.24±13.37 days respectively (P<0.05. The delayed union rate in 6 months was 4.3% in experimental group but 10.9% in control group(P<0.05. The nonunion rate in 12 months was 6.5% in experimental group but 19.6% in control group(P<0.05. In 3, 6, 12 months postoperatively, VAS score and Lane-Sandhu score in experimental group had more significantly difference than them in control group.Conclusions RSSS can intermittently provide dynamic mechanical load and stimulate callus formation, promote lower tibial bone union, reduce bone delayed union or nonunion rate. It is an adjuvant therapy for promoting bone union after lower tibial bone fracture.

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

    International Nuclear Information System (INIS)

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

  18. A survey of nurses' and podiatrists' attitudes, skills and knowledge of lower extremity wound care

    OpenAIRE

    McIntosh, Caroline; Ousey, Karen

    2008-01-01

    Published literature has identified deficits in the wound care knowledge of many healthcare professionals involved in tissue viability, which may suggest some patients are receiving suboptimal care. This article explores podiatrists’ and nurses’ attitudes, knowledge and skills regarding lower extremity wound care. Interactive electronic voting pads were used to survey a sample of nurses and podiatrists (n=102). The results were used to inform the delivery of wound care education at the Unvers...

  19. Peroneal island flap for wound coverage in complex injuries of the lower extremity

    Directory of Open Access Journals (Sweden)

    Fazal A

    2012-01-01

    Full Text Available Akil Fazal1, Haroon-ur-Rashid1, Tahseen Cheema21Section of Orthopedics, Department of Surgery, Aga Khan University, Karachi, Pakistan; 2Department of Orthopedics and Rehabilitation, University of New Mexico, Albuquerque, NM, USABackground: Complex injuries of the lower extremity pose a therapeutic challenge owing to limited availability of local soft tissue for coverage. One option in this region is the pedicled fasciocutaneous flap based on perforators of the peroneal artery. In this case series, we present our experience of the peroneal island pedicled flap for reconstruction of lower extremity wounds.Methods: Records of 18 cases of peroneal island flap admitted consecutively to the Section of Orthopedics at Aga Khan University Hospital from January 1996 to December of 2009 were studied and their outcomes determined.Results: The most common indication for coverage was open wounds due to a road traffic accident (n = 10, followed by burns (n = 3. The most common area exposed was the lower third of the leg followed by the middle third. The tibia was exposed in 11 patients. The flaps ranged in size from 35 cm2 to over 200 cm2. In 13 patients, the flaps healed uneventfully, while in the remaining five there was partial flap necrosis. In four of the latter patients, the residual wound healed with conservative measures only, but the fifth patient required further surgery to achieve acceptable coverage.Conclusion: The peroneal artery flap appears to be a simple, useful, and reliable flap in the armamentarium of the surgeon when planning soft tissue coverage of the lower extremity.Keywords: leg injuries, surgical flaps, lower extremity

  20. Determination of three-dimensional joint loading within the lower extremities in snowboarding.

    Science.gov (United States)

    Krüger, Andreas; McAlpine, Paul; Borrani, Fabio; Edelmann-Nusser, Jürgen

    2012-02-01

    In the biomechanical literature only a few studies are available focusing on the determination of joint loading within the lower extremities in snowboarding. These studies are limited to analysis in a restricted capture volume due to the use of optical video-based systems. To overcome this restriction the aim of the present study was to develop a method to determine net joint moments within the lower extremities in snowboarding for complete measurement runs. An experienced snowboarder performed several runs equipped with two custom-made force plates as well as a full-body inertial measurement system. A rigid, multi-segment model was developed to describe the motion and loads within the lower extremities. This model is based on an existing lower-body model and designed to be run by the OpenSim software package. Measured kinetic and kinematic data were imported into the OpenSim program and inverse dynamic calculations were performed. The results illustrate the potential of the developed method for the determination of joint loadings within the lower extremities for complete measurement runs in a real snowboarding environment. The calculated net joint moments of force are reasonable in comparison to the data presented in the literature. A good reliability of the method seems to be indicated by the low data variation between different turns. Due to the unknown accuracy of this method the application for inter-individual studies as well as studies of injury mechanisms may be limited. For intra-individual studies comparing different snowboarding techniques as well as different snowboard equipment the method seems to be beneficial. The validity of the method needs to be studied further. PMID:22468468

  1. Clinical study on RI angiography in vascular diseases of lower extremities

    International Nuclear Information System (INIS)

    In 203 cases of lower extremity vascular diseases, the findings of RI angiography were compared with those of x-ray angiography. After intravenous infusion of sup(99m)Tc-H.S.A., the blood flow distribution was obtained by an equilibrium method. As this method provides an arterio-venous scintigram, some of the first pass method by intravenous infusion of sup(99m)Tc-H.S.A., intraarterial infusion of sup(99m)Tc-M.A.A., distribution of 201Tl-Cl, measurement of skin temperature, and volume pulse wave method were combined for patients with arterial diseases. For patients with venous diseases, the first pass method with sup(99m)Tc-H.S.A. was used together with the intravenous infusion method of sup(99m)Tc-M.A.A. RI angiography was of value in diagnosis, decision of therapy, follow up of postoperative hemodynamics in lower extremity vascular diseases. (Ueda, J.)

  2. Indocyanine Green Lymphographic Signs of Lymphatic Collateral Formation in Lower Extremity Lymphedema After Cancer Resection.

    Science.gov (United States)

    Tashiro, Kensuke; Shibata, Takashi; Mito, Daisuke; Ishiura, Ryohei; Kato, Motoi; Yamashita, Shuji; Narushima, Mitsunaga; Iida, Takuya; Koshima, Isao

    2016-08-01

    Indocyanine green lymphography has recently been used to assess lymphatic vessel function in lymphedema patients. Postoperative collateral lymphatic vessels toward ipsilateral axillary lymph nodes are rarely seen above the umbilical level in lower lymphedema patients. Between January 2012 and December 2014, we performed indocyanine green lymphography of 192 limbs in 96 lower extremity lymphedema cases. As a result, dermal back flow appeared in 95 cases, with 38 in the lower abdominal area and 31 in the genital area. We confirmed 3 cases of superficial lymphatic collateral ways extending above the umbilical level to the axillary lymph nodes. All 3 cases had similarity in lower abdominal edema, so excessive lymphatic fluid in the lower abdomen was assumed to be the cause. Lymphatic collateral ways from abdomen to axillary lymph nodes in this study was likely to be designed to prevent the progress of lymphedema. PMID:26418772

  3. Peroneal island flap for wound coverage in complex injuries of the lower extremity

    OpenAIRE

    Fazal A; Rashid H; Cheema T

    2012-01-01

    Akil Fazal1, Haroon-ur-Rashid1, Tahseen Cheema21Section of Orthopedics, Department of Surgery, Aga Khan University, Karachi, Pakistan; 2Department of Orthopedics and Rehabilitation, University of New Mexico, Albuquerque, NM, USABackground: Complex injuries of the lower extremity pose a therapeutic challenge owing to limited availability of local soft tissue for coverage. One option in this region is the pedicled fasciocutaneous flap based on perforators of the peroneal artery. In this case se...

  4. The etiology of deep venous thrombosis in the lower extremities and its synthetic therapies

    International Nuclear Information System (INIS)

    Deep venous thrombosis in the lower extremities is a very common disease clinically and can greatly affect people in their work and life without proper treatment promptly. The author reviewed the etiology, diagnosis, preventive measures and the synthetic therapies for dealing the deep venous thrombosis in the lower extremities, especially concerning the interventional radiology. (authors)

  5. Particularities of the therapeutic procedures and success in treatment of combat-related lower extremities injuries

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    Šegrt Budimir

    2014-01-01

    Full Text Available Background/Aim. In a combat environment the extremities continue to be the most common sites of injury with associated high rates of infectious complications due to initial contamination. The aim of this observational study was to determine therapeutic procedures effective in a combat environment and to assess functional outcomes of definitive care. Methods. A total of 44 casualties with combat-related lower extremities fractures sustained during combat operations in former Yugoslavia in a 2-year period (1993-1994 were enrolled. Initial management of these injuries was performed at battlefield (echelon I, surgical treatment was provided in the hospital in Trebinje (echelon II and definitive care was provided in the Orthopedic Ward of General Hospital in Nikšić (echelon III. Results. All combat casualties received surgical treatment within 6-48 hours. Antibiotics were administered during hospitalization in 37 (84% of all the patients. In all the cases fractures healed, while 15 (38.59% of them developed complications (most notably osteomyelitis in 3 of the cases, dysfunction in adjacent joints in 3 of the cases and infection of the soft tissue around pins in 3 of the cases. Follow-up period was a little bit over 2 years and reliable conclusions regarding the therapy and the outcomes could be made. Good functional outcomes were prevalent (63.63%, satisfactory were present in one fifth and inadequate in 13.63% of all the cases. There were no amputations or fatalities. Internal fixation was shown to be the method of definitive surgical care of combat-related lower extremity fractures. Conclusion. The management of combat- related lower extremity fractures is complex, multidisciplinary approach through echelons is necessary and internal fixation as the method of definitive surgical care is essential.

  6. Kinematics analysis and three-dimensional simulation of the rehabilitation lower extremity exoskeleton robot

    OpenAIRE

    Chen, Jiangcheng; Zhang, Xiaodong; Zhu, Lei

    2014-01-01

    The kinematics recursive equation was built by using the modified D-H method after the structure of rehabilitation lower extremity exoskeleton was analyzed. The numerical algorithm of inverse kinematics was given too. Then the three-dimensional simulation model of the exoskeleton robot was built using MATLAB software, based on the model, 3D reappearance of a complete gait was achieved. Finally, the reliability of numerical algorithm of inverse kinematics was verified by the simulation result....

  7. Prevalence of exclusive lower extremity metastases at {sup 18}F-NaF PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Ordones, Monique Beraldo, E-mail: moniqueordones@yahoo.com.br [Universidade de Sao Paulo (In-Rad/HC-FMUSP), Sao Paulo, SP (Brazil). Hospital das Clinicas. Inst. de Radiologia; Valadares, Agnes Araujo [Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP (Brazil). Hospital das Clinicas; Duarte, Paulo Schiavom; Sado, Heitor Naoki; Lima, Marcos Santos; Carvalho, Giovanna [Instituto do Cancer do Estado de Sao Paulo Octavio Frias de Oliveira (ICESP), Sao Paulo, SP (Brazil). Servico de Medicina Nuclear; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto [Universidade de Sao Paulo (FMUSP), Sao Paulo, SP (Brazil). Fac. de Medicina

    2015-05-15

    Objective: to evaluate the prevalence of exclusive lower extremity metastases, specifically in the femur and below the knee, observed at {sup 18}F-NaF PET/CT. Materials and methods: one thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement. The presumptive diagnoses based on such uptakes were subsequently obtained by evaluation of other imaging studies. Results: no exclusive uptake suggestive of metastasis below the femur was observed in the present series. Exclusive uptake was observed in the proximal femur with a presumptive diagnosis of metastasis in two patients. Conclusion: the prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases. (author)

  8. Cosmetic Aspects of the Lower Extremity Dysplastic Viral Deformation Operative Correction

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    Barinov A.S.

    2010-12-01

    Full Text Available Aim of investigation is elaboration of the lower extremity dysplastic viral deformation treatment unified method, considering cosmetic aspects of operative correction. Materials and Methods. The clinical and roentgenologic data of 123 patients with a «viral deformation of crus» diagnosis, who have undergone 246 osteotomies of tibia, is investigated. A subcondyle osteotomy of tibia with the Ilizarov’s apparatus application and subsequent dosed correction of deformation is made. Results. The anatomical alterations, corresponding to a dysplastic process, are revealed in the knee joints in majority of cases even at the lower extremity small axial curvatures, which permits to consider such curvatures not only a cosmetic defect, but the deformations, having the pathologic components. The following results are received in a process of treatment according to the elaborated method: the average dates of correction were 14.70±3.53 days (from 9 to 22 days, which can be explained by the crus curvature different degree; the average dates of fixation were 32.70±6.85 days (from 19 to 51 days for the left crus and 34.70±6.98 days (from 21 to 53 days for the right crus (a fixation duration is stipulated by age and activity of patients; the general dates of treatment in the average were 57.00±11.54 days (from 47 to 93 days, which is significantly lesser the average literary data. Conclusion. The proposed method of the lower extremity dysplastic viral deformation treatment permits to normalize the lower extremity axes, which is a favorable factor in prophylaxis of the knee joint degenerative diseases. It can be used for removal of cosmetic defects in orthopedic cosmetology due to a low traumatic capacity.

  9. The Effect of the Weight of Equipment on Muscle Activity of the Lower Extremity in Soldiers

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    Tobias Lindner

    2012-01-01

    Full Text Available Due to their profession and the tasks it entails, soldiers are exposed to high levels of physical activity and strain. This can result in overexertion and pain in the locomotor system, partly caused by carrying items of equipment. The aim of this study was to analyse the extent of muscle activity in the lower extremities caused by carrying specific items of equipment. For this purpose, the activity of selected groups of muscles caused by different items of equipment (helmet, carrying strap, backpack, and rifle in the upper and lower leg was measured by recording dynamic surface electromyograms. Electrogoniometers were also used to measure the angle of the knee over the entire gait cycle. In addition to measuring muscle activity, the study also aimed to determine out what influence increasing weight load has on the range of motion (ROM of the knee joint during walking. The activity of recorded muscles of the lower extremity, that is, the tibialis anterior, peroneus longus, gastrocnemius lateralis, gastrocnemius medialis, rectus femoris, and biceps femoris, was found to depend on the weight of the items of equipment. There was no evidence, however, that items of equipment weighing a maximum of 34% of their carrier’s body weight had an effect on the ROM of the knee joint.

  10. Transplantation of mobilized peripheral blood mononuclear cells for peripheral arterial occlusive disease of the lower extremity

    Institute of Scientific and Technical Information of China (English)

    Xiaofeng YANG; Yanxiang WU; Hongmei WANG; Yifeng XU; Bo XU; Xin LU; Yibin ZANG; Fa WANG; Yue ZHANG

    2006-01-01

    Objectives To assess the clinical efficacy, safety, and feasibility of autologous transplantation of mobilized peripheral blood mononuclear cells (PBMNCs) for patients with peripheral arterial occlusive disease (PAOD) of the lower extremity. Methods A total of 152 patients with PAOD of the lower extremity were enrolled into this non-controlled observational study from November 2003 to March 2006. All patients received subcutaneous injections of recombinant human granulocyte colony-stimulating factor (G-CSF, 450600 μg/day) for 5 days in order to mobilize stem/progenitor cells; their PBMNCs were collected and transplanted by multiple intramuscular injections into ischemic limbs. Patients were followed up for at least 12 weeks. Results At 12 weeks, primarymanifestations,including lower limb pain and coldness, were significantly improved in 137 (90.1%) of the patients; limb ulcers improved or healed in 46 (86.8%) of the 53 patients, while 25 of the 48 (47.9%) patients with limb gangrene remained steady or improved. Ankle-brachial index (ABI) improved in 33 (22%) of the cases, and TcPO2 increased in 45 (30%) of the cases. Angiography before treatment, and at 12 weeks after treatment, was performed in 10 of the patients and showed formation of new collateral vessels. No severe adverse effects or complications specifically related to cell transplantation were observed. Conclusion Autologous transplantation of G-CSF-mobilized PBMNCs might be a safe and effective treatment for lower limb ischemic disorder.(J Geriatr Cardiol 2006; 3:178-80.)

  11. Isolated lower extremity metastases, 9 years after initial diagnosis of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Mulligan, M.E.; Smith, S.E. [University of Maryland, Department of Radiology, Medical School, Baltimore, MD (United States); McCarthy, E.F. [Johns Hopkins Hospital, Department of Pathology, Baltimore, MD (United States)

    2006-10-15

    We report the development of isolated lower extremity metastases, in a child, 9 years after her initial diagnosis and treatment of bilateral infantile retinoblastomas. The radiographic, scintigraphic, computed tomographic, and magnetic resonance imaging findings are discussed. The dominant metastatic focus was blastic, involving the medial cuneiform. Additional occult lesions were found in the base of the second metatarsal, middle cuneiform, navicular and tibial diaphysis. An open biopsy confirmed the diagnosis. The occurrence of late distant metastases is rare in the USA. (orig.)

  12. Isolated lower extremity metastases, 9 years after initial diagnosis of retinoblastoma

    International Nuclear Information System (INIS)

    We report the development of isolated lower extremity metastases, in a child, 9 years after her initial diagnosis and treatment of bilateral infantile retinoblastomas. The radiographic, scintigraphic, computed tomographic, and magnetic resonance imaging findings are discussed. The dominant metastatic focus was blastic, involving the medial cuneiform. Additional occult lesions were found in the base of the second metatarsal, middle cuneiform, navicular and tibial diaphysis. An open biopsy confirmed the diagnosis. The occurrence of late distant metastases is rare in the USA. (orig.)

  13. Treatment of failing vein grafts in patients who underwent lower extremity arterial bypass

    OpenAIRE

    Park, Keun-Myoung; Park, Yang Jin; Yang, Shin-Seok; Kim, Dong-Ik; Kim, Young-Wook

    2012-01-01

    Purpose We attempted to determine risk factors for the development of failing vein graft and optimal treatment in patients with infrainguinal vein grafts. Methods We retrospectively reviewed a database of patients who underwent infrainguinal bypass using autogenous vein grafts due to chronic atherosclerotic arterial occlusive disease of lower extremity (LE) at a single institute between September 2003 and December 2011. After reviewing demographic, clinical, and angiographic features of the p...

  14. Extreme Ultra-Violet Spectroscopy of the Lower Solar Atmosphere During Solar Flares

    OpenAIRE

    Milligan, Ryan O.

    2015-01-01

    The extreme ultraviolet portion of the solar spectrum contains a wealth of diagnostic tools for probing the lower solar atmosphere in response to an injection of energy, particularly during the impulsive phase of solar flares. These include temperature and density sensitive line ratios, Doppler shifted emission lines and nonthermal broadening, abundance measurements, differential emission measure profiles, and continuum temperatures and energetics, among others. In this paper I shall review s...

  15. Measurement Properties of the Lower Extremity Functional Scale: A Systematic Review.

    Science.gov (United States)

    Mehta, Saurabh P; Fulton, Allison; Quach, Cedric; Thistle, Megan; Toledo, Cesar; Evans, Neil A

    2016-03-01

    Study Design Systematic review of measurement properties. Background Many primary studies have examined the measurement properties, such as reliability, validity, and sensitivity to change, of the Lower Extremity Functional Scale (LEFS) in different clinical populations. A systematic review summarizing these properties for the LEFS may provide an important resource. Objective To locate and synthesize evidence on the measurement properties of the LEFS and to discuss the clinical implications of the evidence. Methods A literature search was conducted in 4 databases (PubMed, MEDLINE, Embase, and CINAHL), using predefined search terms. Two reviewers performed a critical appraisal of the included studies using a standardized assessment form. Results A total of 27 studies were included in the review, of which 18 achieved a very good to excellent methodological quality level. The LEFS scores demonstrated excellent test-retest reliability (intraclass correlation coefficients ranging between 0.85 and 0.99) and demonstrated the expected relationships with measures assessing similar constructs (Pearson correlation coefficient values of greater than 0.7). The responsiveness of the LEFS scores was excellent, as suggested by consistently high effect sizes (greater than 0.8) in patients with different lower extremity conditions. Minimal detectable change at the 90% confidence level (MDC90) for the LEFS scores varied between 8.1 and 15.3 across different reassessment intervals in a wide range of patient populations. The pooled estimate of the MDC90 was 6 points and the minimal clinically important difference was 9 points in patients with lower extremity musculoskeletal conditions, which are indicative of true change and clinically meaningful change, respectively. Conclusion The results of this review support the reliability, validity, and responsiveness of the LEFS scores for assessing functional impairment in a wide array of patient groups with lower extremity musculoskeletal

  16. The coexistence of carotid and lower extremity atherosclerosis further increases cardio-cerebrovascular risk in type 2 diabetes

    OpenAIRE

    Li, Mei-Fang; Zhao, Cui-Chun; Li, Ting-ting; Tu, Yin-Fang; Lu, Jun-Xi; Zhang, Rong; Chen, Ming-Yun; Bao, Yu-Qian; Li, Lian-Xi; Jia, Wei-Ping

    2016-01-01

    Background Both carotid and lower limb atherosclerosis are associated with increased cardiovascular and cerebrovascular risks. However, it is still unclear whether the concomitant presence of carotid and lower extremity atherosclerosis further increases the cardiovascular and cerebrovascular risks. Therefore, our aim is to investigate whether the coexistence of carotid and lower extremity atherosclerosis was associated with higher cardiovascular and cerebrovascular risks in patients with type...

  17. Design and intermediate results of the Lower Extremity Arterial Disease Event Reduction (LEADER* trial of bezafibrate in men with lower extremity arterial disease [ISRCTN41194621

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    Meade Thomas W

    2001-07-01

    Full Text Available Abstract Background Raised levels of both triglycerides and fibrinogen, each of which are reduced by bezafibrate, may contribute to lower extremity arterial disease (LEAD. This condition is characterized by a particularly high incidence of coronary heart disease (CHD and stroke, but is little studied thus far in randomised controlled trials. Method Patients were recruited through 85 practices in the British Medical Research Council General Practice Research Framework and through nine hospital vascular clinics. The treatment regimen, which is double-blind and placebo-controlled, is bezafibrate 400 mg/day. The 1568 patients recruited represent 86% of those eligible at screening. Results None of the anticipated side effects (mainly gastrointestinal differed between the two groups. Nearly 80% of the total person-years accrued at 3 years were spent on trial treatment. Bezafibrate significantly reduced total cholesterol by approximately 8.0% and low-density lipoprotein (LDL-cholesterol by approximately 9.0%, and increased high-density lipoprotein (HDL-cholesterol by approximately 11.0% initially, falling to about 6.0% at 3 years. Triglycerides were significantly reduced by about 23.0% and fibrinogen by about 14.0%. Plasma creatinine rose by approximately 11% in those on active treatment. All of these effects were highly significant (P Conclusion The trial recruited an unusually high proportion of eligible patients, ensuring the general applicability of its results. The fibrinogen-lowering and lipid-modifying effects of bezafibrate were confirmed. Although bezafibrate lowers fibrinogen, it has no effect on CRP; this suggests that the reduction in fibrinogen is due to an effect on its metabolism rather than suppression of an inflammatory response.

  18. Somatotype of the individuals with lower extremity amputation and its association with cardiovascular risk.

    Science.gov (United States)

    Mozumdar, Arupendra; Roy, Subrata K

    2008-03-01

    Anthropometric somatotyping is one of the methods to describe the shape of the human body, which shows some associations with an individual's health and disease condition, especially with cardiovascular diseases (CVD). Individuals with lower extremity amputation (LEA) are known to be more vulnerable to the cardiovascular risk. The objectives of the present study are to report the somatotype of the individuals having lower extremity amputation, to study the possible variation in somatotype between two groups of amputated individuals, and to study the association between cardiovascular disease risk factor and somatotype components among individuals with locomotor disability. 102 adult male individuals with unilateral lower-extremity amputation residing in Calcutta and adjoining areas were investigated. The anthropometric data for somatotyping and data on cardiovascular risk traits (such as body mass index, blood pressure measurements, blood lipids) have been collected. The somatotyping technique of Carter & Heath (1990) has been followed. The result shows high mean values of endomorphy and mesomorphy components and a low mean value of the ectomorphy component among the amputated individuals having cardiovascular risks. The results of both discriminant analysis and logistic regression analysis show a significant relationship between somatotype components and CVD risk among the individuals with LEA. The findings of the present study support the findings of similar studies conducted on the normal population. Diagnosis of CVD risk condition through somatotyping can be utilized in prevention/treatment management for the individuals with LEA. PMID:18435209

  19. The effects of a lateral in-flight perturbation on lower extremity biomechanics during drop landings.

    Science.gov (United States)

    Yom, Jae P; Simpson, Kathy J; Arnett, Scott W; Brown, Cathleen N

    2014-10-01

    One potential ACL injury situation is due to contact with another person or object during the flight phase, thereby causing the person to land improperly. Conversely, athletes often have flight-phase collisions but do land safely. Therefore, to better understand ACL injury causation and methods by which people typically land safely, the purpose of this study was to determine the effects of an in-flight perturbation on the lower extremity biomechanics displayed by females during typical drop landings. Seventeen collegiate female recreational athletes performed baseline landings, followed by either unexpected laterally-directed perturbation or sham (nonperturbation) drop landings. We compared baseline and perturbation trials using paired-samples t tests (P flight perturbation leads to abnormal GRF and angular motions and joint moments of the lower extremity. PMID:25010630

  20. Lower extremity necrotizing fasciitis: A unique initial presentation of Crohn's disease

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    Anna Weiss

    2015-09-01

    Full Text Available Crohn's disease is a disease of the bowel, typically presenting with diarrhea, weight loss, and abdominal pain. Complications such as abscesses, fistulas, and strictures may require surgical intervention. We would like to report a patient with Crohn's disease who presented for the first time with left lower extremity necrotizing fasciitis. There are very few reports of necrotizing fasciitis in Crohn's disease as the initial presentation.

  1. The effects of band exercise using proprioceptive neuromuscular facilitation on muscular strength in lower extremity

    OpenAIRE

    Rhyu, Hyun-seung; Kim, Su-Hyun; Park, Hye-Sang

    2015-01-01

    The purpose of this study was to examine whether a six-week elastic band exercise program using proprioceptive neuromuscular facilitation (PNF) can increase isotonic strength of abductor muscles in the lower extremity. Twenty-eight healthy students from S university were divided into an experimental group and control group. Each group was participated in pre and post-measurement in isotonic strength using an isotonic analyzer, En-treeM. Experimental group performed elastic band exercise using...

  2. Evaluation of curative effect of interventional therapy for chronic simple atherosclerotic occlusive disease of lower extremity

    International Nuclear Information System (INIS)

    Objective: To explore the efficacy and influencing factors of interventional therapy for chronic atherosclerotic occlusive disease of the lower extremity. Methods: 56 cases of simple atherosclerotic occlusive disease of lower extremity were divided into 3 types according to the location of occlusion, including 17 cases of abdominal aorta-iliac artery, 18 cases of iliac-femoral artery, and 21 cases of femoropopliteal inferior genicular artery. Catheter and guide were combined with blunt dissection and subtle banding were used to dredge the occluded vessels, and the stents were implanted when interlayer appeared. Results: After the treatment, 46 cases of occlusion were dredged (82.1%), 6 cases remained occluded with the same symptoms (10.7%), and 4 cases had severer symptoms (7.1%). Among the 46 successful cases, there were 16 cases of abdominal aorta-iliac artery (94.1%), 16 cases of iliac-femoral artery (88.9%) and 14 cases of femoropopliteal inferior genicular artery (66.6%). There was no statistical difference between the abdominal aorta-iliac artery cases and iliac-femoral artery cases (P>0.05), but the rate of abdominal aorta-iliac artery was higher than that of femoropopliteal inferior aorta-iliac artery (P0.05), but there were significant differences between the first two types and the third type (P<0.05). Compared with the 14 dredged cases (71.4%), 7 cases (33.3%) of undredged femoropopliteal inferior genicular artery cases had richer compensatory circulation(P<0.05). Conclusion: It is safe and effective to treat simple atherosclerotic occlusive disease of the lower extremity with interventional therapy. The location and length of occlusion and the abundance of compensatory circulation have effects on the therapy. (authors)

  3. Enhanced MR angiography of the lower extremities with synergy spine coil

    International Nuclear Information System (INIS)

    A synergy spine coil is a phased-array coil designed for spine imaging. The coil's sensitive area is narrow in both the x-axis and y-axis directions but very wide in the z-axis direction. It is therefore suitable for using in long parts of the body, such as the spine. We used the coil for enhanced MR angiography in the lower extremities, which requires a very long field of view on the z-axis direction. Using on the NEMA (National Electrical Manufacturers Association) standard test for special-purpose coils, the sensitive volume of the synergy spine coil was first measured by using a phantom. It was found that the sensitive lengths along x-axis and y-axis were 300 mm and 120 mm, respectively, while that along z-axis could set at any length required for the examination by modifying the element number. The above area was confirmed to be sufficient for obtaining enhanced MR angiograms of the lower extremities. The results of this study showed the use of the synergy spine coil in enhanced MR angiography of the lower extremities is superior to the use of a conventional whole body coil for obtaining good MR angiograms with a good single-to-noise ratio (SNR). (author)

  4. Treatment of acute deep burns in lower extremities of the elderly

    Institute of Scientific and Technical Information of China (English)

    Babur M. Shakirov

    2015-01-01

    Objective: To study the different surgical treatments in 154 elderly patients with acute deep burns of lower extremities admitted in Burn Department of RSCUMA.Methods:Skin grafts in extensive burns were performed in 32 patients for the purpose of achieving early closure of the burn area. In 116 patients with burn surface area of 6-25 %, skin grafting was performed on the granulating wound when the wound was ready for accepting skin graft. In these 19 cases, a stamp graft procedure was used in 12 patients and Mowlen-Jackson method of skin grafting in 7 cases.Results:Analysis of the nearest results showed that 28 out of 154 patients came back to the hospital for new surgery due to loss of ability of normal movement of their extremities.Conclusions:Careful patient selection and timing of surgery will help to avoid any adverse effect on patient outcome.

  5. Lymphoscintigraphic evaluation in the patients with secondary lymphedema of lower extremities

    Energy Technology Data Exchange (ETDEWEB)

    Asakura, Koichi; Ono, Yoshimi; Watari, Kiichi; Yuzuta, Katsuteru; Kawashima, Hiroyuki (Yokohama City Univ. (Japan). Faculty of Medicine)

    1983-02-01

    The results of lymphoscintigraphy in 41 patients with secondary lymphedema of lower extremities using Tc-99m sulfur or rhenium colloid were reviewed. These patients include 23 uterine cervix cancers, 12 other pelvic tumors, 4 malignant lymphomas and others. The patterns of scintigrams were classified as follows; (A) normal radiocolloid distributuion in the ilioinguinal chain of the nodes; (B) decreased uptake or defect in the ipsilateral iliac and/or inguinal nodes; (C) diffuse soft tissue activity throughout lower extremity due to radiocolloid back flow; (D) persistent radioactivity in the lymph vessels in the entire lower extremity; and (E) markedly decreased uptake in the ilioinguinal nodes without dermal back flow. These scintigraphic patterns were well correlated with clinical grades of lymphedemas. The correlation between these findings and clinical grades of lymphedema were observed more severely if the pattern classification goes (A) to (E). This scintigraphic study to evaluate the patients with secondary lymphedema is valuable to determine the cause and the grade of edema without any significant risk.

  6. Lymphoscintigraphic evaluation in the patients with secondary lymphedema of lower extremities

    International Nuclear Information System (INIS)

    The results of lymphoscintigraphy in 41 patients with secondary lymphedema of lower extremities using Tc-99m sulfur or rhenium colloid were reviewed. These patients include 23 uterine cervix cancers, 12 other pelvic tumors, 4 malignant lymphomas and others. The patterns of scintigrams were classified as follows; (A) normal radioFcolloid distributuion in the ilioinguinal chain of the nodes; (B) decreased uptake or defect in the ipsilateral iliac and/or inguinal nodes; (C) diffuse soft tissue activity throughout lower extremity due to radiocolloid back flow; (D) persistent radioFactivity in the lymph vessels in the entire lower extremity; and (E) markedly decreased uptake in the ilioinguinal nodes without dermal back flow. These scintigraphic patterns were well correlated with clinical grades of lymphedemas. The correlation between these findings and clinical grades of lymphedema were observed more severely if the pattern classification goes (A) to (E). This scintigraphic study to evaluate the patients with secondary lymphedema is valuable to determine the cause and the grade of edema without any significant risk. (author)

  7. Techniques and curative effects of fluoroscopy-guided foam sclerotherapy for lower extremity varicosities

    International Nuclear Information System (INIS)

    Objective: To describe the techniques of fluoroscopy-guided foam sclerotherapy for lower extremity varicosities, and evaluate the feasibility, safety and curative effects of it. Methods: From October 2008 to December 2009, a total of 21 legs in 16 patients with lower extremity varicosities received radiological-guided foam sclerotherapy. They were enrolled in this study. Sodium morrhuate was foamed with air according to Tessari's method, with liquid-gas ratio of 1: 4. Foam sclerotherapy of varices were performed by the filling-defects technique under fluoroscopy guidance. Postoperative compression was maintained for 2 weeks. Clinical effect was assessed as full success, partial success and no success. Complications were classified as minor or serious. Results: The technical procedure was successful in all foam sclerotherapies for 21 legs. And, a single sclerotherapy session was adequate for all legs. The median follow-up period was 6.0 months after treatment, ranged from 3.0 to 17.0 months. In this period, Clinical effect was assessed as full success for 17 legs (81.0%) and partial success for 4 legs (19.0%). All patients presented self- limiting minor complications, including cordlike subcutaneous indurations along the treated veins (21 cases), skin hyperpigmentation in 11 legs (8 cases), local pain in 7 legs (6 cases) and superficial thrombophlebitits in one leg (1 case). No serious complications or systemic events occurred. Conclusion: Fluoroscopy-guided foam sclerotherapy was a feasible, safe and effective treatment for lower extremity varicosities. (authors)

  8. Detection of rheumatoid arthritis bone erosions by 2 different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer, Anne; Vestergaard, Aage; Døhn, Uffe Møller;

    2008-01-01

    OBJECTIVES: To compare the ability of 2 different dedicated extremity magnetic resonance imaging (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints. METHODS: CR and 2 MRI-examinations (on 0.2T Esaote...... carpal bones. MagneVu and CR detected 100% and 89%, respectively, of large erosions (OMERACT-RAMRIS-score > 1 on Artoscan) in MCP-joints, and 69% and 15.8% of large erosions in wrists. CONCLUSIONS: Both E-MRI units detected more erosions than CR, particularly due to a higher sensitivity in metacarpal...... Artoscan and 0.2T portable MagneVu MV1000 units) of 418 bones in the dominant wrist and 2.-5. MCP-joints of 15 RA patients and 4 healthy controls were performed and blindedly evaluated for bones being visible and for erosions. RESULTS: In MCP-joints, MagneVu visualized 18.5% of bones entirely and 71...

  9. Preliminary clinical application of SilverHawk directional atherectomy device in arteriosclerosis obliterans of lower extremity

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical efficiency and security of SilverHawk directional atherectomy device in treating arteriosclerosis obliterans of lower extremity. Methods: Seven patients with lower extremity ischemia were treated with SilverHawk directional atherectomy. The lesions length varied from 1.8 to 14.5 cm. Clinical symptoms (Fontaine classification) included 4 cases of grade Ⅱ b, I case of grade Ⅲ, 2 cases of grade Ⅳ. The ABI varied from 0.28 to 0.65. Patency was evaluated with color duplex sonography or CTA besides clinical examination during follow-up. Results: Seven occlusive lesions were recanalizated successfully. The technical success (residual stenosis < 30%) rate was 100%. Clinical symptoms were obviously improved or disappeared. The ABI varied from 0.82 to 1.18 (P=0.002), and Fontaine classification included 6 cases of Ⅰ; 1 case of Ⅱ a. Patency rate was 100% and the ABI varied from 0.75 to 1.14 (P=0.938). Fontaine classifications keep consistent 1-6 months after operation. Conclusion: SilverHawk directional atherectomy was a safe and effective way for treatment of lower arteriosclerosis obliteran. (authors)

  10. A case report of sudden-onset upper and lower extremity weakness.

    Science.gov (United States)

    Haddad, Heba; Rotblatt, Michael

    2015-02-01

    Thyrotoxic hypokalemic periodic paralysis is characterized by acute attacks of muscle paralysis, hypokalemia, and thyrotoxicosis. It is a medical emergency, as fatal and life-threatening ventricular arrhythmia associated with hypokalemia has been reported. A 24-year-old man presented with severe lower extremity weakness, which progressed to his trunk and arms. He denied any associated symptoms and had no history of a similar episode or predisposing condition. The physical examination was significant for bilateral extremity weakness, more severe in the lower as compared to the upper extremities. The rest of the neurologic exam was normal. A small, smooth, nontender goiter was palpated. Laboratory data was significant for a potassium level of 2.0 mEq/L. Final lab data revealed a thyroid panel consistent with hyperthyroidism. Once the patient's potassium level normalized after repletion, he recovered his strength and was able to walk again. He was diagnosed with thyrotoxic hypokalemic periodic paralysis, a potentially lethal complication of hyperthyroidism. Because it is reversible with treatment of hyperthyroidism, it is imperative that this condition be considered, recognized and managed appropriately. PMID:25556330

  11. A review of the risk factors for lower extremity overuse injuries in young elite female ballet dancers.

    Science.gov (United States)

    Bowerman, Erin Anne; Whatman, Chris; Harris, Nigel; Bradshaw, Elizabeth

    2015-06-01

    The objective of this study was to review the evidence for selected risk factors of lower extremity overuse injuries in young elite female ballet dancers. An electronic search of key databases from 1969 to July 2013 was conducted using the keywords dancers, ballet dancers, athletes, adolescent, adolescence, young, injury, injuries, risk, overuse, lower limb, lower extremity, lower extremities, growth, maturation, menarche, alignment, and biomechanics. Thirteen published studies were retained for review. Results indicated that there is a high incidence of lower extremity overuse injuries in the target population. Primary risk factors identified included maturation, growth, and poor lower extremity alignment. Strong evidence from well-designed studies indicates that young elite female ballet dancers suffer from delayed onset of growth, maturation, menarche, and menstrual irregularities. However, there is little evidence that this deficit increases the risk of overuse injury, with the exception of stress fractures. Similarly, there is minimal evidence linking poor lower extremity alignment to increased risk of overuse injury. It is concluded that further prospective, longitudinal studies are required to clarify the relationship between growth, maturation, menarche, and lower extremity alignment, and the risk of lower extremity overuse injury in young elite female ballet dancers. PMID:26045395

  12. Topographical anatomy features of branching of nerves of lower extremities of rat

    Directory of Open Access Journals (Sweden)

    Tsarev A.A.

    2008-01-01

    Full Text Available 12 white rats of the reproductive period were the material for research. The topography of sciatic and femoral nerves of lower extremities of rats were studied by the method of level-by-level preparation. Femoral and sciatic nerves, their branches are ventral branches lumbar and sacral plexuses. Sciatic nerve was characterized by dispersed type of ramifying (78 % of cases, for the femoral nerve – the main type of branching (86%. The femoral nerve is projected on a medial surface of a hip and in the region of knee joint lies superficially that has a practical value. The rest portion of femoral nerve is located in hard-to-reach areas in the view of preparation and experimental approach. The sciatic nerve is projected on the skin of dorsal surfaces of pelvic areas where it leaves sciatic notch. For more reliable results of experimental research we propose to took into account age, sex, and topographical features.

  13. Prophylactic IVC Filter Placement during Endovascular Treatment of Deep Venous Thrombosis of the Lower Extremities

    International Nuclear Information System (INIS)

    To evaluate the efficacy of an IVC filter implantation in the prevent of a pulmonary embolism (PE) during endovascular treatment for a deep venous thrombosis (DVT) of the lower extremities. We implanted IVC filters in 43 patients (22 females, 21 males, average age: 63 years) with DVT and who had undergone treatments including thrombolysis, aspiration and mechanical thrombectomy, as well as stent placement. We evaluated the incidence of PE by capturing the thrombus within the IVC filters, as well as the amount of captured thrombus. New developing PE or aggravating of PE in patients with existing PE was avoided in all patients. No thrombus was evident in the IVC filter of 19 (44%) of the patients, whereas any thrombus was captured in 24 (56%) of the patients. Small amounts of thrombus were captured in 10 patients, whereas large amounts of thrombus were captured in 14 patents within the IVC filter. We performed a retrieval of the IVC filters in 17 patients within an average period of 15.3 days (range 6-45 days). The captured incidence of migrated thrombus in the IVC filters was high in 56% of cases. As a result, PE was effectively prevented by IVC filters during the interventional treatment of DVT in the lower extremities

  14. Effects of sex and lower extremity alignment on orientation of the knee joint line in knee surgery

    Institute of Scientific and Technical Information of China (English)

    ZENG Yi-ming; WANG You; ZHU Zhen-an; DAI Ke-rong

    2012-01-01

    Background Determination of the proper orientation of the knee articular surface is required both for correction of knee malalignment by osteotomy and for correct component alignment in knee arthroplasty.We sought to determine whether the patients' sex and lower extremity alignment (hip-knee-ankle angle) affects proper knee realignment in osteotomy or component alignment in total knee arthroplasty.Methods We examined 199 healthy adult knees with malalignment of <5° to determine the mechanical medial distal femoral angle,mechanical medial proximal tibial angle,surgical transepicondylar axis angle,and discrepancies between bone-cut orientations of osteotomy or total knee arthroplasty and the joint line of the distal femoral condyles,posterior femoral condyles and proximal tibial plateaus,using a three-dimensional computed tomography model.Results The mean mechanical medial distal femoral angle and mean mechanical medial proximal tibial angle were (94.4±1.9)° and (87.6±1.8)° respectively for women and (93.8±2.0)° and (87.1±.1.4)° respectively for men.The surgical transepicondylar axis angle was (2.9±1.6)° for women and (3.2±1.7)° for men.Independent of sex,the hip-knee-ankle angle was closely related to the mechanical medial distal femoral angle and mechanical medial proximal tibial angle,but not to the surgical transepicondylar axis angle.A slightly more valgus alignment of the knee and a more valgus angulation of the distal femoral joint line were found in women,whereas a more varus angulation of the proximal tibial joint line was found in men.Sex had the greatest effect on knee joint line orientation when the lower extremity was valgus in alignment.Conclusions A more valgus femoral joint line can be expected in women and in persons with valgus lower extremity alignment; a more varus tibial joint line can be found in men and in persons with varus lower extremity alignment.

  15. FDG-PET imaging of lower extremity muscular activity during level walking

    International Nuclear Information System (INIS)

    We analyzed muscular activity of the lower extremities during level walking using positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG). We examined 17 healthy male subjects; 11 were assigned to a walking group and 6 to a resting group. After 18F-FDG injection, the walking group subjects walked at a free speed for 15 min. A whole-body image was then obtained by a PET camera, and the standardized uptake ratio (SUR) was computed for each muscle. The SUR for each muscle of the walking group was compared with that for the corresponding muscles in the resting group. The level of muscular activity of all the muscles we examined were higher during level walking than when resting. The activity of the lower leg muscles was higher than that of the thigh muscles during level walking. The muscular activity of the soleus was highest among all the muscles examined. Among the gluteal muscles, the muscular activity of the gluteus minimus was higher than that of the gluteus maximus and gluteus medius. The concurrent validity of measuring muscular activity of the lower extremity during level walking by the PET method using 18F-FDG was demonstrated. (author)

  16. Lower Extremity Muscle Activation and Kinematics of Catchers When Throwing Using Various Squatting and Throwing Postures

    Directory of Open Access Journals (Sweden)

    Yi-Chien Peng, Kuo-Cheng Lo, Lin-Hwa Wang

    2015-09-01

    Full Text Available This study investigated the differences in joint motions and muscle activities of the lower extremities involved in various squatting postures. The motion capture system with thirty-one reflective markers attached on participants was used for motion data collection. The electromyography system was applied over the quadriceps, biceps femoris, tibialis anterior, and gastrocnemius muscles of the pivot and stride leg. The joint extension and flexion in wide squatting are greater than in general squatting (p = 0.005. Knee joint extension and flexion in general squatting are significantly greater than in wide squatting (p = 0.001. The adduction and abduction of the hip joint in stride passing are significantly greater than in step squatting (p = 0.000. Furthermore, the adduction and abduction of the knee joint in stride passing are also significantly greater than in step squatting (p = 0.000. When stride passing is performed, the muscle activation of the hamstring of the pivot foot in general squatting is significantly greater than in wide squatting (p < 0.05, and this difference continues to the stride period. Most catchers use a general or wide squatting width, exclusive of a narrow one. Therefore, the training design for strengthening the lower extremity muscles should consider the appropriateness of the common squat width to enhance squat-up performance. For lower limb muscle activation, wide squatting requires more active gastrocnemius and tibialis anterior muscles. Baseball players should extend the knee angle of the pivot foot before catching the ball.

  17. Sports-related muscle injuries of the lower extremity: MR imaging appearances

    International Nuclear Information System (INIS)

    Sports-related injuries of the lower extremity are frequent. Before magnetic resonance (MR) imaging was available, ultrasound, radionuclide scintigraphy and computed tomography were used to evaluate muscle trauma. Although relatively inexpensive, these imaging modalities are limited by their low specificity. The high degree of soft tissue contrast and multiplanar capability of MR imaging, allow direct visualization as well as characterization of traumatic muscle lesions. This pictorial review highlights the spectrum of traumatic muscle lesions on MRI, with emphasis on its typical appearances. (orig.)

  18. Percutaneous aspiration thrombectomy for the treatment of acute lower extremity deep vein thrombosis: is thrombolysis needed?

    International Nuclear Information System (INIS)

    Aim: To assess the technical feasibility and initial success of aspiration thrombectomy as a potential alternative to lytic therapy in initial endovascular management of acute lower extremity deep vein thrombosis (DVT). Materials and Methods: From July 2004 to October 2007, a retrospective analysis of 27 patients (male:female 5:22; mean age 59 years) with acute iliofemoral or femoropopliteal DVT of less than 2 weeks was performed. All patients underwent sonography of the lower extremities, and 13 patients underwent computed tomography (CT) venography. All patients received an inferior vena cava (IVC) filter and were initially treated with aspiration thrombectomy using the pullback technique with or without basket thrombus fragmentation. If persistent stenotic portions (>50% luminal narrowing) were noted, balloon angioplasty or stent placement was performed. Successful recanalization was defined as successful restoration of antegrade flow in the treated vein with elimination of any underlying obstructive lesion. Results: The mean procedure time was 65 min (range 40-100 min). Successful initial recanalization was achieved in 24 patients (88.9%) without complications. Urokinase was required for three patients (11.1%) due to a hard thrombus remaining in the iliac vein. Of the 27 patients, 23 had residual venous stenosis in the common iliac vein or external iliac vein. Therefore, balloon angioplasty (n = 23) and stent placement (n = 22) was performed. The remaining four patients were treated using only aspiration thrombectomy without angioplasty or stent placement. Conclusion: Aspiration thrombectomy without catheter-directed thrombolysis is a safe and effective treatment for acute DVT of the lower extremities, and minimizes the risk of haemorrhagic complications.

  19. BIOMECHANICAL ANALYSYS OF LOWER EXTREMITIES DURING CONVENTIONAL AND FUNCTIONAL ELECTRICAL STIMULATION (FES) ROWING IN NON-DISABLED INDIVIDUALS

    OpenAIRE

    Takeshima, Masaaki; Shimada, Yoichi; Matsunaga, Toshiki; Iwami, Takehiro; HIRAMOTO, Kazuhiko

    2010-01-01

    Functional electrical stimulation (FES) rowing is a whole-body exercise in which the lower extremities are moved by electric stimulation and the upper extremities are moved voluntarily by paraplegics. The purpose of this study was to identify the kinematic factors of the lower extremities required to perform FES-rowing through the biomechanical analysis. Eighteen healthy adult men participated in this study. A mathematical model was developed to analyze the conventional rowing with or without...

  20. The clinical evaluation of Pterocarpus santalinus Linn. Ointment on lower extremity wounds--a preliminary report.

    Science.gov (United States)

    Biswas, Tuhin Kanti; Maity, Lakshmi Narayan; Mukherjee, Biswapati

    2004-12-01

    Pterocarpus santalinus is described in the Ayurveda for its wide spectrum of medicinal properties including wound healing. Previously the authors reported animal studies that demonstrated that an ointment made from the bark of this tree was effective without any toxic effects. They used the same ointment in 6 cases of lower extremity wounds. Healing was observed in all wounds. The study was not controlled, the findings are presented here as case studies. Further studies are planned to develop a wound healing ointment from a locally available and inexpensive plant. PMID:15866819

  1. Preliminary experience with transabdominal chemical sympatectomy in arterial occlusion of lower extremities using computerized tomography targeting

    International Nuclear Information System (INIS)

    Twenty transabdominal unilateral lumbar sympatectomies were performed using a Chiba needle under computerized tomography control. The intervention was made for advanced occlusive disease of the lower extremities, where reconstruction surgery was not possible. Out of nine patients under evaluation, an excellent effect was seen in two, a significant effect in two others, an uncertain effect in another patient while no improvement was seen in four patients. An alcohol solution containing a local long-acting anaesthetic and a contrast medium was used as the blocking agent. The method may be useful even in advanced disease stages and extends the range of diapeutic methods. (author). 4 figs., 8 refs

  2. Stenting of iliac vein obstruction following catheter-directed thrombolysis in lower extremity deep vein thrombosis

    Institute of Scientific and Technical Information of China (English)

    MENG Qing-you; LI Xiao-qiang; JIANG Kun; QIAN Ai-min; SANG Hong-fei; RONG Jian-jie; DUAN Peng-fei

    2013-01-01

    Background Catheter-directed thrombolysis (CDT) for deep venous thrombosis (DVT) of the lower extremity has good effect,but whether iliac vein stent placement after thrombolytic therapy is still controversial.The goal of this study was to evaluate the efficacy of stent placement in the iliac vein following CDT in lower extremity DVT.Methods This was a single-center,prospective,randomized controlled clinical trial.After receiving CDT,the major branch of the distal iliac vein was completely patent in 155 patients with lower extremity DVT,and 74 of these patients with iliac vein residual stenosis of >50% were randomly divided into a control group (n=29) and a test group (n=45).In the test group,stents were implanted in the iliac vein,whereas no stents were implanted in the control group.We evaluated the clinical indicators,including patency of the deep vein,C in CEAP classification,Venous Clinical Severity Score (VCSS),and Chronic Venous Insufficiency Questionnaire (CIVIQ) Score.Results All patients had postoperative follow-up visits for a period of 6-24 months.Venography or color ultrasound was conducted in subjects.There was a significant difference between the patency rate at the last follow-up visit (87.5% vs.29.6%) and the 1-year patency rate (86.0% vs.54.8%) between the test and control groups.The change in the C in CEAP classification pre-and post-procedure was significantly different between the test and control groups (1.61±0.21 vs.0.69±0.23).In addition,at the last follow-up visit,VCSS and CIVIQ Score were both significantly different between the test and control groups (7.57±0.27 vs.0.69±0.23; 22.67±3.01 vs.39.34±6.66,respectively).Conclusion The stenting of iliac vein obstruction following CDT in lower extremity DVT may increase the patency of the deep vein,and thus provides better efficacy and quality of life.

  3. Rotational profile of the lower extremity in achondroplasia: computed tomographic examination of 25 patients

    Energy Technology Data Exchange (ETDEWEB)

    Song, Hae-Ryong; Suh, Seung-Woo [Korea University Guro Hospital, Department of Orthopaedic Surgery, Rare Diseases Institute, Seoul (Korea); Choonia, Abi-Turab [Laud Clinic, Department of Orthopaedic Surgery, Mumbai (India); Hong, Suk Joo; Cha, In Ho [Korea University Guro Hospital, Department of Radiology, Seoul (Korea); Lee, Seok-Hyun [Dongguk University Ilsan Buddist Hospital, Department of Orthopaedic Surgery, Goyang (Korea); Park, Jong-Tae [Korea University Ansan Hospital, Department of Occupational and Enviornmental Medicine, Ansan (Korea)

    2006-12-15

    To evaluate lower-extremity rotational abnormalities in subjects with achondroplasia using computed tomography (CT) scans. CT scans were performed in 25 subjects with achondroplasia (13 skeletally immature, mean age 8.7 years; 12 skeletally mature, mean age 17.6 years). In a total of 50 bilateral limbs, CT images were used to measure the angles of acetabular anteversion, femoral anteversion, and tibial external torion. Measurement was performed by three examiners and then repeated by one examiner. Inter- and intraobserver agreements were analyzed, and results were compared with previously reported normal values. Mean values for skeletally immature and skeletally mature subjects were 13.6{+-}7.5 and 21.5{+-}6.4 respectively for acetabular anteversion, 27.1{+-}20.8 and 30.5{+-}20.1 for femoral torsion, and 21.6{+-}10.6 and 22.5{+-}10.8 for tibial torsion. Intra- and interobserver agreements were good to excellent. Acetabular anteversion and femoral anteversion in skeletally mature subjects were greater than normal values in previous studies. Both skeletally immature and mature subjects with achondroplasia had decreased tibial torsion compared to normal skeletally immature and mature subjects. Lower-extremity rotational abnormalities in subjects with achondroplasia include decreased tibial external torsion in both skeletally immature and mature subjects, as well as increased femoral and acetabular anteversion in skeletally mature subjects. (orig.)

  4. Rotational profile of the lower extremity in achondroplasia: computed tomographic examination of 25 patients

    International Nuclear Information System (INIS)

    To evaluate lower-extremity rotational abnormalities in subjects with achondroplasia using computed tomography (CT) scans. CT scans were performed in 25 subjects with achondroplasia (13 skeletally immature, mean age 8.7 years; 12 skeletally mature, mean age 17.6 years). In a total of 50 bilateral limbs, CT images were used to measure the angles of acetabular anteversion, femoral anteversion, and tibial external torion. Measurement was performed by three examiners and then repeated by one examiner. Inter- and intraobserver agreements were analyzed, and results were compared with previously reported normal values. Mean values for skeletally immature and skeletally mature subjects were 13.6±7.5 and 21.5±6.4 respectively for acetabular anteversion, 27.1±20.8 and 30.5±20.1 for femoral torsion, and 21.6±10.6 and 22.5±10.8 for tibial torsion. Intra- and interobserver agreements were good to excellent. Acetabular anteversion and femoral anteversion in skeletally mature subjects were greater than normal values in previous studies. Both skeletally immature and mature subjects with achondroplasia had decreased tibial torsion compared to normal skeletally immature and mature subjects. Lower-extremity rotational abnormalities in subjects with achondroplasia include decreased tibial external torsion in both skeletally immature and mature subjects, as well as increased femoral and acetabular anteversion in skeletally mature subjects. (orig.)

  5. Sequence Comparison for Non-Enhanced MRA of the Lower Extremity Arteries at 7 Tesla

    OpenAIRE

    Sören Johst; Stephan Orzada; Anja Fischer; Lena C Schäfer; Kai Nassenstein; Lale Umutlu; Lauenstein, Thomas C.; Ladd, Mark E.; Stefan Maderwald

    2014-01-01

    In this study three sequences for non-contrast-enhanced MRA of the lower extremity arteries at 7T were compared. Cardiac triggering was used with the aim to reduce signal variations in the arteries. Two fast single-shot 2D sequences, a modified Ultrafast Spoiled Gradient Echo (UGRE) sequence and a variant of the Quiescent-Interval Single-Shot (QISS) sequence were triggered via phonocardiogram and compared in volunteer examinations to a non-triggered 2D gradient echo (GRE) sequence. For image ...

  6. Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome

    OpenAIRE

    Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan

    2015-01-01

    Abstract Vascular involvement can be seen in up to 40% of patients with Behcet syndrome (BS), the lower-extremity vein thrombosis (LEVT) being the most common type. The aim of the current study was to compare venous Doppler findings and clinical features between BS patients with LEVT and control patients diagnosed as having LEVT due to other causes. All consecutive 78 patients (71 men, 7 women; mean age 38.6 ± 10.3 years) with LEVT due to BS and 50 control patients (29 men, 21 women; mean age...

  7. Effects of shoe type on lower extremity muscle activity during treadmill walking

    OpenAIRE

    Kim, Mi-Kyoung; Kim, Young-Hwan; Yoo, Kyung-Tae

    2015-01-01

    [Purpose] The purpose of this study was to analyze the effects of different shoe types on lower extremity muscle activity in healthy young women by using electromyography. [Subjects and Methods] Fifteen healthy young women in their 20s were included in this single-group repeated measures study. The subjects were divided into three groups: Converse sneakers, rain boots, and combat boots. The subjects walked on a treadmill at 4 km/h for 30 min, during which six muscles were examined using elect...

  8. An extremely sensitive species-specific ARMS PCR test for the presence of tiger bone DNA.

    Science.gov (United States)

    Wetton, Jon H; Tsang, Carol S F; Roney, Chris A; Spriggs, Adrian C

    2002-04-18

    The survival of the tiger (Panthera tigris) is seriously threatened by poaching to provide raw materials for traditional Chinese medicines (TCMs). Most highly prized are the tiger's bones, which are used in combination with other animal and plant derivatives in pills and plasters for the treatment of rheumatism and other ailments. Hundreds of patent remedies have been produced which claim to contain tiger bone, but proof of its presence is needed if legislation prohibiting the trade in endangered species is to be enforced.A highly sensitive tiger-specific real-time PCR assay has been developed to address this problem. Using primers specific to the tiger mitochondrial cytochrome b gene, successful amplification has been reliably achieved from blood, hair and bone as well as from a range of TCMs spiked with 0.5% tiger bone. Although capable of detecting fewer than 10 substrate molecules, the seven varieties of TCM pills and plasters tested showed no detectable trace of tiger DNA before spiking. Furthermore, sequencing several "tiger bone" fragments seized from TCM shops has shown that they actually originated from cattle and pigs. The potential effects of traditional bone preparation methods, evidence that much lower concentrations are used than alleged on TCM packaging, and substitution of bones from other species all suggest a low likelihood of detecting tiger DNA in patent medicines. Despite this, the basic methods have been thoroughly proven and can be readily applied to derivatives from other Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) protected species, providing a rapid and highly sensitive forensic test for species of origin. Potential applications to the monitoring of wild populations are demonstrated by the successful identification of shed hairs and faecal samples. PMID:12084490

  9. Extreme events: the implication for dredging and navigability of the Lower Niger River

    International Nuclear Information System (INIS)

    Sustainable development of water resources for transportation and other developmental activities requires an assessment of the complex relationships between a variety of environmental and hydrological processes across space and time. The economic benefits of dredging large river body for inland river navigation can only be realized if there is adequate water depth and where the hydro-climatic dynamics generate much water to sustain the high water level year round. The extreme water level is particularly critical to the Lower Niger River given the fact that the least available depth (LAD) of three meters is required for sustaining medium and relatively large shipping activities year round across the 690 km length of the lower Niger River. Based on statistical analysis at 95% level of significance, a 10% increase in the runoff generated was calculated for the wet season months while 5% increase was calculated for the dry season months as the expected runoff after dredging and deforestation. The event of the least available depth (LAD) was critically examine using Newton's gravitational model of Manning equation for water depth analysis as well as water level duration analysis. The water level duration curves were used to determine the least available depth (LAD) for three stations (Onitsha, Lokoja and Baro) along the Lower Niger River. Although the two extremes of minimum and maximum depths and the fluctuations within were critical for the usage of any river for shipping economic activities,it was however, found that the on going dredging of the Lower Niger River would only marginally meets the required LAD for few months within a year and this will reduce from downstream to upstream along the water course.(Author)

  10. Nonprescription, padded, lightweight support socks in treatment of mild to moderate lower extremity venous insufficiency.

    Science.gov (United States)

    Brown, J R; Brown, A M

    1995-03-01

    Currently, strength greater than 20 mm Hg of compression is considered necessary for support hose used to treat symptomatic venous insufficiency in lower extremities. This strength is frequently uncomfortable, which reduces compliance and therefore clinical effectiveness. Whether more comfortable, nonprescription, light-compression support hose is effective in the treatment of mild to moderate venous insufficiency was investigated in 36 men with subjective complaints and objective signs (per Doppler ultrasound) of lower extremity venous insufficiency. All participants wore padded, light-compression (6 mm Hg), crew-height socks for 1 month. Then, participants were assigned to one of two groups on the basis of initial Doppler results. The half with the worst results wore stronger-compression (12 mm Hg) over-the-calf support socks, on the assumption that patients with worse venous insufficiency would require more support; those with the better Doppler results continued to wear the light-compression socks. Participants were retested at monthly intervals for 3 months. In each group, data indicated that the venous insufficiency for all patients improved objectively and subjectively. Many of the objective venous values improved with either statistical or highly statistical significance--specifically deep venous valve function, superficial venous valve functions, and venous capacity--without statistically altering arterial function. Improvement occurred in the first month of the trial and continued throughout the study. The use of light-compression support socks is effective and should be considered as a first line of therapy in treatment of mild to moderate venous insufficiency. PMID:7751167

  11. Post Mortem Human Surrogate Injury Response of the Pelvis and Lower Extremities to Simulated Underbody Blast.

    Science.gov (United States)

    Bailey, Ann M; Christopher, John J; Brozoski, Frederick; Salzar, Robert S

    2015-08-01

    Military vehicle underbody blast (UBB) is the cause of many serious injuries in theatre today; however, the effects of these chaotic events on the human body are not well understood. The purpose of this research was to replicate both UBB loading conditions and investigate occupant response in a controlled laboratory setting. In addition to better understanding the response of the human to high rate vertical loading, this test series also aimed to identify high rate injury thresholds. Ten whole body post mortem human surrogate (PMHS) tests were completed using the University of Virginia's ODYSSEY simulated blast rig under a range of loading conditions. Seat pan accelerations ranged from 291 to 738 g's over 3 ms of positive phase duration, and foot pan accelerations from 234 to 858 g's over 3 ms of positive phase duration. Post-test computed tomography (CT) scans and necropsies were performed to determine injuries, and revealed a combination of pelvic, lumbar, thoracic, and lower extremity injuries. The research in this paper discusses pelvis and lower extremity injuries under high rate vertical loads. PMID:25503737

  12. The Effect of Extremely Low Frequency Magnetic Field and Manganese on Bone Mineral Content and Density

    OpenAIRE

    Akpolat, Veysi

    2008-01-01

    The aim of this study was to investigate the effect of extremely low frequency magnetic field (ELF MF) on bone that exposed us in our daily life. In our study, sixty four male Wistar-Albino rats were used. The rats were exposed to ELF MF (50Hz, 1.5mT) during 4 hours/day for 45 days. The experimental rats were divided into eight groups (n=8 per group). The groups were as follows; only ELF MF was exposed to 1.group, the ELF MF was exposed to the 2., 3. and 4.groups with the doses manganese (Mn)...

  13. Sequence comparison for non-enhanced MRA of the lower extremity arteries at 7 Tesla.

    Directory of Open Access Journals (Sweden)

    Sören Johst

    Full Text Available In this study three sequences for non-contrast-enhanced MRA of the lower extremity arteries at 7T were compared. Cardiac triggering was used with the aim to reduce signal variations in the arteries. Two fast single-shot 2D sequences, a modified Ultrafast Spoiled Gradient Echo (UGRE sequence and a variant of the Quiescent-Interval Single-Shot (QISS sequence were triggered via phonocardiogram and compared in volunteer examinations to a non-triggered 2D gradient echo (GRE sequence. For image acquisition, a 16-channel transmit/receive coil and a manually positionable AngioSURF table were used. To tackle B1 inhomogeneities at 7T, Time-Interleaved Acquisition of Modes (TIAMO was integrated in GRE and UGRE. To compare the three sequences quantitatively, a vessel-to-background ratio (VBR was measured in all volunteers and stations. In conclusion, cardiac triggering was able to suppress flow artifacts satisfactorily. The modified UGRE showed only moderate image artifacts. Averaged over all volunteers and stations, GRE reached a VBR of 4.18±0.05, UGRE 5.20±0.06, and QISS 2.72±0.03. Using cardiac triggering and TIAMO imaging technique was essential to perform non-enhanced MRA of the lower extremities vessels at 7T. The modified UGRE performed best, as observed artifacts were only moderate and the highest average VBR was reached.

  14. Effects of shoe type on lower extremity muscle activity during treadmill walking.

    Science.gov (United States)

    Kim, Mi-Kyoung; Kim, Young-Hwan; Yoo, Kyung-Tae

    2015-12-01

    [Purpose] The purpose of this study was to analyze the effects of different shoe types on lower extremity muscle activity in healthy young women by using electromyography. [Subjects and Methods] Fifteen healthy young women in their 20s were included in this single-group repeated measures study. The subjects were divided into three groups: Converse sneakers, rain boots, and combat boots. The subjects walked on a treadmill at 4 km/h for 30 min, during which six muscles were examined using electromyography: the rectus femoris, vastus medialis, semimembranosus, tibialis anterior, peroneus longus, and medial head of the gastrocnemius. Between switching shoe types, a 24-h rest period was instated to prevent the fatigue effect from treadmill walking. [Results] One-way analysis of variance used to compare electromyography results among the three groups showed that the main effect of group differed significantly for the vastus medialis. Vastus medialis activity was higher in the rain boots group than the Converse sneakers group, and it was higher in the combat boots group than rain boots group. [Conclusion] Shoe type affects lower extremity muscle activity. Our findings may help individuals choose the ideal shoes for daily walking. PMID:26834363

  15. Endovascular management of deep venous thrombotic diseases of the lower extremity

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Byung Suk [School of Medicine, Wonkwang Univ., Iksan (Korea, Republic of)

    2004-07-01

    Pulmonary embolism and venous ischemia are acute complications of deep vein thrombosis (DVT) of the lower extremities. Delayed complications include a spectrum of debilitating symptoms referred to as postthrombotic syndrome (PST). Because the early symptoms and patient signs are nonspecific for DVT, careful history taking and radiological evaluation of the extent and migration of thrombus should be used to establish an objective diagnosis and the need for treatment. Anticoagulation therapy is recognized as the mainstay treatment in acute DVT. However, there are few data to suggest any major beneficial effect of the early clearing of massive DVT and PTS. Endovascular, catheter-directed, thrombolysis techniques, used alone or in combination with mechanical thrombectomy devices, have been proven to be highly effective in clearing acute DVT, which may allow the preservation of venous valve function and the prevention of subsequent venous occlusive disease. Definitive management of the underlying anatomic occlusive abnormalities should also be undertaken.

  16. Endovascular management of deep venous thrombotic diseases of the lower extremity

    International Nuclear Information System (INIS)

    Pulmonary embolism and venous ischemia are acute complications of deep vein thrombosis (DVT) of the lower extremities. Delayed complications include a spectrum of debilitating symptoms referred to as postthrombotic syndrome (PST). Because the early symptoms and patient signs are nonspecific for DVT, careful history taking and radiological evaluation of the extent and migration of thrombus should be used to establish an objective diagnosis and the need for treatment. Anticoagulation therapy is recognized as the mainstay treatment in acute DVT. However, there are few data to suggest any major beneficial effect of the early clearing of massive DVT and PTS. Endovascular, catheter-directed, thrombolysis techniques, used alone or in combination with mechanical thrombectomy devices, have been proven to be highly effective in clearing acute DVT, which may allow the preservation of venous valve function and the prevention of subsequent venous occlusive disease. Definitive management of the underlying anatomic occlusive abnormalities should also be undertaken

  17. MR imaging appearances of soft tissue flaps following reconstructive surgery of the lower extremity

    Energy Technology Data Exchange (ETDEWEB)

    Magerkurth, Olaf [Dept. of Radiology, Hospital Baden, Baden (Switzerland); Girish, Gandikota; Jacobson, Jon A.; Kim, Sung Moon; Brigido, Monica; Dong, Qian; Jamadar, David A. [Dept. of Radiology, University of Michigan Hospitals, Ann Arbor (United States)

    2015-02-15

    MR imaging appearances of different types of reconstructive muscle flaps following reconstructive surgery of the lower extremity with associated post-surgical changes due to altered anatomy, radiation, and potential complications, can be challenging. A multidisciplinary therapeutic approach to tumors allows for limb salvage therapy in a majority of the patients. Decision-making for specific types of soft tissue reconstruction is based on the body region affected, as well as the size and complexity of the defect. Hematomas and infections are early complications that can jeopardize flap viability. The local recurrence of a tumor within six months after a complete resection with confirmed tumor-free margins and adjuvant radiation therapy is rare. Identification of a new lesion similar to the initial tumor favors a finding of tumor recurrence.

  18. MR imaging appearances of soft tissue flaps following reconstructive surgery of the lower extremity

    International Nuclear Information System (INIS)

    MR imaging appearances of different types of reconstructive muscle flaps following reconstructive surgery of the lower extremity with associated post-surgical changes due to altered anatomy, radiation, and potential complications, can be challenging. A multidisciplinary therapeutic approach to tumors allows for limb salvage therapy in a majority of the patients. Decision-making for specific types of soft tissue reconstruction is based on the body region affected, as well as the size and complexity of the defect. Hematomas and infections are early complications that can jeopardize flap viability. The local recurrence of a tumor within six months after a complete resection with confirmed tumor-free margins and adjuvant radiation therapy is rare. Identification of a new lesion similar to the initial tumor favors a finding of tumor recurrence.

  19. Componentry for lower extremity prostheses.

    Science.gov (United States)

    Friel, Karen

    2005-09-01

    Prosthetic components for both transtibial and transfemoral amputations are available for patients of every level of ambulation. Most current suspension systems, knees, foot/ankle assemblies, and shock absorbers use endoskeletal construction that emphasizes total contact and weight distribution between bony structures and soft tissues. Different components offer varying benefits to energy expenditure, activity level, balance, and proprioception. Less dynamic ambulators may use fixed-cadence knees and non-dynamic response feet; higher functioning walkers benefit from dynamic response feet and variable-cadence knees. In addition, specific considerations must be kept in mind when fitting a patient with peripheral vascular disease or diabetes. PMID:16148358

  20. The efficacy of intermittent pneumatic compression in the prevention of lower extremity deep venous thrombosis.

    Science.gov (United States)

    Sadaghianloo, Nirvana; Dardik, Alan

    2016-04-01

    Intermittent pneumatic compression (IPC) has been used to prevent lower extremity deep venous thrombosis for more than 30 years and is a popular choice for prophylaxis among both physicians and patients because of its efficacy and reduced risk of bleeding compared with pharmacologic prophylaxis. However, the efficacy of IPC may depend on the clinical situation as well as on several variables associated with the devices. To determine the efficacy of IPC, recent guidelines and literature were reviewed. IPC is efficacious as a sole prophylactic agent in low- or moderate-risk surgical patients and in patients with high risk of bleeding with pharmacologic prophylaxis. In high-risk surgical and medical patients, IPC is recommended as a synergistic tool in combination with pharmacologic agents, if pharmacologic agents are not contraindicated. No specific compression modality proved its superiority, although newer portable battery-powered devices seem to allow better patient compliance and satisfaction. PMID:26993875

  1. Long-term follow-up of thalidomide embryopathy: malformations and development of osteoarthritis in the lower extremities and evaluation of upper extremity function

    OpenAIRE

    Ghassemi Jahani, Shadi A.; Danielson, Barbro; Karlsson, Jón; Danielsson, Aina J.

    2014-01-01

    Background Between 1959 and 1962, several children with multiple malformations were born after maternal intake of thalidomide during pregnancy, known as thalidomide embryopathy (TE). Objectives The aim of this study was to evaluate the malformations, their long-term effect on the function of the extremities and the development of degenerative osteoarthritis (OA) in the lower extremities. Methods All living persons with TE in Sweden were invited to participate in the study. Thirty-one patients...

  2. The application of thrombectomy with hydrolyser catheter in the treatment of lower extremity deep venous thrombosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical effectiveness of thrombectomy with hydrolyser catheter combined with catheter-directed thrombolysis in the treatment of chronic lower extremity deep venous thrombosis (LEDVT). Methods: 15 patients with thrombosis in left iliac veins (n = 2), left iliac and femoral veins (n = 8 ), left and right iliac and femoral veins (n = 5). Inferior vena cava filters (LVCF) were placed in all patients via the normal femoral veins. Antegrade puncture and catheterization was carried out through the femoral veins or popliteal veins in the thrombotic side. Thrombus aspiration with hydrolyser catheter combined with intravascular thrombolysis was accomplished. Results: The success rate of percutaneous catheterization was 100% (15/15). Total effective rate was 93% (14/15). No serious complications were observed. Conclusion: Thrombectomy with hydrolyser catheter combined with catheter-directed thrombolysis in the treatments of LEDVT is safe and effective

  3. The application of comprehensive nursing measures in interventional therapy for deep vein thrombosis of lower extremities

    International Nuclear Information System (INIS)

    Objective: To discuss the effective nursing measures in interventional therapy for deep vein thrombosis (DVT) of lower extremities in order to improve the successful rate of the procedure and to decrease the occurrence of complications. Methods: Comprehensive nursing measures, including general nursing care, specific nursing care and emergency nursing care, were employed in 63 DVT patients receiving interventional therapy. Clinical response and complications were observed. Results: After the treatment, the disorder was cured in 31 cases, while excellent result was seen in 26 cases and obvious improvement in 6 cases. During the procedure, bleeding at puncture site occurred in 16 cases, pulmonary embolism in 2 cases and cerebral hemorrhage in one case. No death occurred. Conclusion: Comprehensive nursing measures can effectively prevent or reduce the occurrence of complications, decrease the mortality rate. Therefore, Comprehensive nursing measures are the most helpful nursing care for DVT patients receiving interventional therapy. (authors)

  4. Color duplex-Doppler ultrasonography of lower extremities veins. Types of findings

    International Nuclear Information System (INIS)

    Background. The types of ultrasonographic findings observed in patients referred for color duplex Doppler ultrasonography (CDD-US) of veins of lower extremities are presented in this paper. Patients and methods. During 27 months, 934 patients were examined. Among these, 663 were women (71 %) and 271 men (29 %), with the age range 19-86 (mean 58.4) years. Color Doppler scanners Acuson 128 XP 10, ATL HDI 5000 and Siemens Sonoline Elegra were used, with the transducers in the frequency range from 2.5-12 MHz. The types of findings were classified as: (a) deep venous thrombosis (DVT), (b) pathology related to veins without DVT, (c) pathology of adjacent structures, (d) normal findings. Results. DVT was observed in 210 patients (22.5%) - acute or chronic in 129 patients, and 81 patients were examined in the follow-up of the DVT treatment. Postthrombotic syndrome, varicose veins, superficial thrombophlebitis and popliteal venous aneurysms were seen in 415 patients (44.4 %). The pathology unrelated to veins was observed in 117 patients (12.5 %). Muscular hematomas and popliteal cysts were most common in this group, but very rare pathology was noted, as well. In 192 patients (20.6 %) CDD-US was normal. Conclusions. In patients referred for CDD-US examination of lower extremities veins, a high number of findings unrelated to veins, in addition to well-known findings of various venous pathologies, can be observed on CDD-US. The lesions that clinically mimic DVT should be recognized with US in order to avoid erroneous medical treatment. (author)

  5. Effect of Reduced Stiffness Dance Flooring on Lower Extremity Joint Angular Trajectories During a Ballet Jump.

    Science.gov (United States)

    Hackney, James; Brummel, Sara; Newman, Mary; Scott, Shannon; Reinagel, Matthew; Smith, Jennifer

    2015-09-01

    We carried out a study to investigate how low stiffness flooring may help prevent overuse injuries of the lower extremity in dancers. It was hypothesized that performing a ballet jump (sauté) on a reduced stiffness dance floor would decrease maximum joint flexion angles and negative angular velocities at the hips, knees, or ankles compared to performing the same jump on a harder floor. The participants were 15 young adult female dancers (age range 18 to 28, mean = 20.89 ± 2.93 years) with at least 5 years of continuous ballet experience and without history of serious lower body injury, surgery, or recent pain. They performed sautés on a (low stiffness) Harlequin ® WoodSpring Floor and on a vinyl-covered hardwood on concrete floor. Maximum joint flexion angles and negative velocities at bilateral hips, knees, and ankles were measured with the "Ariel Performance Analysis System" (APAS). Paired one-tailed t-tests yielded significant decreases in maximum knee angle (average decrease = 3.4° ± 4.2°, p = 0.026) and angular negative velocity of the ankles (average decrease = 18.7°/sec ± 27.9°/sec, p = 0.009) with low stiffness flooring. If the knee angle is less acute, then the length of the external knee flexion moment arm will also be shorter and result in a smaller external knee flexion moment, given an equal landing force. Also, high velocities of eccentric muscle contraction, which are necessary to control negative angular velocity of the ankle joint, are associated with higher risk of musculotendinous injury. Hence, our findings indicate that reduced floor stiffness may indeed help decrease the likelihood of lower extremity injuries. PMID:26349504

  6. Use of the Endolymphatic Photodynamic Therapy in Treatment of Patients with the Lower Extremity Chronic Lymphatic Edemas

    Directory of Open Access Journals (Sweden)

    Zhukov B.N.

    2010-03-01

    Full Text Available A successful use of the endolymphatic photodynamic therapy in complex treatment of patients with the lower extremity secondary lymphostasis at the background of recurring erysipelatous inflammations is demonstrated. The given method permits to fully eliminate the microbic cells and significantly decrease a lymphohysteocytic infiltration in the extremity soft tissues.

  7. Lower extremity venous thrombosis in patients younger than 50 years of age

    Directory of Open Access Journals (Sweden)

    Kreidy R

    2012-03-01

    Full Text Available Raghid Kreidy1, Pascale Salameh2, Mirna Waked31Department of Vascular Surgery, Saint George Hospital, University Medical Center, University of Balamand, 2Laboratory of Clinical and Epidemiological Research, Faculty of Pharmacy, Lebanese University, 3Department of Pulmonary Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, LebanonAim: Lower extremity deep venous thrombosis in the young adult is uncommon and has not been well studied in the literature. The aim of this study is to define risk factors for deep venous thrombosis among patients younger than 50 years of age, to compare them with a control group, and to suggest recommendations for the management and treatment of venous thrombosis in this particular group of patients.Methods: From January 2003 to January 2011, 66 consecutive Lebanese patients (29 males and 37 females younger than 50 years, diagnosed in an academic tertiary-care center with lower extremity deep venous thrombosis by color flow duplex scan, were retrospectively reviewed. Their age varied between 21 and 50 years (mean 38.7 years. The control group included 217 patients (86 males and 131 females older than 50 years (range: 50–96 years; mean 72.9 years.Results: The most commonly reported risk factors in the younger age group were inherited thrombophilia (46.9% compared with 13.8% in the control group; P < 0.001, pregnancy (18.2% compared with 0.5%; P < 0.001, treatment with estrogen drugs (13.6% compared with 2.3%; P = 0.001, and family history of venous thromboembolism (9.1% compared with 3.8%; P = 0.084.Conclusion: Inherited thrombophilia is the most commonly observed risk factor among patients younger than 50 years, with a prevalence of three times more than the control group. Young adults should be screened for thrombophilia even in the presence of transient acquired risk factors. Pregnancy and treatment with estrogen drugs essentially when associated with inherited thrombophilia

  8. Postural Stability During Single-Leg Stance: A Preliminary Evaluation of Noncontact Lower Extremity Injury Risk.

    Science.gov (United States)

    Dingenen, Bart; Malfait, Bart; Nijs, Stefaan; Peers, Koen H E; Vereecken, Styn; Verschueren, Sabine M P; Janssens, Luc; Staes, Filip F

    2016-08-01

    Study Design Controlled laboratory study with a prospective cohort design. Background Postural stability deficits during single-leg stance have been reported in persons with anterior cruciate ligament (ACL) injury, ACL reconstruction, and chronic ankle instability. It remains unclear whether impaired postural stability is a consequence or cause of these injuries. Objectives To prospectively investigate whether postural stability deficits during single-leg stance predict noncontact lower extremity injuries. Methods Fifty injury-free female athletes performed a transition task from double-leg stance to single-leg stance with eyes closed. Center-of-pressure displacement, the main outcome variable, was measured during the first 3 seconds after the time to a new stability point was reached during single-leg stance. Noncontact lower extremity injuries were recorded at a 1-year follow-up. Results Six participants sustained a noncontact ACL injury or ankle sprain. Center-of-pressure displacement during the first 3 seconds after the time to a new stability point was significantly increased in the injured (P = .030) and noninjured legs (P = .009) of the injured group compared to the respective matched legs of the noninjured group. The area under the receiver operating characteristic curve (AUC) analysis revealed significant discriminative accuracy between groups for the center-of-pressure displacement during the first 3 seconds after the time to a new stability point of the injured (AUC = 0.814, P = .015) and noninjured legs (AUC = 0.897, P = .004) of the injured group compared to the matched legs of the noninjured group. Conclusion This preliminary study suggests that postural stability measurements during the single-leg stance phase of the double- to single-leg stance transition task may be a useful predictor of increased risk of noncontact lower extremity injury. Further research is indicated. Level of Evidence Prognosis, level 4. J Orthop Sports PhysTher 2016

  9. Creation of a neo-aortoiliac system from lower extremity deep and superficial veins.

    Science.gov (United States)

    Clagett, G P; Bowers, B L; Lopez-Viego, M A; Rossi, M B; Valentine, R J; Myers, S I; Chervu, A

    1993-01-01

    OBJECTIVE: This study evaluated the morbidity, mortality, and intermediate term follow-up of patients undergoing replacement of their aortoiliac-femoral systems with lower extremity deep and superficial veins. SUMMARY BACKGROUND DATA: The most commonly used treatment for aortic prosthetic infection is ectopic bypass and removal of the prosthesis. The overall mortality rate with this approach is approximately 20%, with an amputation rate of 10% to 14%. Other limitations include thrombosis of the ectopic bypass leading to limb loss, reinfection of the ectopic bypass, and aortic stump blowout. Dissatisfaction with this approach has led the authors to develop the following. METHODS: A neo-aortoiliac system (NAIS) was fashioned from lower extremity deep veins (DV), greater saphenous veins (GSV), or both in patients with infected aortobifemoral prosthesis (n = 17) and other complex aortic problems (n = 3). Removal of infected prosthetic material, harvest of vein, and creation of NAIS was performed as a single-staged procedure. RESULTS: The in-hospital mortality and amputation rates were 10% each. The mean (+/- standard deviation [SD]) operative time was 6.5 +/- 1.8 hours and the blood transfusion requirement was 4 +/- 3 units. Four patients experienced postoperative gastrointestinal complications with peritonitis and sepsis; NAIS vein graft resisted infection and remained intact. The mean follow-up time was 22.5 +/- 16 months. NAISs constructed from GSVs were prone to the development of focal stenoses requiring intervention or diffuse neointimal hyperplasia leading to occlusion. In contrast, all NAISs from larger caliber DVs have remained widely patent. The failure rate of GSV NAISs was 64%, compared to 0% for DV NAISs (p = 0.006). Despite the high failure rate in patients with GSV NAISs, none has required amputation. In patients who had DVs harvested for NAIS reconstruction, limb edema and other signs of venous hypertension have been minimal. CONCLUSION: NAIS

  10. Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome

    Science.gov (United States)

    Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan

    2015-01-01

    Abstract Vascular involvement can be seen in up to 40% of patients with Behcet syndrome (BS), the lower-extremity vein thrombosis (LEVT) being the most common type. The aim of the current study was to compare venous Doppler findings and clinical features between BS patients with LEVT and control patients diagnosed as having LEVT due to other causes. All consecutive 78 patients (71 men, 7 women; mean age 38.6 ± 10.3 years) with LEVT due to BS and 50 control patients (29 men, 21 women; mean age 42.0 ± 12.5 years) who had LEVT due to other causes, or idiopathic, were studied with the help of a Doppler ultrasonography after a detailed clinical examination. Patterns of venous disease were identified by cluster analyses. Clinical features of chronic venous disease were assessed using 2 classification systems. Venous claudication was also assessed. Patients with BS were more likely to be men, had significantly earlier age of onset of thrombosis, and were treated mainly with immunosuppressives and less frequently with anticoagulants. Furthermore, they had significantly more bilateral involvement, less complete recanalization, and more frequent collateral formation. While control patients had a disorganized pattern of venous involvement, BS patients had a contiguous and symmetric pattern, involving all deep and superficial veins of the lower extremities, with less affinity for crural veins. Clinical assessment, as measured by the 2 classification systems, also indicated a more severe disease among the BS patients. In line, 51% of the BS patients suffered from severe post-thrombotic syndrome (PTS) and 32% from venous claudication, whereas these were present in 8% and 12%, respectively, among the controls. Among BS patients, a longer duration of thrombosis, bilateral femoral vein involvement, and using no anticoagulation along with immunosuppressive treatment when first diagnosed were found to be associated independently with severe PTS. Lower-extremity vein

  11. Extreme Ultra-Violet Spectroscopy of the Lower Solar Atmosphere During Solar Flares (Invited Review)

    Science.gov (United States)

    Milligan, Ryan O.

    2015-12-01

    The extreme ultra-violet (EUV) portion of the solar spectrum contains a wealth of diagnostic tools for probing the lower solar atmosphere in response to an injection of energy, particularly during the impulsive phase of solar flares. These include temperature- and density-sensitive line ratios, Doppler-shifted emission lines, nonthermal broadening, abundance measurements, differential emission measure profiles, continuum temperatures and energetics, among others. In this article I review some of the recent advances that have been made using these techniques to infer physical properties of heated plasma at footpoint and ribbon locations during the initial stages of solar flares. I primarily focus on studies that have utilised spectroscopic EUV data from Hinode/EUV Imaging Spectrometer (EIS) and Solar Dynamics Observatory/EUV Variability Experiment (SDO/EVE), and I also provide some historical background and a summary of future spectroscopic instrumentation.

  12. Chronopharmacodynamics of Intrathecal Co-injection of Sufentanyl and Bupivacaine in Orthopedic Surgery of Lower Extremities

    Directory of Open Access Journals (Sweden)

    B Sadri

    2012-05-01

    Full Text Available  

    Background and objectives: In chronopharmacology the biological rhythm variations caused by drug administration is assessed. Evaluation of the time of drug administration and the qualitative and quantitative effects of reactions to drugs is called chronopharmacodynamics. In this study, we assessed the chronopharmacodynamics of intrathecal co-administration of sufentanyl and bupivacaine in surgical operations of lower extremities.  

    Methods: In 2006, patients aged 20-50 with ASA physical status of I and II, who underwent surgical operation of lower extremities were entered into this prospective study. The patients received a slow intrathecal injection of 10 μg sufentanyl and 15 mg bupivacaine into subarachnoid of third and fourth lumbar spaces in 30 seconds. After the operation, the time of first pain sensation and the visual analogue scale (VAS score, as the measure of severity of pain, were recorded.  

    Results: 115 patients were studied in this project. The pain-free interval was considered as the time between injection and patient’s demand for pain relief. This interval was 746 (± 322 minutes. The average score of pain severity on VAS at the time of demand for pain relief was 24.7 (± 9.3. The average pain-free duration in patients injected about noon or at midnight was significantly longer than the pain-free interval of other patients. 

    Conclusion: The results show that intrathecal co-administration of sufentanyl and bupivacaine at noon or midnight (conforming to the circadian rhythm causes better pain-relief with longer duration in comparison with other times of the day or night. 

  13. Lymphoedema of the lower extremities--background, pathophysiology and diagnostic considerations

    DEFF Research Database (Denmark)

    Jensen, Mads R; Simonsen, Lene; Karlsmark, Tonny;

    2010-01-01

    system most often caused by cancer or its treatment. Many of the underlying pathophysiological mechanisms have yet to be elucidated. Many methods have been developed for examination of the lymphatic system. Lymphoscintigraphy is presently the preferred diagnostic modality. Lack of consensus regarding......Lymphoedema of the lower extremities is a chronic debilitating disease that is often underdiagnosed. Early diagnosis and treatment is paramount in reducing the risk of progression and complications. Lymphoedema has traditionally been defined as interstitial oedema and protein accumulation because...... protocol and qualitative interpretation criteria results in a too observer dependent outcome. Methods for objectifying the scintigraphy through quantification have been criticized. Depot clearance rates are an alternative method of quantification of lymphatic drainage capacity. This method however has...

  14. Imaging features of soft tissue epithelioid angiosarcoma in the lower extremity: A case report

    Science.gov (United States)

    LV, LULU; XU, PENG; SHI, YIBING; HAO, JINGMING; HU, CHUNAI; ZHAO, BAOZHONG

    2016-01-01

    Epithelioid angiosarcomas are extremely rare malignant tumors formed from endothelial cells. The majority of studies reporting these tumors have been concerned with the clinical and pathological aspects, with limited reporting of radiological diagnosis. The aim of the present study was to provide a reference to improve understanding of diagnosis, treatment choice and prognosis assessment of epithelioid angiosarcoma. The current study reports the case of a 44-year-old woman with epithelioid angiosarcoma located in the deep soft tissue of the lower extremities. Physical examination of the right thigh revealed a palpable hard mass and movement was clearly restricted and painful. X-ray, computed tomography (CT) scans and magnetic resonance imaging (MRI) were used to evaluate the imaging features of the tumor. Using X-ray and CT scanning, an inhomogenous tumor with osteolytic osseous destruction was observed. MRI revealed that the bordering skeletal muscles were infiltrated. The patient was treated with palliative surgery and chemotherapy, but succumbed to disease 1 year later. PMID:27123135

  15. Accuracy and consequences of 3D-fluoroscopy in upper and lower extremity fracture treatment: A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Beerekamp, M.S.H., E-mail: m.s.beerekamp@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Sulkers, George S.I., E-mail: georgesulkers@gmail.com [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Ubbink, Dirk T., E-mail: D.Ubbink@amc.nl [Department of Quality and Process Innovation, Academic Medical Center, Amsterdam (Netherlands); Maas, Mario, E-mail: M.Maas@amc.nl [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Schep, Niels W.L., E-mail: N.W.Schep@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Goslings, J. Carel, E-mail: J.C.Goslings@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands)

    2012-12-15

    Objectives: The aim of this systematic review was to compare the diagnostic accuracy, subjective image quality and clinical consequences of 3D-fluoroscopy with standard imaging modalities (2D-fluoroscopy, X-ray or CT) during reduction and fixation of intra-articular upper and lower extremity fractures. Methods: A systematic literature search was performed in MEDLINE, EMBASE and the Cochrane library. In total 673 articles were identified (up to March 2012). The 19 included studies described patients/cadavers with intra-articular upper/lower extremity fractures and compared 3D-fluoroscopy to standard imaging. The study was performed in accordance with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) guidelines. Diagnostic accuracy was defined by the quality of fracture reduction or implant position and, if possible, expressed as sensitivity and specificity; subjective image quality was determined by the quality of depiction of bone or implants; clinical consequences were defined as corrections in reduction or implant position following 3D-fluoroscopy. Results: Ten cadaver- and nine clinical studies were included. A meta-analysis was not possible, because studies used different scoring protocols to express diagnostic accuracy and reported incomplete data. Based on the individual studies, diagnostic accuracy of 3D-fluoroscopy was better than 2D-fluoroscopy and X-ray, but similar to CT-scanning. Subjective image quality of 3D-fluoroscopy was inferior compared to all other imaging modalities. In 11–40% of the operations additional corrections were performed after 3D-fluoroscopy, while the necessity for these corrections were not recognized based on 2D-fluoroscopic images. Conclusions: Although subjective image quality is rated inferior compared to other imaging modalities, intra-operative use of 3D-fluoroscopy is a helpful diagnostic tool for improving the quality of reduction and implant position in intra-articular fractures.

  16. Accuracy and consequences of 3D-fluoroscopy in upper and lower extremity fracture treatment: A systematic review

    International Nuclear Information System (INIS)

    Objectives: The aim of this systematic review was to compare the diagnostic accuracy, subjective image quality and clinical consequences of 3D-fluoroscopy with standard imaging modalities (2D-fluoroscopy, X-ray or CT) during reduction and fixation of intra-articular upper and lower extremity fractures. Methods: A systematic literature search was performed in MEDLINE, EMBASE and the Cochrane library. In total 673 articles were identified (up to March 2012). The 19 included studies described patients/cadavers with intra-articular upper/lower extremity fractures and compared 3D-fluoroscopy to standard imaging. The study was performed in accordance with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) guidelines. Diagnostic accuracy was defined by the quality of fracture reduction or implant position and, if possible, expressed as sensitivity and specificity; subjective image quality was determined by the quality of depiction of bone or implants; clinical consequences were defined as corrections in reduction or implant position following 3D-fluoroscopy. Results: Ten cadaver- and nine clinical studies were included. A meta-analysis was not possible, because studies used different scoring protocols to express diagnostic accuracy and reported incomplete data. Based on the individual studies, diagnostic accuracy of 3D-fluoroscopy was better than 2D-fluoroscopy and X-ray, but similar to CT-scanning. Subjective image quality of 3D-fluoroscopy was inferior compared to all other imaging modalities. In 11–40% of the operations additional corrections were performed after 3D-fluoroscopy, while the necessity for these corrections were not recognized based on 2D-fluoroscopic images. Conclusions: Although subjective image quality is rated inferior compared to other imaging modalities, intra-operative use of 3D-fluoroscopy is a helpful diagnostic tool for improving the quality of reduction and implant position in intra-articular fractures.

  17. Predictors of lower-extremity amputation in patients with an infected diabetic foot ulcer

    DEFF Research Database (Denmark)

    Pickwell, Kirsty; Siersma, Volkert; Kars, Marleen;

    2015-01-01

    OBJECTIVE Infection commonly complicates diabetic foot ulcers and is associated with a poor outcome. In a cohort of individuals with an infected diabetic foot ulcer, we aimed to determine independent predictors of lower-extremity amputation and the predictive value for amputation of the...... International Working Group on the Diabetic Foot (IWGDF) classification system and to develop a risk score for predicting amputation. RESEARCH DESIGN AND METHODS We prospectively studied 575 patients with an infected diabetic foot ulcer presenting to 1 of 14 diabetic foot clinics in 10 European countries...... IWGDF system (area under the ROC curves 0.80, 0.78, and 0.67, respectively). CONCLUSIONS For individuals with an infected diabetic foot ulcer, we identified independent predictors of amputation, validated the prognostic value of the IWGDF classification system, and developed a new risk score for...

  18. US-guided injection of the upper and lower extremity joints

    Energy Technology Data Exchange (ETDEWEB)

    Collins, James M.P., E-mail: j.collins@znb.nl [Department of Radiology, Medical Center Leeuwarden, H. Dunantweg 2, AD Leeuwarden (Netherlands); Smithuis, Robin [Department of Radiology, Rijnland Hospital, Leiderdorp (Netherlands); Rutten, Matthieu J.C.M. [Department of Radiology, Jeroen Bosch Hospital, ‘s-Hertogenbosch (Netherlands)

    2012-10-15

    There is a growing interest in the application of ultrasound (US) guidance for diagnostic and therapeutic joint injections. US provides direct visualization of soft tissues and the outer borders of bony structures. With real-time needle guidance the success rate of intra-articular injections improves and iatrogenic damage to anatomic structures can be avoided. An US machine is more readily available, transferrable and more affordable than a fluoroscopy machine or CT scanner and lacks the risk of radiation. These factors make US a valuable alternative to procedures performed either blind or under fluoroscopic or CT guidance. This article focuses on the rationale for injections in the upper and lower extremity joints and describes and illustrates the different US-guided injection techniques.

  19. A 61-Year-Old Man With Shortness of Breath, Ascites, and Lower Extremity Edema.

    Science.gov (United States)

    Ataya, Ali; Cope, Jessica M; Moguillansky, Diego; Machuca, Tiago N; Alnuaimat, Hassan

    2016-06-01

    A 61-year-old man presented with an 18-month history of progressive shortness of breath on exertion, fatigue, worsening bilateral lower extremity edema, abdominal swelling, and increased assistance with activities of daily living. Pertinent past medical history included right-sided pneumonia secondary to Streptococcus pneumoniae that was complicated by empyema, requiring right-sided video-assisted thoracoscopic surgery with decortication 2 years earlier. He had a negative cardiac history, no recent travel in the last 3 years, and no known exposure to tuberculosis. His medications included aspirin and daily furosemide. His symptoms appeared to be refractory to diuretic therapy. Previous workup 6 months earlier included an echocardiography (ECHO) showing enlarged left and right atria with a normal ejection fraction, and a catheterization of the left side of the heart with reported normal left ventricular function and unobstructed coronary arteries. PMID:27287597

  20. Influence of Lower Extremity Muscle Size and Quality on Stair-Climb Performance in Career Firefighters.

    Science.gov (United States)

    Kleinberg, Craig R; Ryan, Eric D; Tweedell, Andrew J; Barnette, Timothy J; Wagoner, Chad W

    2016-06-01

    Kleinberg, CR, Ryan, ED, Tweedell, AJ, Barnette, TJ, and Wagoner, CW. Influence of lower extremity muscle size and quality on stair-climb performance in career firefighters. J Strength Cond Res 30(6): 1613-1618, 2016-The purpose of this study was to examine the influence of lower extremity muscular size and quality on stair-climb performance (SCP) in career firefighters. Forty-six male career firefighters (age = 37.0 ± 7.2 years; stature = 180.2 ± 6.9 cm; body mass = 108.0 ± 19.8 kg) volunteered for this study. Panoramic ultrasound images of the vastus lateralis and rectus femoris were obtained to determine cross-sectional area (CSA) and echo intensity (EI) of each muscle. The CSA of each muscle was then summed together and normalized to body mass (CSA/BM [QCSA]). Additionally, EI was averaged across both muscles (QEI). Participants then performed a timed and weighted SCP assessment where they ascended and descended 26 stairs 4 times as quickly as possible while wearing a weighted vest (22.73 kg) to simulate the weight of their self-contained breathing apparatus and turnout gear. Bivariate correlations and stepwise regression analyses were used to examine the relationships among variables and the relative contributions of QCSA and QEI to SCP. Partial correlations were used to examine the relationship between QCSA and SCP and QEI and SCP while controlling for age and body mass index (BMI). The results indicated that QCSA and QEI were significantly related to SCP before (r = -0.492, p = 0.001; r = 0.363, p = 0.013, respectively) and after accounting for age and BMI (r = -0.324, p = 0.032; r = 0.413, p = 0.005, respectively). Both QCSA and QEI contributed significantly to the prediction of SCP (r = 0.560, p firefighting tasks, which have been shown to be improved with resistance training. PMID:26605810

  1. Review of supplemental views and stress radiography in musculoskeletal trauma: lower extremity.

    Science.gov (United States)

    Friedman, Michael V; Chris, Smith; Baker, Jonathan C; Hillen, Travis J

    2015-10-01

    The standard radiographic series is not always sufficient to diagnose and characterize subtle musculoskeletal injuries. Missed or delayed diagnoses can negatively affect patient acute morbidity and long-term outcomes. Similarly, management based on erroneous diagnoses may lead to unnecessary treatment and restrictions. Body-part- or joint-specific supplemental radiographic views and stress radiography offer an alternative for further evaluation of subtle injuries in specific clinical situations and may obviate the need for the added cost and potential ionizing radiation exposure of further cross-sectional imaging. Familiarity with these complementary exams allows radiologists to play an important role in patient care, as their utilization can improve diagnostic accuracy, clarify subtle or uncertain findings, and direct timely patient management. This review highlights important supplemental views and stress radiographic examinations useful in the evaluation of emergent lower extremity musculoskeletal trauma. PMID:25855083

  2. Salvage versus amputation: Utility of mangled extremity severity score in severely injured lower limbs

    Directory of Open Access Journals (Sweden)

    Kumar M

    2007-01-01

    Full Text Available Background: The purpose of the present study was to evaluate the clinical utility of Mangled extremity severity score (MESS in severely injured lower limbs. Materials and Methods: Retrospectively 25 and prospectively 36 lower limbs in 58 patients with high-energy injuries were evaluated with the use of MESS, to assist in the decision-making process for the care of patients with such injuries. Difference between the mean MESS scores for amputated and salvaged limbs was analyzed. Results: In the retrospective study 4.65 (4.65 ± 1.32 was the mean score for the salvaged limbs and 8.80 (8.8 ± 1.4 for the amputated limbs. In the prospective study 4.53 (4.53 ± 2.44 was the mean score for the salvaged limbs and 8.83 (8.83 ± 2.34 for the amputated limbs. There was a significant difference in the mean scores for salvaged and amputated limbs. Retrospective 21 (84% and prospective 29 (80.5% limbs remained in the salvage pathway six months after the injury. Conclusion: MESS could predict amputation of severely injured lower limbs, having score of equal or more than 7 with 91% sensitivity and 98% specificity. There was a significant difference in the mean MESS scores in the prospective study (n=36, 4.53 (4.53 ± 2.44 in thirty salvaged limbs (83.33% and 8.83 (8.83 ± 2.34 in six amputated limbs (16.66% with a P -value 0.002 ( P -value < 0.01. Similarly there was a significant difference in the mean MESS score in the retrospective study (n=25, 4.65 (4.65 ± 1.32 in twenty salvaged limbs (80% and 8.80 (8.8 ± 1.4 in five amputated limbs (20% with a P -value 0.00005 ( P -value < 0.01. MESS is a simple and relatively easy and readily available scoring system which can help the surgeon to decide the fate of the lower extremity with a high-energy injury.

  3. Incidence and prevalence of lower extremity tendinopathy in a Dutch general practice population: a cross sectional study

    OpenAIRE

    Albers, Iris Sophie; Zwerver, Johannes; Diercks, Ronald Leo; Dekker, Janny Hendrika; van den Akker-Scheek, Inge

    2016-01-01

    Background Lower extremity tendinopathy is a common sports injury, but it can also affect non-athletes. Because tendinopathy is difficult to treat and has negative effects on the ability to work and quality of life, development of preventive interventions is important. The first step in the Van Mechelen prevention model is to determine the extent of the problem. The primary aim of this study was to determine the incidence and prevalence of lower extremity tendinopathy in a Dutch general pract...

  4. Effect of sprung (suspended) floor on lower extremity stiffness during a force-returning ballet jump.

    Science.gov (United States)

    Hackney, James; Brummel, Sara; Becker, Dana; Selbo, Aubrey; Koons, Sandra; Stewart, Meredith

    2011-12-01

    Our objective in this study was to compare stiffness of bilateral lower extremities (LEs) in ballet dancers performing sauté on a low-stiffness "sprung floor" to that during the same movement on a high-stiffness floor (wood on concrete). LE stiffness was calculated as the ratio of vertical ground reaction force (in kN) to compression of the lower limb (in meters). Seven female dancers were measured for five repetitions each at the point of maximum leg compression while performing sauté on both of the surfaces, such that 43 ms of data were represented for each trial. The stiffness of bilateral LEs at the point of maximum compression was higher by a mean difference score of 2.48 ± 2.20 kN/m on the low-stiffness floor compared to a high-stiffness floor. Paired t-test analysis of the difference scores yielded a one-tailed probability of 0.012. This effect was seen in six out of seven participants (one participant showed no difference between floor conditions). The finding of increased stiffness of the LEs in the sprung floor condition suggests that some of the force of landing the jump was absorbed by the surface, and therefore did not need to be absorbed by the participants' LEs themselves. This in turn implies that a sprung dance floor may help to prevent dance-related injuries. PMID:22211195

  5. Autologous transplantation of bone marrow mesenchymal stem cells on diabetic patients with lower limb ischemia

    Institute of Scientific and Technical Information of China (English)

    Lu Debin; Jiang Youzhao; Liang Ziwen; Li Xiaoyan; Zhang Zhonghui; Chen Bing

    2008-01-01

    Objective: To study the efficacy and safety of autologous transplantation of bone marrow mesenchymal stem cells on diabetic patients with lower limb ischemia. Methods: Fifty Type 2 diabetic patients with lower limb ischemia were enrolled and randomized to either transplanted group or control group. Patients in both group received the same conventional treatment. Meanwhile, 20 ml bone marrow from each transplanted patient were collected, and the mesenchymal stem cells were separated by density gradient centrifugation and cultured in the medium with autologous serum. After three-weeks adherent culture in vitro, 7.32×108-5.61×109 mesenchymal stern cells were harvested and transplanted by multiple intramuscular and hypodermic injections into the impaired lower limbs. Results: At the end of 12-week follow-up, 5 patients were excluded from this study because of clinical worsening or failure of cell culture. Main ischemic symptoms, including rest pain and intermittent claudication, were improved significantly in transplanted patients. The ulcer healing rate of the transplanted group (15 of 18, 83.33%) was significantly higher than that of the control group (9 of 20, 45.00%, P=0.012).The mean of resting ankle-brachial index (ABI) in transplanted group significantly was increased from 0.61±0.09 to 0.74±0.11 (P<0.001). Magnetic resonance angiography (MRA) demonstrated that there were more patients whose score of new vessels exceeded or equaled to 2 in the transplant patients (11 of 15) than in control patients (2 of 14, P=0.001). Lower limb amputation rate was significantly lower in transplanted group than in the control group (P=0.040). No adverse effects was observed in transplanted group. Conclusion: These results indicate that the autologous transplantation of bone marrow mesenehymal stem cells relieves critical lower limb ischemia and promotes ulcers healing in Type 2 diabetic patients.

  6. Landing Error Scoring System (LESS) Items are Associated with the Incidence Rate of Lower Extremity Stress Fracture

    OpenAIRE

    Cameron, Kenneth L.; Peck, Karen Y.; Owens, Brett D.; Svoboda, Steven J.; DiStefano, Lindsay J.; Marshall, Stephen W.; de la Motte, Sarah; Beutler, Anthony I.; Padua, Darin A.

    2014-01-01

    Objectives: Lower-extremity stress fracture injuries are a major cause of morbidity in physically active populations. The ability to efficiently screen for modifiable risk factors associated with injury is critical in developing and implementing effective injury prevention programs. The purpose of this study was to determine if baseline Landing Error Scoring System (LESS) scores were associated with the incidence rate of lower-extremity stress fracture during four years of follow-up. Methods:...

  7. Clinical report of an extremely severe bone marrow form of acute radiation sickness

    International Nuclear Information System (INIS)

    Objective: To sum up the experiences from the diagnosis and treatment of patient B subjected to an accidental 60Co exposure on October 21st, 2004, in Jining, Shandong Province, China. Methods: Radiation dose of B was assessed by analysis of chromosome aberration and microneucleus assay, simulation test of the accident site, autopsy and electron spin resonance (ESR). The ultimate clinical diagnosis was based on analysis of irradiation dose, clinical manifestations and laboratory results. In therapeutical aspects, total environmental protection, HLA-identical allogeneic peripheral blood stem cell transplantation (PBSCT), anti- infection and protection managements of organs were given. Results: Patient B was diagnosed as extremely severe bone marrow form of acute radiation sickness (ARS). HLA-identical allogeneic PBSCT was performed on the patient from his brother on the 7th day after the accident. The hematopoietic recovery began on the 9th day after transplantation. The patient acquired permanent full donor' engraftment without graft versus host disease (GVHD), But the radiation injury was continuing and the patient complicated with polyinfection in lung, and cardiac insufficiency. On the 45th day after the accident, patient B was performed with tracheotomy and maintained ventilation with respirator. On the 75th day after the accident, patient B died of multiple organ failure. Conclusions: Early triage diagnosis and total environmental protection should be performed as soon as possible for extremely severe bone marrow form of ARS. It is very important to perform a successful HLA-identical allogeneic PBSCT, in order to extend the life time of the patient. Multiple organ injuries and infections of bacteria and fungi usually occurred on this kind of patients, so intense measures of anti-infection and protection of multiple organs should be taken. The important and difficult point in the treatment of this kind ARS might be for help the immune-reconstruction and tissue

  8. The effect of virtual reality-based eccentric training on lower extremity muscle activation and balance in stroke patients

    Science.gov (United States)

    Park, Seung Kyu; Yang, Dae Jung; Uhm, Yo Han; Heo, Jae Won; Kim, Je Ho

    2016-01-01

    [Purpose] The purpose of this study was to examine the effect of virtual reality-based eccentric training on lower extremity muscle activity and balance in stroke patients. [Subjects and Methods] Thirty stroke patients participated, with 15 patients allotted to each of two eccentric training groups: one using a slow velocity (group I) and one using a fast velocity (group II). The virtual reality-based eccentric training was performed by the patients for 30 minutes once a day, 5 days a week, for 8 weeks using an Eccentron system. Surface electromyography was used to measure the lower extremity muscle activity, while a BioRescue was used to measure balancing ability. [Results] A significant difference in lower extremity muscle activation and balance ability was observed in group I compared with group II. [Conclusion] This study showed that virtual reality-based eccentric training using a slow velocity is effective for improving lower extremity muscle activity and balance in stroke patients. PMID:27512263

  9. Correlation of Pain Scores, Analgesic Use, and Beck Anxiety Inventory Scores During Hospitalization in Lower Extremity Amputees

    OpenAIRE

    Trame, Cathy D; Greene, Erin; Moddeman, Gail; Booth, Branyan A; Konstantakos, Emmanuel K; Parada, Stephen; Siebuhr, Karl; Laughlin, Richard T.

    2008-01-01

    Post amputation pain can be debilitating for patients and families. Chronic pain is a common phenomenon after lower extremity amputation, occurring in up to 80% of this population. The purpose of this pilot study was to correlate post amputation pain scores to opioid analgesic consumption and Beck Anxiety Inventory (BAI) scores. Twenty-three patients with lower extremity amputation at an 827-bed acute care inner-city hospital were surveyed pre-operatively and post-operatively to determine if ...

  10. Gender-based analysis of perioperative outcomes associated with lower extremity bypass.

    Science.gov (United States)

    Jain, Ashish K; Velazquez-Ramirez, Gabriela; Goodney, Philip P; Edwards, Matthew S; Corriere, Matthew A

    2011-07-01

    We analyzed gender-based differences in preoperative factors, procedural characteristics, and 30-day outcomes after lower extremity bypass (LEB). LEB procedures were identified from the American College of Surgeons National Surgical Quality Improvement Program Participant User File. Groupwise comparisons of preoperative and procedural variables were made using chi square, t tests, and nonparametric methods; gender influences on mortality, systemic, and surgical site complications were evaluated using logistic regression. Women (4,107 of 11,011 [37.3%]) were older and had greater prevalence of hypertension, diabetes, chronic obstructive pulmonary disease, rest pain, dialysis, previous stroke, open/infected wound, and dependent functional status (P < 0.01 for all comparisons). Women more commonly underwent emergent and extra-anatomic procedures but had lower rates of venous conduit or tibial level outflow use. Univariable associations between female gender and risk of 30-day mortality, systemic, and surgical site complications were identified; only the association with surgical site complications remained significant in multivariable modeling (OR, 1.8; 95% CI, 1.6 to 2.1; P < 0.0001). Gender-based differences in demographic, comorbidity, and procedural factors may contribute to disparities in perioperative outcomes associated with LEB. Female gender may be associated with increased risk for surgical site complications, but 30-day mortality and systemic complication rates in women may reflect effects of confounding factors rather than gender-specific influence. PMID:21944345

  11. Precision and accuracy of 3D lower extremity residua measurement systems

    Science.gov (United States)

    Commean, Paul K.; Smith, Kirk E.; Vannier, Michael W.; Hildebolt, Charles F.; Pilgram, Thomas K.

    1996-04-01

    Accurate and reproducible geometric measurement of lower extremity residua is required for custom prosthetic socket design. We compared spiral x-ray computed tomography (SXCT) and 3D optical surface scanning (OSS) with caliper measurements and evaluated the precision and accuracy of each system. Spiral volumetric CT scanned surface and subsurface information was used to make external and internal measurements, and finite element models (FEMs). SXCT and OSS were used to measure lower limb residuum geometry of 13 below knee (BK) adult amputees. Six markers were placed on each subject's BK residuum and corresponding plaster casts and distance measurements were taken to determine precision and accuracy for each system. Solid models were created from spiral CT scan data sets with the prosthesis in situ under different loads using p-version finite element analysis (FEA). Tissue properties of the residuum were estimated iteratively and compared with values taken from the biomechanics literature. The OSS and SXCT measurements were precise within 1% in vivo and 0.5% on plaster casts, and accuracy was within 3.5% in vivo and 1% on plaster casts compared with caliper measures. Three-dimensional optical surface and SXCT imaging systems are feasible for capturing the comprehensive 3D surface geometry of BK residua, and provide distance measurements statistically equivalent to calipers. In addition, SXCT can readily distinguish internal soft tissue and bony structure of the residuum. FEM can be applied to determine tissue material properties interactively using inverse methods.

  12. Cigarette Smoking Is Associated with a Lower Concentration of CD105+ Bone Marrow Progenitor Cells

    Directory of Open Access Journals (Sweden)

    Shaul Beyth

    2015-01-01

    Full Text Available Cigarette smoking is associated with musculoskeletal degenerative disorders, delayed fracture healing, and nonunion. Bone marrow progenitor cells (BMPCs, known to express CD105, are important in local trophic and immunomodulatory activity and central to musculoskeletal healing/regeneration. We hypothesized that smoking is associated with lower levels of BMPC. Iliac bone marrow samples were collected from individuals aged 18–65 years during the first steps of pelvic surgery, under IRB approval with informed consent. Patients with active infectious or neoplastic disease, a history of cytotoxic or radiation therapy, primary or secondary metabolic bone disease, or bone marrow dysfunction were excluded. Separation process purity and the number of BMPCs recovered were assessed with FACS. BMPC populations in self-reported smokers and nonsmokers were compared using the two-tailed t-test. 13 smokers and 13 nonsmokers of comparable age and gender were included. The average concentration of BMPCs was 3.52 × 105/mL ± 2.45 × 105/mL for nonsmokers versus 1.31 × 105/mL ± 1.61 × 105/mL for smokers (t= 3.2, P=0.004. This suggests that cigarette smoking is linked to a significant decrease in the concentration of BMPCs, which may contribute to the reduced regenerative capacity of smokers, with implications for musculoskeletal maintenance and repair.

  13. Assessment of lower extremities ischemic disease by thallium 201 perfusion scintigraphy in patients with diabetic angiopathy

    Directory of Open Access Journals (Sweden)

    Čizmić Milica

    2011-01-01

    Full Text Available Background/Aim. Tibial perfusion in diabetic microangiopathy is considered to be a diagnostic problem. A special place in quantifying muscle microcirculatory perfusion belongs to thallium 201 muscle perfusion scintigraphy (201Tl PS. Thallium, showing the characteristics of potassium (K+, enters a cell by means of active cell transportation and follows erythrocyte up to the tissue. The aim of this study was to determine if 201Tl PS of lower extremities (LE is a good method for estimating muscle microcirculatory perfusion in diabetic microangiopathy. Methods. The study included 32 patients of an average age 66.1 ± 14.9 years with signs of LE ischemia befalling into III and IV stage of ischemic disease according to the Lariche-Fontain classification. Out of that number there were 27 of the patients with non-insulin-dependent diabetes mellitus (NIDDM, while 5 of the patients were with Burger's disease and Raynand's disorder. Lower extremities PS was performed after 3 min of tibial loading by the use of dorsoplantar foot flexion and intravenous 74 MBq 201Tl as a 10-minute dynamic study. A 10 minute static scintigraphy was carried out of the gluteal region, femurs, tibias and feet per a position and repeated after 3 h at rest in the same projections. The results were interpreted visually and by the semiquantitive method using a program for calculating the number of pulses per pixel in the corresponding region over 1-, 2- and 10-minute dynamic study, thus obtaining numerical data for estimating perfusion. Binding ratio in both legs was estimated visually as low (1, medium (2 and significant (3 difference in both legs. The results were compared with doppler hemodynamic indices (PI and RI. Results. Regardless the group, 201Tl binding intensity rising was significantly 2 min after application, as compared to 1 min, and the obtained level of binding was maintained even after 10 min. In the group Fontain III the majority of the patients showed a medium

  14. Effects of Varus Orthotics on Lower Extremity Kinematics During the Pedal Cycle

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2014-12-01

    Full Text Available Purpose. Cycling has been shown to be associated with a high incidence of chronic pathologies. Foot orthoses are frequently used by cyclists in order to reduce the incidence of chronic injuries. The aim of the current investigation was to examine the influence of different varus orthotic inclines on the three-dimensional kinematics of the lower extremities during the pedal cycle. Methods. Kinematic information was obtained from ten male cyclists using an eight-camera optoelectronic 3-D motion capture system operating at 250 Hz. Participants cycled with and without orthotic intervention at three different cadences (70, 90 and 110 RPM. The orthotic device was adjustable and four different wedge conditions (0 mm - no orthotic, 1.5 mm, 3.0 mm and 4.5 mm were examined. Two-way repeated measures ANOVAs were used to compare the kinematic parameters obtained as a function of orthotic inclination and cadence. Participants were also asked to subjectively rate their comfort in cycling using each of the four orthotic devices on a 10-point Likert scale. Results. The kinematic analysis indicated that the orthotic device had no significant influence at any of the three cadences. Analysis of subjective preferences showed a clear preference for the 0 mm, no orthotic, condition. Conclusions. This study suggests that foot orthoses do not provide any protection from skeletal malalignment issues associated with the aetiology of chronic cycling injuries.

  15. An evolutionary algorithm for the segmentation of muscles and bones of the lower limb.

    Science.gov (United States)

    Lpez, Marco A.; Braidot, A.; Sattler, Anbal; Schira, Claudia; Uriburu, E.

    2016-04-01

    In the field of medical image segmentation, muscles segmentation is a problem that has not been fully resolved yet. This is due to the fact that the basic assumption of image segmentation, which asserts that a visual distinction should ex- ist between the different structures to be identified, is infringed. As the tissue composition of two different muscles is the same, it becomes extremely difficult to distinguish one another if they are near. We have developed an evolutionary algorithm which selects the set and the sequence of morphological operators that better segments muscles and bones from an MRI image. The achieved results shows that the developed algorithm presents average sensitivity values close to 75% in the segmentation of the different processed muscles and bones. It also presents average specificity values close to 93% for the same structures. Furthermore, the algorithm can identify muscles that are closely located through the path from their origin point to their insertions, with very low error values (below 7%) .

  16. The geobiology of the extremely enriched polymetallic sulfides in the black shale of the lower Cambrian Niutitang formation, Southwestern China

    OpenAIRE

    Xu, Jun; 徐俊

    2014-01-01

    The Precambrian-Cambrian transition is a period with enormous geological and biological changes. There is a wide distribution of black shale sequence in the Late Sinian and Early Cambrian strata along the passive southern margin of the Yangtze Platform in South China. The remarkable polymetallic sulfide extremely enriched ore layer is embedded at the bottom of the Lower Cambrian Niutitang Formation, but its genesis remains highly disputable. Known mechanisms can hardly explain the extreme enr...

  17. Diagnosis of deep vein thrombosis in lower extremities with equilibrium radionuclide imaging

    International Nuclear Information System (INIS)

    A procedure was developed for detecting deep vein thrombosis (DVT) in lower extremities. 30 min after i.v. of in vivo labelled 99mTc-RBC to the arm, equilibrium venography (EV) was performed. Radionuclide plethysmography (RPG was continued and divided into two types: cuff above knees and above ankles. The following information were provided by this technique: 91) equilibrium images of both legs, (2) segment of thrombosed vein (iliac, femoral, popliteal or tibial), (3) RPG curves, amount and speed of venous flow, (4) degree of venous occlusion (complete and incomplete obstruction). Among 350 patients with suspected DVT, (1) 78 cases were normal in venous flow, (2) 133 cases had unilateral and 108 had bilateral obstruction, (3) 31 cases suffered from venous insufficiency. Equilibrium method was compared with radionuclide venography (RNV) in 50 patients and compared with contrast venography (CV) in 10 patients. The coincidence rates were both 90%. Instead of RNV, equilibrium method (EV + RPG) is recommended for routine examination of patients suspected DVT

  18. Experience had with 36 balloon-expendable stents implanted in peripheral arteries of the lower extremities

    International Nuclear Information System (INIS)

    This is a report on 16-month-long experience (November 1999 - February 2001) with 36 balloon-expandable stents applied to 32 patients aged 46 to 72 years. Two stent per patient are implanted in 4 instances, and one stent each in the remainder. The atherosclerotic lesions are located in lower extremity arteries - 4 thromboses long 1-5 cm, and 32 stenoses reducing the vascular lumen by 60 to 90 per cent, long 23.5 cm. An immediate technical success is recorded in all patients, including five cases presenting stenosis of the distal anastomoses after femoropopliteat bypass reconstruction. The clinical and angiographic follow-up study shows very good results after 15 and 6 months, respectively. The obtained results and the absence of serious complications are good reasons to conclude that the use of balloon-expanding stents is a safe and effective procedure of treating atherosclerotic stenotic and thrombotic segments of the iliac and femoral arteries, with superior potentials compared to PTA, especially in lesions of longstanding. The obtained results in stenoses located in the zone of anastomoses associated with bypass confirm this conclusion. (authors)

  19. The effect of backpack heaviness on trunk-lower extremity muscle activities and trunk posture.

    Science.gov (United States)

    Al-Khabbaz, Yusuf S S M; Shimada, Tomoaki; Hasegawa, Masashi

    2008-08-01

    The purpose of the present study is to analyze trunk-lower extremity muscle activities and trunk postural changes during the carriage of different backpacks. Nineteen male university students (21+/-3 years) participated in the experiment's four standing modes: (1) unloaded standing, (2) 10% body weight (BW) load (in the form of a backpack), (3) 15% BW load and (4) 20% BW load. Bilateral rectus abdominis, erector spinae, vastus medialis and biceps femoris muscle activities were recorded using surface electromyography (SEMG), while trunk inclination, side flexion and rotation were measured by using VICON 250 during all standing modes. The results showed that rectus abdominis muscle activities increased progressively and disproportionably as the backpack load increased. As for the trunk posture, almost the same backward inclination was adapted even with increasing backpack heaviness. Twenty percent BW backpack causes the most significant muscular and postural changes so it should be avoided. However, it is recommended to study other backpack factors such as frequency of usage, usage time, type of the backpack and age to come up with a complete usage recommendation. PMID:18329270

  20. The consensus among Chinese interventional experts on the standard of interventional therapy for deep venous thrombosis of lower extremity

    International Nuclear Information System (INIS)

    This paper aims to introduce the indications and contraindications of catheter-directed thrombolysis, percutaneous mechanical thrombectomy, balloon angioplasty and stent implantation for deep venous thrombosis of lower extremity, and also aims to summarize and to illustrate the manipulating procedure, the points for attention, the perioperative complications and preventions in performing different kind of interventional technique. Great importance is attached to the interventional therapy for both acute and subacute deep venous thrombosis of lower extremity in order to effectively reduce the occurrence of post-thrombosis syndrome. (authors)

  1. The comparative study of 64-slices spiral CT angiography with DSA in lower extremity arterial occlusive diseases

    International Nuclear Information System (INIS)

    Objective: To study the clinical value of 64-slices spiral CTA with DSA comparatively in diagnosis of lower extremity arterial occlusive diseases. Methods: 31 patients with lower extremity arterial occlusive diseases underwent 64-slice spiral CT angiography of lower extremity arteries and they also underwent digital subtraction angiography (DSA)two weeks later. Reconstruction by maximum intensity projection (MIP), volume render (VR)and multiplanar reformatting (MPR)in working-station was undertaken comparing with the bolus chase DSA and traditional DSA for diagnostic accuracy. Results: The 216 arterial segments of lower extremity were selected, including 157 segments with consistent results in demonstrating degree of stenosis by both examinations. On CT angiography, 5 segmental stenosis were overestimated and 9 were underestimated. When stenosis of detected segments is more than 50%, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CTA were 98.21%, 96.15%, 97.22%, 96.49%, and 98.04%, respectively. Conclusion: 64-slices spiral CT angiography is an effective and reliable method for evaluating the lower extremity arterial occlusive diseases and may provide precious information for planning interventional therapy. (authors)

  2. An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus

    Directory of Open Access Journals (Sweden)

    Ford KR

    2015-08-01

    Full Text Available Kevin R Ford,1 Anh-Dung Nguyen,2 Steven L Dischiavi,1 Eric J Hegedus,1 Emma F Zuk,2 Jeffrey B Taylor11Department of Physical Therapy, High Point University, High Point, NC, USA; 2Department of Athletic Training, School of Health Sciences, High Point University, High Point, NC, USAAbstract: Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus. Measures of dynamic lower extremity valgus have been previously shown to relate to increased risk of several knee pathologies, specifically anterior cruciate ligament ruptures and patellofemoral pain. Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies. The purpose of the review was to identify and discuss hip-focused exercise interventions that aim to address dynamic lower extremity valgus. Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus. Further studies should be developed to identify and understand the mechanistic relationship between optimized biomechanics during sports and hip-focused neuromuscular exercise interventions.Keywords: dynamic lower extremity valgus, hip neuromuscular control, ACL injury rehabilitation, patellofemoral pain, hip muscular activation

  3. Ectopic major transplantation for salvage of upper and lower extremity amputations

    Directory of Open Access Journals (Sweden)

    Nazerani Shahram

    2013-12-01

    Full Text Available 【Abstract】Objective: Ectopic tissue transplanta- tion is not a new idea. Godina and his colleagues pioneered this method in the 1980s. This method is a last resort method of preserving an amputated body part, which consists of banking the amputated segment in an ectopic area and re- turning it to its native place at a later date. In this article we present our experience with this demanding procedure. Methods: Debridement was the mainstay of this procedure. The stump and amputated part are carefully de- brided and the stump was either closed primarily or covered by a flap. The amputated part was transplanted to one of several banking sites in the body and at a later date it will be transferred to its native site in an elective setting. Results: Seven patients meeting the set criteria for ectopic transplantation were enrolled in this study. The over- all success rate was about 70%, lower than expected but these are cases of severe crush injury. Although the func- tional recovery of these patients are very low, all of the successful cases except one could find a job as a janitor or light manual worker. No patient could return to his previous job. Conclusion: Ectopic transplantation of body parts is an accepted method of treatment of severely crushed ex- tremity or finger injuries. In our country an amputee has very little chance of finding a job instead a disabled person can. In addition in Iran cultures amputation is seen as pu- nishment of either the God or the society, so it is not well accepted and many patients persist on saving the limb even with no functional recovery. None of our successful cases could return to his previous occupation but almost all of them could find a job as janitors or light manual workers. Key words: Replantation; Transplantation; Extremities; Amputation, traumatic

  4. [Efficacy of oral drug Thrombovasim® in therapy of lower extremity deep vein thromboses].

    Science.gov (United States)

    Mishenina, S V; Madonov, P G; Kinsht, D N; Émedova, T A; Zotov, S P; Ufimtsev, M S; Leont'ev, S G

    2016-01-01

    Within the framework of the multicenter randomized placebo-controlled double-blind clinical trial "VETTER-1" the authors carried out assessment of therapeutic efficacy and safety of oral drug Thrombovasim® possessing a thrombolytic effect in comprehensive treatment of lower-extremity deep vein thrombosis (LEDVT). The clinical study comprised a total of 154 patients. All patients received standard therapy accepted in LEDVT. The patients were subdivided into 4 groups. Patients from the three study groups received Thrombovasim® at a daily dose of 1,600, 3,200, and 4,800 IU. The control group patients were given placebo. Efficacy was assessed by the results of ultrasound duplex scanning first performed before treatment commenced and then after it terminated. The relative frequency of positive dynamics according to the findings of instrumental methods of study in patients taking Thrombovasim® amounted to 0.728 and in the group of patients receiving placebo to 0.585, p=0.0031. Comparing the degree of blood flow normalization in the zone of the compromised blood flow revealed a pronounced dose-dependent effect: in patients taking the drug at a daily dose of 1,600 IU, the relative frequency of positive dynamics amounted to 0.707 corresponding to an increase in therapeutic efficacy by 21%, for a dose of 3,200 IU these parameters amounted to 0.0257 and 24% and for 4,800 IU - 0.747 and 28%, respectively. In patients taking Thrombovasim® there were no cases of negative dynamics observed. Of the patients taking Thrombovasim®, none developed undesirable or severe adverse events. Inclusion of Thrombovasim® into the composition of comprehensive therapy for LEDVT increases efficacy of treatment at the expense of a spontaneous thrombolytic effect. The most effective dose amounted to 4,800 IU daily. Thrombovasim® turned out to be an efficient and safe agent in treatment of venous thromboses. PMID:27626255

  5. CT angiography in the diagnosis of lower extremity arteriosclerosis obliterans: a Meta analysis

    International Nuclear Information System (INIS)

    Objective: To systematically assess the diagnostic performance of CTA for lower extremity peripheral arterial disease (PAD) using a Meta analysis method. Methods: Studies were located through electronic searching of the PubMed, EBSCO, Springer, Ovid, CNKI, Cochrane library (from the date of establishment of the databases to October 2009). Bibliographies of the retrieved articles were also checked. All the studies concerning the diagnosis of PAD using CTA had been searched and reviewed, and the studies with the DSA as the gold standard were adopted as eligible. Subsequently, the characteristics of the included articles were appraised and extracted. Data on accuracy of included studies were extracted for further heterogeneity exploring, statistical pooling and SROC (summary receiver operating characteristics) analyzing using the Meta Disc 1.4 software. Results: Totally 24 studies met the inclusion criteria with a total of 1096 patients. The heterogeneity was found in these studies. The pooled accuracy indicators like sensitivity, specificity, and diagnostic odds ratio (DOR) were 0.95 (95% CI: 0.94-0.95), 0.96 (95% CI: 0.95-0.96), and 471.13 (95% CI: 242.92-913.71), respectively. The area under of SROC curve was 0.9888 and the Q index was 0.9555. Subgroup analysis demonstrated significant difference on diagnostic performance for various CT slices (P<0.05). Conclusion: CTA can be regarded as an effective and feasible method for PAD diagnosis and screening, based on the results of this systematic review. However, more rigorous evaluations of CTA in patients with critical limb ischemia are needed. (authors)

  6. Spectral Clustering for Unsupervised Segmentation of Lower Extremity Wound Beds Using Optical Images.

    Science.gov (United States)

    Dhane, Dhiraj Manohar; Krishna, Vishal; Achar, Arun; Bar, Chittaranjan; Sanyal, Kunal; Chakraborty, Chandan

    2016-09-01

    Chronic lower extremity wound is a complicated disease condition of localized injury to skin and its tissues which have plagued many elders worldwide. The ulcer assessment and management is expensive and is burden on health establishment. Currently accurate wound evaluation remains a tedious task as it rely on visual inspection. This paper propose a new method for wound-area detection, using images digitally captured by a hand-held, optical camera. The strategy proposed involves spectral approach for clustering, based on the affinity matrix. The spectral clustering (SC) involves construction of similarity matrix of Laplacian based on Ng-Jorden-Weiss algorithm. Starting with a quadratic method, wound photographs were pre-processed for color homogenization. The first-order statistics filter was then applied to extract spurious regions. The filter was selected based on the performance, evaluated on four quality metrics. Then, the spectral method was used on the filtered images for effective segmentation. The segmented regions were post-processed using morphological operators. The performance of spectral segmentation was confirmed by ground-truth pictures labeled by dermatologists. The SC results were additionally compared with the results of k-means and Fuzzy C-Means (FCM) clustering algorithms. The SC approach on a set of 105 images, effectively delineated targeted wound beds yielding a segmentation accuracy of 86.73 %, positive predictive values of 91.80 %, and a sensitivity of 89.54 %. This approach shows the robustness of tool for ulcer perimeter measurement and healing progression. The article elucidates its potential to be incorporated in patient facing medical systems targeting a rapid clinical assistance. PMID:27520612

  7. PRE-ACTIVITY MODULATION OF LOWER EXTREMITY MUSCLES WITHIN DIFFERENT TYPES AND HEIGHTS OF DEEP JUMP

    Directory of Open Access Journals (Sweden)

    Vladimir Mrdakovic

    2008-06-01

    Full Text Available The purpose of this study was to determine modulation of pre- activity related to different types and heights of deep jump. Sixteen male soccer players without experience in deep jumps training (the national competition; 15.0 ± 0.5yrs; weight 61.9 ± 6.1kg; height 1.77 ± 0.07m, who participated in the study, performed three types of deep jump (bounce landing, counter landing, and bounce drop jump from three different heights (40cm, 60cm, and 80cm. Surface EMG device (1000Hz was used to estimate muscle activity (maximal amplitude of EMG - AmaxEMG; integral EMG signal - iEMG of five muscles (mm.gastrocnemii, m.soleus, m.tibialis anterior, m.vastus lateralis within 150ms before touchdown. All the muscles, except m. gastrocnemius medialis, showed systematic increase in pre-activity when platform height was raised. For most of the lower extremity muscles, the most significant differences were between values of pre-activity obtained for 40 cm and 80 cm platforms. While the amount of muscle pre-activity in deep jumps from the heights above and beneath the optimal one did not differ significantly from that generated in deep jumps from the optimal drop height of 60 cm, the patterns of muscle pre-activity obtained for the heights above the optimal one did differ from those obtained for the optimal drop height. That suggests that deep jumps from the heights above the optimal one do not seem to be an adequate exercise for adjusting muscle activity for the impact. Muscle pre-activity in bounce drop jumps differed significantly from that in counter landing and bounce landing respectively, which should indicate that a higher amount of pre-activity generated during bounce drop jumps was used for performing take-offs. As this study included the subjects who were not familiar with deep jumps training, the prospective studies should reveal the results of athletes with previous experience

  8. An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus

    OpenAIRE

    Ford KR; Nguyen AD; Dischiavi SL; Hegedus EJ; Zuk EF; Taylor JB

    2015-01-01

    Kevin R Ford,1 Anh-Dung Nguyen,2 Steven L Dischiavi,1 Eric J Hegedus,1 Emma F Zuk,2 Jeffrey B Taylor11Department of Physical Therapy, High Point University, High Point, NC, USA; 2Department of Athletic Training, School of Health Sciences, High Point University, High Point, NC, USAAbstract: Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus. Measures of dynamic lower extremity valgus have been previously shown to relate to increased risk of se...

  9. Assessment on the vulnerability of different ecosystems to extreme rainfalls in the middle and lower reaches of Yangtze River

    Science.gov (United States)

    Yongxiang, Zhang; Bo, Tao; Li, Yu

    2015-07-01

    The vulnerability of major ecosystems to extreme rainfalls was investigated across the middle and lower reaches of the Yangtze River, China, during 1961-2000, by using an improved process-based model (Carbon Exchange between Vegetation, Soil, and Atmosphere, CEVSA). The simulated Net Primary Productivity (NPP) was selected as the indicator to identify impacts of extreme rainfalls on ecosystem functioning. The changing characteristics of the NPP in the five extreme rainfall years are employed to represent the sensitivity and adaptive capacity of ecosystems to extreme rainfalls events. The vulnerability of major ecosystems to extreme rainfalls was then examined by comparing with the averaged status during 1961-1990. Our results suggest that the relatively lower and higher vulnerable agro-ecosystems were mainly distributed in the central and northwest of the study area. The proportions of high and very high vulnerable agro-ecosystems to rainfall were about 19 and 5 % of the total area. For the forest ecosystem, the lower vulnerability mainly occurred in the south, while the higher vulnerability happened in the north of the study area which had taken about 15 % of the high vulnerable level and about 2 % of the very high vulnerable level. The extreme rainfalls enhanced the vulnerability both of agro-ecosystems and forest ecosystems. The vulnerability of agro-ecosystems to droughts was higher than that of forest ecosystems, while the vulnerability of forest ecosystems to floods was higher than that of agro-ecosystems. Our study demonstrates that both human-dominated (e.g., agro-ecosystem) and natural ecosystems are vulnerable to extreme climatic events. Future warming climate might further worsen the ecosystem sustainability in this area if no mitigation and adaptation measures are adopted.

  10. Application of sub-regional analysis to bone mineral density of the lower limb from whole body DXA scans

    International Nuclear Information System (INIS)

    Bone mineral density at spine and hip is widely used to diagnose osteoporosis. Certain conditions cause changes in bone density at other sites, particularly in the lower limb, with fractures occurring in non-classical locations. Bone density changes at these sites would be of interest for diagnosis and treatment. We describe an application, based on an existing software option for Hologic scanners, which allows reproducible measurement of bone density at six lower limb sites (upper femur, mid-femur, lower femur; upper leg, mid-leg, lower leg). In 30 unselected subjects, referred for bone density, precision (CV%) measured on 2 occasions, separated by repositioning, ranged from 1.7% (mid-femur) to 4.5% at the lowest leg site. Intra-operator precision, measured by three operators on ten subjects on three occasions, was between 1.0% and 2.9%, whilst inter-operator precision was between 1.0% and 3.6%, according to region. These values compare well with those at the spine and upper femur, and in the literature. There was no evidence that this operator agreement improved between occasions 1 and 3. This technique promises to be useful for assessing bone changes at vulnerable sites in the lower limb, in diverse pathological states and in assessing response to treatment. (paper)

  11. The clinical efficacy observation of fluoroscopy-guided foam sclerotherapy with lauromacrogol for varicose veins of the lower extremities

    International Nuclear Information System (INIS)

    Objective: To assess the clinical efficacy of foam sclerotherapy with lauromacrogol for varicose veins of the lower extremities. Methods: During the period from February to July 2011, we retrospectively analyzed 20 patients with varicose veins of the lower extremities, who were treated with lauromacrogol foam sclerosing agent injected directly at varicose veins, and in 5 extremities injected at the great saphenous vein (GSV) through a catheter at the same time. Elastic bandages were applied at the site of the injected varicosities after the therapy. The clogging of the varicose veins, the improvement of the clinical symptoms and the adverse reaction were observed. Results: Lauromacrogol foam sclerosing agent was successfully injected under the guidance of fluoroscopy in 20 patients with 28 affected extremities. The average volume of foam sclerosing agent in each affected extremity was 7.8 ml. All patients presented self limiting minor complications, including swelling and pain, which was obviously alleviated by the externally applied Mucopolysaccharide Polysulfate Cream. Two patients presented cough that was relieved after inhaling oxygen. Most of treated varicosities demonstrated pigmentation after the first week, which gradually disappeared after the four-month use of vitamin E capsule. A second foam sclerotherapy was carried out for 3 affected extremities of 3 patients two months after the first therapy. Two cases of leg venous ulcer were healed within a few weeks. All patients could walk immediately with no deep vein thrombosis, pulmonary embolism, anaphylaxis, or transient visual disturbance. Obvious abnormal varicose veins as well as the soreness and fatigue of the lower extremities disappeared in all patients at the 10th-month follow-up. The grading of the disease was significantly improved by the treatment (Z=5.103, P<0.01). Conclusions: The efficacy of lauromacrogol foam sclerosing agent in the treatment of varicose veins of the lower extremities is

  12. Determination of bone mineral density of the distal extremity of the radio in Rottweiller, by radiographic optic densitometry

    International Nuclear Information System (INIS)

    This study allowed the standardization of the bone mineral density (BMD) of the distal extremity of the radio of 36 dogs adults in Rottweiler breed by radiographic optic densitometry. The limbs of the animals were radiographed with scale of aluminum that served as a reference. The radiographs images were digitalized and analyzed by a computer program for comparison of gray tones between the standard image and the image of the reference scale radiographed with the bone. Afterwards the values of density were expressed in millimeters of aluminum. Also studied the correlations between BMD and the sex, weight and external measures as the length of spine, height of the animal and circumference the distal extremity of the limb in study. The mean values and standard deviations of the bone mineral density of the distal extremity of the radio were: for the metaphyseal region the average of BMD of 7,88±0,89 mmAl, the diaphyseal region 1 the average of BMD of 8,58±0,80 mmAl and for diaphyseal region 2 of BMD of 9,00±0,74 mmAl. (author)

  13. Digital subtraction angiography for lower extremity phlebography

    International Nuclear Information System (INIS)

    DSA was applied to the lower extremity phlebography on 21 cases (36 legs). The patient lay in the supine position and a tourniquet was placed around the ankle. Forty ml of contrast medium, diluted to 25% of the original concentration with normal saline, was injected into the dorsal vein of the foot. The anterior tibial vein, posterior tibial vein, peroneal vein and muscular vein of the calf were identified in 24(63.2%), 36(94.7%), 37(97.4%) and 7 legs (18.4%), respectively. The poor opacification of the anterior tibial vein was attributed partly to the compression effect of the tourniquet. The abnormal findings were deep vein thrombosis (5 legs), reflux from the deep to the superficial vein (14 legs) and irregularity of the vein wall (16 legs). The superficial varicose veins were not demonstrated in DSA phlebography. The examination was comfortable because the patient position was supine and the dilute contrast medium caused no burning sensation. We believe that DSA phelobography is a safe and useful method for diagnosing the deep venous system disorders. (author)

  14. Lower extremity corrective reactions to slip events.

    Science.gov (United States)

    Cham, R; Redfern, M S

    2001-11-01

    A significant number of injuries in the workplace is attributed to slips and falls. Biomechanical responses to actual slip events determine whether the outcome of a slip will be recovery or a fall. The goal of this study was to examine lower extremity joint moments and postural adjustments for experimental evidence of corrective strategies evoked during slipping in an attempt to prevent falling. Sixteen subjects walked onto a possibly oily vinyl tile floor, while ground reaction forces and body motion were recorded at 350 Hz. The onset of corrective reactions by the body in an attempt to recover from slips became evident at about 25% of stance and continued until about 45% into stance, i.e. on average between 190 and 350 ms after heel contact. These reactions included increased flexion moment at the knee and extensor activity at the hip. The ankle, on the other hand, acted as a passive joint (no net moment) during fall trials. Joint kinematics showed increased knee flexion and forward rotation of the shank in an attempt to bring the foot back towards the body. Once again, the ankle kinematics appeared to play a less dominant role (compared to the knee) in recovery attempts. This study indicates that humans generate corrective reactions to slips that are different than previously reported responses to standing perturbations translating the supporting surface. PMID:11672718

  15. Transradial approach to lower extremity interventions

    Directory of Open Access Journals (Sweden)

    Ravikiran Korabathina

    2010-07-01

    Full Text Available Ravikiran Korabathina1, Sidharth S Yadav1, John T Coppola2, Cezar S Staniloae21Department of Cardiovascular Medicine, Saint Vincents Catholic Medical Center, New York, NY, USA; 2Cardiac and Vascular Institute, New York University Medical Center, New York, NY, USAAbstract: Percutaneous interventions of the coronary and peripheral vessels have historically been performed using a femoral artery approach. There has been increasing recognition of postprocedural bleeding complications and its impact on short- and long-term mortality. Because of its now recognized safety, the transradial approach has recently emerged as a preferred method compared to the transfemoral approach. The limitations associated with the distance from the puncture site to the lesion location are being addressed as new tools are developed for the endovascular treatment of peripheral arterial disease. In this review, we discuss the many facets of the transradial approach to lower extremity endovascular interventions, highlighting its safety and efficacy. Approaches to special populations including individuals with prior surgical bypass, Leriche’s syndrome, and those committed to chronic anticoagulation are also reviewed.Keywords: peripheral arterial disease, endovascular interventions, transradial interventions, aorto-iliac angioplasty

  16. High-Flow Arteriovenous Malformation of the Lower Extremity: Ethanolamine Oleate Sclerotherapy

    International Nuclear Information System (INIS)

    We report the case of a young man presenting with high-flow arteriovenous malformation (AVM), in whom percutaneous direct nidus puncture ethanolamine oleate (EO) sclerotherapy was useful in the management of the AVM. To our knowledge, this is the first report of percutaneous trans-nidus EO sclerotherapy for AVM in the extremities. Percutaneous trans-nidus sclerotherapy should be considered as an alternative choice for the management of symptomatic AVM

  17. A rare case of bilateral lower extremity edema due to low dose gabapentin therapy in a young male patient

    OpenAIRE

    Kahlon, Arunpreet; Gnanabakthan, Naveen; Dhillon, Amrita; Subedi, Dinesh

    2015-01-01

    46 year old male with past medical history of schizoaffective disorder and chronic lower back pain, was admitted for management of worsening depression and anxiety. He was started on gabapentin, 300mg twice daily for his back pain and anxiety symptoms. His only other medication was hydrocodone. Over next few days, he started developing worsening bilateral lower extremity edema. He did not have any cardiovascular related symptoms. Physical exam was only significant for 3+ pitting edema with al...

  18. Incidence and prevalence of lower extremity tendinopathy in a Dutch general practice population : a cross sectional study

    NARCIS (Netherlands)

    Albers, Iris Sophie; Zwerver, Johannes; Diercks, Ronald Leo; Dekker, Janny Hendrika; Van den Akker-Scheek, Inge

    2016-01-01

    BACKGROUND: Lower extremity tendinopathy is a common sports injury, but it can also affect non-athletes. Because tendinopathy is difficult to treat and has negative effects on the ability to work and quality of life, development of preventive interventions is important. The first step in the Van Mec

  19. Incidence and prevalence of lower extremity tendinopathy in a Dutch general practice population: A cross sectional study

    NARCIS (Netherlands)

    Albers, Iris Sophie; Zwerver, Johannes; Diercks, Ronald Leo; Dekker, Janny Hendrika; Van den Akker-Scheek, Inge

    2016-01-01

    Background: Lower extremity tendinopathy is a common sports injury, but it can also affect non-athletes. Because tendinopathy is difficult to treat and has negative effects on the ability to work and quality of life, development of preventive interventions is important. The first step in the Van Mec

  20. Reconstructive procedures on lower extremities using Mitković external fixation system

    Directory of Open Access Journals (Sweden)

    Abdala K.

    2005-01-01

    Full Text Available The results of limb lengthening, correction of limb deformities and solving of bone loss, by the use of Mitković external fixation system and minimally invasive technique on the series of 96 operations in 89 patients are shown. Only lower extremities were included in this series. The advantages of this external fixation system in comparison to other systems are pointed out. The main advantages are the optimal biomechanical conditions including unilateral but 3-dimensional frame, which provides conditions very similar to natural biomechanical features of the human long bones, simplicity of application and low cost. The received result was excellent or very good in 98.4%. Maximal limb lengthening was 18 cm (at the same time in the femur and the tibia. Angular deformity correction is extremely simplified with minimized possibility of complications. The frame for bone transport is very simple. It can be concluded that presented methods are suitable for routine use.

  1. STUDY OF AN ASSESSMENT OF THE FATE OF CALCIUM HYDROXY APATITE BLOCK WITH CORTICO CANCELLOUS BONE GRAFT USED IN COMMUNITED FRACTURES OF LONG BONE OF LOWER LIMB

    Directory of Open Access Journals (Sweden)

    Ahmad

    2015-03-01

    Full Text Available INTRODUCTION: In recent years there has been an increasing interest in biologically active calcium phosphate ceramic materials for orthopaedic application. A number of materials from human, animal or non - biological sources have been used to fill defects with or without additional autogenus bone. It would be ideal to have bone substitute w hich is easily fabricated and preserved, is biocompatible with bone, and is biodegradable. The calcium phosphate system, and in particular hydroxyappatite (HA, has long been the subject of intensive investigation. MATERIAL AND METHODS: This observational two year study was undertaken at S.N. Medical College and Hospital, Agra (U.P.. The patients having the comminuted fracture of the long bone of lower limbs were treated with autogenus bone graft and calcium hydroxy Apatite bone block. Functional results w ere presented according to Klemm and Borner (1986 criteria. RESULTS: The total cases studied were 25 out of which 21 cases had fracture of both bones of leg and 4 were of fracture femur. The patients were aged between 15 to 70 years. Most of the patients were males and the common mode of injury was road traffic accident. An excellent result were seen in the majority 9(36% of patients while 8(32% patients showed a good result and 6(24% showed a fair result. 17(68% patients had compound fracture while 8( 32% patients were having closed fracture. CONCLUSION: Calcium Hydroxy Apatite is a suitable alternative to bone graft. There was no evidence of any foreign body reaction and infection at the Calcium Hydroxy Apatite implanted site. There was satisfactory h ealing of all the comminuted fractures. The movement of adjacent joints was nearly normal. No refracture was observed on follow up.

  2. The application of bilateral femoral vein approaches in interventional treatment of deep venous thrombosis of left lower extremity

    International Nuclear Information System (INIS)

    Objective: To investigate the feasibility of interventional catheterization with bilateral femoral vein approaches for performing the thrombolytic treatment of acute deep venous thrombosis of left lower extremity. Methods: Antegrade puncturing into the left femoral vein was carried out in eighteen patients with acute deep vein thrombosis in the left lower extremity after left iliac-femoral vein catheterization via the right femoral vein or the right jugular vein access failed. When the puncturing of the left femoral vein was successfully done and was confirmed by angiography, the guide wire was inserted into the inferior vena cava and was pulled out through the right femoral vein or right jugular vein, and a wire track was thus established. Then, retrograde insertion of the catheter was conducted along the wire from the right to the left until the catheter was placed into the left iliac-femoral vein for thrombolysis. Results: Of 18 cases,successful puncturing into the left femoral vein was achieved in 16, and an effective wire track was established between the left and right femoral veins, based on which the catheter was smoothly inserted into the left iliac-femoral vein via the right femoral vein or jugular vein. Catheter thrombolysis was employed for 3 to 14 days, the thrombus was completely dissolved and the lower extremity swelling subsided. During the course of thrombolysis, no obvious congestion or hematoma occurred at the puncturing site of the left femoral vein. Conclusion: For patients with deep vein thrombosis of left lower extremity, when left iliac-femoral vein catheterization via the right femoral vein or the right jugular vein access failed, the establishment of wire track by using bilateral femoral vein approaches for further catheterization of left iliac-femoral vein and subsequent thrombolysis is feasible in clinical practice. This technique is safe and minimally-invasive with higher success rate. (authors)

  3. Therapeutic evaluation of catheter-directed thrombolysis for the treatment of acute arterial ischemia of lower extremities

    International Nuclear Information System (INIS)

    Objective: To evaluate the therapeutic effect and safety of catheter-directed thrombolysis in treating acute arterial ischemia of lower extremities. Methods: From Jan. 1, 2008 to Dec. 31, 2009, a total of 56 patients with acute arterial ischemia of lower extremities, who were encountered at the affiliated Renji hospital of Shanghai Jiaotong University, received catheter-directed thrombolysis treatment with urokinase. The therapeutic effect,safety and complications were observed and analyzed. Results: Of the total 56 cases, complete cure was obtained in 10 (17.8%), effective response in 38 (67.9%) and valueless in 8 (14.3%) with an overall effectiveness of 85.7%. Complications occurred in 11 cases (19.6%). The complications happened in six cases (10.7%) were directly related to the catheter-directed thrombolysis, which included hematoma at puncture site (n = 5, 8.9%) and bleeding due to the rupture of cerebrovascular malformation (n = 1, 1.7%). Conclusion: Catheter-directed thrombolysis is a safe and effective treatment for the acute arterial ischemia of lower extremities. (authors)

  4. The role of bone scanning in severe frostbite of the extremities: a retrospective study of 88 cases

    International Nuclear Information System (INIS)

    We performed a retrospective study of the results of two-phase technetium-99m hydroxymethylene diphosphonate bone scans in 88 patients with severe frostbite of the extremities. All patients were evaluated within 48 h after rewarming and all underwent a first bone scan (BS1) within 5 days after rewarming (median, day 2) (group 1). An excellent correlation was found between absence of tracer uptake in the phalanges and later amputation; this correlation was especially strong during the bone phase of the scans (specificity = 0.99, sensitivity = 0.96, positive predictive value = 0.92). Normal or high uptake in the phalanges was a reliable indicator of ultimate healing (negative predictive value = 0.99). The sensitivity of the examination was enhanced by performing a second scan (BS2) more than 5 days (median, day 8) after rewarming (group 2, n=36). A comparative analysis of BS1 and BS2 demonstrated that some of the lesions continued to evolve between day 2 and day 8. This suggests that the lesions could still be modified during this period. On the basis of the findings it is recommended that bone scan be performed close to day 2 in all patients who present with lesions extending proximally to include the entirety of one or more phalanges. In the case of severe sepsis, the results of the first bone scan, BS1, can serve as an indication for emergency amputation. BS2 should be performed close to day 8 only if there is an area of low or absent uptake on BS1. It is concluded that scintigraphy is an excellent means of evaluating patients with severe frostbite of the extremities: as early as day 2 after the injury it can indicate whether amputation is necessary, and between days 2 and 8 it provides valuable information on the efficacy of treatment. (orig.)

  5. Detection of rheumatoid arthritis bone erosions by 2 different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer, Anne; Vestergaard, Aage; Døhn, Uffe Møller; Ejbjerg, Bo; Hetland, Merete; Albrecht-Beste, Elisabeth; Østergaard, Mikkel; Hetland, Merete Lund

    2008-01-01

    previously validated Artoscan-unit as standard reference, MagneVu and CR had sensitivities of 0.82 and 0.55, respectively, in MCP-joint bones and 0.41 and 0.14 in wrist bones. Specificities of CR and MagneVu were comparable (0.82-0.99). MagneVu was particularly more sensitive than CR in metacarpal heads and...

  6. Nonspecific collagenolytic activity of the femoral bone in immobilized rat extremities.

    Science.gov (United States)

    Prokopová, D; Tesárek, B; Susta, A

    1975-01-01

    Nonspecific collagenolytic activity was studied in rat bones after immobilization. The left hind limb was immobilized by sectioning the sciatic nerve. Enzyme activity was determined by using synthetic pentapeptide substrate (Pz-Pro-Leu-Gly-Pro-D-Arg). After immobilization the activity of nonspecific collagenase increased and reached its maximum on the third day after the operation. The activity was decreased after one week and attained levels of control bones three weeks after sciatic nerve section. PMID:167392

  7. Diagnosis of arterial occlusive disease of the lower extremities by laser Doppler flowmetry.

    Science.gov (United States)

    Van den Brande, P; Welch, W

    1988-01-01

    Laser Doppler Flowmetry offers the possibility of non-invasive and continuous recording of tissue blood flow. Skin blood flux in resting state and during postocclusive reactive hyperemia was measured at the pulpa of the toe in 21 normal lower limbs and in 58 limbs with arterial occlusive disease. Proper assessment of postischemic flux- and time- parameters (beginning of reactive hyperemia, peak flux, time of peak flux and duration of hyperemic flux) permits accurate separation of healthy and diseased limbs. PMID:3058833

  8. The Role of Limb Torque, Muscle Action and Proprioception During Closed Kinetic Chain Rehabilitation of The Lower Extremity

    OpenAIRE

    Bunton, Edwin E.; Pitney, William A.; Cappaert, Thomas A.; Kane, Alexander W.

    1993-01-01

    This paper defines the differences between open and closed kinetic chain exercise and explains the role of limb torque, muscle action, and proprioception during rehabilitation of the lower extremity. Closed kinetic chain rehabilitation is shown to decrease shear forces, increase proprioception, and increase muscle group coordination through examples of progressive exercises. The authors conclude that closed kinetic chain rehabilitation is an economical, efficient, and effective means of rehab...

  9. The Change of Hemostasis System in Patients with Thrombophlebitis of Lower Extremities Deep Veins in Ozone Therapy

    Directory of Open Access Journals (Sweden)

    Piksin I.N.

    2011-12-01

    Full Text Available The aim of the investigation is to study the change of hemostasis system in patients with acute thrombophlebitis of deep veins of lower extremities using ozone therapy. Materials and Methods. There have been examined 25 healthy people and 65 patients with acute thrombophlebitis of deep veins of lower extremities who had traditional treatment in combination with systemic ozone therapy (the main group. Indexes of clotting and fibrinolysis have been determined on admission and after the treatment. Conclusion. The dynamics of indexes characterizing coagulation and fibrinolytic blood properties gives the evidence of the more considerable shift of hemostasis indexes towards incoagulability in patients with thrombophlebitis of deep veins of lower extremities after systemic ozone therapy compared to the patients with traditional treatment only. The changes revealed seem to be due to the activation of oxygen dependent processes in the body under the influence of ozone therapy, both in internal organs and tissues synthesizing blood coagulation factors and fibrinolysis and in the area of venous thrombosis.

  10. MR criteria for differentiation of 'pseudo tumourous' lesions from bone sarcomas of the extremities

    International Nuclear Information System (INIS)

    The MRT scans of 57 patients with Ewing or osteosarcomas and 34 patients with haematogenous osteomyelitis or periostitis/stress fractures were examined in order to determine whether a distinction between benign or malignant lesions is possible. Four criteria were evaluated: The margin of the bone marrow component; intensity and homogeneity of the T1-weighted signal in the bone marrow; presence of an extraosseus structured soft tissue mass and/or soft tissue edema. It was found that central osteosarcomas and Ewing's sarcomas reduced signal intensity of the marrow to become muscle-isointense with a well defined margin. In acute haematogenous osteomyelitis and periostitis/stress fracture the marrow lesion was not sharply demarcated. In contrast to patients with bone sarcomas only one case of osteomyelitis showed an extrosseus structured soft tissue mass. On the basis of these findings we believe that acute haematogenous osteomyelitis can be distinguished with high degree of accuracy from Ewing's sarcoma and central osteosarcomas. (orig.)

  11. Effects of Juvenile Idiopathic Arthritis on Kinematics and Kinetics of the Lower Extremities Call for Consequences in Physical Activities Recommendations

    OpenAIRE

    M. Hartmann; Kreuzpointner, F; Haefner, R.; Michels, H.; Schwirtz, A; Haas, J.P.

    2010-01-01

    Juvenile idiopathic arthritis (JIA) patients (n = 36) with symmetrical polyarticular joint involvement of the lower extremities and healthy controls (n = 20) were compared concerning differences in kinematic, kinetic, and spatio-temporal parameters with 3D gait analysis. The aims of this study were to quantify the differences in gait between JIA patients and healthy controls and to provide data for more detailed sport activities recommendations. JIA-patients showed reduced walking speed and s...

  12. Multiple myeloma of an extremity: must the whole bone be irradiated?

    International Nuclear Information System (INIS)

    Purpose/Objective: Radiation of the entire shaft of a long bone affected by multiple myeloma is often advocated to prevent recurrent disease in the bone remote from the symptomatic site. Our standard of care has been to irradiate only the symptomatic area. We investigated the pattern of recurrence in patients treated in this manner. Materials and Methods: 163 patients with multiple myeloma were treated between 1971 and 1994. Twenty-seven patients received treatment to a long bone with 43 sites irradiated (17 humeri, 24 femurs, 1 radius, 1 ulna.) The most common long bone treated was the femur. All patients were treated with megavoltage therapy. The symptomatic lesion, plus a margin of 1-2 cm was treated with no attempt to treat the entire shaft. Mean radiation dose was 2782 cGy (range 600-4480 cGy). The length of the field was measured in centimeters and expressed as both an absolute (AL) and relative (RL) length (i.e. percentage of total length of bone). Results: The mean total AL and RL for femur fields was 18 cm and 42% respectively. For the humerus, the AL and RL were 20 cm and 68% respectively. Only 4 patients developed progressive disease in the same bone but outside the previously irradiated field. In 3 of the 4 patients the RL was between 20 and 30%. The dose of radiation given to these patients was 1250, 2100, 3000 and 3500 cGy. In all of these 4 cases, treatment of progressive disease in adjacent sites provided effective palliation of symptoms. Conclusion: Radiation therapy to the symptomatic portion of a long bone affected by MM is effective for palliation. Symptomatic recurrence out of the irradiated field is uncommon and can be effectively treated. Potential benefits of this approach include irradiation of less normal marrow and elimination of use of pairs of fields or extended distance treatment to cover the entire femur

  13. Total Adiponectin and Risk of Symptomatic Lower Extremity Peripheral Artery Disease in Men

    NARCIS (Netherlands)

    Joosten, Michel M.; Joshipura, Kaumudi J.; Pai, Jennifer K.; Bertoia, Monica L.; Rimm, Eric B.; Mittleman, Murray A.; Mukamal, Kenneth J.

    2013-01-01

    Objective-Lower concentrations of adiponectin have been linked to subsequent risk of coronary heart disease in healthy individuals. Whether similar relationships exist for the development of systemic atherosclerosis, such as peripheral artery disease (PAD), is uncertain. We investigated the associat

  14. Pyogenic Arthritis of the Ankle Joint Following a High-Voltage Electrical Burn in the Lower Extremity: A Case Report

    International Nuclear Information System (INIS)

    A high-voltage electrical burn caused extensive deep muscle injuries beneath a relatively small skin wound at the contact point. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, which can lead to major amputations or sepsis. The radiologic features of this rare, sometimes life-threatening injury have occasionally been described in the literature. However, to the best of our knowledge, there have been no reports on a case of pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity. We report a case of the pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity.

  15. Pyogenic Arthritis of the Ankle Joint Following a High-Voltage Electrical Burn in the Lower Extremity: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kuk Seon; Lee, Gyung Kyu; Kang, Ik Won; Hwang, Dae Hyun; Lee, Eil Seong; Min, Seon Jung; Han, You Mie [Dept. of Radiology, Hangang Scared Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of); Lee, Eil Seong [Dept.of Radiology, Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju (Korea, Republic of)

    2011-04-15

    A high-voltage electrical burn caused extensive deep muscle injuries beneath a relatively small skin wound at the contact point. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, which can lead to major amputations or sepsis. The radiologic features of this rare, sometimes life-threatening injury have occasionally been described in the literature. However, to the best of our knowledge, there have been no reports on a case of pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity. We report a case of the pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity.

  16. A new concept for evaluating muscle function in the lower extremities in cases of low back pain syndrome in anamnesis

    Directory of Open Access Journals (Sweden)

    Przemysław Lisiński

    2014-06-01

    Full Text Available introduction. There are difficulties in objective evaluation of activity of the muscles in the lower extremities of patients after successful treatment of sciatica and pseudosciatica, when no clear clinical symptoms are detected. However, the existence of some muscle dysfunction can be hypothesised and its detection was the aim of the study. objective. Recordings from chosen lower extremity muscles during standing were performed as supplementary differential diagnosis in evaluation of these patients. EMG in standing positions constitutes a new methodological approach not described in detail. methods. Twenty patients (11 after sciatica and 9 after sciatica-like episodes were enrolled into the study. On the day of examination, clinical and electroneurographical (ENG; M and F waves tests studies showed no pathology. The percentage of maximal voluntary contraction (MVC defined muscle activity during standing. Mean amplitude and number of changes in muscle activity (fluctuations were measured in surface electromyography recordings (sEMG during normal standing and tandem positions. results and conclusions. Activity of proximal lower extremity muscles expressed as percentage of MVC was bilaterally increased in patients after sciatica in normal standing position, compared with results from the group of healthy volunteers (N=9. Patients after sciatica were also characterized with a significant increase of mean sEMG amplitude, recorded especially in distal muscles on the affected side during tandem position. This pathological change was related to decrease in ‘fluctuations’ frequency in patients after sciatica (P<0.001 more than after pseudosciatica (P<0.01 groups in both standing positions, compared to parameters of healthy volunteers. Sciatica and pseudosciatica in anamnesis cause different abnormal patterns of lower extremity muscle activity during standing positions when recorded with surface EMG.

  17. The application of DSA bolus chase technology in diagnosing the vascular disorders of lower extremities due to diabetes mellitus

    International Nuclear Information System (INIS)

    Objective: To retrospectively evaluate the digital subtraction angiography (DSA) bolus chase technology in diagnosing the vascular disorders of lower extremities due to diabetes mellitus. Methods: From January 2004 to March 2010, DSA was performed in forty-five diabetes patients with suspicious vascular diseases of lower extremities. Among them, 24 cases (31 lower limbs)were examined with DSA bolus chase technology and the remaining 21 cases (21 lower limbs)were examined with traditional segmentational technique. The contrast dosage used in angiography, the total exposure time, the examination time and the imaging value for making diagnosis were analyzed and compared between two techniques. Results: For DSA bolus chase technology group, the contrast dosage used in angiography, the total exposure time and the examination time were 25.26 ml, 13.23 s and 37.26 min, respectively,with an average exposure of 101.65 pictures. For traditional segmentational technique group, the contrast dosage used in angiography, the total exposure time and the examination time were 130.00 ml, 52.38 s and 50.48 min, respectively, with an average exposure of 118.33 pictures. The percentage of high quality images in bolus chase technology group and in traditional segmentational technique group were 90.3% and 90.5%, respectively. All the images could meet the requirements for making a reliable diagnosis. Conclusion: Digital subtraction angiography by using bolus-chase technology can well demonstrate the vascular pathology of lower extremities caused by diabetes mellitus, obtain sufficient imaging information necessary for making a reliable diagnosis. DSA bolus chase technology is superior to traditional segmentational technique in shortening procedure time, reducing contrast medium dosage and decreasing radiation dose. (authors)

  18. Consequences of lower extremity and trunk muscle fatigue on balance and functional tasks in older people: A systematic literature review

    OpenAIRE

    Helbostad Jorunn L; Sturnieks Daina L; Menant Jasmine; Delbaere Kim; Lord Stephen R; Pijnappels Mirjam

    2010-01-01

    Abstract Background Muscle fatigue reduces muscle strength and balance control in young people. It is not clear whether fatigue resistance seen in older persons leads to different effects. In order to understand whether muscle fatigue may increase fall risk in older persons, a systematic literature review aimed to summarize knowledge on the effects of lower extremity and trunk muscle fatigue on balance and functional tasks in older people was performed. Methods Studies were identified with se...

  19. Incomplete palmar fracture of the proximal extremity of the third metacarpal bone in horses: ten cases (1981-1986)

    International Nuclear Information System (INIS)

    In 4 adult horses, simple, non displaced, incomplete fracture of the proximal extremity of the third metacarpal bone (MC3) was identified radiographically only on the dorsopalmar projection. Lameness was slight to moderate. Although nerve blocks of the foot and fetlock did not alter the lameness, high palmar regional nerve block improved the gait in 1 of the 2 horses on which it was performed. Pain on palpation or swollen distal accessory (inferior check) ligament, flexor tendons, and suspensory ligament were not found in any horse. The fracture was localized to the palmar surface of the proximal extremity of the MC3 on the basis of the intense uptake of radiopharmaceutical (99MTc-labeled sodium medronate) observed in that area during the soft tissue and delayed bone phases of a nuclear scintigraphic examination (nuclear scan) performed concurrently with radiography. Of 4 horses evaluated 6 months after the initial diagnosis, 3 had medullary sclerosis without radiographic evidence of fracture; results of follow-up nuclear scintigraphy performed in one of these horses at the same time were normal. Incomplete fracture also was suspected in another 6 adult horses with clinical lameness referable to the proximal extremity of the MC3. Although a fracture line could not be seen radiographically, trabecular hypertrophy and/or medullary sclerosis of the proximal extremity of the MC3 were detected on the dorsopalmar projection. Further, during nuclear scintigraphy, an intense uptake of the radiopharmaceutical was observed on the palmar aspect of the proximal extremity of the MC3 in all 6 horses

  20. Biofidelity Evaluation of a Prototype Hybrid III 6 Year-Old ATD Lower Extremity.

    Science.gov (United States)

    Boucher, Laura C; Bing, Julie; Bolte, John H

    2016-09-01

    Incomplete instrumentation and a lack of biofidelity in the extremities of the 6 year-old anthropomorphic test device (ATD) pose challenges when studying regions of the body known to interact with the vehicle interior. This study sought to compare a prototype Hybrid III 6 year-old ATD leg (ATD-LE), with a more biofidelic ankle and tibia load cell, to previously collected child volunteer data and to the current Hybrid III 6 year-old ATD (HIII). Anthropometry, range of motion (ROM), and stiffness measurements were taken, along with a dynamic evaluation of the ATD-LE using knee-bolster airbag (KBA) test scenarios. Anthropometry values were similar in eight of twelve measurements. Total ankle ROM was improved in the ATD-LE with no bumper compared to the HIII. The highest tibia moments and tibia index values were recorded in KBA scenarios when the toes were positioned in contact with the dashboard prior to airbag deployment, forcing the ankle into axial loading and dorsiflexion. While improvements in the biofidelity of the ATD-LE are still necessary, the results of this study are encouraging. Continued advancement of the 6 year-old ATD ankle is necessary to provide a tool to directly study the behavior of the leg during a motor vehicle crash. PMID:26864538

  1. Hip External Rotator Strength Is Associated With Better Dynamic Control of the Lower Extremity During Landing Tasks.

    Science.gov (United States)

    Malloy, Philip J; Morgan, Alexander M; Meinerz, Carolyn M; Geiser, Christopher F; Kipp, Kristof

    2016-01-01

    The purpose of this study was to determine the association between hip strength and lower extremity kinematics and kinetics during unanticipated single-leg landing and cutting tasks in collegiate female soccer players. Twenty-three National Collegiate Athletic Association division I female soccer players were recruited for strength testing and biomechanical analysis. Maximal isometric hip abduction and external rotation strength were measured using a hand-held dynamometer and expressed as muscle torque (force × femoral length) and normalized to body weight. Three-dimensional lower extremity kinematics and kinetics were assessed with motion analysis and force plates, and an inverse dynamics approach was used to calculate net internal joint moments that were normalized to body weight. Greater hip external rotator strength was significantly associated with greater peak hip external rotation moments (r = 0.47; p = 0.021), greater peak knee internal rotation moments (r = 0.41; p = 0.048), greater hip frontal plane excursion (r = 0.49; p = 0.017), and less knee transverse plane excursion (r = -0.56; p = 0.004) during unanticipated single-leg landing and cutting tasks. In addition, a statistical trend was detected between hip external rotator strength and peak hip frontal plane moments (r = 0.39; p = 0.06). The results suggest that females with greater hip external rotator strength demonstrate better dynamic control of the lower extremity during unanticipated single-leg landing and cutting tasks and provide further support for the link between hip strength and lower extremity landing mechanics. PMID:26110347

  2. Quantification of axial alignment of the lower extremity on conventional and digital total leg radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Sailer, J.; Scharitzer, M.; Peloschek, P.; Imhof, H.; Grampp, S. [Medizinische Fakultaet der Universitaet Wien, Univ. Klinik fuer Radiodiagnostik, Abteilung Osteoradiologie, Vienna (Austria); Giurea, A. [Medizinische Fakultaet der Universitaet Wien, Univ. Klinik fuer Orthopaedie, Vienna (Austria)

    2005-01-01

    The purpose was to assess axial alignment of the lower limb using mechanical axis measurements on conventional and digital radiographs. Total-leg radiographs of 24 patients, 8 male and 16 female, with a mean age of 68.6{+-}10.2 years, were performed in a standardized anterior-posterior projection and standing position using a conventional and digital phosphor storage film screen radiography system. Knee joint angulation was assessed by measuring the angle between a line drawn from the center of the femoral head to the middle of the femoral condyles and a line drawn from the middle of the tibial condyles to the midpoint of the malleolus. On conventional leg radiographs, line drawing and angle measurement were performed manually with a transparent goniometer. Angle measurement on digital leg radiographs was performed on a PACS workstation using computer-assisted measurement software (IMPAX, AGFA-GEVAERT, Belgium). Evaluation time for both measurements was recorded. We diagnosed 14 varus and 10 valgus angulations of the knee joint. The mean individual difference between axis deviation of conventional digital leg radiographs was 0.93+0.6 (min 0 , max 2 ), the mean difference in varus angulation was 1.13{+-}0.45 (min 0.3 , max 2 ), and the mean difference in valgus angulation was 0.65{+-}0.71 (min 0 , max 2 ). Angle measurements on conventional and digital radiographs did not show any statistically significant difference. Mean time exposure was 4.9 min/patient for manual and 1.08 min/patient for computer-assisted angle measurement (P<0.001). Computer-assisted angle measurement on digital total-leg radiographs represents a reliable method with no significant angle differences compared to conventional radiographic systems and offers a significantly lower evaluation time. (orig.)

  3. Quantification of axial alignment of the lower extremity on conventional and digital total leg radiographs

    International Nuclear Information System (INIS)

    The purpose was to assess axial alignment of the lower limb using mechanical axis measurements on conventional and digital radiographs. Total-leg radiographs of 24 patients, 8 male and 16 female, with a mean age of 68.6±10.2 years, were performed in a standardized anterior-posterior projection and standing position using a conventional and digital phosphor storage film screen radiography system. Knee joint angulation was assessed by measuring the angle between a line drawn from the center of the femoral head to the middle of the femoral condyles and a line drawn from the middle of the tibial condyles to the midpoint of the malleolus. On conventional leg radiographs, line drawing and angle measurement were performed manually with a transparent goniometer. Angle measurement on digital leg radiographs was performed on a PACS workstation using computer-assisted measurement software (IMPAX, AGFA-GEVAERT, Belgium). Evaluation time for both measurements was recorded. We diagnosed 14 varus and 10 valgus angulations of the knee joint. The mean individual difference between axis deviation of conventional digital leg radiographs was 0.93+0.6 (min 0 , max 2 ), the mean difference in varus angulation was 1.13±0.45 (min 0.3 , max 2 ), and the mean difference in valgus angulation was 0.65±0.71 (min 0 , max 2 ). Angle measurements on conventional and digital radiographs did not show any statistically significant difference. Mean time exposure was 4.9 min/patient for manual and 1.08 min/patient for computer-assisted angle measurement (P<0.001). Computer-assisted angle measurement on digital total-leg radiographs represents a reliable method with no significant angle differences compared to conventional radiographic systems and offers a significantly lower evaluation time. (orig.)

  4. Efficacy of Lower-Extremity Venous Thrombolysis in the Setting of Congenital Absence or Atresia of the Inferior Vena Cava

    Energy Technology Data Exchange (ETDEWEB)

    Ganguli, Suvranu, E-mail: sganguli@partners.org; Kalva, Sanjeeva; Oklu, Rahmi; Walker, T. Gregory; Datta, Neil [Massachusetts General Hospital and Harvard Medical School, Division of Vascular Imaging and Intervention, Department of Imaging (United States); Grabowski, Eric F. [Massachusetts General Hospital and Harvard Medical School, Division of Hematology and Oncology, Department of Pediatrics (United States); Wicky, Stephan [Massachusetts General Hospital and Harvard Medical School, Division of Vascular Imaging and Intervention, Department of Imaging (United States)

    2012-10-15

    Purpose: A rare but described risk factor for deep venous thrombosis (DVT), predominately in the young, is congenital agenesis or atresia of the inferior vena cava (IVC). The optimal management for DVT in this subset of patients is unknown. We evaluated the efficacy of pharmacomechanical catheter-directed thrombolysis (PCDT) followed by systemic anticoagulation in the treatment of acute lower-extremity DVT in the setting of congenital IVC agenesis or atresia. Materials and Methods: Between November of 2005 and May of 2010, six patients (three women [average age 21 years]) were referred to our department with acute lower-extremity DVT and subsequently found to have IVC agenesis or atresia on magnetic resonance imaging. A standardized technique for PCDT (the Angiojet Rheolytic Thrombectomy System followed by the EKOS Microsonic Accelerated Thrombolysis System) was used for all subjects. Successful thrombolysis was followed by systemic heparinization with transition to Coumadin or low molecular-weight heparin and compression stockings. Subjects were followed-up at 1, 3, and then every 6 months after the procedure with clinical assessment and bilateral lower-extremity venous ultrasound. Results: All PCDT procedures were technically successful. No venous stenting or angioplasty was performed. The average thrombolysis time was 28.6 h (range 12-72). Two patients experienced heparin-induced thrombocytopenia, and one patient developed a self-limited knee hemarthrosis, No patients were lost to follow-up. The average length of follow-up was 25.8 {+-} 20.2 months (range 3.8-54.8). No incidence of recurrent DVT was identified. There were no manifestations of postthrombotic syndrome. Conclusions: PCDT followed by systemic anticoagulation and the use of compression stockings appears to be safe and effective in relatively long-term follow-up treatment of patients who present with acute DVT and IVC agenesis or atresia.

  5. Efficacy of Lower-Extremity Venous Thrombolysis in the Setting of Congenital Absence or Atresia of the Inferior Vena Cava

    International Nuclear Information System (INIS)

    Purpose: A rare but described risk factor for deep venous thrombosis (DVT), predominately in the young, is congenital agenesis or atresia of the inferior vena cava (IVC). The optimal management for DVT in this subset of patients is unknown. We evaluated the efficacy of pharmacomechanical catheter-directed thrombolysis (PCDT) followed by systemic anticoagulation in the treatment of acute lower-extremity DVT in the setting of congenital IVC agenesis or atresia. Materials and Methods: Between November of 2005 and May of 2010, six patients (three women [average age 21 years]) were referred to our department with acute lower-extremity DVT and subsequently found to have IVC agenesis or atresia on magnetic resonance imaging. A standardized technique for PCDT (the Angiojet Rheolytic Thrombectomy System followed by the EKOS Microsonic Accelerated Thrombolysis System) was used for all subjects. Successful thrombolysis was followed by systemic heparinization with transition to Coumadin or low molecular-weight heparin and compression stockings. Subjects were followed-up at 1, 3, and then every 6 months after the procedure with clinical assessment and bilateral lower-extremity venous ultrasound. Results: All PCDT procedures were technically successful. No venous stenting or angioplasty was performed. The average thrombolysis time was 28.6 h (range 12–72). Two patients experienced heparin-induced thrombocytopenia, and one patient developed a self-limited knee hemarthrosis, No patients were lost to follow-up. The average length of follow-up was 25.8 ± 20.2 months (range 3.8–54.8). No incidence of recurrent DVT was identified. There were no manifestations of postthrombotic syndrome. Conclusions: PCDT followed by systemic anticoagulation and the use of compression stockings appears to be safe and effective in relatively long-term follow-up treatment of patients who present with acute DVT and IVC agenesis or atresia.

  6. Pathology Image Of the Month: Rapidly Progressive Hemorrhagic Cellulitis of Bilateral Lower Extremities with Subsequent Septic Shock and Death.

    Science.gov (United States)

    Connor, Ellen E; Jackson, Nicole R; McGoey, Robin R

    2016-01-01

    A 51-year-old man presented to a community based emergency department with bilateral lower extremity swelling that began four days prior and that had evolved into recent blister formation on the left lower extremity. Medical history was significant only for hypertension and a recent self-described episode of "food poisoning" five days earlier characterized by diarrhea, nausea, and vomiting that quickly resolved. Physical exam revealed marked bilateral lower extremity edema and an ecchymotic rash below the knee. In addition to the rash, there were large flaccid bullae on the left leg, mostly intact but some notable for draining of scanty serosanguinous fluid. The patient was tachycardic with a rate of 114 bpm and initial labs showed thrombocytopenia (platelets 56 x 103/uL [140-440 x 103/uL]), hypoglycemia (15mg/dl [70-105mg/dl]), an elevated creatinine (2.7mg/dL [0.7- 1.25mg/dL]), and aspartate aminotransferase (AST 156U/L [5- 34U/L]). Two sets of blood cultures were drawn, broad spectrum antibiotics including doxycycline were empirically initiated and then he was subsequently transported to a tertiary care hospital for escalation of care. Within hours of presentation to the tertiary care facility, the rash appeared progressively hemorrhagic and bullous, lactic acidosis and coagulopathy developed and hemodynamic instability and septic shock necessitated endotracheal intubation and vasopressors. He was taken to the operating room for skin debridement but was emergently converted to bilateral above the knee lower extremity amputations due to the extent of the soft tissue necrosis. The patient remained intubated and in critical condition following surgery and the ecchymotic rash reappeared at the amputation sites. A newly developed ecchymotic rash with bullae formation was noted on the right upper extremity forearm. At that time, the clinicians were notified that four out of four blood culture bottles from admission were rapidly growing a microorganism. The family

  7. Physiotherapy in the physical rehabilitation of patients with sequelae of injuries of the lower extremities in Zhitomir of rehabilitation facilities

    Directory of Open Access Journals (Sweden)

    Zhelezniy O.D.

    2015-02-01

    Full Text Available Purpose : to study the physical properties and therapeutic effect of mechanical factors in the pathogenetic treatment in traumatology. Material : 622 patients were studied with the consequences of injuries of the lower extremities (age 18-64 years. Observations carried out since 2005 in hospitals and medical health institutions of Zhitomir. Selected physiotherapy factors that are mainly used for the physical rehabilitation of patients in trauma. Results : identified the factors that were intended to eliminate the consequences of injuries of the lower extremities. Analyzed their effect in the author's method of complex rehabilitation of patients. Performed systematization selected physiotherapy factors in a table to read and understand forms. In the medical health institutions in the city of Zhytomyr investigated and established the effectiveness of the recommendations. Conclusions : physical factors cause the body general, non-specific and specific response to each type of impact. This allows you to selectively influence the pathogenic elements of the disease. Should strictly adhere to the indications and contraindications to the use of physiotherapy factor. It is necessary to take into account age, sex, and comorbidity.

  8. Prevention and nursing care of the complications occurred in interventional therapy for arteriosclerosis obliterans of lower extremity

    International Nuclear Information System (INIS)

    Objective: To discuss the prevention and nursing care of the perioperative complications occurred in interventional therapy for arteriosclerosis obliterans of lower extremity. Methods: During the period of July 2006 to June 2009, interventional treatment for the arteriosclerosis obliterans of lower extremity was performed in 380 cases. The clinical data and complications were reviewed and analyzed, and the prevention and nursing care of the complications were summarized. Results: Complications occurred in 41 cases. During the surgery, vascular rupture or arterial dissection occurred in 5 cases, hypoglycemia reaction in 3 cases and elevation of blood pressure in 2 cases. The complications,which occurred after the treatment,included acute arterial thrombosis (n=3), deep vein thrombosis (n=2), bleeding of different tissues or organs (n=17), acute myocardial infarction (n=2), pseudoaneurysm (n=2), excessive lower limb perfusion syndrome (n=4) and compression sores (n=1). Conclusion: Detailed information of medical history, careful observation of clinical condition, intensive care of patient, adequate preparation of medical materials, seriously handing over the duty to the next shift and taking one's turn on duty, etc. are all the effective measures to prevent and to reduce the occurrence of complications. (authors)

  9. Leg ulcer due to multiple arteriovenous malformations in the lower extremity of an elderly patient.

    Science.gov (United States)

    Ueda, Takashi; Tanabe, Kenichi; Morita, Miho; Nakahara, Chihoko; Katsuoka, Kensei

    2016-04-01

    A 66-year-old woman with a history of deep vein thrombosis (DVT) presented with an irregularly shaped leg ulcer surrounded by pigmentation on the left lower limb. In addition, the circumference of her left thigh had gradually increased. The ulcer did not respond to topical treatment and enlarged, therefore, she visited our hospital. Arteriography of the left lower limb showed multiple arteriovenous malformations (AVMs), based on which we made a diagnosis of a leg ulcer due to multiple AVMs. Transcatheter arterial embolisation with a mixture of N-butyl-2-cyanoacrylate and lipiodol was performed six times in the period of about a year for treating the AVMs. The ulcer was managed with bed rest, surgical debridement, continuous pressure support with elastic wrap and topical treatment. After 15 months, the ulcer healed, leaving pigmentation and scarring. It is quite rare for AVMs to progress in the elderly. We speculate that the DVT had caused occult AVMs to become symptomatic following an increase in size. PMID:24720817

  10. A rare case of bilateral lower extremity edema due to low dose gabapentin therapy in a young male patient.

    Science.gov (United States)

    Kahlon, Arunpreet; Gnanabakthan, Naveen; Dhillon, Amrita; Subedi, Dinesh

    2015-09-01

    46 year old male with past medical history of schizoaffective disorder and chronic lower back pain, was admitted for management of worsening depression and anxiety. He was started on gabapentin, 300mg twice daily for his back pain and anxiety symptoms. His only other medication was hydrocodone. Over next few days, he started developing worsening bilateral lower extremity edema. He did not have any cardiovascular related symptoms. Physical exam was only significant for 3+ pitting edema with all laboratory values and imaging being unremarkable. Gabapentin was discontinued and his lower extremity swelling improved over subsequent days. Incidence of pedal edema with gabapentin use is approximately 7 to 7.5% with all studies being in elderly patients receiving doses above 1200 mg/day. This case illustrates that lower doses of gabapentin can also cause this adverse effect. It is important to recognize this adverse effect because gabapentin is used in conditions like diabetic neuropathy, which is associated with multiple co-morbidities that can give rise to bilateral leg swelling. Presence of gabapentin induced leg swelling can thus confound the clinical picture. PMID:26692738

  11. Fixed-site high-frequency transcutaneous electrical nerve stimulation for treatment of chronic low back and lower extremity pain

    Directory of Open Access Journals (Sweden)

    Gozani SN

    2016-06-01

    Full Text Available Shai N Gozani NeuroMetrix, Inc., Waltham, MA, USA Objective: The objective of this study was to determine if fixed-site high-frequency transcutaneous electrical nerve stimulation (FS-TENS is effective in treating chronic low back and lower extremity pain. Background: Transcutaneous electrical nerve stimulation is widely used for treatment of chronic pain. General-purpose transcutaneous electrical nerve stimulation devices are designed for stimulation anywhere on the body and often cannot be used while the user is active or sleeping. FS-TENS devices are designed for placement at a pre-determined location, which enables development of a wearable device for use over extended time periods. Methods: Study participants with chronic low back and/or lower extremity pain self-administered an FS-TENS device for 60 days. Baseline, 30-, and 60-day follow-up data were obtained through an online questionnaire. The primary outcome measure was the patient global impression of change. Pain intensity and interference were assessed using the Brief Pain Inventory. Changes in use of concomitant pain medications were evaluated with a single-item global self-rating. Results: One hundred and thirty participants were enrolled, with 88 completing the 60-day follow-up questionnaire. Most participants (73.9% were 50 years of age or older. At baseline, low back pain was identified by 85.3%, lower extremity pain by 71.6%, and upper extremity pain by 62.5%. Participants reported widespread pain, at baseline, with a mean of 3.4 (standard deviation 1.1 pain sites. At the 60-day follow-up, 80.7% of participants reported that their chronic pain had improved and they were classified as responders. Baseline characteristics did not differentiate non-responders from responders. There were numerical trends toward reduced pain interference with walking ability and sleep, and greater pain relief in responders. There was a large difference in use of concomitant pain medications, with 80

  12. Length and angle measurements of the lower extremity in digital composite overview images

    International Nuclear Information System (INIS)

    We here introduce a digital scanning method for determining leg length and angles. The leg length and angle measurements, image quality and radiation dose were evaluated. A composite overview image was reconstructed from a series of individual images. In 45 overview images, the total leg length and the femoro-tibial angle were determined by two radiologists, and the inter- and intra-observer variability was examined in the light of the measured values as well as the subjective assessment of the image quality. A dose comparison was carried out with a series of conventional whole leg images. The mean standard deviation of the multiple measurements of leg length was 0.4 mm for researcher I and 0.5 mm for researcher II. The difference in the mean values of the measured leg lengths between the researchers was 0.3 mm. The mean standard deviation of the multiple measurements of the femoro-tibial angle was 0.1 for both researchers. The difference in the mean values of the measured femoro-tibial angle between the researchers was 0.03 . On average, the marks for the image quality awarded by researcher II with an average score of 2 were very significantly worse than those awarded by researcher I with an average score of 1.5. The mean entrance dose value determined was 0.16 mGy lower in the digital system (0.49 mGy) than that of the comparative conventional series (0.65 mGy). Where there is a large number of possible length and angle measurements, the proposed procedure offers the advantages of good image quality, digital image processing, measurements that are easy to perform, reproducible and accurate, and lower radiation dose, and it is superior to conventional whole leg images. (orig.)

  13. Evaluation of elastic bands for lower extremity resistance training in adults with and without musculo-skeletal pain

    DEFF Research Database (Denmark)

    Sundstrup, E; Jakobsen, M D; Andersen, C H;

    2014-01-01

    findings. However, pain in the lower back decreased muscular activity of the gluteus maximus and vastus medialis (P < 0.01). Lunges with elastic resistance induce high levels of muscle activity in all the large muscle groups at the hip, knee, and back. Importantly, the efficiency of these exercises was...... equally high regardless of gender, age, and pain in the knees and hip, whereas pain in the lower back led to altered activation strategies.......Therapists commonly use elastic bands in resistance exercises during rehabilitation of smaller muscles, such as in the shoulder. However, the effectiveness has not yet been investigated for larger muscle groups. This study investigates muscle activity during lower extremity exercises...

  14. Anesthetic effects of adding intrathecal neostigmine or magnesium sulphate to bupivacaine in patients under lower extremities surgeries

    Directory of Open Access Journals (Sweden)

    Seyed Hamid Reza Faiz

    2012-01-01

    Full Text Available Background: Regional anesthesia is widely used to perform different surgical procedures including those performed on the extremities. In this study, the anesthetic effects of adding intrathecal neostigmine or magnesium sulphate to bupivacaine in patients under lower extremities surgeries were assessed. Materials and Methods: In this double-blind randomized clinical trial, 90 patients, candidate for lower extremities surgeries in a training hospital, were recruited. The patients with ASA class I and II aging from 20 to 65 years between 2009 and 2010 were evaluated. The selected patients were randomly assigned to receive either bupivacaine alone (Group A, n=30, or bupivacaine plus magnesium sulphate 50% (Group B, n=30, or bupivacaine plus neostigmine (Group C, n=30. Then sensory and motor onset and complete block and the time of recovery were measured. Results: The sensory block onset time were 3.03 ± 0.981 in group A, 3.90 ± 2.71 in group B and 3.7 ± 1.08 in group C and knee flexion time were not significantly different among the three groups (P > 0.05, whereas the time to complete motor block was significantly longer in group C and motor recovery time were significantly different between groups (P=0.001. Conclusions: According to the obtained results, it may be concluded that magnesium sulphate is a safe and effective adjuvant for increasing the onset time of motor block.

  15. Saphenous Vein Sparing Superficial Inguinal Dissection in Lower Extremity Melanoma

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    Muhammed Beşir Öztürk

    2014-01-01

    Full Text Available Aim. The classic inguinal lymph node dissection is the main step for the regional control of the lower extremity melanoma, but this surgical procedure is associated with significant postoperative morbidity. The permanent lymphedema is the most devastating long-term complication leading to a significant decrease in the patient’s quality of life. In this study we present our experience with modified, saphenous vein sparing, inguinal lymph node dissections for patients with melanoma of the lower extremity. Methods. Twenty one patients (10 women, 11 men who underwent saphenous vein sparing superficial inguinal lymph node dissection for the melanoma of lower extremity were included in this study. The effects of saphenous vein sparing on postoperative complications were evaluated. Results. We have observed the decreased rate of long-term lymphedema in patients undergoing inguinal lymphadenectomy for the lower extremity melanoma. Conclusion. The inguinal lymphadenectomy with saphenous vein preservation in lower extremity melanoma patients seems to be an oncologically safe procedure and it may offer reduced long-term morbidity.

  16. Contrast-enhanced MR angiography in the routine work-up of the lower extremity arteries

    International Nuclear Information System (INIS)

    Purpose: Prospective evaluation of the effectiveness of contrast-enhanced moving-table magnetic resonance angiography (CEMRA) as the sole routine tool for the diagnosis of peripheral arterial occlusive disease and determination whether it can replace catheter arteriography. Subjects and Methods: In a time period of 23 weeks, 100 consecutive patients were evaluated. A total of 112-contrast-enhanced moving-table MR angiograms were performed at 1.5 Tesla. A dedicated vascular coil system was used. It was evaluated in which cases MR angiography was sufficient to determine the treatment plan and in which cases limited quality required additional examinations. Results: In 93.75% (105/112) of all examinations, the treatment plan was determined by MRA as the sole diagnostic tool. Twenty-two patients underwent surgery or percutaneous angioplasty based on MRA findings. Additional examinations due to impaired quality were performed in seven (6.25%) cases: two MR angiographies of the pelvic arteries, one MR angiography of the calf, and four selective arteriographies because of venous overlay at the calf. Conclusion: Contrast-enhanced MR angiography can take the place of catheter angiography in the routine work-up of patients with peripheral arterial occlusive disease. Further assessment might be necessary in five to ten percent of the case when the diagnostic quality is inadequate, mostly due to venous overlay in the lower leg. (orig.)

  17. A clinical study on chronic arterial occlusive diseases of the lower extremities by scintiangiography of the foot

    International Nuclear Information System (INIS)

    Scintiangiography of the foot was performed on 210 limbs with peripheral vascular diseases of the lower extremities in comparison with 12 normal limbs. After an intravenous bolus of 10 to 20 mCi of sup(99m)Tc-human serum albumin, the arrival and distribution of activity in foot during reactive hyperemia were observed and photographed on the monitor scope of the gamma camera and recorded on video tape. The activity curve was obtained for several regions of interest and analysed to obtain the arrival time of activity Ta, the maximum counts time Tmax and the perfusion index. Those results were compared with angiography and the pressure index. The gamma camera image provided approximately the state of the peripheral circulation, and the defect or delay of the image was obtained on 93 per cent of the ischemic extremities. The pattern of the activity curves were classified into three types, I: rapid appearance with high activity peak, II: relatively rapid appearance with low activity peak, III: delayed appearance with the absence of the activity peak. In normal subjects and good run-off patients, the typical pattern of the activity curve was mainly observed being to I type, on the other hand, the pattern was generally being to III type in patients with ulcerated or cyanotic foot. The difference between the arrival time of activity of foot and toe under conditions of reactive hyperemia was longer evidently according to degree of arterial occlusion. The perfusion index was well correlated to the pressure index on foot and toe. In conclusion, scintiangiography of the foot is a simple and harmless procedure to evaluate the hemodynamic state of the lower extremities and is applicable for screening the peripheral vascular diseases and postoperative study. (author)

  18. Gadolinium-enhanced MR angiography of arterial occlusive disease in lower extremity : comparison with conventional digital subtraction angiography

    International Nuclear Information System (INIS)

    To compare the diagnostic value of gadolinium-enhanced MR angiography with that of conventional digital subtraction angiography for the evaluation of lower extremity arterial occlusive diseases. In 26 patients with symptomatic lower extremity arterial occlusive disease, both conventional digital subtraction angiography (DSA) and gadolinium-enhanced MR angiography (CE-MRA) were performed during the same week. MR angiography was performed using three-dimensional gradient-echo acquisition before, and two sequential acquisitions after, the administration of gadolinium (0.2 mmol/kg). In 23 patients, two separate, contiguous areas were scanned using additional doses. In three patients, only one field with a suspicious lesion was scanned. Three radiologists independently analyzed the CE-MRA and DSA findings of each vascular segment (20 segments per arterial tree) for the presence of obstructive lesions; the grade assigned was either mild or none (less than 50%), stenotic (50%-99%), or occlusion (100%). From among a total of 462 segments, DSA detected 99 which were significantly narrowed (stenosis, 33; occlusion, 66). Using MR angiography, 102 segments (stenosis 39; occlusion, 63) were identified, and 94 lesions (stenosis, 32; occlusion, 62) were graded correctly. Seven lesions were overestimated and four were underestimated. For the detection of hemodynamically significant stenosis or occlusions using MR angiography, sensitivity, specificity, and diagnostic accuracy were 95%, 98%, and 98% (G=3D0.995, P less than 0.001), respectively. To prove the absence of lesions, we repeated DSA in two patients with arterial spasm due to puncture. Three occluded segments seen on DSA, which revealed intact segments on MR angiography, suggested slow distal flow after reconstitution. For the evaluation of lower extremity arterial occlusive disease, the diagnostic value of gadolinium-enhanced MR angiography is comparable with that of digital subtraction angiography. The advantages of the

  19. A randomized, controlled trial of spinal endoscopic adhesiolysis in chronic refractory low back and lower extremity pain [ISRCTN 16558617

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    McManus Carla D

    2005-07-01

    Full Text Available Abstract Background Postoperative epidural fibrosis may contribute to between 5% to 60% of the poor surgical outcomes following decompressive surgery. Correlations have been reported between epidural scarring and radicular pain, poor surgical outcomes, and a lack of any form of surgical treatment. The use of spinal endoscopic adhesiolysis in recent years in the management of chronic refractory low back and lower extremity pain has been described. Methods A prospective, randomized, double-blind trial was conducted to determine the outcome of spinal endoscopic adhesiolysis to reduce pain and improve function and psychological status in patients with chronic refractory low back and lower extremity pain. A total of 83 patients were evaluated, with 33 patients in Group I and 50 patients in Group II. Group I served as the control, with endoscopy into the sacral level without adhesiolysis, followed by injection of local anesthetic and steroid. Group II received spinal endoscopic adhesiolysis, followed by injection of local anesthetic and steroid. Results Among the 50 patients in the treatment group receiving spinal endoscopic adhesiolysis, significant improvement without adverse effects was shown in 80% at 3 months, 56% at 6 months, and 48% at 12 months. The control group showed improvement in 33% of the patients at one month and none thereafter. Based on the definition that less than 6 months of relief is considered short-term and longer than 6 months of relief is considered long-term, a significant number of patients obtained long-term relief with improvement in pain, functional status, and psychological status. Conclusion Spinal endoscopic adhesiolysis with targeted delivery of local anesthetic and steroid is an effective treatment in a significant number of patients with chronic low back and lower extremity pain without major adverse effects.

  20. High dose botulinum toxin A for the treatment of lower extremity hypertonicity in children with cerebral palsy

    OpenAIRE

    Willis, Allison W.; Crowner, Beth; Brunstrom, Janice E; Kissel, Abigail; Racette, Brad A.

    2007-01-01

    The aim of this study was to determine the safety profile of high dose (15–25 units/kg) of botulinum toxin A (BTX-A) in children with cerebral palsy (CP) and increased lower extremity muscle tone. We performed a retrospective review of 929 patient encounters at the Movement Disorders Center at Washington University. A total of 261 patients (105 females; 156 males) were treated during these visits, ages 6 months to 21 years (mean 8y 4mo [SD 4y 8mo]). Ambulatory ability at the time of BTX-A inj...

  1. Chronic lower extremity lymphedema: A comparative study of high-resolution interstitial MR lymphangiography and heavily T2-weighted MRI

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    Lu Qing [Department of Radiology, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dong Fang Rd, Shanghai 200127 (China)], E-mail: luqingshan@sjtu.edu.cn; Xu Jianrong [Department of Radiology, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dong Fang Rd, Shanghai 200127 (China)], E-mail: jiangrongx@hotmail.com; Liu Ningfei [Department of Plastic and Reconstructive Surgery, Shanghai 9th People' s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Second Medical University, 639 Zhi Zao Ju Rd, Shanghai 200011 (China)], E-mail: luqing_1973@163.com

    2010-02-15

    Purpose: To assess the role of heavily T2-weighted image and interstitial MR lymphangiography (MRL) for the visualization of lymphatic vessels in patients with disorders of the lymphatic circulation. Methods: Forty lower extremities in 31 patients (9 bilateral and 22 unilateral) with primary lymphedema were examined by heavily T2-weighted image and indirect MRL. Maximum-intensity projection (MIP) was used to reconstruct the images of the lymphatic system. Two experienced radiologists analyzed the images with regard to the differences in image quality, number of lymphatic vessels, its maximum diameter and two other findings: accumulated lymph fluid in the tissue and honeycombing pattern. Results: The beaded appearance of the affected vessels in 73 leg segments of 40 lower extremities were present on both modalities 3D MIP. Larger amount of the dilated lymphatic vessels were visualized on heavily T2-weighted image than that on MRL (p = 0.003) and the maximum diameter of it was 4.28 {+-} 1.53 mm on heavily T2-weighted image, whereas 3.41 {+-} 1.05 mm on MRL (p < 0.01). The dilated lymphatic vessels on MRL showed better image quality and greater SNR and CNR than that on heavily T2-weighted image (p < 0.01). The regions of accumulated lymph fluid and the honeycombing pattern extent were identified on heavily T2-weighted image scored statistically higher than that on MRL (p < 0.01). Conclusion: The heavily T2-weighted imaging has greater sensitivity and the MRL image has higher legibility for detecting the pathologically modified lymphatic vessels and accompanying complications non-invasively. Combining these two MR techniques can accurately access the pathological changes in the lower extremity with lymphedema.

  2. Chronic lower extremity lymphedema: A comparative study of high-resolution interstitial MR lymphangiography and heavily T2-weighted MRI

    International Nuclear Information System (INIS)

    Purpose: To assess the role of heavily T2-weighted image and interstitial MR lymphangiography (MRL) for the visualization of lymphatic vessels in patients with disorders of the lymphatic circulation. Methods: Forty lower extremities in 31 patients (9 bilateral and 22 unilateral) with primary lymphedema were examined by heavily T2-weighted image and indirect MRL. Maximum-intensity projection (MIP) was used to reconstruct the images of the lymphatic system. Two experienced radiologists analyzed the images with regard to the differences in image quality, number of lymphatic vessels, its maximum diameter and two other findings: accumulated lymph fluid in the tissue and honeycombing pattern. Results: The beaded appearance of the affected vessels in 73 leg segments of 40 lower extremities were present on both modalities 3D MIP. Larger amount of the dilated lymphatic vessels were visualized on heavily T2-weighted image than that on MRL (p = 0.003) and the maximum diameter of it was 4.28 ± 1.53 mm on heavily T2-weighted image, whereas 3.41 ± 1.05 mm on MRL (p < 0.01). The dilated lymphatic vessels on MRL showed better image quality and greater SNR and CNR than that on heavily T2-weighted image (p < 0.01). The regions of accumulated lymph fluid and the honeycombing pattern extent were identified on heavily T2-weighted image scored statistically higher than that on MRL (p < 0.01). Conclusion: The heavily T2-weighted imaging has greater sensitivity and the MRL image has higher legibility for detecting the pathologically modified lymphatic vessels and accompanying complications non-invasively. Combining these two MR techniques can accurately access the pathological changes in the lower extremity with lymphedema.

  3. Long bone histology of sauropterygia from the lower Muschelkalk of the Germanic basin provides unexpected implications for phylogeny.

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    Nicole Klein

    Full Text Available BACKGROUND: Sauropterygia is an abundant and successful group of Triassic marine reptiles. Phylogenetic relationships of Triassic Sauropterygia have always been unstable and recently questioned. Although specimens occur in high numbers, the main problems are rareness of diagnostic material from the Germanic Basin and uniformity of postcranial morphology of eosauropterygians. In the current paper, morphotypes of humeri along with their corresponding bone histologies for Lower to Middle Muschelkalk sauropterygians are described and interpreted for the first time in a phylogenetic context. METHODOLOGY/PRINCIPAL FINDINGS: Nothosaurus shows a typical plesiomorphic lamellar-zonal bone type, but varying growth patterns and the occurrence of a new humerus morphotype point to a higher taxonomic diversity than was known. In contrast to the enormous morphological variability of eosauropterygian humeri not assigned to Nothosaurus, their long bone histology is relatively uniform and can be divided into two histotypes. Unexpectedly, both of these histotypes reveal abundant fibrolamellar bone throughout the cortex. This pushes the origin of fibrolamellar bone in Sauropterygia back from the Cretaceous to the early Middle Triassic (early Anisian. Histotype A is assigned to Cymatosaurus, a basal member of the Pistosauroidea, which includes the plesiosaurs as derived members. Histotype B is related to the pachypleurosaur Anarosaurus. Contrary to these new finds, the stratigraphically younger pachypleurosaur Neusticosaurus shows the plesiomorphic lamellar-zonal bone type and an incomplete endochondral ossification, like Nothosaurus. CONCLUSIONS/SIGNIFICANCE: Histological results hypothetically discussed in a phylogenetical context have a large impact on the current phylogenetic hypothesis of Sauropterygia, leaving the pachypleurosaurs polyphyletic. On the basis of histological data, Neusticosaurus would be related to Nothosaurus, whereas Anarosaurus would follow

  4. THE INFLUENCE OF A FOOT ORTHOTIC ON LOWER EXTREMITY TRANSVERSE PLANE KINEMATICS IN COLLEGIATE FEMALE ATHLETES WITH PES PLANUS

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    Christopher R. Carcia

    2006-12-01

    Full Text Available Non-contact anterior cruciate ligament (ACL injuries in female athletes remain prevalent. Athletes with excessive foot pronation have been identified to be at greater risk for non-contact ACL injury. Excessive foot pronation has been linked to increased medial tibial rotation. Increased medial tibial rotation heightens ACL strain and has been observed at or near the time of ACL injury. Foot orthotics have been shown to decrease medial tibial rotation during walking and running tasks. The effect of a foot orthotic on activities that simulate a non-contact ACL injury mechanism (i.e. landing however is unknown. Therefore, the objective of this study was to determine whether a foot orthotic was capable of altering transverse plane lower extremity kinematics in female athletes during landing. Twenty uninjured collegiate female athletes participating in the sports of basketball, soccer or volleyball with pes planus volunteered. Utilizing a repeated measures counterbalanced design, subjects completed two landing tasks with and without a foot orthotic using standardized footwear. The prefabricated orthotic had a rigid shell and a 6 extrinsic rear-foot varus post. Dependent measures included initial contact angle, peak angle, excursion and time to peak angle for both the tibia and femur. Statistical analysis suggested that the selected foot orthosis had little influence over lower extremity transverse plane kinematics. Several factors including: the limitation of a static measure to predict dynamic movement, inter-subject variability and the physical characteristics of the orthotic device likely account for the results. Future research should examine the influence of different types of foot orthotics not only on lower extremity kinematics but also tibiofemoral kinetics

  5. Unilateral lower extremity edema in iliac compression syndrome

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of iliac compression syndrome for etiological diagnosis and treatment of unilateral lower extremity edema. Methods: The diagnosis of iliac compression syndrome was confirmed with venography in 32 cases presented with left lower extremity edema. The compressed or occluded venous segment was dilated with a 10 mm or 12 mm diameter balloon and then followed by self-expandable stent placement with a diameter from 10 to 16 mm in the diseased left iliac vein. Oral anticoagulant was taken for 6 months. Results: Left lower extremity edema was resolved within 2 days after the procedure in all 32 cases without any major complications. The primary patency of stents reached 100% and no deep venous thrombosis occurred afterwards. Conclusion: Early recognition and treatment of iliac compression syndrome could prevent DVT. (authors)

  6. Prognosis of complicated clinical course of varicose veins of lower extremities on the basis of analysis of phenotypic characteristics of connective tissue dysplasia

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    Tsarev О.А.

    2015-12-01

    Full Text Available Aim: to identify the phenotypic characteristics of indeterminate connective tissue dysplasia, which help to predict the progression of varicose veins of lower extremities and disease recurrence after surgery. Material and Methods. The long-term results of surgical treatment of 60 patients with varicose veins of lower extremities in a 5-year period after phlebectomy were analyzed. The phenotypic characteristics of indeterminate connective tissue dysplasia were researched. 24 patients had recurrence of varicose veins of lower extremities associated with disease progression; 36 patients did not have recurrence of varicose veins of lower extremities. Results. All the patients demonstrated the signs of indeterminate connective tissue dysplasia, whereas their frequency was different. There were specified nine phenotypic characteristics of indeterminate connective tissue dysplasia, which were significantly more frequent for patients with recurrence of varicose vein disease of lower extremities: 1 postural abnormality, 2 flat foot, 3 skin pallor, 4 hyperextension of skin, 5 positive "wrist test", 6 positive "pollex test", 7 diastasis recti abdominis, 8 myopia, 9 hematomas which form quickly. Conclusion. The determined sum of phenotypic characters of indeterminate connective tissue dysplasia allows to predict progression of varicose vein disease of lower extremities, and offers new opportunities for improving the results of surgical treatment via developing special therapeutic measures aimed at improving lifestyle and dysplasia treatment.

  7. Side-to-side comparisons of bone mineral density in upper and lower limbs of collegiate athletes.

    Science.gov (United States)

    McClanahan, Barbara S; Harmon-Clayton, Karen; Ward, Kenneth D; Klesges, Robert C; Vukadinovich, Christopher M; Cantler, Edwin D

    2002-11-01

    This cross-sectional study investigated the effects of participation in various sports on side-to-side (contralateral) differences in bone mineral density (BMD) of the upper and lower limbs. The BMD of the arms and legs was measured using dual energy X-ray absorptiometry. The subjects were 184 collegiate athletes, both men and women, who participated in NCAA Division I-A baseball, basketball, football, golf, soccer, tennis, cross-country, indoor/outdoor track, and volleyball. Results revealed greater BMD of the right arms compared with the left arms for all teams, with the most pronounced differences observed in men's and women's tennis and men's baseball. Differences in the lower limbs were less common. No significant differences in lower limb BMD were found in the women. In men, differences in lower limb BMD were found in the football and tennis teams, with the nondominant leg having greater bone mass. Recognition of contralateral differences in bone density may be of particular interest to strength and conditioning professionals as they consider the need to include bilateral and unilateral training programs in an effort to maximize performance and minimize stress-related injuries. PMID:12423190

  8. X-ray morphology of the joints and the bones of the extremities of aged people

    International Nuclear Information System (INIS)

    The radiograms of the healthy extremities of aged people are analyzed and the normal formations, typical at higher age, are differentiated from the pathological phenomena. The ''physiological'' decalcification can cause the following symptoms: trabecular microfractures, areas without structure, pseudoforamena, discrete spicules at the edges of the joints, periostoses, fibrous structure of the compacta. The deformations occurring in the different joints are detailed. The relationship between high age and arthrosis is also investigated. It is concluded that the occurrence of arthrosis is not inevitable and it is not seriously influenced neither by the weight nor by the profession of the patient. The thesis contains 49 radiograms. (L.E.)

  9. Experience of intervention combined with surgery in treatment of different stage deep venous thrombosis of lower extremity

    International Nuclear Information System (INIS)

    Objective: To evaluate the preliminary probe into the curative effect of combination treatment of surgery and intervention for lower limb deep venous thrombosis. Methods: The therapeutic methods and effects of 40 patients with 42 occluded limbs during the last two years, including iliac-femoral trunk old cast thrombosis in 8 cases, secondary new thrombosis with obstruction or narrow opening of iliac veins in 25, unilateral new thrombosis in 5 and secondary new thrombosis after inferior vena cava filter placement in 2; were retrospectively analyzed. The main procedure included incision of the affected femoral veins, interventional embolectomy combined with balloon dilatation and/or stenting. Results: All the affected inferior vena cavas and deep veins of lower limb were totally recognized and patent successfully, including iliac venous stenting in 19 patients, balloon dilatation in 14 and prosthesis implantation in 1. In the mean follow-up of 10 months, all the patients showed obvious improvement of clinical presentation, with color Doppler or angiography demonstrating blood flow fluently. Conclusions: The combination of intervention and surgery has good efficiency in treatment of thrombosis of deep veins of lower extremity, deserving deeper research and recommendation. (authors)

  10. Long Bone Histology of Sauropterygia from the Lower Muschelkalk of the Germanic Basin Provides Unexpected Implications for Phylogeny

    OpenAIRE

    Klein, Nicole

    2010-01-01

    Background Sauropterygia is an abundant and successful group of Triassic marine reptiles. Phylogenetic relationships of Triassic Sauropterygia have always been unstable and recently questioned. Although specimens occur in high numbers, the main problems are rareness of diagnostic material from the Germanic Basin and uniformity of postcranial morphology of eosauropterygians. In the current paper, morphotypes of humeri along with their corresponding bone histologies for Lower to Middle Muschelk...

  11. Gunther Tulip Inferior Vena Cava Filter Placement During Treatment for Deep Venous Thrombosis of the Lower Extremity

    International Nuclear Information System (INIS)

    Purpose. To evaluate the efficacy and safety of Gunther tulip retrievable vena cava filter (GTF) implantation to prevent pulmonary embolism during intravenously administered thrombolytic and anticoagulation therapy and interventional radiological therapy for occlusive or nonocclusive deep venous thrombosis (DVT) of the lower extremity. Methods. We evaluated placement of 55 GTFs in 42 patients with lower extremity DVT who had undergone various treatments including those utilizing techniques of interventional radiology. Results. Worsening of pulmonary embolism in patients with existing pulmonary embolism or in those without pulmonary embolism at the time of GTF insertion was avoided in all patients. All attempts at implantation of the GTF were safely accomplished. Perforation and migration experienced by one patient was the only complication. Mean period of treatment for DVT under protection from pulmonary embolism by the GTF was 12.7 ± 8.3 days (mean ± SD, range 4-37 days). We attempted retrieval of GTFs in 18 patients in whom the venous thrombus had disappeared after therapy, and retrieval in one of these 18 cases failed. GTFs were left in the vena cava in 24 patients for permanent use when the DVT was refractory to treatment. Conclusion. The ability of the GTF to protect against pulmonary embolism during treatment of DVT was demonstrated. Safety in both placement and retrieval was clarified. Because replacement with a permanent filter was not required, use of the GTF was convenient when further protection from complicated pulmonary embolism was necessary

  12. A research on the effects of practicing Baduanjin on the lower extremities by using sEMG

    Science.gov (United States)

    Jin, Li; Li, Ran; Chen, Jing; Tian, Ye

    2015-03-01

    The purpose of this study was to evaluate the effects of practicing Baduanjin exercises on the lower extremities of subjects, using electromyography analysis, and values of IEMG were calculated. [Subjects] Forty, healthy adults were randomly assigned as subjects to two groups: SG (Study Group, n=20) who received twelve weeks of Baduanjin training, and CG (Control Group, n=20), who received no training. [Methods] A sixteen-channel sEMG system (ME6000, Mega Electronics Ltd., Kuopio, Finland) was selected to record and measure activity changes in two muscles (vastus medialis and vastus lateralis). [Results] After twelve-week of Baduanjin training, the results of this study showed that the SG group had significant increases in values of IEMG in second, fifth and seventh section of the Baduanjin exercises. In second section, the values of IEMG had increased for 56.95% in vastus lateralis (p strength and the physical function of the lower extremities among healthy adults. With no adverse events from exercise were reported during the training procedure, the safety and low intensity of Baduanjin exercise was also proved, it could be widely taken as an appropriate no-risk treatment exercise for healthy adults.

  13. Testing and Modeling the Responses of Hybrid III Crash-Dummy Lower Extremity under High-speed Vertical Loading.

    Science.gov (United States)

    Zhu, Feng; Dong, Liqiang; Jin, Xin; Jiang, Binhui; Kalra, Anil; Shen, Ming; Yang, King H

    2015-11-01

    Anthropometric test devices (ATDs), such as the Hybrid III crash-test dummy, have been used to simulate lowerextremity responses to military personnel subjected to loading conditions from anti-vehicular (AV) landmine blasts. Numerical simulations [e.g., finite element (FE) analysis] of such high-speed vertical loading on ATD parts require accurate material parameters that are dependent on strain rate. This study presents a combined experimental and computational study to calibrate the rate-dependent properties of three materials on the lower extremities of the Hybrid III dummy. The three materials are heelpad foam, foot skin, and lower-leg flesh, and each has properties that can affect simulation results of forces and moments transferred to the lower extremities. Specifically, the behavior of the heel-pad foam was directly calibrated through standard compression tests, and the properties of the foot skin and lower-leg flesh were calibrated based on an optimization procedure in which the material parameters were adjusted for best fit between the calculated force-deflection responses and least squares of the experimental data. The material models updated with strain-rate effects were then integrated into an ATD full-body FE model (FEM), which was used to simulate vertical impulsive loading responses at different speeds. Results of validations using this model demonstrated basic replication of experimentally obtained response patterns of the tibia. The bending moments matched those calculated from the experimental data 25-40% more accurately than those obtained from the original model, and axial forces were 60-90% more accurate. However, neither the original nor the modified models well captured whole-body response patterns, and further improvements are required. As a generalized approach, the optimization method presented in this paper can be applied to characterize material constants for a wide range of materials. PMID:26660755

  14. THE EFFECTS OF TAI CHI CHUAN COMBINED WITH VIBRATION TRAINING ON BALANCE CONTROL AND LOWER EXTREMITY MUSCLE POWER

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    Pao-Hung Chung

    2013-03-01

    Full Text Available The aim of this study was to determine whether performing Tai Chi Chuan on a customized vibration platform could enhance balance control and lower extremity muscle power more efficiently than Tai Chi Chuan alone in an untrained young population. Forty-eight healthy young adults were randomly assigned to the following three groups: a Tai Chi Chuan combined with vibration training group (TCV, a Tai Chi Chuan group (TCC or a control group. The TCV group underwent 30 minutes of a reformed Tai Chi Chuan program on a customized vibration platform (32 Hz, 1 mm three times a week for eight weeks, whereas the TCC group was trained without vibration stimuli. A force platform was used to measure the moving area of a static single leg stance and the heights of two consecutive countermovement jumps. The activation of the knee extensor and flexor was also measured synchronously by surface electromyography in all tests. The results showed that the moving area in the TCV group was significantly decreased by 15.3%. The second jump height in the TCV group was significantly increased by 8.14%, and the activation of the knee extensor/flexor was significantly decreased in the first jump. In conclusion, Tai Chi Chuan combined with vibration training can more efficiently improve balance control, and the positive training effect on the lower extremity muscle power induced by vibration stimuli still remains significant because there is no cross-interaction between the two different types of training methods.

  15. Results of a bone splint technique for the treatment of lower limb deformities in children with type I osteogenesis imperfecta

    OpenAIRE

    Dasheng Lin; Wenliang Zhai; Kejian Lian; Zhenqi Ding

    2013-01-01

    Background: Children with osteogenesis imperfecta (OI) can suffer from frequent fractures and limb deformities, resulting in impaired ambulation. Osteopenia and thin cortices complicate orthopedic treatment in this group. This study evaluates the clinical results of a bone splint technique for the treatment of lower limb deformities in children with type I OI. The technique consists of internal plating combined with cortical strut allograft fixation. Materials and Methods: We prospectivel...

  16. Dynamic Frequency Analyses of Lower Extremity Muscles during Sit-To-Stand Motion for the Patients with Knee Osteoarthritis.

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    Masaya Anan

    Full Text Available Muscle activities during the sit-to-stand motion (STS are characterized by coordinated movements between hip extensors and knee extensors. However, previous reports regarding the STS and lower extremity muscle activities have focused on some quantitative assessment, but little qualitative research. This study aimed to examine the muscle activities of the lower extremity both quantitatively and qualitatively.Study participants included 13 patients with knee osteoarthritis (knee OA and 11 age-matched asymptomatic controls. The task was STS from a chair with a height-adjustable seat. EMG activities were acquired using surface electromyogram. The root mean square signals normalized as a percentage of maximum voluntary isometric contraction values (RMS%MVC and the mean power frequency (MPF were calculated.During STS, knee OA patients had increased RMS%MVC of the vastus medialis and raised MPF of the rectus femoris before buttocks-off.These findings suggest that STS of knee OA patients not only increased relative muscle activity of the vastus medialis, but also enlisted the rectus femoris in knee extension to improve muscle contraction force by activating more type II fibers to accomplish buttocks-off.

  17. VARIATION IN THE NUMBER AND POSITION OF NUTRIENT FORAMINA OF LONG BONES OF LOWER LIMB IN NORTH INDIANS

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    Seema

    2015-12-01

    Full Text Available Aims and Objectives: The major blood supply of the long bones is through the nutrient arterywhich enter through the nutrient foramina leadinginto an oblique nutrient canal. The presence, number, position and distances from the various prominent landmarks on the bone have medical as well as surgical significance. The present study was done on the long bones of North Indians to know the mean values of the number, position of nutrient foramina and distance from various landmarks on the bones and ultimately to compare with other populations. Materials and Methods: The present study consists of 180 long bones of lower limb (60 femora, 60 tibiae, 60 fibulae which were taken from Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah (Amritsar, India and studied carefully for the number, position and distance of nutrient foramina in relation to length and from the proximal epiphysis of the long bones. Also the anteroposterior and lateromedial diameter of the bone at the level of nutrient foramen were studied. Main outcome measure: Variations in number, position and distance in relation to length and from proximal epiphysis of long bones was seen. Results: The nutrient foramen of femur was located on the linea aspera in 76.50% of cases(39% in interstice 9.5% on the lateral lip and 28.00% on the medial lip of the linea aspera, 18.50 %on the medial surface and 5%.on the lateral surface. Nutrient foramen of tibia was located in 95.50% of cases under the soleal line at the average distance of 119.8 mm from intercondylar eminence to the nutrient foramen, on the soleal line in 4%and on the lateral border in 0.50% of cases. Nutrient foramen of fibula was found on the posterior surface in 65 % of cases, in 15% on the medial surface, on the interosseous border in 10% ,on the lateral surface in 7% and on the posterior border in 3% of cases. Conclusion: This study will provide the ethnic data for comparison among various

  18. The Effects of Taping Prior to PNF Treatment on Lower Extremity Proprioception of Hemiplegic Patients

    OpenAIRE

    Choi, Yong-Kyu; Nam, Chan-Woo; Lee, Jung-Ho; Park, Young-Han

    2013-01-01

    [Purpose] The purpose of this study was to compare the effects of taping on the articular angle of the knee joint and on the functioning of patients with hemiplegia resulting from stroke. [Subjects] The subjects of this study were 30 patients who were diagnosed with hemiplegia due to stroke. The subjects were randomly assigned to either an experimental group which received proprioceptive neuromuscular facilitation combination patterns and kinesio taping were applied, or a control group which ...

  19. Framework for Assessment of the Usability of Lower-Extremity Robotic Exoskeletal Orthoses.

    Science.gov (United States)

    Bryce, Thomas N; Dijkers, Marcel P; Kozlowski, Allan J

    2015-11-01

    Persons with neurologic conditions such as spinal cord injury, stroke, and multiple sclerosis often lose the ability to stand and walk. Robotic hip-knee-ankle-foot exoskeletal orthoses have become commercially available and may allow some of these people to stand and walk again. These devices may also have applications beyond mobility, such as exercise, amelioration of secondary complications related to lack of ambulation, and the promotion of neuroplasticity. The authors present a framework for assessment of the usability of robotic exoskeletal orthoses available now or in the near future. The framework contains six modules: Functional applications, Personal factors, Device factors, External factors, Activities, and Health outcomes. Metrics and measures are suggested for each framework factor. PMID:26098923

  20. Effects of lower extremity muscle fatigue on the outcomes of slip-induced falls

    OpenAIRE

    Parijat, Prakriti; Lockhart, Thurmon E.

    2008-01-01

    Slip-induced fall accidents continue to be a significant cause of fatal injuries and economic losses. Identifying the risk factors causing slip-induced falls is key to developing better preventive measures to reduce fall accidents. Although epidemiological studies suggest localised muscle fatigue may be one of the risk factors for slip-induced falls, there has been no documented biomechanical study examining the relationship between fatigue and fall accidents. As such, the overall objective o...

  1. Laser technologies in treatment of patients with secondary lymphostasis of lower extremities

    Directory of Open Access Journals (Sweden)

    B.N. Jukov

    2010-06-01

    Full Text Available Photodynamic therapy (PDT, matured as a feasible medical technology in the 1980s at several institutions throughout the world, is a ternary treatment for cancer involving three key components: a photosensitizer, light, and tissue oxygen. It is also being investigated for treatment of psoriasis and acne, and is an approved treatment for wet macular degeneration. A photosensitizer is a chemical compound that can be excited by light of a specific wavelength. This excitation uses visible or near-infrared light. In photodynamic therapy, either a photosensitizer or the metabolic precursor of one is administered to the patient. The tissue to be treated is exposed to light suitable for exciting the photosensitizer. Usually, the photosensitizer is excited from a ground singlet state to an excited singlet state. It then undergoes intersys-tem crossing to a longer-lived excited triplet state. Singlet oxygen is a very aggressive chemical species and will very rapidly react with any nearby biomolecules

  2. Necrotizing fasciitis of the lower extremity: a case report and current concept of diagnosis and management.

    LENUS (Irish Health Repository)

    Naqvi, G A

    2012-02-01

    Necrotizing fasciitis is a severe soft tissue infection characterized by rapidly progressing necrosis, involving subcutaneous tissues. This rare condition carries high mortality rate and require prompt diagnosis and urgent treatment with radical debridement and antibiotics. We describe a case of 21-year old man who presented with the history of trivial injury to the knee. Initially he was admitted and treated for septic arthritis but later was diagnosed as necrotizing fasciitis which was successfully treated with no ill effects what so ever from this devastating condition. This rare condition has been reported in literature but still early diagnosis, which is a key for successful treatment, remains a challenge.

  3. Relation of selective voluntary motor control of the lower extremity and extensor strength of the knee joint in children with spastic diplegia

    Science.gov (United States)

    Kusumoto, Yasuaki; Takaki, Kenji; Matsuda, Tadamitsu; Nitta, Osamu

    2016-01-01

    [Purpose] The aim of this study was to investigate differences in selective voluntary motor control of the lower extremities by objective assessment and determine the relationship between selective voluntary motor control and knee extensor strength in children with spastic diplegia. [Subjects and Methods] Forty individuals who had spastic cerebral palsy, with Gross Motor Function Classification System levels ranging from I to III, were assessed using the Selective Control Assessment of the Lower Extremity and by testing the maximum knee extensor strength. The unaffected side was defined as the lower limb with the higher score, and the affected side was defined as the lower limb with the lower score. [Results] The Selective Control Assessment of the Lower Extremity score on the affected side had a lower average than that on the unaffected side. The scores showed a significant inverse correlation with the maximum knee extensor strength. [Conclusion] There was bilateral difference in the selective voluntary motor control of the lower extremities in children with spastic diplegia, and the selective voluntary motor control of the lower extremity was related to maximum knee extensor strength. PMID:27390436

  4. Different radionuclide imaging in diagnosis, assessment of response and detection of recurrence in bone and soft tissue tumours of the extremities

    International Nuclear Information System (INIS)

    The objectives of the present work are: a) to compare different radionuclides in the diagnosis of bone and soft tissue tumours; b) to evaluate the role of 99mTc-MIBI uptake and washout kinetics in assessing the tumour response to initial chemotherapy; c) to study the diagnostic efficacy of different radionuclides in detecting recurrent bone and soft tissue tumours (STS) of the extremities in comparison to CT and/or MRI

  5. Chronic exertional compartment syndrome of the lower extremities: improved screening using a novel dual birdcage coil and in-scanner exercise protocol

    International Nuclear Information System (INIS)

    The purpose of this study was to design and evaluate an MRI screening protocol for chronic exertional compartment syndrome (CECS) of the lower legs using an in-scanner exercise protocol and novel dual birdcage coil design for improved imaging. Coil and phantom studies: a custom-made dual birdcage coil designed for this protocol was evaluated for uniformity and signal-to-noise ratio (SNR) compared with a conventional phased-array receive-only torso coil and the body coil. Phantom and normal subject studies were performed to confirm coil performance. In-vivo studies: eight unaffected subjects and 42 patients with lower extremity symptoms suggestive of CECS were imaged with the dual birdcage coil and an in-scanner exercise protocol which included imaging at rest, during isometric resisted dorsi flexion, at rest (recovery), during isometric resisted plantar flexion and, again, at rest. Of 42 patients, 14 had confirmed CECS and 28 had lower extremity anomalies attributable to other causes. Ratios of relative T2-weighted signal intensities were calculated for exercise and recovery images compared to baseline after processing of images, including re-registration for motion, smoothing and segmentation to remove bone and pulsation artifacts from blood vessels. Receiver operating characteristic (ROC) analysis showed a threshold for the ratio of relative T2-weighted signal intensity of 1.54 to have a sensitivity of 96%, specificity of 90% and accuracy of 96% for CECS. Patients with CECS had their peak ratio of signal intensity compared with baseline during the first recovery period after isometric dorsi flexion, whereas unaffected subjects and patients with other causes of exercise-induced lower extremity pain reached their peak values during exercise (P < 0.001). We have developed the first in-scanner MRI exercise protocol for the assessment of patients with suspected CECS. The technique shows high accuracy, sensitivity and specificity for diagnosis in this small cohort of

  6. Results of a bone splint technique for the treatment of lower limb deformities in children with type I osteogenesis imperfecta

    Directory of Open Access Journals (Sweden)

    Dasheng Lin

    2013-01-01

    Full Text Available Background: Children with osteogenesis imperfecta (OI can suffer from frequent fractures and limb deformities, resulting in impaired ambulation. Osteopenia and thin cortices complicate orthopedic treatment in this group. This study evaluates the clinical results of a bone splint technique for the treatment of lower limb deformities in children with type I OI. The technique consists of internal plating combined with cortical strut allograft fixation. Materials and Methods: We prospectively followed nine children (five boys, four girls with lower limb deformities due to type I OI, who had been treated with the bone splint technique (11 femurs, four tibias between 2003 and 2006. The fracture healing time, deformity improvement, ambulation ability and complications were recorded to evaluate treatment effects. Results: At the time of surgery the average age in our study was 7.7 years (range 5-12 years. The average length of followup was 69 months (range 60-84 months. All patients had good fracture healing with an average healing time of 14 weeks (range 12-16 weeks and none experienced further fractures, deformity, or nonunion. The fixation remained stable throughout the procedure in all cases, with no evidence of loosening or breakage of screws and the deformity and mobility significantly improved after surgery. Of the two children confined to bed before surgery, one was able to walk on crutches and the other needed a wheelchair. The other seven patients could walk without walking aids or support like crutches. Conclusions: These findings suggest that the bone splint technique provides good mechanical support and increases the bone mass. It is an effective treatment for children with OI and lower limb deformities.

  7. ADHD Meds Tied to Lower Bone Density in Kids

    Science.gov (United States)

    ... nlm.nih.gov/medlineplus/news/fullstory_157591.html ADHD Meds Tied to Lower Bone Density in Kids ... 3, 2016 (HealthDay News) -- Children on medications for attention deficit hyperactivity disorder (ADHD) may have lower bone density than their ...

  8. Intra-arterial Autologous Bone Marrow Cell Transplantation in a Patient with Upper-extremity Critical Limb Ischemia

    International Nuclear Information System (INIS)

    Induction of therapeutic angiogenesis by autologous bone marrow mononuclear cell transplantation has been identified as a potential new option in patients with advanced lower-limb ischemia. There is little evidence of the benefit of intra-arterial cell application in upper-limb critical ischemia. We describe a patient with upper-extremity critical limb ischemia with digital gangrene resulting from hypothenar hammer syndrome successfully treated by intra-arterial autologous bone marrow mononuclear cell transplantation.

  9. Prevalence and risk factor analysis of lower extremity abnormal alignment characteristics among rice farmers

    OpenAIRE

    Puntumetakul, Rungthip

    2015-01-01

    Usa Karukunchit,1,2 Rungthip Puntumetakul,1,3 Manida Swangnetr,1,4 Rose Boucaut5 1Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), 2Faculty of Associated Medical Sciences, Khon Kaen University, 3School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, 4Department of Production Technology, Faculty of Technology, Khon Kaen University, Khon Kaen, Thailand; 5School of Health Sciences (Physiotherapy), iCAHE (International Centre for ...

  10. Catheter-Directed Thrombolysis of Acute Deep Vein Thrombosis in the Lower Extremity of a Child with Interrupted Inferior Vena Cava

    International Nuclear Information System (INIS)

    We present the case of a 14-year-old girl who developed acute deep vein thrombosis (DVT) in her right lower extremity. Laboratory testing revealed protein S deficiency, and the patient's father also had this abnormality with a history of lower extremity DVT. Manual thromboaspiration followed by catheter-directed thrombolysis resulted in total clearance of all thrombi. Computed tomography and later venography revealed an interrupted inferior vena cava. Catheter-directed thrombolysis is an established treatment for adults with acute DVT. To the best of our knowledge, this report is the first to describe catheter-directed thrombolysis in a pediatric patient with lower extremity DVT. Our results suggest that catheter-directed thrombolysis is safe and effective for use in selected older children and adolescents with acute DVT in the lower extremity

  11. High-resolution magnetic resonance imaging of the lower extremity nerves.

    Science.gov (United States)

    Burge, Alissa J; Gold, Stephanie L; Kuong, Sharon; Potter, Hollis G

    2014-02-01

    Magnetic resonance (MR) imaging of the nerves, commonly known as MR neurography is increasingly being used as noninvasive means of diagnosing peripheral nerve disease. High-resolution imaging protocols aimed at imaging the nerves of the hip, thigh, knee, leg, ankle, and foot can demonstrate traumatic or iatrogenic injury, tumorlike lesions, or entrapment of the nerves, causing a potential loss of motor and sensory function in the affected area. A thorough understanding of normal MR imaging and gross anatomy, as well as MR findings in the presence of peripheral neuropathies will aid in accurate diagnosis and ultimately help guide clinical management. PMID:24210318

  12. Intra-Arterial Thrombolysis for Deep Vein Thrombosis of the Lower Extremity: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Moo Sang; Roh, Byung Suk [Dept. of Radiology, Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2011-09-15

    If the appropriate catheterization of the affected vein was not possible because of a narrowed or thrombus-filled venous lumen, successful treatment gets into trouble during catheter directed regional thrombolysis for treatment of deep vein thrombosis. In this situation, intra-arterial thrombolysis can be considered as an alternative treatment, but to the best of our knowledge, only two reports have been described. We present here cases of successful intra-arterial thrombolysis in patients with deep vein thrombosis.

  13. Coagulation disorders in the patients with deep vein thrombosis of lower extremity

    Directory of Open Access Journals (Sweden)

    Milić Dragan J.

    2003-01-01

    Full Text Available PURPOSE Venous thromboembolism is a relevant social and health care problem for its high incidence, pulmonary embolism-related mortality and long-term sequelae which may be disabling (post-thrombotic syndrome and ulceration. PROCEDURES The aim of our work was to establish the presence of coagulation disorders (hypercoagulable states in the patients with deep vein thrombosis (DVT of the leg. Prospectively we have analyzed a group of 30 patients with echosono-graphicaly verified DVT of the leg who were admitted to the department of vascular surgery from August 1st 2000 to July 31st 2001.The following parameters were monitored: prothrombin time (PT partial thromboplastin time (PTT, fibrinogen (Fib, alpha 2 antiplasmin (A-2 AP, D-dimer (DD, antithrombin III (AT III and factor VII. FINDINGS Activation of the coagulation process was registered. The values of monitored coagulation parameters are shown in table 1. Plasma levels of monitored parameters in the patients with DVT of the leg were significantly higher than in the control subjects. CONCLUSION In patients with a DVT a hypercoagulable state is common finding. Some parameters of coagulation activity such as D-dimer might be of great interest in the diagnostic strategy of DVT.

  14. Autotransfusion of UV-irradiated blood for obliterating vascular diseases in the lower extremities

    International Nuclear Information System (INIS)

    Knott's autotransfusion of UV-irradiated blood was performed in 163 inoperable patients, including 141 patients with obliterating atherosclerosis and 22 patients with endarteritis. Good clinical effect was produced that was particularly apparent in patients with obliterating atherosclerosis. Assessment of the effects of autotransfusion of US-irradiated blood on microcirculation, peripheral circulation, hemostasis and humoral immunity in the two samples confirmed the method's efficiency

  15. Lymphoedema of the lower extremities--background, pathophysiology and diagnostic considerations

    DEFF Research Database (Denmark)

    Jensen, Mads R; Simonsen, Lene; Karlsmark, Tonny; Bülow, Jens

    2010-01-01

    lymphatic system most often caused by cancer or its treatment. Many of the underlying pathophysiological mechanisms have yet to be elucidated. Many methods have been developed for examination of the lymphatic system. Lymphoscintigraphy is presently the preferred diagnostic modality. Lack of consensus...... of a defect in the lymphatic drainage; however, some findings suggest that the interstitial protein concentration may be low in some types of lymphoedema. Primary lymphoedema is caused by an inherent defect in the lymphatic vessels or lymph nodes. Secondary lymphoedema is caused by damages to the...... regarding protocol and qualitative interpretation criteria results in a too observer dependent outcome. Methods for objectifying the scintigraphy through quantification have been criticized. Depot clearance rates are an alternative method of quantification of lymphatic drainage capacity. This method however...

  16. Sensitivity of the WRF model to the lower boundary in an extreme precipitation event – Madeira Island case study

    Directory of Open Access Journals (Sweden)

    J. C. Teixeira

    2013-10-01

    Full Text Available Through the years, the advances in satellite technology made feasible the acquisition of information about the Earth surface, such as elevation and land use with great detail and resolution. This information can be included in numerical atmospheric models, updating them and providing a more detailed lower boundary, which in turn can improve the results of events forced by it. Given this, this work aims to study the sensitivity of the Weather Research and Forecast model to three different topography datasets as well as two different land use datasets in an extreme precipitation event. A test case study in which topography driven precipitation was dominant over Madeira Island was considered which triggered several flash floods and mudslides in the southern parts of the island. Model results show higher model skill in precipitation over Madeira leeward and in the windward wind flow, in spite of the non significant enhancement on the overall results with higher resolution datasets of topography and land use.

  17. Ocelot catheter for the recanalization of lower extremity arterial chronic total occlusion

    International Nuclear Information System (INIS)

    Peripheral arterial disease (PAD) is a growing clinical condition affecting more than 10 million patients in the United States and it is responsible for more than 120,000 amputations annually. The presence of chronic total occlusions (CTO) increases the complexity of endovascular procedures and open surgery may often be the preferred approach. Despite the optimization of the CTO devices and technique, percutaneous CTO revascularization remains a challenging procedure even for experienced operators with important complication rates. The OcelotTM system is a novel CTO device to use real-time optical coherence tomography (OCT) imaging guidance for the recanalization of peripheral CTOs. We review the mechanism of the Ocelot system, the initial results from the multi-center Connect-II trial and two cases of Ocelot-assisted CTO recanalization

  18. Ocelot catheter for the recanalization of lower extremity arterial chronic total occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Marmagkiolis, Konstantinos [Citizens Memorial Hospital Heart and Vascular Institute, Bolivar, MO (United States); Lendel, Vasili; Cawich, Ian [Arkansas Heart Hospital, Little Rock, AR (United States); Cilingiroglu, Mehmet, E-mail: mcilingiroglu@yahoo.com [Arkansas Heart Hospital, Little Rock, AR (United States)

    2014-01-15

    Peripheral arterial disease (PAD) is a growing clinical condition affecting more than 10 million patients in the United States and it is responsible for more than 120,000 amputations annually. The presence of chronic total occlusions (CTO) increases the complexity of endovascular procedures and open surgery may often be the preferred approach. Despite the optimization of the CTO devices and technique, percutaneous CTO revascularization remains a challenging procedure even for experienced operators with important complication rates. The Ocelot{sup TM} system is a novel CTO device to use real-time optical coherence tomography (OCT) imaging guidance for the recanalization of peripheral CTOs. We review the mechanism of the Ocelot system, the initial results from the multi-center Connect-II trial and two cases of Ocelot-assisted CTO recanalization.

  19. Amyoplasia Congenita of the Lower Extremity: Report in a Premature Baby

    OpenAIRE

    Lee, Hyeon-Soo

    2005-01-01

    Amyoplasia congenita is a diagnostic subgroup of children with arthrogryposis multiplex congenita (AMC). AMC is a relatively rare syndrome characterized by multiple joint contractures at birth. Amyoplasia congenita is the most common type of this syndrome with an occurrence rate of 1 in 10,000 live births, and mainly refers to the disorders with limb involvement. In this report, the author presents a premature baby with amyoplasia congenita, whose hips showed flexion, abduction, and external ...

  20. Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis

    Directory of Open Access Journals (Sweden)

    Shimpei Miyamoto, MD

    2014-03-01

    Conclusions: This study demonstrates that early mobilization after free-flap transfer to the lower extremity is made possible by flow-through anastomosis for both arteries and veins. Flow-through flaps have stable circulation from the acute phase and can tolerate early dangling and ambulation.

  1. A Decade of Progress Using Virtual Reality for Poststroke Lower Extremity Rehabilitation: Systematic Review of the Intervention Methods

    Directory of Open Access Journals (Sweden)

    Carlos Luque-Moreno

    2015-01-01

    Full Text Available Objective. To develop a systematic review of the literature, to describe the different virtual reality (VR interventions and interactive videogames applied to the lower extremity (LE of stroke patients, and to analyse the results according to the most frequently used outcome measures. Material and Methods. An electronic search of randomized trials between January 2004 and January 2014 in different databases (Medline, Cinahl, Web of Science, PEDro, and Cochrane was carried out. Several terms (virtual reality, feedback, stroke, hemiplegia, brain injury, cerebrovascular accident, lower limb, leg, and gait were combined, and finally 11 articles were included according to the established inclusion and exclusion criteria. Results. The reviewed trials showed a high heterogeneity in terms of study design and assessment tools, which makes it difficult to compare and analyze the different types of interventions. However, most of them found a significant improvement on gait speed, balance and motor function, due to VR intervention. Conclusions. Although evidence is limited, it suggests that VR intervention (more than 10 sessions in stroke patients may have a positive impact on balance, and gait recovery. Better results were obtained when a multimodal approach, combining VR and conventional physiotherapy, was used. Flexible software seems to adapt better to patients’ requirements, allowing more specific and individual treatments.

  2. Exoskeleton control for lower-extremity assistance based on adaptive frequency oscillators: adaptation of muscle activation and movement frequency.

    Science.gov (United States)

    Aguirre-Ollinger, Gabriel

    2015-01-01

    In this article, we analyze a novel strategy for assisting the lower extremities based on adaptive frequency oscillators. Our aim is to use the control algorithm presented here as a building block for the control of powered lower-limb exoskeletons. The algorithm assists cyclic movements of the human extremities by synchronizing actuator torques with the estimated net torque exerted by the muscles. Synchronization is produced by a nonlinear dynamical system combining an adaptive frequency oscillator with a form of adaptive Fourier analysis. The system extracts, in real time, the fundamental frequency component of the net muscle torque acting on a specific joint. Said component, nearly sinusoidal in shape, is the basis for the assistive torque waveform delivered by the exoskeleton. The action of the exoskeleton can be interpreted as a virtual reduction in the mechanical impedance of the leg. We studied the ability of human subjects to adapt their muscle activation to the assistive torque. Ten subjects swung their extended leg while coupled to a stationary hip joint exoskeleton. The experiment yielded a significant decrease, with respect to unassisted movement, of the activation levels of an agonist/antagonist pair of muscles controlling the hip joint's motion, which suggests the exoskeleton control has potential for assisting human gait. A moderate increase in swing frequency was observed as well. We theorize that the increase in frequency can be explained by the impedance model of the assisted leg. Per this model, subjects adjust their swing frequency in order to control the amount of reduction in net muscle torque. PMID:25655955

  3. An MRI-based technique for assessment of lower extremity deformities - reproducibility, accuracy, and clinical application

    International Nuclear Information System (INIS)

    The hypothesis of this study was that length, torsion, and axis of a leg phantom can be measured accurately and reproducibly by magnetic resonance imaging (MRI) and that this can be applied to patients with leg deformities. Two phantoms and 30 patients (genu varum, n=15; genu valgum, n=15) were investigated using an optimized MRI technique. Reference measurements were performed with a micrometer screw and a goniometer. Patient leg length and axis were compared with long radiographs in bipedal stance. Intra- and interobserver reproducibility and accuracy were calculated using the mean absolute difference (MAD) and the 95% confidence interval. In patients, comparisons were done using a paired Student's t-test. MAD, intraobserver MAD, and interobserver MAD were 0.03, 0.03, 0.04 mm (length); 0.98, 1.2, 0.98 (torsion); and 0.18, 0.23, 0.22 (axis), respectively. In patients, leg length was underestimated by MRI (-2.4 ± 0.7%; 1.9±0.7 cm; P0.05), while it was significantly underestimated in valgus knees (-3.6 ± 2.8 ; P<0.05). The phantom study revealed that leg length, torsion, and axis can be measured accurately and reproducibly by MRI. Although underestimation of leg length and HKA in valgus knees occurred, this optimized MRI technique can be applied to patients with leg deformities. (orig.)

  4. Is thrombophilia a major risk factor for deep vein thrombosis of the lower extremities among Lebanese patients?

    Directory of Open Access Journals (Sweden)

    R Kreidy

    2009-07-01

    Full Text Available R Kreidy1, N Irani-Hakime21Department of Vascular Surgery, 2Department of Laboratory Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, LebanonAim: Factor V Leiden (R506Q mutation is the most commonly observed inherited genetic abnormality related to vein thrombosis. Lebanon has one of the highest frequencies of this mutation in the world with a prevalence of 14.4% in the general population. The aim of this study is to define risk factors including inherited genetic abnormalities among Lebanese patients with lower extremity deep vein thrombosis. We report the clinical outcome of patients with thrombophilia.Methods: From January 1998 to January 2008, 162 patients (61 males and 101 females were diagnosed with lower extremity deep vein thrombosis. Mean age was 61 years (range: 21 to 95 years.Results: The most frequent risk factors for vein thrombosis were surgery, advanced age, obesity, and cancer. Twenty-five patients had thrombophilia, 16 patients had factor V Leiden (R506Q mutation, and seven patients had MTHFR C677T mutation. Ninety-two percent of patients screened for thrombophilia were positive. Screening was requested in young patients (16, patients with recurrent (11, spontaneous (8, and extensive (5 venous thrombosis, familial history (5, pregnancy (4, estroprogestative treatment (3, and air travel (1. Nine patients had one, 11 patients had two, and five had three of these conditions. Follow-up (6 to 120 months of these 25 patients treated with antivitamin K did not reveal recurrences or complications related to venous thromboembolism.Conclusion: Factor V Leiden mutation followed by MTHFR mutation are the most commonly observed genetic abnormalities in these series. Defining risk factors and screening for thrombophilia when indicated reduce recurrence rate and complications. Recommendations for thrombophilia screening will be proposed.Keywords: venous thrombosis, risk factors, genetics, factor V

  5. The Effects of Wearing High Heels while Pressing a Car Accelerator Pedal on Lower Extremity Muscle Activation.

    Science.gov (United States)

    Jung, Jaemin; Lee, Sang-Yeol

    2014-11-01

    [Purpose] The purpose of this study was to determine the effects of wearing high heels while driving on lower extremity muscle activation. [Subjects] The subjects of this experimental study were 14 healthy women in their 20s who normally wear shoes with high heels. [Methods] The subjects were asked to place their shoes on an accelerator pedal with the heel touching the floor and then asked to press the pedal with as much pressure as possible for 3 seconds before removing their feet from the pedal. A total of 3 measurements were taken for each heel height (flat, 5 cm, 7 cm), and the heel height was randomly selected. [Results] The levels of muscle activity, indicated as the percentage of reference voluntary contraction, for gastrocnemius muscle in the flat, 5 cm, and 7 cm shoes were 180.8±61.8%, 285.4±122.3%, and 366.2±193.7%, respectively, and there were significant differences between groups. Those for the soleus muscle were 477.3±209.2%, 718.8±380.5%, and 882.4±509.9%, and there were significant differences between groups. [Conclusion] To summarize the results of this study, it was found that female drivers require greater lower extremity muscle activation when wearing high heels than when wearing low heels. Furthermore, instability and muscle fatigue of the ankle joint, which results from wearing high heels on a daily basis, could also occur while driving. PMID:25435684

  6. Effects of Juvenile Idiopathic Arthritis on Kinematics and Kinetics of the Lower Extremities Call for Consequences in Physical Activities Recommendations

    Directory of Open Access Journals (Sweden)

    M. Hartmann

    2010-01-01

    Full Text Available Juvenile idiopathic arthritis (JIA patients (n=36 with symmetrical polyarticular joint involvement of the lower extremities and healthy controls (n=20 were compared concerning differences in kinematic, kinetic, and spatio-temporal parameters with 3D gait analysis. The aims of this study were to quantify the differences in gait between JIA patients and healthy controls and to provide data for more detailed sport activities recommendations. JIA-patients showed reduced walking speed and step length, strongly anterior tilted pelvis, reduced maximum hip extension, reduced knee extension during single support phase and reduced plantar flexion in push off. Additionally the roll-off procedure of the foot was slightly decelerated. The reduced push off motion in the ankle was confirmed by lower peaks in ankle moment and power. The gait of JIA-patients can be explained as a crouch-like gait with hyperflexion in hip and knee joints and less plantar flexion in the ankle. A preventive mobility workout would be recommendable to reduce these restrictions in the future. Advisable are sports with emphasis on extension in hip, knee, and ankle plantar flexion.

  7. Radiation planning comparison for superficial tissue avoidance in radiotherapy for soft tissue sarcoma of the lower extremity

    International Nuclear Information System (INIS)

    Purpose: Three types of preoperative radiotherapy (RT) plans for extremity soft tissue sarcoma were compared to determine the amount of dose reduction possible to the planned surgical skin flaps required for tumor resection and wound closure, without compromising target coverage. Methods and Materials: Twenty-four untreated patients with large, deep, lower extremity STS treated with preoperative RT and limb salvage surgery had their original conventional treatment plans re-created. The same clinical target volume was used for all three plans. The future surgical skin flaps were created virtually through contouring by the treating surgeon and regarded as an organ at risk. The original, conformal, and intensity-modulated RT (IMRT) plans were created to deliver 50 Gy in 25 fractions to the clinical target volume. Clinical target volume and organ-at-risk dose-volume histograms were calculated and the plans compared for conformality, target coverage, and dose sparing. Results: The mean dose to the planned skin flaps was 42.62 Gy (range, 30.24-48.65 Gy) for the original plans compared with 40.12 Gy (range, 24.24-47.26 Gy) for the conformal plans and 26.71 Gy (range, 22.31-31.91 Gy) for the IMRT plans (p = 0.0008). An average of 86.4% (range, 53.2-97.4%) of the planned skin flaps received ≥30 Gy in the original plans compared with 83.4% (range, 36.2-96.2%) in the conformal plans and only 34.0% (range, 22.5-53.3%) in the IMRT plans (p = 0.0001). IMRT improved target conformality compared with the original and conformal plans (1.27, 2.34, and 1.76, respectively, p = 0.0001). Conclusion: In a retrospective review, preoperative IMRT substantially lowered the dose to the future surgical skin flaps, sparing a greater percentage of this structure's volume without compromising target (tumor) coverage

  8. Nutritive orifice and nutritive channel in the long bones of the extremities of newborn children - roentgenanatomical and roentgenometric study

    International Nuclear Information System (INIS)

    A roentgenoanatomic and roentgenometric study was performed on 1239 bones from the limbs of dead newborn children from both sexes. Frontally made roentgenographies were used of the following kinds of bones: shoulder bones (210), cubit (222), radius (223), thigh bone (201), big tibia (192), and small tibia (191). The characteristics of the gastrointestinal tract for those bones are described, and measure the distance of its opening from the proximal and distal end along the bone, according to Pyle's method. The author offers the usage of the results as a norm for characterising the newborn children in the People's Republic of Bulgaria. The establishment of deviations in the characteristics of the gastrointestinal tract and its opening in the long bones, will enable the early diagnostic of congenital systematic diseases of the skeleton, as well as in forensic medicine in view of identification. (author)

  9. The use of Papineau technique for the treatment of diabetic and non-diabetic lower extremity pseudoarthrosis and chronic osteomyelitis

    Directory of Open Access Journals (Sweden)

    Vasilios D. Polyzois

    2011-03-01

    Full Text Available The treatment of 31 consecutive adult patients, ages 25–67 years with chronic draining osteomyelitis (12 cases or infected pseudarthrosis (19 cases by the Papineau technique was retrospectively reviewed. The initial injury was an open fracture in 24 patients and a closed fracture in 7 patients. In all cases an Ilizarov circular external fixation device was used for the stabilization of the fracture or for bone lengthening. Mean follow-up for the group was 20 months (range, 10 months to 5 years and there was successful limb salvage in all cases with eradication of infection and bone consolidation was achieved. The Ilizarov circular external fixation was removed at a mean of 18 weeks (range, 14–24 weeks. The mean time to bone union was 5 months (range, 4–10 months. All patients returned to their pre-treatment activity levels or better.

  10. Predictive factors for lower extremity amputations in diabetic foot infections

    OpenAIRE

    Keng Lin, Wong; Aziz, Zameer; Nather, Aziz; Huak, Chan Yiong

    2011-01-01

    The objective of this study was to evaluate the epidemiology of diabetic foot infections (DFIs) and its predictive factors for lower extremity amputations. A prospective study of 100 patients with DFIs treated at the National University Hospital of Singapore were recruited in the study during the period of January 2005- June 2005. A protocol was designed to document patient’s demographics, type of DFI, presence of neuropathy and/or vasculopathy and its final outcome. Predictive factors for li...

  11. Effects of bone marrow mesenchymal stem cells and benefiting-Qi nourishing-Yin and dissolving-congestion prescription on lower extremity arterial restenosis in model dogs with diabetes mellitus%骨髓间充质干细胞联合益气养阴化瘀中药干预糖尿病下肢动脉再狭窄模型犬

    Institute of Scientific and Technical Information of China (English)

    成雪; 王意忠; 丁明超; 崔晓兰; 王斌; 王嘉; 时翰; 王立梅

    2014-01-01

    背景:目前大量研究已经证实了中药制剂、骨髓间充质干细胞在防治血管再狭窄中的有效性,但二者联合应用防治糖尿病下肢动脉介入成形后血管再狭窄的相关研究较少。  目的:观察骨髓间充质干细胞联合益气养阴化瘀中药对犬糖尿病股动脉介入成形后血管再狭窄的影响。  方法:采用四氧嘧啶静脉注射结合球囊损伤建立糖尿病下肢血管再狭窄犬模型,造模成功后将22只犬随机分为3组,即糖尿病模型组(模型组,n=6)、益气养阴化瘀方治疗组(中药组,n=8)及益气养阴化瘀方联合骨髓间充质干细胞治疗组(联合治疗组,n=8)。分别在经皮腔内血管成形前、治疗后1,2,4,8周采用ELISA法检测血清中血管内皮生长因子水平。治疗后8周取股动脉血管标本进行病理血管形态学观察及增生程度的定量分析,并取心肝肾胰腺组织标本行病理切片苏木精-伊红染色评价干细胞静脉移植安全性。  结果与结论:治疗后1周,中药组和联合治疗组血清血管内皮细胞生长因子均开始升高,模型组治疗后4周开始升高(与治疗前比较,P OBJECTIVE:To observe the effects of combined application of bone marrow mesenchymal stem cel s and benefiting-Qi nourishing-Yin and dissolving-congestion prescription on restenosis after percutaneous transluminal angioplasty in dogs with diabetes mel itus. METHODS:A dog model of vascular restenosis with diabetes mel itus was established by bal oon injury of femoral artery and intravenous injection of al oxan. After successful model induction, 22 dog models were randomly divided into three groups:model group (n=6), treatment with Chinese medicine (n=8), and combined treatment with bone marrow mesenchymal stem cel s and Chinese medicine (n=8). Serum vascular endothelial growth factor levels were measured using enzyme-linked immunosorbent assay preoperatively and at 1, 2, 4

  12. Lower Extremity Malalignments and Anterior Cruciate Ligament Injury History

    OpenAIRE

    Braham, Rebecca A.; Jennifer H. Dorfman; Jay Hertel

    2004-01-01

    To identify if lower extremity malalignments were associated with increased propensity of a history of anterior cruciate ligament (ACL) ruptures in males and females using a case control design. Twenty subjects (10 males, 10 females) had a history of ACL injury and twenty (10 males, 10 females) had no history of ACL injury. Subjects were assessed for navicular drop, quadriceps angle, pelvic tilt, hip internal and external rotation range of motion, and true and apparent leg length discrepancie...

  13. The effect of hip abductor exercise on muscle strength and trunk stability after an injury of the lower extremities.

    Science.gov (United States)

    Kak, Hwang-Bo; Park, Sun-Ja; Park, Byun-Joon

    2016-03-01

    [Purpose] The gluteus medius, a hip abductor, controls femoral movement and stabilizes the pelvis during lower extremity mobilization. [Subjects] This study enrolled 24 subjects into control and experimental groups. [Methods] This randomized controlled study included patients who underwent arthroscopy after meniscus injury and started a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into the experimental gluteus medius resistance exercise group (n=12) and the control group (n=12). The study investigated muscle strength and balance of the flexors, extensors, and abductors of the knee for 8 weeks. [Results] Strengths of knee extensors in patients who underwent rehabilitative exercise for 8 weeks were measured. Strength of the knee extensors of the experimental and control groups increased by 40% and 31%, respectively; strength of the hip flexors of the experimental and control groups increased by 31% and 18%, respectively. Strength of the hip joint muscles showed a 40% increase in the experimental group and a 14% increase in the control group. However, there was a significant difference (18%) in muscle strength of the hip abductors between the groups. Measurements of trunk lateral flexion showed a difference within a group, but no intergroup difference was found. [Conclusion] This study investigated the effect of hip abductor exercise on muscular strength and trunk stability in patients with a meniscus injury. PMID:27134387

  14. Long-Term Clinical and Functional Outcomes After Treatment for Localized Ewing's Tumor of the Lower Extremity

    International Nuclear Information System (INIS)

    Purpose: Retrospective review describing the 35-year University of Florida experience with Ewing's tumors of the lower extremity. Patients and Methods: Fifty-three patients were treated between 1971 and 2006. Thirty patients were treated with radiotherapy (RT) alone and 23 patients were treated with surgery ± RT. Larger tumors and tumors of the femur were treated more often with definitive RT. Median potential follow-up was 19.2 years. Functional outcome was assessed using the Toronto Extremity Salvage Score (TESS). Results: Before 1985, 24% of patients were treated with surgery; since then, the rate has increased to 61%. The 15-year actuarial overall survival (OS), cause-specific survival (CSS), freedom from relapse, and limb preservation rates were 68% vs. 47% (p = 0.21), 73% vs. 47% (p = 0.13), 73% vs. 40% (p = 0.03), and 43% vs. 40% (p = 0.52), respectively, for patients treated with surgery ± RT vs. RT alone. Excluding 8 patients who underwent amputation or rotationplasty, the 15-year actuarial local control rate was 100% for the surgery ± RT group and 68% for the definitive RT group (p = 0.03). The ranges of the TESS for surgery ± RT vs. RT alone were 70-100 (mean, 94) and 97-100 (mean, 99), respectively. Twenty-six percent (6/23) of patients had complications related to surgery requiring amputation or reoperation. Conclusions: Overall survival and CSS were not statistically compromised, but we observed an increased risk of relapse and local failure in patients treated with RT alone, thereby justifying a transition toward primary surgical management in suitable patients. However, despite an adverse risk profile, patients treated with RT alone had similar long-term amputation-free survival and demonstrated comparable functional outcomes. Poor results observed in Ewing's of the femur mandate innovative surgical and RT strategies

  15. A prospective comparison of pedal ergometry with conventional treadmill testing in the investigation of lower extremity pain.

    LENUS (Irish Health Repository)

    Manning, B J

    2012-02-03

    BACKGROUND: Investigation of lower extremity pain is compromised by comorbid disorders that may interfere with conventional testing. AIMS: To compare pedal ergometry with conventional treadmill testing. METHODS: A prospective study was performed where patients presenting with a diagnosis of intermittent claudication were assessed by both methods of testing. RESULTS: Of 78 patients studied with both tests, no exercise-induced ankle pressure changes occurred in 26, two were unable to complete either test despite normal pressure measurements, while 24 had exercise-induced pressure drop detected by both tests. Of patients who completed pedal ergometry, 21 were unable to complete the treadmill test, 14 of whom had negative ergometry, while seven had a pressure drop detected by pedal ergometry. Three had pressure changes with pedal ergometry, but not with treadmill testing and two had pressure changes on the treadmill not reproduced by pedal ergometry. CONCLUSIONS: Pedal ergometer is more sensitive than treadmill testing in detecting arterial insufficiency, as indicated by a 20% or greater fall in ankle pressure, and more suitable in a subgroup of patients unable to tolerate conventional treadmill testing.

  16. Multiple Lower Extremity Mononeuropathies by Segmental Schwannomatosis: A Case Report

    OpenAIRE

    Kwon, Na Yeon; Oh, Hyun-Mi; Ko, Young Jin

    2015-01-01

    Schwannoma is an encapsulated nerve sheath tumor that is distinct from neurofibromatosis. It is defined as the occurrence of multiple schwannomas without any bilateral vestibular schwannomas. A 46-year-old man with multiple schwannomas involving peripheral nerves of the ipsilateral lower extremity presented with neurologic symptoms. Electrodiagnostic studies revealed multiple mononeuropathies involving the left sciatic, common peroneal, tibial, femoral and superior gluteal nerves. Histologic ...

  17. Odds ratios for hip- and lower forearm fracture using peripheral bone densitometry; a case-control study of postmenopausal women

    DEFF Research Database (Denmark)

    Saleh, M M A; Jørgensen, H L; Lauritzen, J B

    2002-01-01

    BACKGROUND: Dual-energy X-ray absorptiometry (DXA) measured at the lumbar spine and particularly at the hip remain the gold-standard for diagnosing osteoporosis. However, devices for assessing the peripheral skeleton present several advantages in terms of lower price and portability. A major...... rather than an absolute measure of bone mass. METHODS: A total of 76 women with lower forearm fracture, 47 women with hip fracture and 231 age-matched women (controls) were included. All had broadband ultrasound attenuation (BUA) and speed of sound (SOS) measured at the heel using the DTU-one ultrasound......: Peripheral densitometry can discriminate between hip- and lower forearm fracture patients and age-matched controls. Significantly elevated odds ratios for incurring these fractures can be calculated using device- and site specific t-score cutoff values. The results from this case-control study need to be...

  18. Dose-Effect Relationships for Femoral Fractures After Multimodality Limb-Sparing Therapy of Soft-Tissue Sarcomas of the Proximal Lower Extremity

    Energy Technology Data Exchange (ETDEWEB)

    Pak, Daniel; Vineberg, Karen A. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Griffith, Kent A. [Biostatistics Unit, Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI (United States); Sabolch, Aaron [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Chugh, Rashmi [Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI (United States); Ben-Josef, Edgar [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Biermann, Janet Sybil [Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI (United States); Feng, Mary, E-mail: maryfeng@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

    2012-07-15

    Purpose: We investigated the clinical and dosimetric predictors for radiation-associated femoral fractures in patients with proximal lower extremity soft tissue sarcomas (STS). Methods and Materials: We examined 131 patients with proximal lower extremity STS who received limb-sparing surgery and external-beam radiation therapy between 1985 and 2006. Five (4%) patients sustained pathologic femoral fractures. Dosimetric analysis was limited to 4 fracture patients with full three-dimensional dose information, who were compared with 59 nonfracture patients. The mean doses and volumes of bone (V{sub d}) receiving specified doses ({>=}30 Gy, 45 Gy, 60 Gy) at the femoral body, femoral neck, intertrochanteric region, and subtrochanteric region were compared. Clinical predictive factors were also evaluated. Results: Of 4 fracture patients in our dosimetric series, there were three femoral neck fractures with a mean dose of 57.6 {+-} 8.9 Gy, V30 of 14.5 {+-} 2.3 cc, V45 of 11.8 {+-} 1.1 cc, and V60 of 7.2 {+-} 2.2 cc at the femoral neck compared with 22.9 {+-} 20.8 Gy, 4.8 {+-} 5.6 cc, 2.5 {+-} 3.9 cc, and 0.8 {+-} 2.7 cc, respectively, for nonfracture patients (p < 0.03 for all). The femoral neck fracture rate was higher than at the subtrochanteric region despite lower mean doses at these subregions. All fracture sites received mean doses greater than 40 Gy. Also, with our policy of prophylactic femoral intramedullary nailing for high-risk patients, there was no significant difference in fracture rates between patients with and without periosteal excision. There were no significant differences in age, sex, tumor size, timing of radiation therapy, and use of chemotherapy between fracture and nonfracture patients. Conclusions: These dose-volume toxicity relationships provide RT optimization goals to guide future efforts for reducing pathologic fracture rates. Prophylactic femoral intramedullary nailing may also reduce fracture risk for susceptible patients.

  19. Dose–Effect Relationships for Femoral Fractures After Multimodality Limb-Sparing Therapy of Soft-Tissue Sarcomas of the Proximal Lower Extremity

    International Nuclear Information System (INIS)

    Purpose: We investigated the clinical and dosimetric predictors for radiation-associated femoral fractures in patients with proximal lower extremity soft tissue sarcomas (STS). Methods and Materials: We examined 131 patients with proximal lower extremity STS who received limb-sparing surgery and external-beam radiation therapy between 1985 and 2006. Five (4%) patients sustained pathologic femoral fractures. Dosimetric analysis was limited to 4 fracture patients with full three-dimensional dose information, who were compared with 59 nonfracture patients. The mean doses and volumes of bone (Vd) receiving specified doses (≥30 Gy, 45 Gy, 60 Gy) at the femoral body, femoral neck, intertrochanteric region, and subtrochanteric region were compared. Clinical predictive factors were also evaluated. Results: Of 4 fracture patients in our dosimetric series, there were three femoral neck fractures with a mean dose of 57.6 ± 8.9 Gy, V30 of 14.5 ± 2.3 cc, V45 of 11.8 ± 1.1 cc, and V60 of 7.2 ± 2.2 cc at the femoral neck compared with 22.9 ± 20.8 Gy, 4.8 ± 5.6 cc, 2.5 ± 3.9 cc, and 0.8 ± 2.7 cc, respectively, for nonfracture patients (p < 0.03 for all). The femoral neck fracture rate was higher than at the subtrochanteric region despite lower mean doses at these subregions. All fracture sites received mean doses greater than 40 Gy. Also, with our policy of prophylactic femoral intramedullary nailing for high-risk patients, there was no significant difference in fracture rates between patients with and without periosteal excision. There were no significant differences in age, sex, tumor size, timing of radiation therapy, and use of chemotherapy between fracture and nonfracture patients. Conclusions: These dose–volume toxicity relationships provide RT optimization goals to guide future efforts for reducing pathologic fracture rates. Prophylactic femoral intramedullary nailing may also reduce fracture risk for susceptible patients.

  20. Risk Factors for Lower Extremity Tendinopathies in Military Personnel

    OpenAIRE

    Owens, Brett D.; Wolf, Jennifer Moriatis; Seelig, Amber D.; Jacobson, Isabel G.; Boyko, Edward J.; Smith, Besa; Ryan, Margaret A. K.; Gackstetter, Gary D; Smith, Tyler C; ,

    2013-01-01

    Background: Overuse injuries have a significant impact on United States military service members, but research to date has been limited in its ability to assess occupational and behavioral risk factors. Hypothesis/Purpose: To prospectively identify risk factors for the development of lower extremity tendinopathy and plantar fasciitis in United States military personnel. Study Design: Descriptive epidemiology study. Methods: Baseline data from the Millennium Cohort Study, a long-term observati...

  1. Compromised trabecular microarchitecture and lower finite element estimates of radius and tibia bone strength in adults with turner syndrome

    DEFF Research Database (Denmark)

    Hansen, Stinus; Brixen, Kim; Gravholt, Claus H

    2012-01-01

    Although bone mass appear ample for bone size in Turner syndrome (TS), epidemiological studies have reported an increased risk of fracture in TS. We used high-resolution peripheral quantitative computed tomography (HR-pQCT) to measure standard morphological parameters of bone geometry and...

  2. Evaluation of joints in the lower limbs in adults and children using bone SPECT: Technical aspects and results

    International Nuclear Information System (INIS)

    Optimization procedures for and results of single photon emission computed tomography (SPECT) bone scintigraphy scans of the lower limbs are discussed. A group of patients was selected comprising 12 adults with chronic knee pain and 11 children with disorders which might affect growth cartilage. For the latter, it was proposed to evaluate the global and localized activity of the physics using SPECT with post-processing in three dimensions. These results are important in that they may directly influence the decision whether or not to proceed with orthopedic treatment or surgery, the aim being to prevent or predict dysmetrias and secondary deformities caused by various pathologies. (author). 3 refs, 3 figs, 3 tabs

  3. Use of a Dehydrated Amniotic Membrane Allograft on Lower Extremity Ulcers in Patients with Challenging Wounds: A Retrospective Case Series.

    Science.gov (United States)

    Lintzeris, Dimitrios; Yarrow, Kari; Johnson, Laura; White, Amber; Hampton, Amanda; Strickland, Andy; Albert, Kristy; Cook, Arlene

    2015-10-01

    Lower extremity ulcers in patients with diabetes mellitus may take a long time to heal despite the use of advanced topical therapies. A retrospective review of cases was conducted to assess the use of a dehydrated amniotic membrane allograft (DAMA) in a convenience sample of 9 wounds in 8 patients (5 men, 3 women, average age 62 years [range 31-81 years]) with diabetes mellitus and/or vascular disease. Wound data and patient characteristics were abstracted from medical records. Descriptive statistics were used to summarize the data. In 5 of 9 wounds, DAMA was applied after a failure to demonstrate a 50% reduction in area after 4 weeks of treatment with advanced wound care, offloading, and compression as indicated. In 4 wounds, DAMA was applied 2-4 weeks after presentation because of concerns about existing patient risk factors for nonhealing. Wounds were present for an average of 11 weeks (range 1-35 weeks) before application of DAMA. Mean baseline wound area and volume were 3.11 cm2 (± 3.73) and 0.55 cm3 (± 0.58), respectively. All wounds healed in an average of 5.7 (± 2.9) weeks (range: 1-9 weeks) after a mean of 2.7 applications (± 1.7) (range 1-5 applications). No adverse events occurred. These observations suggest prospective, randomized, controlled clinical studies to compare the use of DAMA to other topical treatment modalities are warranted. PMID:26479124

  4. Residual impairment after lower extremity fracture

    DEFF Research Database (Denmark)

    Faergemann, C; Frandsen, P A; Röck, N D

    1998-01-01

    2.7 pretraumatically and 8.7 6 months posttraumatically. Major deficits in range of motion was observed, especially in the ankle joint. Additionally, loss of muscle strength was observed in the thigh and calf muscles in one fourth of the patients. Only low levels of residual pain were reported after...... functional status before the injury. Additionally, three major aspects of impairments were measured 6 months after the fractures: range of motion, muscle strength, and pain. Most patients had a significantly higher SIP score 6 months after the fracture(s) than pretraumatically. The mean overall SIP score was...

  5. Age-related differences in muscle control of the lower extremity for support and propulsion during walking

    Science.gov (United States)

    Toda, Haruki; Nagano, Akinori; Luo, Zhiwei

    2016-01-01

    [Purpose] This study examined age-related differences in muscle control for support and propulsion during walking in both males and females in order to develop optimal exercise regimens for muscle control. [Subjects and Methods] Twenty elderly people and 20 young people participated in this study. Coordinates of anatomical landmarks and ground reaction force during walking were obtained using a 3D motion analysis system and force plates. Muscle forces during walking were estimated using OpenSim. Muscle modules were obtained by using non-negative matrix factorization analysis. A two-way analysis of covariance was performed to examine the difference between the elderly and the young in muscle weightings using walking speed as a covariate. The similarities in activation timing profiles between the elderly and the young were analyzed by cross-correlation analysis in males and females. [Results] In the elderly, there was a change in the coordination of muscles around the ankle, and muscles of the lower extremity exhibited co-contraction in late stance. Timing and shape of these modules were similar between elderly and young people. [Conclusion] Our results suggested that age-related alteration of muscle control was associated with support and propulsion during walking. PMID:27134360

  6. Age-related differences in muscle control of the lower extremity for support and propulsion during walking.

    Science.gov (United States)

    Toda, Haruki; Nagano, Akinori; Luo, Zhiwei

    2016-03-01

    [Purpose] This study examined age-related differences in muscle control for support and propulsion during walking in both males and females in order to develop optimal exercise regimens for muscle control. [Subjects and Methods] Twenty elderly people and 20 young people participated in this study. Coordinates of anatomical landmarks and ground reaction force during walking were obtained using a 3D motion analysis system and force plates. Muscle forces during walking were estimated using OpenSim. Muscle modules were obtained by using non-negative matrix factorization analysis. A two-way analysis of covariance was performed to examine the difference between the elderly and the young in muscle weightings using walking speed as a covariate. The similarities in activation timing profiles between the elderly and the young were analyzed by cross-correlation analysis in males and females. [Results] In the elderly, there was a change in the coordination of muscles around the ankle, and muscles of the lower extremity exhibited co-contraction in late stance. Timing and shape of these modules were similar between elderly and young people. [Conclusion] Our results suggested that age-related alteration of muscle control was associated with support and propulsion during walking. PMID:27134360

  7. Lower extremity dep vein thrombosis in children

    International Nuclear Information System (INIS)

    Of 113 leg venograms performed in patients of all ages between 1969 and 1982, 68 were in children 16 years old or less. The patients were all studied on a tilt table (method of Rabinov and Paulin) in a head-up, 40-500 incline without tourniquets, supporting their weight on the unaffected leg. Among the 68 venograms, 12 (18%) were positive for deep vein thrombosis. The clinical settings for thrombosis in children were post-catheterization (two patients), post surgery (two), tumor/tumor therapy (three), drug abuse (one), and idiopathic (three). There were no long-term clinical sequelae in five patients. Pulmonary infarction occurred in three, and three patients required either long-term anticoagulation or IVC clipping. Clinical diagnosis is no more accurate for the diagnosis of deep vein thrombosis in children than it is in adults. Venography is the best method for making an accurate diagnosis and directing subsequent therapy.(orig.)

  8. Safety and Efficacy of Mild Compression (18–25 mm Hg) Therapy in Patients with Diabetes and Lower Extremity Edema

    Science.gov (United States)

    Wu, Stephanie C; Crews, Ryan T; Najafi, Bijan; Slone-Rivera, Nancy; Minder, Jessica L; Andersen, Charles A

    2012-01-01

    Background Patients with diabetes often present with lower extremity (LE) edema; however, because of concomitant peripheral arterial disease, compression therapy is generally avoided by providers in fear of compromising arterial circulation. This pilot study sought to assess whether diabetic socks with mild compression (18–25 mm Hg) can reduce LE edema in patients with diabetes without negatively impacting vascularity. Methods Eighteen subjects (9 males, 9 females) aged 61 ± 11 years with diabetes, LE edema, and a mean ankle–brachial index (ABI) of 1.10 ± 0.21 successfully completed this uncontrolled study. At baseline, subjects were fitted and instructed to wear the socks during all waking hours. Follow-up visits occurred weekly for four consecutive weeks. Edema was quantified through midfoot, ankle, and calf circumferences and cutaneous fluid measurements. Vascular status was tracked via ABI. Results Repeated measures analysis of variance and least significant difference post hoc analyses were used for data analyses. Calf circumferences showed a statistically significant (p compression therapy (18–25 mm Hg) decreased swelling in diabetes patients with LE edema without compromising vascularity. PMID:22768895

  9. [Changes in bones of the foot and development of inserting tendons of the lower leg musculature in tibial aplasia].

    Science.gov (United States)

    Selke, B; Bogusch, G

    1989-01-01

    Skeleton, muscles and tendons were investigated in 3 lower legs with aplasia of the tibia. The tibiofibular joint appears to be rather a syndesmosis than a diarthrosis. In all 3 cases, talus and calcaneus are connected by a synostosis. Also in the other parts of the skeleton of the feet, synarthroses with different extensions are found. The muscles, normally originating from the tibia, have shifted their origin to the fibula. The proximal part of the inserting tendons under the retinacula is quite normal. Also, their distal part in the region of the metatarsalia and of the digits exhibits no alterations. In the region of the tarsus in which already alterations in bone formation are found, the tendons of the flexor muscles of the toes exhibit some variations. Often the muscles show a new, strong insertion into the bones of the tarsus. The normal connection between the proximal and distal parts of the tendons is sometimes still indicated by a thin bundle of collagenous fibers. In all 3 cases, the tibialis anterior muscle inserts into the distal part of the tendons of the flexor muscles of the toes, indicating that there are also connections between tendons of muscles from different blastemas. PMID:2816255

  10. Modeling of the blood flow in the lower extremities for dynamic diffuse optical tomography of peripheral artery disease

    Science.gov (United States)

    Marone, A.; Hoi, J. W.; Khalil, M. A.; Kim, H. K.; Shrikhande, G.; Dayal, R.; Hielscher, A. H.

    2015-07-01

    Peripheral Arterial Disease (PAD) is caused by a reduction of the internal diameters of the arteries in the upper or lower extremities mainly due to atherosclerosis. If not treated, its worsening may led to a complete occlusion, causing the death of the cells lacking proper blood supply, followed by gangrene that may require chirurgical amputation. We have recently performed a clinical study in which good sensitivities and specificities were achieved with dynamic diffuse optical tomography. To gain a better understanding of the physiological foundations of many of the observed effects, we started to develop a mathematical model for PAD. The model presented in this work is based on a multi-compartment Windkessel model, where the vasculature in the leg and foot is represented by resistors and capacitors, the blood pressure with a voltage drop, and the blood flow with a current. Unlike existing models, the dynamics induced by a thigh-pressure-cuff inflation and deflation during the measurements are taken into consideration. This is achieved by dynamically varying the resistances of the large veins and arteries. By including the effects of the thigh-pressure cuff, we were able to explain many of the effects observed during our dynamic DOT measurements, including the hemodynamics of oxy- and deoxy-hemoglobin concentration changes. The model was implemented in MATLAB and the simulations were normalized and compared with the blood perfusion obtained from healthy, PAD and diabetic patients. Our preliminary results show that in unhealthy patients the total system resistance is sensibly higher than in healthy patients.

  11. The anabolic activity of bone tissue, suppressed by disuse, is normalized by brief exposure to extremely low-magnitude mechanical stimuli

    Science.gov (United States)

    Rubin, C.; Xu, G.; Judex, S.

    2001-01-01

    It is generally believed that mechanical signals must be large in order to be anabolic to bone tissue. Recent evidence indicates, however, that extremely low-magnitude (<10 microstrain) mechanical signals readily stimulate bone formation if induced at a high frequency. We examined the ability of extremely low-magnitude, high-frequency mechanical signals to restore anabolic bone cell activity inhibited by disuse. Adult female rats were randomly assigned to six groups: baseline control, age-matched control, mechanically stimulated for 10 min/day, disuse (hind limb suspension), disuse interrupted by 10 min/day of weight bearing, and disuse interrupted by 10 min/day of mechanical stimulation. After a 28 day protocol, bone formation rates (BFR) in the proximal tibia of mechanically stimulated rats increased compared with age-matched control (+97%). Disuse alone reduced BFR (-92%), a suppression only slightly curbed when disuse was interrupted by 10 min of weight bearing (-61%). In contrast, disuse interrupted by 10 min per day of low-level mechanical intervention normalized BFR to values seen in age-matched controls. This work indicates that this noninvasive, extremely low-level stimulus may provide an effective biomechanical intervention for the bone loss that plagues long-term space flight, bed rest, or immobilization caused by paralysis.

  12. Improvement of lower extremity electrodiagnostic findings following a trial of spinal manipulation and motion-based therapy

    Directory of Open Access Journals (Sweden)

    Morningstar Mark W

    2006-09-01

    Full Text Available Abstract Background Lumbar disc herniation is a problem frequently encountered in manual medicine. While manual therapy has shown reasonable success in symptomatic management of these cases, little information is known how manual therapy may affect the structure and function of the lumbar disc itself. In cases where lumbar disc herniation is accompanied by radicular symptoms, electrodiagnostic testing has been used to provide objective clinical information on nerve function. This report examines the treatment rendered for a patient with lower extremity neurological deficit, as diagnosed on electrodiagnostic testing. Patient was treated using spinal manipulation and exercises performed on a Pettibon Wobble Chair™, using electrodiagnostic testing as the primary outcome assessment. Case Presentation An elderly male patient presented to a private spine clinic with right-sided foot drop. He had been prescribed an ankle-foot orthosis for this condition. All sensory, motor, and reflex findings in the right leg and foot were absent. This was validated on prior electromyography and nerve conduction velocity testing, performed by a board certified neurologist. Patient was treated using spinal manipulation twice-weekly and wobble chair exercises three times daily for 90 days total. Following this treatment, the patient was referred for follow-up electrodiagnostic studies. Significant improvements were made in these studies as well as self-rated daily function. Conclusion Motion-based therapies, as part of a comprehensive rehabilitation program, may contribute to the restoration of daily function and the reversal of neurological insult as detected by electrodiagnostic testing. Electrodiagnostic testing may be a useful clinical tool to evaluate the progress of chiropractic patients with lumbar disc herniation and radicular pain syndromes.

  13. Comparison of CO2 DSA and conventional angiography using non-ionic contrast media in lower extremity angiography

    International Nuclear Information System (INIS)

    The purpose of this study is to compare CO2 DSA and nonionic contrast media angiography in respect to the quality of the opacification of collaterals and incidence of side-effects in peripheral occlusive arterial disease. Sixteen patients who were suspected to have peripheral occlusive arterial disease were performed angiography with nonionic contrast media and CO2 at the same location with the same catheter. The causes of the lesions were atherosclerosis(n=7) and Buerger's disease(n=9). CO2 DSA was compared with nonionic contrast media angiography in respect to the quality of image in the diagnosis of the lesions, opacifications of collaterals and side-effects. In atherosclerosis; quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 6 patients and was poor in 1 patient; opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 5 patients and was poor in 2 patients. In Buerger's disease; quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 2 patients and was poor in 7 patients; opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 1 patient and was poor in 8 patients. Leg pain was the only side-effect after CO2 injection occurring in 4 out of 16 patients. CO2 could be used as safe contrast media in patient with risk factors for nonionic contrast media and for diagnosis of the atherosclerosis in lower extremity. For the procedures such as vascular intervention requiring large amount of contrast media CO2 could effectively replace nonionic contrast media

  14. Combined detection for pulmonary embolism and venous thrombosis of lower extremity using sup(99m)Tc labeled microsphere

    International Nuclear Information System (INIS)

    Using capillary blockage for radionuclide venography (RNV) as well as lung scintigraphy, we attempted to investigate the relation between venous thrombosis and pulmonary embolism. Fourty patients with a symptom of swelling of the lower extremity were investigated. About 10 mCi of diluted volume of sup(99m)Tc microsphere was introduced into dorsal vein, and standard RNV were taken concerning deep and superficial vein with or without application of tourniquet to the proximal site of ankle. Early dynamic images and late static images were taken, respectively, followed by the standard lung scintigraphy. Additional inhalation scintigraphy was done later, if it was necessary to differentiate pulmonary embolism with other diseases with a perfusion defect. The criteria for the presence of venous thrombosis was as follows; the presence of stenosis or defect with collateral circulation at the early dynamic images, and the presence of hot spot formation at the late static images. A sole finding of the hot spot formation was evaluated to be false positive and twelve of seventeen cases with the hot spot at calf revealed to be false positive. According to this criteria, thirty five cases of all revealed positive findings, which located mostly in pelvic region and in popliteocalf region. Twelve of all cases revealed the pulmonary embolism, half of these have not any symptom suggestive of this disease, nine of these were with positive RNV findings and remainders were with false positive finding at calf region. In conclusion 25% of cases with venous thrombosis resulted in pulmonary embolism, which was the same incidence comparable with the reports in the western country. Hence, whenever indicative, combined RNV and lung scintigraphy for the detection of the thromboembolic disease should be necessary also in Japan. (auth.)

  15. Three-dimensional measurements of the lower extremity in children and adolescents using a low-dose biplanar X-ray device

    Energy Technology Data Exchange (ETDEWEB)

    Gheno, Ramon [Centre Hospitalier Regional Universitaire de Lille, Hopital Roger Salengro, Department of Musculoskeletal Radiology, Lille (France); Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre (Brazil); Hopital Roger Salengro, Service de Radiologie Osteo-articulaire, Lille Cedex (France); Nectoux, Eric; Herbaux, Bernard [Centre Hospitalier Regional Universitaire de Lille, Hopital Jeanne de Flandre, Department of Pediatric Surgery and Orthopaedics, Lille (France); Baldisserotto, Matteo [Pontificia Universidade Catolica do Rio Grande do Sul, Department of Radiology, Porto Alegre (Brazil); Glock, Luiz [Pontificia Universidade Catolica do Rio Grande do Sul, Department of Statistics, Porto Alegre (Brazil); Cotten, Anne [Centre Hospitalier Regional Universitaire de Lille, Hopital Roger Salengro, Department of Musculoskeletal Radiology, Lille (France); Boutry, Nathalie [Centre Hospitalier Regional Universitaire de Lille, Hopital Roger Salengro and Jeanne de Flandre, Department of Musculoskeletal and Pediatric Radiology, Lille (France)

    2012-04-15

    To evaluate three-dimensional (3D) measurements of the lower extremity using a biplanar low-dose X-ray device in children and adolescents. Firstly, 3D measurements of eight dried bones were analysed by a biplanar low-dose X-ray device (LDX) using stereoscopic software and compared with 3D computed tomography (CT). Secondly, 47 lower limbs of children and adolescents were studied using LDX two-dimensional (2D) and 3D measurements. Both parts were evaluated for femoral and tibial lengths and mechanical angles, frontal and lateral knee angulations, and the femoral neck-shaft angle. The 3D specimen comparison between LDX and CT measurements showed no significant differences: femoral length (P = 0.069), tibial length (P = 0.059), femoral mechanical angle (P = 0.475), tibial mechanical angle (P = 0.067), frontal knee angulation (P = 0.198), lateral knee angulation (P = 0.646) and femoral neck-shaft angle (P = 0.068). The comparison between LDX 2D and 3D measurements showed significant differences in tibial length (P = 0.003), femoral mechanical angle (P < 0.001) and femoral neck-shaft angle (P = 0.001); other parameters were unremarkable. The 3D LDX system presented reliable measurements compared with 3D CT. Differences between LDX 2D and 3D measurements were noted in the femoral mechanical angle, femoral neck-shaft angle and tibial length. Moderate to good interobserver agreement for the 3D LDX measurements were found. (orig.)

  16. Three-dimensional measurements of the lower extremity in children and adolescents using a low-dose biplanar X-ray device

    International Nuclear Information System (INIS)

    To evaluate three-dimensional (3D) measurements of the lower extremity using a biplanar low-dose X-ray device in children and adolescents. Firstly, 3D measurements of eight dried bones were analysed by a biplanar low-dose X-ray device (LDX) using stereoscopic software and compared with 3D computed tomography (CT). Secondly, 47 lower limbs of children and adolescents were studied using LDX two-dimensional (2D) and 3D measurements. Both parts were evaluated for femoral and tibial lengths and mechanical angles, frontal and lateral knee angulations, and the femoral neck-shaft angle. The 3D specimen comparison between LDX and CT measurements showed no significant differences: femoral length (P = 0.069), tibial length (P = 0.059), femoral mechanical angle (P = 0.475), tibial mechanical angle (P = 0.067), frontal knee angulation (P = 0.198), lateral knee angulation (P = 0.646) and femoral neck-shaft angle (P = 0.068). The comparison between LDX 2D and 3D measurements showed significant differences in tibial length (P = 0.003), femoral mechanical angle (P < 0.001) and femoral neck-shaft angle (P = 0.001); other parameters were unremarkable. The 3D LDX system presented reliable measurements compared with 3D CT. Differences between LDX 2D and 3D measurements were noted in the femoral mechanical angle, femoral neck-shaft angle and tibial length. Moderate to good interobserver agreement for the 3D LDX measurements were found. (orig.)

  17. Association between polymorphisms of apolipoprotein E, bone mineral density of the lower forearm, quantitative ultrasound of the calcaneus and osteoporotic fractures in postmenopausal women with hip or lower forearm fracture

    DEFF Research Database (Denmark)

    Sennels, Henriette Pia; Sand, J C; Madsen, B; Lauritzen, J B; Fenger, Mogens; Jørgensen, H L

    2003-01-01

    A genetic contribution to the development of osteoporosis is well documented. Although the association between the common allelic variation of apolipoprotein E (APOE), fracture risk, bone loss and bone mineral density (BMD) has been examined in several studies, the results of these investigations...... fragment length polymorphism (PCR-RFLP) was used to detect the APOE genotypes. Quantitative ultrasound was measured at the calcaneus. Bone mineral density (BMD) of the lower forearm was measured with dual-energy X-ray absorptiometry. The distributions of genotype frequencies in this study were: E2/E2: 0...

  18. The combined interventional treatment for lower extremity deep venous thrombosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical effectiveness of the combined interventional treatment for lower extremity deep venous thrombosis (LEDVT). Methods: 156 cases with LEDVT were treated by interventional thrombolysis. Among them, 39 cases were treated with placement of inferior vena cava filters, thrombosis of 18 cases were drawn by guiding catheter, 26 cases by PTA and 12 cases were placed with stents. Results: The total effective rate was 96.2%, ineffective rate was 3.8%. Average resident date was 10.5 days. Conclusions: The combined interventional treatment for LEDVT has better clinical effect and shorten the course of the disease

  19. Multiple Lower Extremity Mononeuropathies by Segmental Schwannomatosis: A Case Report.

    Science.gov (United States)

    Kwon, Na Yeon; Oh, Hyun-Mi; Ko, Young Jin

    2015-10-01

    Schwannoma is an encapsulated nerve sheath tumor that is distinct from neurofibromatosis. It is defined as the occurrence of multiple schwannomas without any bilateral vestibular schwannomas. A 46-year-old man with multiple schwannomas involving peripheral nerves of the ipsilateral lower extremity presented with neurologic symptoms. Electrodiagnostic studies revealed multiple mononeuropathies involving the left sciatic, common peroneal, tibial, femoral and superior gluteal nerves. Histologic findings confirmed the diagnosis of schwannoma. We reported this rare case of segmental schwannomatosis that presented with neurologic symptoms including motor weakness, which was confirmed as multiple mononeuropathies by electrodiagnostic studies. PMID:26605183

  20. Standardized voluntary force measurement in a lower extremity rehabilitation robot

    Directory of Open Access Journals (Sweden)

    Bolliger Marc

    2008-10-01

    Full Text Available Abstract Background Isometric force measurements in the lower extremity are widely used in rehabilitation of subjects with neurological movement disorders (NMD because walking ability has been shown to be related to muscle strength. Therefore muscle strength measurements can be used to monitor and control the effects of training programs. A new method to assess isometric muscle force was implemented in the driven gait orthosis (DGO Lokomat. To evaluate the capabilities of this new measurement method, inter- and intra-rater reliability were assessed. Methods Reliability was assessed in subjects with and without NMD. Subjects were tested twice on the same day by two different therapists to test inter-rater reliability and on two separate days by the same therapist to test intra-rater reliability. Results Results showed fair to good reliability for the new measurement method to assess isometric muscle force of lower extremities. In subjects without NMD, intraclass correlation coefficients (ICC for inter-rater reliability ranged from 0.72 to 0.97 and intra-rater reliability from 0.71 to 0.90. In subjects with NMD, ICC ranged from 0.66 to 0.97 for inter-rater and from 0.50 to 0.96 for intra-rater reliability. Conclusion Inter- and intra- rater reliability of an assessment method for measuring maximal voluntary isometric muscle force of lower extremities was demonstrated. We suggest that this method is a valuable tool for documentation and controlling of the rehabilitation process in patients using a DGO.

  1. Oral Administration and External Application of Chinese Drugs Combined with Micro-invasive Operation for the Treatment of Varicose Ulcers in the Lower Extremities

    Institute of Scientific and Technical Information of China (English)

    王小平; 张宇; 粟文娟; 王珊珊; 王英

    2009-01-01

    Objective:To evaluate the clinical therapeutic effects of oral administration and external application of Chinese drugs combined with micro-invasive surgery for the treatment of varicose ulcers in the lower extremities(ecthyma).Methods:A total of 152 patients(163 limbs) suffering from varicose ulcers on the lower limbs were assigned to two groups according to the patients' willingness.The 102 cases(109 limbs) in the treatment group underwent the method of endovenous microwave closure of communicating vei...

  2. Lower Trabecular Volumetric BMD at Metaphyseal Regions of Weight-Bearing Bones is Associated With Prior Fracture in Young Girls

    OpenAIRE

    Joshua N Farr; Tomás, Rita; Chen, Zhao; Lisse, Jeffrey R; Lohman, Timothy G.; Going, Scott B.

    2010-01-01

    Understanding the etiology of skeletal fragility during growth is critical for the development of treatments and prevention strategies aimed at reducing the burden of childhood fractures. Thus we evaluated the relationship between prior fracture and bone parameters in young girls. Data from 465 girls aged 8 to 13 years from the Jump-In: Building Better Bones study were analyzed. Bone parameters were assessed at metaphyseal and diaphyseal sites of the nondominant femur and tibia using peripher...

  3. Association between polymorphisms of apolipoprotein E, bone mineral density of the lower forearm, quantitative ultrasound of the calcaneus and osteoporotic fractures in postmenopausal women with hip or lower forearm fracture

    DEFF Research Database (Denmark)

    Sennels, Henriette Pia; Sand, J C; Madsen, B; Lauritzen, J B; Fenger, Mogens; Jørgensen, H L

    2003-01-01

    fragment length polymorphism (PCR-RFLP) was used to detect the APOE genotypes. Quantitative ultrasound was measured at the calcaneus. Bone mineral density (BMD) of the lower forearm was measured with dual-energy X-ray absorptiometry. The distributions of genotype frequencies in this study were: E2/E2: 0......A genetic contribution to the development of osteoporosis is well documented. Although the association between the common allelic variation of apolipoprotein E (APOE), fracture risk, bone loss and bone mineral density (BMD) has been examined in several studies, the results of these investigations...... are contradictory. The aim of this study was to examine the association between polymorphisms of APOE, BMD of the lower forearm, quantitative ultrasound of the calcaneus and osteoporotic fractures in a population of postmenopausal women with hip or lower forearm fractures admitted to a department of...

  4. The use of Papineau technique for the treatment of diabetic and non-diabetic lower extremity pseudoarthrosis and chronic osteomyelitis

    OpenAIRE

    Polyzois, Vasilios D.; Galanakos, Spyridon P.; Vassiliki A. Tsiampa; Papakostas, Ioannis D.; Kouris, Nikiforos K.; Adrian M. Avram; Papalois, Apostolos E.; Ignatiadis, Ioannis A.

    2011-01-01

    The treatment of 31 consecutive adult patients, ages 25-67 years with chronic draining osteomyelitis (12 cases) or infected pseudarthrosis (19 cases) by the Papineau technique was retrospectively reviewed. The initial injury was an open fracture in 24 patients and a closed fracture in 7 patients. In all cases an Ilizarov circular external fixation device was used for the stabilization of the fracture or for bone lengthening. Mean follow-up for the group was 20 months (range, 10 months to 5 ye...

  5. Trends in the incidence of lower extremity amputations in people with and without diabetes over a five-year period in the Republic of Ireland.

    LENUS (Irish Health Repository)

    Buckley, Claire M

    2012-01-01

    To describe trends in the incidence of non-traumatic amputations among people with and without diabetes and estimate the relative risk of an individual with diabetes undergoing a lower extremity amputation compared to an individual without diabetes in the Republic of Ireland.

  6. Foot skin depots of 18F-fluorodeoxyglucose do not enable PET/CT lymphography of the lower extremity lymphatic system in man

    DEFF Research Database (Denmark)

    Jensen, Mads Radmer; Simonsen, Lene; Lonsdale, Markus;

    2013-01-01

    of this study was to elucidate whether foot skin depots of 18F-FDG make PET/CT imaging of the lower extremity lymphatic system possible in man. FINDINGS: In four healthy volunteers, 18F-FDG depots (5 MBq in 0.1-mL isotonic saline) were injected intradermally in one foot and subcutaneously in the...

  7. LOWER EXTREMITY MALALIGNMENTS AND ANTERIOR CRUCIATE LIGAMENT INJURY HISTORY

    Directory of Open Access Journals (Sweden)

    Rebecca A. Braham

    2004-12-01

    Full Text Available To identify if lower extremity malalignments were associated with increased propensity of a history of anterior cruciate ligament (ACL ruptures in males and females using a case control design. Twenty subjects (10 males, 10 females had a history of ACL injury and twenty (10 males, 10 females had no history of ACL injury. Subjects were assessed for navicular drop, quadriceps angle, pelvic tilt, hip internal and external rotation range of motion, and true and apparent leg length discrepancies. Statistical analysis was performed to identify differences in these measures in regard to injury history and gender, and to identify if any of these measures were predictive of ACL injury history. Increased navicular drop and anterior pelvic tilt were found to be statistically significant predictors of ACL injury history regardless of gender. Limbs that had previously suffered ACL ruptures were found to have increased navicular drop and anterior pelvic tilt compared to uninjured limbs. Based on the results of this retrospective study, the lower extremity malalignments examined do not appear to predispose females to tearing their ACLs more than males.

  8. CT demonstration of the extensive extension of the emphysematous gangrene of the lower extremity extending to the body : a case report

    International Nuclear Information System (INIS)

    Emphysematous gangrene of the lower extremity in a diabetic patient due to minor trauma is being presented. The gas originating from the extremity extended along the fascial planes into the pelvic cavity, scrotal region, retroperitoneal space, and abdominal wall. CT demonstrated the pathways of upward extension of emphysematous gangrene. anatomic pathways of the spread of the disease are insertions of the iliopsoas, piriformis and obturator internus muscles, and their fascial investments, and the endopelvic fascia. Anatomic pathways on CT and the role of CT are discussed

  9. High dose botulinum toxin A for the treatment of lower extremity hypertonicity in children with cerebral palsy

    Science.gov (United States)

    Willis, Allison W; Crowner, Beth; Brunstrom, Janice E; Kissel, Abigail; Racette, Brad A

    2011-01-01

    The aim of this study was to determine the safety profile of high dose (15–25 units/kg) of botulinum toxin A (BTX-A) in children with cerebral palsy (CP) and increased lower extremity muscle tone. We performed a retrospective review of 929 patient encounters at the Movement Disorders Center at Washington University. A total of 261 patients (105 females; 156 males) were treated during these visits, ages 6 months to 21 years (mean 8y 4mo [SD 4y 8mo]). Ambulatory ability at the time of BTX-A injection was independent ambulation (36.4%, n=95), ambulation with a walker (27.6%, n=72), and non-ambulatory (31.8%, n=83). A few patients (4.2%, n=11) were able to ambulate with a cane or crutch at the time of injection. Participants were characterized according to BTX-A dose, CP etiology, motor involvement pattern, muscles injected, ambulatory ability, and use of oral tone medications. Follow-up records were searched for reported adverse events (AEs), with a mean time to AE assessment of 6.5 weeks (SD 3.38). The AE occurrence was determined for doses of 0 to 4.9 units/kg, 5 to 9.9 units/kg, 10 to 14.9 units/kg, 15 to 19.9 units/kg, and 20 to 25 units/kg. The overall AE occurrence was 4.2%. Standard doses of BTX-A had side-effect occurrences of 3.9% for 5 to 10 units/kg and 7.6% for 10 to 15 units/kg. Among higher doses (15–20 units/kg and 20–25 units/kg) the AE occurrence was 3.5% and 8.6% respectively. No patient developed botulism. AEs were randomly distributed across dosing groups, CP etiologies, clinical phenotypes, ambulatory status, and treatment duration. All doses were associated with a significant increase in passive range of motion using the Tardieu scale. We conclude that higher dose BTX-A is safe in children with a spectrum of CP phenotypes and are well tolerated over time. PMID:17979859

  10. Lower Extremity Muscle Activity During a Women's Overhand Lacrosse Shot

    Directory of Open Access Journals (Sweden)

    Millard Brianna M.

    2014-07-01

    Full Text Available The purpose of this study was to describe lower extremity muscle activity during the lacrosse shot. Participants (n=5 females, age 22±2 years, body height 162.6±15.2 cm, body mass 63.7±23.6 kg were free from injury and had at least one year of lacrosse experience. The lead leg was instrumented with electromyography (EMG leads to measure muscle activity of the rectus femoris (RF, biceps femoris (BF, tibialis anterior (TA, and medial gastrocnemius (GA. Participants completed five trials of a warm-up speed shot (Slow and a game speed shot (Fast. Video analysis was used to identify the discrete events defining specific movement phases. Full-wave rectified data were averaged per muscle per phase (Crank Back Minor, Crank Back Major, Stick Acceleration, Stick Deceleration. Average EMG per muscle was analyzed using a 4 (Phase x 2 (Speed ANOVA. BF was greater during Fast vs. Slow for all phases (p0.05. RF and GA were each influenced by the interaction of Phase and Speed (p<0.05 with GA being greater during Fast vs. Slow shots during all phases and RF greater during Crank Back Minor and Major as well as Stick Deceleration (p<0.05 but only tended to be greater during Stick Acceleration (p=0.076 for Fast vs. Slow. The greater muscle activity (BF, RF, GA during Fast vs. Slow shots may have been related to a faster approach speed and/or need to create a stiff lower extremity to allow for faster upper extremity movements.

  11. The Association Analysis between Lower Extremity Arterial Disease, Body Fat and the Bone Mineral Density in Patients with Type 2 Diabetes%2型糖尿病患者下肢动脉疾病与体脂及骨密度的相关性分析

    Institute of Scientific and Technical Information of China (English)

    汤莎莎; 张雅静; 张宏

    2013-01-01

    目的 探讨2型糖尿病(T2DM)患者下肢动脉疾病程度与体脂含量及骨密度(BMD)的相关性.方法 319例T2DM患者根据双下肢各动脉最大狭窄值,将其分为无狭窄组、轻度狭窄组、中度狭窄组及重度狭窄组4组,检测并比较各组不同部位体脂百分比、腰椎(L2~4)和左股骨BMD及相关代谢指标,分析其与下肢动脉疾病的相关性.结果 随着狭窄严重程度增加,脊柱脂肪百分比(SF%)升高,左股骨BMD下降;中、重度狭窄组全身体脂百分比(BF%)高于轻度狭窄组、无狭窄组,重度狭窄组左侧股骨脂肪百分比(LF%)高于无狭窄组,中、重度狭窄组L2~4BMD低于轻度狭窄组、无狭窄组.中、重度狭窄组病程、体质指数(BMI)、三酰甘油(TG)、糖化血红蛋白(HbA1c)、收缩压(SBP)高于轻度狭窄组、无狭窄组,中、重度狭窄组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)高于无狭窄组,重度狭窄组血钙高于轻度狭窄组、无狭窄组,中、重度狭窄组高密度脂蛋白胆固醇(HDL-C)低于轻度狭窄组.下肢动脉疾病与SF%、HbA1c、TC、病程、BF%、SBP呈正相关,与左股骨BMD、L2~4BMD呈负相关(P<0.05).且SF%、HbA1c、TC升高,左股骨BMD下降为患者发生糖尿病下肢病变的危险因素.结论 腹型肥胖及下肢BMD降低与T2DM患者合并下肢动脉疾病密切相关.%Objective To investigate the correlation between the severity of lower extremity arterial disease and the body fat percentage and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM).Methods According to the maximum stenosis value of the lower extremity artery, three hundred and nineteen hospitalized T2DM patients were divided into four groups, including non-stenosis group, mild stenosis group, moderate stenosis group and severe stenosis group.The values of body fat percentage in different parts of body, BMD of the second to fourth lumber vertebrate (L2-4BMD), BMD of

  12. Energy Availability and Dietary Patterns of Adult Male and Female Competitive Cyclists With Lower Than Expected Bone Mineral Density.

    Science.gov (United States)

    Viner, Rebecca T; Harris, Margaret; Berning, Jackie R; Meyer, Nanna L

    2015-12-01

    The purpose of this study was to assess energy availability (EA) and dietary patterns of 10 adult (29-49 years) male (n = 6) and female (n = 4) competitive (USA Cycling Category: Pro, n = 2; 1-4, n = 8) endurance cyclists (5 road, 5 off-road), with lower than expected bone mineral density (BMD; Z score competition (C), and off-season (OS) were estimated from 3-day dietary records, completed once per month, across a cycling season. BMD was measured by DXA at 0 months/5 months/10 months. The Three-Factor Eating Questionnaire (TFEQ) was used to assess cognitive dietary restraint. Seventy percent of participants had low EA [(LEA); competitive road and off-road cyclists in the United States may be at risk for long-term LEA. Further studies are needed to explore strategies to prevent and monitor long-term LEA in these athletes. PMID:26131616

  13. [The assessment of long-term results of surgical treatment of patients with secondary lymphostasis lower extremity in predicting the course of the disease].

    Science.gov (United States)

    Zhukov, B N; Kukol'nikova, E L; Lapina, N V

    2011-01-01

    With the development of vascular surgery began to attract attention to the problem of studying the long-term results of treatment. Long-term results of surgical treatment were studied in 110 patients with secondary lymphostasis lower extremities in the period 1997-2010. The estimation was made in two ways. First, the definition of value of basic clinical and social indicators, and secondly, the study target quality of life of patients. The analysis of remote results of treatment of patients with secondary lymphostasis lower extremities indicates that the quality of life and values of major clinical and social indicators quite adequately characterize the patient's condition after treatment and can be used alongside traditional medical data to assess long-term results, as well as serve as criteria in solving the optimal choice of treatment. PMID:21983583

  14. Autologous transplantation of CD34(+) bone marrow derived mononuclear cells in management of non-reconstructable critical lower limb ischemia.

    Science.gov (United States)

    Ismail, Ahmed M; Abdou, Said M; Aty, Hassan Abdel; Kamhawy, Adel H; Elhinedy, Mohammed; Elwageh, Mohammed; Taha, Atef; Ezzat, Amal; Salem, Hoda A; Youssif, Said; Salem, Mohamed L

    2016-08-01

    Patients with a decrease in limb perfusion with a potential threat to limb viability manifested by ischemic rest pain, ischemic ulcers, and/or gangrene are considered to have critical limb ischemia (CLI). Because of this generally poor outcome, there is a strong need for attempting any procedure to save the affected limb. The aim of this work is to evaluate the possibility to use stem cell therapy as a treatment option for patients with chronic critical lower limb ischemia with no distal run off. This study includes 20 patients with chronic critical lower limb ischemia with no distal run off who are unsuitable for vascular or endovascular option. These patients underwent stem cell therapy (SCT) by autologous transplantation of bone marrow derived mononuclear cells. 55 % of patients treated with SCT showed improvement of the rest pain after the first month, 60 % continued improvement of the rest pain after 6 months, 75 % after 1 year and 80 % after 2 years and continued without any deterioration till the third year. Limb salvage rate after STC was 80 % after the first year till the end of the second and third years. SCT can result in angiogenesis in patients with no-option CLI, providing a foundation for the application of this therapy to leg ischemia. PMID:25511801

  15. Assessment of image quality in soft tissue and bone visualization tasks for a dedicated extremity cone-beam CT system

    Energy Technology Data Exchange (ETDEWEB)

    Demehri, S. [Johns Hopkins University, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Johns Hopkins Outpatient Center, JHOC 5168, Musculoskeletal Radiology, Baltimore, MD (United States); Muhit, A.; Zbijewski, W.; Stayman, J.W. [Johns Hopkins University, Department of Biomedical Engineering, Baltimore, MD (United States); Yorkston, J.; Packard, N.; Senn, R.; Yang, D.; Foos, D. [Carestream Health, Rochester, NY (United States); Thawait, G.K.; Fayad, L.M.; Chhabra, A.; Carrino, J.A. [Johns Hopkins University, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Siewerdsen, J.H. [Johns Hopkins University, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Johns Hopkins University, Department of Biomedical Engineering, Baltimore, MD (United States)

    2015-06-01

    To assess visualization tasks using cone-beam CT (CBCT) compared to multi-detector CT (MDCT) for musculoskeletal extremity imaging. Ten cadaveric hands and ten knees were examined using a dedicated CBCT prototype and a clinical multi-detector CT using nominal protocols (80kVp-108mAs for CBCT; 120kVp- 300mAs for MDCT). Soft tissue and bone visualization tasks were assessed by four radiologists using five-point satisfaction (for CBCT and MDCT individually) and five-point preference (side-by-side CBCT versus MDCT image quality comparison) rating tests. Ratings were analyzed using Kruskal-Wallis and Wilcoxon signed-rank tests, and observer agreement was assessed using the Kappa-statistic. Knee CBCT images were rated ''excellent'' or ''good'' (median scores 5 and 4) for ''bone'' and ''soft tissue'' visualization tasks. Hand CBCT images were rated ''excellent'' or ''adequate'' (median scores 5 and 3) for ''bone'' and ''soft tissue'' visualization tasks. Preference tests rated CBCT equivalent or superior to MDCT for bone visualization and favoured the MDCT for soft tissue visualization tasks. Intraobserver agreement for CBCT satisfaction tests was fair to almost perfect (κ ∝ 0.26-0.92), and interobserver agreement was fair to moderate (κ ∝ 0.27-0.54). CBCT provided excellent image quality for bone visualization and adequate image quality for soft tissue visualization tasks. (orig.)

  16. Irradiated long bone transplants in limb saving surgeries for extremity bone cancers

    International Nuclear Information System (INIS)

    In the Philippines, the treatment of cancers of the limbs has always been by amputation. In recent decades, better understanding of these cancers and advances in the disciplines of cancer medicine have made the saving of these limbs almost routine in better developed countries. Surgeries entail two steps: (1) excision of the tumor and the bone from which the tumor arose, followed by (2) reconstruction of the defect resulting from the excision. Tumor implants, however, are not available locally, and are too costly for the average Filipino patient. Microvascular surgery is limited by the size of the defect it can bridge; and bone cement, not being biologic, can result in greater long term problems. Recently, the option of long bone transplants (aka large-segment allografts) to reconstruct these defects has become available locally. These bones are harvested from both cadaveric and live amputee donors after appropriate consent and medical work-up. After processing at the UP-PGH Tissue and Bone Bank, the bones are sterilized by irradiation at the PNRI(Philippine Nuclear Research Institute), and store in deep freezers until use. In the Philippines, limb saving surgery for bone cancers of the extremities using these large-segment alloografts was introduced in 1993 at the UP-PGH Musculoskeletal Tumor Unit. This paper will present the author's initial 3-year experience with 19 patients whose limbs were saved using bone transplantation. All surgeries were performed by the author and all patients have been personally followed up by the author (follow-up ranging from 6 months to 3-1/2 years). Cases will be presented to show the pre- and intraoperative processing of the irradiated bone; and the patients before and after the operations with emphasis on their improved quality of life and return to function. These results would seem to show that irradiated long bone transplants coupled with skills for limb saving surgery may make amputations a thing of the past for many of our

  17. Related research of blood glucose, blood lipid and serum cystatin C and lower-extremity arterial disease in type 2 diabetic mellitus

    Institute of Scientific and Technical Information of China (English)

    Juan Zeng; Jie Ou; Yun-Mei He; Chun-Yu Cai

    2016-01-01

    Objective:To explore the relationship between levels of blood glucose, blood lipid and serum cystatin C and lower-extremity arterial disease in type 2 diabetic mellitus so as to provide the basis for the prevention and treatment of the disease.Methods:A total of 240 cases of patients with type 2 diabetic mellitus receiving physical examinations in our hospital from March 2014 to March 2015 were selected and divided into three groups. The control group was consisted of type 2 diabetes patients without lower-extremity arterial disease, the observation group 1 included type 2 diabetes patients with mild or moderate lower-extremity arterial disease, and the observation group 2 was formed by type 2 diabetes patients with severe lower-extremity arterial disease. Each group contained 80 cases. Then, the heights, weights, waist and hip circumferences of patients in the three groups were determined and the body mass index (BMI) and waist to hip ratio (WHR) were calculated; the fasting blood glucose (FBG), fasting insulin (FINS), insulin resistance index (HOMA-IR), 2 h postprandial blood glucose (2 h PG) and glycosylated hemoglobin (HBA1c) in two groups were detected; and the levels of serum total cholesterol(TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (apoA1), apolipoprotein B (apoB) and cystatin C (CysC) in two groups were also tested.Results:Compared with the control group, the WHR, FBG, HOMA-IR, 2 h PG, HBA1c, LDL-C, apoB and CysC all increased significantly, and the differences were statistically significant. Besides, there were statistically significances existing between the observation groups 1 and 2. What’s more, the serum levels of TC, HDL-C, TG and apoA1 in the observation groups were not significantly different from those of the control group.Conclusions: There is a close relationship between blood glucose, blood lipid, serum cystatin C level and lower-extremity arterial

  18. Dimensional changes in height of labial alveolar bone of proclined lower incisor after lingual positioning by orthodontic treatment: A cephalometric study on adult Bengali population

    Directory of Open Access Journals (Sweden)

    Amit Shaw

    2015-01-01

    Full Text Available Aim: The study aims to know whether modern orthodontic treatment procedure do actually cause permanent bone loss at the alveolar bone crest or improve alveolar bone morphology on labial aspect of permanent incisors which are to be moved lingually. Settings and Design: manual tracings of pre and post treatment lateral cephalometric radiographs were used. Material and Method: The cephalometric radiographs of 34 adult bengali subjects whose orthodontic treatment involved lingual positioning of procumbent mandibular central incisors were examined to determine the morphologic changes (bone height in the labial alveolar bone that resulted from orthodontic treatment. Result: Comparison of tracings of radiographs taken before and after treatment indicated that 57.6% shows an increase in labial alveolar bone height, 30.3% shows decreased value and 12.1% shows no change with the decrease in the angulation between long axis of lower incisor and mandibular plane (GoGn. In the increase group there is a significant increase in the distance ′incisal edge to D point′ whereas this dimension decreased significantly in the rest of the cases. In addition, a significant positive correlation (r = 0.56 was found between the changes in the distance from the incisal edge to the ′D′ point and the alveolar bone height. But no significant relation was found between alveolar bone height and decrease in angulation of lower incisor either in the ′increase group′ (r = 0.13, p > 0.05 or in the ′decrease group′ (r = 0.37, p > 0.05. Conclusion: These findings indicate that during orthodontic treatment that involves lingual positioning of procumbent teeth but no intrusion, an increase in the amount of buccal alveolar bone may take place.

  19. Lower Extremity Fracture Reduction: Tips, Tricks, and Techniques So That You Leave the Operating Room Satisfied.

    Science.gov (United States)

    Mir, Hassan R; Boulton, Christina L; Russell, George V; Archdeacon, Michael

    2016-01-01

    It can be challenging for surgeons to obtain proper alignment and to create stable constructs for the maintenance of many lower extremity fractures until union is achieved. Whether lower extremity fractures are treated with plates and screws or intramedullary nails, there are numerous pearls that may help surgeons deal with these difficult injuries. Various intraoperative techniques can be used for lower extremity fracture reduction and stabilization. The use of several reduction tools, tips, and tricks may facilitate the care of lower extremity fractures and, subsequently, improve patient outcomes. PMID:27049180

  20. Incorporating kettlebells into a lower extremity sports rehabilitation program.

    Science.gov (United States)

    Brumitt, Jason; En Gilpin, Hui; Brunette, Meredith; Meira, Erik P

    2010-12-01

    The primary goal of a sports rehabilitation program is to return the injured athlete back to competition as quickly and as safely as possible. Sports physical therapists utilize a variety of exercise equipment to help an athlete restore function after an injury. An injured athlete's therapeutic exercise program frequently includes the prescription of functional strengthening and power exercises during the later stages of rehabilitation. One piece of exercise equipment, the kettlebell, has gained popularity for its ability to allow the user to perform functional power exercises. The unique exercises that can be performed with kettlebells may have utility in sports physical therapy practice. This clinical suggestion outlines the clinical rationale for the inclusion of kettlebell exercises when rehabilitating an athlete with a lower extremity injury. PMID:21655384

  1. Our Experience in treating Ischemic Ulcer of a Lower Limb in 4 diabetic patients with Autologous Bone Marrow Stem Cells

    Directory of Open Access Journals (Sweden)

    Subrammaniyan SR

    2007-01-01

    Full Text Available Chronic limb ischemia is an outcome of peripheral arterial occlusive disease. When conventional medical and surgical treatments are not feasible, amputation is the only option left. Recent studies report that the injection of bone marrow mononuclear cells and Peripheral blood mononuclear cells rich in CD34+ cells have resulted in symptomatic recovery, improved functional activity of the ischemic limb as well as healing of the ulcers. Here we report our experience with 4 patients of such case where autologous bone marrow mononuclear cells were injected and the patient followed up for 6 months. Materials and Methods: Four patients with critical limb ischemia with ulcers were referred for amputation of their limb. A 68-year-old female with critical limb ischemia with an ulcer in the left leg measuring 30X12 cm over the posterior portion of the leg and extending to the medial aspect of the foot measuring 14X10 cm, a 65-year-old male with necrotic wound in his lower foot, a 69-year-old male with a deep wound in his lower foot and a 61-year-old male with ulcer in his toe amputated with all the toe fingers. The first two patients were given injections for more than one sitting at appropriate intervals specified by the clinician. Under short general anesthesia, 110 ml of Bone marrow was aspirated each time, transported in Acid Citrate Dextrose and was processed for mononuclear cells (MNC by Ficoll density gradient centrifugation, following the cGMP protocols. The MNC concentrate was injected at various sites in the Gastrocnemius muscle and the surrounding area after necessary debridement. Skin grafting was performed in the first two patients and followed up for a period of at regular intervals of 6 to 9 months. The patients have been followed up at regular intervals for six months after the treatment with investigations such as Ankle-Brachial Index, Doppler and Angiogram.Results: All the patients showed improvements with healthy granulation gradually

  2. Detection of recurrent cutaneous angiosarcoma of lower extremity with 18 F-fluorodeoxyglucose positron emission tomography-computed tomography: Report of three cases

    Directory of Open Access Journals (Sweden)

    Punit Sharma

    2013-01-01

    Full Text Available Cutaneous angiosarcomas (CAS are uncommon, aggressive tumours. Very rarely, they arise from the lower extremity. Such tumours are usually associated with chronic lymphedema, a phenomenon known as Stewart-Treves Syndrome. Treatment is usually radical surgery with adjuvant therapy (radiotherapy/chemotherapy. Recurrence rate after primary treatment is high. Because of post therapy changes, conventional imaging has limited specificity for diagnosing recurrence. 18 F-Fluorodeoxyglucose ( 18 F-FDG positron emission tomography-computed tomography (PET-CT might be useful in such patients. It can demonstrate local recurrence along with distant metastasis, if any and can have significant impact on patient management. We here present three cases of recurrent CAS of lower extremity diagnosed with 18 F-FDG PET-CT.

  3. Effects of fast and slow squat exercises on the muscle activity of the paretic lower extremity in patients with chronic stroke

    OpenAIRE

    Choi, Young-Ah; Kim, Jin-Seop; Lee, Dong-Yeop

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effects of the speed of squat exercises on paretic lower extremity muscle activity in patients with hemiplegia following a stroke. [Subjects and Methods] Ten stroke patients performed fast and slow squat exercises for 2 seconds and 8 seconds, respectively. The muscle activities of the paretic and non-paretic sides of the rectus femoris muscle, the biceps femoris muscle, and the tibialis anterior muscle were assessed and compared using...

  4. Intraarterial digital subtraction angiography (i.a. DSA) of the lower extremity using fine-needle technique

    International Nuclear Information System (INIS)

    206 FNA of the lower limb were evaluated retrospectively. Besides evaluation of the image quality of the 1119 angiographic image series, main points of interest were the determination of accuracy of the FNA in comparison to the operative findings, the average radiocontrast agent consumption and the rate of complication. In all cases the image quality was rated either very good or good in the pelvic, femoral and popliteal vessels. 94% of the image series of the lower leg and foot could be rated as well as very good/good although 75% of all patients demonstrated an advanced stage of pAOD. Accuracy of FNA compared to operative findings came up to 82%. The average radiocontrast consumption amounted to 69 ml per examination. Overall, two major complications were seen. I.a. DSA of the lower limb using fine-needle-technique is an easily applied angiographic method of low radiocontrast agent consumption and a low complication rate. (orig./MG)

  5. Repair of a wide lower extremity defect with cross-leg free transfer of latissimus dorsi and serratus anterior combined flap: a case report

    OpenAIRE

    Turgut, Gursel; Kayalı, Mahmut Ulvi; Köse, Özkan; Baş, Lütfü

    2010-01-01

    Composite tissue loss in extremities involving neurovascular structures has been a major challenge for reconstructive surgeons. Reconstruction of large defects can only be achieved with microsurgical procedures. The success of free flap operations depends on the presence of healthy recipient vessels. In cases with no suitable donor artery and vein or in which even the use of vein grafts would not be feasible, the lower limb can be salvaged with a cross-leg free flap procedure. We present a ca...

  6. An old male patient with paroxysmal chest distress,shortness of breath and edema of both lower extremities (the 27th case)

    Institute of Scientific and Technical Information of China (English)

    陈琪

    2008-01-01

    @@ The patient,a 78-year-old male,was admitted to the hospital on Nov.15,2007 because of paroxysmal chest distress and shortness of breath for 11years and edema of lower extremities for 3 days.The patient began to suffer from paroxysmal chest distress and shortness of breath after exertion in 1997,then these symptoms recurred frequently,which lasted 10 min to several hours.

  7. Position of the pelvis, lower extremities load and the arch of the feet in young adults who are physically active

    Directory of Open Access Journals (Sweden)

    Agnieszka Jankowicz-Szymańska

    2013-10-01

    Full Text Available Introduction: Body posture is an individual motion habit. It is variable and depends on the gender, age, structure of the body but also on mental and physical state. Although it is difficult to formulate a universal definition of correct body posture, the opinion that its elementary feature is symmetry is beyond any doubt. Such symmetry is related to the position of particular anatomical points and effects of static and dynamic forces. Aim of the research: To assess the relations between the pelvis position in the frontal plane, the static load on the lower limbs and architecture of the feet. The following features were analysed in a group of young, healthy and particularly physically active women and men: the frequency of asymmetry related to pelvis position, the load on the lower limbs related to body weight and foot architecture. Material and methods: The study group consisted of 100 students of physical education. To assess the position of the pelvis a palpable-visual method was used. Clarke’s method was applied to characterize the foot architecture determined by the position of standing with one leg on the CQ Elektronik podoscope. The static load on the lower limbs was assessed using the stabilographic platform EMILDUE from Technomex. Results : Collected data and observations show frequent asymmetric changes of pelvis position in the frontal plane and incorrect balance of the body in the standing position. The change of static load on the lower limbs influences the longitudinal architecture of the feet and this influence is statistically significant. Increased asymmetry of the pelvis in the frontal plane is related to profound disorder of body balance. Conclusions : Asymmetric position of the pelvis is associated with asymmetric arching of the feet and asymmetric body weight distribution. Full symmetric position of the pelvis is rare even among young people who are physically active.

  8. Lymphoscintigraphy for sentinel lymph node mapping in Japanese patients with malignant skin neoplasms of the lower extremities. Comparison with previously investigated Japanese lymphatic anatomy

    International Nuclear Information System (INIS)

    Lymph nodes (LN) and lymphatic drainage were identified by lymphoscintigraphy using 99mTc-phytate in order to map the sentinel lymph nodes (SLNs) in patients with malignant skin neoplasms of the lower extremities, and to compare the results with an atlas of Japanese lymphatic anatomy. Sentinel lymphoscintigraphs of 18 patients with malignant skin neoplasms of the lower extremities (9 men, 9 women; age range 45-84 years, mean age 66 years) were analyzed retrospectively, and the LNs detected were identified as SLNs or secondary nodes. The patterns of lymphatic drainage were divided into three different categories: initial drainage into inguinal LN without visualization of popliteal LNs (inguinal type), initial drainage into popliteal LNs and then into intrapelvic LNs (popliteal type), and initial drainage into both popliteal and inguinal LNs (inguinal and popliteal type). More than half of the cases were the inguinal and popliteal type, as both inguinal and popliteal LNs were identified as SLNs. In the cases in which the hallux and its surrounding area were injected, all were the inguinal type and popliteal LNs were not visualized. In one case, only dynamic images detected lymphatic drainage without visualization of popliteal LNs. In contrast to the previously published literature on Japanese lymphatic anatomy, SLN lymphatic drainage from the skin of the lower extremities was wide and overlapping in many areas. However, in agreement with currently accepted anatomy, only the great saphenous lymphatic vessel drained the skin of the hallux and its surrounding area. The present results suggest that it is important to confirm lymphatic drainage in order to identify SLNs in the lower extremities. The patterns of lymphatic drainage from the skin of the foot were divided into three different categories. In contrast to previously published Japanese lymphatic anatomy, lymphatic drainage from the skin of the lower extremities was wide and overlapping in many areas. However

  9. High Spatial and Temporal Resolution Imaging of the Arterial Vasculature of the Lower Extremity With Contrast Enhanced MR Angiography

    OpenAIRE

    Mostardi, Petrice M.; Haider, Clifton R.; Glockner, James F; Young, Phillip M.; Riederer, Stephen J.

    2011-01-01

    Vascular imaging can be essential in the diagnosis, monitoring, and planning and assessment of treatment of patients with peripheral vascular disease. The purpose of this work is to describe a recently developed three-dimensional (3D) time-resolved contrast-enhanced MR angiography (CE-MRA) technique, Cartesian Acquisition with Projection Reconstruction-like sampling (CAPR), and its application to imaging of the vasculature of the lower legs and feet. CAPR implements accelerated imaging techni...

  10. Effectiveness of mirror therapy on lower extremity motor recovery, balance and mobility in patients with acute stroke: A randomized sham-controlled pilot trial

    Directory of Open Access Journals (Sweden)

    Uthra Mohan

    2013-01-01

    Full Text Available Objective: To evaluate the effectiveness of mirror therapy on lower extremity motor recovery, balance and mobility in patients with acute stroke. Design: A randomized, sham-controlled, assessor blinded, pilot trial. Setting: Inpatient stroke rehabilitation unit. Subjects: First time onset of stroke with mean post-stroke duration of 6.41 days, able to respond to verbal instructions, and Brunnstrom recovery stage 2 and above were enrolled. Intervention: Mirror therapy group performed 30 minutes of functional synergy movements of non-paretic lower extremity, whereas control group underwent sham therapy with similar duration. In addition, both groups were administered with conventional stroke rehabilitation regime. Altogether 90 minutes therapy session per day, six days a week, for two weeks duration was administered to both groups. Outcome Measures: Lower extremity motor subscale of Fugl Meyer Assessment (FMA, Brunnel Balance Assessment (BBA and Functional Ambulation Categories (FAC. Results: Amongst the 22 patients included, equal number of patients participated in mirror group (N = 11 and control group (N = 11. Baseline variables were similar in both groups, except for Brunnstrom recovery stage. There was no statistical difference between groups, except for FAC. (FMA: P = 0.894; BBA: P = 0.358; FAC: P = 0.02. Significance was set at P < 0.05. Conclusion: Administration of mirror therapy early after stroke is not superior to conventional treatment in improving lower limb motor recovery and balance, except for improvement in mobility.

  11. Application of DCE-MRI in evaluating lower extremity capillary endothelial function in patients with diabetes mellitus complicated by peripheral vascular disease after PTA

    International Nuclear Information System (INIS)

    Objective: To quantify endothelial function of lower extremity capillary in patients with peripheral vascular disease associated with diabetes mellitus by using DCE-MRI, and to explore the feasibility of DCE-MRI in predicting vascular restenosis in lower extremity after PTA. Methods: During the period form May 2009 to Jan. 2012, a total of 51 patients (study group) with diabetic lower extremity vascular diseases (77 diseased legs in total) were admitted to the hospital and were treated with PTA. Another 20 volunteers were used as control group. K-trans values were measured in soleus muscle using DCE-MRI. Based on the results after 6 months follow-up, the patients were classified into restenosis group and non-restenosis group. The K -trans values and others clinical data were compared between the two groups. Results: Although clinical symptoms and signs were improved in both groups after the treatment, K-trans value of restenosis group showed no obvious changes after PTA, while K-trans value of non-restenosis group was improved significantly. Before PTA, the difference in K -trans value between the two groups was not statistically significant, while K-trans values of the two groups were significantly lower than that of the control group (P<0.05). Conclusion: K-trans value can reflect the endothelial function in diabetes mellitus patients with peripheral vascular disease, and it can also predict the occurrence of restenosis, providing a useful evidence for clinical. therapy. (authors)

  12. Effectiveness and Safety of the Tempofilter II to Prevent the Occurrence of Pulmonary Thromboembolism in Patients with Lower Extremity Deep Vein Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Byung Hyun; Jung, Min Young; Oh, Hyun Jun; Kim, Jae Kyu; Lee, Ho Kyun [Chonnam National University College of Medicine, Gwangju (Korea, Republic of); Jang, Nam Kyu [Chonnam National University Hospital, Hwasun (Korea, Republic of)

    2010-04-15

    To evaluate the efficacy and safety of the Tempofilter II for the prevention of a pulmonary thromboembolism (PTE) in patients with lower extremity deep vein thrombosis (DVT). Between January 2007 and December 2008, thirteen patients with lower extremity DVT whom were implanted with the Tempofilter II to prevent PTE were analyzed. A chest CT was compared before and after filter placement, to evaluate effectiveness of preventing PTE. Clinical symptoms of PTE were checked. Fluoroscopy and a plain radiograph were examined to evaluate filter status. The tempofilter II was successfully inserted in 13 patients. Nine patients underwent endovascular treatment after filter insertion. Trapping of thrombus was evaluated by following CT, venography, and filter retrieval. Trapped thrombus was detected in four patients by CT or retrieved filter. Two patients showed a decrease in thrombus in a follow-up chest CT. Not all patients showed symptoms of PTE. One filter was surgically removed due to the detachment of the anchoring device. The placement and retrieval of the Tempofilter II is feasible and effective for the prophylaxis of PTE in patients with lower extremity DVT; especially for patients that underwent subsequent endovascular treatment

  13. Invasively-treated incidence of lower extremity peripheral arterial disease and associated factors in Taiwan: 2000–2011 nationwide hospitalized data analysis

    OpenAIRE

    Chang, Nien-Tzu; Chan, Chien-Lung; Lu, Yu-Tzuen; Hsu, Jin-Chyr; Hsu, Yuan-Nian; Chu, Dachen; Yang, Nan-Ping

    2013-01-01

    Background Lower extremity (LE) peripheral artery disease (PAD), which is associated with a reduced quality of life and increased mortality from atherosclerotic cardio-/cerebro-vascular occlusion, is a significant public health problem, especial for an aging society such as that of Taiwan. Methods Specific datasets of the 2000–2011 nationwide inpatient databases were analyzed. Two inclusion criteria, including one of the major diagnosis codes of PAD and one of three categorical invasive treat...

  14. The SNaP™ Wound Care System: A Case Series Using a Novel Ultraportable Negative Pressure Wound Therapy Device for the Treatment of Diabetic Lower Extremity Wounds

    OpenAIRE

    Lerman, Bruce; Oldenbrook, Leslie; Ryu, Justin; Fong, Kenton D.; Schubart, Peter J.

    2010-01-01

    Although there is significant evidence supporting the use of negative pressure wound therapy (NPWT) for the treatment of lower extremity diabetic ulcers, currently available electrically powered NPWT systems are not ideally suited for treating smaller diabetic foot ulcers. The Smart Negative Pressure (SNaP™) Wound Care System is a novel, ultraportable device that delivers NPWT without the use of an electrically powered pump. It was specifically designed to meet the wound care needs of patient...

  15. Effectiveness of mirror therapy on lower extremity motor recovery, balance and mobility in patients with acute stroke: A randomized sham-controlled pilot trial

    OpenAIRE

    Uthra Mohan; S Karthik babu; K Vijaya Kumar; Suresh, B. V.; Z K Misri; M Chakrapani

    2013-01-01

    Objective: To evaluate the effectiveness of mirror therapy on lower extremity motor recovery, balance and mobility in patients with acute stroke. Design: A randomized, sham-controlled, assessor blinded, pilot trial. Setting: Inpatient stroke rehabilitation unit. Subjects: First time onset of stroke with mean post-stroke duration of 6.41 days, able to respond to verbal instructions, and Brunnstrom recovery stage 2 and above were enrolled. Intervention: Mirror therapy group performed 30 minutes...

  16. Which Screening Tools Can Predict Injury to the Lower Extremities in Team Sports? A Systematic Review

    NARCIS (Netherlands)

    Dallinga, Joan M.; Benjaminse, Anne; Lemmink, Koen A. P. M.

    2012-01-01

    Background: Injuries to lower extremities are common in team sports such as soccer, basketball, volleyball, football and field hockey. Considering personal grief, disabling consequences and high costs caused by injuries to lower extremities, the importance for the prevention of these injuries is evi

  17. High spatial and temporal resolution imaging of the arterial vasculature of the lower extremity with contrast enhanced MR angiography.

    Science.gov (United States)

    Mostardi, Petrice M; Haider, Clifton R; Glockner, James F; Young, Phillip M; Riederer, Stephen J

    2011-05-01

    Vascular imaging can be essential in the diagnosis, monitoring, and planning and assessment of treatment of patients with peripheral vascular disease. The purpose of this work is to describe a recently developed three-dimensional (3D) time-resolved contrast-enhanced MR angiography (CE-MRA) technique, Cartesian Acquisition with Projection Reconstruction-like sampling (CAPR), and its application to imaging of the vasculature of the lower legs and feet. CAPR implements accelerated imaging techniques and uses specialized multielement imaging coil arrays to achieve high temporal and high spatial resolution imaging. Volunteer and patient studies of the vasculature of the lower legs and feet have been performed. Temporal resolution of 4.9-6.5 sec and spatial resolution less than or equal to 1 mm in all directions allow for the depiction of progressive arterial filling and complex flow patterns as well as sharp visualization of vascular structure as small as the fine muscular branches. High-quality diagnostic imaging is made possible with CAPR's advanced acquisition and reconstruction techniques and the use of specialized coil arrays. PMID:21509813

  18. High Spatial and Temporal Resolution Imaging of the Arterial Vasculature of the Lower Extremity With Contrast Enhanced MR Angiography

    Science.gov (United States)

    MOSTARDI, PETRICE M.; HAIDER, CLIFTON R.; GLOCKNER, JAMES F.; YOUNG, PHILLIP M.; RIEDERER, STEPHEN J.

    2011-01-01

    Vascular imaging can be essential in the diagnosis, monitoring, and planning and assessment of treatment of patients with peripheral vascular disease. The purpose of this work is to describe a recently developed three-dimensional (3D) time-resolved contrast-enhanced MR angiography (CE-MRA) technique, Cartesian Acquisition with Projection Reconstruction-like sampling (CAPR), and its application to imaging of the vasculature of the lower legs and feet. CAPR implements accelerated imaging techniques and uses specialized multielement imaging coil arrays to achieve high temporal and high spatial resolution imaging. Volunteer and patient studies of the vasculature of the lower legs and feet have been performed. Temporal resolution of 4.9–6.5 sec and spatial resolution less than or equal to 1 mm in all directions allow for the depiction of progressive arterial filling and complex flow patterns as well as sharp visualization of vascular structure as small as the fine muscular branches. High-quality diagnostic imaging is made possible with CAPR’s advanced acquisition and reconstruction techniques and the use of specialized coil arrays. PMID:21509813

  19. Oxidation state of the lower mantle: In situ observations of the iron electronic configuration in bridgmanite at extreme conditions

    Science.gov (United States)

    Kupenko, I.; McCammon, C.; Sinmyo, R.; Cerantola, V.; Potapkin, V.; Chumakov, A. I.; Kantor, A.; Rüffer, R.; Dubrovinsky, L.

    2015-08-01

    We have investigated the electronic configuration of iron in Fe-, Al-containing magnesium silicate perovskite, i.e., bridgmanite, the main component of the lower mantle, at conditions of the deep Earth's interior using the energy domain Synchrotron Mössbauer Source technique. We show that the high ferric iron content observed previously in quenched samples is preserved at high temperatures and high pressures. Our data are consistent with high-spin to intermediate-spin (HS-IS) crossover in Fe2+ at high pressures and ambient temperature. We see no evidence of spin crossover in Fe3+ occupying the A-position of bridgmanite. On laser heating at pressures above ∼40 GPa we observe a new doublet with relative area below 5% which is assigned to Fe3+ in the octahedral (B-site) position in bridgmanite. We conclude that at lower mantle conditions Fe3+ remains predominantly in the HS state, while Fe2+ occurs solely in the IS state.

  20. Review of Modelling Techniques for In Vivo Muscle Force Estimation in the Lower Extremities during Strength Training

    OpenAIRE

    Florian Schellenberg; Katja Oberhofer; Taylor, William R.; Silvio Lorenzetti

    2015-01-01

    Background. Knowledge of the musculoskeletal loading conditions during strength training is essential for performance monitoring, injury prevention, rehabilitation, and training design. However, measuring muscle forces during exercise performance as a primary determinant of training efficacy and safety has remained challenging. Methods. In this paper we review existing computational techniques to determine muscle forces in the lower limbs during strength exercises in vivo and discuss their po...

  1. Effect of attending to a ball during a side-cut maneuver on lower extremity biomechanics in male and female athletes.

    Science.gov (United States)

    Fedie, Rebecca; Carlstedt, Kristen; Willson, John D; Kernozek, Thomas W

    2010-09-01

    Many sports associated with anterior cruciate ligament (ACL) injury require athletes attend to a ball during participation. We investigated effects of attending to a ball on lower extremity mechanics during a side-cut maneuver and if these effects are consistent for males and females. Sagittal and frontal plane hip and knee kinematics and joint moments were measured during side-cut maneuvers in 19 male and 19 female National Collegiate Athletic Association division III basketball players. Participants also experienced two side-cut conditions that required attention to a ball. Our results did not indicate that the effect of attention varies with gender. However, during side-cut conditions while attending to a ball, internal knee adductor moment was 20% greater (p = 0.03) and peak knee flexion angle was 4 degrees larger (p knee flexion (p knee abduction (p = 0.026) at initial contact during all side-cut conditions than males. Attention to a ball may affect lower extremity mechanics relevant to ACL injury. The validity of laboratory studies of lower extremity mechanics for sports that include attention to a ball may be increased if participants are required to attend to a ball during the task. PMID:21162362

  2. RARE PRESENTATION OF MELORHEOSTEOSIS INVOLVING CARPAL BONES

    OpenAIRE

    Ramana; Srinivas,; Reddy; Harshad; Guruvardhan

    2014-01-01

    Melorheostosis is a rare sclerosing bone dysplasia, known as Leri disease characterized by a “flowing” hyperostosis of the cortex. Classically, melorheostosis affects the long bones of the skeleton, especially those in the lower extremities . Involvement of wrist is rare. The radiographic appearance has been likened to “dripping wax down the side of a candle.” The clinical and the radiographic manifestations of melorheostosis have been encountered in a 12 - year ...

  3. 下肢毁损伤外科治疗的护理体会%Nursing experience on surgical treatment of lower extremity injury

    Institute of Scientific and Technical Information of China (English)

    王晓玲; 王秀娟

    2014-01-01

    目的:总结下肢毁损伤外科治疗的护理方法。方法:2011-2012年收治下肢毁损患者28例,分析其所采取的术前一般护理、心理护理,术后护理及VSD护理技术。结果:28例患者中26例保肢成功,2例截肢。结论:对下肢毁损伤患者的精心护理可提高保肢率,是外科治疗过程中的重要环节。%Objective:To summarize the nursing methods on surgical treatment of lower extremity injuries.Methods:28 cases with lower extremity mutilation were selected from 2011 to 2012.We analyzed their general nursing,psychological nursing before operation,the nursing after operation and VSD nursing technology.Results:Among 28 cases,26 cases were successful limb salvage;2 cases were amputation.Conclusion:Careful nursing on patients with lower extremity injuries can improve the rate of limb salvage. It is an important link in the process of surgery.

  4. One Case of Lower Extremity Leiomyosarcoma Take for Chronic Hematoma%下肢平滑肌肉瘤误为慢性血肿1例

    Institute of Scientific and Technical Information of China (English)

    杨智凯; 郭继阳; 李文正; 邱丰祥

    2015-01-01

    Objective 1 case of lower extremity leiomyosarcoma Take for chronic Hematoma was reported in this study.A 56 years old woman represented pain at left hip for half a year and activity dif iculty for 1 month because of fal . pelvic plain film,MRI scan and weighted imaging and three-phase whole bone scintigraphy al promoted chronic Hematoma and high probability of heterotopic ossification.The chest X-ray and whole body bone scan results showed no metastatic lesion. Thigh mass biopsy in conversional outpatient could not af irm the histologic origin due to little biopsy tissue samples. The mass detection biopsy and intraoperative frozen biopsy showed benign lesion. The malignancy was not excluded completely considering the absent of immunohistochemical result and it is essential to operate tumor wide excision. The results of pathology and immunohistochemistry after operation showed as fol ows:local dense spindle cel s were observed, epithelioid tumor cel s were arranged in beam,mitotic figures were commonly observed,stromal vessels were abundant,Bcl-2,CD34,CK 7,EMA and S 100 were negative,CK.Pan,Desmin and SMA were positive. This case accords with primary leiomyosarcoma.%本文报道1例下肢平滑肌肉瘤误为慢性血肿诊疗经过。56岁女性患者,摔伤致左髋部疼痛不适半年,酸胀伴活动费力1月。安排骨盆平片、骨盆核磁共振平扫及增强、3相核素全身骨扫描报告皆提示慢性血肿、因患者于半年前有明确摔伤情况,有高度怀疑异位骨化可能性。行肺部X光及全身骨扫描未见肺部转移病灶及全身骨转移病灶。常规门诊行大腿肿物穿刺活检,但因活检组织量过少,无法确定组织来源,入院后行肿物探查活检术,术中冰冻活检提示良性病变,考虑免疫组化结果未出,恶性肿瘤未能完全排除,积极行肿瘤广泛切除术。术后病理及免疫组化提示局部有致密的梭形细胞与上皮样细胞瘤细胞排列呈束状

  5. [Features of allele polymorphism of genes involved in homocysteine and folate metabolism in patients with atherosclerosis of the lower extremity arteries].

    Science.gov (United States)

    Klenkova, N A; Kapustin, S I; Saltykova, N B; Shmeleva, V M; Blinov, M N

    2009-01-01

    Under study were features of allele polymorphism of genes of methylenetetrahydrofolate reductase (MTHFR C677T and A1298C), methionine synthase (MS A 2756G), methionine synthase reductase (MTRR A66G) and methylenetetrahydrofolate dehydrogenase (MTHFD G1958A) in patients with atherosclerosis of the lower extremity arteries (ALEA). Patients with hyperhomocysteinemia (HHcy) had statistically significant increase of allele MTHFR 677T and MTRR 66GG as compared both with the control group and with the group of patients without HHcy. It suggests that polymorphism of genes involved in homocystein and folate metabolism might affect the risk of HHcy in patients with ALEA. PMID:20209990

  6. Clinical impact of 'true whole-body' 18F-FDG PET/CT. Lesion frequency and added benefit in distal lower extremities

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the lesion frequency and incremental added benefit with 'true whole-body' 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of distal lower extremities. We compared this field of view with the typical whole-body view, from head to upper thighs, in numerous patients with known or suspected malignancy. True whole-body 18F-FDG PET/CT, from the top of the head to the bottom of the feet, was performed on 4574 consecutively registered patients with known or suspected malignancy. Using a variable sampling method, the PET images of head and torso were acquired for 90 s per bed position, and the images of lower extremities were acquired for 30 s per position, thus requiring between 22 and 24 min of emission scanning per patient. A log was maintained to record cases of abnormal findings in distal lower extremities outside the typical whole-body field of view. Suspected malignant lesions in distal lower extremities were verified by correlation with pathological findings and clinical follow-up. Abnormal findings in distal lower extremities were found in 647 (14.1%; 95% CI 13.1-15.2%) of 4574 examinations. Increased FDG uptake was found in 559 examinations (12.2%; 95% CI 11.3-13.2%). Lesions appeared malignant or equivocal in 67 examinations (1.5%; 95% CI 1.1-1.8%) on the PET images. In 42 (0.9%; 95% CI 0.6-1.2%) of 4574 examinations, these lesions were pathologically or clinically proven to be malignant. Detection of these malignancies resulted in changing clinical management in 21 (50%) of 42 examinations. Definitive benign lesions were found in 492 examinations (10.7%; 95% CI 9.9-11.7%) on the PET images. Abnormal findings were noted in 90 examinations (2.0%; 95% CI 1.6-2.4%) consisting of 88 benign and 2 malignancies on the CT images alone. True whole-body 18F-FDG PET/CT was not of high yield and appears to offer little additional benefit, as to detection of additional metastases and

  7. Effect of Virtual Reality Exercise Using the Nintendo Wii Fit on Muscle Activities of the Trunk and Lower Extremities of Normal Adults

    OpenAIRE

    Park, Jungseo; Lee, Daehee; Lee, Sangyong

    2014-01-01

    [Purpose] The present study aimed to determine the effect of virtual reality exercise using the Nintendo Wii Fit on the muscle activities of the trunk and lower extremities of normal adults. [Subjects] The subjects of the study were 24 normal adults who were divided into a virtual reality exercise group (VREG, n=12) and a stable surface exercise group (SEG, n=12). [Methods] The exercises of the VREG using the Nintendo Wii Fit and the SEG using a stable surface were conducted three times a wee...

  8. Evaluation of Treadmill Exercise in a Lower Body Negative Pressure Chamber as a Countermeasure for Weightlessness-Induced Bone Loss: a Bed Rest Study with Identical Twins

    Science.gov (United States)

    Smith, Scott M.; Davis-Street, Janis E.; Fesperman, J. Vernell; Calkins, D. S.; Bawa, Maneesh; Macias, Brandon R.; Meyer, R. Scott; Hargens, Alan R.

    2003-01-01

    Counteracting bone loss is required for future space exploration. We evaluated the ability of treadmill exercise in a LBNP chamber to counteract bone loss in a 30-day bed rest study. Eight pairs of identical twins were randomly assigned to sedentary control or exercise groups. Exercise within LBNP decreased the bone resorption caused by bed rest and may provide a countermeasure for spaceflight. INTRODUCTION: Bone loss is one of the greatest physiological challenges for extended-duration space missions. The ability of exercise to counteract weightlessness-induced bone loss has been studied extensively, but to date, it has proven ineffective. We evaluated the effectiveness of a combination of two countermeasures-treadmill exercise while inside a lower body negative pressure (LBNP) chamber-on bone loss during a 30-day bed rest study. MATERIALS AND METHODS: Eight pairs of identical twins were randomized into sedentary (SED) or exercise/LBNP (EX/LBNP) groups. Blood and urine samples were collected before, several times during, and after the 30-day bed rest period. These samples were analyzed for markers of bone and calcium metabolism. Repeated measures ANOVA was used to determine statistical significance. Because identical twins were used, both time and group were treated as repeated variables. RESULTS: Markers of bone resorption were increased during bed rest in samples from sedentary subjects, including the collagen cross-links and serum and urinary calcium concentrations. For N-telopeptide and deoxypyridinoline, there were significant (p < 0.05) interactions between group (SED versus EX/LBNP) and phase of the study (sample collection point). Pyridinium cross-links were increased above pre-bed rest levels in both groups, but the EX/LBNP group had a smaller increase than the SED group. Markers of bone formation were unchanged by bed rest in both groups. CONCLUSIONS: These data show that this weight-bearing exercise combined with LBNP ameliorates some of the negative

  9. Timing of access to secondary healthcare services for diabetes management and lower extremity amputation in people with diabetes: a protocol of a case-control study.

    LENUS (Irish Health Repository)

    Buckley, Claire M

    2013-09-03

    Lower extremity amputation (LEA) is a complication of diabetes and a marker of the quality of diabetes care. Clinical and sociodemographic determinants of LEA in people with diabetes are well known. However, the role of service-related factors has been less well explored. Early referral to secondary healthcare is assumed to prevent the occurrence of LEA. The objective of this study is to investigate a possible association between the timing of patient access to secondary healthcare services for diabetes management, as a key marker of service-related factors, and LEA in patients with diabetes.

  10. The response of bone to unloading

    Science.gov (United States)

    Bikle, D. D.; Halloran, B. P.

    1999-01-01

    Skeletal unloading leads to decreased bone formation and decreased bone mass. Bone resorption is uncoupled from bone formation, contributing to the bone loss. During spaceflight bone is lost principally from the bones most loaded in the 1-g environment, and some redistribution of bone from the lower extremities to the head appears to take place. Although changes in calcitropic hormones have been demonstrated during skeletal unloading (PTH and 1,25(OH)2D decrease), it remains unclear whether such changes account for or are in response to the changes in bone formation and resorption. Bed rest studies with human volunteers and hindlimb elevation studies with rats have provided useful data to help explain the changes in bone formation during spaceflight. These models of skeletal unloading reproduce a number of the conditions associated with microgravity, and the findings from such studies confirm many of the observations made during spaceflight. Determining the mechanism(s) by which loading of bone is sensed and translated into a signal(s) controlling bone formation remains the holy grail in this field. Such investigations couple biophysics to biochemistry to cell and molecular biology. Although studies with cell cultures have revealed biochemical responses to mechanical loads comparable to that seen in intact bone, it seems likely that matrix-cell interactions underlie much of the mechanocoupling. The role for systemic hormones such as PTH, GH, and 1,25(OH)2D compared to locally produced factors such as IGF-I, PTHrP, BMPs, and TGF-beta in modulating the cellular response to load remains unclear. As the mechanism(s) by which bone responds to mechanical load with increased bone formation are further elucidated, applications of this knowledge to other etiologies of osteoporosis are likely to develop. Skeletal unloading provides a perturbation in bone mineral homeostasis that can be used to understand the mechanisms by which bone mineral homeostasis is maintained, with

  11. What Is Safe Limit of the Perforator Flap in Lower Extremity Reconstruction? Do We Have Answers Yet?

    Directory of Open Access Journals (Sweden)

    Nikhil S. Panse

    2011-01-01

    Full Text Available We make an attempt to define the safe extent of local perforator flap for lower limb reconstruction by comparing it with the limb length of the patient. The maximum flap length from the perforator was compared to the limb length in 35 patients using EPI info 6.04 D software. On comparison of flaps that were less than one-third of limb length to those which were more than one-third of limb length, the statistical values were significant. The odds ratio calculated was 6, which means that there is a six times more chance that a local perforator flap will necrose if it is more than one-third of the limb length as compared to a flap which is less than one-third of the limb length.

  12. Lower extremity compartment syndrome in the setting of iliofemoral deep vein thrombosis, phlegmasia cerulea dolens and factor VII deficiency.

    Science.gov (United States)

    Abdul, Wahid; Hickey, Ben; Wilson, Chris

    2016-01-01

    Acute compartment syndrome requires urgent fasciotomies to prevent irreversible muscle damage. We present a case of massive iliofemoral deep vein thrombosis (DVT) presenting as acute compartment syndrome. A healthy 21-year-old man presented with a 2-day history of worsening left leg pain with swelling and bluish discolouration. Clinical diagnosis of compartment syndrome secondary to phlegmasia cerulea dolens (PCD) was made and he underwent emergency fasciotomies. Postoperative venous duplex confirmed a massive iliofemoral DVT and intravenous heparin was started. Following skin grafting, the patient made a good recovery. Massive iliofemoral DVT is an uncommon cause of compartment syndrome and has been reported in lower limbs, secondary to PCD. Failure to treat early carries a high degree of morbidity, with amputation rates up to 50% and mortality rates between 25% and 40%. It is important to recognise compartment syndrome as an acute presentation of PCD. Urgent fasciotomies can prevent limb amputation and mortality. PMID:27113791

  13. [The application of the method of kinesio-taping technique for the combined non-pharmacological rehabilitation of the patients presenting with lymphedema of the lower extremities].

    Science.gov (United States)

    Gerasimenko, M Yu; Knyazeva, T A; Apkhanova, T V; Kul'Chitskaya, D B

    2015-01-01

    Based on the innovative "kinesio-taping" technique proposed by the Japanese researcher Kenzo Kace, we have designed a new physiotherapeutic complex including the well-known physiotherapeutic methods of lymphatic drainage with intermittent pneumatic compression and underwater massage shower. The objective of our study was to evaluate the efficiency of the application of the "kinesio-taping" technique for the non-pharmacological rehabilitative treatment of the patients presenting with stage I-III lymphedema of the lower sextremities. The secondary objective was to evaluate the possibility of correction of endothelial dysfunction in the patients with lymphedema after the application of the "kinesio-taping" technique. The study included 30 patients with stage I-III lymphedema of the lower extremities randomized into two groups. Group 1 was comprised of 15 patients who were consistently treated by a combination of intermittent pneumatic compression, "akinesio-taping", and underwater massage shower. Group 2 contained 15 patients treated with the use of intermittent pneumatic compression and underwater massage shower. The results of study give evidence of positive changes in microcirculation of the patients comprising group 1 that suggest the improvement of endothelial function, vasodilation of precapillaries, enhancement of the blood flow in the microcirculatory system, and reduction of the influence of the ineffective shunting blood flow. The data obtained confirm the effectiveness of the new non-pharmacological rehabilitation complex that includes the innovative lymph-draining method of kinesio-taping, intermittent pneumatic compression and underwater massage shower for the treatment of patients with lymphedema of the lower extremities. The effectiveness of this complex is due to combined stimulation of the lymphatic and venous drainage systems and coupled to the stimulation of blood flow in the microcirculatory bed and the formation of a positive endothelial response

  14. Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis in the treatment of symptomatic lower extremity deep venous thrombosis

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy of percutaneous mechanical thrombectomy (PMT) combined with catheter-directed thrombolysis (CDT) in the treatment of massive symptomatic lower limb deep venous thrombosis (DVT). Materials and methods: One hundred and three clinically confirmed DVT patients were discharged from our institution. Sixteen patients with massive lower limb DVT were included in this retrospective study. After prophylactic placement of inferior vena cava filters (IVCFs), percutaneous mechanical thrombectomy (ATD, n = 10; Straub, n = 6) and catheter-directed thrombolysis were performed in all patients. Complementary therapy included percutaneous transluminal venous angioplasty (PTA, n = 3) and stent placement (n = 1). The doses of thrombolytic agents, length of hospital stay, peri-procedure complications and discharge status were reviewed. Oral anticoagulation was continued for at least 6 months during follow-up. Results: The average hospital stay was 7 days. The technical success rate (complete and partial lysis of clot) was 89%, the other 11% patients only achieved less than 50% clot lysis. The mean dose of urokinase was 3.3 million IU. There were no significant differences of clinical outcome between the ATD and Straub catheter group. The only major complication was an elderly male who experienced a fatal intracranial hemorrhage while still in the hospital (0.97%, 1/103). Minor complications consisted of three instances of subcutaneous bleeding. No transfusions were required. Vascular patency was achieved in 12 limbs during follow-up. No pulmonary emboli occurred. There is one recurrent DVT 4.5 months after the treatment. Conclusions: Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis is an effective and safe method for the treatment of symptomatic DVT. A randomized prospective study is warranted.

  15. Use of sup(99m)technetium-pyrophosphate scintiscanning to determine the optimum amputation height in cases of arterial occlusion at the lower extremity

    International Nuclear Information System (INIS)

    This work investigates whether sup(99m)Tc-pyrophosphate scintiscanning is a suitable method to determine the optimum amputation height in cases of peripheral arterial occlusive disease. 10 patients were examined who had to be amputated between 1979 and 1981 for advanced arterial occlusive disease at the lower extremity. Throughout, the scintigraphic results and height of successful amputations were found to be in accordance. The amputation plane was chosen in the zone above the highest sup(99m)Tc-PYP accumulation. The advantages of scintiscanning are presented. (orig./MG)

  16. Interventional therapy for arterial occlusive disease of lower extremity in patients with diabetes: an analysis of therapeutic results

    International Nuclear Information System (INIS)

    Objective: To discuss the feasibility and outcomes of interventional therapy for peripheral arterial occlusive disease (PAOD) in patients with diabetes. Methods: During the period of 2006-2009 a total of 80 interventional procedures were performed in 63 diabetes patients who suffered from intermittent claudication or severe ischemia of lower limb. Forty-six patients received a single interventional procedure and the other seventeen patients received the treatment two times. The clinical data, including complications and outcomes, were retrospectively analyzed. The therapeutic means included PTA alone and PTA together with arterial stenting. The treated arteries included iliac (17.6%), femoral (42.4%), popliteal (23.5%) and tibial artery (16.5%). Based on the ultrasonographic re-examination findings the arterial patent rate was determined with Kaplan-Meier method. The mean follow-up time was 21.9 months (ranged from 6 to 36 months). Results: The mean age was 71.4 years and 57.3% were males. Hypertension was accompanied in 37 patients (58.7%), and coronary artery disease in 19 patients (30.4%). In 52.2% of patients there was a history of cigarette smoking. The technical success rate of interventional procedure was 97.8% (45/46). No death occurred within 30 days after the treatment. Ankle brachial index was increased from 0.397±0.136 before operation to 0.783±0.134 after operation, with P<0.001. The initial arterial patency at 6, 12, 242 and 36 months was 84.4%, 57.9%, 49.8% and 40.7% respectively, while the corresponding secondary arterial patency was 91.1%, 79.1%, 65.7% and 54.1% respectively (P<0.01). At 6, 12, 24 and 36 months, the limb-salvage rate was 93.3%, 86%, 83.3% and 83.3% in patients with limb-threatening conditions. Conclusion: Percutaneous interventional revascularization management is a micro-invasive treatment for peripheral arterial occlusive disease in diabetes patients. This techniaue carries low risk of morbidity and mortality and fewer

  17. Gadolinium-enhanced MR angiography of the lower extremity arteries with an automated table-feed technique

    International Nuclear Information System (INIS)

    Purpose: To evaluate contrast enhanced magnetic resonance angiography (ceMRA) with an automated table-feed technique in patients with arterio-occlusive disease for imaging of the pelvic and peripheral arteries. Methods: Twenty-two patients underwent three-dimensional gadolinium-enhanced MR angio-graphy in a three-step automatic table-feed technique on a Magnetom Symphony operating at 1.5 Tesla. Maximum intensity projection images (MIP) were generated from the subtracted and original studies. Image quality and venous contrast were evaluated by two groups of observers. 304 vessels (17 patients) were compared with DSA as the standard of reference. Results: All examinations were performed without any technical problems. Diagnostic quality of the MIP of subtracted data sets was superior to that of the unsubtracted images. Venous overlay was 61% in the lower leg. In a total of 599 observations, a sensitivity of 96% (95%, 82%) and a specificity of 87% (88%, 99%) were high compared to DSA in the detection of significant stenoses ≥50% (≥75%, occlusions). Interobserver correlation was good (linear correlation 0.9). Conclusion: Stepping-table digital subtraction contrast enhanced MRA is a promising technique in the diagnosis of peripheral arterio-occlusive disease. (orig.)

  18. Home-based Exercise on Functional Outcome of the Donor Lower Extremity in Oral Cancer Patients after Fibula Flap Harvest

    Directory of Open Access Journals (Sweden)

    Ting-Yuan Liu

    2013-04-01

    Full Text Available Background: After harvesting the fibula flap, pain, sensory disturbance, weakness of donor leg, reduced walking endurance, ankle instability, and lower walking speed had been reported. The aim of this study was to quantitatively assess functional outcome of regular home-based exercise on donor ankle strength, endurance, and walking ability after free fibula flap for mandibular reconstruction. Methods: Fourteen patients were recruited. Objective isokinetic testing and a 6-min walk test (6MWT were used to evaluate ankle strength/endurance and walking ability, respectively. Results: There was a significant increase in the peak torque of ankle dorsiflexion/foot inversion of the healthy leg and ankle dorsiflexion/foot eversion of the donor leg after exercise (p < 0.05. After home-based exercise, there was reduced asymmetry in the peak torques of ankle dorsiflexion and foot eversion and the total work of foot eversion between the donor and healthy legs. In 6MWT, no significant difference was found between the walking distances before and after exercise. Conclusion: Regular home-based exercise could improve the strength of ankle dorsiflexion and foot eversion of the donor leg, and get more symmetric ankle motor function between the donor and healthy legs.

  19. Anatomic variation of the deep venous system and its relationship with deep vein thrombosis found on the lower extremity venograms that were obtained after artificial joint replacements

    International Nuclear Information System (INIS)

    We wanted to evaluate the anatomic variations, the number of valves and the presence of deep vein thrombosis (DVT) on the lower extremity venograms obtained after artificial joint replacements, and we also wanted to determine the correlation of the incidence of DVT with the above-mentioned factors and the operation sites. From January to June 2004, conventional ascending contrast venographies of the lower extremities were performed in 119 patients at 7-10 days after artificial joint replacement, and all the patients were asymptomatic. Total knee replacement was done for 152 cases and total hip replacement was done for 34 cases. On all the venographic images of 186 limbs, the anatomic variations were classified and the presence of DVT was evaluated; the number of valves in the superficial femoral vein (SFV) and calf veins was counted. The sites of DVT were classified as calf, thigh and pelvis. Statistically, chi square tests and Fischer's exact tests were performed to determine the correlation of the incidence of DVT with the anatomic variations, the numbers of valves and the operation sites. Theoretically, there are 9 types of anatomical variation in the deep vein system of the lower extremity that can be classified, but only 7 types were observed in this study. The most frequent type was the normal single SFV type and this was noted in 117 cases (63%), and the others were all variations (69 cases, 37%). There was a 22.2% incidence of DVT (69 cases) in the normal single SFV type and 26.4% (17 cases) in the other variations. No significant difference was noted in the incidences of DVT between the two groups. In addition, no significant statistical differences were noted for the incidences of DVT between the single or variant multiple veins in the SFV and the popliteal vein (PV) respectively, between the different groups with small or large numbers of valves in the thigh and calf, respectively, and also between the different operation sites of the hip or knee

  20. The Relationship Between Lower Limb Bone and Muscle in Military Recruits, Response to Physical Training, and Influence of Smoking Status

    OpenAIRE

    Puthucheary, Z; Kordi, M.; Rawal, J.; Eleftheriou, K I; Payne, J.; Montgomery, H. E.

    2015-01-01

    The relationship between bone and skeletal muscle mass may be affected by physical training. No studies have prospectively examined the bone and skeletal muscle responses to a short controlled exercise-training programme. We hypothesised that a short exercise-training period would affect muscle and bone mass together. Methods: Femoral bone and Rectus femoris Volumes (RFVOL) were determined by magnetic resonance imaging in 215 healthy army recruits, and bone mineral density (BMD) by Dual X-Ray...

  1. Predictive factors for lower extremity amputations in diabetic foot infections

    Directory of Open Access Journals (Sweden)

    Zameer Aziz

    2011-09-01

    Full Text Available The objective of this study was to evaluate the epidemiology of diabetic foot infections (DFIs and its predictive factors for lower extremity amputations. A prospective study of 100 patients with DFIs treated at the National University Hospital of Singapore were recruited in the study during the period of January 2005–June 2005. A protocol was designed to document patient's demographics, type of DFI, presence of neuropathy and/or vasculopathy and its final outcome. Predictive factors for limb loss were determined using univariate and stepwise logistic regression analysis. The mean age of the study population was 59.8 years with a male to female ratio of about 1:1 and with a mean follow-up duration of about 24 months. All patients had type 2 diabetes mellitus. Common DFIs included abscess (32%, wet gangrene (29%, infected ulcers (19%, osteomyelitis (13%, necrotizing fasciitis (4% and cellulitis (3%. Thirteen patients were treated conservatively, while surgical debridement or distal amputation was performed in 59 patients. Twenty-eight patients had major amputations (below or above knee performed. Forty-eight percent had monomicrobial infections compared with 52% with polymicrobial infections. The most common pathogens found in all infections (both monomicrobial and polymicrobial were Staphylococcus aureus (39.7%, Bacteroides fragilis (30.3%, Pseudomonas aeruginosa (26.0% and Streptococcus agalactiae (21.0%. Significant univariate predictive factors for limb loss included age above 60 years, gangrene, ankle-brachial index (ABI <0.8, monomicrobial infections, white blood cell (WBC count ≥ 15.0×109/L, erythrocyte sedimentation rate ≥100 mm/hr, C-reactive protein ≥15.0 mg/dL, hemoglobin (Hb ≤10.0g/dL and creatinine ≥150 µmol/L. Upon stepwise logistic regression, only gangrene, ABI <0.8, WBC ≥ 15.0×109/L and Hb ≤10.0g/dL were significant.

  2. A novel mouse model of human breast cancer stem-like cells with high CD44+CD24-/lower phenotype metastasis to human bone

    Institute of Scientific and Technical Information of China (English)

    LING Li-jun; WANG Feng; WANG Shui; LIU Xiao-an; SHEN En-chao; DING Qiang; LU Chao; XU Jian; CAO Qin-hong; ZHU Hai-qing

    2008-01-01

    Background A satisfactory animal model of breast cancer metastasizing to bone is unavailable. In this study, we used human breast cancer stem-like cells and human bone to build a novel "human-source" model of human breast cancer skeletal metastasis.Methods Human breast cancer stem-like cells, the CD44+/CD24-/lower subpopulation, was separated and cultured. Before injection with the stem-like cells, mice were implanted with human bone in the right or left dorsal flanks. Animals in Groups A, B, and C were injected with 1x105, 1x106 human breast cancer stem-like cells, and 1x106 parental MDA-MB-231 cells, respectively. A positive control group (D) without implantation of human bone was also injected with 1x106 MDA-MB-231 cells. Immunohistochemistry was performed for determination of CD34, CD105, smooth muscle antibody, CD44, CD24, cytokine, CXC chemokine receptor-4 (CXCR4), and osteopontin (OPN). mRNA levels of CD44, CD24, CXCR4, and OPN in bone metastasis tissues were analyzed by real-time quantitative polymerase chain reaction (PCR). Results Our results demonstrated that cells in implanted human bones of group B, which received 1x106 cancer stem-like cells, stained strongly positive for CD44, CXCR4, and OPN, whereas those of other groups showed no or minimum staining. Moreover, group B had the highest incidence of human bone metastasis (77.8%, P=0.0230) and no accompaniment of other tissue metastasis. The real-time PCR showed an increase of CD44, CXCR4, and OPN mRNA in metastatic bone tissues in group B compared with those of groups C and D, however the expression of CD24 mRNA in group B were the lowest. Conclusions In the novel "human source" model of breast cancer, breast cancer stem-like cells demonstrated a higher human bone-seeking ability. Its mechanism might be related to the higher expressions of CD44, CXCR4, and OPN, and the lower expression of CD24 in breast cancer stem-like cells.

  3. Review of Modelling Techniques for In Vivo Muscle Force Estimation in the Lower Extremities during Strength Training

    Directory of Open Access Journals (Sweden)

    Florian Schellenberg

    2015-01-01

    Full Text Available Background. Knowledge of the musculoskeletal loading conditions during strength training is essential for performance monitoring, injury prevention, rehabilitation, and training design. However, measuring muscle forces during exercise performance as a primary determinant of training efficacy and safety has remained challenging. Methods. In this paper we review existing computational techniques to determine muscle forces in the lower limbs during strength exercises in vivo and discuss their potential for uptake into sports training and rehabilitation. Results. Muscle forces during exercise performance have almost exclusively been analysed using so-called forward dynamics simulations, inverse dynamics techniques, or alternative methods. Musculoskeletal models based on forward dynamics analyses have led to considerable new insights into muscular coordination, strength, and power during dynamic ballistic movement activities, resulting in, for example, improved techniques for optimal performance of the squat jump, while quasi-static inverse dynamics optimisation and EMG-driven modelling have helped to provide an understanding of low-speed exercises. Conclusion. The present review introduces the different computational techniques and outlines their advantages and disadvantages for the informed usage by nonexperts. With sufficient validation and widespread application, muscle force calculations during strength exercises in vivo are expected to provide biomechanically based evidence for clinicians and therapists to evaluate and improve training guidelines.

  4. Effect of nordic walking and water aerobics training on body composition and the blood flow in lower extremities in elderly women.

    Science.gov (United States)

    Jasiński, Ryszard; Socha, Małgorzata; Sitko, Ludmiła; Kubicka, Katarzyna; Woźniewski, Marek; Sobiech, Krzysztof A

    2015-03-29

    Nordic walking and water aerobics are very popular forms of physical activity in the elderly population. The aim of the study was to evaluate the influence of regular health training on the venous blood flow in lower extremities and body composition in women over 50 years old. Twenty-four women of mean age 57.9 (± 3.43) years, randomly divided into three groups (Nordic walking, water aerobics, and non-training), participated in the study. The training lasted 8 weeks, with one-hour sessions twice a week. Dietary habits were not changed. Before and after training vein refilling time and the function of the venous pump of the lower extremities were measured by photoplethysmography. Body composition was determined by bioelectrical impedance. Eight weeks of Nordic walking training improved the venous blood flow in lower extremities and normalized body composition in the direction of reducing chronic venous disorder risk factors. The average values of the refilling time variable (p = 0.04, p = 0.02, respectively) decreased in both the right and the left leg. After training a statistically significant increase in the venous pump function index was found only in the right leg (p = 0.04). A significant increase in fat-free mass, body cell mass and total body water was observed (p = 0.01), whereas body mass, the body mass index, and body fat decreased (p < 0.03). With regard to water aerobic training, no similar changes in the functions of the venous system or body composition were observed. PMID:25964815

  5. Effect of Nordic Walking and Water Aerobics Training on Body Composition and the Blood Flow in Lower Extremities in Elderly Women

    Directory of Open Access Journals (Sweden)

    Jasiński Ryszard

    2015-03-01

    Full Text Available Nordic walking and water aerobics are very popular forms of physical activity in the elderly population. The aim of the study was to evaluate the influence of regular health training on the venous blood flow in lower extremities and body composition in women over 50 years old. Twenty-four women of mean age 57.9 (± 3.43 years, randomly divided into three groups (Nordic walking, water aerobics, and non-training, participated in the study. The training lasted 8 weeks, with one-hour sessions twice a week. Dietary habits were not changed. Before and after training vein refilling time and the function of the venous pump of the lower extremities were measured by photoplethysmography. Body composition was determined by bioelectrical impedance. Eight weeks of Nordic walking training improved the venous blood flow in lower extremities and normalized body composition in the direction of reducing chronic venous disorder risk factors. The average values of the refilling time variable (p = 0.04, p = 0.02, respectively decreased in both the right and the left leg. After training a statistically significant increase in the venous pump function index was found only in the right leg (p = 0.04. A significant increase in fat-free mass, body cell mass and total body water was observed (p = 0.01, whereas body mass, the body mass index, and body fat decreased (p < 0.03. With regard to water aerobic training, no similar changes in the functions of the venous system or body composition were observed.

  6. Effect of Nordic Walking and Water Aerobics Training on Body Composition and the Blood Flow in Lower Extremities in Elderly Women

    OpenAIRE

    Jasiński Ryszard; Socha Małgorzata; Sitko Ludmiła; Kubicka Katarzyna; Woźniewski Marek; Sobiech Krzysztof A.

    2015-01-01

    Nordic walking and water aerobics are very popular forms of physical activity in the elderly population. The aim of the study was to evaluate the influence of regular health training on the venous blood flow in lower extremities and body composition in women over 50 years old. Twenty-four women of mean age 57.9 (± 3.43) years, randomly divided into three groups (Nordic walking, water aerobics, and non-training), participated in the study. The training lasted 8 weeks, with one-hour sessions tw...

  7. Soft tissue sarcomas of the distal lower extremities: A single-institutional analysis of the prognostic significance of surgical margins in 120 patients.

    Science.gov (United States)

    Harati, Kamran; Kirchhoff, Pascal; Behr, Björn; Daigeler, Adrien; Goertz, Ole; Hirsch, Tobias; Lehnhardt, Marcus; Ring, Andrej

    2016-08-01

    Soft tissue sarcomas (STS) arising in the distal lower extremities pose a therapeutic challenge due to concerns of functional morbidity. The impact of surgical margins on local recurrence‑free survival (LRFS) and overall survival (OS) still remains controversial. The aim of this study was to identify prognostic indicators of survival and functional outcome in patients with STS of the distal lower extremities through a long‑term follow‑up. Between 1999 and 2014, 120 patients with STS of the foot, ankle and lower leg were treated surgically at our institution. The median follow‑up was 6.3 years. The results reveal that the 5‑year estimate of the OS rate was 80.0% [95% confidence interval (CI): 69.6‑87.1] for the entire series. Surgical margins attained at the resection of the primary tumor did not influence OS significantly [5‑year OS: R0 80.5% (69.7‑87.9) vs. R1 74.1% (28.9‑93.0); P=0.318]. Within the R0 subgroup, negative surgical margin widths ≤1 and >1 mm led to similar outcomes, as well as ≤5 and >5 mm, respectively. In the multivariate analysis, significant adverse prognostic features included male gender and age >60 years at the time point of primary diagnosis. In conclusion, the data from this study could not underscore the long‑term benefit of negative margins achieved at the resection of the primary tumor. Surgical efforts should aim at function‑sparing resections when feasible with negative margins. Here, close negative margins seem to be adequate. PMID:27278861

  8. Feasibility and outcomes of a classical Pilates program on lower extremity strength, posture, balance, gait, and quality of life in someone with impairments due to a stroke.

    Science.gov (United States)

    Shea, Sarah; Moriello, Gabriele

    2014-07-01

    Pilates is a method that can potentially be used for stroke rehabilitation to address impairments in gait, balance, strength, and posture. The purpose of this case report was to document the feasibility of using Pilates and to describe outcomes of a 9-month program on lower extremity strength, balance, posture, gait, and quality of life in an individual with stroke. The participant was taught Pilates exercises up to two times per week for nine months in addition to traditional rehabilitation in the United States. Outcomes were assessed using the Berg Balance Scale (BBS), Stroke Impact Scale (SIS), GAITRite System(®), 5 repetition sit-to-stand test (STST), and flexicurve. Improvements were found in balance, lower extremity strength, and quality of life. Posture and gait speed remained the same. While these changes cannot be specifically attributed to the intervention, Pilates may have added to his overall rehabilitation program and with some modifications was feasible to use in someone with a stroke. PMID:25042304

  9. Preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty for the treatment of chronic occlusive arterial disorders of lower extremities

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and efficacy of preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty in treating chronic occlusive arterial disorders of lower extremities. Methods: From January 2008 to December 2009, preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty was performed in 12 patients with chronic occlusive arterial disorders of lower extremities, including 8 males and 4 females with an average age of 56.3 years (within a range of 38-71 years). All 12 patients had a history of chronic ischemia of lower limb,the mean ill duration was 19.3 months (3-48 months). All patients complained of intermittent claudication with a mean distance of 125 m (50-200 m). Rest pain occurred in 5 patients (42%), toe necrosis was seen in 3 patients (25%) and critically ischemic limb in 4 patients (33%). Ankle-brachial index (ABI) was 0.00 0.65 with a mean of 0.33. In all 12 patients catheter-directed thrombolysis with rt-PA or urokinase was initially carried out, which was followed by endovascular angioplasty (balloon dilatation or stent placement) in two days. The clinical data and the therapeutic results were analyzed. Results: Technical success was achieved in all 12 patients. The mean time of thrombolysis was 48 hours. Of 12 patients, rt-PA was employed in 4 and urokinase in 8. The occluded length of the diseased arteries before the treatment was 60-150 mm, with a mean of 80 mm. After catheter-directed thrombolysis,the occluded length decreased to 10-50 mm (mean of 30 mm). Endovascular angioplasty was successfully completed in all patients after thrombolysis therapy. Postoperative ABI was 0.64-1.0 (mean of 0.86), which was increased by 0.53 when compared to the preoperative figure. During the perioperative period neither complications needed to be surgically treated nor death occurred. All patients were followed up, and the arteries remained open after one year in all cases. Conclusion

  10. Virtual CT morphometry of lower limb long bones for estimation of the sex and stature using postmortem Japanese adult data in forensic identification.

    Science.gov (United States)

    Hishmat, Asmaa Mohammed; Michiue, Tomomi; Sogawa, Nozomi; Oritani, Shigeki; Ishikawa, Takaki; Fawzy, Irene Atef; Hashem, Mohamed Abdel Mohsen; Maeda, Hitoshi

    2015-09-01

    The application of computed tomography (CT) is useful for the documentation of whole-body anatomical data on routine autopsy, virtual reconstruction of skeletal structure, objective measurements, and reassessment by repetitive analyses. In addition, CT data processing facilitates volumetric and radiographic density analyses. Furthermore, a recently developed automated analysis system markedly improved the performance and accuracy of three-dimensional (3D) reconstruction. The present study investigated virtual CT morphometry of lower limb long bones, including the femur, tibia, fibula, and first metatarsus, to estimate the sex and stature using postmortem CT data of forensic autopsy cases of Japanese over 19 years of age (total n = 259, 150 males and 109 females). Bone mass volumes, lengths, and total CT attenuation values of bilateral femurs, tibias, and fibulas correlated with the stature; however, the mean CT attenuation (HU) values showed age-dependent decreases. Correlations with the stature were similar for the lengths and mass volumes of the femur, tibia, and fibula (r = 0.77-0.85) but were higher for the mass volume of the first metatarsus (r = 0.77 for right and r = 0.58 for left). In addition, the ratio of the bone volume to the length of each bone showed the most significant sex-related differences (males > females with accuracy of 75.8-98.1 %). These findings indicate the usefulness of virtual CT morphometry of individual lower limb long bones, including volumetry, to estimate the sex and stature in identification. PMID:26156452

  11. Dual-energy imaging of bone marrow edema on a dedicated multi-source cone-beam CT system for the extremities

    Science.gov (United States)

    Zbijewski, W.; Sisniega, A.; Stayman, J. W.; Thawait, G.; Packard, N.; Yorkston, J.; Demehri, S.; Fritz, J.; Siewerdsen, J. H.

    2015-03-01

    Purpose: Arthritis and bone trauma are often accompanied by bone marrow edema (BME). BME is challenging to detect in CT due to the overlaying trabecular structure but can be visualized using dual-energy (DE) techniques to discriminate water and fat. We investigate the feasibility of DE imaging of BME on a dedicated flat-panel detector (FPD) extremities cone-beam CT (CBCT) with a unique x-ray tube with three longitudinally mounted sources. Methods: Simulations involved a digital BME knee phantom imaged with a 60 kVp low-energy beam (LE) and 105 kVp high-energy beam (HE) (+0.25 mm Ag filter). Experiments were also performed on a test-bench with a Varian 4030CB FPD using the same beam energies as the simulation study. A three-source configuration was implemented with x-ray sources distributed along the longitudinal axis and DE CBCT acquisition in which the superior and inferior sources operate at HE (and collect half of the projection angles each) and the central source operates at LE. Three-source DE CBCT was compared to a double-scan, single-source orbit. Experiments were performed with a wrist phantom containing a 50 mg/ml densitometry insert submerged in alcohol (simulating fat) with drilled trabeculae down to ~1 mm to emulate the trabecular matrix. Reconstruction-based three-material decomposition of fat, soft tissue, and bone was performed. Results: For a low-dose scan (36 mAs in the HE and LE data), DE CBCT achieved combined accuracy of ~0.80 for a pattern of BME spherical lesions ranging 2.5 - 10 mm diameter in the knee phantom. The accuracy increased to ~0.90 for a 360 mAs scan. Excellent DE discrimination of the base materials was achieved in the experiments. Approximately 80% of the alcohol (fat) voxels in the trabecular phantom was properly identified both for single and 3-source acquisitions, indicating the ability to detect edemous tissue (water-equivalent plastic in the body of the densitometry insert) from the fat inside the trabecular matrix

  12. Observation and nursing of complications due to high re-perfusion injury occurring after balloon angioplasty for diabetic vascular diseases of lower extremity

    International Nuclear Information System (INIS)

    Objective: To evaluate the symptomatic nursing in treating the complications caused by high re-perfusion which develops after balloon angioplasty for the treatment of diabetic vascular diseases of lower extremity. Methods: Eighteen patients with lower limb ischemia caused by diabetes mellitus developed high re-perfusion injury complications after receiving balloon angioplasty. The patients were randomly and equally divided into study group and control group. The special nursing measures designed by the author's department, including raising the diseased lower limb, enforcing the flexion and extension movement of the leg, cold compress, wound exposure, etc. were carried out for patients of study group, while no special nursing measures were adopted for patients of control group. The clinical results, such as limb pain, swelling and subcutaneous petechia after re-perfusion injury, were evaluated and compared between two groups. Results: After the treatment, the limb pain, swelling and subcutaneous petechia due to high re-perfusion injury in study group were relieved more markedly than that in control group, the difference in evaluation score between two groups was statistically significant (P<0.01). Conclusion: The special symptomatic nursing measures are very effective in relieving the high re-perfusion injury after balloon angioplasty for the treatment of diabetic lower limb ischemia. (authors)

  13. Relationship between Serum 25-Hydroxyvitamin D and Lower Extremity Arterial Disease in Type 2 Diabetes Mellitus Patients and the Analysis of the Intervention of Vitamin D

    Directory of Open Access Journals (Sweden)

    Wan Zhou

    2015-01-01

    Full Text Available The aim of this study was to explore the relationship between serum 25-hydroxyvitamin D [25(OHD] concentrations and lower extremity arterial disease (LEAD in type 2 diabetes mellitus (T2DM patients and to investigate the intervention effect of vitamin D. 145 subjects were assigned to a control group (Group NC, T2DM group (Group DM1, and T2DM complicated with LEAD group (Group DM2; then Group DM2 were randomly divided into Group DM3 who received oral hypoglycemic agents and Group DM4 who received oral hypoglycemic drugs and vitamin D3 therapy. Compared to Group NC, 25(OHD was significantly lower in Group DM2 and marginally lower in Group DM1. In contrast to baseline and Group DM3, 25(OHD rose while low density lipoprotein (LDL, retinol binding protein 4 (RBP4, and HbA1c significantly lowered in Group DM4. Statistical analysis revealed that 25(OHD had a negative correlation with RBP4, duration, HbA1c, homeostasis model assessment for insulin resistance (HOMA-IR, and fasting plasma glucose (FPG. LDL, systolic blood pressure (SBP, FPG, and smoking were risk factors of LEAD while high density lipoprotein (HDL and 25(OHD were protective ones. Therefore, we deduced that low level of 25(OHD is significantly associated with the occurrence of T2DM complicated with LEAD.

  14. [Improvement of approach to performance of lumbar sympathetic blockade in patients with tissue ischemia of the lower extremities].

    Science.gov (United States)

    Panov, V M; Fesenko, U A; Kutsyn, V M

    2014-06-01

    New access for performance of sympathic blockade in region of aortal bifurcation, was elaborated, basing on calculations, conducted on 30 spiral computeric tomograms of lumbar and sacral parts of vertebral column. Application of the method permits to escape such complications, as a renal and the main vessels damage, the sympathetic nerves blockade, do not demand roentgenological control. PMID:25252554

  15. Catastrophic impact of extreme flood events on the morphology and evolution of the lower Jökulsá á Fjöllum (northeast Iceland) during the Holocene

    Science.gov (United States)

    Baynes, Edwin R. C.; Attal, Mikaël; Dugmore, Andrew J.; Kirstein, Linda A.; Whaler, Kathryn A.

    2015-12-01

    The impact of extreme flood events is rarely considered in studies of long-term landscape evolution, despite the potential for catastrophic landscape change in a short period of time. Here, we use an integrated approach of geomorphological mapping, topographic analysis and geophysical surveys to identify and quantify the impact of extreme flood events (jökulhlaups) along the Jökulsá á Fjöllum, Iceland, where evidence for the action of such floods is widespread on microspatial to macrospatial scales. The apex of the 28-km-long Jökulsárgljúfur canyon is characterised by a complex network of palaeo-flood channels and large vertical knickpoints such as Dettifoss (54 m high) and Hafragilsfoss (20 m high). Downstream, the Forvoð valley contains large terraces of boulder-rich deposits (50 m thick, > 3 km long). Near the outlet of the canyon is Ásbyrgi, a dry canyon (3 km long, 1 km wide, up to 90 m deep) with eroded cataracts and scabland morphology immediately upstream and ~ 90 m above the current river channel. Topographic analysis and electrical resistivity tomography surveys show that 0.144 km3 of rock was eroded from Ásbyrgi during its formation ~ 10,000 years ago, and just 4% of this eroded volume is currently filled with sediment deposits, up to 5 m thick. Deposited boulders across the canyon floor of Ásbyrgi demonstrate that the discharge of the jökulhlaup that formed the canyon was at least 39,000 m3 s- 1. We present a model for the evolution of the lower Jökulsá á Fjöllum and the Jökulsárgljúfur canyon during various stages of an extreme flood event. Reconstruction of the early Holocene flood event includes the initiation and development of different canyons before the capture of all floodwater within one canyon at the end. We tie the evolution of the lower Jökulsárgljúfur canyon to established chronology of flood events during the Holocene farther upstream and highlight the dominant impact of extreme flood events over background processes

  16. Risk Factors for Lower Extremity Muscle Injury in Professional Soccer : The UEFA Injury Study

    OpenAIRE

    Hägglund, Martin; Waldén, Markus; Ekstrand, Jan

    2013-01-01

    Background: Muscle injury is the most common injury type in professional soccer players. Despite this, risk factors for common lower extremity injuries remain elusive. Purpose: To evaluate the effects of various player- and match-related risk factors on the occurrence of lower extremity muscle injury in male professional soccer. Study Design: Cohort study; Level of evidence, 2. Methods: Between 2001 and 2010, 26 soccer clubs (1401 players) from 10 European countries participated in the study....

  17. Development Of A Laser Intravascular Fiber Optic Probe For The Treatment Of Superficial Telangiectasia Of The Lower Extremity In Man

    Science.gov (United States)

    Goldman, Leon; Taylor, W. A.

    1984-10-01

    Because of the difficulty of laser treatment of superficial telangiectasia in man, a mini vascular fiberoptics probe has been developed for these vessels. Controls have included sclerotherapy, intravascular-galvanic current probes and direct impacts from 0.2 mm argon fiberoptics probes.

  18. Primary Pseudomyogenic Hemangioendothelioma of Bone.

    Science.gov (United States)

    Inyang, Alero; Mertens, Fredrik; Puls, Florian; Sumathi, Vaiyapuri; Inwards, Carrie; Folpe, Andrew; Lee, Cheng-Han; Zhang, Yaxia; Symmans, Pennie; Rubin, Brian; Nielsen, Gunnlaugur P; Nguyen, Van-Hung; Rosenberg, Andrew E

    2016-05-01

    Pseudomyogenic hemangioendothelioma (PMH) is a well-recognized neoplasm that usually arises in the soft tissue; concurrent bone involvement occurs in 24% of cases. PMH of bone without soft tissue involvement is rare. We describe the clinicopathologic findings of 10 such cases, the largest series reported to date. The study included 9 male and 1 female patient; their ages ranged from 12 to 74 years (mean 36.7 y). All patients had multiple tumors with a distinct regional distribution: 45% restricted to the lower extremity; 25% to the spine and pelvis; and 15% to the upper extremity. On imaging studies the tumors were well circumscribed and lytic. The neoplasms were composed of spindled cells arranged in intersecting fascicles with scattered epithelioid cells; epithelioid cells predominated in 3 cases. The neoplastic cells contained abundant densely eosinophilic cytoplasm and vesicular nuclei. There was limited cytologic atypia and necrosis, few mitoses (0 to 2/10 high-power fields), and inconspicuous stroma. Unique findings included abundant intratumoral reactive woven bone and hemorrhage with numerous osteoclast-like giant cells. Immunohistochemically, most tumors were positive for keratin, ERG, and CD31; CD34 was negative. The balanced t(7:19)(q22;13) translocation was documented in 3 cases. Follow-up is limited, but no patient developed documented visceral dissemination, and all have stable or progressive osseous disease. PMH exclusively involving bone is rare. It is multicentric, often involves the lower extremity, and has unusual morphology. The differential diagnosis includes epithelioid vascular neoplasms, giant cell tumor, bone forming neoplasms, and metastatic carcinoma. Because of its rarity, unusual presentation, and morphology, accurate diagnosis can be challenging. PMID:26872012

  19. Small-field-of-view MR angiography of the lower extremity with use of gradient echo techniques

    International Nuclear Information System (INIS)

    Ten volunteers and 18 patients with angiographically proven vascular disease were studied using 1.5-T superconductive magnet with 10 mT/m gradient capabilities and surface coil. Areas of interest were localized using a 20-30-slice, 200 to 400 tip angle, 50-150-msec repetition time, 5-msec echo time (TE) (FLASH) study, sequentially gated through the cardiac cycle. Subtractions of maximum dephased systolic and diastolic studies produced arteriographic images. Evaluation of arterial structures was facilitated by a small-field-of-view, 20-30-mm anisotropic 3D volume set. Rephasing was facilitated by fast low-angle scans (TE, 10-14msec) with velocity and/or velocity and acceleration gradient compensation schemes. Similar scans with dephasing gradients were obtained and subtracted. These high-resolution, small-field-of-view studies will be discussed and compared with digital subtraction angiograms and film-screen arteriograms

  20. Women with primary ovarian insufficiency have lower bone mineral density

    Directory of Open Access Journals (Sweden)

    F. Amarante

    2011-01-01

    Full Text Available The aim of the present study was to assess the prevalence of osteoporosis in a sample of 32 patients with spontaneous primary ovarian insufficiency (POI in comparison to reference groups of 25 pre- and 55 postmenopausal women. Hip (lumbar and spinal bone mineral density (BMD measurements were performed by dual-energy X-ray absorptiometry in the three groups. The median age of POI patients at the time of diagnosis was 35 years (interquartile range: 27-37 years. The mean ± SD age of postmenopausal reference women (52.16 ± 3.65 years was higher than that of POI (46.28 ± 10.38 years and premenopausal women (43.96 ± 7.08; P = 0.001 at the time of BMD measurement. Twenty-seven (84.4% POI women were receiving hormone replacement therapy (HRT at the time of the study. In the postmenopausal reference group, 30.4% were current users of HRT. Lumbar BMD was significantly lower in the POI group (1.050 ± 0.17 g/cm² compared to the age-matched premenopausal reference group (1.136 ± 0.12 g/cm²; P = 0.040. Moreover, 22 (68.7% POI women had low bone density (osteopenia/osteoporosis by World Health Organization criteria versus 47.3% of the postmenopausal reference group (P = 0.042. In conclusion, the present data indicate that BMD is significantly lower in patients with POI than in age-matched premenopausal women. Also, the prevalence of osteopenia/osteoporosis is higher in POI women than in women after natural menopause. Early medical interventions are necessary to ensure that women with POI will maintain their bonemass.

  1. Short-Term Catheter-Directed Thrombolysis with Low-Dose Urokinase Followed by Aspiration Thrombectomy for Treatment of Symptomatic Lower Extremity Deep Venous Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Se Hee; Lim, Nam Yeul; Song, Jang Hyeon [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Kim, Jae Kyu; Lim, Jae Hoon [Dept. of Radiology, Hospital, Ulsan University School of Medicine, Gweangju (Korea, Republic of); Chang, Nam Kyu [Dept. of Radiology, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Choi, Soo Jin Na; Chung, Sang Young [Dept. of Radiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju (Korea, Republic of)

    2011-10-15

    To evaluate the venous patency in patients treated by catheter-directed thrombolysis with low-dose urokinase (UK) for symptomatic lower extremity deep venous thrombosis (DVT). Eighty-nine consecutive patients (46 women and 43 men; mean age, 58.1 years), treated by catheter-directed thrombolysis with low-dose UK were included in this study. Immediate venous patency was evaluated in terms of technical success (successful restoration of antegrade in-line flow in the treated vein with residual stenosis rate of less than 30%) and clinical success (significant reduction of clinical symptoms before hospital discharge). Late venous patency was evaluated in terms of primary patency rate and clinical success. Immediate technical success was achieved in all patients and immediate clinical success in 80 (90%) patients. There was no major systemic bleeding complication. The primary patency rate at 6 months and 12 months was 84% and 79%, respectively. Fifty-six (63%) patients were asymptomatic after a median clinical follow-up of 18 months, eleven (12%) patients improved moderately, seven (8%) patients remained unchanged, and fifteen (17%) patients had no clinical follow-up. Short-term catheter-directed thrombolysis with low-dose UK can be an effective, safe method to manage DVT of the lower extremities.

  2. Short-Term Catheter-Directed Thrombolysis with Low-Dose Urokinase Followed by Aspiration Thrombectomy for Treatment of Symptomatic Lower Extremity Deep Venous Thrombosis

    International Nuclear Information System (INIS)

    To evaluate the venous patency in patients treated by catheter-directed thrombolysis with low-dose urokinase (UK) for symptomatic lower extremity deep venous thrombosis (DVT). Eighty-nine consecutive patients (46 women and 43 men; mean age, 58.1 years), treated by catheter-directed thrombolysis with low-dose UK were included in this study. Immediate venous patency was evaluated in terms of technical success (successful restoration of antegrade in-line flow in the treated vein with residual stenosis rate of less than 30%) and clinical success (significant reduction of clinical symptoms before hospital discharge). Late venous patency was evaluated in terms of primary patency rate and clinical success. Immediate technical success was achieved in all patients and immediate clinical success in 80 (90%) patients. There was no major systemic bleeding complication. The primary patency rate at 6 months and 12 months was 84% and 79%, respectively. Fifty-six (63%) patients were asymptomatic after a median clinical follow-up of 18 months, eleven (12%) patients improved moderately, seven (8%) patients remained unchanged, and fifteen (17%) patients had no clinical follow-up. Short-term catheter-directed thrombolysis with low-dose UK can be an effective, safe method to manage DVT of the lower extremities.

  3. Multidetector row CT angiography of the abdominal aorta and lower extremities in patients with peripheral arterial occlusive disease: diagnostic accuracy and interobserver agreement

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Maurizio E-mail: maurizio.romano@mailcmn.area.na.cnr.it; Mainenti, Pier Paolo; Imbriaco, Massimo; Amato, Bruno; Markabaoui, Karim; Tamburrini, Oscar; Salvatore, Marco

    2004-06-01

    Purpose: To evaluate the accuracy of four channel multidetector row CT angiography (MDCTA) of the abdominal aorta and lower extremities arteries compared with digital subtraction angiography (DSA). Materials and methods: In our prospective study 42 patients with peripheral vascular occlusive disease (27 M, 15 F, age range 40-79 years) underwent MDCTA and DSA within 5 days. Images were blindly interpreted by two radiologists. Maximum intensity projections (MIP), multiplanar (MPR) reformations, three-dimensional (3D) reconstructions as well as axial images were available for analysis of MDCTA. DSA were analyzed on hard copies. Results: Overall sensitivity and specificity of MDCTA were 93 and 95%, respectively, with positive and negative predictive values of 90 and 97%. Overall diagnostic accuracy was 94%. Normal arterial segments and 100% occlusions were correctly identified in all cases by MDCTA. Moderately stenotic segments interpretation in the calves appeared to be more controversial, but no statistical difference in accuracy of MDCTA in the infrapopliteal district arteries was noted with respect to accuracy in the more proximal arterial bed. Good to excellent interobserver and intraobserver agreement were observed, with k values greater than 0.80. Conclusions: MDCTA of the abdominal aorta and lower extremities is an accurate imaging modality in clinical practice when compared with DSA.

  4. Non-invasive neurosensory testing used to diagnose and confirm successful surgical management of lower extremity deep distal posterior compartment syndrome

    Directory of Open Access Journals (Sweden)

    Guyton Gregory P

    2009-05-01

    Full Text Available Abstract Background Chronic exertional compartment syndrome (CECS is characterized by elevated pressures within a closed space of an extremity muscular compartment, causing pain and/or disability by impairing the neuromuscular function of the involved compartment. The diagnosis of CECS is primarily made on careful history and physical exam. The gold standard test to confirm the diagnosis of CECS is invasive intra-compartmental pressure measurements. Sensory nerve function is often diminished during symptomatic periods of CECS. Sensory nerve function can be documented with the use of non-painful, non-invasive neurosensory testing. Methods Non-painful neurosensory testing of the myelinated large sensory nerve fibers of the lower extremity were obtained with the Pressure Specified Sensory Device™ in a 25 year old male with history and invasive compartment pressures consistent with CECS both before and after running on a tread mill. After the patient's first operation to release the deep distal posterior compartment, the patient failed to improve. Repeat sensory testing revealed continued change in his function with exercise. He was returned to the operating room where a repeat procedure revealed that the deep posterior compartment was not completely released due to an unusual anatomic variant, and therefore complete release was accomplished. Results The patient's symptoms numbness in the plantar foot and pain in the distal calf improved after this procedure and his repeat sensory testing performed before and after running on the treadmill documented this improvement. Conclusion This case report illustrates the principal that non-invasive neurosensory testing can detect reversible changes in sensory nerve function after a provocative test and may be a helpful non-invasive technique to managing difficult cases of persistent lower extremity symptoms after failed decompressive fasciotomies for CECS. It can easily be performed before and after

  5. Changes in the Loading of Tibial Articular Cartilage Following Varus and Valgus Mechanical Axis of Lower Extremity: A Finite Element Model Study

    Directory of Open Access Journals (Sweden)

    Halil Atmaca

    2014-06-01

    Full Text Available Objective: To evaluate changes in the loading of tibial articular cartilage following varus and valgus mechanical axis of lower extremity. Methods: Three- Dimensional (3D solid models were created on MIMICS ® by using DICOM formatted longitudinal computed tomography scans. Respectively 2.5°, 5°, 7.5°, 10°, 12.5° and 15° varus and valgus osteotomies were performed to 3D solid models. ANSYS ® WorkbenchTM (Version 12 was used to analyze the stress/load distribution, that is to say MES (maximum equivalent stress- von Mises stres, which affect the tibia cartilage in the finite element model obtained by MIMICS ® . Results: MES of the tibial cartilage was measured 0.860 MPa in the reference model. With regard to the varus models, MES was measured 0.935 MPa in 2.5° varus model, 1.010 MPa in 5°, 1.113 MPa in 7.5°, 1.247 MPa in 10°, 1.388 MPa in 12.5° and 1.530 MPa in 15° varus model. MES was measured 0.813, 0.792, 0.769, 0.745, 0.718 and 0.690 MPa in 2.5°, 5°, 7.5°, 10°, 12.5° and 15° valgus osteotomy models respectively (p=0.028. Conclusion: MES increased in all models of varus position when was compared with reference and valgus models. The decrease of load bearing on tibial articular cartilage in valgus position was lower and statistically different than the reference and varus models. This study clearly showed that tibia cartilage is more sensitive to load bearing in varus position than the valgus positioned lower extremity mechanical axis.

  6. Tooth-marked small theropod bone: an extremely rare trace

    DEFF Research Database (Denmark)

    Jacobsen, Aase Roland

    2001-01-01

    Tooth-marked dinosaur bones provide insight into feeding behaviours and biting strategies of theropod dinosaurs. The majority of theropod tooth marks reported to date have been found on herbivorous dinosaur bones, although some tyrannosaurid bones with tooth marks have also been reported. In 1988...... partial skeleton of the dromaeosaurid Saurornitholestes was collected from southern Alberta, Canada, that bore marks on one dentary. The location and morphology of the tooth marks suggests that a theropod (possible a juvenile tyrannosaurid) included a Saurornitholestes in its diet....

  7. The Relationship between Lower Extremity Alignment Characteristics and Anterior Knee Joint Laxity

    OpenAIRE

    Shultz, Sandra J.; Anh-Dung, Nguyen; Levine, Beverly J.

    2009-01-01

    Background: Lower extremity alignment may influence the load distribution at the knee, potentially predisposing the anterior cruciate ligament to greater stress. We examined whether lower extremity alignment predicted the magnitude of anterior knee laxity in men and women. Hypothesis: Greater anterior pelvic angle, hip anteversion, tibiofemoral angle, genu recurvatum, and navicular drop will predict greater anterior knee laxity. Study Design: Descriptive laboratory study. Methods: Women (n = ...

  8. Catheter-Directed Thrombolysis with a Continuous Infusion of Low-Dose Urokinase for Non-Acute Deep Venous Thrombosis of the Lower Extremity

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Binbin; Zhang, Jingyong; Wu, Xuejun; Han, Zonglin; Zhou, Hua; Dong, Dianning; Jin, Xing [Shandong Provincial Hospital, Shandong University, Ji' nan (China)

    2011-02-15

    We wanted to evaluate the feasibility of catheter-directed thrombolysis with a continuous infusion of low-dose urokinase for treating non-acute (less than 14 days) deep venous thrombosis of the lower extremity. The clinical data of 110 patients who were treated by catheter-directed thrombolysis with a continuous infusion of low-dose urokinase for lower extremity deep venous thrombosis was analysed. Adjunctive angioplasty or/and stenting was performed for the residual stenosis. Venous recanalization was graded by pre- and posttreatment venography. Follow-up was performed by clinical evaluation and Doppler ultrasound. A total of 112 limbs with deep venous thrombosis with a mean symptom duration of 22.7 days (range: 15-38 days) were treated with a urokinase infusion (mean: 3.5 million IU) for a mean of 196 hours. After thrombolysis, stent placement was performed in 25 iliac vein lesions and percutaneous angioplasty (PTA) alone was done in fi ve iliac veins. Clinically significant recanalization was achieved in 81% (90 of 112) of the treated limbs: complete recanalization was achieved in 28% (31 of 112) and partial recanalization was achieved in 53% (59 of 112). Minor bleeding occurred in 14 (13%) patients, but none of the patients suffered from major bleeding or symptomatic pulmonary embolism. During followup (mean: 15.2 months, range: 3-24 months), the veins were patent in 74 (67%) limbs. Thirty seven limbs (32%) showed progression of the stenosis with luminal narrowing more than 50%, including three with rethrombosis, while one revealed an asymptomatic iliac vein occlusion: 25 limbs (22%) developed mild post-thrombotic syndrome, and none had severe post-thrombotic syndrome. Valvular reflux occurred in 24 (21%) limbs. Catheter-directed thrombolysis with a continuous infusion of low-dose urokinase combined with adjunctive iliac vein stenting is safe and effective for removal of the clot burden and for restoration of the venous flow in patients with non-acute lower

  9. Effect of negative pressure therapy on repair of soft tissues of the lower extremities in patients with neuropathic and neuroischaemic forms of diabetic foot syndrome

    Directory of Open Access Journals (Sweden)

    Ekaterina Leonidovna Zaytseva

    2014-06-01

    Full Text Available AimTo evaluate the efficiency of topical negative pressure wound therapy (NPWT compared with standard therapy for the regeneration of the soft tissues of the lower extremities in patients with diabetic foot syndrome.Materials and MethodsThe effects of negative pressure therapy on the clinical (size, tissue oxygenation, histological (light microscopy and immunohistochemical (CD68, MMP-9, TIMP-1 aspects of repair of the soft tissue of the lower extremities in patients with diabetes mellitus were compared with those of standard treatment. Thirty-one patients with diabetic foot ulcers were included in the study from the moment of debridement until the plastic closure of the wound. During the perioperative period, 13 patients received NPWT (-90 to -120 mmHg and 18 patients received standard therapy.ResultsA reduction of the wound area (26.6%±17.2% and the depth of the defects (40.5%±25.6% were achieved with negative pressure therapy compared with baseline data. In the control group, the corresponding values were 25.3%±19.4% and 21.8%±21.6%, respectively. The results of transcutaneous oximetry showed a greater increase in the level of local hemodynamics in the study group (p <0.04. An important criterion for wound preparation for a plastic closure is filling it with granulation tissue by more than 75%. In the study group, 95% of patients had wounds filled with 89.9%±17% of abundant granulation tissue. The histological data of the study group show a significant reduction of oedema by 80% (p <0.05, improved extracellular matrix organization (p <0.05, 90% (p <0.05 dissolution of inflammatory infiltrate and the formation of healthy granulation tissue (p <0.05. Immunohistochemical analysis demonstrated a significant decrease in the number of macrophages in the dermis (CD68 expression (p <0.05. In both groups, the level of MMP-9 was decreased. However, the ratio of MMP-9:TIMP-1 was lower in the study group (p <0.05.ConclusionThe findings suggest that

  10. Statistics of Local Extremes

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Bierbooms, W.; Hansen, Kurt Schaldemose

    2003-01-01

    theoretical expression for the probability density function associated with local extremes of a stochasticprocess is presented. The expression is basically based on the lower four statistical moments and a bandwidth parameter. The theoretical expression is subsequently verified by comparison with simulated...

  11. Improving the image quality of contrast-enhanced MR angiography by automated image registration: A prospective study in peripheral arterial disease of the lower extremities

    International Nuclear Information System (INIS)

    Objective: If a patient has moved during digital subtraction angiography (DSA), manual pixel shift can improve the image quality. This study investigated whether such image registration can also improve the quality of contrast-enhanced magnetic resonance angiography (MRA) in patients with peripheral arterial disease of the lower extremities. Materials and methods: 404 leg MRAs of patients likely to have peripheral artery disease were included in this prospective study. The standard non-registered MRAs were compared to automatically linear, affine and warp registered MRAs by four image quality parameters, including the vessel detection probability (VDP) in maximum intensity projection (MIP) images and contrast-to-noise ratios (CNR). The different registration types were compared by analysis of variance. Results: All studied image quality parameters showed similar trends. Generally, registration improved the leg MRA quality significantly (P < 0.05). The 12% of lower legs with a body shift of 1 mm or more showed the highest gain in image quality when using linear registration instead of no registration, with an average VDP gain of 20-49%. Warp registration improved the image quality slightly further. Conclusion: Automated image registration can improve the MRA image quality especially in the lower legs, which is comparable to the effect of pixel shift in DSA.

  12. Effect of jaw clenching on balance recovery: Dynamic stability and lower extremity joint kinematics after forward loss of balance

    OpenAIRE

    Ringhof, Steffen; Stein, Thorsten; Hellmann, Daniel; Schindler, Hans Jürgen; Potthast, Wolfgang

    2016-01-01

    Postural control is crucial for most tasks of daily living, delineating postural orientation and balance, with its main goal of fall prevention. Nevertheless, falls are common events, and have been associated with deficits in muscle strength and dynamic postural stability. Recent studies reported on improvements in rate of force development and static postural control evoked by jaw clenching activities, potentially induced by facilitation of human motor system excitability. However, there are...

  13. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities

    OpenAIRE

    Saranat Orrapin; Supapong Arworn; Kittipan Rerkasem

    2016-01-01

    Chronic traumatic arteriovenous fistula (AVF) commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1) and shotgun wounds (case 2). Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases...

  14. Effect of calcified plaques on estimation of arterial stenosis of lower extremity in diabetic foot patients using multislice computed tomography angiography

    International Nuclear Information System (INIS)

    Objective: To investigate the impacts of calcified plaques on estimation of arterial stenosis of lower extremity in diabetic foot patients using 16 -slice computed tomography angiography (MSCTA). Materials and Methods: Thirty-five patients (representing 38 cases)underwent both MSCTA and digital subtraction angiography (DSA) examinations. The arteries of lower extremity were divided into 15 anatomic segments, and the degree of artery stenosis in each segment was classified as normal, mildly, moderately. severely or occluded. The extent of calcification in each segment was also assessed on cross -sectional image of MDCTA and was classified as absent, mildly, moderately, or severely. Using DSA as the standard reference, the sensitivity, specificity, accuracy, Youden index, positive predictive value and negative predictive value of MSCTA were calculated. Agreement between MSCTA and DSA was assessed by Cohen's kappa statistics. Results: In the noncalcified, mildly and moderately calcified segments of the artery above the knee, for the detection of segments that had more than mild stenosis, the sensitivity, specificity, accuracy. Youden index, positive predictive value and negative predictive value of MSCTA were 97.1%, 98.7%, 98.2%, 95.8%, 97.0% and 98.7%, respectively. In the severely calcified segments of the artery above the knee, for the detection of segments that had more than mild stenosis, the sensitivity, specificity, accuracy, Youden index, positive predictive value and negative predictive value of MSCTA were 96.3%, 93.8%, 94.7%, 90.1%, 89.7% and 97.8%, respectively. In the noncalcified, mildly and moderately calcified segments of the artery below the knee, for the detection of segments that had more than mild stenosis, the sensitivity, specificity, accuracy, Youden index, positive predictive value and negative predictive value of MSCTA were 95.1%, 93.2%, 94.1%, 88.3%, 93.4% and 94.9%, respectively. In the severely calcified segments of the artery below the

  15. Center of Pressure Displacement of Standing Posture during Rapid Movements Is Reorganised Due to Experimental Lower Extremity Muscle Pain

    OpenAIRE

    Shinichiro Shiozawa; Rogerio Pessoto Hirata; Thomas Graven-Nielsen

    2015-01-01

    Background Postural control during rapid movements may be impaired due to musculoskeletal pain. The purpose of this study was to investigate the effect of experimental knee-related muscle pain on the center of pressure (CoP) displacement in a reaction time task condition. Methods Nine healthy males performed two reaction time tasks (dominant side shoulder flexion and bilateral heel lift) before, during, and after experimental pain induced in the dominant side vastus medialis or the tibialis a...

  16. Effect of Jaw Clenching on Balance Recovery: Dynamic Stability and Lower Extremity Joint Kinematics after Forward Loss of Balance

    Directory of Open Access Journals (Sweden)

    Steffen eRinghof

    2016-03-01

    Full Text Available Postural control is crucial for most tasks of daily living, delineating postural orientation and balance, with its main goal of fall prevention. Nevertheless, falls are common events and have been associated with deficits in muscle strength and dynamic stability. Recent studies reported on improvements in rate of force development and static postural control evoked by jaw clenching activities, potentially induced by facilitation of human motor system excitability. However, there are no studies describing the effects on dynamic stability. The present study, therefore, aimed investigated the effects of submaximum jaw clenching on recovery behavior from forward loss of balance. Participants were twelve healthy young adults, who were instructed to recover balance from a simulated forward fall by taking a single step while either biting at a submaximum force or keeping the mandible at rest. Bite forces were measured by means of hydrostatic splints, whereas a 3D motion capture system was used to analyze spatiotemporal parameters and joint angles, respectively. Additionally, dynamic stability was quantified by the extrapolated CoM concept, designed to determine postural stability in dynamic situations. Paired t-tests revealed that submaximum biting did not significantly influence recovery behavior with respect to any variable under investigation. Therefore, reductions in postural sway evoked by submaximum biting are obviously not transferable to dynamic stability. It is suggested that these contradictions are the result of different motor demands associated with the abovementioned tasks. Furthermore, floor effects and the sample size might be discussed as potential reasons for the absence of significances. Notwithstanding this, the present study also revealed that bite forces under both conditions significantly increased from subjects’ release to touchdown of the recovery limb. Clenching the jaw, hence, seems to be part of a common physiological

  17. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities

    Directory of Open Access Journals (Sweden)

    Saranat Orrapin

    2016-01-01

    Full Text Available Chronic traumatic arteriovenous fistula (AVF commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1 and shotgun wounds (case 2. Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases large venous aneurysm was found next to a large AVF. An open surgical AVF closure for the large AVF was performed in case 1 successfully, but patient developed acute deep vein thrombosis (DVT in a large venous aneurysm. In the second case, in order to prevent DVT, only closure of the large AVF was performed, which preserved arterial flow into the venous aneurysm. Case 2 did not have acute DVT. This report raised the concern about acute DVTs in venous aneurysms following the closure of chronic traumatic AVF in terms of prevention. Also chronic traumatic AVF is commonly due to misdiagnosis in the initial treatment, so complete and serial physical examinations in penetrating vascular injury patients are of paramount importance.

  18. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities.

    Science.gov (United States)

    Orrapin, Saranat; Arworn, Supapong; Rerkasem, Kittipan

    2016-01-01

    Chronic traumatic arteriovenous fistula (AVF) commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1) and shotgun wounds (case 2). Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases large venous aneurysm was found next to a large AVF. An open surgical AVF closure for the large AVF was performed in case 1 successfully, but patient developed acute deep vein thrombosis (DVT) in a large venous aneurysm. In the second case, in order to prevent DVT, only closure of the large AVF was performed, which preserved arterial flow into the venous aneurysm. Case 2 did not have acute DVT. This report raised the concern about acute DVTs in venous aneurysms following the closure of chronic traumatic AVF in terms of prevention. Also chronic traumatic AVF is commonly due to misdiagnosis in the initial treatment, so complete and serial physical examinations in penetrating vascular injury patients are of paramount importance. PMID:27293948

  19. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities

    Science.gov (United States)

    Orrapin, Saranat; Arworn, Supapong; Rerkasem, Kittipan

    2016-01-01

    Chronic traumatic arteriovenous fistula (AVF) commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1) and shotgun wounds (case 2). Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases large venous aneurysm was found next to a large AVF. An open surgical AVF closure for the large AVF was performed in case 1 successfully, but patient developed acute deep vein thrombosis (DVT) in a large venous aneurysm. In the second case, in order to prevent DVT, only closure of the large AVF was performed, which preserved arterial flow into the venous aneurysm. Case 2 did not have acute DVT. This report raised the concern about acute DVTs in venous aneurysms following the closure of chronic traumatic AVF in terms of prevention. Also chronic traumatic AVF is commonly due to misdiagnosis in the initial treatment, so complete and serial physical examinations in penetrating vascular injury patients are of paramount importance. PMID:27293948

  20. Changing from analog to digital images: Does it affect the accuracy of alignment measurements of the lower extremity?

    OpenAIRE

    Lohman, Martina; Tallroth, Kaj; Kettunen, Jyrki A.; Remes, Ville

    2011-01-01

    Background and purpose Medical imaging has changed from analog films to digital media. We examined and compared the accuracy of orthopedic measurements using different media. Methods Before knee arthroplasty, full-length standing radiographs of 52 legs were obtained. The mechanical axis (MA), tibio-femoral angle (TFA), and femur angle (FA) were measured and analyzed twice, by 2 radiologists, using (1) true-size films, (2) short films, (3) a digital high-resolution workstation, and (4) a web-b...

  1. Center of Pressure Displacement of Standing Posture during Rapid Movements Is Reorganised Due to Experimental Lower Extremity Muscle Pain.

    Directory of Open Access Journals (Sweden)

    Shinichiro Shiozawa

    Full Text Available Postural control during rapid movements may be impaired due to musculoskeletal pain. The purpose of this study was to investigate the effect of experimental knee-related muscle pain on the center of pressure (CoP displacement in a reaction time task condition.Nine healthy males performed two reaction time tasks (dominant side shoulder flexion and bilateral heel lift before, during, and after experimental pain induced in the dominant side vastus medialis or the tibialis anterior muscles by hypertonic saline injections. The CoP displacement was extracted from the ipsilateral and contralateral side by two force plates and the net CoP displacement was calculated.Compared with non-painful sessions, tibialis anterior muscle pain during the peak and peak-to-peak displacement for the CoP during anticipatory postural adjustments (APAs of the shoulder task reduced the peak-to-peak displacement of the net CoP in the medial-lateral direction (P<0.05. Tibialis anterior and vastus medialis muscle pain during shoulder flexion task reduced the anterior-posterior peak-to-peak displacement in the ipsilateral side (P<0.05.The central nervous system in healthy individuals was sufficiently robust in maintaining the APA characteristics during pain, although the displacement of net and ipsilateral CoP in the medial-lateral and anterior-posterior directions during unilateral fast shoulder movement was altered.

  2. The effects of yoga training and a single bout of yoga on delayed onset muscle soreness in the lower extremity.

    Science.gov (United States)

    Boyle, Colleen A; Sayers, Stephen P; Jensen, Barbara E; Headley, Samuel A; Manos, Tina M

    2004-11-01

    The purpose of this study was to determine the effects of yoga training and a single bout of yoga on the intensity of delayed onset muscle soreness (DOMS). 24 yoga-trained (YT; n = 12) and non-yoga-trained (CON; n = 12), matched women volunteers were administered a DOMS-inducing bench-stepping exercise. Muscle soreness was assessed at baseline, 24, 48, 72, 96, and 120 hours after bench-stepping using a Visual Analog Scale (VAS). Groups were also compared on body awareness (BA), flexibility using the sit-and-reach test (SR), and perceived exertion (RPE). Statistical significance was accepted at p yoga class than after yoga class at 24 hours (21.4 [+/- 6.9] mm vs. 11.1 [+/- 4.1] mm; p = 0.02). The SR was greater in YT than in CON (65.0 [+/- 7.9] cm vs. 33.3 [+/- 7.0] cm; p yoga and control in BA (94.0 [+/- 4.4] units vs. 83.8 [+/- 3.7] units; p = 0.21) or in RPE at 5-minute intervals (2.9 [+/- 0.3], 5.3 [+/- 0.8], 5.8 [+/- 0.9], and 5.2 [+/- 0.8] vs. 2.5 [+/- 0.3], 4.0 [+/- 0.5], 4.2 [+/- 0.3], and 4.9 [+/-