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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

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    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

    Energy Technology Data Exchange (ETDEWEB)

    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. Bone multicentric epithelioid hemangioendothelioma of the lower and upper extremities with pulmonary metastases: A case report

    Science.gov (United States)

    ZHANG, HUA; FU, YANBIAO; YE, ZHAOMING

    2015-01-01

    The present study reports a rare case of bone multicentric epithelioid hemangioendothelioma (EH) involving the upper and lower extremities simultaneously, with visceral involvement of the lung. Osteolytic lesions were first identified in the right distal femur and proximal tibia. Slight increased radionuclide uptake was observed in the right shoulder joint on bone scintigraphy, however, this was ignored, as no clinical symptoms were present. The patient was initially misdiagnosed with multifocal chondroblastoma, and an extra-articular curettage of lesions was performed in the proximal tibia and medial femoral condyle, which was filled with bone cement. The histopathological diagnosis was corrected post-operatively following immunohistochemical analysis, which indicated EH, and subsequently, an amputation of the right leg at thigh level was performed. In addition, multiple lytic lesions in the right shoulder joint and pulmonary metastases were identified on whole-body radiological examination. Radiotherapy was administered to the right shoulder joint, however, the patient refused chemotherapy or further surgery. At 15 months after the initial surgery, the patient currently remains alive. This case indicates that an improved understanding with regard to the clinical features of this disease may prevent misdiagnosis and improve EH treatment. PMID:26137035

  7. The results of bone deformity correction using a spider frame with web-based software for lower extremity long bone deformities

    Science.gov (United States)

    Tekin, Ali Çağrı; Çabuk, Haluk; Dedeoğlu, Süleyman Semih; Saygılı, Mehmet Selçuk; Adaş, Müjdat; Esenyel, Cem Zeki; Büyükkurt, Cem Dinçay; Tonbul, Murat

    2016-01-01

    Aim: To present the functional and radiological results and evaluate the effectiveness of a computer-assisted external fixator (spider frame) in patients with lower extremity shortness and deformity. Materials and methods: The study comprised 17 patients (14 male, 3 female) who were treated for lower extremity long bone deformity and shortness between 2012 and 2015 using a spider frame. The procedure’s level of difficulty was determined preoperatively using the Paley Scale. Postoperatively, the results for the patients who underwent tibial operations were evaluated using the Paley criteria modified by ASAMI, and the results for the patients who underwent femoral operations were evaluated according to the Paley scoring system. The evaluations were made by calculating the External Fixator and Distraction indexes. Results: The mean age of the patients was 24.58 years (range, 5–51 years). The spider frame was applied to the femur in 10 patients and to the tibia in seven. The mean follow-up period was 15 months (range, 6–31 months) from the operation day, and the mean amount of lengthening was 3.0 cm (range, 1–6 cm). The mean duration of fixator application was 202.7 days (range, 104–300 days). The mean External Fixator Index was 98 days/cm (range, 42–265 days/cm). The mean Distraction Index was 10.49 days/cm (range, 10–14 days/cm). Conclusion: The computer-assisted external fixator system (spider frame) achieves single-stage correction in cases of both deformity and shortness. The system can be applied easily, and because of its high-tech software, it offers the possibility of postoperative treatment of the deformity. PMID:27163100

  8. The results of bone deformity correction using a spider frame with web-based software for lower extremity long bone deformities

    Directory of Open Access Journals (Sweden)

    Tekin Ali Çağrı

    2016-01-01

    Full Text Available Aim: To present the functional and radiological results and evaluate the effectiveness of a computer-assisted external fixator (spider frame in patients with lower extremity shortness and deformity. Materials and methods: The study comprised 17 patients (14 male, 3 female who were treated for lower extremity long bone deformity and shortness between 2012 and 2015 using a spider frame. The procedure’s level of difficulty was determined preoperatively using the Paley Scale. Postoperatively, the results for the patients who underwent tibial operations were evaluated using the Paley criteria modified by ASAMI, and the results for the patients who underwent femoral operations were evaluated according to the Paley scoring system. The evaluations were made by calculating the External Fixator and Distraction indexes. Results: The mean age of the patients was 24.58 years (range, 5–51 years. The spider frame was applied to the femur in 10 patients and to the tibia in seven. The mean follow-up period was 15 months (range, 6–31 months from the operation day, and the mean amount of lengthening was 3.0 cm (range, 1–6 cm. The mean duration of fixator application was 202.7 days (range, 104–300 days. The mean External Fixator Index was 98 days/cm (range, 42–265 days/cm. The mean Distraction Index was 10.49 days/cm (range, 10–14 days/cm. Conclusion: The computer-assisted external fixator system (spider frame achieves single-stage correction in cases of both deformity and shortness. The system can be applied easily, and because of its high-tech software, it offers the possibility of postoperative treatment of the deformity.

  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. 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

  11. 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

  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.

  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

    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

  15. 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.

  16. 牵拉成骨技术治疗下肢大段骨缺损%Distraction osteogenesis for large bone defect of the lower extremity

    Institute of Scientific and Technical Information of China (English)

    王富明; 陈鸿奋; 陈滨; 任高宏; 杨运平; 秦煜; 王钢

    2011-01-01

    Objective To discuss the therapeutic effect of distraction osteogenesis for large bone defect of the lower extremity. Methods From August 2002 to August 2010, 11 patients with large bone defect at the lower extremity were treated with distraction osteogenesis. They were 10 men and one woman, aged from 14 to 53 years (average, 34. S years). The defect was at the right tibia in 7 cases, left tibia in 3 cases and right femur in one case. The lengths of bone defect ranged from 5 to 15 cm (average, 8. 6 cm). Results The patients were followed up for 7 to 48 months, with a mean period of 27. 3 months. The treatment of 9 cases was over, with a mean healing index of 1. 99 months/cm. According to the Paley evaluation system, the bony results were excellent in 6 and good in 3 patients; the functional results were excellent in 4, good in 4, and fair in one patient. Two cases were still in the mineralization period. Conclusion Treatment of large bone defects with distraction osteogenesis is simple and can obtain satisfactory therapeutic effects, especially when a monolateral external fixator is used for the simple shaft bone defect.%目的 探讨应用牵拉成骨技术治疗下肢大段骨缺损的临床疗效.方法 回顾性分析2002年8月至2010年8月收治的11例下肢大段骨缺损患者临床资料,男10例,女1例;年龄14~53岁,平均34.5岁.均行牵拉成骨治疗,右侧胫骨7例,左侧胫骨3例,右侧股骨1例;骨缺损长度5~15cm,平均8.6 cm;9例治疗已结束,2例仍处于矿化阶段.结果 所有患者术后获7~48个月(平均27.3个月)随访.9例治疗结束患者,平均骨愈合指数为1.99个月/cm;根据Paley评价系统评价骨性结果:优6例,良3例,优良率为100%;功能结果:优4例,良4例,一般1例.结论应用牵拉成骨技术治疗大段骨缺损,手术操作简单,尤其是对于单纯骨干缺损患者,采用单边外固定支架治疗,且其手术操作更为简洁.

  17. Short-term effects of teriparatide versus placebo on bone biomarkers, structure, and fracture healing in women with lower-extremity stress fractures: A pilot study

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    Ellen A. Almirol

    2016-09-01

    Conclusions: In this randomized, pilot study, brief administration of TPTD showed anabolic effects that TPTD may help hasten fracture healing in premenopausal women with lower-extremity stress fractures. Larger prospective studies are warranted to determine the effects of TPTD treatment on stress fracture healing in premenopausal women.

  18. Reconstruction of the Lower Extremity Using Free Flaps

    OpenAIRE

    Min Jo Kang; Chul Hoon Chung; Yong Joon Chang

    2013-01-01

    Background The aim of lower-extremity reconstruction has focused on wound coverage and functional recovery. However, there are limitations in the use of a local flap in cases of extensive defects of the lower-extremities. Therefore, free flap is a useful option in lower-extremity reconstruction. Methods We performed a retrospective review of 49 patients (52 cases) who underwent lower-extremity reconstruction at our institution during a 10-year period. In these patients, we evaluated causes an...

  19. 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

  20. [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

  1. 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.

  2. 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...

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. Venous hemodynamic changes of lower extremity during gynecological laparoscopy

    Institute of Scientific and Technical Information of China (English)

    YIN Shan-de; LIU Yan; HE Sheng

    2004-01-01

    To study the effect of CO2 pneumoperitoneum and the special 30 degree head-down tilt positionon the venous hemodynamics in the lower extremity. Methods: Color doplex ultrasound was adopted to evaluate the diameterand blood flow velocity of the right femoral vein of 18 patients undergoing gynecologic laparoscopy under the same pressure ofpneumoperitoneum of 12 mmHg. The diameter of femoral vein and the flow velocity were measured; the blood flow volumewas calculated based on the equation of Q = vπr2 . Result: After establishment of pneumoperitoneum, the dilation of the fem-oral vein and the decrease in the velocity and volume can be observed (P < 0.05). And the 30 degree head-down positioncould increase the flow velocity and volume of the femoral vein and decrease the diameter of the vessel ( P < 0.05). At 30minutes of the 30 degree head-down tilt position, the blood flow ameliorated compared with that in prone position after theestablishment of pneumoperitoneum. After deflation of pneumoperitoneum, the femoral vein remained dilated( P < 0.05 ).Conclusion: During laparoscopy, CO2 pneumoperitoneum may result in the dilation of the vein in lower extremity and retar-dance of blood flow. The 30 degree Trendlenburg position can ameliorate the blood flow in the lower extremity. The deflationof the pneumoperitoneum cannot eliminate the effect of CO2 pneumoperitoneum on the lower extremity veins, which may pre-dispose deep venous thrombosis after laparoscopy.

  8. 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.

  9. 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.

  10. 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)

  11. 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 ...

  12. 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...

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

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    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.

  14. 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.

  15. 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.

  16. [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

  17. 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

    2016-08-02

    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.

  18. 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

  19. Contemporary evaluation and management of lower extremity peripheral artery disease.

    Science.gov (United States)

    Foley, T Raymond; Armstrong, Ehrin J; Waldo, Stephen W

    2016-09-15

    Peripheral artery disease (PAD) includes atherosclerosis of the aorta and lower extremities. Affecting a large segment of the population, PAD is associated with impaired functional capacity and reduced quality of life as well as an increased risk of stroke, myocardial infarction and cardiovascular death. The evaluation of PAD begins with the physical examination, incorporating non-invasive testing such as ankle-brachial indices to confirm the diagnosis. Therapeutic interventions are aimed at alleviating symptoms while preserving limb integrity and reducing overall cardiovascular risk. With this in mind, risk factor modification with exercise and medical therapy are the mainstays of treatment for many patients with PAD. Persistent symptoms or non-healing wounds should prompt more aggressive therapies with endovascular or surgical revascularisation. The following manuscript provides a comprehensive review on the contemporary evaluation and management of PAD.

  20. Development of HIFU Treatment for Lower Extremity Varicose Veins

    Science.gov (United States)

    Senoo, Naohiko; Ushijima, Hiroyuki; Suzuki, Jun; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2011-09-01

    High-intensity focused ultrasound (HIFU) has recently been developed as a noninvasive therapeutic method. In our study, a novel noninvasive therapy with HIFU was proposed for occlusion of lower extremity varicose veins. The temperature increase caused by HIFU is used to occlude varicose veins. Occluded veins became fibrotic, resulting in complete recovery. Our final goal is the medical application of HIFU treatment for varicose veins. In this study, we attempted to occlude the veins of rabbits. Prior to venous occlusion experiments, the area heated by HIFU was investigated using bovine serum albumin (BSA) gel, which denatures at >70 °C. The results indicate that the size of the heated area mainly depends on intensity at the focal point and the exposure time. A tendency was also seen for the heated area to extend toward the transducer with increasing exposure time. In animal experiments, skin burns during HIFU exposure represented a critical problem. We therefore examined the safe range of HIFU intensities in abdominal exposure experiments before conducting venous occlusion experiments. The ultrasound frequency was 1.7 MHz. Intensity at the focal point was 900 W/cm2, and the exposure time was 20 s. Rabbits underwent chemical depilation and echo gel was applied to the exposed skin to fill the boundary gap. Target veins were compressed during HIFU exposure to avoid thermal dissipation, and hyaluronan water solution was injected between the veins and skin to maintain the distance between the skin and veins at ≥5 mm. Veins were then exposed to HIFU and occluded. The capability of HIFU treatment to occlude lower extremity varicose veins was verified by the present study.

  1. 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)

  2. 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 ...

  3. 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

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

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    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.

  5. 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.

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

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    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.

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

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    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.

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

    OpenAIRE

    Tolga Ege; Aytekin Unlu; Huseyin Tas; Dogan Bek; Selim Turkan; Aytac Cetinkaya

    2015-01-01

    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 envi...

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

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    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.

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

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    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.)

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

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    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

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

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    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.

  13. 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).

  14. 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...

  15. Therapeutic ultrasound to promote healing of lower extremity venous ulcers: CAT

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    Raúl Alberto Aguilera Eguía

    2013-10-01

    Full Text Available Purpose. The aim of this CAT (Critically Appraised Topic was to check the validity of the results and applicability regarding the effectiveness of therapeutic ultrasound in increasing healing of lower extremity ulcers and to answer the question: In subjects that have lower extremity venous ulcers, does high-frequency therapeutic ultrasound improve healing rate compared to placebo? Method. We conducted an analysis of the article "Therapeutic Ultrasound for lower extremity venous ulcers, Cochrane Systematic Review" of Cullum, et al (2010. Results. The application of high-frequency therapeutic ultrasound could increase healing in patients with lower extremity venous ulcers, RR = 1.40 (95% CI 1.00 to 1.96. Conclusion. The use of therapeutic ultrasound to promote healing in lower extremity venous ulcers is neither endorsed nor discouraged.

  16. 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...

  17. 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…

  18. The effect of cushioning insoles on back and lower extremity pain in an industrial setting.

    Science.gov (United States)

    Jefferson, John R

    2013-10-01

    The purpose of this study was to examine the relationship between low back pain and lower extremity pain in a group of factory workers and determine the effect of cushioning insoles on low back pain and lower extremity pain. Data were gathered via questionnaire from 306 employees of an aircraft engine assembly factory. A subset of 40 workers who had reported significant levels of back or lower extremity pain were sampled for four consecutive 12-hour shifts wearing their normal footwear and then a week later for four consecutive shifts wearing cushioning insoles. High levels of low back pain and lower extremity pain were reported by workers on the plant floor, but low back pain was poorly correlated to lower extremity pain (r = 0.371). The effect of insoles on the subset of 40 workers was to lower low back pain by 38%, foot pain by 37%, and knee pain by 38% (p < .001). The reduction in low back pain, however, was not correlated to the reduction in lower extremity pain; workers reporting a decrease in low back pain differed from those reporting less lower extremity pain.

  19. Patterns of disease distribution of lower extremity peripheral arterial disease.

    Science.gov (United States)

    Chen, Qian; Shi, Yang; Wang, Yutang; Li, Xiaoying

    2015-03-01

    Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis that is associated with an increased risk of mortality and cardiovascular (CV) events. Peripheral arterial disease involves the arteries distal to the aortic bifurcation in a nonuniform manner. Studies have shown that symptoms and prognosis of patients with PAD vary according to the location and size of the affected artery. Several modalities have been used to identify the location of PAD, including noninvasive evaluations and invasive procedures. Peripheral arterial disease has a risk factor profile similar to that associated with coronary artery disease (ie, age, gender, diabetes, smoking, hypertension, and hyperlipidemia). Many studies have shown that the distribution, extent, and progression of PAD are influenced by CV risk factors but the findings are not consistent. Management strategies for PAD are different for proximal and distal PAD. The objective of this review is to discuss the patterns of diseases distribution in patients with PAD.

  20. [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

  1. 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...

  2. 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...

  3. 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.

  4. Varicose veins of lower extremities, hemodynamics and treatment methods.

    Science.gov (United States)

    Chwała, Maciej; Szczeklik, Wojciech; Szczeklik, Michał; Aleksiejew-Kleszczyński, Tomasz; Jagielska-Chwała, Maria

    2015-01-01

    Chronic venous insufficiency is one of the most common disorders of the vascular system, affecting approximately 50% of adults. If left untreated it can lead to a number of complications, including venous ulceration and venous thrombosis. This review paper outlines the epidemiology and ethiopathogenesis of the disease with regard to hemodynamics and microcirculation disturbances. It describes the medical treatment as well as the traditional surgical approach to varicose veins (with several modifications of this technique), and its limitations and contraindications. Furthermore, it discusses a number of new, minimally invasive treatment methods, namely thermal in form (radiofrequency ablation, endovenous laser ablation, steam ablation) and nonthermal (sclerotherapy, echosclerotherapy, Clarivein, Sapheon). For each method, there is a brief historical overview, a description of its mechanism of action, and its indications and limitations. The results of comparative studies on individual treatment methods as well as meta-analyses on this topic are briefly discussed. This paper highlights the progressive trend towards minimally invasive methods and attempts to predict the further development.

  5. 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.

  6. Analysis of variance (ANOVA) models in lower extremity wounds.

    Science.gov (United States)

    Reed, James F

    2003-06-01

    Consider a study in which 2 new treatments are being compared with a control group. One way to compare outcomes would simply be to compare the 2 treatments with the control and the 2 treatments against each using 3 Student t tests (t test). If we were to compare 4 treatment groups, then we would need to use 6 t tests. The difficulty with using multiple t tests is that as the number of groups increases, so will the likelihood of finding a difference between any pair of groups simply by change when no real difference exists by definition a Type I error. If we were to perform 3 separate t tests each at alpha = .05, the experimental error rate increases to .14. As the number of multiple t tests increases, the experiment-wise error rate increases rather rapidly. The solution to the experimental error rate problem is to use analysis of variance (ANOVA) methods. Three basic ANOVA designs are reviewed that give hypothetical examples drawn from the literature to illustrate single-factor ANOVA, repeated measures ANOVA, and randomized block ANOVA. "No frills" SPSS or SAS code for each of these designs and examples used are available from the author on request.

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

    Science.gov (United States)

    Ota, Ryuhei; Suzuki, Jun; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2009-04-01

    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® 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.

  8. 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.

  9. 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

  10. 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.

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

    OpenAIRE

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

    2015-01-01

    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 rela...

  12. 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

  13. 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.

  14. 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.

  15. 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....

  16. 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...

  17. 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

  18. 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.

  19. 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

  20. 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)

  1. 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.

  2. [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

  3. 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

  4. 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....

  5. Evaluation and Treatment of Patients With Lower Extremity Peripheral Artery Disease

    Science.gov (United States)

    Patel, Manesh R.; Conte, Michael S.; Cutlip, Donald E.; Dib, Nabil; Geraghty, Patrick; Gray, William; Hiatt, William R.; Ho, Mami; Ikeda, Koji; Ikeno, Fumiaki; Jaff, Michael R.; Jones, W. Schuyler; Kawahara, Masayuki; Lookstein, Robert A.; Mehran, Roxana; Misra, Sanjay; Norgren, Lars; Olin, Jeffrey W.; Povsic, Thomas J.; Rosenfield, Kenneth; Rundback, John; Shamoun, Fadi; Tcheng, James; Tsai, Thomas T.; Suzuki, Yuka; Vranckx, Pascal; Wiechmann, Bret N.; White, Christopher J.; Yokoi, Hiroyoshi; Krucoff, Mitchell W.

    2016-01-01

    The lack of consistent definitions and nomenclature across clinical trials of novel devices, drugs, or biologics poses a significant barrier to accrual of knowledge in and across peripheral artery disease therapies and technologies. Recognizing this problem, the Peripheral Academic Research Consortium, together with the U.S. Food and Drug Administration and the Japanese Pharmaceuticals and Medical Devices Agency, has developed a series of pragmatic consensus definitions for patients being treated for peripheral artery disease affecting the lower extremities. These consensus definitions include the clinical presentation, anatomic depiction, interventional outcomes, surrogate imaging and physiological follow-up, and clinical outcomes of patients with lower-extremity peripheral artery disease. Consistent application of these definitions in clinical trials evaluating novel revascularization technologies should result in more efficient regulatory evaluation and best practice guidelines to inform clinical decisions in patients with lower extremity peripheral artery disease. PMID:25744011

  6. [EXPERIENCE OF SEVERE CHRONIC VENOUS INSUFFICIENCY OF THE LOWER EXTREMITIES TREATMENT].

    Science.gov (United States)

    Ponomarenko, A V

    2015-06-01

    The results of treatment of 246 patients on different forms of chronic venous insufficiency of the lower extremities were presented. The leading diagnostic criterion when choosing tactics consider patients ultrasound duplex scanning with color mapping. Patients in the presence of large ulcers basic treatment is autodermoplasty. The complex treatment include pharmacotherapy, the use of elastic compression hosiery.

  7. Analysis thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis in the lower extremities

    Institute of Scientific and Technical Information of China (English)

    刘心; 张梅; 刘陕西; 祈光裕; 刘亚民

    2003-01-01

    Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein thrombosis (DVT) in the lower extremities treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively. Results: The thrombolytic effect was significant. After treatment, the deep veins were recanalized without regurgitation in 75.3% of the patients. The total effective rate was 100%. Only three patients had hemorrhagic complication, but none of the patients died. Conclusion: Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.

  8. 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

  9. 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,

  10. 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.

  11. 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 ...

  12. 负压封闭引流技术结合肌瓣转移游离植皮治疗小腿及足踝部软组织缺损伴骨外露%Treatment of soft tissue defects complicated with bone exposure at the lower extremity and ankle with free skin graft and muscle flap transfer combined with vacuum sealing drainage

    Institute of Scientific and Technical Information of China (English)

    曲家富; 闫荣亮; 王良; 吴俊; 曹立海; 赵国志; 孙开艳; 张玲; 杜晓健

    2013-01-01

    目的 探讨负压封闭引流(VSD)技术结合肌瓣转移游离植皮治疗小腿及足踝部大面积软组织缺损伴骨外露的疗效. 方法 2006年3月至2011年12月共收治52例小腿及足踝部大面积软组织缺损伴骨外露患者,男37例,女15例;年龄24 ~ 66岁,平均38.9岁;软组织缺损面积:20 cm×15cm~35 cm×30cm,骨外露面积:6 cm×4 cm~lO cm×5 cm.开放性骨折按Gustilo分型:Ⅲ A型17例,Ⅲ B型35例.急诊清创后利用邻近肌瓣转移最大限度覆盖骨外露,缩小骨外露范围,裸露骨质钻数个小孔后使用VSD技术治疗待创面肉芽组织生长良好后,采用游离植皮术联合持续VSD技术修复创面.小腿及足踝部功能按Lowa踝关节评分标准评定. 结果 52例患者应用VSD技术治疗1~4次,骨外露被完全覆盖时间为6 ~ 29d,平均18.2d.所有患者术后获6个月至5年(平均为2年8个月)随访,所有患者软组织缺损区的创面肉芽组织生长快、质地好,骨外露被快速生长的肉芽组织所覆盖,创面游离植皮全部成活.骨折愈合时间为3~6个月(平均4个月).5例发生跟腱挛缩致马蹄足畸形,后期行矫正术.无合并感染、骨坏死和慢性骨髓炎等并发症发生.小腿及足踝部功能按Lowa踝关节评分标准评定:优9例,良33例,可8例,差2例,优良率为80.8%. 结论 VSD技术结合肌瓣转移游离植皮治疗小腿及足踝部大面积软组织缺损伴骨外露,可避免截肢和复杂手术,是一种简单、快捷、有效的治疗方法.%Objective To explore the efficacy of free skin graft and muscle flap transfer combined with vacuum sealing drainage (VSD) in repairing soft tissue defects complicated with bone exposure at the lower extremity and ankle.Methods From March 2006 to December 2011,52 patients with large soft tissue defect and bone exposure at the lower extremity and ankle were in our department.They were 36 males and 15 females,with an average age of 38.9 years (from 24 to 66

  13. 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.

  14. 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

  15. 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

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

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    Seyhan Karaçavuş

    2015-06-01

    Full Text Available 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. Lymphoscintigraphy scan was started as dynamic viewing followed by static whole body imaging at 10 minute, 1 hour and 4 hours after injection. Results: Eighty-seven patients had lymphedema. Patients who had lymphedema were divided into two groups according to their scintigraphy findings: Group I included 58 patients without uptake in the popliteal nodes, and group II included 29 patients with positive popliteal nodes. The rate of popliteal node visualization was higher in patients with dermal backflow as compared to those without dermal backflow (p<0.001. The duration of lymphedema was also longer in patients with dermal backflow and popliteal nodes (p<0.004. Conclusion: Lymphoscintigraphy is a reliable, easily applied and well-tolerated objective method to diagnose lower extremity lymphedema. Uptake by popliteal lymph nodes and the presence of dermal backflow on lymphoscintigraphy, which is performed for evaluation of the lower limb lymphedema, were important signs indicating longer disease duration and higher severity of lymphatic dysfunction.

  17. 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

  18. 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

    and 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...... heads and carpal bones. The MagneVu detected fewer erosions than the Artoscan, due to a lower average image quality and a smaller proportion of bones being visualized....

  19. 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...

  20. Overuse lower extremity injuries in sports.

    Science.gov (United States)

    Fullem, Brian W

    2015-04-01

    When athletes train harder the risk of injury increases, and there are several common overuse injuries to the lower extremity. Three of the most common lower extremity overuse injuries in sports are discussed including the diagnosis and treatments: medial tibal stress syndrome, iliotibial band syndrome, and stress fractures. The charge of sports medicine professionals is to identify and treat the cause of the injuries and not just treat the symptoms. Symptomatology is an excellent guide to healing and often the patient leads the physician to the proper diagnosis through an investigation of the athlete's training program, past injury history, dietary habits, choice of footwear, and training surface. PMID:25804713

  1. Application of Advanced Magnetic Resonance Imaging Techniques in Evaluation of the Lower Extremity

    Science.gov (United States)

    Braun, Hillary J.; Dragoo, Jason L.; Hargreaves, Brian A.; Levenston, Marc E.; Gold, Garry E.

    2012-01-01

    Synopsis This article reviews current magnetic resonance imaging techniques for imaging the lower extremity, focusing on imaging of the knee, ankle, and hip joints. Recent advancements in MRI include imaging at 7 Tesla, using multiple receiver channels, T2* imaging, and metal suppression techniques, allowing more detailed visualization of complex anatomy, evaluation of morphological changes within articular cartilage, and imaging around orthopedic hardware. PMID:23622097

  2. Technique of torsion measurement of the lower extremity using computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Widjaja, P.M.; Ermers, J.W.; Sijbrandij, S.; Damsma, H.; Klinkhamer, A.C.

    1985-05-01

    Axial CT is the most accurate and convenient technique for the measurement of lower limb torsion; its accuracy is equal to that of cadaveric skeletal measurement. Both extremities are examined simultaneously, and the comparison of the right and the left leg provides the most important value. The torsion angulation is obtained directly by superimposing the magnified image of each scan on the other. Patient positioning is comfortable and a relatively short examination time is required. It does not require special equipment or skill on the part of the examiner. The radiation dose appears to be lower than that of the conventional radiographic method.

  3. Evaluation of Haemodynamic Changes of Proximal Arterial Occlusion in the Lower Extremities by Spectrum Doppler Ultrasonography

    Directory of Open Access Journals (Sweden)

    Z Wang

    2015-06-01

    Full Text Available Objective: The objective is to analyse the changes of haemodynamic and Doppler ultrasonography spectrum in the proximal arterial occlusion of lower extremities, and to explore the value of spectrum Doppler ultrasonography in the diagnosis of lower extremity arterial occlusive disease. Methods: Thirty-four patients (thirty-nine occlusion arteries were examined with two-dimensional ultrasound combined with colour Doppler flow imaging (CDFI, and the results were compared. Result: The waveform shape in the artery proximal to the occlusion shows that blood flow velocity becomes slower, and diastolic reverse wave slowly disappears even upward. Systolic waveform records a steep upstroke, a slow downstroke and a shoulder on the downstroke. The appearance of the shoulder on the downstroke is earlier than the diastolic upward wave. The differences of peak systolic velocity, acceleration time, deceleration time, systolic acceleration, deceleration, diastolic reverse flow velocity, systolic acceleration time/systolic duration and systolic deceleration time/systolic duration in the proximal occlusion segment compared with the control group are statistically significant (p < 0.05. Conclusion: Artery occlusion can lead to haemodynamic response and spectrum waveform change. Timely discovery of the changes of the spectrum can be of clinical significance in the diagnosis of lower extremity arterial occlusive disease.

  4. 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

  5. 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.

  6. Changes of the intensity of morphogenetic process in the bone skeleton under lowering of gravitational loading

    Science.gov (United States)

    Vasilievna Rodionova, Natalia; Zolotova-Haidamaka, Nadezhda

    The development of long skeleton bones and reconstruction of bone structures in ontogenesis during adaptive remodeling are performed due to a combination of the bone apposition and bone resorption processes. With the use of radioactive markers of specific biosyntheses -3H- thymidine and 3H-glycine we studied the dynamics and peculiarities of these processes under modeling microgravity conditions by unloading the hind limbs of young white rats (tail suspension method) during 28 days. The radionuclides were administered in a single dose at the end of the experiment and the biomaterial was taken 1, 24, 48, 120 and 192 h. after injection. In histoautographs the counts were made of a nuclei labeling index (3H-thymidine), of the number of silver grains over the cells and in the forming bone matrix in growth and remodeling zones of the femoral bone (3H-glycine). The tendency for a reduction of a labeling index in the 3H-thymidine-labeled osteogenic cells in the periost and endost has been established. The dynamics of labeled cells following various intervals after 3H-thymidine injection testifies to a delay in the rates of osteoblasts' differentiation and their transformation to osteocytes in the experiment animals. 3H-glycine is assimilated by osteogenic cells 30 min after the radionuclide injection and following 24 h. it is already incorporated into the forming bone matrix. As a result an appositional bone addition by 192 h. the silver grains are registered in the bone matrix as "labeling lines". A lower 3H-glycine uptake by the osteogenic cells and bone matrix as compared with a control is indicative of a decrease of the osteoplastic process under hypokinesia, particulary in the periost. At the same time the resorption and remodeling bone zones reveal regions of an intensive 3H-glycine uptake after 1 and 24 h. We associate this latter fact with an activation of collagen proteins in the differentiating fibroblasts (instead of osteoblasts) in these locations. This is

  7. 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

  8. Endovascular Management of Deep venous Thrombosis of Lower Extremity in Patients with Malignant Disease

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Su Jin; Kim, Jae Kyu; Jang, Nam Kyu; Han, Seung Min; Kang, Heoung Keun; Choi, Soo Jin Nah [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2009-07-15

    To evaluate the efficacy of endovascular management of lower extremity deep vein thrombosis (DVT) in patients with malignant disease. Between January 2002 and January 2008, six consecutive patients (5 male and 1 female, mean age-65 years) with lower extremity DVT and malignant disease underwent endovascular management. The duration of symptoms lasted 4-120 days (mean-31 days; 20 days or less in four patients and more than 20 days in two). A catheter-directed thrombolysis was performed via the ipsilateral popliteal vein or common femoral vein, used alone or combined with a percutaneous mechanical thrombectomy. Angioplasty or stent placement was performed in residual stenosis or occlusion of the vein. The follow-up period lasted 1-14 months (mean 7.6 months) and was performed via a color Doppler ultrasonography or computed tomographic venography. Technical success and relief from symptoms was achieved within two days was achieved in five patients. Minor hemorrhagic complications occurred in two cases: hematuria and a hematoma at the puncture site. Upon follow-up, a recurrent DVT occurred in three patients as well as a patent venous flow in two. One patient died within 1 month due to a metastatic mediastinal lymphadenopathy. Endovascular management of the lower extremity DVT is effective for quickly eliminating a thrombus, relieving symptoms, and decreasing hemorrhagic complications in patients with malignant disease.

  9. Lower Extremity Arterial Occlusive Disease As a Rare Complication of Crohn's Disease

    Institute of Scientific and Technical Information of China (English)

    Wei-wei Wu; Xue-ying Jiang; Chang-wei Liu; Yong-jun Li; Rong Zeng

    2009-01-01

    Objective To investigate the dinical characteristics and treatment strategy of lower extremity arterial occlusive disease in patients with Crohn's disease(CD).Methods Clinical information of 9 cases suffering from lower extremity arterial occlusion and CD was investigated retrospectively.Results All the cases were less than 50 years old and the most were females(8/9).Arterial occlusions occurred in either active(5/9)or inactive(4/9)stage of CD.Besides the arteries of lower extremities,other arteries could also be involved such as aorta,iliac artery,renal artery or mesentery artery.Seven cases had atherosclerotic imaging findings(4 had aortic plaques and 6 had iliac artery stenoses).Embolectomy or thromboendarterectomy were mostly performed.Four(44.4% )cases had recurrent lower limb ischemia.Conclusions Arterial occlusive disease is a rare extraintestinal manifestation of CD.A thorough inspection of aorta is necessary.Embolectomy is mostly preferred.Anticoagulation treatment is highly recommended after the operation.

  10. 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.)

  11. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Types of psychological reactions in patients with lower-extremity amputations

    Directory of Open Access Journals (Sweden)

    Platiša Nedeljko

    2006-01-01

    Full Text Available The aim of this study was to establish types of psychological reactions and conditions in patients with lower-extremity amputations. Apart from using psychological interviews, detection was performed using psychometric tests: Minnesota Multiphasic Personality Inventory and Beck Depression Inventory. Psychometric parameters were analyzed in a group of 20 examinees treated at the Medical Rehabilitation Clinic in Novi Sad. Out of the whole sample. 45% of patients presented with adaptive reactions to amputation and consequent disability, whereas 55% presented with maladaptive responses. The registered psychopathological symptoms included nosologic categories: reaction to stressful events and adjustment disorder (predominantly affecting other emotions: mixed disorder of conduct and emotions: prolonged depressive reaction and dysthymia. When working with lower-extremity amputees, apart from adaptive, nonpathological forms of behavior, one also encounters maladaptive responses with predomination of mood disorders due to severe somatic stress. .

  14. Effect of commercially available pantyhose on venous return in the lower extremity.

    Science.gov (United States)

    Godin, M S; Rice, J C; Kerstein, M D

    1987-06-01

    Although compression stockings have long been recognized as a physiologically significant tool for the promotion of venous return from the lower extremity, the role of nonprescription, commercially available support hose has not been assessed in this regard. The present study involved 100 consecutive women with no known prior history of vascular disease, who responded to an advertisement for free evaluation of the venous status of their legs. The subjects, all of whom wore commercial support hose routinely, were screened for the presence of venous disease by means of Doppler ultrasonography, phleborheography, and a detailed history focusing on risk factors and unrecognized symptoms of venous disease. Photoplethysmography (PPG) was then used to evaluate the efficiency of venous return from the lower extremity with and without the support hose in place. Worsening of PPG results occurred in 43% of the women with commercial stockings in place, whereas 23% improved and 34% showed no change. Women 50 years of age and older had a somewhat higher tendency toward poorer PPG results while wearing the support hose. Furthermore, measurements in women who showed evidence of venous disease by an abnormality in one or more of the screening tests were significantly different from the overall group (p = 0.025): 61% exhibited worsening of PPG results when wearing stockings, only 14% showed improvement, and 25% were unchanged. These results suggest that the use of a commercial support hose may be particularly deleterious to older women and is contraindicated in those with evidence of venous disease in the lower extremity. PMID:3295307

  15. EMG analysis of the lower extremities during pitching in high-school baseball.

    Science.gov (United States)

    Yamanouchi, T

    1998-01-01

    I evaluated the contractions of the muscles of the lower extremities during baseball pitching using video imaging and simultaneous surface EMG. The subjects were 10 members of a high school baseball club and, for contrast, 10 students without any baseball club experience. I divided their pitching movements into two phases determined with respect to the landing of the non-pivot leg. The EMG signal intensities over the 2 seconds prior to landing, and over the 2 seconds after landing, were then integrated to give an EMG value to each phase. I then computed this value as the % MMT. The abductor and adductor of the hip muscles of both lower extremities in the players were strongly contracted, especially the adductor. This finding was consistent with the observation that pitching tends to lead to adductor muscle disorders. Strengthening the adductor and its antagonist abductor can therefore directly influence the capability for pitching, and can reduce the risk for the adductor disorders. PMID:9658746

  16. 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)

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Bilateral lower extremity hyperkeratotic plaques: a case report of ichthyosis vulgaris.

    Science.gov (United States)

    Leight, Hayley; Zinn, Zachary; Jalali, Omid

    2015-01-01

    Here, we report a case of a middle-aged woman presenting with severe, long-standing, hyperkeratotic plaques of the lower extremities unrelieved by over-the-counter medications. Initial history and clinical findings were suggestive of an inherited ichthyosis. Ichthyoses are genetic disorders characterized by dry scaly skin and altered skin-barrier function. A diagnosis of ichthyosis vulgaris was confirmed by histopathology. Etiology, prevalence, and treatment options are discussed.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.)

  1. 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...

  2. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Digital Model of Human Lower Extremity Musculoskeletal System Based on CT & MRI

    Institute of Scientific and Technical Information of China (English)

    尚鹏; 王成焘; 王立

    2004-01-01

    A new method to reconstruct a comparatively complete muscle model of the human lower limb from CT and MRI data is presented. Topological structure of more than fourteen muscles is built and coordinates of origin and insertion points are given.Based on this model, straight-line model and centroid-line muscle model are acquired. Muscle force prediction is discussed according to the model reconstructed, and a multi-objective optimization method is put forward for evaluating muscle forces of the human lower extremity.

  6. Lower Extremity Arterial Calcification as a Predictor of Coronary Atherosclerosis in Patients with Peripheral Arterial Disease

    Science.gov (United States)

    Shin, Hwa Seon; Jung Park, Mi; Nyeo Jeon, Kyung; Min Cho, Jae; Soo Bae, Kyung; Seob Choi, Dae; Boem Na, Jae; Cheol Choi, Ho; Young Choi, Hye; Eun Kim, Ji; Bueum Cho, Soo; Eun Park, Sung

    2016-01-01

    Background Until now, there has been no study on the relationship between the calcification of the lower extremity arteries and significant coronary arterial disease (CAD). Objectives To evaluate whether lower extremity calcium scores (LECS) are associated with CAD and whether this can predict multivessel-CAD in patients with peripheral arterial disease (PAD). Patients and Methods We retrospectively enrolled 103 PAD patients without cardiac symptoms or known CAD. All patients underwent cardiac computed tomography (CT) and lower extremity CT within 1 month and were categorized as nonsignificant CAD, single-CAD, or multivessel-CAD. The coronary calcium scores (CCS) were quantitatively measured according to the Agatston method and LECS were semi-quantitatively measured according to the presence of lower extremity calcification in the segment. The extent of CAD was evaluated according to the presence of ≥ 50% luminal diameter stenosis in the segment of CAD. Results LECS in multivessel-CAD were significantly higher than those in nonsignificant CAD (10.0 ± 5.8 versus 4.0 ± 3.1, P < 0.001). LECS significantly correlated with CCS (r = 0.831, P < 0.001) and the extent of CAD (r = 0.631, P < 0.001). Multivariate regression analysis demonstrated LECS and log-transformed CCS were independent predictors for multivessel-CAD. In receiver operating characteristic curve analysis, the diagnostic performance of LECS was 0.807 (95% confidence interval = 0.724-0.891, P < 0.001) for predicting multivessel-CAD. Conclusion Peripheral arterial calcification is significantly correlated with CAD extent in patients with PAD. Peripheral arterial calcification can be a useful marker for predicting multivessel-CAD.

  7. 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.

  8. 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.

  9. 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)

  10. 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...

  11. 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)

  12. 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

  13. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Byung Suk; Cho, Han Il; Lee, Yeum Sik; Bang, Dong Ho; Park, Seong Hoon; Lee, Young Hwan [Wonkwang University Hospital, Iksan (Korea, Republic of)

    2009-09-15

    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.

  15. Catheter-directed thrombolysis of below-knee deep venous thrombosis of the lower extremities

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Byung Suk; Sohn, Young Jun; Heo, Eun A; Cho, Hyun Sun; Park, Seong Hoon; Lee, Young Hwan [Wonkwang University Hospital, Iksan (Korea, Republic of)

    2008-02-15

    To evaluate the technical feasibility and clinical efficacy of the use of local thrombolysis for below-knee deep vein thrombosis (DVT). From a population of 41 patients with a lower extremity DVT, the prospective clinical trial included 11 patients (7 female, 4 male, average age 61.4 years) treated with catheter-directed thrombolysis with urokinase for below-knee DVT. After removal of the proximal ilofemoral DVT, additional interventional procedures to remove the residual thrombosis and restore the venous flow from the below-knee vein were performed in cases of continuous occlusion of venous flow from the popliteal and tibial veins. Under ultrasound (US) guidance, catheter-directed thrombolysis with urokinase was performed through the ipsilateral popliteal vein. After administration of oral anticoagulation therapy, CT and venography were performed to identify patency and the presence of a recurrent thrombosis. Successful removal of the thrombus and restoration of venous flow were achieved in all of the patients (100%). Restoration of flow with a residual thrombus occurred in one case. Focal venous stenosis was discovered in four cases. The duration of urokinase infusion was 1-4 days (average 2.36 days), which was considered long. For 15.2 months, the venous lumen of all cases was preserved without a recurrent thrombosis. Catheter-directed thrombolysis is an effective procedure for recanalization of below-knee DVT in patients with a lower extremity DVT.

  16. Inter-rater reliability for measurement of passive physiological movements in lower extremity joints is generally low: a systematic review

    NARCIS (Netherlands)

    E. van Trijffel; R.J. van de Pol; R.A. Oostendorp; C. Lucas

    2010-01-01

    Question: What is the inter-rater reliability for measurements of passive physiological or accessory movements in lower extremity joints? Design: Systematic review of studies of inter-rater reliability. Participants: Individuals with and without lower extremity disorders. Outcome measures: Range of

  17. Inter-rater reliability for measurement of passive physiological movements in lower extremity joints is generally low: a systematic review.

    NARCIS (Netherlands)

    Trijffel, E. van; Pol, R.J. van de; Oostendorp, R.A.B.; Lucas, C.

    2010-01-01

    QUESTION: What is the inter-rater reliability for measurements of passive physiological or accessory movements in lower extremity joints? DESIGN: Systematic review of studies of inter-rater reliability. PARTICIPANTS: Individuals with and without lower extremity disorders. OUTCOME MEASURES: Range of

  18. 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.

  19. Standardization of care in patients with lower extremity ulcers venous etiology

    Directory of Open Access Journals (Sweden)

    Diego López Muñoz

    2012-11-01

    Full Text Available The ulcer of the lower extremity is a common chronic disease process in daily practice, in which there is wide variability in treatment. Venous ulcers account for 70% of all vascular ulcers. They occur mainly as there is a valve dysfunction as a result of venous incompetence in the lower limbs. Due to the impact they pose is necessary to apply a corrective treatment and also to demonstrate effectiveness in repairing these ulcers. Our goals are to unify and standardize criteria for action by nursing language records and all perform a standardization of care for these patients. This has been an analysis of the needs of care in patients with ulcers of the lower extremity venous etiology methodology by applying nurse. The patient assessment is made by functional health patterns of M. Gordon, for the diagnosis, interventions and outcome criteria necessary use the NNN taxonomy (NANDA-NIC-NOC. We obtained a total of 3 major diagnostic labels, encoded according to NANDA taxonomy for nursing care quality required 13 interventions. Plant 5 outcome criteria to evaluate the effectiveness and quality of nurse activity. Standardized care plans are a valuable tool. Its use ensures that share a common language, unified performance criteria, achieved quality care for our patients.

  20. 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.

  1. 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

    was particularly more sensitive than CR for metacarpal heads and carpal bones. MagneVu MRI and CR detected 100% and 89%, respectively, of large erosions (Outcome Measures in Rheumatoid Arthritis Clinical Trials-Rheumatoid Arthritis MRI Scoring System (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, 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. Complications of Sclerotherapy with Sclerosing Foam in Lower Extremity Varicose Veins

    Directory of Open Access Journals (Sweden)

    Hossein Hemmati

    2015-01-01

    Full Text Available Background: Using sclerotherapy with foam has caused a great change in treatment of varicose veins. Although, it is more than a century that it is being used, no exact and comprehensive knowledge of its complications has been published yet with regard to the existing facilities in Iran. Materials and Methods: In this cross-sectional study, Patients with varicose veins of lower extremity referred to cardiology clinic of Razi hospital, Rasht were included in the study after doppler sonography and in case of presence of varicose veins with more than 2 mm diameter in lower extremities without inadequacy of saphenofemoral and saphenopopliteal valve. They then underwent sclerosing with foam treatment. The total number of patients was 156 who were examined 2 weeks and 3 months after sclerotherapy in terms of complications such as pain, pigmentation, recurrence, phlebitis, deep vein thrombosis and skin necrosis. Results: Out of 156 patients, 47 were men and 109 women whose mean±SD age was 46.5±12.2 years. Two weeks after sclerotherapy, pain in 95 patients (65.1%, pigmentation in 79 patients (53.4%, recurrence in 5 patients (3.4%, necrosis in 8 patients (5.5% and no phlebitis was witnessed. Three months after sclerotherapy, pain in 10 patients (6.8%, pigmentation in 52 patients (35.1%, recurrence in 13 patients (8.8% and phlebitis in 13 patients (8.8% were seen; however, necrosis was not observed Conclusion: Sclerotherapy with foam is an effective, safe and inexpensive method for treatment of varicose veins of lower extremities. Thus, in case of a careful selection of patients and conduction in an equipped center, few complications will be seen.

  3. [Phlebosclerosing therapy after operative intervention for chronic venous insufficiency of the lower extremities].

    Science.gov (United States)

    Shamsadinskiĭ, A A; Shamsadinskaia, T A

    2009-02-01

    To the Center of angiology and microsurgery have been submitted 75 patients seeking for the cosmetic result of their treatment improvement, to whom operative interventions for the lower extremities varicosities were performed previously. The sclerosing procedures for the dilated venous tributaries, reticular veins and teleangiectasiae was conducted, complete elimination of a "heavy feet" syndrome was noted together with reduction of the symptoms severity. The phlebosclerosing method permits to achieve good clinical, aesthetic results, to improve the quality of life and social activity of the patients.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    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...... influencing the outcome of the examination stresses the need for consensus regarding examination protocols and interpretation. Further studies are needed to improve diagnostic performance and understanding of pathophysiological mechanisms....... 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...

  5. 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.)

  6. Bilateral lower extremity hyperkeratotic plaques: a case report of ichthyosis vulgaris

    Directory of Open Access Journals (Sweden)

    Leight H

    2015-09-01

    Full Text Available Hayley Leight, Zachary Zinn, Omid JalaliDepartment of Dermatology, West Virginia University, Morgantown, WV, USA Abstract: Here, we report a case of a middle-aged woman presenting with severe, long-standing, hyperkeratotic plaques of the lower extremities unrelieved by over-the-counter medications. Initial history and clinical findings were suggestive of an inherited ichthyosis. Ichthyoses are genetic disorders characterized by dry scaly skin and altered skin-barrier function. A diagnosis of ichthyosis vulgaris was confirmed by histopathology. Etiology, prevalence, and treatment options are discussed. Keywords: filaggrin gene, FLG, profilaggrin, keratohyalin granules, hyperkeratosis

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

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez-Marquez, A.; Gil-Garcia, M.; Valls, C.; Narvaez-Garcia, J.; Andia-Navarro, E.; Pozuelo-Segura, O. [Inst. de Diagnostic per la Imatge (IDI), Hospital Duran i Reynals, Barcelona (Spain); Portabella-Blavia, F. [Servei de Cirurgia Ortopedica i Traumatologia, Ciutat Sanitaria i Univ., Barcelona (Spain)

    1999-08-01

    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.) With 12 figs., 12 refs.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, S.H. [Department of Radiology, Kyung Hee University Medical Center, Seoul (Korea, Republic of); Oh, J.H. [Department of Radiology, Kyung Hee University Medical Center, Seoul (Korea, Republic of)], E-mail: radkwon@dreamwiz.com; Seo, T.-S. [Department of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of); Ahn, H.J.; Park, H.C. [Department of Surgery, Kyung Hee University Medical Center, Seoul (Korea, Republic of)

    2009-05-15

    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.

  9. 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...

  10. 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

  11. 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

  12. 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.

  13. 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

  14. THE LOWER EXTREMITY BIOMECHANICS OF SINGLE- AND DOUBLE-LEG STOP-JUMP TASKS

    Directory of Open Access Journals (Sweden)

    Li-I Wang

    2011-03-01

    Full Text Available The anterior cruciate ligament (ACL injury is a common occurrence in sports requiring stop-jump tasks. Single- and double-leg stop-jump techniques are frequently executed in sports. The higher risk of ACL injury in single-leg drop landing task compared to a double-leg drop landing task has been identified. However the injury bias between single- and double-leg landing techniques has not been investigated for stop-jump tasks. The purpose of this study was to determine the differences between single- and double-leg stop-jump tasks in knee kinetics that were influenced by the lower extremity kinematics during the landing phase. Ground reaction force, lower extremity kinematics, and knee kinetics data during the landing phase were obtained from 10 subjects performing single- and double-leg stop-jump tasks, using motion-capture system and force palates. Greater peak posterior and vertical ground reaction forces, and peak proximal tibia anterior and lateral shear forces (p < 0.05 during landing phase were observed of single-leg stop-jump. Single-leg stop-jump exhibited smaller hip and knee flexion angle, and knee flexion angular velocity at initial foot contact with the ground (p < 0.05. We found smaller peak hip and knee flexion angles (p < 0.05 during the landing phase of single-leg stop-jump. These results indicate that single-leg landing may have higher ACL injury risk than double-leg landing in stop-jump tasks that may be influenced by the lower extremity kinematics during the landing phase.

  15. 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

    2004-02-10

    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 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.

  16. 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 ...

  17. 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...

  18. Effect of rain boot shaft length on lower extremity muscle activity during treadmill walking

    Science.gov (United States)

    Kim, Young-Hwan; Yoo, Kyung-Tae

    2016-01-01

    [Purpose] This study aimed to determine the extent of lower extremity muscle activity before and after walking based on rain boot shaft length. [Subjects and Methods] The subjects, 12 young and healthy females, were divided into three groups based on rain boot shaft length (long, middle, and short). They walked on a treadmill for 30 minutes. Activity of the rectus femoris, vastus lateralis, semitendinosus, tibialis anterior, peroneus longus, and gastrocnemius was measured using electromyography before and after walking. Two-way repeated measures analysis of variance was performed to compare the muscle activities of each group. [Results] There were no significant differences in terms of the interactive effects between group and time for all muscles, the main effects of group, or the main effects of time. [Conclusion] The results of this study may indicate that movement of the lower extremities was not significantly limited by friction force based on the characteristics of the boot material or the circumference of the boot shaft. Thus, it may be helpful instead to consider the material of the sole or the weight of the boots when choosing which rain boots to wear. PMID:27799685

  19. 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

  20. Local dynamic stability of the trunk segments and lower extremity joints during backward walking.

    Science.gov (United States)

    Wu, Yu; Xiao, Fei; Gu, Dong-Yun

    2015-01-01

    Backward walking has become a popular training method in physical exercise and clinical rehabilitation. For the sake of safety, it is important to keep a stable gait during backward walking. However, the gait stability during backward walking was rarely studied. This study investigated the effects of walking direction on local dynamic stability of the trunk segments (neck, torso and pelvis) and lower extremity joints (hip, knee and ankle joint). The maximum Lyapunov exponents (λ(s)) of 17 young healthy male adults were calculated while they were walking under three conditions: backward walking with preferred walking speed (BW), forward walking (FW) with the same speed determined by BW, and forward walking with normal speed (FWN). We found that compared with FW, BW showed significant higher values of λ(s) in the trunk segments in vertical (VT) direction (psegment also displayed a higher value of λ(s) in anterior-posterior (AP) direction (pwalking speed was found between FW and FWN condition in VT direction (pwalking did impair the local dynamic stability in trunk segments and lower extremity joints. Especially, the negative effect of BW on the poor gait stability in the AP direction of torso segment, and AB/AD and RT motion of knee joint should not be neglected.

  1. Simultaneous toe-to-hand transfer and lower extremity amputations for severe upper and lower limb defects: the use of spare parts.

    Science.gov (United States)

    Chang, J; Jones, N F

    2002-06-01

    From 1995 to 2000, five microvascular toe-to-hand transfers were performed in three children who were simultaneously undergoing lower extremity amputations. Their ages at time of transfer ranged from 4 to 10 years and the types of lower extremity amputation included toe amputation, foot amputation and through-knee amputation. The resulting toe-to-hand transfers included three great toe-to-thumb transfers and one combined great and second toe-to-hand transfer. The toe-to-hand transfers were all successful and all the lower extremity amputations healed without complications. In all cases, improved hand function and lower extremity function was noted by the families. These unique cases represent the ultimate use of spare parts in congenital hand surgery.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Pitfalls and sources of error of color duplex ultrasonography in detecting deep vein thrombosis of proximal lower extremities

    Institute of Scientific and Technical Information of China (English)

    GAO Jing; YI Lianhua; Auh Yong Ho

    2004-01-01

    Purpose To analyze the sources of errors and discuss the techniques to eliminate pitfalls in detecting deep vein thrombosis (DVT) of the proximal lower extremities with color duplex ultrasonography (CDUS). Methods Sixty-eight cases with initial and repeat venous CDUS of the proximal lower extremities were retrospectively reviewed. The repeat was done within 24 hours after initial CDUS scanning. Comparing repeated images to initial ones, the pitfalls and sources of error in CDUS of the proximal lower extremities were discussed. Results In total 68 repeat studies, there were 62 results as same as initials and 4 cases of false negative DVT and 2 cases of false positive DVT. Conclusion Venous CDUS in detecting DVT is observer dependent. Some pitfalls and errors can be eliminated and corrected with proper scan techniques. CDUS is the most valuable imaging modality for assessing suspected DVT in the proximal lower extremities.

  7. 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)

  8. 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

  9. 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.

  10. MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary Tumor

    Directory of Open Access Journals (Sweden)

    D. Ryan Ormond

    2012-01-01

    Full Text Available Background. Causalgia is continuing pain, allodynia, or hyperalgesia after nerve injury with edema, changes in skin blood flow, or abnormal sudomotor activity. Here we report a case of lower extremity causalgia following elective transsphenoidal resection of a pituitary tumor in a young man. Clinical Presentation. A 33-year-old man with acromegaly underwent elective sublabial transsphenoidal resection of his pituitary tumor. During the three-hour surgery, the lower limbs were kept in a supine, neutral position with a pillow under the knees. The right thigh was slightly internally rotated with a tape to expose fascia lata, which was harvested to repair the sella. Postoperatively, he developed causalgia in a distal sciatic and common peroneal nerve distribution. Pain was refractory to several interventions. Finally, phenoxybenzamine improved his pain significantly. Conclusions. Malpositioning in the operating room resulted in causalgia in this young man. Phenoxybenzamine improved, and ultimately resolved, his symptoms. Improvement in his pain symptoms correlated with resolution of imaging changes in the distal sciatic and peroneal nerves on the side of injury.

  11. Structural bone allografts with intramedullary vascularized fibular autografts for the treatment of massive bone defects in extremities

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To report the clinical outcome of repairing massive bone defects biologically in limbs by homeochronous using structural bone allografts with intramedullary vascularized fibular auto-grafts. Methods: From January 2001 to December 2005. large bone defects in 19 patients (11 men and 8 women, aged 6 to 35 years) were repaired by structural bone allografts with intramedullary vascularized fibular autografts in the homeochronous period. The range of the length of bone defects was 11 to 25 cm (mean 17. 6 cm), length of vascularized free fibular was 15 to 29 cm (mean 19. 2 cm), length of massive bone allografts was 11 to 24 cm (mean 17. 1 cm). Location of massive bone defects was in humerus(n = 1), in femur(n = 9) and in tibia(n = 9), respectively. Results: After 9 to 69 months (mean 38. 2 months) follow-up, wounds of donor and recipient sites were healed in Ⅰ stage, monitoring-flaps were alive, eject reaction of massive bone allografts were slight, no complications in donor limbs. Fifteen patients had the evidence of radiographic union 3 to 6 months after surgery, 3 cases united 8 months later, and the remained one case of malignant synovioma in distal femur recurred and amputated the leg 2. 5 months, post-operatively. Five patients had been removed internal fixation, complete bone unions were found one year postoperatively. None of massive bone allografts were absorbed or collapsed at last follow-up. Conclusion: The homeochronous usage of structural bone allograft with an intramedullary vascularized fibular au-tograft can biologically obtain a structure with the immediate mechanical strength of the allograft, a potential result of revascularization through the vascularized fibula, and accelerate bone union not only between fibular autograft and the host but also between massive bone allograft and the host.

  12. 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

  13. 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

  14. Immune function of erythrocytes in patients with chronic venous insufficiency of the lower extremities

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lan; ZHANG Bai-gen; ZHANG Ji-wei; ZHANG Hao

    2007-01-01

    Background The influence of inflammatory processes has been one of the hot topics in discussions of the etiology of chronic venous insufficiency(CVI).Erythrocytes are very important in controlling inflammatory immunity and innate immune reactions.The purpose of this study was to analyze the correlation between the development of CVI and the change of CD35,Fy6 on erythrocytes,and interleukin-8(IL-8) levels.Methods A group of 43 patients with CVI were studied in parallel with 8 healthy individuals serving as centrol subjects.Control subjects were those with normal findings on lower extremity duplex examinations.We used an erythrocyte flow cytometer to examine the expression of both CD35 and Fy6 on red blood cells,and an enzyme-linked immunosorbent assay analysis method to measure plasma IL-8 levels.We also analyzed the change of IL-8 levels under the influence of erythrocytes using a modified method of the hemaimmune reaction.Results Compared with normal centrol subjects,CD35 expression increased significantly among patients with CVI classified as C4 without lipodermatosclerosis,but tended to decrease and reach the lowest level among patients classified as C5-C6.Fy6 expression increased significantly among patients in the early stages of CVI,but tended to decrease remarkably among patients classified as C5-C6.The inflammatory response intensified at the C5-C6 classification,where high levels of IL-8 coexisted with a low expression of Fy6.The increase in IL-8 in the CVI group was higher than in the control group in association with the complete blood cells,regardless of the presence of erythrocytes,when inactive tumour cells were added,whereas the level of IL-8 in the CVI group was significantly lower than in the control group.Conclusions Abnormalities of erythrocyte innate immunity represents a fundamental derangement in CVI.These inadequate inflammatory responses may lead to local tissue and microvascular damage of the lower extremity.

  15. 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.

  16. 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

  17. 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...

  18. 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...... the 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...

  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. 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...

  1. 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

  2. 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.

  3. 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.; Stephen W Marshall; 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:...

  4. 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

  5. Investigation of fall prediction factors in elderly population using isokinetic assessment of the lower extremities

    Directory of Open Access Journals (Sweden)

    SEMALTIANOY ELENI

    2011-01-01

    Full Text Available The purpose of the present study was to investigate for predictive factors for falls in the elderly population after lower extremity strength assessment in an isokinetic dynamometer and to construct a discrimination model for the classification of the elderly in a fallers and non-fallers group. 59 community dwelling elderly men and women aged60 years and older with or without a history of falls all in good health were selected to participate in the study. For the assessment, we used six concentric and two eccentric speeds isokinetically (60°, 90°, 120°, 180°, 240°, 300°/secand 60°, 120°/sec respectively and four different angular positions isometrically (75°, 60°, 45°, 30° of knee flexion,0°=anatomical zero. All measures were conducted with a Cybex Norm® Isokinetic Dynamometer in the knee joint for both legs in flexion and extension. T-test was used in order to identify differences between fallers and non-fallers. Step-wise discriminant analysis performed in order to reveal the factors for classification of the elderly in fallers/non-fallers group. Statistical significant differences (p<0.05 were ob-served for strength and power measures in 42 of the 60variables, between the two groups (fallers/non-fallers, with non-fallers performing better in all examined variables. Three variables out of the initially 42 that included in the discriminant analysis were present in the discriminant model: Mean peak torque in 120°/sec in Extension, mean total work in 60°/secin flexion and mean total work ratio (Flexors/Extensors in 60°/sec. These three variables classified correctly the 91.4% of the cases in the fallers/non-fallers groups. The conclusion of the researchers was that isokinetic and isometric assessment of the lower extremities strength in the elderly population can discriminate fallers and non fallers. As a result we can therefore classify older people in prevention programs according to their probability for falls.

  6. 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

  7. 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.

  8. 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.

  9. Investigation of postural edema in the lower extremities of traffic control workers

    Directory of Open Access Journals (Sweden)

    Ana Paula Nunes Pereira Brito

    2013-12-01

    Full Text Available OBJECTIVE: Determine the prevalence of postural edema and investigate whether working posture - sitting down or standing up - affect its frequency. METHODS: Sixteen traffic control agents were assessed by water displacement volumetry and the results were analyzed in two groups, depending on working posture. Those who worked standing up for more than 4 hours were allocated to the SU group and those who worked sitting down for more than 4 hours were allocated to the SD group. Each worker was assessed before and after their working shift for three consecutive days. Data were analyzed using ANOVA and the test of equality of two proportions. The significance level was set at p ≤ 0.05. The assessment showed that members of both groups had postural edema of the lower extremities (p ≤ 0.001. RESULTS: When the frequency of postural edema was compared across groups, a trend was observed for greater edema formation in the SU group than in the SD group, although without statistically significant difference. CONCLUSION: It was concluded that traffic control agents suffer postural edema after 4 hours working in either of the postures investigated although with a predominance of edema formation among those who work standing up.

  10. Muscle activation patterns of the upper and lower extremity during the windmill softball pitch.

    Science.gov (United States)

    Oliver, Gretchen D; Plummer, Hillary A; Keeley, David W

    2011-06-01

    Fast-pitch softball has become an increasingly popular sport for female athletes. There has been little research examining the windmill softball pitch in the literature. The purpose of this study was to describe the muscle activation patterns of 3 upper extremity muscles (biceps, triceps, and rhomboids [scapular stabilizers]) and 2 lower extremity muscles (gluteus maximus and medius) during the 5 phases of the windmill softball pitch. Data describing muscle activation were collected on 7 postpubescent softball pitchers (age 17.7 ± 2.6 years; height 169 ± 5.4 cm; mass 69.1 ± 5.4 kg). Surface electromyographic data were collected using a Myopac Jr 10-channel amplifier (RUN Technologies Scientific Systems, Laguna Hills, CA, USA) synchronized with The MotionMonitor™ motion capture system (Innovative Sports Training Inc, Chicago IL, USA) and presented as a percent of maximum voluntary isometric contraction. Gluteus maximus activity reached (196.3% maximum voluntary isometric contraction [MVIC]), whereas gluteus medius activity was consistent during the single leg support of phase 3 (101.2% MVIC). Biceps brachii activity was greatest during phase 4 of the pitching motion. Triceps brachii activation was consistently >150% MVIC throughout the entire pitching motion, whereas the scapular stabilizers were most active during phase 2 (170.1% MVIC). The results of this study indicate the extent to which muscles are activated during the windmill softball pitch, and this knowledge can lead to the development of proper preventative and rehabilitative muscle strengthening programs. In addition, clinicians will be able to incorporate strengthening exercises that mimic the timing of maximal muscle activation most used during the windmill pitching phases.

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

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    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

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

    Science.gov (United States)

    Beyth, Shaul; Mosheiff, Rami; Safran, Ori; Daskal, Anat; Liebergall, Meir

    2015-01-01

    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. PMID:26346476

  13. 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.

  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. Influences of trunk flexion on mechanical energy flow in the lower extremities during gait

    Science.gov (United States)

    Takeda, Takuya; Anan, Masaya; Takahashi, Makoto; Ogata, Yuta; Tanimoto, Kenji; Shinkoda, Koichi

    2016-01-01

    [Purpose] The time-series waveforms of mechanical energy generation, absorption, and transfer through the joints indicate how movements are produced and controlled. Previous studies have used these waveforms to evaluate and describe the efficiency of human movements. The purpose of this study was to examine the influence of trunk flexion on mechanical energy flow in the lower extremities during gait. [Subjects and Methods] The subjects were 8 healthy young males (mean age, 21.8 ± 1.3 years, mean height, 170.5 ± 6.8 cm, and mean weight, 60.2 ± 6.8 kg). Subjects walked at a self-selected gait speed under 2 conditions: normal gait (condition N), and gait with trunk flexion formed with a brace to simulate spinal curvature (condition TF). The data collected from initial contact to the mid-stance of gait was analyzed. [Results] There were no significant differences between the 2 conditions in the mechanical energy flow in the knee joint and negative mechanical work in the knee joint. However, the positive mechanical work of the knee joint under condition TF was significantly less than that under condition N. [Conclusion] Trunk flexion led to knee flexion in a standing posture. Thus, a strategy of moving of center of mass upward by knee extension using less mechanical energy was selected during gait in the trunk flexed posture. PMID:27313351

  16. Perioperative complications of orthopedic surgery for lower extremity in patients with cerebral palsy.

    Science.gov (United States)

    Lee, Seung Yeol; Sohn, Hye-Min; Chung, Chin Youb; Do, Sang-Hwan; Lee, Kyoung Min; Kwon, Soon-Sun; Sung, Ki Hyuk; Lee, Sun Hyung; Park, Moon Seok

    2015-04-01

    Because complications are more common in patients with cerebral palsy (CP), surgeons and anesthesiologists must be aware of perioperative morbidity and be prepared to recognize and treat perioperative complications. This study aimed to determine the incidence of and risk factors for perioperative complications of orthopedic surgery on the lower extremities in patients with CP. We reviewed the medical records of consecutive CP patients undergoing orthopedic surgery. Medical history, anesthesia emergence time, intraoperative body temperature, heart rate, blood pressure, immediate postoperative complications, Gross Motor Function Classification System (GMFCS) level, Cormack-Lehane classification, and American Society of Anesthesiologists physical status classification were analyzed. A total of 868 patients was included. Mean age at first surgery was 11.8 (7.6) yr. The incidences of intraoperative hypothermia, absolute hypotension, and absolute bradycardia were 26.2%, 4.4%, and 20.0%, respectively. Twenty (2.3%) patients had major complications, and 35 (4.0%) patients had minor complications postoperatively. The incidences of intraoperative hypothermia, absolute hypotension, and major postoperative complications were significantly higher in patients at GMFCS levels IV and V compared with patients at GMFCS levels I to III (PGMFCS level, patient age, hip reconstructive surgery, and history of pneumonia are associated with adverse effects on intraoperative body temperature, the cardiovascular system, and immediate postoperative complications.

  17. Influences of trunk flexion on mechanical energy flow in the lower extremities during gait.

    Science.gov (United States)

    Takeda, Takuya; Anan, Masaya; Takahashi, Makoto; Ogata, Yuta; Tanimoto, Kenji; Shinkoda, Koichi

    2016-05-01

    [Purpose] The time-series waveforms of mechanical energy generation, absorption, and transfer through the joints indicate how movements are produced and controlled. Previous studies have used these waveforms to evaluate and describe the efficiency of human movements. The purpose of this study was to examine the influence of trunk flexion on mechanical energy flow in the lower extremities during gait. [Subjects and Methods] The subjects were 8 healthy young males (mean age, 21.8 ± 1.3 years, mean height, 170.5 ± 6.8 cm, and mean weight, 60.2 ± 6.8 kg). Subjects walked at a self-selected gait speed under 2 conditions: normal gait (condition N), and gait with trunk flexion formed with a brace to simulate spinal curvature (condition TF). The data collected from initial contact to the mid-stance of gait was analyzed. [Results] There were no significant differences between the 2 conditions in the mechanical energy flow in the knee joint and negative mechanical work in the knee joint. However, the positive mechanical work of the knee joint under condition TF was significantly less than that under condition N. [Conclusion] Trunk flexion led to knee flexion in a standing posture. Thus, a strategy of moving of center of mass upward by knee extension using less mechanical energy was selected during gait in the trunk flexed posture.

  18. The Incidence of Giacomini Vein and Its Association with Lower Extremity venous Insufficiency: An Ultrasonographic Study

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soon Chan; Kwon, Se Hwan; Oh, Joo Hyeong; Ryu, Kyung Nam; Ahn, Hyung Joon; Park, Ho Chul [Kyunghee University Medical Center, Seoul (Korea, Republic of)

    2009-09-15

    We wanted to evaluate the incidence of Giacomini vein and its association with lower extremity venous insufficiency by performing US. From September 2006 to July 2007, 173 patients (58 males and 115 females, mean age: 52.7 years, age range: 22-72 years) who had been diagnosed with unilateral/bilateral varicose veins or telangiectasias were evaluated with duplex Doppler ultrasonography. The presence of Giacomini vein, superficial/deep vein reflux, the anatomical sites of the venous reflux and the abnormal perforating veins was investigated in 346 legs. Giacomini veins were found in 33 limbs (9.5%) of 21 patients (12.1%). Bilateral Giacomini veins were found in 12 patients. Of the 33 limbs that had Giacomini veins, 20 limbs had great saphenous vein (GSV) reflux and 4 limbs had small saphenous vein (SSV) reflux. The patients with Giacomini veins were classified into two groups according to the presence of Giacomini vein. There was no significant difference of the GSV reflux (p = 0.155), the SSV reflux (p = 0.760) and the mean velocity of the GSV reflux or the SSV reflux (p = 0.685, p = 0.431, respectively) between the two groups. Our results indicated that Giacomini vein is not associated with either GSV or SSV reflux, and this is contrary to conventional belief

  19. Lower extremity mechanics of iliotibial band syndrome during an exhaustive run.

    Science.gov (United States)

    Miller, Ross H; Lowry, Jennifer L; Meardon, Stacey A; Gillette, Jason C

    2007-09-01

    Injury patterns in distance running may be related to kinematic adjustments induced by fatigue. The goal was to measure changes in lower extremity mechanics during an exhaustive run in individuals with and without a history of iliotibial band syndrome (ITBS). Sixteen recreational runners ran to voluntary exhaustion on a treadmill at a self-selected pace. Eight runners had a history of ITBS. Twenty-three reflective marker positions were recorded by an eight-camera 120 Hz motion capture system. Joint angles during stance phase were exported to a musculoskeletal model (SIMM) with the iliotibial band (ITB) modeled as a passive structure to estimate strain in the ITB. For ITBS runners, at the end of the run: (1) knee flexion at heel-strike was higher than control (20.6 degrees versus 15.3 degrees, p=0.01); (2) the number of knees with predicted ITB impingment upon the lateral femoral epicondyle increased from 6 to 11. Strain in the ITB was higher in the ITBS runners throughout all of stance. Maximum foot adduction in the ITBS runners was higher versus control at the start of the run (p=0.003). Maximum foot inversion (p=0.03) and maximum knee internal rotation velocity (p=0.02) were higher versus control at the end of the run. In conclusion, ITB mechanics appear to be related to changes in knee flexion at heel-strike and internal rotation of the leg. These observations may suggest kinematic discriminators for clinical assessment.

  20. 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...

  1. Mechanical axis of the lower extremity determined by a new digital photographic method.

    Science.gov (United States)

    Simonsen, Ole Højgaard; Thomsen, Hanne; Skou, Søren Thorgaard; Andersen, Mikkel Meyer

    2013-08-01

    Assessment of the mechanical axis is routine during the examination of patients with lower extremity pain. Long-leg radiographic examination is the gold standard for exact measurement, but it is associated with a significant radiation dose. An alternative method to examine the mechanical axis has been warranted. This article validates a newly developed computerized photograph method to calculate the mechanical axis using a digital photograph. The location of the center of the femoral head was calculated using ink marks on both superior iliac spines. Twenty-five patients (10 women and 15 men) had both legs examined using the photographic method and long-leg radiography examination. The digital photograph method was found to be highly reliable. The interobserver absolute mean difference was 0.99°±0.85°, and the intraobserver absolute mean difference (day-to-day variation) was 1.04°±0.81°. The mechanical axis determined by the 2 methods was highly correlated (R=0.943). The long-leg radiography method was within an average of ±1.88° of the photographic method, with a 95% probability. The photographic method appears to be an effective alternative to conventional long-leg radiography. The photographic method seems convenient in the routine examination of patients with leg pain and children with suspected axial deformity and for follow-up after treatment for malalignment. Calculation coefficients for children and a possible racial difference remain to be studied.

  2. 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

  3. Psychometric Properties of the Lower Extremity Subscale of the Fugl-Myer Assessment for Community-dwelling Hemiplegic Stroke Patients.

    Science.gov (United States)

    Park, Eun Young; Choi, Yoo Im

    2014-11-01

    [Purpose] The purpose of this study was to investigate the psychometric properties of the lower extremity subscale of the Fugl-Meyer Assessment lower extremity (FMA-LE) for community-dwelling hemiplegic stroke patients. [Subjects] The participants were 140 community-dwelling hemiplegic stroke patients. [Methods] To determine the psychometric properties of the FMA-LE, we examined construct validity, response characteristics, item discrimination, and internal consistency. [Results] Factor analysis of the FMA-LE revealed that the first factor explained 61.73% of the variance and provided evidence of unidimensionality. The FMA-LE did not show ceiling or floor effects; Cronbach's α was 0.935 (95% CI: 0.919-0.950). [Conclusion] Because the FMA-LE seems to be both valid and reliable, we conclude that it is appropriate for the measurement of the lower extremity motor impairment of community-dwelling hemiplegic stroke patients.

  4. 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%) .

  5. 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)

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

    Institute of Scientific and Technical Information of China (English)

    Shahram Nazerani; Hamed Vaseghi; Saied Hesami; Tina Nazerani

    2013-01-01

    Objective:Ectopic tissue transplantation 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 returning 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 debrided 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 overall success rate was about 70%,lower than expected but these are cases of severe crush injury.Although the functional 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 extremity 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 punishment 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.

  7. 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

  8. [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

  9. 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)

  10. Transplantation of autologous bone marrow mononuclear cells for patients with lower limb ischemia

    Institute of Scientific and Technical Information of China (English)

    GU Yong-quan; LI Xue-feng; YU Heng-xi; CUI Shi-jun; WANG Zhong-gao; ZHANG Jian; GUO Lian-rui; QI Li-xing; ZHANG Shu-wen; XU Juan; LI Jian-xin; LUO Tao; JI Bing-xin

    2008-01-01

    Background Many treatment options for lower limb ischemia are difficult to apply for the patients with poor arterial outflow or with poor general conditions.The effect of medical treatment alone is far from ideal.especially in patients with diabetic foot.A high level amputation is inevitable in these patients.This study aimed to explore the effect of transplantation of autologous bone marrow mononuclear cells on the treatment of lower limb ischemia and to compare the effect of intra-artedal transplantation with that of intra-muscular transplantation.Methods In this clinical trial,32 patients with lower limb ischemia were divided into two groups.Group 1 (16 patients with 18 affected limbs) received transplantation of autologous bone marrow mononuclear cells by intra-muscular injection into the affected limbs;and group 2(16 patients with 17 affected limbs)received transplantation of autologous bone marrow mononucJear cells by intra-arterial injection into the affected limbs.Rest pain,coldness,ankle/brachial index (ABI),claudication,transcutaneous oxygen pressure(tcPO2)and angiography(15 limbs of 14 patients)were evaluated before and after the mononuclear cell transplantation to determine the effect of the treatment.Results Two patients died from heart failure.The improvement of rest pain was seen in 76.5%(13/17)of group 1 and 93.3%(14/15)of group 2.The improvement of coldness was 100%in both groups.The increase of ABI was 44.4%(8/18)in group 1 and 41.2%(7,17)in group 2.The value of tcPO2 increased to 20 mmHg or more in 20 limbs.Nine of 15 limbs which underwent angiography showed rich collaterals.Limb salvage rate was 83.3%(15,18)in group 1 and 94.1%(16/17)in group 2.There was no statistically significant difference in the effectiveness of the treatment between the two groups.Conclusions Transplantation of autologous bone marrow mononucJear cells is a simple,safe and effective method for the treatment of lower limb ischemia,and the two approaches for the implantation

  11. Reducing major lower extremity amputations after the introduction of a multidisciplinary team for the diabetic foot.

    Science.gov (United States)

    Rubio, José Antonio; Aragón-Sánchez, Javier; Jiménez, Sara; Guadalix, Gregorio; Albarracín, Agustín; Salido, Carmen; Sanz-Moreno, José; Ruiz-Grande, Fernando; Gil-Fournier, Nuria; Álvarez, Julia

    2014-03-01

    We analyzed the incidence of lower extremity amputations (LEAs) in the 3rd Health Care Area of Madrid before and after the March 2008 introduction of a multidisciplinary team for managing diabetic foot disease. We compared the amputation rates in people with and without diabetes during 2 periods: before (2001-2007) and after (2008-2011) the introduction of a Multidisciplinary Diabetic Foot Unit (MDFU). We also analyzed the trend of the amputation rates by joinpoint regression analysis and measured the annual percentage change (APC). During the study period, 514 nontraumatic LEAs were performed, 374 (73%) in people with diabetes and 140 (27%) in people without the disease. The incidence of LEAs showed a significant reduction in major amputations in people with diabetes, from 6.1 per 100 000 per year (95% confidence interval [CI] = 4.9 to 7.2), in the 2001 to 2007 period, to 4.0 per 100 000 per year (95% CI = 2.6 to 5.5) in the 2008 to 2011 period (P = .020). There were no changes in incidence of minor or total amputations in the diabetic population or in amputations in the nondiabetic population during the study period. Joinpoint regression analysis showed a significant reduction in the incidence of major LEAs in diabetic population with an APC of -6.6% (95% CI = -10.2 to -2.8; P = .003), but there were no other significant changes. This study demonstrates that the introduction of a multidisciplinary team, coordinated by an endocrinologist and a podiatrist, for managing diabetic foot disease is associated with a reduction in the incidence of major amputations in patients with diabetes.

  12. 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

  13. Evaluation and treatment of patients with lower extremity peripheral artery disease: consensus definitions from Peripheral Academic Research Consortium (PARC).

    Science.gov (United States)

    Patel, Manesh R; Conte, Michael S; Cutlip, Donald E; Dib, Nabil; Geraghty, Patrick; Gray, William; Hiatt, William R; Ho, Mami; Ikeda, Koji; Ikeno, Fumiaki; Jaff, Michael R; Jones, W Schuyler; Kawahara, Masayuki; Lookstein, Robert A; Mehran, Roxana; Misra, Sanjay; Norgren, Lars; Olin, Jeffrey W; Povsic, Thomas J; Rosenfield, Kenneth; Rundback, John; Shamoun, Fadi; Tcheng, James; Tsai, Thomas T; Suzuki, Yuka; Vranckx, Pascal; Wiechmann, Bret N; White, Christopher J; Yokoi, Hiroyoshi; Krucoff, Mitchell W

    2015-03-10

    The lack of consistent definitions and nomenclature across clinical trials of novel devices, drugs, or biologics poses a significant barrier to accrual of knowledge in and across peripheral artery disease therapies and technologies. Recognizing this problem, the Peripheral Academic Research Consortium, together with the U.S. Food and Drug Administration and the Japanese Pharmaceuticals and Medical Devices Agency, has developed a series of pragmatic consensus definitions for patients being treated for peripheral artery disease affecting the lower extremities. These consensus definitions include the clinical presentation, anatomic depiction, interventional outcomes, surrogate imaging and physiological follow-up, and clinical outcomes of patients with lower-extremity peripheral artery disease. Consistent application of these definitions in clinical trials evaluating novel revascularization technologies should result in more efficient regulatory evaluation and best practice guidelines to inform clinical decisions in patients with lower extremity peripheral artery disease.

  14. 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

  15. An important Norwegian contribution to the study of the bursae of the upper and lower extremities

    OpenAIRE

    Musil, Vladimir; Selnes, Christoffer V; Falck, Aleksander T; Sandve, Lars; Shekarchi, Siamek; O'Donnell, Bruce; Kachlik, David

    2010-01-01

    We present a critical analysis of the monograph of A.S.D. Synnestvedt (1869) “En anatomisk beskrivelse af de paa over- og underestremiteterne forekommende Bursae mucosae”. The analysis was completed using anatomical information from the historically oldest publications dealing with the bursae of the extremities: Albinus (1734), Monro (1788), Rosenmüller (1799). We are of the opinion that Synnestvedt's publication is important, not only historically but also as a source of information for rece...

  16. 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...

  17. Fast gaze reorientations by combined movements of the eye, head, trunk and lower extremities.

    Science.gov (United States)

    Anastasopoulos, Dimitri; Naushahi, J; Sklavos, Sokratis; Bronstein, Adolfo M

    2015-05-01

    Large reorientations of the line of sight, involving combined rotations of the eyes, head, trunk and lower extremities, are executed either as fast single-step or as slow multiple-step gaze transfers. In order to obtain more insight into the mechanisms of gaze and multisegmental movement control, we have investigated time-optimal gaze shifts (i.e. with the instruction to move as fast as possible) during voluntary whole-body rotations to remembered targets up to 180° eccentricity performed by standing healthy humans in darkness. Fast, accurate, single-step movement patterns occurred in approximately 70 % of trials, i.e. considerably more frequently than in previous studies with the instruction to turn at freely chosen speed (30 %). Head-in-space velocity in these cases was significantly higher than during multiple-step transfers and displayed a conspicuously regular bell-shaped profile, increasing smoothly to a peak and then decreasing slowly until realignment with the target. Head-in-space acceleration was on average not different during reorientations to the different target eccentricities. In contrast, head-in-space velocity increased with target eccentricity due to the longer duration of the acceleration phase implemented during trials to more distant targets. Eye saccade amplitude approached the eye-in-orbit mechanical limit and was unrelated to eye/head velocity, duration or target eccentricity. Overall, the combined movement was stereotyped such that the first two principal components accounted for data variance almost up to gaze shift end, suggesting that the three mechanical degrees of freedom under consideration (eye-in-orbit, head-on-trunk and trunk-in-space) are on average reduced to two kinematic degrees of freedom (i.e. eye, head-in-space). Synchronous EMG activity in the anterior tibial and gastrocnemius muscles preceded the onset of eye rotation. Since the magnitude and timing of peak head-in-space velocity were scaled with target eccentricity and

  18. 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

  19. 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

  20. Lower extremity stress fractures in the military.

    Science.gov (United States)

    Jacobs, Jeremy M; Cameron, Kenneth L; Bojescul, John A

    2014-10-01

    Stress fractures of the lower extremities are common among the military population and, more specifically, military recruits who partake in basic training. Both intrinsic and extrinsic factors play a role in the development of these injuries, and it is important to identify those individuals at risk early in their military careers. Some of these factors are modifiable, so they may become preventable injuries. It is important to reiterate that one stress fracture places the soldier at risk for future stress fractures; but the first injury should not be reason enough for separation from the military, as literature would support no long-term deficits from properly treated stress fractures. Early in the process, radiographic analysis is typically normal; continued pain may warrant advanced imaging, such as scintigraphy or MRI. Most stress fractures that are caught early are amendable to nonoperative management consisting of a period of immobilization and NWB followed by progressive rehabilitation to preinjury levels. Complete or displaced fractures may require operative intervention as do tension-sided FNSF. Improving dietary and preaccession physical fitness levels may play a role in reducing the incidence of stress fractures in the active-duty military population. It is important to keep in mind when evaluating soldiers and athletes who present with activity-related pain that stress fractures are not uncommon and should be given significant consideration.

  1. 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

  2. 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...

  3. 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

  4. 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

  5. A multiple degree of freedom lower extremity isometric device to simultaneously quantify hip, knee, and ankle torques

    NARCIS (Netherlands)

    Sánchez, N.; Acosta, A.M.; Stienen, A.H.A.; Dewald, J.P.A.

    2015-01-01

    Characterization of the joint torque coupling strategies used in the lower extremity to generate maximal and submaximal levels of torque at either the hip, knee, or ankle is lacking. Currently, there are no available isometric devices that quantify all concurrent joint torques in the hip, knee, and

  6. Antihypertensive drug therapy and the risk of lower extremity amputations in pharmacologically treated type 2 diabetes patients

    NARCIS (Netherlands)

    Erkens, JA; Klungel, OH; Stolk, RP; Spoelstra, JA; Grobbee, DE; Leufkens, HGM

    2004-01-01

    Purpose The objective of this study was to determine the association between different antihypertensive drug therapies and lower extremity amputations (LEAs) in type 2 diabetes patients. Methods Data were obtained from the PHARMO Record Linkage System comprising pharmacy records and data on hospital

  7. Sympathetic reflex control of resistance in collateral arteries in the lower extremities in patients with diabetes mellitus

    DEFF Research Database (Denmark)

    Agerskov, K; Tønnesen, K H

    1982-01-01

    The vascular response in the lower extremities to 40 degrees head-up tilt was studied in 5 patients with occlusion of the superficial femoral artery and maturity onset diabetes mellitus with symptoms suggesting autonomic neuropathy. The pressure measurements were performed via catheters placed in...

  8. Guideline for the management of wounds in patients with lower-extremity neuropathic disease: an executive summary.

    Science.gov (United States)

    Crawford, Penny Ellen; Fields-Varnado, Myra

    2013-01-01

    This article summarizes the WOCN Evidence-Based Clinical Practice Guideline for Management of Wounds in Patients with Lower Extremity Neuropathic Disease. It is intended for use by physicians, nurses, therapists, and other health care professionals who work with adults who have or are at risk for, lower-extremity neuropathic disease (LEND), and includes updated scientific literature available from January 2003 through February 2012. The full guideline contains definitions of lower extremity neuropathic disorders and disease, prevalence of the problem, relevance and significance of the disorders, as well as comprehensive information about etiology, the nervous system, pathogenesis, and the overall management goals for patients at risk for developing neuropathic foot ulcers. A detailed assessment section describes how to conduct a full clinical history and physical examination. The guideline also provides two approaches to interventions. The first focuses on prevention strategies to reduce the risk of developing LEND wounds or recurrence, including life-long foot offloading, routine dermal temperature surveillance, use of adjunctive therapies, medication management, and implementing lower extremity amputation prevention measures and patient self-care education. The second approach summarized LEND wound management strategies including wound cleansing, debridement, infection management, maintenance of intact peri-wound skin, nutrition considerations, pain and paresthesia management, edema management, offloading and management of gait and foot deformity, medication management, surgical options, adjunctive therapies, patient education, and health care provider follow-up. A comprehensive reference list, glossary of terms, and several appendices regarding an algorithm to determine wound etiology, pharmacology, Lower Extremity Amputation (LEAP) Program, diabetes foot screening and other information is available at the end of the guideline.

  9. Assessment of coagulation function and ultrasound features after reteplase and recombinant streptokinase thrombolysis of lower extremity deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    Wei Xiong

    2016-01-01

    Objective: To assess coagulation function and ultrasound features after reteplase and recombinant streptokinase thrombolysis of lower extremity deep venous thrombosis. Methods:A total of 78 cases of patients with lower extremity deep venous thrombosis who were treated in our hospital were selected as research subjects and divided into observation group 39 cases and control group 39 cases according to different treatment regimens. Control group received recombinant streptokinase thrombolysis, observation group received reteplase thrombolysis, and then the effect of the two thrombolytic ways was evaluated by color Doppler ultrasonography and circulating blood test. Results:Ultrasound showed that complete recanalization rate of thrombus of observation group after treatment was higher than that of control group;plasma PT, APTT and TT values of observation group after thrombolysis were higher than those of control group, FIB, D-D, NO, ET, E-selectin, P-selectin, Hcy, CRP, IL-6, IL-8 and TNF-αvalues were lower than those of control group, and WBC, Nc and Mc cell number were less than those of control group. Conclusion:Reteplase for thrombolysis of lower extremity deep venous thrombosis has more distinguished effect on dissolving thrombus as well as optimizing body’s coagulation, inflammatory system state and other aspects, and is a more ideal thrombolytic drug.

  10. Hyperbaric oxygenation effects determination in the therapy of chronic occlusive lower extremities arteries disease by the use of perfusion scintigraphy

    Directory of Open Access Journals (Sweden)

    Zoranović Uroš

    2010-01-01

    Full Text Available Background/Aim. Hyperbaric oxygenation (HBO is a medical treatment of a patient with 100% oxygen inspiration under the pressure higher than atmospheric in a special unit designed to let the whole patient's body rest in a chamber. The aim of the study was to determine the effect of the application of HBO treatment on the patient's lower extremities with chonic inoperabile occlusive disease by measning the parameters of perfusion scintigraphy (perfusion reserve, relative perfusion. Methods. This investigation included 22 patients (19 males and 3 famales. Following clinical assessment of lower extremities condition according to the skin appearance and its adnexa, claudication distance was performed. Clinical condition was graded by the use of 5-point nominal scale. In all of the patients 99mTctetraphosmine lower extremities scintigraphy was done ten days prior to the treatment start and ten days after the treatment with HBO. Lower legs were imaged from the posterior view. Prior to imaging the patients were obligatory lying approximately half an hour. Results. In 18 (86% of the patients there was an improvement manifested as better subjective condition and better skin and its adnexa appearance. Following HBO treatment there was a statistically significant change in collecting the radiopharmac at rest. This finding indicates an increased viability of muscles as well as an increased perfusion reserve. Perfusion reserve mean values increased from 39.99 to 50.86%, and from 38.46 to 49.33% for the right and the left lower leg, respectively. This parameter clearly indicates favorable effects of HBO treatment pertaining neoangiogenesis and, consequently, increased viability of the lower leg muscles. It was also obvious in visual analysis of the obtained images. Conclusion. The obtained results confirm that muscle perfusion measured by the parameters of perfusion scintigraphy using 99mTc-tetrophosmine (perfusion reserve, relative perfusion in patients with

  11. 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

  12. 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

    these findings. However, pain in the lower back decreased muscular activity of the gluteus maximus and vastus medialis (P 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...

  13. 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.

  14. 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

  15. 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...

  16. 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

  17. Computed tomography angiography of lower extremities in the emergency room for evaluation of patients with gunshot wounds

    Energy Technology Data Exchange (ETDEWEB)

    Adibi, Ali; Plotnik, Adam N.; Mohajer, Kiyarash; Arellano, Cesar; Ruehm, Stefan G. [University of California, Diagnostic Cardiovascular Imaging, Department of Radiological Sciences, Los Angeles, CA (United States); Krishnam, Mayil S.; Dissanayake, Sumudu [University of California, Cardiovascular and Thoracic Imaging, Department of Radiology, Irvine, CA (United States)

    2014-07-15

    To assess the role of CT angiography in the evaluation of patients with lower extremity gunshot wounds in the emergency room. Eighty patients (73 male, 7 female, mean age 26 years) underwent CT angiography for the evaluation of lower extremity gunshot injuries. Imaging was conducted on the basis of standardized protocols utilizing 16-slice and 64-slice multidetector systems and images were qualitatively graded and assessed for various forms of arterial injury. CT angiography findings indicative of arterial injury were observed in 24 patients (30 %) and a total of 43 arterial injuries were noted; the most common form was focal narrowing/spasm (n = 16, 37.2 %); the most common artery involved was the superficial femoral artery (n = 12, 50 %). In qualitative assessment of images based on a 4-point grading system, both readers considered CT angiography diagnostically excellent (grade 4) in most cases. Surgical findings were consistent with CT angiography and follow-up of patients' medical records showed no arterial injuries in patients with normal findings on initial imaging. Our findings demonstrate that CT angiography is an effective imaging modality for evaluation of lower extremity gunshot wounds and could help limit more invasive procedures such as catheter angiography to a select group of patients. (orig.)

  18. 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...

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. [Renal infarction and acute arterial obstruction of the lower extremity encountered after surgery for primary lung cancer].

    Science.gov (United States)

    Tamaki, Masafumi; Miura, Kazumasa; Norimura, Shoko; Kenzaki, Koichirou; Yosizawa, Kiyoshi

    2013-02-01

    The patient was 68-year-old who underwent left upper lobectomy and lymph node dissection. On the 4th postoperative day, he developed vomiting and lumbar pain. On 5th postoperative day, he complained of pain, sensory paralysis and cold sensation of the right lower extremity. Computed tomography(CT)examination revealed left renal infarction and acute arterial obstruction of the right common iliac artery. Emergency thrombectomy of the right lower extremity was performed. Postoperatively, he received anticoagulant therapy and was able to leave the hospital on the 20th postoperative day. Attention should be paid to the infarction of abdominal organs when developing abdominal symptoms after lung cancer surgery in elderly patients.

  4. 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)

  5. Effect of ski simulator training on kinematic and muscle activation of the lower extremities.

    Science.gov (United States)

    Moon, Jeheon; Koo, Dohoon; Kim, Kitae; Shin, Insik; Kim, Hyeyoung; Kim, Jinhae

    2015-08-01

    [Purpose] This study aimed to verify the effectiveness of an augmented reality-based ski simulator through analyzing the changes in movement patterns as well as the engagement of major muscles of the lower body. [Subjects] Seven subjects participated in the study. All were national team-level athletes studying at "K" Sports University in Korea who exhibited comparable performance levels and had no record of injuries in the preceding 6 months (Age 23.4 ± 3.8 years; Height 172.6 ± 12.1 cm; Weight 72.3 ± 16.2 kg; Experience 12.3 ± 4.8 years). [Methods] A reality-based ski simulator developed by a Korean manufacturer was used for the study. Three digital video cameras and a wireless electromyography system were used to perform 3-dimensional motion analysis and measure muscle activation level. [Results] Left hip angulation was found to increase as the frequency of the turns increased. Electromyography data revealed that the activation level of the quadriceps group's extension muscles and the biceps femoris group's flexing muscles had a crossing pattern. [Conclusion] Sustained training using an augmented reality-based ski simulator resulted in movements that extended the lower body joints, which is thought to contribute to increasing muscle fatigue.

  6. 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.

  7. 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

  8. 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

  9. 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.)

  10. 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.

  11. 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

  12. 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.

  13. Adaptive prosthetics for the lower extremity.

    Science.gov (United States)

    Carroll, K

    2001-06-01

    The potential for lifestyle recovery is tremendous for most lower extremity amputees. The amazing and ever-expanding array of adaptive prosthetics can help make the devastating loss of amputation more bearable for patients, their families, and their health care team. The new amputee, in a state of shock and grief, does not know what his or her prosthetic options are. It is crucial that the surgeon is knowledgeable about what the patient can have and what the patient needs to ask for. Dana Bowman stated: Ideally, the new amputee should say to their doctor, "I'd like my leg to be lightweight, flexible, durable, comfortable. I want to do sports or I want to ride bikes with my kids." Whatever it is they like to do. I was told I would never be able to wear two dynamic feet and that my sky diving days were over. I said, "Well how do you know? Can't I try?" It took years to find out what I could have and then to find people to help me get it. The prosthetic prescription the physician writes is the patient's gateway to the kind of prosthetics that will enable him or her to pursue the activities of their life. Often, new amputees end up with the bare minimum prosthesis, which can cause problems with comfort and mobility. A poorly designed or badly fitting prosthesis is as disabling as the actual amputation. When the surgeon can help the amputee and his or her family understand what kind of prosthetic choices are available, it establishes an optimistic outlook that is highly beneficial to the entire recovery process physically and mentally. "When I lost my leg, if someone would have told me that I could at least try to run again, that would have meant a lot," said Brian Frasure. "Getting that positive mental attitude is every bit as important as having good medical and prosthetic care." By asking probing questions about the patient's preamputation lifestyle and postamputation goals, the physician can write a prescription for truly adaptive prosthetics. The surgeon should

  14. 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)

  15. Older women with dementia can perform fast alternating forearm movements and performance is correlated with tests of lower extremity function

    Directory of Open Access Journals (Sweden)

    Bramell-Risberg E

    2013-02-01

    Full Text Available Eva Bramell-Risberg,1 Gun-Britt Jarnlo,2 Sölve Elmståhl11Division of Geriatric Medicine, 2Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, SwedenBackground: The purpose of this work was to study the performance and reliability of a test of fast alternating forearm movements and its relationship with measures of lower extremity function in older women with dementia.Methods: Fast alternating movements was studied in 26 female patients (mean age 81.7 ± 5.9 years with dementia and 34 controls (mean age 87.5 ± 4.7 years. Subgroup analyses for those aged 80–89 years were performed due to significant differences in the mean ages of the study groups. Test–retest reliability for alternating forearm movements was studied in 11 patients (mean age 80.3 ± 6.7 years and 10 controls (mean age 87.4 ± 1.6 years. Pulses generated were transformed to an analog signal shown on a modified electrocardiogram. Numbers of cycles at 10 and 15 seconds were calculated for the right and left hand. Walking 2 × 15 m and the Get-Up-and Go (GUG test were performed at self-selected and maximal speed. Associations between tests of upper and lower extremity function were sought in eight patients (mean age 85 ± 2.7 years and 16 controls (mean age 85.1 ± 2.8 years and also according to types of dementia in nine patients with probable Alzheimer's disease and 10 patients with other types of dementia.Results: Patients with dementia could perform the test and had significantly fewer cycles (P = 0.02–0.006 at both 10 and 15 seconds compared with controls after age adjustment. A higher number of cycles was associated with higher self-selected walking speeds in patients (r = -0.79. Test–retest reliability for alternating forearm movements was high for both patients (intraclass correlation 0.88–0.94 and controls (intraclass correlation 0.74–0.94.Conclusion: Alternating forearm movements at fast speed can be used as a reliable test in both

  16. 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

  17. 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

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

    Science.gov (United States)

    Gozani, Shai N

    2016-01-01

    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 80.3% of responders reporting a reduction compared to 11.8% of non

  19. Northern Hemisphere Stratospheric Polar Vortex Extremes in February under the Control of Downward Wave Flux in the Lower Stratosphere

    Institute of Scientific and Technical Information of China (English)

    WEI Ke; CHEN Wen

    2012-01-01

    Using ECWMF ERA-40 and Interim reanalysis data, the planetary wave fluxes associated with the February extreme stratospheric polar vortex were studied. Using the three-dimensional Eliassen-Palm (EP) flux as a measure of the wave activity propagation, the authors show that the unusual warm years in the Arctic feature an anomalous weak stratosphere-troposphere coupling and weak downward wave flux at the lower stratosphere, especially over the North America and North Atlantic (NANA) region. The extremely cold years are characterized by strong stratosphere-troposphere coupling and strong downward wave flux in this region. The refractive index is used to examine the conception of planetary wave reflection, which shows a large refractive index (low reflection) for the extremely warm years and a small refractive index (high reflection) for the extremely cold years. This study reveals the importance of the downward planetary wave propagation from the stratosphere to the troposphere for explaining the unusual state of the stratospheric polar vortex in February.

  20. Kinematics of the trunk and the lower extremities during restricted and unrestricted squats.

    Science.gov (United States)

    List, Renate; Gülay, Turgut; Stoop, Mirjam; Lorenzetti, Silvio

    2013-06-01

    Squatting is a common strength training exercise used for rehabilitation, fitness training, and in preparation for competition. Knowledge about the loading and the motion of the back during the squat exercise is crucial to avoid overuse or injury. The aim of this study was the measurement and comparison of the kinematics of the lower leg, trunk, and spine during unrestricted and restricted (knees are not allowed beyond toes) squats. A total of 30 subjects performed unrestricted and restricted barbell squats with an extra load of 0, 25, and 50% bodyweight. Motion was tracked using a 12-camera Vicon system. A newly developed marker set with 24 trunk and 7 pelvic markers allowed us to measure 3D segmental kinematics between the pelvic and the lumbar regions, between the lumbar and the thoracic segments, and the sagittal curvatures of the lumbar and the thoracic spine. In an unrestricted squat, the angle of the knee is larger and the range of motion (ROM) between the lumbar and the thoracic segments is significantly smaller compared with a restricted squat (p studied subjects showed significantly increased ROM for thoracic curvature during restricted squats. The unrestricted execution of a squat leads to a larger ROM in the knee and smaller changes in the curvature of the thoracic spine and the range of smaller segmental motions within the trunk. This execution in turn leads to lower stresses in the back. To strengthen the muscles of the leg, the unrestricted squat may be the best option for most people. Thus, practitioners should not be overly strict in coaching against anterior knee displacement during performance of the squat.

  1. Uso de expansores de tecidos nos membros inferiores The use of tissue expanders in lower extremity

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    João Medeiros Tavares Filho

    2005-12-01

    Full Text Available OBJETIVO: A expansão tecidual é um fenômeno, que pode ser observado na gravidez e no crescimento de tumores. A expansão controlada, descrita pela primeira vez em 1957, foi aprimorada e desenvolvida em quase todas as regiões corpóreas, a partir da década de 80. A expansão tecidual, nos membros inferiores, tem se mostrado de difícil realização devido à pouca elasticidade da pele, principalmente no 1/3 inferior da perna e do pé. Ocorre ainda falta de anteparo rígido, circulação terminal, restrição das atividades físicas dos pacientes durante a fase de infiltração e maior índice de complicações, o que restringe suas indicações. O objetivo deste trabalho é descrever nossa experiência com a expansão tecidual nos membros inferiores. MÉTODO: Estudo de 24 procedimentos de expansão nos membros inferiores indicados no tratamento de hemangioma (4,2%, seqüela de poliomielite (8,3%, seqüela pósqueimadura (33,3% e pós-trauma (54,2%. RESULTADOS: Das expansões realizadas, tivemos sucesso no resultado prévio planejado, em 19 casos (79,1% e insucesso em quatro casos (16,7%, nos quais o resultado final foi parcial, e um caso (4,2%, com interrupção precoce da expansão, em que não se obteve qualquer resultado. CONCLUSÕES: A expansão nos membros inferiores é viável, com menor índice de complicações, desde que se faça uma seleção adequada dos pacientes e se adote uma sistematização para a colocação, período de infiltração e retirada do expansor.BACKGROUND: Tissue expansion is a physiological phenomenon, we observed in pregnancy and in tumors development. The expansion control was described for the first time in 1957, being improved and developed in almost all body areas ever since. Tissue expansion of the lower limb has shown difficult accomplishments, due to limited skin elasticity, mainly on the distal lower leg, lack of a hard plan, few axial vessels and developed sub dermal plexus, restraint of physical

  2. 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.

  3. 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.

  4. 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...

  5. Effect of cause of iliac vein stenosis and extent of thrombus in the lower extremity on patency of iliac venous stent placed after catheter-directed thrombolysis of acute deep venous thrombosis in the lower extremity

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Sung Il; Choi, Young Ho; Yoon, Chang Jin; Lee, Min Woo; Chung, Jin Wook; Park, Jae Hyung [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2003-10-01

    To assess the CT findings of acute deep venous thrombosis (DVT) in a lower extremity prior to catheter-directed thrombolysis, and to evaluate their relevance to the patency of an iliac venous stent placed with the help of CT after catheter-directed thrombolysis of DVT. Fourteen patients [M:F=3:11; age, 33-68 (mean, 50.1) years] with acute symptomatic DVD of a lower extremity underwent CT before and after catheter-directed thrombolysis using an iliac venous stent. The mean duration of clinical symptoms was 5.0 (range, 1-14 days. The CT findings prior to thrombolysis were evaluated in terms of their anatomic cause and the extent of the thrombus, and in all patients, the patency of the iliac venous stent was assessed at CT performed during a follow-up period lasting 6-31 (mean, 18.9) months. All patients were assigned to the patent stent group (n=9) or the occluded stent group (n=5). In the former, the anatomic cause of patency included typical iliac vein compression (May-Thurner syndrome) (n=9), and a relatively short segmental thrombus occurring between the common iliac and the popliteal vein (n=8). Thrombi occurred in the iliac vein (n=3), between the common iliac and the femoral vein (n=3), and between the common iliac and the popliteal vein (n=2). In one case, a relatively long segmental thrombus occurred between the common iliac vein and the calf vein. In the occluded stent group, anatomic causes included atypical iliac vein compression (n=3) and a relatively long segmental thrombus between the common iliac and the calf vein (n=4). Typical iliac vein compression (May-Thurner syndrome) occurred in two cases, and a relatively short segmental thrombus between the external iliac and the common femoral vein in one. Factors which can affect the patency of an iliac venous stent positioned after catheter-directed thrombolysis are the anatomic cause of the stenosis, and the extent of a thrombus revealed at CT of acute DVT and occurring in a lower extremity prior to

  6. The usefulness of three-dimensional gadolinium-enhanced MR venography for the evaluation of varices in lower-extremities

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Myong Kwan; Lee, Hee; Kang, Sung Gwon; Choi, Jeong Yeol; Byun, Ju Nam; Jang, Jeong Hwan; Lim, Chae Ha [Chosun Univ. College of Medicine, Kwangju (Korea, Republic of); Kim, Young Cheol [Yeong Gwang Christian Hospital, Yeong Gwang (Korea, Republic of)

    2001-11-01

    To assess the performance of contrast-enhanced three-dimensional(3-D) magnetic resonance venography (MRV) of the pelvis and lower extremities in patients with varicose veins. Ascending and MR venography were performed in seven legs of seven patients, and duplex Doppler sonography and MR venography in 15 legs of 12 patients, all referred for evaluation of varicose veins. For analysis, the venous system as revealed by ascending and MR venographic images was divided into 13 segments. For detection of reflux to the great saphenous vein, duplex Doppler sonography and MRV were performed. In ascending venography and MRV, 91 venous segments were potentially visible; both modalities depicted 78 of these, but failed to detect four. Ascending venography and MRV detected 17 and 19 varices, respectively. When two tourniquets were placed around the ankle and knee using the Valsalva maneuver, MRV and duplex Doppler sonography detected reflux in 8 or 11 and 13 or 15 legs, respectively. Contrast-enhanced 3-D MRV comprehensively displays the venous system of the lower extremities and permits assessment of varicose veins. MRV using the Valsalva maneuver allows assessment of reflux to the great saphenous vein.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. 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

  9. 儿童双骨肢体单骨骨折对关节的影响%Influence on Joints Due to Fracture of Single Bone on Double Bone Extremities in Children

    Institute of Scientific and Technical Information of China (English)

    俞志涛; 王承武; 范源

    1997-01-01

    Objective:To observe the overgrowth after the fracture of a single bone in double bone extremities in children.Methods:179 cases of forearm fracture and 123 of lower leg fracture (excluding Monteggia fracture,Galeazzi fracture or physeal injuries)were reviewed.The time of follow-up was 5~8 years(mean 7.5 years).Comparative assessments of bilateral extremities on X-ray examination included length of ulna and radius,radioulnar angle,anteversion of the radius,radiocapitular line,position of the capitellium,length of the tibia and fibula,and anteroposteriorproject of the ankle.Ranges of motion of the wrist,elbow,forearm and ankle were examined.Results:Overgrowth of affected bones With 2~4 mm in length were found only in 4 cases of forearm fracture and in 7 cases of lower leg fracture.Conclusions:In most cases of fracture of singlebone on double bone extremities,overgrowth of affected bone has been rarely observed.%目的:为了观察儿童双骨肢体单骨骨折后的过度生长.方法:对前臂单骨骨折179例(不包括孟氏骨折、盖氏骨折及骨骺损伤),小腿单骨骨折123例(不包括骨骺损伤),进行了5~6年的随访,平均7.5年.对比测量了双侧X线片中的尺、桡骨长度、胫腓骨长度、桡尺角、桡骨内倾角、桡骨头线、肱骨小头的位置以及踝关节正位片,并对腕、肘关节、踝关节活动进行了对比.结果:前臂有4例,小腿有7例较对侧长2~4 mm.前臂、腕、肘关节及踝关节活动无异常.结论:前臂是双骨均衡支撑肢体,小腿虽以胫骨负重为主,但单骨骨折后另一骨同样可起支撑作用,因此均不会出现明显的过度生长.

  10. 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

  11. 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.

  12. 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

  13. A Multiple Degree of Freedom Lower Extremity Isometric Device to Simultaneously Quantify Hip, Knee, and Ankle Torques.

    Science.gov (United States)

    Sánchez, Natalia; Acosta, Ana Maria; Stienen, Arno H A; Dewald, Julius P A

    2015-09-01

    Characterization of the joint torque coupling strategies used in the lower extremity to generate maximal and submaximal levels of torque at either the hip, knee, or ankle is lacking. Currently, there are no available isometric devices that quantify all concurrent joint torques in the hip, knee, and ankle of a single leg during maximum voluntary torque generation. Thus, joint-torque coupling strategies in the hip, knee, and concurrent torques at ankle and/or coupling patterns at the hip and knee driven by the ankle have yet to be quantified. This manuscript describes the design, implementation, and validation of a multiple degree of freedom, lower extremity isometric device (the MultiLEIT) that accurately quantifies simultaneous torques at the hip, knee, and ankle. The system was mechanically validated and then implemented with two healthy control individuals and two post-stroke individuals to test usability and patient acceptance. Data indicated different joint torque coupling strategies used by both healthy individuals. In contrast, data showed the same torque coupling patterns in both post-stroke individuals, comparable to those described in the clinic. Successful implementation of the MultiLEIT can contribute to the understanding of the underlying mechanisms responsible for abnormal movement patterns and aid in the design of therapeutic interventions.

  14. 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

  15. 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.

  16. Examination of MR venography of the lower extremity deep vein using non-contrasted 2D-time of flight (2D-TOF) method. Correlation of blood circulation and detectability in warming the lower extremity and avascularization

    Energy Technology Data Exchange (ETDEWEB)

    Namihei, Tatsunori; Sakai, Tomotsune; Kuwata, Hiromasa; Fujimoto, Kenichiro; Furukawa, Kiyoshi [Hiroshima Prefectural Hospital (Japan)

    1999-02-01

    In 8 healthy volunteers (5 males and 3 females), MR venography (MRV) of deep vein in the lower extremities using 2D-TOF method was performed with avascularization and warming, and detectability was examined. The parameter was as follows; TR: 40 ms, TE: 4.6 ms, flip angle: 75 degrees, NEX: 1, matrix: 512 x 128, FOV: 32 x 16 cm, slice thickness: 2.5 mm, slice interval: 0 mm and BW: {+-}32 kHz. There was little effect by avascularization alone, but detectability improved conspicuously for extension of deep vein by avascularization with warming. In addition, MRV was compared with phlebography in patients with varicose veins (4 males and 3 females). The detectability was similar in both methods. These results suggest that this method is useful in clinical diagnosis. (K.H.)

  17. Examination of MR venography of the lower extremity deep vein using non-contrasted 2D-time of flight (2D-TOF) method. Correlation of blood circulation and detectability in warming the lower extremity and avascularization

    Energy Technology Data Exchange (ETDEWEB)

    Namihei, Tatsunori; Sakai, Tomotsune; Kuwata, Hiromasa; Fujimoto, Kenichiro; Furukawa, Kiyoshi (Hiroshima Prefectural Hospital (Japan))

    1999-02-01

    In 8 healthy volunteers (5 males and 3 females), MR venography (MRV) of deep vein in the lower extremities using 2D-TOF method was performed with avascularization and warming, and detectability was examined. The parameter was as follows; TR: 40 ms, TE: 4.6 ms, flip angle: 75 degrees, NEX: 1, matrix: 512 x 128, FOV: 32 x 16 cm, slice thickness: 2.5 mm, slice interval: 0 mm and BW: [+-]32 kHz. There was little effect by avascularization alone, but detectability improved conspicuously for extension of deep vein by avascularization with warming. In addition, MRV was compared with phlebography in patients with varicose veins (4 males and 3 females). The detectability was similar in both methods. These results suggest that this method is useful in clinical diagnosis. (K.H.)

  18. Measurements of HIFU-induced Lesions in BSA Gel Phantoms for HIFU Treatment of Varicose Veins of Lower Extremity

    Science.gov (United States)

    Ushijima, Hiroyuki; Senoo, Naohiko; Suzuki, Jun; Ichiyanagi, Mitsuhisa; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2011-09-01

    HIFU treatment has been developed for various diseases because of its minimal invasiveness, and we are now developing a HIFU treatment for varicose veins of the lower extremity. Previous studies have succeeded in occluding rabbit's veins with HIFU, but the success rate was low (about 10%). Failures were mainly caused by skin burns. When the heating lesion comes close to skin, the absorbed ultrasound energy may cause skin burns. Therefore, it is necessary to study the relationships between HIFU lesions and skin burns to improve the success rate. To visualize heating lesions from HIFU, we used tissue-mimicking BSA gel phantoms. We tried various concentrations of BSA in gels, and determined 14% BSA as the most suitable for phantoms for experiments. The attenuation coefficient of the gel was 0.73 dB/cm, and the denaturation temperature was 70 °C. We put the BSA gel phantom in a water tank in which the temperature was kept at 39 °C, and used HIFU exposures at various intensities and irradiation times. After irradiation, we measured the sizes and positions of HIFU-induced lesions, and the results indicate that the sizes of lesion become larger when the intensitiy rises or irradiation time becomes longer. Furthermore, when the intensity rises and irradiation time becomes longer, the heating lesions move closer to upper surface of the gel, which means skin easily gets burned. Thus we have investigated relationships between HIFU parameters and heated lesions that can be used for further research into HIFU treatment of varicose veins of the lower extremity.

  19. 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...

  20. [Use of the Doppler effect in pathology and vascular surgery of the lower extremities].

    Science.gov (United States)

    Lévy, J B; Battino, J

    1975-11-01

    A clinical, arteriographic and hemodynamic comparative study, using the Doppler effect in 100 cases, suggests: -- that a study of the Doppler effect is a very useful method of diagnosis to determine the site of obstruction and the state of the blood vessels beyond the obstruction, even in the absence of adequate radiological images; -- following operation, it permits one to assess a case of thrombosis, even when the latter is not obvious clinically. It makes unnecessary post-operative arteriographic controls in tired or high-risk patients.

  1. [Ambulatory prevention of thrombosis with low molecular weight heparin in plaster immobilization of the lower extremity].

    Science.gov (United States)

    Kock, H J; Schmit-Neuerburg, K P; Hanke, J; Hakmann, A; Althoff, M; Rudofsky, G; Hirche, H

    1993-06-01

    Plaster cast immobilisation following trauma is a major risk factor for the development of deep vein thrombosis. In our controlled, randomized and prospective study on patients with minor injuries incidence of DVT in conservatively treated out-patients with plaster cast immobilisation of the leg was 3.9% in the control group (n = 126) without prophylaxis. By s.c. self-application of LMV heparin once daily the number of DVT in the prophylaxis group (n = 115) was reduced to 0. No severe side effects of NMH were observed. We conclude that thromboprophylaxis with LMW heparin once daily up to now conspiciously reduced the risk of DVT in outpatients with plaster cast immobilisation of the leg.

  2. 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

  3. 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

  4. Necrotizing Fasciitis of the lower extremity: a case report and current concept of diagnosis and management

    Directory of Open Access Journals (Sweden)

    Malik SA

    2009-06-01

    Full Text Available Abstract 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.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  7. Complexity of lower extremity peripheral artery disease reflects the complexity of coronary artery disease.

    Science.gov (United States)

    Aykan, Ahmet Çağrı; Hatem, Engin; Karabay, Can Yücel; Gül, İlker; Gökdeniz, Tayyar; Kalaycıoğlu, Ezgi; Turan, Turhan; Kara, Faruk; Arslan, Ahmet Oğuz; Dursun, İhsan; Çetin, Mustafa; Güler, Ahmet

    2015-08-01

    We investigated the relationship between peripheral artery disease complexity and coronary artery disease complexity in patients with peripheral artery disease. A total of 449 patients were enrolled. SYNTAX score, a marker of coronary artery disease complexity, was assessed by dedicated computer software and complexity of peripheral artery disease was determined by Trans Atlantic Inter-Society Consensus II classification. The SYNTAX score of patients with minimal peripheral artery disease, Trans Atlantic Inter-Society Consensus A, Trans Atlantic Inter-Society Consensus B, Trans Atlantic Inter-Society Consensus C and Trans Atlantic Inter-Society Consensus D were 5 (11), 12.5 (13.25), 20 (14), 20.5 (19) and 27.5 (19), respectively (values in brackets represent the interquartile range). SYNTAX score and Trans Atlantic Inter-Society Consensus class was moderately correlated (r = 0.495, p low-density lipoprotein (B = 0.114, p = 0.003, CI95% = 0.001-0.006) and high-density lipoprotein (B = -0.360, p artery disease had complex coronary artery disease.

  8. Iliofemoral venous thrombosis following fascial excision of a deep burn of the lower extremity: case report.

    Science.gov (United States)

    Gibran, N S; Heimbach, D M; Nicholls, S C

    1992-12-01

    Burned patients with deep venous thrombosis present a particularly perplexing challenge. They frequently require central venous catheters. Their altered skin integrity does not permit correlation with the typical changes described by the classic terminology for thrombophlebitis or its most severe forms, phlegmasia cerulea dolens or phlegmasia alba dolens. They are at risk of exsanguination or massive graft loss with lytic therapy or anticoagulation. Venous thrombectomy may be a necessary limb-saving surgical option.

  9. 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

    2016-06-01

    [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.

  10. 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

  11. Comparative analysis of lower extremities tissue perfusion by the use of perfusion scintigraphy method after hyperbaric oxygenation and lumbar sympathectomy

    Directory of Open Access Journals (Sweden)

    Zoranović Uroš

    2009-01-01

    Full Text Available Background/Aim. Lumbar syphatectomy (LS increases pheripheral blood flow primarily by the arteriolar vasodilatation within the skin vascular net. Increase in tissue nutrition takes place only in the distal blood vessels of the skin. Nevertheless, in some patients sympathectomy brings about improvement in ischemic ulcerations healing. Hyperbaric oxigenation (HBO is a medical treatment in which a patient breathes 100% oxygen under pressure higher than atmospheric implemented in special units allowing the whole body be in a chamber. The aim of the study was to determine efficacy of the applied therapies for the treatment of inoperable occlusive lower extremities (LE arteries diseases according to the obtained results. Methods. The study included 30 patients divided into two groups (15 patients each in which stenosis level of the lower extremities arteries had been determined using aortography due to further treatment with HBO and LS. All the patients were clinically examined, their objective condition evaluation based on claudication distance, pain in rest, skin and skin adnexa atrophy, and temperature and LE functionality, as well as exposed to perfusion scintigraphy prior to the treatment and within 30 days after the treatment finishing. Results. Analyzing patients' status prior to and after the treatments applied the number of patients with obvious improvement was higher in those treated by HBO than those treated by LS. Measuring claudication distance revealed significantly greater changes in patients treated by HBO (from 178.57 m to 754.76 m than in those treated by LS (from 229 m to 253 m. Other clinical symptoms, such as parasthesia, status of the skin adnexes (hair, nails, skin colour and temperature were also improved after the treatment by HBO. Conclusion. The results obatined in this study confirm the advantages of HBO over LS in therapy of inoperable occlusive LE disease, so LS could be definitely abandoned as a choice for treating such

  12. 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

  13. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Madaric, Juraj, E-mail: jurmad@hotmail.com [National Institute of Cardiovascular Diseases (NUSCH) and Slovak Medical University, Department of Cardiology and Angiology (Slovakia); Klepanec, Andrej [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia); Mistrik, Martin [Clinic of Hematology and Transfusiology, Faculty Hospital (Slovakia); Altaner, Cestmir [Slovak Academy of Science, Institute of Experimental Oncology (Slovakia); Vulev, Ivan [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia)

    2013-04-15

    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.

  15. Upper Extremity Sports Injury : Risk Factors in Comparison to Lower Extremity Injury in More Than 25 000 Cases

    NARCIS (Netherlands)

    Sytema, Renee; Dekker, Rienk; Dijkstra, Pieter U.; ten Duis, Hendrik J.; van der Sluis, Corry K.

    2010-01-01

    Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting:

  16. Upper Extremity Sports Injury: Risk Factors in Comparison to Lower Extremity Injury in More Than 25 000 Cases

    NARCIS (Netherlands)

    Sytema, R.; Dekker, R.; Dijkstra, P.U.; ten Duis, H.J.; van der Sluis, C.K.

    2010-01-01

    Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting:

  17. 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.

  18. 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.

  19. Subject-specific lower extremity modeling: personalization of musculoskeletal models using medical imaging and functional measurements

    NARCIS (Netherlands)

    Carbone, Vincenzo

    2016-01-01

    Musculoskeletal models have represented for decades one of the most important research tools to understand how the human body works, and to have a better comprehension of the dysfunctions of the locomotor system. In the last years, progress in musculoskeletal mechanics, medical imaging and computati

  20. Systematic Review: Effectiveness of Mirror Therapy for Lower Extremity Post-Stroke

    Directory of Open Access Journals (Sweden)

    Goris Kin Nga Hung

    2015-12-01

    Conclusion: Further research is needed to determine the best treatment regimen and optimal time to initiate MT intervention in terms of the phases of stroke. No firm conclusions can be drawn on the effectiveness of MT on the hemiplegic LE until more evidence is available.

  1. Motor Control of the Lower Extremity Musculature in Children with Cerebral Palsy

    Science.gov (United States)

    Arpin, David J.; Stuberg, Wayne; Stergiou, Nicholas; Kurz, Max J.

    2013-01-01

    The aim of this investigation was to quantify the differences in torque steadiness and variability of the muscular control in children with cerebral palsy (CP) and typically developing (TD) children. Fifteen children with CP (age = 14.2 [plus or minus] 0.7 years) that had a Gross Motor Function Classification System (GMFCS) score of I-III and 15…

  2. 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.

  3. 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.

  4. 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.

  5. Impact of chronic kidney disease stage on lower-extremity arthroplasty.

    Science.gov (United States)

    Deegan, Brian F; Richard, Raveesh D; Bowen, Thomas R; Perkins, Robert M; Graham, Jove H; Foltzer, Michael A

    2014-07-01

    End-stage renal disease and dialysis is commonly associated with poor outcomes after joint replacement surgery. The goal of this study was to evaluate postoperative complications in patients with less advanced chronic kidney disease undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). Patients who underwent THA or TKA between 2004 and 2011 with stage 1, 2, or 3 chronic kidney disease were retrospectively reviewed via an electronic medical record. The authors compared 377 patients who had stage 1 to 2 chronic kidney disease with 402 patients who had stage 3 chronic kidney disease. No significant differences in 90-day readmission or revision rates were found between the stage 1 to 2 and stage 3 patient groups. For patients with stage 3 chronic kidney disease, the overall mortality rate was greater than that in patients with stage 1 to 2 chronic kidney disease. However, when adjusted for comorbid disease, no significant increases were seen in joint infection, readmission, or early revision between patients with stage 1 to 2 chronic kidney disease vs patients with stage 3 chronic kidney disease. The overall incidence of infection was high (3.5%) but far less than reported for patients with end-stage renal disease, dialysis, and kidney transplant. In conclusion, patients with stage 1, 2, or 3 chronic kidney disease may have a higher than expected rate of prosthetic joint infection (3.5%) after total joint arthroplasty. Patients with stage 3 chronic kidney disease are at higher risk for postoperative mortality compared with those with lesser stages of kidney disease. PMID:24992055

  6. 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.

  7. A newly developed technique involving the optimization of flow velocity compensation for lower extremity CT angiography

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lei; XU Dong; LI KunCheng; JIN ErHu; BARNES Bret

    2013-01-01

    Advanced computed tomography (CT) technology has allowed for faster and more robust imaging.However,it has been a technical challenge to correctly synchronize CT acquisition with adequate and uniform arterial enhancement in the entire peripheral arterial tree.In this summary,we introduce a method of injection/acquisition optimization strategy based on a velocity-compensated CT angiography technique for the peripheral artery system,which is currently used in the United States.We believe that this imaging technique will provide additional information for our daily CT services in China.

  8. 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

  9. Mobility-Related Consequences of Reduced Lower-Extremity Peripheral Nerve Function with Age: A Systematic Review.

    Science.gov (United States)

    Ward, Rachel E; Caserotti, Paolo; Cauley, Jane A; Boudreau, Robert M; Goodpaster, Bret H; Vinik, Aaron I; Newman, Anne B; Strotmeyer, Elsa S

    2016-08-01

    The objective of this study is to systematically review the relationship between lower-extremity peripheral nerve function and mobility in older adults. The National Library of Medicine (PubMed) was searched on March 23, 2015 with no limits on publication dates. One reviewer selected original research studies of older adults (≥65 years) that assessed the relationship between lower-extremity peripheral nerve function and mobility-related outcomes. Participants, study design and methods of assessing peripheral nerve impairment were evaluated and results were reported and synthesized. Eight articles were identified, including 6 cross-sectional and 2 longitudinal studies. These articles investigated 6 elderly cohorts (4 from the U.S. and 2 from Italy): 3 community-dwelling (including 1 with only disabled women and 1 without mobility limitations at baseline), 1 with both community-dwelling and institutionalized residents, 1 from a range of residential locations, and 1 of patients with peripheral arterial disease. Mean ages ranged from 71-82 years. Nerve function was assessed by vibration threshold (n=2); sensory measures and clinical signs and symptoms of neuropathy (n=2); motor nerve conduction (n=1); and a combination of both sensory measures and motor nerve conduction (n=3). Each study found that worse peripheral nerve function was related to poor mobility, although relationships varied based on the nerve function measure and mobility domain assessed. Six studies found that the association between nerve function and mobility persisted despite adjustment for diabetes. Evidence suggests that peripheral nerve function impairment at various levels of severity is related to poor mobility independent of diabetes. Relationships varied depending on peripheral nerve measure, which may be particularly important when investigating specific biological mechanisms. Future research needs to identify risk factors for peripheral nerve decline beyond diabetes, especially those

  10. One-week postoperative patency of lower extremity in situ bypass graft comparing epidural and general anesthesia

    DEFF Research Database (Denmark)

    Wiis, Julie Therese; Jensen-Gadegaard, Peter; Altintas, Ümit;

    2014-01-01

    BACKGROUND: The purpose of this study was to determine whether anesthesia affects graft patency after lower extremity arterial in situ bypass surgery. METHODS: This investigation was a retrospective study using a national database on vascular surgical patients at a single medical institution. We...... under epidural (n = 386) or general (n = 499) anesthesia. Thirty-day mortality (3.4% for epidural anesthesia versus 4.4% general anesthesia; P = 0.414) and comorbidity were comparable in the 2 groups. Graft occlusion within 7 days after surgery was reported in 93 patients, with a similar incidence...... in the epidural (10.1%) and general (10.8%) anesthesia groups (P = 0.730). When examining a subgroup of patients (n = 242) exposed to surgery on smaller vessels (femorodistal in situ bypass procedures, n = 253), the incidence of graft occlusion was also similar in the 2 groups at 14.0% and 9.4%, respectively (P...

  11. 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.

  12. Association of lower extremity arterial calcification with amputation and mortality in patients with symptomatic peripheral artery disease.

    Directory of Open Access Journals (Sweden)

    Chi-Lun Huang

    Full Text Available OBJECTIVE: The clinical implication of the coronary artery calcium score (CS is well demonstrated. However, little is known about the association between lower extremity arterial calcification and clinical outcomes. METHODS AND RESULTS: Eighty-two patients with symptomatic peripheral artery disease (age 61.0±12.4 years were followed for 21±11 months. CSs, ranging from the common iliac artery bifurcation to the ankle area, were analyzed through noncontrast multidetector computed tomography images retrospectively. The primary endpoints of this study were amputation and mortality. Old age, diabetes, hyperlipidemia, and end-stage renal disease were associated with higher CSs. Patients with more advanced Fontaine stages also tended to have significantly higher CSs (p = 0.03. During the follow-up period (21±11 months, 29 (35% patients underwent amputation, and 24 (29% patients died. Among the patients who underwent amputation, there were no significant differences in CSs between the amputated legs and the non-amputated legs. In the Cox proportional hazard model with CS divided into quartiles, patients with CS in the highest quartile had a 2.88-fold (95% confidence interval [CI] 1.18-12.72, p = 0.03 and a 5.16-fold (95% CI 1.13-21.61, p = 0.04 higher risk for amputation and all-cause mortality, respectively, than those with CS in the lowest quartile. These predictive effects remained after conventional risk factor adjustment. CONCLUSION: Lower extremity arterial CSs are associated with disease severity and outcomes, including amputation and all-cause mortality, in patients with symptomatic peripheral artery disease. However, the independent predictive value needs further investigation in large scale, prospective studies.

  13. Lower extremity lipedema, upper extremity lipodystrophy and severe calcinosis complicating juvenile dermatomyositis.

    Science.gov (United States)

    Pavlov-Dolijanovic, Slavica R; Vujasinovic Stupar, Nada Z; Gavrilov, Nikola; Seric, Srdjan

    2014-11-01

    Juvenile dermatomyositis (JDM) is a rare but complex and potentially life-threatening autoimmune disease of childhood. Significant proportions of patients have residual weakness, muscle atrophy, joint contractures, and calcinosis. Recently, new clinical findings, such as lipodystrophy accompanied with increased fat deposition in certain areas, have been reported. So far, it is not known whether the redistribution of body fat may be the type of lipedema of lower extremity. We describe a 39-year-old woman who was diagnosed with JDM at the age of 7. Later she developed symmetrical lipodystrophy of upper extremities and symmetrical lipedema of lower extremities (making 2 and 58.3 % of total body fat mass, respectively), with multiple calcified nodules in the subcutaneous tissues. These nodules gradually increased in size despite therapy. Capillaroscopy findings showed scleroderma-like abnormalities. ANA and anti-U1RNP antibodies were positive. Similar cases with simultaneous occurrence of the lipedema of lower extremities, lipodystrophy of upper extremities, and severe calcinosis complicating JDM have not been published so far. We showed that the calcinosis and lipodystrophy were associated with short duration of active disease. Also, we display case that raises the question whether it is possible overlapping autoimmune diseases revealed during follow-up.

  14. 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.

  15. 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

  16. The Saudi clinical practice guideline for the diagnosis of the first deep venous thrombosis of the lower extremity

    Directory of Open Access Journals (Sweden)

    Fahad Al-Hameed

    2015-01-01

    Full Text Available The diagnosis of deep venous thrombosis (DVT may be challenging due to the inaccuracy of clinical assessment and diversity of diagnostic tests. On one hand, missed diagnosis may result in life-threatening conditions. On the other hand, unnecessary treatment may lead to serious complications. As a result of an initiative of the Ministry of Health of the Kingdom of Saudi Arabia (KSA, an expert panel led by the Saudi Association for Venous Thrombo-Embolism (SAVTE; a subsidiary of the Saudi Thoracic Society with the methodological support of the McMaster University Working Group, produced this clinical practice guideline to assist healthcare providers in evidence-based clinical decision-making for the diagnosis of a suspected first DVT of the lower extremity. Twenty-four questions were identified and corresponding recommendations were made following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE approach. These recommendations included assessing the clinical probability of DVT using Wells criteria before requesting any test and undergoing a sequential diagnostic evaluation, mainly using highly sensitive D-dimer by enzyme-linked immunosorbent assay (ELISA and compression ultrasound. Although venography is the reference standard test for the diagnosis of DVT, its use was not recommended.

  17. Design and evaluation of a quasi-passive knee exoskeleton for investigation of motor adaptation in lower extremity joints.

    Science.gov (United States)

    Shamaei, Kamran; Cenciarini, Massimo; Adams, Albert A; Gregorczyk, Karen N; Schiffman, Jeffrey M; Dollar, Aaron M

    2014-06-01

    In this study, we describe the mechanical design and control scheme of a quasi-passive knee exoskeleton intended to investigate the biomechanical behavior of the knee joint during interaction with externally applied impedances. As the human knee behaves much like a linear spring during the stance phase of normal walking gait, the exoskeleton implements a spring across the knee in the weight acceptance (WA) phase of the gait while allowing free motion throughout the rest of the gait cycle, accomplished via an electromechanical clutch. The stiffness of the device is able to be varied by swapping springs, and the timing of engagement/disengagement changed to accommodate different loading profiles. After describing the design and control, we validate the mechanical performance and reliability of the exoskeleton through cyclic testing on a mechanical knee simulator. We then describe a preliminary experiment on three healthy adults to evaluate the functionality of the device on both left and right legs. The kinetic and kinematic analyses of these subjects show that the exoskeleton assistance can partially/fully replace the function of the knee joint and obtain nearly invariant moment and angle profiles for the hip and ankle joints, and the overall knee joint and exoskeleton complex under the applied moments of the exoskeleton versus the control condition, implying that the subjects undergo a considerable amount of motor adaptation in their lower extremities to the exoskeletal impedances, and encouraging more in-depth future experiments with the device.

  18. 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 microar......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...

  19. Color Doppler Ultrasound of Lower Extremity Varicose Veins: A Simple Grading of Sapheno-Femoral Junction Reflux

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Sik; Hong, Suk Joo; Kim, Shin Kee; Hong, Sun Hwa [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Park, Sang Woo [Konkuk University Hospital, Konkuk University School of Medicine, Seoul (Korea, Republic of); Kim, Yeon Soo [Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of)

    2011-12-15

    To establish a simple grading method for the severity of an incompetent sapheno-femoral junction (SFJ) using color Doppler ultrasound in patients with lower extremity varicose veins. 346 legs of 241 consecutive patients with varicose veins were examined (M:F = 96:145, 11-74 years, mean 50 years). The severity of SFJ and sapheno-popliteal (SPJ) incompetence was graded from I to IV according to the patient's position (standing versus supine or prone) and whether the Valsalva's maneuver had been induced. The extent of varicose veins was graded as I to III by the US findings in the SFJ incompetence group. The grading of SFJ incompetence was compared to the extent of varicose vein. SFJ, SPJ, both SFJ and SPJ, and perforator incompetence was observed in 198 (57.2%), 81 (23.4%), 21 (6.1%) and 54 (15.6%), respectively. Among the SFJ incompetence group, severity grade I - IV were observed in 14 (7.1%), 75 (37.9%), 73 (36.9%), and 36 (18.2%), respectively, and the extent grade I - III were noted in 47 (23.7%), 95 (48.0%), and 56 (28.3%), respectively. The SFJ incompetence grade and varicose extent grade showed a positive correlation (p < 0.0001). Simple sonographic grading of the severity of SFJ incompetence is possible. The extent of varicose veins in the SFJ incompetence group can be determined using this new grading system

  20. Non-specific Inflammatory Disease Showed Abnormal FDG Uptake in Lower Extremities

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Kyung Ah; Kong, Eun Jung; Cho, Ihn Ho; Hong, Young Hoon; Lee, Choong Ki [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2008-02-15

    Including malignancy, various disease can show abnormal uptake in bone marrow.{sup 1,2} We report a case of non-specific inflammatory FDG uptake in bone marrow mimicking malignancy. A 35-year old woman with fever of unknown origin (FUO) underwent {sup 18}F-FDG PET/CT to find out fever focus and unknown malignancy. {sup 18}F-FDG was injected and imaged 1hr after injection with Discovery ST (GE, USA). {sup 18}F-FDG PET/CT whole body image showed abnormal uptake in lower extremities. MRI and biopsy was also done in the sites of abnormal uptake. PET and MRI suspect malignancy, but biopsy result was non-specific inflammatory process. The patient was improved her clinical condition after antibiotics therapy.

  1. The effect of lateral banking on the kinematics and kinetics of the lower extremity during lateral cutting movements.

    Science.gov (United States)

    Wannop, John W; Graf, Eveline S; Stefanyshyn, Darren J

    2014-02-01

    There are many aspects of cutting movements that can limit performance, however, the implementation of lateral banking may reduce some of these limitations. Banking could provide a protective mechanism, placing the foot and ankle in orientations that keep them out of dangerous positions. This study sought to determine the effect of two banking angles on the kinematics and kinetics of the lower extremity during two athletic maneuvers. Kinematic and kinetic data were collected on 10 recreational athletes performing v-cuts and side shuffle movements on different banked surfaces (0°, 10°, 20°). Each sample surface was rigidly attached to the force platform. Joint moments were calculated and compared between conditions using a repeated measures ANOVA. Banking had a pronounced effect on the ankle joint. As banking increased, the amount of joint loading in the transverse and frontal planes decreased likely leading to a reduction in injury risk. Also an increase in knee joint loading in the frontal plane was seen during the 20° bank during the v-cut. Conversely loading in the sagittal plane at the ankle joint increased with banking and coupled with a reorientation of the ground reaction vector may facilitate a performance increase. The current study indicates that the 10° bank may be the optimal bank, in that it decreases ankle joint loading, as well as increases specific performance variables while not increasing frontal plane knee joint loading. If banking could be incorporated in footwear it may be able to provide a protective mechanism for athletes.

  2. 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.

  3. 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 ...

  4. Validation of the Microsoft Kinect® camera system for measurement of lower extremity jump landing and squatting kinematics.

    Science.gov (United States)

    Eltoukhy, Moataz; Kelly, Adam; Kim, Chang-Young; Jun, Hyung-Pil; Campbell, Richard; Kuenze, Christopher

    2016-01-01

    Cost effective, quantifiable assessment of lower extremity movement represents potential improvement over standard tools for evaluation of injury risk. Ten healthy participants completed three trials of a drop jump, overhead squat, and single leg squat task. Peak hip and knee kinematics were assessed using an 8 camera BTS Smart 7000DX motion analysis system and the Microsoft Kinect® camera system. The agreement and consistency between both uncorrected and correct Kinect kinematic variables and the BTS camera system were assessed using interclass correlations coefficients. Peak sagittal plane kinematics measured using the Microsoft Kinect® camera system explained a significant amount of variance [Range(hip) = 43.5-62.8%; Range(knee) = 67.5-89.6%] in peak kinematics measured using the BTS camera system. Across tasks, peak knee flexion angle and peak hip flexion were found to be consistent and in agreement when the Microsoft Kinect® camera system was directly compared to the BTS camera system but these values were improved following application of a corrective factor. The Microsoft Kinect® may not be an appropriate surrogate for traditional motion analysis technology, but it may have potential applications as a real-time feedback tool in pathological or high injury risk populations. PMID:26835547

  5. Validation of the Microsoft Kinect® camera system for measurement of lower extremity jump landing and squatting kinematics.

    Science.gov (United States)

    Eltoukhy, Moataz; Kelly, Adam; Kim, Chang-Young; Jun, Hyung-Pil; Campbell, Richard; Kuenze, Christopher

    2016-01-01

    Cost effective, quantifiable assessment of lower extremity movement represents potential improvement over standard tools for evaluation of injury risk. Ten healthy participants completed three trials of a drop jump, overhead squat, and single leg squat task. Peak hip and knee kinematics were assessed using an 8 camera BTS Smart 7000DX motion analysis system and the Microsoft Kinect® camera system. The agreement and consistency between both uncorrected and correct Kinect kinematic variables and the BTS camera system were assessed using interclass correlations coefficients. Peak sagittal plane kinematics measured using the Microsoft Kinect® camera system explained a significant amount of variance [Range(hip) = 43.5-62.8%; Range(knee) = 67.5-89.6%] in peak kinematics measured using the BTS camera system. Across tasks, peak knee flexion angle and peak hip flexion were found to be consistent and in agreement when the Microsoft Kinect® camera system was directly compared to the BTS camera system but these values were improved following application of a corrective factor. The Microsoft Kinect® may not be an appropriate surrogate for traditional motion analysis technology, but it may have potential applications as a real-time feedback tool in pathological or high injury risk populations.

  6. 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.

  7. 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.

  8. 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

  9. Force-displacement differences in the lower extremities of young healthy adults between drop jumps and drop landings.

    Science.gov (United States)

    Hackney, James M; Clay, Rachel L; James, Meredith

    2016-10-01

    We measured ground reaction force and lower extremity shortening in ten healthy, young adults in order to compare five trials of drop jumps to drop landings. Our dependent variable was the percentage of displacement (shortening) between the markers on the ASIS and second metatarsal heads on each LE, relative to the maximum shortening (100% displacement) for that trial at the point of greatest ground reaction force. We defined this as "percent displacement at maximum force" (%dFmax). The sample mean %dFmax was 0.73%±0.14% for the drop jumps, and 0.47%±0.09% for the drop landings. The mean within-subject difference score was 0.26%±0.20%. Two-tailed paired t test comparing %dFmax between the drop jump and drop landing yielded P=0.002. For all participants in this study, the %dFmax was greater in drop jumps than in drop landings. This indicates that in drop jumps, the point of maximum force and of maximum shortening was nearly simultaneous, compared to drop landings, where the point of maximum shortening followed that of maximum force by a greater proportion. This difference in force to displacement behavior is explained by linear spring behavior in drop jumps, and linear damping behavior in drop landings. PMID:27344129

  10. 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.)

  11. 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

  12. Residual impairment after lower extremity fracture

    DEFF Research Database (Denmark)

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

    1998-01-01

    to the hospital for an interview and a clinical assessment 6 months later. The disability was measured by administering the Sickness Impact Profile (SIP) to all patients by an interview process. SIP scores were calculated for pretraumatic and posttraumatic states. The pretraumatic SIP scores described...... the 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...

  13. 口服维生素D3对维生素D不足绝经后妇女血清25-羟维生素D、骨密度和下肢肌力的影响%Effects of oral cholecalciferol on serum 25-hydroxyvitamin D level, bone mineral density and lower extremity function in postmenopausal women with vitamin D insufficiency

    Institute of Scientific and Technical Information of China (English)

    黄琪仁; 李水军; 张浩; 蒋建新; 虞申; 樊家珠; 胡云秋; 刘玉娟; 章振林

    2015-01-01

    目的:给予不同年龄、维生素D不足的绝经后妇女口服1325 U维生素D3,观察其对血清总25-羟维生素D (25OHD)水平、骨密度( BMD)和下肢肌力(行走八步计时)的影响。方法上海市某社区67名绝经后妇女纳入本研究,按年龄将受试者分成2组:<70岁组[ n=35,(63.6±5.1)岁],≥70岁组[ n=32,(75.2±3.4)岁]。受试者口服1200 U/d维生素D3制剂加1片钙尔奇D (每片含维生素D3125 U和钙600 mg),为期1年。在0、3、6、9和12个月检测血清25OHD,干预前和研究结束时测定BMD及下肢肌力。结果干预1年后,2组平均血清25OHD水平均较基线值显著升高:<70岁组从(17.8±6.7) ng/mL升至(33.8±5.8) ng/mL (P<0.001);≥70岁组从(18.3±6.7) ng/mL升至(34.1±5.7) ng/mL (P<0.001),但2组间增幅差异无统计学意义。有25%受试者(<70岁组9名,≥70岁组6名)平均血清25OHD仍低于30 ng/mL。<70岁组血清甲状旁腺素(PTH)明显降低,从(46.0±14.7) pg/mL降至(37.9±10.0) pg/mL ( P<0.01),各部位BMD较基线值无统计学差异。≥70岁组腰椎BMD提高1.37%(P=0.005),全髋部位BMD提高1.28%( P=0.028)。2组干预后下肢肌力均较干预前改善( P<0.05)。2组均未出现高钙血症及过高的血清25OHD浓度。结论2组维生素D不足的绝经后妇女每日口服1325U维生素D3可将血清25OHD升至理想水平,可改善下肢肌力,≥70岁组腰椎及全髋部BMD均有上升。%Objective To evaluate the effects of daily supplement of 1 325 U cholecalciferol for one year on cir-culation serum 25-hydroxyvitamin D [25OHD] level, bone mineral density ( BMD) and lower extremity function in post-menopausal women with vitamin D insufficiency.Methods Sixty-seven postmenopausal women were recruited from urban area of Shanghai.The subjects

  14. 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

  15. Correlation between the selective control assessment of lower extremity and pediatric balance scale scores in children with spastic cerebral palsy

    Science.gov (United States)

    Lim, Hyoungwon

    2015-01-01

    [Purpose] The purpose of this study was to investigate the correlation between the Selective Control Assessment of Lower Extremity (SCALE) and Pediatric Balance Scales (PBS) in children with spastic cerebral palsy and further to test whether the SCALE is a valid tool to predict the PBS. [Subjects and Methods] A cross-sectional study was conducted to evaluate the SCALE and PBS in 23 children (9 females, 14 males, GMFCS level I–III) with spastic cerebral palsy. [Results] Both the SCALE and PBS scores for children with spastic hemiplegia were significantly higher than those for children with spastic diplegia. The scores for SCALE items were low for distal parts. The PBS items that were difficult for the participants to perform were items 8, 9, 10, and 14 with the highest difficulty experienced for item 8 followed by items 9, 10, and 14. The correlation coefficient (0.797) between the SCALE and PBS scores was statistically significant. The correlations between each SCALE item and the PBS scores were also statistically significant. SCALE items were significantly correlated with two PBS dimensions (standing and postural change). [Conclusion] In SCALE assessment, more severe deficits were observed in the distal parts. Standing and postural changes in the PBS method were difficult for the participants to perform. The two tests, that is, the SCALE and PBS, were highly correlated. Therefore, the SCALE is useful to prediction of PBS outcomes and is also applicable as a prognostic indicator for treatment planning. PMID:26834323

  16. The effects of lower extremity muscle activation and passive range of motion on single leg squat performance.

    Science.gov (United States)

    Mauntel, Timothy C; Begalle, Rebecca L; Cram, Tyler R; Frank, Barnett S; Hirth, Christopher J; Blackburn, Troy; Padua, Darin A

    2013-07-01

    Knee valgus is a potential risk factor for lower extremity (LE) injuries. Clinical movement screenings and passive range of motion (PROM) measurements may help identify neuromuscular patterns, which contribute to knee valgus. The purpose of this study was to compare LE muscle activation and PROM between subjects who display visual medial knee displacement (MKD) during a single leg squat (SLS) and those who do not. We hypothesized that muscular activation and PROM would differ between the groups. Forty physically active adults (20 controls, 20 MKDs) participated in this study. Subjects completed 10 LE PROM assessments and performed 5 SLS trials while electromyography (EMG) data were collected from 8 LE muscles. Three separate multivariate analysis of variance were used to identify group differences in EMG data, muscle coactivation, and PROM. Results during the SLS indicated hip coactivation ratios revealed smaller gluteus medius to hip adductor (GMed:Hip Add) (p = 0.028) and gluteus maximus to hip adductor (GMax:Hip Add) coactivation ratios (p = 0.007) compared with the control group. Also, the MKD group displayed significantly less passive ankle dorsiflexion with the knee extended (p = 0.047) and flexed (p = 0.034), and greater talar glide motion (p = 0.012). The findings of this study indicate that MKD during a SLS seems to be influenced by decreased coactivation of the gluteal to the hip adductor muscles and restricted dorsiflexion. Therefore, conditioning, rehabilitation, and injury prevention programs should focus on decreasing hip adductor activity, increasing hip abductor and external rotator activity, and increasing ankle dorsiflexion in hopes to decrease the incidence of these injuries. PMID:23096063

  17. 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.

  18. Dynamic Solution of the Lower Extremity Joint Torques in Man machine System of Lower Extremity Exoskeleton%外骨骼机器人系统中人体下肢关节力矩动态解算

    Institute of Scientific and Technical Information of China (English)

    郭伟; 杨丛为; 邓静; 查富生

    2015-01-01

    The method uses joint displacement sensors and inertial navigation unit on lower ex-tremity exoskeleton to collect human motion infor-mation.Gets the relative angle of hip,knee and the posture and acceleration of torso.With inverse dy-namics real time calculating the joint driving torque of the wearers.In the procedure,with the 5 bar human model the kinematics and dynamics of human limb’s movement were analyzed.By Mat-lab /Simulink programming to obtain the curve of the joint torque of human lower limb joints in suc-cessive gait cycle.In order to prove the Correct-ness of the result,compare the joint torque of sup-porting leg ankle solved by lagrange dynamics e-quations with the ankle torque which was calculat-ed by the plantar force measured during the experi-ment,the feasibility of the solving method was proved.Exoskeleton robot assiste the wearer with the torques information.%利用下肢外骨骼关节位移传感器及惯性导航单元采集人体运动信息,计算获得下肢髋、膝关节的相对角度以及躯干的姿态和加速度,通过动力学逆解实时解算穿戴者运动所需的关节驱动力矩。在此过程中,利用人体五杆模型,对人体下肢的运动进行了运动学和动力学分析,通过 Matlab/Simulink 软件编程求解,得到了人体下肢关节在连续步态周期内关节力矩的变化,通过对比计算获得的支撑踝关节力矩值与足底力传感器实测值,证明了关节力矩求解方法的正确性,保障了外骨骼机器人能够根据此力矩对穿戴者提供助力。

  19. Lower extremity compartmental anatomy: clinical relevance to radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Toomayan, Glen A.; Robertson, Fabienne; Major, Nancy M. [Duke University Medical Center, Department of Radiology, Durham (United States)

    2005-06-01

    A thorough understanding of compartmental anatomy is necessary for the radiologist participating in the care of a patient with a lower extremity musculoskeletal malignancy. Localization of tumor to compartment of origin and identification of extracompartmental spread preoperatively are needed to correctly stage a tumor and determine the appropriate surgical management. An understanding of the locations of fascial boundaries, extracompartmental tissues, and neurovascular structures of the thigh and lower leg facilitates this diagnostic process. For the radiologist planning to biopsy a suspicious musculoskeletal lesion, consultation with the referring orthopaedic surgeon is recommended in order to jointly select an appropriate percutaneous biopsy approach. Adequate preprocedural planning ensures selection of an approach which prevents iatrogenic tumor spread beyond the compartment of origin, protects neurovascular structures, and allows complete resection of the biopsy tract and scar at the time of surgical resection without jeopardizing a potential limb-sparing procedure. Cross-sectional anatomic review and case examples demonstrate the importance of a detailed understanding of compartmental anatomy when approaching the patient with a lower extremity musculoskeletal tumor. (orig.)

  20. Higher Dietary Acidity is Associated with Lower Bone Mineral Density in Postmenopausal Iranian Women, Independent of Dietary Calcium Intake.

    Science.gov (United States)

    Shariati-Bafghi, Seyedeh-Elaheh; Nosrat-Mirshekarlou, Elaheh; Karamati, Mohsen; Rashidkhani, Bahram

    2014-01-01

    Findings of studies on the link between dietary acid-base balance and bone mass are relatively mixed. We examined the association between dietary acid-base balance and bone mineral density (BMD) in a sample of Iranian women, hypothesizing that a higher dietary acidity would be inversely associated with BMD, even when dietary calcium intake is adequate. In this cross-sectional study, lumbar spine and femoral neck BMDs of 151 postmenopausal women aged 50-85 years were measured using dual-energy x-ray absorptiometry. Dietary intakes were assessed using a validated food frequency questionnaire. Renal net acid excretion (RNAE), an estimate of acid-base balance, was then calculated indirectly from the diet using the formulae of Remer (based on dietary intakes of protein, phosphorus, potassium, and magnesium; RNAERemer) and Frassetto (based on dietary intakes of protein and potassium; RNAEFrassetto), and was energy adjusted by the residual method. After adjusting for potential confounders, multivariable adjusted means of the lumbar spine BMD of women in the highest tertiles of RNAERemer and RNAEFrassetto were significantly lower than those in the lowest tertiles (for RNAERemer: mean difference -0.084 g/cm2; P=0.007 and for RNAEFrassetto: mean difference -0.088 g/cm2; P=0.004). Similar results were observed in a subgroup analysis of subjects with dietary calcium intake of >800 mg/day. In conclusion, a higher RNAE (i. e. more dietary acidity), which is associated with greater intake of acid-generating foods and lower intake of alkali-generating foods, may be involved in deteriorating the bone health of postmenopausal Iranian women, even in the context of adequate dietary calcium intake.

  1. 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.)

  2. 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.)

  3. Use of extended curettage with osteotomy and fenestration followed by reconstruction with conservation of muscle insertion in the treatment of Enneking stage II locally aggressive bone tumor of the proximal extremities: resection and treatment of bone tumors

    Science.gov (United States)

    2013-01-01

    Background The purpose of this study was to investigate the clinical efficacy of extended resection with osteotomy, fenestration and conservation of muscle (tendon) insertion in the treatment of bone tumors. Methods A total of 15 patients with locally aggressive bone tumors (Enneking stage II) in the adjacent muscle (tendon) insertion of the proximal extremity were enrolled in the present study (mean age of 29 years). Extended curettage of lesions with osteotomy, fenestration and/or conservation of muscle (tendon) insertion and internal fixation with a bone graft or bone cement was performed at stage I. Postsurgical brace protection was used for 4 to 12 weeks and the patients were periodically followed-up by X-ray and functional assessment. Recurrence, postsurgical Enneking score and outcome rating were assessed. Results Treated cases included 15 patients aged 29 ±7.75 years (range, 18 to 42) with a male to female ratio of 8:7. Six had a femoral tumor and nine had a humeral tumor. These tumors comprised three chondroblastomas, five giant-cell tumors and seven aneurysmal bone cysts. Follow-up for 48 ±12.95 months (range, 25 to 72) revealed that 13 of 15 (87%) patients exhibited no recurrence. Local recurrence was observed in a patient with an aneurysmal bone cyst (nine months) and one with a giant-cell tumor (12 months). Mean Enneking scores were 27 ±4.07 (range, 18 to 29). Except for the patient with the recurrent giant-cell tumor, all patients reported good (13%, 2 out of 15) or very good (80%, 12 out of 15) outcomes. Very good outcomes were reported in 92% of patients (12 out of 13) without recurrence. Conclusions The procedures used in this study achieved high clinical efficacy, complete lesion removal, reduced recurrence and good restoration of joint function in patients with primary locally aggressive Enneking stage II bone tumors of the proximal extremities. PMID:23497479

  4. Aspiration Thrombectomy Using a Guiding Catheter in Acute Lower Extremity Deep Vein Thrombosis: Usefulness of the Calf-Squeeze Technique

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae A; Kwak, Hyo Sung; Han, Young Min; Yu, Hee Chul [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2011-05-15

    The effectiveness of the calf-squeeze technique during aspiration thrombectomy using guiding catheter in the treatment of an acute lower extremity deep vein thrombosis (DVT) was evaluated by the use of imaging and the clinical follow-up of patients. A prospective analysis of ten patients (seven women, three men; median age, 56.9 years) with common iliac vein (CIV) obstruction and ipsilateral DVT was performed for this study. All patients presented with leg edema or pain and were treated with catheter-directed thrombolysis via an ipsilateral popliteal vein approach after insertion of a temporary inferior vena cava (IVC) filter. Subsequently, the patients were treated with by aspiration thrombectomy using a guiding catheter to remove the residual thrombus. The calf-squeeze technique during aspiration thrombectomy can be used to induce the proximal migration of thrombi in the popliteal, tibial, and muscular veins were used to increase venous flow. The calf-squeeze technique was employed at mean of 1.3 times (range, 1-3 times). All patients showed proximal migration of a popliteal and muscular vein thrombus during the execution of the calf-squeeze technique. Successful recanalization was achieved in all patients (100%) without any complications. On duplex ultrasonography, which was performed immediately after the aspiration thrombectomy, four patients had a residual thrombus in the soleal muscular veins. However, none of the patients had a thrombus in the popliteal and tibial veins; and, during follow-up, no DVT recurred in any patient. The use of the calf-squeeze technique during aspiration thrombectomy after catheter-directed thrombolysis can induce the proximal migration of thrombi in the popliotibial and muscular veins and is an effective method that can remove a thrombus in calf veins.

  5. 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

  6. 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...

  7. COMPARATIVE STUDY OF HEMODYNAMIC STABILITY AND COST EFFECTIVENESS BETWEEN GENERAL AND SPINAL ANAESTHESIA IN PATIENTS AGE GROUP (0-5YEARS IN LOWER ABDOMINAL AND LOWER EXTREMITIES SURGERIES

    Directory of Open Access Journals (Sweden)

    Jaitawat

    2015-12-01

    Full Text Available BACKGROUND AND AIMS Aim of this study was to compare the changes in heart rate, blood pressure, oxygen saturation and cost effectiveness between general anaesthesia and spinal anaesthesia in pediatric patients undergoing lower abdominal and lower limb surgeries for the same duration. MATERIAL AND METHODS Fifty ASA1 patients in age group 0-5 years of either sex undergoing lower abdominal and lower limb surgeries were randomly divided in to two groups (Group-I GA group-n25 and Group-II SA group-n25. Group1 was given general anaesthesia and group-II was given spinal anaesthesia. Haemodynamic parameters and side effects during intra operative and immediate post-operative period were recorded and cost of GA and SA was calculated. RESULTS Patients in both the groups were comparable in surgical procedures and duration of surgery. Haemodynamically children in spinal group (Group-II remained more stable intra operatively and no untoward incidence was observed in group-II. Spinal Anaesthesia was much more cost effective as compared to general anaesthesia. CONCLUSION Pediatric spinal anaesthesia is a safe and effective anaesthetic technique for lower abdominal and lower limb surgeries. It is much more cost effective as compared to general anaesthesia.

  8. 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.

  9. Unsuspected lower extremity deep venous thrombosis simulating musculoskeletal pathology

    Energy Technology Data Exchange (ETDEWEB)

    Parellada, Antoni J.; Reiter, Sean B.; Glickman, Peter L.; Kloss, Linda A. [Frankford Hospitals, DII - Diagnostic Imaging, Inc., Department of Radiology, Philadelphia, PA (United States); Morrison, William B. [Thomas Jefferson University, Philadelphia, PA (United States); Carrino, John A. [Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Patel, Pinecca [Frankford Hospitals, Jefferson Health System, Philadelphia, PA (United States)

    2006-09-15

    The purpose of this study was to highlight the critical role that MRI may play in diagnosing unsuspected lower extremity deep venous thrombosis and to stress the importance of scrutinizing MRI studies of the lower extremity showing apparently non-specific muscle edema for any evidence of intramuscular venous thrombosis. The imaging studies of four patients in whom deep venous thrombosis was unsuspected on clinical grounds, and first diagnosed on the basis of MRI findings, were reviewed by two musculoskeletal radiologists in consensus. In all four patients the initial clinical suspicion was within the scope of musculoskeletal injuries (gastrocnemius strain, n=3; ruptured Baker cyst, n=1), explaining the choice of MRI over ultrasound as the first diagnostic modality. All patients showed marked reactive edema in the surrounding soft tissues or muscles. Three patients showed MR evidence of branching rim-enhancing structures within intramuscular plexuses characteristic of venous thrombosis (gastrocnemius, n=1; sural, n=2); one patient showed a distended popliteal vein. Ultrasound was able to duplicate the MRI findings in three patients: one patient showed above-the-knee extension on ultrasound; neither of the two patients with intramuscular thrombosis demonstrated on ultrasound showed extension to the deep venous trunks. Intramuscular venous thrombosis can present as marked edema-like muscle changes on MRI, simulating primary musculoskeletal conditions. In the absence of clinical suspicion for deep venous thrombosis, only the identification of rim-enhancing branching intramuscular tubular structures will allow the correct diagnosis to be made. (orig.)

  10. Effect of surgical decompression of nerves in the lower extremity in patients with painful diabetic polyneuropathy on stability : A randomized controlled trial

    NARCIS (Netherlands)

    Macare van Maurik, JFM; Ter Horst, Britt; Van Hal, Mireille; Kon, Moshe; Peters, Edgar J G

    2015-01-01

    Objective: To investigate the effect of decompression of nerves in the lower extremity in patients with painful diabetic polyneuropathy on static balance using a sensitive pressure mat system. Design: Non-blinded randomized controlled trial. Setting: Single center study performed at the University M

  11. Lower extremity amputation in peripheral artery disease: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Swaminathan A

    2014-07-01

    Full Text Available Aparna Swaminathan,1 Sreekanth Vemulapalli,1,2 Manesh R Patel,1,2 W Schuyler Jones1,2 1Department of Medicine, Duke University Medical Center, Durham, NC, USA; 2Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA Abstract: Peripheral artery disease affects over eight million Americans and is associated with an increased risk of mortality, cardiovascular disease, functional limitation, and limb loss. In its most severe form, critical limb ischemia, patients are often treated with lower extremity (LE amputation (LEA, although the overall incidence of LEA is declining. In the US, there is significant geographic variation in the performing of major LEA. The rate of death after major LEA in the US is approximately 48% at 1 year and 71% at 3 years. Despite this significant morbidity and mortality, the use of diagnostic testing (both noninvasive and invasive testing in the year prior to LEA is low and varies based on patient, provider, and regional factors. In this review we discuss the significance of LEA and methods to reduce its occurrence. These methods include improved recognition of the risk factors for LEA by clinicians and patients, strong advocacy for noninvasive and/or invasive imaging prior to LEA, improved endovascular revascularization techniques, and novel therapies. Keywords: peripheral artery disease, lower extremity amputation, mortality

  12. CT demonstration of the extensive extension of the emphysematous gangrene of the lower extremity extending to the body : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hak Soo; Rhim, Hyun Chul; Kim, Yong Soo; Song, Soon Young; Koh, Byung Hee; Cho, On Koo; Joo, Kyung Bin [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-08-01

    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.

  13. 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.)

  14. Lower Extremity Muscle Activity During a Women's Overhand Lacrosse Shot.

    Science.gov (United States)

    Millard, Brianna M; Mercer, John A

    2014-06-28

    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) × 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. PMID:25114727

  15. 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.

  16. 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

  17. A new classification of peri-implant bone morphology: a radiographic study of patients with lower implant-supported mandibular overdentures

    NARCIS (Netherlands)

    L. Zhang; W. Geraets; Y. Zhou; W. Wu; D. Wismeijer

    2014-01-01

    Objective This study aimed to classify peri-implant bone defects (PIBDs) on the basis of their radiographic appearance in a cohort of patients with lower implant-supported overdentures. Materials and methods Eighty-three patients with lower implant-supported overdentures were recruited to participat

  18. 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

  19. 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.

  20. 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

  1. Co-Activity during Maximum Voluntary Contraction: A Study of Four Lower-Extremity Muscles in Children with and without Cerebral Palsy

    Science.gov (United States)

    Tedroff, Kristina; Knutson, Loretta M.; Soderberg, Gary L.

    2008-01-01

    This study was designed to determine whether children with cerebral palsy (CP) showed more co-activity than comparison children in non-prime mover muscles with regard to the prime mover during maximum voluntary isometric contraction (MVIC) of four lower-extremity muscles. Fourteen children with spastic diplegic CP (10 males, four females; age…

  2. Effect of Roy’s Adaptation Model-Guided Education on Coping Strategies of the Veterans with Lower Extremities Amputation: A Double-Blind Randomized Controlled Clinical Trial

    Science.gov (United States)

    Farsi, Zahra; Azarmi, Somayeh

    2016-01-01

    Background: Any defect in the extremities of the body can affect different life aspects. The purpose of this study was to investigate the effect of Roy’s adaptation model-guided education on coping strategies of the veterans with lower extremities amputation. Methods: In a double-blind randomized controlled clinical trial, 60 veterans with lower extremities amputation referring to Kowsar Orthotics and Prosthetics Center of Veterans Clinic in Tehran, Iran were recruited using convenience method and randomly assigned to intervention and control groups in 2013-2014. Lazarus and Folkman coping strategies questionnaire was used to collect the data. After completing the questionnaires in both groups, maladaptive behaviours were determined in the intervention group and an education program based on Roy’s adaptation model was implemented. After 2 months, both groups completed the questionnaires again. Data were analyzed using SPSS software. Results: Independent T-test showed that the score of the dimensions of coping strategies did not have a statistically significant difference between the intervention and control groups in the pre-intervention stage (P>0.05). This test showed a statistically significant difference between the two groups in the post-intervention stage in terms of the scores of different dimensions of coping strategies (P>0.05), except in dimensions of social support seeking and positive appraisal (P>0.05). Conclusion: The findings of this research indicated that the Roy’s adaptation model-guided education improved the majority of coping strategies in veterans with lower extremities amputation. It is recommended that further interventions based on Roy’s adaptation model should be performed to improve the coping of the veterans with lower extremities amputation. Trial Registration Number: IRCT2014081118763N1 PMID:27218110

  3. 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

  4. 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

  5. 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

  6. Analysis of Lower Extremity Exoskeleton Walker Robot Driving System%下肢外骨骼助行机器人驱动系统分析

    Institute of Scientific and Technical Information of China (English)

    刘会勇; 赵青

    2013-01-01

    下肢外骨骼助行机器人驱动系统的性能对于保证穿戴者和机器人之间的相互协调并真正实现“人机一体化”至关重要.简要分析了人体下肢运动机制,介绍下肢外骨骼助行机器人驱动系统研究现状,并且对各种不同的下肢外骨骼助行机器人驱动系统进行分析,为下肢外骨骼助行机器人驱动系统的设计提供参考.%The performance of the drive system of lower extremity exoskeleton walker robot is essential to ensure coordination between the wearer and the robot and the real man-machine integration.The human lower limb movement mechanism was analyzed,then the research status of the lower extremity exoskeleton walker robot drive system was described.A variety of different lower limb exoskeleton walker robot drive systems were analyzed.It provides a reference for design of the lower extremity exoskeleton walker robot drive system.

  7. 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.

  8. [Modification of bone quality by extreme physical stress. Bone density measurements in high-performance athletes using dual-energy x-ray absorptiometry].

    Science.gov (United States)

    Sabo, D; Reiter, A; Pfeil, J; Güssbacher, A; Niethard, F U

    1996-01-01

    The treatment of osteoporosis is still controversial. Rehabilitation programs which stress strengthening exercises as well as impact loading activities increase the bone mass. On the other side activity level early in life has not been proven to correlate with increased bone mineral content later in life. Little is known on the influence of high performance sports on the bone density especially in athletes with high demands on weight bearing of the spine. In (n = 40) internationally top ranked high performance athletes of different disciplines (n = 28 weight-lifters, n = 6 sports-boxers and n = 6 bicycle-racers) bone density measurements of the lumbar spine and the left hip were performed. The measurements were carried out by dual-photonabsorptiometry (DEXA; QDR 2000, Siemens) and evaluated by an interactive software-programme (Hologic Inc.). The results were compared to the measurements of 21 age-matched male control individuals. In the high performance weight lifters there was an increase of bone density compared to the control individuals of 23% in the Ward's triangle (p boxers had an increase up to 17% (lumbar spine), 9% (hip) and 7% (Wards' triangle). In the third athletes group (Tour de France-bikers) BMD was decreased 10% in the lumbar spine, 14% in the hip and 17% in the Wards' triangle. Our results show that training programs stressing axial loads of the skeletal system may lead to an increase of BMD in the spine and the hip of young individuals. Other authors findings, that the BMD of endurance athletes may decrease, is confirmed. Nevertheless the bikers BMD-loss of 10 to 17% was surprisingly high.

  9. 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...

  10. 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...

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 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)

  17. 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...

  18. 产后下肢深静脉血栓的病因及预防%Cause and Prevention of Postpartum Deep Venous Thrombosis of Lower Extremities

    Institute of Scientific and Technical Information of China (English)

    钱芳; 赵小魁; 吴萍; 黄文英; 线小英

    2012-01-01

    目的:探讨产后下肢深静脉血栓形成的原因及预防.方法:对我院2006年1月至2010年12月发生的8例产后下肢深静脉血栓形成的病例资料进行回顾性分析.结果:所有病例经治疗后症状改善,复查超声提示血栓消失.无一例发生肺栓塞.结论:产后下肢深静脉血栓形成与血液高凝状态、血流缓慢以及静脉壁损伤等因素有关.严格掌握剖宫产手术指征,降低剖宫产率,产后早下床活动以促进静脉回流可预防深静脉血栓形成.%Objective: To investigate the causes and prevention methods of postpartum deep venous thrombosis of lower extremities. Methods: Clinical data of 8 patients with postpartum deep vein thrombosis of lower extremities were analyzed and summarized in our department from January, 2006 to December, 2010. Result: After the treatment, the symptoms and signs of all the cases were relieved. Ultrasound showed that deep venous thrombosis was disappeared. No one pulmonary embolism occurred. Conclusion: Factors which induced postpartum deep venous thrombosis of lower extremities are related to blood hypercoagulability, slow blood flow and venous endothelium injury, and so on. The indications of cesarean section should be controlled to reduce the rate of cesarean section. Early postpartum activities are taken to accelerate the venous refluence, which can prevent deep venous thrombosis of lower extremities.

  19. Pharmacomechanical thrombectomy and catheter-directed thrombolysis of acute lower extremity deep venous thrombosis in a 9-year-old boy with inferior vena cava atresia.

    Science.gov (United States)

    Hamidian Jahromi, Alireza; Coulter, Amy H; Bass, Patrick; Zhang, Wayne W; Tan, Tze-Woei

    2015-04-01

    Lower extremity deep venous thrombosis (DVT) is uncommon in the pediatric population, but it can be associated with severe symptoms and potential long-term morbidity secondary to post-thrombotic syndrome. Inferior vena cava (IVC) atresia can predispose a patient to the development of extremity DVT. There is no clear consensus on optimal management of extensive extremity DVT in pediatric patients, especially in patients with IVC anomalies. We report a case of iliofemoral DVT in a 9-year-old boy with IVC atresia and presumed protein S deficiency that was treated successfully using pharmacomechanical thrombectomy and catheter-directed thrombolysis. He was maintained on long-term anticoagulation and remained symptom free at 6 months' follow-up.

  20. 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...

  1. Peri Operative Nursing of Varicose Veins of Lower Extremities%下肢静脉曲张的围手术期护理

    Institute of Scientific and Technical Information of China (English)

    陈福英

    2015-01-01

    Objective To investigate the perioperative nursing care of lower extremity varicose veins. Methods 408 patients with varicose veins of lower extremity were treated with combined surgery of varicose vein (EVLT). Results Given to the patients with primary healing, and no complications such as lower extremity venous thrombosis occur ed. Conclusion EVLT technology is safe, ef ective, minimal y invasive, easy to operate and not to leave a scar, etc, good care is the key to ensure the success of the operation.%目的探讨下肢静脉曲张的围手术期护理。方法对204例下肢静脉曲张患者静脉曲张(EVLT)联合手术治疗。结果原发性愈合,无下肢静脉血栓等并发症发生。结论 EVLT技术是安全,有效,微创,操作简便,不留疤痕,等,良好的护理是保证手术成功的关键。

  2. 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...

  3. 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

  4. Which screening tools can predict injury to the lower extremities in team sports? : A systematic review

    NARCIS (Netherlands)

    Dallinga, J.M.; Benjaminse, A.; Lemmink, K.A.

    2012-01-01

    Abstract 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 injuri

  5. 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

  6. 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

  7. 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.

  8. [Interpretation and consideration of the Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities management of asymptomatic disease and claudication].

    Science.gov (United States)

    Shen, Chenyang; Li, Weihao

    2016-02-01

    Atherosclerotic occlusive disease of the lower extremities (ASO-LE) has the third highest rate among systematic atherosclerosis obliterans, ranking after coronary heart disease and stoke, and the disease burden of ASO-LE has been continuously increasing. Invasive revascularizations, which is presented by endovascular therapy technique, has undergone a dramatic development in the past couples of decades. However, controversy concerned about the surgical management and operative indications has heated up in the meanwhile. Thus Society for Vascular Surgery (SVS) published the practice guidelines for ASO-LE with asymptomatic disease and claudication in March, 2015. At the first time the guideline definitely opposed the aggressive invasive revascularization for ASO-LE patients with asymptomatic disease or claudication under satisfied tolerance. Instead, it posed the extreme emphasis on the pharmacotherapy with risk reduction of atherosclerosis at the core and the exercise therapy with supervised or home-based exercise program at the core for ASO-LE patients with asymptomatic disease and claudication.

  9. 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

  10. 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.

  11. 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

  12. [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

  13. 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...

  14. Lower extremity amputation in peripheral artery disease: improving patient outcomes

    Science.gov (United States)

    Swaminathan, Aparna; Vemulapalli, Sreekanth; Patel, Manesh R; Jones, W Schuyler

    2014-01-01

    Peripheral artery disease affects over eight million Americans and is associated with an increased risk of mortality, cardiovascular disease, functional limitation, and limb loss. In its most severe form, critical limb ischemia, patients are often treated with lower extremity (LE) amputation (LEA), although the overall incidence of LEA is declining. In the US, there is significant geographic variation in the performing of major LEA. The rate of death after major LEA in the US is approximately 48% at 1 year and 71% at 3 years. Despite this significant morbidity and mortality, the use of diagnostic testing (both noninvasive and invasive testing) in the year prior to LEA is low and varies based on patient, provider, and regional factors. In this review we discuss the significance of LEA and methods to reduce its occurrence. These methods include improved recognition of the risk factors for LEA by clinicians and patients, strong advocacy for noninvasive and/or invasive imaging prior to LEA, improved endovascular revascularization techniques, and novel therapies. PMID:25075192

  15. 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.

  16. 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

  17. 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.

  18. Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis in the treatment of symptomatic lower extremity deep venous thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Sh, Hongjian [Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, 2 North Yongning Road, Changzhou 213002 (China)], E-mail: shihongjian@sina.com; Huang Youhua; Shen Tao; Xu Qiang [Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, 2 North Yongning Road, Changzhou 213002 (China)

    2009-08-15

    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.

  19. Safety and efficacy of botox injection in alleviating post-operative pain and improving quality of life in lower extremity limb lengthening and deformity correction

    Directory of Open Access Journals (Sweden)

    Finley Allen

    2007-09-01

    Full Text Available Abstract Background Distraction osteogenesis is the standard treatment for the management of lower limb length discrepancy of more than 3 cm and bone loss secondary to congenital anomalies, trauma or infection. This technique consists of an osteotomy of the bone to be lengthened, application of an external fixator, followed by gradual and controlled distraction of the bone ends. Although limb lengthening using the Ilizarov distraction osteogenesis principle yields excellent results in most cases, the technique has numerous problems and is not well tolerated by many children. The objective of the current study is to determine if Botulinum Toxin A (BTX-A, which is known to possess both analgesic and paralytic actions, can be used to alleviate post-operative pain and improve the functional outcome of children undergoing distraction osteogenesis. Methods/Design The study design consists of a multi centre, randomized, double-blinded, placebo-controlled trial. Patients between ages 5–21 years requiring limb lengthening or deformity correction using distraction will be recruited from 6 different sites (Shriners Hospital for Children in Montreal, Honolulu, Philadelphia and Portland as well as DuPont Hospital for Children in Wilmington, Delaware and Hospital for Sick Children in Toronto, Ont. Approximately 150 subjects will be recruited over 2 years and will be randomized to either receive 10 units per Kg of BTX-A or normal saline (control group intraoperatively following the surgery. Functional outcome effects will be assessed using pain scores, medication dosages, range of motion, flexibility, strength, mobility function and quality of life of the patient. IRB approval was obtained from all sites and adverse reactions will be monitored vigorously and reported to IRB, FDA and Health Canada. Discussion BTX-A injection has been widely used world wide with no major side effects reported. However, to the best of our knowledge, this is the first time BTX

  20. 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.

  1. 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

  2. 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

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Sun; Lee, Jee Eun; Hwang, Ji Young; Shim, Sung Shine; Yoo, Jeong Hyun; Suh, Jeong Soo; Park, Jae Young [College of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2006-11-15

    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

  3. THE PROGRESS OF MSCTA IN LOWER EXTREMITY ARTERIAL DISEASE%下肢动脉性疾病MSCTA的研究进展

    Institute of Scientific and Technical Information of China (English)

    李伟; 苏秉亮

    2011-01-01

    Lower extremity arterial disease is a common and frequently - occurring disease in China. As a "gold standard" diagnosis of lower extremity arterial disease, DSA was limited in widespread clinical application because of its own limitations. With the advent and maturity of 64 - slice CT technology, postprocessing technology aftevcorreceing application and careful observation can ensure the accuracy of diagnosis of 64 - SCTA, MSCTA has been the routine diagnosis method of lower limb arterial disease in its diagnosis and follow -up after treatment.%下肢动脉性疾病诊断"金标准"DSA因其自身的局限性,限制了其临床广泛应用.随着64排螺旋CT的问世及其技术的日臻成熟,正确应用后处理技术并仔细观察,能够保证多层螺旋CT血管成像(Multi-slice spiral CT angiography,MSCTA)诊断的准确性,MSCTA已经成为下肢动脉性疾病诊断和治疗后随访的首选及常规的检查方法.

  4. Observed Rates of Lower Extremity Stress Fractures After Implementation of the Army Physical Readiness Training Program at JBSA Fort Sam Houston.

    Science.gov (United States)

    Chalupa, Robyn L; Aberle, Curtis; Johnson, Anthony E

    2016-01-01

    Millions of dollars are lost each year to the US military in medical discharges from injuries sustained in the initial training of recruits. Most medical discharges in recruits are related to musculoskeletal overuse injuries, including stress fractures. Any strategies that can reduce injury rates are also likely to reduce rates of medical discharge. This study evaluated the Army Physical Readiness Training (PRT) program which was established to provide a method of physical fitness training that would reduce the number of preventable injuries. We conducted a retrospective study to evaluate the number of lower extremity stress fractures that were diagnosed in the 6 months prior to and 6 months following the implementation of the PRT program. Electronic medical records were queried for specific diagnoses of stress fractures to the pelvis, femoral neck, femoral shaft, tibia, fibula, tarsals and metatarsals. The observed number of diagnoses in each time period were compared using the χ² method. Decrease was shown not only in the overall occurrence of stress fractures, but specifically in the occurrence of stress fractures of the femoral neck, femoral shaft, and tarsals. Our study was able to show a correlation between the PRT program and a decrease in the observed occurrence of lower extremity stress fractures.

  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.

    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

  7. High spatial resolution time-resolved magnetic resonance angiography of lower extremity tumors at 3T: Comparison with computed tomography angiography.

    Science.gov (United States)

    Wu, Gang; Jin, Teng; Li, Ting; Morelli, John; Li, Xiaoming

    2016-09-01

    The aim of this study was to compare diagnostic value of high spatial resolution time-resolved magnetic resonance angiography with interleaved stochastic trajectory (TWIST) using Gadobutrol to Computed tomography angiography (CTA) for preoperative evaluation of lower extremity tumors.This prospective study was approved by the institutional review board. Fifty consecutive patients (31 men, 19 women, age range 18-80 years, average age 42.7 years) with lower extremity tumors underwent TWIST magnetic resonance angiography (MRA) and CTA. Digital subtraction angiography was available for 8 patients. Image quality of MRA was compared with CTA by 2 radiologists according to a 4-point Likert scale. Arterial involvement by tumor was compared using kappa test between MRA and CTA. The ability to identify feeding arteries and arterio-venous fistulae (AVF) was compared using Wilcoxon signed rank test and McNemar test, respectively.Image quality of MRA and CTA was rated without a statistically significant difference (3.88 ± 0.37 vs. 3.97 ± 0.16, P = 0.135). Intramodality agreement was high for the identification of arterial invasion (kappa = 0.806 ± 0.073 for Reader 1, kappa = 0.805 ± 0.073 for Reader 2). Readers found AVF in 27 of 50 MRA cases and 14 of 50 CTA cases (P < 0.001). Mean feeding arteries identified with MRA were significantly more than that with CTA (2.08 ± 1.72 vs. 1.62 ± 1.52, P = .02).TWIST MRA is a reliable imaging modality for the assessment of lower extremity tumors. TWIST MRA is comparable to CTA for the identification of AVF and feeding arteries. PMID:27631262

  8. 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.

  9. 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...

  10. 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

  11. Patellar Taping, Patellofemoral Pain Syndrome, Lower Extremity Kinematics, and Dynamic Postural Control

    OpenAIRE

    Aminaka, Naoko; Gribble, Phillip A

    2008-01-01

    Context: Patellar taping has been a part of intervention for treatment of patellofemoral pain syndrome (PFPS). However, research on the efficacy of patellar taping on lower extremity kinematics and dynamic postural control is limited.

  12. Radiographic evaluation of bone regeneration after the application of plasma rich in growth factors in a lower third molar socket: a case report.

    Science.gov (United States)

    Nazaroglou, Ioannis; Stavrianos, Christos; Kafas, Panagiotis; Matoulas, Euthimios; Upile, Tahwinder; Barlas, Irodis; Jerjes, Waseem

    2009-12-03

    A 42-year-old Mediterranean male presented complaining of inability to sustain good oral care at the posterior aspect of the lower right jaw. The main problems were food impaction in the area and the subsequent malodor. The patient reported remarkable medical history. Clinical examination revealed local erytherma with noticeable bone defect distal to the second molar with obvious defect in the mesial wall of the third molar; the penetration depth was found to be up to 6 mm.Radiological evaluation confirmed the defect and it was attributed to the mesioangularly partially impacted lower third molar. It was decided that third molar should be extracted and concentrate of the patient's growth factors (PRGF) to be applied into the bony defect to stimulate bone regeneration and promote healing.The third molar tooth was, then, removed surgically and the PRGF, which was prepared preoperatively, was implanted in the socket. At the first postoperative day, moderate pain was the main complaint and was controlled by NSAIDs. One week postoperatively, the sutures were removed and there was good tissue healing on examination.On the fiftieth postoperative day, radiographic evaluation took place and showed noticeable enhancement of density and radio-opacity in the third molar socket area, in comparison with the baseline image. Further, clinical examination showed significant reduction of periodontal pocketing and evidence of new bone formation.In conclusion, PRGF was very successful in stimulating bone regeneration and promote healing following dental extraction.

  13. 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...

  14. 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

  15. 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.

  16. 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

  17. Pulse Waves in the Lower Extremities as a Diagnostic Tool of Peripheral Arterial Disease and Predictor of Mortality in Elderly Chinese.

    Science.gov (United States)

    Sheng, Chang-Sheng; Li, Yan; Huang, Qi-Fang; Kang, Yuan-Yuan; Li, Fei-Ka; Wang, Ji-Guang

    2016-03-01

    Patients with peripheral arterial disease may have elongated upstroke time in pulse waves in the lower extremities. We investigated upstroke time as a diagnostic tool of peripheral arterial disease and predictor of mortality in an elderly (≥60 years) Chinese population. We recorded pulse waves at the left and right ankles by pneumoplethysmography and calculated the percentage of upstroke time per cardiac cycle. Diagnostic accuracy was compared with the conventional ankle-brachial index method (n=4055) and computed tomographic angiography (34 lower extremities in 17 subjects). Upstroke time per cardiac cycle at baseline (mean±SD, 16.4%±3.1%) was significantly (Pperipheral arterial disease (upstroke time per cardiac cycle, ≥21.7%) in comparison with computed tomographic angiography. During 5.9 years (median) of follow-up, all-cause and cardiovascular deaths occurred in 366 and 183 subjects, respectively. In adjusted Cox regression analyses, an upstroke time per cardiac cycle ≥21.7% (n=219; 5.4%) significantly (Pperipheral arterial disease and predictor of mortality in the elderly.

  18. Clinical application of venography with DSA in lower extremity%DSA在下肢深静脉造影中的临床应用

    Institute of Scientific and Technical Information of China (English)

    胡可明; 孙志先; 张毅; 汪志超; 陈康海; 汪长胜

    2012-01-01

    Objective To explore the clinical value of venography with DSA in lower extremity. Methods 28 patients(33 limbs) with lower extremity venous disease were examined by anterograde or retrograde venography with DSA. 3 patients of them received catheterization venography by percutaneous popliteal vein. Results The various venous diseases of lower extremity were classified according to the main X-ray appearances as follows: there were only superficial venous valve insufficiency in 5 limbs(15%) , communicating venous valve insufficiency in 22 limbs (67 %) , primary deep venous valve insufficiency in 17 limbs (52%) , deep venous thrombosis in 8 limbs(24%) and sequelae of deep venous thrombosis in 3 limbs (9%). According to severity of the reflux , there were grade Ⅰ in 5 vessels, grade Ⅱ in 7 vessels, grade Ⅲ in 3 vessels, grade Ⅳ in 1 vessel. Conclusion The venography with DSA in lower extremity can display the location,shape and extent of venous lesions, and provide reliable evidence in the selection of therapeutic methods. It is worth popularizing clinically.%目的 探讨DSA 在下肢深静脉造影中的临床应用.方法 28例(33条)下肢静脉疾病的患者在DSA下行下肢深静脉顺、逆行造影,其中3例行经皮穿刺腘静脉插管造影.结果 根据主要X线表现将下肢静脉疾病分为:单纯性浅静脉瓣膜功能不全5条(15%),交通静脉瓣膜功能不全22条(67%),原发性深静脉瓣膜功能不全17条(52%),深静脉血栓形成8条(24%)和深静脉血栓形成后遗症3条(9%).根据深静脉逆流程度分为:Ⅰ级5条,Ⅱ级7条,Ⅲ级3条,Ⅳ级1条.结论 在DSA下行下肢深静脉造影能清楚地显示病变的部位、形态和范围,为临床治疗方案的选择提供可靠依据,值得推广.

  19. The Physiological Mechanisms of Performance Enhancement with Sprint Interval Training Differ between the Upper and Lower Extremities in Humans

    Science.gov (United States)

    Zinner, Christoph; Morales-Alamo, David; Ørtenblad, Niels; Larsen, Filip J.; Schiffer, Tomas A.; Willis, Sarah J.; Gelabert-Rebato, Miriam; Perez-Valera, Mario; Boushel, Robert; Calbet, Jose A. L.; Holmberg, Hans-Christer

    2016-01-01

    To elucidate the mechanisms underlying the differences in adaptation of arm and leg muscles to sprint training, over a period of 11 days 16 untrained men performed six sessions of 4–6 × 30-s all-out sprints (SIT) with the legs and arms, separately, with a 1-h interval of recovery. Limb-specific VO2peak, sprint performance (two 30-s Wingate tests with 4-min recovery), muscle efficiency and time-trial performance (TT, 5-min all-out) were assessed and biopsies from the m. vastus lateralis and m. triceps brachii taken before and after training. VO2peak and Wmax increased 3–11% after training, with a more pronounced change in the arms (P < 0.05). Gross efficiency improved for the arms (+8.8%, P < 0.05), but not the legs (−0.6%). Wingate peak and mean power outputs improved similarly for the arms and legs, as did TT performance. After training, VO2 during the two Wingate tests was increased by 52 and 6% for the arms and legs, respectively (P < 0.001). In the case of the arms, VO2 was higher during the first than second Wingate test (64 vs. 44%, P < 0.05). During the TT, relative exercise intensity, HR, VO2, VCO2, VE, and Vt were all lower during arm-cranking than leg-pedaling, and oxidation of fat was minimal, remaining so after training. Despite the higher relative intensity, fat oxidation was 70% greater during leg-pedaling (P = 0.017). The aerobic energy contribution in the legs was larger than for the arms during the Wingate tests, although VO2 for the arms was enhanced more by training, reducing the O2 deficit after SIT. The levels of muscle glycogen, as well as the myosin heavy chain composition were unchanged in both cases, while the activities of 3-hydroxyacyl-CoA-dehydrogenase and citrate synthase were elevated only in the legs and capillarization enhanced in both limbs. Multiple regression analysis demonstrated that the variables that predict TT performance differ for the arms and legs. The primary mechanism of adaptation to SIT by both the arms and legs

  20. 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)

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. Statistics of Local Extremes

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Bierbooms, W.; Hansen, Kurt Schaldemose

    2003-01-01

    . A 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...

  6. [FUNCTIONAL STATE OF PERIPHERAL VESSELS OF THE LOWER EXTREMITIES AND INTRAOSSEOUS PRESSURE IN PATIENTS, SUFFERING OBLITERATING ATHEROSCLEROSIS ON BACKGROUND OF DIABETES MELLITUS].

    Science.gov (United States)

    Rusyn, V I; Korsak, V V; Rusyn, V V; Gorlenko, F V; Mashura, V V; Pekahr, M I; Langazo, O V

    2016-01-01

    Results of examination of 46 patients, suffering obliterating atherosclerosis of the lower extremities arteries solely or in combination with diabetes mellitus (DM), were analyzed. The malleolar pressure index (MPI), regional systolic pressure (RSP), velocity of the volume blood flow (VVBF), rheographic index (RI), using test with nitroglycerine, postocclusion venous pressure (POVP) and intaosseous pressure (IOP) in tibiae were studied. The RI reduction, parallel to the arterial ischemia progression, was established. The test indices with nitroglycerine in patients with obliterating atherosclerosis have reduced step by step. With coexistent DM the efficacy of nitroglycerine was practically absent. POVP is upgraded in patients of all the groups and it have lowered step by step in a laying position of the patient, and while transition into standing position--it have upgraded progressively with a progress of arterial ischemia. IOP have upgraded significantly in isolated obliterating atherosclerosis in ischemia stage 3a and have lowered--in stage 3b. In coexistent DM IOP is upgraded in ischemia stage 3b also.

  7. 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.

  8. 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

  9. 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 = ...

  10. 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

  11. 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

  12. 下肢动脉疾病危险因素研究现状%Study status on risk factors of lower extremity arterial disease

    Institute of Scientific and Technical Information of China (English)

    尹彦亮; 沈彦明

    2012-01-01

    Lower extremity arterial disease in the elderly has become a common disease, and slow progress of lower extremity arterial disease, longer duration, its risk factors contribute to the early high-risk groups to take preventive measures to avoid the serious consequences from occurring. And what are the factors promoting the development of LEAD play the more important role were not yet clear. The article from the smoking, hypertension, diabetes, blood lipids and other aspects-review the risk factors LEAD.%下肢动脉疾病已成为中老年人常见的疾病,而下肢动脉疾病进展慢,病程长,对其相关危险因素的研究有助于使高危人群早期采取预防措施,避免其严重后果的发生.而哪些因素在促进LEAD的发展中起到更加重要的作用,尚未明确.本文主要从吸烟、高血压、糖尿病、血脂等方面对LEAD的危险因素研究现状作一综述.

  13. [Implementing ambulatory prevention of thrombosis with low molecular weight heparin in plaster immobilization of the lower extremity].

    Science.gov (United States)

    Kock, H J; Schmit-Neuerburg, K P; Hanke, J; Terwort, A; Rudofsky, G; Hirche, H

    1994-12-01

    Plaster cast immobilisation following trauma is a major risk factor for the development of deep vein thrombosis. In our controlled, randomized and prospective study in patients with minor injuries the incidence of deep vein thrombosis was 4.3% in conservatively treated outpatients with plaster cast immobilisation of the leg (n = 163 control group without prophylaxis). By application of low molecular weight heparin once daily the number of deep vein thrombosis in the prophylaxis group (n = 176) was reduced to 0% (p = 0.006). No severe side effects of low molecular weight heparin were observed. Subcutaneous injections were self-applicated by 89% of males and 72% of females. We conclude that thromboprophylaxis with low molecular weight heparin once daily is effective to reduce the risk of deep vein thrombosis in outpatients with plaster cast immobilisation of the leg.

  14. Model and Control of Lower Extreme Exoskeleton System%下肢携行外骨骼系统建模及控制

    Institute of Scientific and Technical Information of China (English)

    杨秀霞; 杨晓冬; 王亭; 杨智勇

    2016-01-01

    针对下肢携行外骨骼系统这一典型的人机一体化系统,采用拉格朗日方法建立了其刚体动态数学模型,运用虚拟关节力矩控制法对下肢外骨骼进行了控制,并运用仿真实验对建模方法及控制进行了验证。结果表明,所施加控制能明显减轻人的负重感,实现了外骨骼系统的携行。%Considering the typicla lower extreme exoskeleton human-machine system ,the Lagrange method is used to build the rigid-body dynamic mathematics model .The virtual joint torque control is applied to control the lower extreme exo -skeleton .The simulation tests the validity of the model and the control method ,which shows that the control method can re-lieve the load feeling and complete the load carrying .

  15. 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...

  16. 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...

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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...

  2. 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.

  3. The StethoDop: a Doppler stethoscope attachment for investigation of arterial and venous insufficiency of the lower extremities.

    NARCIS (Netherlands)

    Ven, A.C. van de; Bredie, S.J.H.; Vleuten, C.J.M. van der; Holewijn, S.; Thien, Th.

    2004-01-01

    BACKGROUND: The aim of the current study was to investigate whether the StethoDop can serve as a valid and reproducible instrument for measuring the ankle-brachial index (ABI) and assessing venous reflux, even when used by inexperienced investigators, in comparison with the classic Doppler. METHODS:

  4. Quantitative three-phase bone scintigraphy in the evaluation of intravenous regional blockade treatment in patients with stage-I reflex sympathetic dystrophy of upper extremity

    International Nuclear Information System (INIS)

    The objective this study was to investigate the role of quantitative three phase bone scintigraphy (QTPBS) in the evaluation of efficacy of intravenous regional blockade treatment in patients having reflex sympathetic dystrophy (RSD) of the upper extremity. Twenty-six patients with stage-I RSD were focused on in this study. Patients were treated with physical therapy and intravenous (I.V.) regional blockade therapy consisting of dexamethasone and lidocaine. All patients were clinically evaluated before and 1 month after the completion of the therapy protocol. QTPBS was applied to patients before therapy and 1 month after the therapy. As a control group, 11 healthy subjects also underwent QTPBS. Perfusion, hyperemic and fixation indices were calculated from three-phase bone scintigraphy. All patients showed statistically significant clinical improvement after the therapy (p<0.01). Pre-treatment, perfusion (1.67±0.63), hyperemic (1.44±0.48) and fixation (1.69±0.48) indices of patients were higher than those of healthy subjects (perfusion index (PI): 0.95±0.05, hyperemic index (HI): 0.94±0.06, fixation (FI): 1.01±0.2) (p<0.01) and all indices significantly decreased after the treatment (PI: 1.33±0.46, HI: 1.18±0.23, FI: 1.42±0.26) (p<0.01). I.V. regional blockade therapy combined with corticosteroids is a simple, safe and effective method for the treatment of patients with stage-I RSD in the upper extremity. QTPBS is a valuable and objective method to evaluate the response to therapy and may be useful for staging of patients and predicting the response to therapy. (authors)

  5. A Rare Case of Aggressive Digital Adenocarcinoma of the Lower Extremity, Masquerading as an Ulcerative Lesion that Clinically Favored Benignancy

    Directory of Open Access Journals (Sweden)

    Ryan Vazales

    2014-08-01

    Full Text Available A rare case report of Aggressive Digital Adenocarcinoma (ADPCa is presented complete with a literature review encompassing lesions that pose potential diagnostic challenges. Similarities between basal cell carcinoma (BCC, marjolin’s ulceration/squamous cell carcinoma (MSCC and ADPCa are discussed. This article discusses potential treatment options for ADPCa and the need for early biopsy when faced with any challenging lesion. An algorithmic approach to ADPCa treatment based on the most current research is recommended.

  6. Assessment of Genotoxic and Cytotoxic Hazards in Brain and Bone Marrow Cells of Newborn Rats Exposed to Extremely Low-Frequency Magnetic Field

    Directory of Open Access Journals (Sweden)

    Monira M. Rageh

    2012-01-01

    Full Text Available The present study aimed to evaluate the association between whole body exposure to extremely low frequency magnetic field (ELF-MF and genotoxic , cytotoxic hazards in brain and bone marrow cells of newborn rats. Newborn rats (10 days after delivery were exposed continuously to 50 Hz, 0.5 mT for 30 days. The control group was treated as the exposed one with the sole difference that the rats were not exposed to magnetic field. Comet assay was used to quantify the level of DNA damage in isolated brain cells. Also bone marrow cells were flushed out to assess micronucleus induction and mitotic index. Spectrophotometric methods were used to measure the level of malondialdehyde (MDA and the activity of glutathione (GSH and superoxide dismutase (SOD. The results showed a significant increase in the mean tail moment indicating DNA damage in exposed group (P<0.01,0.001,0.0001. Moreover ELF-MF exposure induced a significant (P<0.01,0.001 four folds increase in the induction of micronucleus and about three folds increase in mitotic index (P<0.0001. Additionally newborn rats exposed to ELF-MF showed significant higher levels of MDA and SOD (P<0.05. Meanwhile ELF-MF failed to alter the activity of GSH. In conclusion, the present study suggests an association between DNA damage and ELF-MF exposure in newborn rats.

  7. Impressive Performance: New Disposable Digital Ureteroscope Allows for Extreme Lower Pole Access and Use of 365 μm Holmium Laser Fiber

    Science.gov (United States)

    Kelly, Emily Fell

    2016-01-01

    Abstract Background: Since the development of the first flexible ureteroscope, in 1964, technological advances in image quality, flexibility, and deflection have led to the development of the first single-use digital flexible ureteroscope, LithoVue™ (Boston Scientific, Marlborough, MA). With respect to reusable fiber-optic and now digital ureteroscopes, there is an initial capital cost of several thousand dollars (USD) as well as, controversy regarding durability, the cost of repairs and the burdensome reprocessing steps of ureteroscopy. The single-use LithoVue eliminates the need for costly repairs, the occurrence of unpredictable performance, and procedural delays. Renal stones located in the lower pole of the kidney can be extremely challenging as extreme deflections of greater than 160° are difficult to maintain and are often further compromised when using stone treatment tools, such as laser fibers and baskets. This case describes an initial use of the LithoVue digital disposable ureteroscope in the effective treatment of lower pole calculi using a 365 μm holmium laser fiber. Case Report: A 35-year-old female, with a medical history significant for chronic bacteriuria, and recurrent symptomatic culture proven urinary tract infections, underwent localization studies. Retrograde ureteropyelography demonstrated two calcifications adjoining, measuring a total of 1.4 cm, overlying the left renal shadow. Urine aspirated yielded clinically significant, >100,000, Escherichia coli and Streptococcus anginosus bacteriuria, which was felt to be originating from the left lower calix. This case used the newly FDA-approved LithoVue flexible disposable ureteroscope. The two stones were seen using the ureteroscope passed through an ureteral access sheath in the lower pole calix. A 365 μm holmium laser fiber was inserted into the ureteroscope and advanced toward the stones. There was no loss of deflection as the ureteroscope performed reproducibly. The laser was used

  8. Lower extremity work is associated with club head velocity during the golf swing in experienced golfers.

    Science.gov (United States)

    McNally, M P; Yontz, N; Chaudhari, A M

    2014-08-01

    While the golf swing is a complex whole body movement requiring coordination of all joints to achieve maximum ball velocity, the kinetic contribution of the lower extremities to club head velocity has not been quantified, despite the perception that the legs are a primary source of power during the swing. Mechanical power at the hips, knees, and ankles was estimated during the downswing phase of a full swing with a driver using a passive optical motion capture system and 2 force plates for adult males across a range of age and self-reported skill levels. Total work by the lower extremities was calculated by integrating the powers of all 6 joints over the downswing. Regression analyses showed that total lower extremity work was a strong predictor of club head velocity (R=0.63). Secondary analyses showed different relationships to club head velocity in lead and trail leg lower extremity joints, but none of these were as predictive of club head velocity as the total work performed by the lower extremities. These results provide quantitative evidence that the lower body's kinetic contribution may be an important factor in achieving greater club head velocity, contributing to greater driving distance and overall golf performance. PMID:24577856

  9. Clinical features and risk factor analysis for lower extremity deep venous thrombosis in Chinese neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Fuyou Guo

    2015-01-01

    Full Text Available Background: Deep venous thrombosis (DVT contributes significantly to the morbidity and mortality of neurosurgical patients; however, no data regarding lower extremity DVT in postoperative Chinese neurosurgical patients have been reported. Materials and Methods: From January 2012 to December 2013, 196 patients without preoperative DVT who underwent neurosurgical operations were evaluated by color Doppler ultrasonography and D-dimer level measurements on the 3rd, 7th, and 14th days after surgery. Follow-up clinical data were recorded to determine the incidence of lower extremity DVT in postoperative neurosurgical patients and to analyze related clinical features. First, a single factor analysis, Chi-square test, was used to select statistically significant factors. Then, a multivariate analysis, binary logistic regression analysis, was used to determine risk factors for lower extremity DVT in postoperative neurosurgical patients. Results: Lower extremity DVT occurred in 61 patients, and the incidence of DVT was 31.1% in the enrolled Chinese neurosurgical patients. The common symptoms of DVT were limb swelling and lower extremity pain as well as increased soft tissue tension. The common sites of venous involvement were the calf muscle and peroneal and posterior tibial veins. The single factor analysis showed statistically significant differences in DVT risk factors, including age, hypertension, smoking status, operation time, a bedridden or paralyzed state, the presence of a tumor, postoperative dehydration, and glucocorticoid treatment, between the two groups (P < 0.05. The binary logistic regression analysis showed that an age greater than 50 years, hypertension, a bedridden or paralyzed state, the presence of a tumor, and postoperative dehydration were risk factors for lower extremity DVT in postoperative neurosurgical patients. Conclusions: Lower extremity DVT was a common complication following craniotomy in the enrolled Chinese neurosurgical

  10. Real-time screening tests for functional alignment of the trunk and lower extremities in adolescent – a systematic review

    DEFF Research Database (Denmark)

    Junge, Tina; Wedderkopp, N; Juul-Kristensen, B

    2012-01-01

    methodological quality. Results Of 1475 articles, 28 articles met all inclusion criteria. Only 3 studies assessing functional alignment were identified. The Drop Jump Test showed moderate to excellent reliability (Kappa .75-.85) of clinically assessed knee valgus motion in detection of knee midline collapse...... in the frontal plane, (three raters, n=40). However, the sensitivity was inadequate, ranging from 67-87% compared to 3D analysis. Concurrent validity during Drop Jump showed a correlation between assessed knee valgus motion and 3D measurements of r = .87 (n=20). Reliability of The Single-limb mini squat test...

  11. Real-time screening tests for functional alignment of the trunk and lower extremities in adolescent – a systematic review

    DEFF Research Database (Denmark)

    Junge, Tina; Wedderkopp, Niels; Juul-Kristensen, Birgit

    2012-01-01

    Introduction The presence of neuromuscular imbalance (Hewett, 2010) or functional malalignment may be part of the increased rate of adolescent knee injuries, specifically the anterior cruciate ligament (ACL). Abnormal lateral trunk and knee abduction moment are possibly linked to the biomechanical...... mechanisms resulting in ACL injuries (Hewett, 2010). Prevention may therefore depend on identifying these potentially injury risk factors. Screening tools must thus include patterns of typical movements in sport and leisure time activities, consisting of high-load and multi-directional tests, focusing...

  12. The Physiological Mechanisms of Performance Enhancement with Sprint Interval Training Differ between the Upper and Lower Extremities in Humans

    DEFF Research Database (Denmark)

    Zinner, Christoph; Morales-Alamo, David; Ørtenblad, Niels;

    2016-01-01

    , reducing the O2 deficit after SIT. The levels of muscle glycogen, as well as the myosin heavy chain composition were unchanged in both cases, while the activities of 3-hydroxyacyl-CoA-dehydrogenase and citrate synthase were elevated only in the legs and capillarization enhanced in both limbs. Multiple...

  13. Dutch evidence-based guidelines for amputation and prosthetics of the lower extremity : Rehabilitation process and prosthetics. Part 2

    NARCIS (Netherlands)

    Geertzen, Jan; van der Linde, Harmen; Rosenbrand, Kitty; Conradi, Marcel; Deckers, Jos; Koning, Jan; Rietman, Hans S.; van der Schaaf, Dick; van der Ploeg, Rein; Schapendonk, Johannes; Schrier, Ernst; Duijzentkunst, Rob Smit; Spruit-van Eijk, Monica; Versteegen, Gerbrig; Voesten, Harrie

    2015-01-01

    Background: A structured, multidisciplinary approach in the rehabilitation process after amputation is needed that includes a greater focus on the involvement of both (para)medics and prosthetists. There is considerable variation in prosthetic prescription concerning the moment of initial prosthesis

  14. A simplified approach to reconstruction of hemipelvectomy defects with lower extremity free fillet flaps to minimize ischemia time.

    Science.gov (United States)

    Bibbo, Christopher; Newman, Andrew S; Lackman, Richard D; Levin, L Scott; Kovach, Stephen J

    2015-12-01

    External hemipelvectomy associated with trauma or during the operative management of musculoskeletal sarcomas may yield a soft tissue defect that can only be sufficiently covered by free tissue transfers. The application of "spare-parts surgery," such as a fillet of leg or thigh flap, uses distal uninvolved parts that are otherwise viable tissues as donor tissues to cover defects. This concept has great utility to achieve soft tissue coverage in challenging cases, such as hemipelvectomy. However, during such complicated and time-consuming cases, prolonged ischemia time of the proposed donor tissues can be problematic. We describe a technique developed by the senior author (SJK) that minimizes the ischemia time of donor free tissues during external hemipelvectomy. This technique is applicable to other surgeries where filleted spare parts are the donor-site source for free tissue transfer. PMID:26576702

  15. Age-related differences in muscle control of the lower extremity for support and propulsion during walking

    OpenAIRE

    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 OpenS...

  16. Biomechanical analysis of weight bearing force and muscle activation levels in the lower extremities during gait with a walker.

    Directory of Open Access Journals (Sweden)

    Ishikura T

    2001-04-01

    Full Text Available The biomechanics of using a walker for the partial weight bearing gait and as a method for gradually increasing the muscle activation level were examined with a force plate and surface electromyography. The results showed that the weight bearing force during gait with a walker is determined by the flexion angle of the hip joint. The value remains constant for each stride, indicating that a walker can be used for the partial weight bearing gait. Moreover, the muscle activation levels in the rectus femoris muscle and biceps femoris muscle per unit time during normal gait and gait with a walker with varying hip joint flexion angles were found to be correlated with the weight bearing force and to be constant for each stride. In addition, the muscle activation level was consistent with the level observed during the open kinetic chain resistance exercise with a specific loading level. These findings suggest that normal gait and gait with a walker may be applicable as a method for gradually increasing the muscle activation level.

  17. Relationship between the Late Spring NAO and Summer Extreme Precipitation Frequency in the Middle and Lower Reaches of the Yangtze River

    Institute of Scientific and Technical Information of China (English)

    TTIAN Bao-Qiang; FAN Ke

    2012-01-01

    The relationship between the late spring North Atlantic Oscillation (NAO) and the summer extreme precipitation frequency (EPF) in the middle and lower reaches of the Yangtze River Valley (MLYRV) is examined using an NECP/NCAR reanalysis dataset and daily precipitation data from 74 stations in the MLYRV. The results show a significant negative correlation between the May NAO index and the EPF over the MLYRV in the subsequent summer. In positive EPF index years, the East Asian westerly jet shifts farther southward, and two blocking high positive anomalies appear over the Sea of Okhotsk and the Ural Mountains. These anomalies are favorable to the cold air from the mid-high latitudes invading the Yangtze River Valley (YRV). The moisture convergence and the ascending motion dominate the MLYRV. The above patterns are reversed in negative EPF index years. A wave train pattern that originates from the North Atlantic extends eastward to the Mediterranean and then moves to the Tibetan Plateau and from there to the YRV, which is an important link in the May NAO and the summer extreme precipitation in the MLYRV. The wave train may be aroused by the tripole pattern of the SST, which can explain why the May NAO affects the summer EPF in the MLYRV.

  18. Efficacy of Preoperative Color Doppler Sonography of Lower Extremity Veins on Postoperative Outcomes in Candidates of Saphenectomy: A Randomized Clinical Trial

    Science.gov (United States)

    Zarepur, Rouhollah; Kargar, Saeed; Hadadzadeh, Mehdi; Hatamizadeh, Nooshin; Zarepur, Ehsan; Forouzannia, Seyed Khalil; Faraji, Reza; Sarebanhassanabadi, Mohammadtaghi

    2016-01-01

    Background Doppler sonogra