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Sample records for leg ischemia due

  1. Leg ulcers due to hyperhomocysteinemia

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    Krupa Shankar D

    2006-01-01

    Full Text Available Chronic leg ulcers are rare in young adults and generally indicate a vascular cause. We report a case of a 26-year-old man with leg ulcers of eight months duration. Doppler study indicated venous incompetence and a postphlebitic limb. However, as the distribution and number of ulcers was not consistent with stasis alone and no features of collagen vascular disease were noted, a hyperviscosity state was considered and confirmed with significantly elevated homocysteine level in the serum. Administration of vitamins B1, B2, B6 and B12, trimethyl-glycine, mecobalamine, folic acid and povidone iodine dressings with culture-directed antibiotic therapy led to a satisfactory healing of ulcers over a period of one month. Hyperhomocysteinemia must be considered in the differential diagnosis of leg ulcers in young individuals.

  2. Colonic urticaria pattern due to early ischemia

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    Greenberg, H.M.; Goldberg, H.I.; Axel, L.

    1981-05-15

    The unusual radiographic pattern of bleb-like mounds on the surface of the colon mucosa, previously described as colonic urticaria, was seen in 3 patients in whom no allergic state was present. This urticaria-like pattern was due to colonic distention in all 3, and represented only submucosal edema on the gross and microscopic specimens. We hypothesize that this pattern is due to early changes of ischemia caused by colon distention.

  3. Large leg ulcers due to autoimmune diseases

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    Rozin, Alexander P.; Egozi, Dana; Ramon, Yehuda; Toledano, Kohava; Braun-Moscovici, Yolanda; Markovits, Doron; Schapira, Daniel; Bergman, Reuven; Melamed, Yehuda; Ullman, Yehuda; Balbir-Gurman, Alexandra

    2011-01-01

    Summary Background Large leg ulcers (LLU) may complicate autoimmune diseases. They pose a therapeutic challenge and are often resistant to treatment. To report three cases of autoimmune diseases complicated with LLU. Case Report Case 1. A 55-year old woman presented with long-standing painful LLU due to mixed connective tissue disease (MCTD). Biopsy from the ulcer edge showed small vessel vasculitis. IV methylprednisolone (MethP) 1 G/day, prednisolone (PR) 1mg/kg, monthly IV cyclophosphamide (CYC), cyclosporine (CyA) 100mg/day, IVIG 125G, ciprofloxacin+IV Iloprost+enoxaparin+aspirin (AAVAA), hyperbaric oxygen therapy (HO), maggot debridement and autologous skin transplantation were performed and the LLU healed. Case 2. A 45-year old women with MCTD developed multiple LLU’s with non-specific inflammation by biopsy. MethP, PR, hydroxychloroquine (HCQ), azathioprine (AZA), CYC, IVIG, AAVAA failed. Treatment for underlying the LLU tibial osteomyelitis and addition of CyA was followed by the LLU healing. Case 3. A 20-year-old man with history of polyarteritis nodosa (PAN) developed painful LLU’s due to small vessel vasculitis (biopsy). MethP, PR 1 mg/kg, CYC, CyA 100 mg/d, AAVAA failed. MRSA sepsis and relapse of systemic PAN developed. IV vancomycin, followed by ciprofloxacin, monthly IVIG (150 g/for 5 days) and infliximab (5 mg/kg) were instituted and the LLU’s healed. Conclusions LLU are extremely resistant to therapy. Combined use of multiple medications and services are needed for healing of LLU due to autoimmune diseases. PMID:21169912

  4. Injury due to leg bands in willow flycatchers

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    Sedgwick, J.A.; Klus, R.J.

    1997-01-01

    We report an apparently unusually high incidence of leg injury in Willow Flycatchers (Empidonax traillii) as a result of banding and color banding. Color bands and U.S. Fish and Wildlife Service (USFWS) bands applied to Willow Flycatchers from 1988-1995 resulted in an overall leg injury rate of 9.6% to birds returning to our study areas in subsequent years. Most injuries occurred on legs with only color band(s) (58.3%) or on legs with both a USFWS band and a color band (35%); only 6.7% of injuries (4/60) were due to USFWS bands alone, yielding an overall USFWS band injury rate of only 0.6%. Injuries ranged from severe (swollen, bleeding legs; a missing foot) to relatively minor (irritations on the tarsus). Amputation of the foot occurred in 33.9% of the cases. Return rates of adult injured birds in the year(s) following injury were significantly lower than for the population at large.

  5. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

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    Deniz Kamacı Şener

    2012-12-01

    Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  6. Association of Serum Uric Acid Levels with Leg Ischemia in Patients with Peripheral Arterial Disease after Treatment.

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    Sotoda, Yoko; Hirooka, Shigeki; Orita, Hiroyuki; Wakabayashi, Ichiro

    2017-07-01

    We investigated the relationships of serum uric acid levels with the progression of atherosclerosis in patients with peripheral arterial disease (PAD) after treatment. Subjects were male patients diagnosed with PAD. Atherosclerosis at the common carotid artery was evaluated based on its intima-media thickness (IMT). Leg arterial flow was evaluated by measuring ankle-brachial index (ABI) and exercise-induced decrease in ABI. Among various risk factors including age, blood pressure, adiposity, estimated glomerular filtration rate, and blood lipid, blood glucose, uric acid, fibrinogen and C-reactive protein levels, only uric acid levels showed significant correlations with ABI [Pearson's correlation coefficient, -0.292 (p<0.01)] and leg exercise-induced decrease in ABI [Pearson's correlation coefficient, 0.236 (p< 0.05)]. However, there was no significant correlation between uric acid levels and maximum or mean IMT. Odds ratios of subjects with the 3rd tertile versus subjects with the 1st tertile for uric acid levels were significantly higher than the reference level of 1.00 for low ABI [4.44 (95% confidence interval, 1.45-13.65, p<0.01)] and for high % decrease in ABI after exercise [4.31 (95% confidence interval, 1.34-13.82, p<0.05)]. The associations of uric acid levels with the indicators of leg ischemia were also found after adjustment for age, history of revascularization therapy, diabetes, smoking, alcohol consumption, body mass index, triglyceride levels, and renal function. Uric acid levels are associated with the degree of leg ischemia in patients with PAD. Further interventional studies are needed to determine whether the correction of uric acid levels is effective in preventing the progression of PAD.

  7. Transmural myocardial ischemia due to slow coronary flow

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacification in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies, clinical manifestations and treatment of this unique angiographic phenomenon. In our case report, we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries, especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation.

  8. Ischemia

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    Byeon, Suk Ho; Kim, Min; Kwon, Oh Woong

    "Ischemia" implies a tissue damage derived from perfusion insufficiency, not just an inadequate blood supply. Mild thickening and increased reflectivity of inner retina and prominent inner part of synaptic portion of outer plexiform layer are "acute retinal ischemic changes" visible on OCT. Over time, retina becomes thinner, especially in the inner portion. Choroidal perfusion supplies the outer portion of retina; thus, choroidal ischemia causes predominant change in the corresponding tissue.

  9. Left ventricular ischemia due to coronary stenosis as an unexpected treatable cause of paroxysmal atrial fibrillation

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    Schoonderwoerd, BA; Van Gelder, IC; Crijns, HJGM

    Ischemia-Related Paroxysmal Atrial Fibrillation. We present a patient with exercise-induced paroxysmal atrial fibrillation who was eventually scheduled for a Cox-maze operation due to persistence of his complaints of fatigue, impaired exercise tolerance, and predominantly exercise-related irregular

  10. Tuina for Leg Length Discrepancy and Lumbosacral Pain Due to Sacroiliac Joint Subluxation

    Institute of Scientific and Technical Information of China (English)

    Zhang Zhao-xing; Zhu Hong; Wang Rui-hui; Du Xu; Qu Hong-yan

    2014-01-01

    Objective: To observe theclinical effect of tuina reduction manipulation on leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation. Methods: A total of 60eligible cases were randomly allocated into an observation group and a control group, 30 in each group. Cases in the observation group were treated with conventional tuina plus reduction manipulation of sacroiliac joint subluxation; whereas cases in the control group were treated with conventional tuina plus acupuncture. The clinical effects were observed after 10 times of treatment. In addition, the relapse rates were observed 2 months after treatment. Results: The total effective rate in the observation group was 80.0%, versus 50.0% in the control group, showing a statistically significant difference (P Conclusion: Tuina reduction manipulation can obtain substantial therapeutic effect for leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation, coupled with a low relapse rate.

  11. Fatal exsanguination due to ruptured vericose vein of the lower leg: Case report

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    Živković Vladimir

    2011-01-01

    Full Text Available Introduction. Lethal exanguination due to haemorrhage from ruptured peripheral varicose veins of the lower leg usually in the elderly are exceptionally rare in clinical, and particularly in forensic medicine. In persons with varicosities there are two types of lower leg ulcers (acute perforated and chronic that can be associated with spontaneous bleeding. Ulcer exanguination can occur spontaneously or after a minor injury. Injuries in the ulcer region are rarer. Case Outline. We present a case of fatal exsanguination due to a ruptured varicose vein in a 77-year-old woman. The body was found on the porch floor, beside a sink, lying on the back, with bent knees, so that the lower legs were almost in the standing position, with the feet in a pool of blood. The entire interior of the house floor was covered with various bloodstains; blood-drops in form of spilling and spattering, foot-prints, as well as larger pools of blood. Death was attributed to massive external haemorrhage due to the acute perforated ulcer of the right lower leg with the rupture of the varicose vein wall surface along the entire depth. Conclusion. Although death due to haemorrhage from ruptured peripheral varicose veins is an uncommon complication of this disease, it should be taken into consideration by the forensic medicine examiner. In such cases autopsy should determine both the origin of bleeding (varicosities and venous wall damage and other underlying conditions, primarily ischemic cardiac disease. To resolve such cases, full cooperation with investigators and police is necessary.

  12. Severe Lower Limb Ischemia by Massive Arterial Thrombosis Revealing an Acute Myeloid Leukemia Needing for Leg Amputation: Clinical and Emotional Aspects Related to the Communication with the Patient and His Family

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    Taormina, Calogero; Mosa, Clara; Di Marco, Floriana; Valentino, Fabrizio; Trizzino, Angela; Guadagna, Paola; Talarico, Francesco

    2016-01-01

    Large vessel thrombosis is a very rare clinical presentation of acute leukemia, generally associated with coagulopathy, usually characteristic of acute promyelocytic leukemia. A 13- year-old boy with a previously undiagnosed acute myeloid leukemia was referred to our hospital with acute ischemia of the right lower limb due to occlusion of the right external iliac artery, treated with emergency double surgical thromboembolectomy and chemotherapy. The thrombotic complication resulted in leg amputation. Now the boy is well in complete remission, with a good social integration and quality of life, 30 months after completing treatment. The report highlights the crucial role of early diagnosis and subsequent chemotherapy in avoiding amputation. We particularly focused critical and emotional aspects related to the communication about the leg amputation with the patient and his family. PMID:28058104

  13. Chronic ulceration of the leg following extensive scarring due to a snake bite complicated by squamous cell carcinoma

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    Mello, L.F.B.; Barcelos, M.G.; Nogueira Neto, N.C. [Dept. of Radiology, National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Meohas, W. [Dept. of Surgery (Bone and Soft Tissue), National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Pinto, L.W. [Department of Surgical Pathology, National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Melo, P.A. [Pharmacology Lab. of Snake-related Toxins, Department of Basic and Clinical Pharmacology, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ (Brazil); Smith, J. [Dept. of Radiology, National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Rua Humberto de Campos 974/1301, Leblon 22430 - 190, Rio de Janeiro, RJ (Brazil)

    2000-05-01

    Chronic ulcers of the leg are common in Brazil, perhaps more common than in the developed world. We report a case of a chronic ulcer of the leg following extensive scarring due to a bite by a venomous snake, which eventually led to a squamous cell carcinoma. (orig.)

  14. Recovery of atrophic leg muscles in the hemiplegics due to cerebrovascular accidents. Computed tomographic study

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    Odajima, Natsu; Ishiai, Sumio; Okiyama, Ryouichi; Furukawa, Tetsuo; Tsukagoshi, Hiroshi.

    1988-02-01

    Thirty-five patients with hemiplegia due to cerebrovascular accidents were studied with regared to the muscle wastings before and after rehabilitation training. Hemiplegics were composed of 12 improved and 23 non-improved patients. The CT scan was carried out at the midportion of the thigh and largest-diameter section of the calf. Muscle size of each cross-sectional area was measured on CT image and the increase of size (..delta..S) in each muscle after training was calculated. The ..delta..S of quadriceps femoris was correlated with that of whole cross-section of the thigh. The gracilis in non-affected side was not correlated with that of whole muscles. In both legs, there was an increase in leg muscle size after training. These changes were nost marked in the non-affected side of the improved patients. After training the difference between the two limbs remained unchanged. Recovery of muscle wasting in both legs was seen first in the quadriceps in thigh and flexors in calf. Gracilis was relatively unchanged in comparison with other muscles. Remarkable increase of muscle size in non-affected side was worthwhile to note.

  15. Life Threatening Complication during Treatment of Erysipelas due to Undiagnosed Ischemia of the Calf

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    Tomasz Brzeziński

    2009-01-01

    Full Text Available Erysipelas is a superficial skin infection due to streptococci strains, which usually responds well to conservative treatment. Coexisting undiagnosed ischemia of the extremity may lead to severe complications. 57-year-old man developed large, circumflex ulceration of his right calf within two weeks before the admission after three-month treatment of erysipelas. Computer angiography showed chronic occlusion of the superficial femoral artery and the above knee popliteal artery. Rapid debridement of the wound took control over the infection. Patient required complex vascular procedure which allowed to prepare the ulcer for meshed skin grafts. Patient was discharged home on 64th hospital day with completely healed ulcer.

  16. Mutability of bifunctional thigh muscle activity in pedaling due to contralateral leg force generation.

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    Kautz, S A; Brown, D A; Van der Loos, H F M; Zajac, F E

    2002-09-01

    Locomotion requires uninterrupted transitions between limb extension and flexion. The role of contralateral sensorimotor signals in executing smooth transitions is little understood even though their participation is crucial to bipedal walking. However, elucidating neural interlimb coordinating mechanisms in human walking is difficult because changes to contralateral sensorimotor activity also affect the ipsilateral mechanics. Pedaling, conversely, is ideal for studying bilateral coordination because ipsilateral mechanics can be independently controlled. In pedaling, the anterior and posterior bifunctional thigh muscles develop needed anterior and posterior crank forces, respectively, to dominate the flexion-to-extension and extension-to-flexion transitions. We hypothesized that contralateral sensorimotor activity substantially contributes to the appropriate activation of these bifunctional muscles during the limb transitions. Bilateral pedal forces and surface electromyograms (EMGs) from four thigh muscles were collected from 15 subjects who pedaled with their right leg against a right-crank servomotor, which emulated the mechanical load experienced in conventional two-legged coupled-crank pedaling. In one pedaling session, the contralateral (left) leg pseudo-pedaled (i.e., EMG activity and pedal forces were pedaling-like, but pedal force was not allowed to affect crank rotation). In other sessions, the mechanically decoupled contralateral leg was first relaxed and then produced rhythmic isometric force trajectories during either leg flexion or one of the two limb transitions of the pedaling leg. With contralateral force production in the extension-to-flexion transition (predominantly by the hamstrings), rectus femoris activity and work output increased in the pedaling leg during its flexion-to-extension transition, which occurs simultaneously with contralateral extension-to-flexion in conventional pedaling. Similarly, with contralateral force production in the

  17. Intermittent claudication in diabetes mellitus due to chronic exertional compartment syndrome of the leg: an observational study of 17 patients.

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    Edmundsson, David; Svensson, Olle; Toolanen, Göran

    2008-08-01

    Intermittent claudication in diabetes mellitus is commonly associated with arterial disease but may occur without obvious signs of peripheral circulatory impairment. We investigated whether this could be due to chronic exertional compartment syndrome (CECS). We report on 17 patients (3 men), mean age 39 (18-72) years, with diabetes mellitus--12 of which were type 1--and leg pain during walking (which was relieved at rest), without clinical signs of peripheral arterial disease. The duration of diabetes was 22 (1-41) years and 12 patients had peripheral neuropathy, retinopathy, or nephropathy. The leg muscles were tender and firm on palpation. Radiography, scintigraphy, and intramuscular pressure measurements were done during exercises to reproduce their symptoms. 16 of the 17 patients were diagnosed as having CECS. The intramuscular pressures in leg compartments were statistically significantly higher in diabetics than in physically active non-diabetics with CECS (p leg pain increased after surgery from less than 10 min to unlimited time in 8 of 9 patients who were followed up. Intermittent claudication in diabetics may be caused by CECS of the leg. The intramuscular pressures were considerably elevated in diabetics. One pathomechanism may be fascial thickening. The results after fasciotomy are good, and the increased pain-free walking time is especially beneficial for diabetics.

  18. Changes in the lower leg moment of inertia due to child's growth.

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    Lebiedowska, M K; Polisiakiewicz, A

    1997-07-01

    During growth the size and shape of the child's body changes. It is not clear whether the shape of a body segment changes proportionally in children between the age 5 and 18 years. The aim of this study is to describe these changes for the lower leg moment of inertia in a population of children. The segment moment of inertia describes the mass distribution along the body segment axis. The moment of inertia of the lower leg (including the foot) was measured by the free oscillation technique in 90 healthy children (61 boys and 29 girls) between and 5 and 18 years of age. The period of free oscillation was measured with and without external mass loading. The moment of inertia was calculated using a relation between the mass and the period of oscillation. A two-cylinder model of constant body density was used to predict the moment of inertia. Anthropometric measurements of length of the lower leg and foot, the circumference of the knee, ankle and foot were made. Experimental and model data of the lower leg of inertia were described by a fifth power function of body height. The experimental and model data showed high degree of convergence, confirming that the segment growth of the human body can be treated like the volume growth of a cylindrical object of constant body density. Thus it was experimentally confirmed that the lower leg segment growth between age 5 and 18 years may be considered as proportional.

  19. Ischemia reperfusion dysfunction changes model-estimated kinetics of myofilament interaction due to inotropic drugs in isolated hearts

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    Riess Matthias L

    2006-03-01

    Full Text Available Abstract Background The phase-space relationship between simultaneously measured myoplasmic [Ca2+] and isovolumetric left ventricular pressure (LVP in guinea pig intact hearts is altered by ischemic and inotropic interventions. Our objective was to mathematically model this phase-space relationship between [Ca2+] and LVP with a focus on the changes in cross-bridge kinetics and myofilament Ca2+ sensitivity responsible for alterations in Ca2+-contraction coupling due to inotropic drugs in the presence and absence of ischemia reperfusion (IR injury. Methods We used a four state computational model to predict LVP using experimentally measured, averaged myoplasmic [Ca2+] transients from unpaced, isolated guinea pig hearts as the model input. Values of model parameters were estimated by minimizing the error between experimentally measured LVP and model-predicted LVP. Results We found that IR injury resulted in reduced myofilament Ca2+ sensitivity, and decreased cross-bridge association and dissociation rates. Dopamine (8 μM reduced myofilament Ca2+ sensitivity before, but enhanced it after ischemia while improving cross-bridge kinetics before and after IR injury. Dobutamine (4 μM reduced myofilament Ca2+ sensitivity while improving cross-bridge kinetics before and after ischemia. Digoxin (1 μM increased myofilament Ca2+ sensitivity and cross-bridge kinetics after but not before ischemia. Levosimendan (1 μM enhanced myofilament Ca2+ affinity and cross-bridge kinetics only after ischemia. Conclusion Estimated model parameters reveal mechanistic changes in Ca2+-contraction coupling due to IR injury, specifically the inefficient utilization of Ca2+ for contractile function with diastolic contracture (increase in resting diastolic LVP. The model parameters also reveal drug-induced improvements in Ca2+-contraction coupling before and after IR injury.

  20. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) and the (hoped for) dawn of evidence-based treatment for advanced limb ischemia.

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    Conte, Michael S

    2010-05-01

    The Bypass versus Angioplasty in Severe Ischemia of the Leg (BASIL) trial is the only randomized controlled trial (RCT) to date comparing open surgical bypass with endovascular therapy for severe limb ischemia (SLI). In their initial 2005 publication, the BASIL investigators reported that the main clinical outcomes (overall survival and amputation-free survival) were no different at 2 years after randomization to angioplasty-first or bypass-first revascularization strategies. However, beyond 2 years there appeared to be a benefit for open bypass surgery, providing impetus for an extension study. The final analysis of the long-term outcomes from BASIL is now presented in a set of articles that are reviewed in this commentary. The benefit of initial randomization to open surgery for patients surviving > or =2 years (70% of the BASIL cohort) was confirmed. When outcomes were analyzed by treatment received, patients who had received prosthetic bypass grafts (25% of the surgical arm) fared much more poorly than those treated with a vein bypass. Patients who underwent surgical bypass after an initial failed angioplasty also fared significantly worse than those who were treated initially with bypass surgery. Health-related quality of life measures and costs were not significantly different overall. There are many controversies surrounding the BASIL trial and its interpretation, which are reviewed herein. These include the choice of study population, end points examined, and the nature of procedures performed. The BASIL trial confirms the primacy of open surgical bypass with vein for most patients with SLI and raises questions about the sequelae of failed endovascular interventions. Further multicenter trials are needed to address the large gap in evidence for treatment selection in this patient population.

  1. Isquemia grave de membros inferiores por arterite por HIV Severe ischemia of lower limbs due to arteritis caused by HIV infection

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    Guilherme Benjamin Brandão Pitta

    2011-12-01

    Full Text Available A isquemia aguda de membros pode se manifestar, embora de forma incomum, como consequência à vasculite associada ao vírus da imunodeficiência humana (HIV. O presente caso descreve a evolução de uma paciente soropositiva para o HIV, que apresentou quadro de isquemia distal bilateral, com diminuição da temperatura de terço distal das pernas e pés, dor intensa, cianose fixa de pododátilos e ausência de pulsos distais. Submetida ao tratamento com terapia trombolítica, apresentou sinais de lesões decorrentes da isquemia e lesão tecidual de reperfusão com perda tecidual em regiões distais dos dedos, porém com melhora dos sinais e sintomas dos membros inferiores. Trata-se de um caso raro na literatura em função da associação da vasculite com o HIV e do acometimento dos vasos distais nos membros inferiores. Entretanto, o conhecimento desta associação é de extrema importância devido à repercussão na vida dos pacientes acometidos.The acute limb ischemia may manifest itself, albeit unusual, as a consequence of vasculitis associated with human immunodeficiency virus (HIV. This case report described a patient seropositive for HIV who developed bilateral distal ischemia with temperature decrease of distal legs and feet, severe pain, cyanosis of fixed toes, and absence of distal pulses. She underwent treatment with thrombolytic therapy, showed signs of injury resulting from ischemia and reperfusion tissue injury with tissue loss in the distal regions of the fingers, but with improvement of the signs and symptoms of lower limbs. It is a rare case in literature due to the association of vasculitis with HIV and to the torment of distal vases of the lower limbs. Despite of that, the knowledge of the pathology is extremely important because of the repercussion in the patients' lives.

  2. Acute Upper Limb Ischemia due to Cardiac Origin Thromboembolism: the Usefulness of Percutaneous Aspiration Thromboembolectomy via a Transbrachial Approach

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    Kim, Sung Kwan; Kwak, Hyo Sung; Chung, Gyoung Ho; Han, Young Min [Chonbuk National University Hospital and Medical School, Chonju (Korea, Republic of)

    2011-10-15

    To evaluate the usefulness of percutaneous aspiration thromboembolectomy (PAT) via a transbrachial approach in patients with acute upper limb ischemia. From July 2004 to March 2008, eleven patients with acute upper limb ischemia were enrolled in this study. They were initially treated with thrombolysis (n = 1), PAT (n = 6), or both (n = 4) via a femoral artery approach. However, all of the patients had residual thrombus in the brachial artery, which was subsequently managed by PAT via the transbrachial approach for removal of residual emboli. Successful re-canalization after PAT via a transbrachial approach was achieved in all patients. Two patients experienced early complications: one experienced a massive hematoma of the upper arm due to incomplete compression and was treated by stent deployment. The other patient experienced a re-occlusion of the brachial artery the day after the procedure due to excessive manual compression of the puncture site, but did not show recurrence of ischemic symptoms in the artery of the upper arm. Clinical success with complete resolution of ischemic symptoms was achieved in all patients. PAT via a transbrachial approach is a safe and effective treatment for patients with acute upper limb ischemia.

  3. Damaged Neocortical Perineuronal Nets Due to Experimental Focal Cerebral Ischemia in Mice, Rats and Sheep.

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    Härtig, Wolfgang; Mages, Bianca; Aleithe, Susanne; Nitzsche, Björn; Altmann, Stephan; Barthel, Henryk; Krueger, Martin; Michalski, Dominik

    2017-01-01

    As part of the extracellular matrix (ECM), perineuronal nets (PNs) are polyanionic, chondroitin sulfate proteoglycan (CSPG)-rich coatings of certain neurons, known to be affected in various neural diseases. Although these structures are considered as important parts of the neurovascular unit (NVU), their role during evolution of acute ischemic stroke and subsequent tissue damage is poorly understood and only a few preclinical studies analyzed PNs after acute ischemic stroke. By employing three models of experimental focal cerebral ischemia, this study was focused on histopathological alterations of PNs and concomitant vascular, glial and neuronal changes according to the NVU concept. We analyzed brain tissues obtained 1 day after ischemia onset from: (a) mice after filament-based permanent middle cerebral artery occlusion (pMCAO); (b) rats subjected to thromboembolic MACO; and (c) sheep at 14 days after electrosurgically induced focal cerebral ischemia. Multiple fluorescence labeling was applied to explore simultaneous alterations of NVU and ECM. Serial mouse sections labeled with the net marker Wisteria floribunda agglutinin (WFA) displayed largely decomposed and nearly erased PNs in infarcted neocortical areas that were demarcated by up-regulated immunoreactivity for vascular collagen IV (Coll IV). Subsequent semi-quantitative analyses in mice confirmed significantly decreased WFA-staining along the ischemic border zone and a relative decrease in the directly ischemia-affected neocortex. Triple fluorescence labeling throughout the three animal models revealed up-regulated Coll IV and decomposed PNs accompanied by activated astroglia and altered immunoreactivity for parvalbumin, a calcium-binding protein in fast-firing GABAergic neurons which are predominantly surrounded by neocortical PNs. Furthermore, ischemic neocortical areas in rodents simultaneously displayed less intense staining of WFA, aggrecan, the net components neurocan, versican and the cartilage link

  4. Damaged Neocortical Perineuronal Nets Due to Experimental Focal Cerebral Ischemia in Mice, Rats and Sheep

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    Wolfgang Härtig

    2017-08-01

    Full Text Available As part of the extracellular matrix (ECM, perineuronal nets (PNs are polyanionic, chondroitin sulfate proteoglycan (CSPG-rich coatings of certain neurons, known to be affected in various neural diseases. Although these structures are considered as important parts of the neurovascular unit (NVU, their role during evolution of acute ischemic stroke and subsequent tissue damage is poorly understood and only a few preclinical studies analyzed PNs after acute ischemic stroke. By employing three models of experimental focal cerebral ischemia, this study was focused on histopathological alterations of PNs and concomitant vascular, glial and neuronal changes according to the NVU concept. We analyzed brain tissues obtained 1 day after ischemia onset from: (a mice after filament-based permanent middle cerebral artery occlusion (pMCAO; (b rats subjected to thromboembolic MACO; and (c sheep at 14 days after electrosurgically induced focal cerebral ischemia. Multiple fluorescence labeling was applied to explore simultaneous alterations of NVU and ECM. Serial mouse sections labeled with the net marker Wisteria floribunda agglutinin (WFA displayed largely decomposed and nearly erased PNs in infarcted neocortical areas that were demarcated by up-regulated immunoreactivity for vascular collagen IV (Coll IV. Subsequent semi-quantitative analyses in mice confirmed significantly decreased WFA-staining along the ischemic border zone and a relative decrease in the directly ischemia-affected neocortex. Triple fluorescence labeling throughout the three animal models revealed up-regulated Coll IV and decomposed PNs accompanied by activated astroglia and altered immunoreactivity for parvalbumin, a calcium-binding protein in fast-firing GABAergic neurons which are predominantly surrounded by neocortical PNs. Furthermore, ischemic neocortical areas in rodents simultaneously displayed less intense staining of WFA, aggrecan, the net components neurocan, versican and the

  5. Reversibility of retinal ischemia due to central retinal artery occlusion by hyperbaric oxygen

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    Hadanny A

    2016-12-01

    than the time delay, should be used as a marker for irreversible damage. Keywords: HBOT, hyperbaric oxygen, central retinal artery occlusion, cherry-red spot, CRAO, retinal ischemia

  6. Intestinal Ischemia

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    ... some generally recognized patterns. Symptoms of acute intestinal ischemia Signs and symptoms of acute intestinal ischemia typically ... confusion in older adults Symptoms of chronic intestinal ischemia Signs and symptoms of chronic intestinal ischemia can ...

  7. Chronic critical ischemia of the lower leg: pretherapeutic imaging and methods for revascularization; Die chronische kritische Unterschenkelischaemie: praetherapeutische Diagnostik, Methoden der Revaskularisation

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    Treitl, M.; Degenhart, C.; Reiser, M.; Rieger, J. [Innenstadt-Klinikum der Ludwig-Maximilians-Universitaet, Institut fuer Klinische Radiologie, Muenchen (Germany); Ruppert, V. [Chirurgische Klinik und Poliklinik am Innenstadt-Klinikum der Ludwig-Maximilians-Universitaet, Funktionsbereich Gefaesschirurgie, Muenchen (Germany); Mayer, A.K. [Chirurgische Klinik und Poliklinik am Innenstadt-Klinikum der Ludwig-Maximilians-Universitaet, Funktionsbereich Fusschirurgie, Muenchen (Germany)

    2006-11-15

    Each year 1-2% of patients with peripheral arterial occlusive disease (pAOD) develop critical limb ischemia (CLI), characterized by rest pain and peripheral ulcer or gangrene. This aggravation of the disease is accompanied by an increase of the 1-year mortality rate up to 25% and a similarly increased frequency of major amputation. We can choose between conservative, endovascular, and surgical procedures for an adequate therapy of the underlying vascular stenoses or occlusions. Yet, clear therapeutic recommendations only exist for suprapopliteal lesions. However, in a number of cases, especially in diabetics, target lesions have an infrapopliteal location. Since endovascular procedures have undergone significant improvement in the last few years, the following review discusses methods for infrapopliteal revascularization taking into consideration the newest publications on this topic. (orig.) [German] Jaehrlich entwickeln 1-2% der Patienten mit peripherer arterieller Verschlusskrankheit (pAVK) eine chronisch-kritische Ischaemie (chronic limb ischemia, CLI) der unteren Extremitaet, die durch Ruheschmerzen und/oder periphere Ulzerationen bzw. Gangraene charakterisiert ist. Sie bedeutet einen Zusammenbruch der Mikrozirkulation und ist mit einem Anstieg der Einjahresmortalitaetsrate auf 25% und einem hohen Amputationsrisiko vergesellschaftet. Zur Behandlung der CLI stehen konservative, endovaskulaere und operative Behandlungsmassnahmen zur Verfuegung, wobei klare Therapieempfehlungen bislang nur fuer Laesionen der suprapoplitealen Strombahn existieren. Oft und gerade bei Diabetikern liegt die Ursache jedoch infrapopliteal. Die endovaskulaeren Therapieverfahren haben in den letzten Jahren eine massive Weiterentwicklung erfahren. Grund genug, um unter Beruecksichtigung neuester Erkenntnisse die Alternativen zur Revaskularisierung infrapoplitealer Gefaessveraenderungen bei der CLI neu zu diskutieren. (orig.)

  8. Pendulating—A grounded theory explaining patients’ behavior shortly after having a leg amputated due to vascular disease

    Directory of Open Access Journals (Sweden)

    Ulla Riis Madsen

    2016-09-01

    Full Text Available Introduction: Although the group of vascular leg amputated patients constitutes some of the most vulnerable and frail on the orthopedic wards, previous research of amputated patients has focused on patients attending gait training in rehabilitation facilities leaving the patient experience shortly after surgery unexplored. Understanding patients’ behavior shortly after amputation could inform health professionals in regard to how these vulnerable patients’ needs at hospital can be met as well as how to plan for care post-discharge. Aim: To construct a grounded theory (GT explaining patients’ behavior shortly after having a leg amputated as a result of vascular disease. Method: In line with constructivist GT methodology, data from ethnographic observations and interviews were simultaneously collected and analyzed using the constant comparative method covering the patients’ experiences during the first 4 weeks post-surgery. Data collection was guided by theoretical sampling and comprised 11 patients. A GT was constructed. Results: Patients went through a three-phased process as they realized they were experiencing a life-changing event. The first phase was “Losing control” and comprised the sub-categories “Being overwhelmed” and “Facing dependency.” The second phase was “Digesting the shock” and comprised the sub-categories “Swallowing the life-changing decision,” “Detecting the amputated body” and “Struggling dualism.” The third phase was “Regaining control” and comprised the sub-categories “Managing consequences” and “Building-up hope and self-motivation.” “Pendulating” was identified as the core category describing the general pattern of behavior and illustrated how patients were swinging both cognitively and emotionally throughout the process. Conclusion: The theory of “Pendulating” offers a tool to understand the amputated patients’ behavior and underlying concerns and to recognize

  9. Pendulating—A grounded theory explaining patients’ behavior shortly after having a leg amputated due to vascular disease

    Science.gov (United States)

    Madsen, Ulla Riis; Hommel, Ami; Bååth, Carina; Berthelsen, Connie Bøttcher

    2016-01-01

    Introduction Although the group of vascular leg amputated patients constitutes some of the most vulnerable and frail on the orthopedic wards, previous research of amputated patients has focused on patients attending gait training in rehabilitation facilities leaving the patient experience shortly after surgery unexplored. Understanding patients’ behavior shortly after amputation could inform health professionals in regard to how these vulnerable patients’ needs at hospital can be met as well as how to plan for care post-discharge. Aim To construct a grounded theory (GT) explaining patients’ behavior shortly after having a leg amputated as a result of vascular disease. Method In line with constructivist GT methodology, data from ethnographic observations and interviews were simultaneously collected and analyzed using the constant comparative method covering the patients’ experiences during the first 4 weeks post-surgery. Data collection was guided by theoretical sampling and comprised 11 patients. A GT was constructed. Results Patients went through a three-phased process as they realized they were experiencing a life-changing event. The first phase was “Losing control” and comprised the sub-categories “Being overwhelmed” and “Facing dependency.” The second phase was “Digesting the shock” and comprised the sub-categories “Swallowing the life-changing decision,” “Detecting the amputated body” and “Struggling dualism.” The third phase was “Regaining control” and comprised the sub-categories “Managing consequences” and “Building-up hope and self-motivation.” “Pendulating” was identified as the core category describing the general pattern of behavior and illustrated how patients were swinging both cognitively and emotionally throughout the process. Conclusion The theory of “Pendulating” offers a tool to understand the amputated patients’ behavior and underlying concerns and to recognize where they are in the

  10. Comparison of skin and muscle biopsies before and after pentoxifylline treatment in patients with leg ulcers due to deep venous incompetence.

    Science.gov (United States)

    Angelides, N S; von der Ahe, C W; Themistocleus, P

    1991-01-01

    The aim of this study was to understand the possible mechanisms by which deep venous insufficiency and venous hypertension are associated with trophic skin changes and ulceration and to explain the therapeutic effect of Pentoxifylline in patients with leg ulcers due to deep venous incompetence. Twenty patients were included in this pilot study. They were graded into two groups: group 1, included 10 patients (5 F and 5 M) with deep venous incompetence and normal arteries; group 2, included 10 patients (1 F and 9 M) with deep venous incompetence and moderate arterial disease. Skin and muscle biopsies were carried out before and after the oral administration of 1,200 mg of Pentoxifylline daily (400 mg t.d.s). The following parameters were investigated by means of light microscopy and immunofluorescence tests: engorgement of venous stroma; decrease of intimal elastica; hyaline degeneration; floccular degeneration; pericapillary fibrin deposits and fibrin degradation products; inflammation and fat necrosis; myofibril degeneration; fibrous scar; regeneration and reconstitution of muscle fibres. The results indicated that local inflammation at the ulcer's area cause accumulation of white blood cells in the capillaries and the interstitial fluid, where there is also accumulation of fibrinogen. These changes may lead to chronic tissue ischaemia and ulceration. The known favourable effect of Pentoxifylline on red cells and leucocyte function as well as its lowering effect on plasma fibrinogen level, may be responsible for the observed therapeutic effect of Pentoxifylline on venous leg ulcers.

  11. Leg pain

    Science.gov (United States)

    ... when you walk or exercise and improves with rest. The leg is black and blue. The leg is cold ... chap 81. Marcussen B, Hogrefe C, Amendola A. Leg pain and exertional compartment syndromes. In: Miller MD, Thompson SR, eds. DeLee & Drez's ...

  12. Prosthetic fitting in a patient with a transtibial amputation due to a congenital vascular malformation of the right leg

    NARCIS (Netherlands)

    Simmelink, Elisabeth K.; Rommers, Gerardus M.; Gardeniers, Jean W. M.; Zijlstra, Henk

    2014-01-01

    Background: The problems of prescribing a prosthesis for a young girl with severe congenital vascular malformation deformity leading to a transtibial amputation. Case description and methods: Due to the high risk of recurrent bleeding and limitations regarding full weight bearing of the stump, a nor

  13. Effects of postconditioning with leg ischemia on focal cerebral ischemia-reperfusion injury in diabetic rats%肢体缺血后处理对糖尿病大鼠局灶性脑缺血再灌注损伤的影响

    Institute of Scientific and Technical Information of China (English)

    李燕; 王翠兰; 卢英云

    2009-01-01

    Objective To evaluate the effects of leg ischemic postconditioning on focal cerebral ischemia-reperfusion (I/R) injury in diabetic rats. Methods Forty male diabetic SD rats weighing 270-320 g were randomly assigned to one of 4 groups (n=10 each):group Ⅰcontrol (C);group Ⅱ sham operation (S);group Ⅲ fecal cerebral ischemia-repertusion (I/R) and group Ⅳ leg ischemic postconditioning (IPC). Diabetes mellitus was induced by intraperitoneal streptozotocin. Local cerebral I/R was produced by middle cerebral artery occlusion (MCAO) for 1.5 h followed by 6 h reperfusion. A nylon thread with rounded tip was inserted into internal carotid artery and threaded cranially until resistance was felt. Leg isebemia was induced by placing tourniquet on beth legs at 30 min before repeffusion. The animals underwent 3 episodes of 5 min leg ischemia at 5 min intervals. Neuro-functional deficit was assessed and recorded at the end of 6h reperfusion using neurologic deficit scores (NDS) (0=no deficit, 4=unable to crawl and semiconscious). The animals were then decapitated and their brains were removed for determination of volume of cerebral infaret (by TIC staining) and ratio' of neuronal apoptosis (by TUNEL). Results NDS and cerebral infarct volume were significantly increased at the end of 6 h reperfusion in group I/R and IPC as compared with group C and S. IPC significantly decreased cerebral infarct volume and ratio of neuronal apoptosis induced by MCAO. There was no significant difference in NDA between group I/R and IPC. Conclusion Leg iscbemic postconditioning can protect the brain against focal cerebral I/R injury in diabetic rats.%目的 评价肢体缺血后处理对糖尿病大鼠局灶性脑缺血再灌注损伤的影响.方法 腹腔注射链脲佐菌素制备大鼠糖尿病模型,造模成功的雄性SD大鼠40只,随机分为4组(n=10):对照组(C组);假手术组(S组)仅暴露颈动脉;缺血再灌注组(IR组)线栓阻断人脑中动脉1.5 h,再灌注6 h;肢体

  14. Quercetin protects the retina by reducing apoptosis due to ischemia-reperfusion injury in a rat model

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    Sedat Arikan

    2015-04-01

    Full Text Available Purpose: This study aimed to investigate the effect of quercetin on apoptotic cell death induced by ischemia-reperfusion (I/R injury in the rat retina. Methods: Twenty-four rats were divided into four equal groups: control, ischemic, solvent, and quercetin. I/R injury was achieved by elevating the intraocular pressure above the perfusion pressure. Intraperitoneal injections of 20 mg/kg of quercetin and dimethyl sulfoxide (DMSO were performed in the quercetin and solvent groups, respectively, immediately prior to I/R injury, and the researchers allowed for the retinas to be reperfused. Forty-eight hours after injury, the thicknesses of the retinal ganglion cell layer (RGCL, inner nuclear layer (INL, inner plexiform layer (IPL, outer plexiform layer (OPL, and outer nuclear layer (ONL were measured in all groups. Moreover, the numbers of terminal deoxynucleotidyl transferase dUTP nick-end-labeled [TUNEL (+] cells and caspase-3 (+ cells in both INL and ONL were evaluated in all groups. Results: The administration of quercetin was found to reduce the thinning of all retinal layers. The mean thickness of INL in the quercetin and ischemic groups was 21 ± 5.6 µm and 16 ± 6.4 µm, respectively (P<0.05. Similarly, the mean thickness of ONL in the quercetin and ischemic groups was 50 ± 12.8 µm and 40 ± 8.7 µm, respectively (P<0.05. The antiapoptotic effect of quercetin in terms of reducing the numbers of both TUNEL (+ cells and caspase-3 (+ cells was significant in INL. The mean number of TUNEL (+ cells in INL in the ischemic and quercetin groups was 476.8 ± 45.6/mm2 and 238.72 ± 251/mm2, respectively (P<0.005. The mean number of caspase-3 (+ cells in INL of ischemic and quercetin groups was 633.6 ± 38.7/mm2 and 342.4 ± 36.1/mm2, respectively (P<0.001. Conclusion: The use of quercetin may be beneficial in the treatment of retinal I/R injury because of its antiapoptotic effect on the retinal layers, particularly in INL.

  15. Point-of-Care Ultrasound in Necrotizing Acute Pancreatitis Complicated by Perforated Ileum Due to Nonocclusive Mesenteric Ischemia

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    Sonia López-Cuenca

    2016-09-01

    Full Text Available Necrotizing acute pancreatitis is the most severe form of pancreatitis, and it is a potentially life-threatening condition. Its diagnosis and severity are based on radiological signs. Although computed tomography is the most used imaging tool, ultrasound can be a quick and useful technique in emergency and intensive care scenarios. The use of abdominal ultrasound is generally limited to ruling out cholecystitis. Bowel gas can limit the accuracy of pancreatic imaging. When the pancreas is visualized, ultrasound can reveal pancreatic enlargement, echotextural changes, and peripancreatic fluid. We present a patient with necrotizing pancreatitis who developed peritonitis due to ileal perforation, where the use of ultrasound as a bedside imaging technique was very useful.

  16. [Mononeuritis multiplex due to thrombotic ischemia of primary antiphospholipid antibody syndrome without vasculitis: an autopsy case report].

    Science.gov (United States)

    Takahashi, Masatoshi; Katada, Fumiaki; Sato, Susumu; Shibayama, Hidehiro; Fukutake, Toshio; Murayama, Shigeo

    2015-01-01

    The patient was a 78-year-old man. Three years before admission, he developed transient peripheral neuropathy and purpura, and at admission, he presented with livedo reticularis of both his lower extremities and with mononeuritis multiplex. Vasculitis was not observed, and antiphospholipid antibodies were detected. The nerve and skin biopsies revealed no inflammation; axonal degeneration accompanied by thrombi was found in his arterioles and venules. Based on these findings, he was diagnosed with ischemic peripheral neuropathy due to primary antiphospholipid syndrome. Administration of anticoagulant therapy resulted in an improvement in symptoms; however, two months later, a relapse occurred, and the patient contracted an infection while undergoing immunosuppressive therapy. The infection became fulminant, and the patient succumbed to multiple organ failure. The autopsy revealed a systemic arterial and venous embolism; however, no vasculitis was observed. Antiphospholipid syndrome, which is responsive to antithrombotic treatment, should be considered as a differential diagnosis of mononeuritis multiplex.

  17. Silent myocardial ischemia.

    Science.gov (United States)

    Gutterman, David D

    2009-05-01

    Although much progress has been made in reducing mortality from ischemic cardiovascular disease, this condition remains the leading cause of death throughout the world. This might in part be due to the fact that over half of patients have a catastrophic event (heart attack or sudden death) as their initial manifestation of coronary disease. Contributing to this statistic is the observation that the majority of myocardial ischemic episodes are silent, indicating an inability or failure to sense ischemic damage or stress on the heart. This review examines the clinical characteristics of silent myocardial ischemia, and explores mechanisms involved in the generation of angina pectoris. Possible mechanisms for the more common manifestation of injurious reductions in coronary flow; namely, silent ischemia, are also explored. A new theory for the mechanism of silent ischemia is proposed. Finally, the prognostic importance of silent ischemia and potential future directions for research are discussed.

  18. Silent Ischemia

    Science.gov (United States)

    ... silent ischemia: An exercise stress test can show blood flow through your coronary arteries in response to exercise. Holter monitoring records your heart rate and rhythm over a 24-hour period (or ...

  19. Hepatic ischemia

    Science.gov (United States)

    ... or oxygen, causing injury to liver cells. Causes Low blood pressure from any condition can lead to hepatic ischemia. ... leading to reduced blood flow (vasculitis) Symptoms If low blood pressure continues for a long time, you may feel ...

  20. Detection and monitoring of tissue ischemia due to acute arterial obstruction in the limbs of patients with quantitative violations in consciousness, peridural anesthesia

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    Ognyan Zlatev

    2017-01-01

    Full Text Available Traced and interpreted is the dynamic and correlative relations between the values of certain biochemical parameters of the homeostasis connected with cell metabolism in skeletal muscles so a verification of tissue ischemia (TI and ischemic tissue lesion (ITL can be performed. The target group is patients with quantitative violations in consciousness and peridural catheters placed for anesthesia, with the suspicion that an acute arterial obstruction in the limbs (AAOL has occurred, or one has already been verified. Test of the serum levels of CK; CK (MB; ASAT; ALAT and Myoglobin were initially performed and were monitored in dynamic. A valuation of the ASAT/ALAT index in close correlation with the other parameters and clinical course of the disease was also performed. A particular dynamic and correlation, before the operation, after the timely revascularization, during the development of ischemic gangrene and after the amputation on an optimal level, was observed. We found an acute elevation of the enzyme activity of CK; CK (MB and ASAT in the case of AAOL which generated TI. ALAT and Myoglobin remained in the reference ranges. In cases with unsuccessful, late or impossible revascularization and transition to TI and ITL (ischemic rhabdomyolysis we found progressive elevation in the levels of the parameters being monitored, including ALAT and Myoglobin. The registered values, in the patients who were not operated, before death, were 900 times above for CK, and CK (MB did not exceed 5% of CK. Over 100 times the standard value for ASAT and ALAT without and hepatic pathology and acute coronary incident. The ASAT/ALAT index is extremely positive in the group with ITL. The registered values of serum Myoglobin reached up to 70 times above the reference range. Upon, revascularization, amputation on an optimal level or an experienced gangrene, a rapid decrease in the values to the reference range for a period 24-48 hours, was observed, except for ALAT

  1. Ischemia-driven angiogenesis.

    Science.gov (United States)

    Dor, Y; Keshet, E

    1997-11-01

    New blood vessels usually develop in places where they are most needed. A prime example of neovascularization representing a positive feedback response to insufficient perfusion is the development of collateral blood vessels in the ischemic myocardium and leg. The recent discoveries of hypoxia-inducible transcription and angiogenic factors have provided important mechanistic links between the metabolic consequences of ischemia and compensatory angiogenesis. Vascular endothelial growth factor (VEGF) has emerged as the key mediator of ischemia-driven angiogenesis. Environmental stresses, including hypoxia, hypoglycemia, and hypoferremia, upregulate VEGF expression at both the transcriptional and posttranscriptional levels. VEGF acts in turn on adjacent vascular beds expressing cognate receptors and induces sprouting and capillary growth toward the ischemic tissue. In addition to expanding the vasculature at sites where existing vessels have been occluded or obliterated, VEGF also functions to match the vascular density according to development and physiologic increases in oxygen consumption. Fine adjustment of the vasculature includes a step of oxygen-regulated vascular pruning mediated by VEGF in its capacity as a survival factor for newly formed vessels. Pathologic settings of ischemia-driven angiogenesis include a major component of stress-induced angiogenesis during tumor neovascularization and abnormal vessel growth associated with retinopathies. The latter represents an excessive angiogenic response to conditions of severe retinal ischemia. Further insights into the mechanism of stress-induced angiogenesis are likely to suggest new ways to augment growth of collateral vessels and to restrain unwarranted neovascularization in tumors and retinopathies. (Trends Cardiovasc Med 1997;7:289-294). © 1997, Elsevier Science Inc.

  2. Leg ulcer and osteomyelitis due to methicillin-susceptible Staphylococcus aureus infection after fracture repair treatment: a case highlighting the potential role of prostaglandin E₁ vasodilator.

    Science.gov (United States)

    Bentivegna, Erminia; Citarrella, Emanuele; Vivaldi, Roberto; De Luca, Dario; Maira, Giovanna Grazia; Casuccio, Alessandra; Di Carlo, Paola

    2015-03-01

    Prostaglandins appear to reduce biofilm formation and chronicization of infections, and stimulate a rapid and effective clearance of infecting micro-organisms. We report a case of recovery from methicillin-susceptible Staphylococcus aureus (MSSA) osteomyelitis after multidisciplinary management with antibiotics, anti-thrombotics and prostaglandin E1 (PGE1) vasodilator, in a patient with tibial plateau fracture repaired with internal fixation devices. A 47-year-old HIV-negative male with chronic ulcer on the proximal third of the left leg was admitted to the Orthopaedic Unit of the Orestano Clinic in Palermo, Italy, for suspected osteomyelitis. A biopsy of the skin ulcer and blood cultures were performed and resulted positive for MSSA. Labelled leukocyte scintigraphy confirmed osteomyelitis. No clinical improvement was observed after combined antibiotic treatment with rifampicin plus trimethoprim-sulfamethoxazole. The patient underwent a 4-day therapeutic cycle: PGE1 (alprostadil 60 mg/day IV) combined with nadroparin calcium plus gentamicin, followed by treatment with aminaftone plus sulodexide plus levofloxacin. At discharge, the patient's painful symptoms had completely resolved and the ulcer had cicatrized; recovery from osteomyelitis was confirmed by scintigraphy. This treatment protocol including PGE1 may result in a significant improvement in quality of life and functional status of patients with a reduction in direct and indirect costs and economic benefit for the National Health Service.

  3. Improvement in Memory and Brain Long-term Potentiation Deficits Due to Permanent Hypoperfusion/Ischemia by Grape Seed Extract in Rats

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    Alireza Sarkaki

    2013-09-01

    Full Text Available   Objective(s: Cerebral hypoperfusion/ischemia (CHI is a neurological disease where impaired hippocampus electrical activity and cognition caused by a serial pathophysiological events. This study aimed to evaluate the effects of chronic oral administration of grape seed extract (GSE on passive avoidance memory and long-term potentiation (LTP after permanent bilateral common carotid arteries occlusion (2CCAO in male adult rats.   Materials and Methods: Thirty-two adult male Wistar rats were randomly divided into: 1 Sham+Veh, 2 Isch+Veh, 3 Sham+GSE, 4 Isch+GSE. In order to make 2CCAO as an animal model of CHI, carotid arteries were ligatured and then cut bilaterally. To evaluation of passive avoidance memory, step-down latency (STL was measured and LTP was recorded from hippocampal dentate gyrus (DG after high frequency stimulation (HFS in all rats. Results: We found that memory was significantly impaired in rats after CHI (P

  4. Textiloma in the leg

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    Patel Amol

    2007-01-01

    Full Text Available Textiloma is defined as a tumor formed due to retained gauze. It is rarely reported in the musculoskeletal system. We are presenting a case with a soft tissue swelling over the lateral aspect of the lower third of the leg, come for implant removal of the distal tibia and fibular fracture. We removed the soft tissue mass enbloc thinking it to be a benign tumor. On cutting the mass on the operation table, a gauze piece encased by fibrous tissue was found. Textiloma can present as tumoral forms and can mimic as a pseudo-tumor.

  5. The angiographic features of cerebral ischemia due to Takayasu arteritis%大动脉炎性脑缺血的脑血管造影特征分析

    Institute of Scientific and Technical Information of China (English)

    刁士元

    2010-01-01

    Objective To explore the angiographic features of c cerebral ischemia due to Takayasu arteritis. Methods The clinical data and angiographic findings of twenty patients with Takayasu rteritis were analyzed retrospectively. Two experienced radiologists read all the angiographic images of the patients with a double-blind method, then discussed together, and finally formed an unanimous interpretation. Results According to the Lupi-Herrera classification, 17 of 20 patients were type Ⅰ and the rest 3 were type Ⅲ on angiograms. The affected arteries mainly included subclavian artery (19 patients), carotid artery (17 patients), vertebral artery (12 patients), and brachiocephalic trunk (6 patients). Conclusions Cerebral angiography can accurately and effectively assess the vascular status in patients with cerebral ischemia due to Takayasu arteritis. It is beneficial in the diagnosis of Takayasu arteritis..%目的 探讨大动脉炎性脑缺血的脑血管造影特征.方法 回顾性分析20例大动脉炎性脑缺血患者的病例资料及脑血管造影结果.脑血管造影资料由有经验的介入放射学医师按盲法对比进行分析,然后共同讨论并达成一致意见.结果 20例中,经血管造影按Lupi-Herrera 综合分型法Ⅰ型17例,Ⅲ型3例.主要受累动脉包括锁骨下动脉19例,颈动脉17例,椎动脉12例,头臂干6例.结论脑血管造影可准确、有效的评估大动脉炎性脑缺血患者的血管情况,有利于大动脉炎的诊断.

  6. Restless Legs Syndrome Foundation

    Science.gov (United States)

    ... Into Relieved Are you experiencing symptoms linked to restless legs syndrome (RLS)? Find tools and support to help get ... I couldn’t sleep. Fortunately, I found the Restless Legs Syndrome Foundation and learned what type of doctor to ...

  7. Restless Legs Syndrome

    Science.gov (United States)

    ... and Teens, Men, WomenTags: neurological disorders, restless legs syndrome, RLS, sitting, sleep disorders, sleeping, uncomfortable feeling in legs at rest Family Health, Kids and Teens, Men, Women November ...

  8. Local lysis with Alteplase for the treatment of acute embolic leg ischemia following the use of the Duett {sup trademark} closure device: preliminary results; Lokale Alteplase-Lyse zur Therapie der akuten embolischen Beinischaemie nach Einsatz des Duett {sup trademark} -Verschluss-Systems: vorlaeufige Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Schuermann, K.; Buecker, A.; Wingen, M.; Tacke, J.; Wein, B.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik des Universitaetsklinikums der RWTH Aachen (Germany); Janssens, U. [Medizinische Klinik I (Kardiologie) des Universitaetsklinikums der RWTH Aachen (Germany)

    2004-04-01

    Purpose: To analyze retrospectively the result of the alteplase lysis therapy of embolic complications following the use of the Duett closure device. Methods and Materials: For 3.5 years, the Duett closure device was used in 1,398 angiographies to close the femoral puncture site. The Duett device consists of a balloon and a liquid procoagulant containing collagen and thrombin, which is injected into the puncture tract under endovascular balloon protection of the arterial puncture site. In 9 patients (0.64%), the procoagulant was incidentally injected into the femoral artery causing acute leg ischemia. Eight patients received local lysis therapy with alteplase via a contralateral femoral access. One patient underwent surgery. On average, 21 mg alteplase (4-35 mg) were administered within 14 h (4-21 h). The course of the lysis was followed angiographyically and clinically. All patients were inteerviewed by telephone 23 months (4-35 months) later.Results: In 3 patients, lysis was complete. In 5 patients, only little thrombotic material remained. In all patients, symptoms of ischemia resolved completely within the first hours after initiation of lysis. In 5 cases, bleeding occurred at the puncture site closed with the Duett device during lysis, including development of a false aneurysm in 2 cases. Complications led to premature termination (n=2) or interruption of the lysis (n=3). All complications were treated conservatively. Clinically, long-term sequelae were paresthesia and hypoesthesia in the lower leg and foot in 2 patients treated with lysis, and in the patient who underwent surgery. (orig.) [German] Ziel: Das Ergebnis der Alteplase-Lysetherapie von Embolien nach Einsatz des Duett-Verschluss-Systems wurde retrospektiv untersucht. Methoden: Innerhalb von 3,5 Jahren wurde nach 1398 Angiographien das Duett-System zum Verschluss der femoralen Punktionsstelle eingesetzt. Das System besteht aus einem Ballon und einem fluessigen Prokoagulans (Kollagen, Thrombin), das

  9. Restless legs syndrome mimicking S1 radiculopathy.

    Science.gov (United States)

    Zambelis, Th; Wolgamuth, B R; Papoutsi, S N; Economou, N T

    2016-01-01

    Α case of a chronic idiopathic form of a severe type of Restless Legs Syndrome (RLS), which developed during pregnancy and persisted after this, misdiagnosed for 34 years as radiculopathy S1, is reported. In spite of the thorough clinical and laboratory investigation, in addition to constant changes of the therapeutic approach, the diagnosis of S1 radiculopathy could not be confirmed, resulting in a chronic clinical course; the latter was characterized by relapses and remissions not attributed or linked in any way to the treatment (various types of). In fact, it was due to a routine workup in a sleep clinic, where the patient was referred because of a coincident chronic insomnia (Restless Legs Syndrome is a known and important cause of insomnia/chronic insomnia), which resulted in a proper diagnosis and treatment of this case. With the use of Restless Legs Syndrome appropriate treatment (Pramipexole 0.18 mg taken at bedtime, a dopaminergic agent and Level A recommended drug for Restless Legs Syndrome) an excellent response and immediate elimination of symptoms was achieved. Restless Legs Syndrome may present with a variety of symptoms (with the most prominent shortly being reported with the acronym URGE: Urge to move the legs usually associated with unpleasant leg sensations, Rest induces symptoms, Getting active brings relief, Evening and night deteriorate symptoms); given the fact that Restless Legs Syndrome presents with a great variety and heterogeneity of symptoms (mostly pain, dysesthesia and paresthesia), which may occur in several other diseases (the so called "RLS mimics"), proper diagnosis of Restless Legs Syndrome usually fails. Restless Legs Syndrome misinterpreted as S1 radiculopathy, to the best of our knowledge, has not been reported yet in the literature. Here, case history, clinical course and common RLS mimics are presented. Different forms of Restless Legs Syndrome manifestations, which are commonly -as in this case- misinterpreted due to their

  10. Acute Mesenteric Ischemia

    Science.gov (United States)

    ... Side Effects Additional Content Medical News Acute Mesenteric Ischemia By Parswa Ansari, MD, Department of Surgery, Lenox ... Abscesses Abdominal Wall Hernias Inguinal Hernia Acute Mesenteric Ischemia Appendicitis Ileus Intestinal Obstruction Ischemic Colitis Perforation of ...

  11. Mesenteric artery ischemia

    Science.gov (United States)

    ... medlineplus.gov/ency/article/001156.htm Mesenteric artery ischemia To use the sharing features on this page, please enable JavaScript. Mesenteric artery ischemia occurs when there is a narrowing or blockage ...

  12. Intestinal ischemia and infarction

    Science.gov (United States)

    ... medlineplus.gov/ency/article/001151.htm Small intestinal ischemia and infarction To use the sharing features on this page, please enable JavaScript. Intestinal ischemia and infarction occurs when there is a narrowing ...

  13. Lyden-af-Leg

    DEFF Research Database (Denmark)

    Toft, Herdis

    Præsentation af seniorforsker-projekt Lyden-af-Leg i et traderingsperspektiv og med indledende fokus på YouTube som traderings-platform.......Præsentation af seniorforsker-projekt Lyden-af-Leg i et traderingsperspektiv og med indledende fokus på YouTube som traderings-platform....

  14. Leg 179 summary

    Digital Repository Service at National Institute of Oceanography (India)

    Pettigrew, T.J.; Casey, J.F.; Miller, D.J.; Araki, E.; Boissonnas, R.; Busby, R.; Einaudi, F.; Gerdom, M.; Guo, Z.P.; Hopkins, H.; Myers, G.; Rao, D.G.; Shibata, T.; Thy, P.

    Ocean Drilling Program (ODP) Leg 179 set out with two primary objectives. These objectives were (1) testing the recently developed hammer drill-in casing system on the Atlantis Bank, Southwest Indian Ridge (SWIR), and (2) drilling a cased reentry...

  15. RESTLESS LEGS SYNDROME

    Directory of Open Access Journals (Sweden)

    Dmitriy Valer'evich Artem'ev

    2009-01-01

    Full Text Available The paper describes the epidemiology, etiology, pathogenesis, clinical picture, diagnosis, differential diagnosis, and treatment of restless legs syndrome. Recommendations are given how to choose therapeutic modalities and drugs in relation to different factors.

  16. Migraine and ischemia

    NARCIS (Netherlands)

    van der Wammes-van der Heijden, E.A.

    2009-01-01

    An association between migraine and ischemic events, especially ischemic stroke, has been debated for many years. Whether migraine is a risk factor for ischemic events or ischemia triggers migraine, or both, is still unclear. This thesis explores different relationships between migraine and ischemia

  17. [The physiopathology of critical ischemia of the lower limbs].

    Science.gov (United States)

    Novo, S; Abrignani, M G; Liquori, M; Sangiorgi, G B; Strano, A

    1993-10-01

    Peripheral obstructive arterial disease (POAD) of the lower limbs is the third main complication of atherosclerosis, after coronary artery disease and cerebrovascular disease. In 15-20% of cases POAD have an unfavourable evolution toward critical leg ischemia (CLI). This clinical condition is characterized by the onset of rest pain and/or trophic cutaneous lesions until gangrene appears. In some cases amputation is needed. The pathophysiological, clinical and therapeutic aspects of CLI were recently discussed in two Consensus Conferences held in Berlin in 1989 and in Rudesheim in 1991, with the elaboration of a final draft published on circulation. CLI appears when peripheral perfusion critically decreases due to macro and microcirculatory alterations. Atherosclerotic plaque is the primum movens, but often there are more plaques in sequence along the ilio-femoro-popliteal axis. The pathophysiological and clinical consequences are more severe if the stenosis is haemodynamically important, after a rapid progression of plaque growth or when thrombotic complications develop. The reduction in distal perfusion induces troubles in the microcirculation and an embalancement between the microvascular defense system (MDS) and the microvascular flow regulating system (MFRS) with endothelial dysfunction, platelet and leucocytes activation, worsening of blood viscosity due to the increase in fibrinogen levels and to the red cells deformability changes, activation of coagulation and impairment of fibrinolysis. So, a vicious circle appears with further worsening of distal perfusion and onset of trophic lesions. A further worsening of CLI can derive from local recurrent infections particularly frequent in diabetic patients.

  18. Acu-moxibustion Prevention and Control of Injured Mitochondrial Pathway due to Myocardial Ischemia-Reperfusion%针灸防治心肌缺血再灌注损伤的线粒体通路研究进展

    Institute of Scientific and Technical Information of China (English)

    樊海龙; 赵凌; 任玉兰; 梁繁荣

    2015-01-01

    Objective:To investigate acu-moxibustion protection of mitochondrial cellular signal transduction dysfunction due to myocardial ischemia-reperfusion injury.Methods:The research was made by studying research results published in recent years. Results:Most research used rats as study subjects and found acupuncture can improve mitochondria function,reduce mitochondrial reactive oxygen species (ROS)which caused excessive oxidative stress,prevent the intracellular Ca2 + overload and the mitochon-drial permeability transition pore (mPTP)open.Conclusion:MicroRNA (miRNA)is the control factor of such upstream networks as genetic networks,protein networks,and metabolic networks.Given the overall characteristics of acupuncture effect,introducing the miRNA into the acupuncture mechanism research can better reveal acupuncture mechanism.%目的:探讨针灸防治心肌缺血再灌注损伤的线粒体细胞信号转导机制,为后续研究提供思路。方法:通过对近年来国内外有关线粒体心脏损伤的研究入手,分析针灸防治心肌缺血再灌注损伤的线粒体通路的研究进展。结果:研究多以大鼠为观察对象,主要从针刺改善线粒体功能,减少线粒体活性氧类(ROS)产生过量引起氧化应激,防止细胞内 Ca2+超载和阻止线粒体通透性转换孔(mPTP)的开放等角度切入研究。结论:微小 RNA(microRNA,miRNA)是基因网络、蛋白网络、代谢网络等的上游网络的调控环节。鉴于针灸作用的整体性特点,将 miRNA 引入针灸作用机制研究领域,可在基因或其他水平层面更好地揭示针灸作用机制。

  19. Venous leg ulcers.

    Science.gov (United States)

    Nelson, E Andrea

    2011-12-21

    Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.0/1000 people have active leg ulcers. Prevalence increases with age to about 20/1000 in people aged over 80 years. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of standard treatments, adjuvant treatments, and organisational interventions for venous leg ulcers? What are the effects of advice about self-help interventions in people receiving usual care for venous leg ulcers? What are the effects of interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 101 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: compression bandages and stockings, cultured allogenic (single or bilayer) skin replacement, debriding agents, dressings (cellulose, collagen, film, foam, hyaluronic acid-derived, semi-occlusive alginate), hydrocolloid (occlusive) dressings in the presence of compression, intermittent pneumatic compression, intravenous prostaglandin E1, larval therapy, laser treatment (low-level), leg ulcer clinics, multilayer elastic system, multilayer elastomeric (or non-elastomeric) high-compression regimens or bandages, oral treatments (aspirin, flavonoids, pentoxifylline, rutosides, stanozolol, sulodexide

  20. [Restless legs syndrome].

    Science.gov (United States)

    Lai, Szu-Chia; Chen, Rou-Shayn

    2008-03-01

    The restless legs syndrome (RLS) is a common neurological disorder to take possession of increasing attention. RLS is characterized by an urge to move the legs, usually accompanied by uncomfortable or unpleasant sensations, that occurs or worsen at rest and is relieved by activity. The symptoms of RLS have a major impact on nocturnal sleep and daytime functions. The clinical diagnostic criteria were established and published in 2003 by International Restless Legs Syndrome Study Group (IRLSSG). All four essential criteria must be met for a positive diagnosis. However, RLS encompassed an idiopathic form of genetic or unknown origin and secondary forms associated with many causes. Special awareness should be kept for differential diagnosis such as uremia, iron deficiency anemia, polyneuropathy, rheumatoid arthritis, and other neurodegenerative diseases. Polysomnography, actinography, L-dopa loading test, and suggested immobilization test (SIT) are helpful tools to reduce the diagnostic puzzle of false positive and false negative. Pathophysiological concepts of RLS are essentially based on the neuroimaging and neurophysiological data to assume a dysfunction of the dopaminergic system, possibly on the All neuron group localized in the hypothalamus. These neurons modulate spinal excitability and alter the sensory processing predominantly of leg afferents. Treatment may be closely linked to the dopaminergic system and iron metabolism. Dopaminergic stimulation with levodopa or dopamine agonists is the first choice in idiopathic restless legs syndrome, but the long-term adverse effect of augmentation should be carefully monitored.

  1. Ergotamine-induced upper extremity ischemia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Deuk; Lee, Gun [Bundang CHA General Hospital, Pochon (China); Shin, Sung Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-06-15

    Ergotamine-induced limb ischemia is an extremely rare case. We present a case of a 64-year-old man, who developed ischemia on the right upper extremity due to long-term use of Ergot for migraine headache. Angiography revealed diffused, smooth, and tapered narrowing of the brachial artery. The patient was successfully treated with intravenous nitroprusside.

  2. Retino-choroidal ischemia in central retinal vein occlusion

    OpenAIRE

    Hussain, Nazimul; Hussain, Anjli

    2014-01-01

    A 41-year-old gentleman with insulin dependent diabetes had decreased vision in the right eye due to non-ischemic central retinal vein occlusion with macular edema. One month following intravitreal ranibizumab, he developed retino-choroidal ischemia with further loss of vision. Authors show the fluorescein angiographic transition from non-ischemic central retinal vein occlusion to retino-choroidal ischemia.

  3. Hemoglobinopathies and Leg Ulcers.

    Science.gov (United States)

    Alavi, Afsaneh; Kirsner, Robert S

    2015-09-01

    Major hemoglobinopathies, including sickle cell anemia, are becoming a global health issue. Leg ulcers are the most common cutaneous manifestation of sickle cell disease and an important contributor to morbidity burden in this population. Leg ulcers following sickling disorders are extremely painful, and hard to heal. The clinical evidence for the optimal management of these ulcers is limited. Treating the cause and the strategies to prevent sickling are the mainstay of treatment. The basic principles of wound bed preparation and compression therapy is beneficial in these patients.

  4. Symmetry Analysis of Thermoelectric Energy Converters with Inhomogeneous Legs

    Science.gov (United States)

    Korzhuev, M. A.

    2010-09-01

    Symmetry analysis has been applied to thermoelectric energy converters [thermoelectric generators (TEG), coolers (TEC), and heaters (TEH)] with inhomogeneous legs. The features of the crystallographic symmetry of thermoelectric materials and the symmetry of legs, thermocouples, and modules are studied. The effect of symmetry on the figure of merit Z of thermoelectric energy converters is considered. A general rule for proper placement of legs in thermoelectric converters is developed. A modified tetratomic classification for thermoelectric energy converters with inhomogeneous legs (TEGa, TEGb, TEC, and TEH) is proposed. An increase in Z for thermoelectric energy converters with inhomogeneous legs is due to the bulk thermoelectric effect. An increase in Z gives the reduction of irreversible processes in the modules (Joule heating and thermal conductivity), accompanying breaking of the symmetry of the legs. It is found that violations of the symmetry requirements can lead to significant energy losses in converters.

  5. Spinal cord ischemia following thoracotomy without epidural anesthesia.

    Science.gov (United States)

    Raz, Aeyal; Avramovich, Aharon; Saraf-Lavi, Efrat; Saute, Milton; Eidelman, Leonid A

    2006-06-01

    Paraplegia is an uncommon yet devastating complication following thoracotomy, usually caused by compression or ischemia of the spinal cord. Ischemia without compression may be a result of global ischemia, vascular injury and other causes. Epidural anesthesia has been implicated as a major cause. This report highlights the fact that perioperative cord ischemia and paraplegia may be unrelated to epidural intervention. A 71-yr-old woman was admitted for a left upper lobectomy for resection of a non-small cell carcinoma of the lung. The patient refused epidural catheter placement and underwent a left T5-6 thoracotomy under general anesthesia. During surgery, she was hemodynamically stable and good oxygen saturation was maintained. Several hours following surgery the patient complained of loss of sensation in her legs. Neurological examination disclosed a complete motor and sensory block at the T5-6 level. Magnetic resonance imaging (MRI) revealed spinal cord ischemia. The patient received iv steroid treatment, but remained paraplegic. Five months following the surgery there was only partial improvement in her motor symptoms. A follow-up MRI study was consistent with a diagnosis of spinal cord ischemia. In this case of paraplegia following thoracic surgery for lung resection, epidural anesthesia/analgesia was not used. The MRI demonstrated evidence of spinal cord ischemia, and no evidence of cord compression. This case highlights that etiologies other than epidural intervention, such as injury to the spinal segmental arteries during thoracotomy, should be considered as potential causes of cord ischemia and resultant paraplegia in this surgical population.

  6. The mangled lower leg

    NARCIS (Netherlands)

    Hoogendoorn, Jochem Maarten

    2002-01-01

    A surgeon faced with a patient presenting with an open tibial/fibular fracture in combination with severe damage of the surrounding soft tissues, has to make the difficult decision whether to attempt salvage or to perform an immediate amputation of the leg. Until late in the nineteenth century the

  7. Leg med vision

    DEFF Research Database (Denmark)

    Munk, Mette; Bertelsen, Katrine

    2011-01-01

    alle med interesse for leg og bevægelse i daginstitutioner. Bogen er skrevet i et samarbejde mellem Ringsted Kommune og det nationale videncenter for sundhed, kost og motion for børn og unge, KOSMOS (www.vicekosmos.dk).Der er i samarbejde med to daginstitutioner indhentet vigtige og kvalificerede...

  8. Leg CT scan

    Science.gov (United States)

    ... x-ray beam rotates around you. (Modern "spiral" scanners can perform the exam without stopping.) A computer creates separate images of the body area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional (3D) models of the leg can be created by ...

  9. Leg design in hexapedal runners

    National Research Council Canada - National Science Library

    Full, R J; Blickhan, R; Ting, L H

    1991-01-01

    .... To explain how diverse leg designs can result in common whole-body dynamics, we used a miniature force platform to measure the ground reaction forces produced by individual legs of the cockroach Blaberus discoidalis...

  10. Critical Limb Ischemia (CLI)

    Science.gov (United States)

    ... Buerger’s Disease Carotid Artery Disease Chronic Venous Insufficiency Congenital Vascular Malformation Critical Limb Ischemia (CLI) Deep Vein Thrombosis (DVT) Diabetes and Vascular Disease Fibromuscular Dysplasia High Blood Pressure and Vascular Disease Kidney Failure ...

  11. Severe digital ischemia due to systemic sclerosis successfully treated with bosentan: case report Tratamento de isquemia digital severa em paciente com esclerose sistêmica utilizando bosentana: relato de caso

    Directory of Open Access Journals (Sweden)

    Cesar José Guimarães Soares

    2007-09-01

    Full Text Available Systemic sclerosis (SSc is an autoimmune connective tissue disease characterized by cutaneous and visceral fibrosis and widespread vascular pathology. Raynaud's phenomenon is one of the most common manifestations of SSc. It may lead to complications such as digital ulceration and infarction and its treatment remains elusive. We present the case of a female patient with severe digital ischemia secondary to SSc. Treatment using vasodilators and prostacyclin analogues was ineffective, but the patient experienced a remarkable response to bosentan, a dual endothelin receptor antagonist. This report suggests that endothelin antagonists may benefit patients with SSc and vasculopathy as a major feature of the disease, including limb ischemia.Esclerose sistêmica (SSc é uma doença auto-imune do tecido conjuntivo caracterizada por fibrose cutânea e visceral, além de vasculopatia difusa.Ofenômeno deRaynaud é uma das manifestações mais comuns da SSc, que pode levar a complicações como úlceras digitais e infarto. Seu tratamento ainda é indefinido. Apresentamos o caso de uma paciente com isquemia digital grave secundária a SSc. O tratamento incluindo vasodilatadores e análogos de prostaciclina foi ineficaz, mas a paciente apresentou excelente resposta ao bosentan, um antagonista de receptores de endotelina. Este relato sugere que antagonistas de endotelina podem beneficiar pacientes com SSc e vasculopatia como principal característica da doença, incluindo isquemia de extremidades.

  12. ORTHOPEDIC LEG BRACE

    Science.gov (United States)

    Myers, William Neil (Inventor)

    2005-01-01

    Knee braces generally have been rigid in both the knee bending direction and in the knee straightening direction unless a manually operated release is incorporated in them to allow the knee to bend. Desirably a braced knee joint should effectively duplicate the compound, complex, actions of a normal knee. The key to knee braces is the knee joint housing. The housing herein carries a number of cam action pawls. with teeth adapted to engage the internal teeth of a ratchet ring mounted in the housing. Cam action return springs and the shape of the cam action pawl teeth allow rotation of the ratchet ring in a leg straightening direction while still supporting a load. The leg can then be extended during walking while at the same time being prevented by the cam action pawls from buckling in the knee bending direction.

  13. Restless legs syndrome.

    Science.gov (United States)

    Klingelhoefer, Lisa; Bhattacharya, Kalyan; Reichmann, Heinz

    2016-08-01

    Restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), is a common movement disorder characterised by an uncontrollable urge to move because of uncomfortable, sometimes painful sensations in the legs with a diurnal variation and a release with movement. The pathophysiology is only partially known and a genetic component together with dopaminergic and brain iron dysregulation plays an important role. Secondary causes for RLS need to be excluded. Treatment depends on the severity and frequency of RLS symptoms, comprises non-pharmacological (eg lifestyle changes) and pharmacological interventions (eg dopaminergic medication, alpha-2-delta calcium channel ligands, opioids) and relieves symptoms only. Augmentation is the main complication of long-term dopaminergic treatment of RLS. This article will provide a clinically useful overview of RLS with provision of diagnostic criteria, differential diagnoses, possible investigations and different treatment strategies with their associated complications. © 2016 Royal College of Physicians.

  14. Venous Leg Ulcers.

    Science.gov (United States)

    Vivas, Alejandra; Lev-Tov, Hadar; Kirsner, Robert S

    2016-08-02

    This issue provides a clinical overview of venous leg ulcers, focusing on prevention, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  15. have a hollow leg

    Institute of Scientific and Technical Information of China (English)

    周立

    2003-01-01

    英语对话 A:We must prevent our family members from getting involved with drugs, really. B:That’s a sure thing.We must make sure that they never involve them- selves with that. A:By the way,does your husband drink a lot? B:Yeah.That’s the only thing that keeps worrying me.And he often boasts that he has a hollow leg and nobody can drink him under the ta- ble.

  16. Update in restless legs syndrome

    Science.gov (United States)

    Salas, Rachel E.; Gamaldo, Charlene E.; Allen, Richard P.

    2016-01-01

    Purpose of review Although restless legs syndrome (RLS) is a disorder recognized in the medical literature since the 17th century, there have only recently been significant clinical and scientific advances in diagnosis, epidemiology and understanding the disorder, mainly due to the advent of dopaminergic treatment. Recent findings Recent discoveries have uncovered the iron–dopamine connection in RLS and the basic dopaminergic pathology related to the RLS symptoms. These have led to new understanding of the morbidity of RLS and the many conditions associated with RLS, which have also supported new approaches to treatment. These developments are each briefly described here. Summary Although there has been progress in understanding, diagnosing and treating RLS, it remains an underdiagnosed and undertreated condition severely impairing functioning of patients with moderate-to-severe disease. Much work is needed to improve on current, as well as other novel therapies. PMID:20581683

  17. Quadrupedal gaits in hexapod animals - inter-leg coordination in free-walking adult stick insects.

    Science.gov (United States)

    Grabowska, Martyna; Godlewska, Elzbieta; Schmidt, Joachim; Daun-Gruhn, Silvia

    2012-12-15

    The analysis of inter-leg coordination in insect walking is generally a study of six-legged locomotion. For decades, the stick insect Carausius morosus has been instrumental for unravelling the rules and mechanisms that control leg coordination in hexapeds. We analysed inter-leg coordination in C. morosus that freely walked on straight paths on plane surfaces with different slopes. Consecutive 1.7 s sections were assigned inter-leg coordination patterns (which we call gaits) based on footfall patterns. Regular gaits, i.e. wave, tetrapod or tripod gaits, occurred in different proportions depending on surface slopes. Tetrapod gaits were observed most frequently, wave gaits only occurred on 90 deg inclining slopes and tripod gaits occurred most often on 15 deg declining slopes, i.e. in 40% of the sections. Depending on the slope, 36-66% of the sections were assigned irregular gaits. Irregular gaits were mostly due to multiple stepping by the front legs, which is perhaps probing behaviour, not phase coupled to the middle legs' cycles. In irregular gaits, middle leg and hindleg coordination was regular, related to quadrupedal walk and wave gaits. Apparently, front legs uncouple from and couple to the walking system without compromising middle leg and hindleg coordination. In front leg amputees, the remaining legs were strictly coordinated. In hindleg and middle leg amputees, the front legs continued multiple stepping. The coordination of middle leg amputees was maladapted, with front legs and hindlegs performing multiple steps or ipsilateral legs being in simultaneous swing. Thus, afferent information from middle legs might be necessary for a regular hindleg stepping pattern.

  18. Differential diagnosis of leg ulcers.

    Science.gov (United States)

    Pannier, F; Rabe, E

    2013-03-01

    Leg and foot ulcers are symptoms of very different diseases. The aim of this paper is to demonstrate the differential diagnosis of leg ulcers. The majority of leg ulcers occur in the lower leg or foot. In non-venous ulcers the localization in the foot area is more frequent. The most frequent underlying disease is chronic venous disease. In 354 leg ulcers, Koerber found 75.25% venous leg ulcers, 3.66% arterial leg ulcers, 14.66% ulcers of mixed venous and arterial origin and 13.5% vasculitic ulcers. In the Swedish population of Skaraborg, Nelzen found a venous origin in 54% of the ulcer patients. Each leg ulcer needs a clinical and anamnestic evaluation. Duplex ultrasound is the basic diagnostic tool to exclude vascular anomalies especially chronic venous and arterial occlusive disease. Skin biopsies help to find a correct diagnosis in unclear or non-healing cases. In conclusion, chronic venous disease is the most frequent cause of leg ulcerations. Because 25% of the population have varicose veins or other chronic venous disease the coincidence of pathological venous findings and ulceration is very frequent even in non-venous ulcerations. Leg ulcers without the symptoms of chronic venous disease should be considered as non-venous.

  19. [Cerebral ischemia and histamine].

    Science.gov (United States)

    Adachi, Naoto

    2002-10-01

    Cerebral ischemia induces excess release of glutamate and an increase in the intracellular Ca2+ concentration, which provoke catastrophic enzymatic processes leading to irreversible neuronal injury. Histamine plays the role of neurotransmitter in the central nervous system, and histaminergic fibers are widely distributed in the brain. In cerebral ischemia, release of histamine from nerve endings has been shown to be enhanced by facilitation of its activity. An inhibition of the histaminergic activity in ischemia aggravates the histologic outcome. In contrast, intracerebroventricular administration of histamine improves the aggravation, whereas blockade of histamine H2 receptors aggravates ischemic injury. Furthermore, H2 blockade enhances ischemic release of glutamate and dopamine. These findings suggest that central histamine provides beneficial effects against ischemic neuronal damage by suppressing release of excitatory neurotransmitters. However, histaminergic H2 action facilitates the permeability of the blood-brain barrier and shows deleterious effects on cerebral edema.

  20. Adaptive leg coordination with a biologically inspired neurocontroller

    Science.gov (United States)

    Braught, Grant; Thomopoulos, Stelios C.

    1996-10-01

    Natural selection is responsible for the creation of robust and adaptive control systems. Nature's control systems are created only from primitive building blocks. Using insect neurophysiology as a guide, a neural architecture for leg coordination in a hexapod robot has been developed. Reflex chains and sensory feedback mechanisms from various insects and crustacea form the basis of a pattern generator for intra-leg coordination. The pattern generator contains neural oscillators which learn from sensory feedback to produce stepping patterns. Using sensory feedback as the source of learning information allows the pattern generator to adapt to changes in the leg dynamics due to internal or external causes. A coupling between six of the single leg pattern generators is used to produce the inter-leg coordination necessary to establish stable gaits.

  1. Leg cramps and restless legs syndrome during pregnancy.

    Science.gov (United States)

    Hensley, Jennifer G

    2009-01-01

    Sleep disturbance during pregnancy can result in excessive daytime sleepiness, diminished daytime performance, inability to concentrate, irritability, and the potential for an increased length of labor and increased risk of operative birth. Sleep disturbance may be the result of a sleep disorder, such as leg cramps, a common yet benign disorder, or restless legs syndrome, a sensorimotor disorder. Both disrupt sleep, are distressing to the pregnant woman, and mimic one another and other serious disorders. During pregnancy, up to 30% of women can be affected by leg cramps, and up to 26% can be affected by restless legs syndrome.

  2. Impact of Restless Legs Syndrome on Cardiovascular Autonomic Control.

    Science.gov (United States)

    Bertisch, Suzanne M; Muresan, Cristen; Schoerning, Laura; Winkelman, John W; Taylor, J Andrew

    2016-03-01

    To examine whether patients with restless legs syndrome demonstrate specific alterations in cardiovascular autonomic control. Patients with moderate-severe restless legs syndrome (n = 20, 80% female) and controls (n = 20) matched for age, sex, body mass index, and free of hypertension and cardiovascular disease were enrolled. We assessed cardiovagal baroreflex gain via the modified Oxford technique, sympathetically mediated vascular responses to isometric exercise to fatigue, bradycardiac response to Valsalva maneuver, and respiratory sinus arrhythmia during paced breathing. Standard electrocardiography, beat-by-beat arterial pressure, respiration, and popliteal blood flow velocity were recorded continuously. Resting blood pressure and heart rate were similar between groups. However, baroreflex gain averaged 14.3 ± 1.4 msec/mm Hg in restless legs syndrome and was lower than in controls (22.6 ± 3.5 msec/mm Hg, P = 0.04). Hemodynamic responses to isometric exercise were similar between groups, though participants with restless legs syndrome had lower leg blood flow (P leg vascular resistance (P legs syndrome demonstrate compromised cardiovagal control, specific to the arterial baroreflex, with greater peripheral vascular resistance, potentially due to heightened sympathetic outflow. These autonomic alterations may directly relate to the higher prevalence of cardiovascular disease in restless legs syndrome. © 2016 Associated Professional Sleep Societies, LLC.

  3. Evaluation of a postulated loss of coolant accident (LOCA) due to a 160 cm{sup 2} break in a cold leg of Angra 2 nuclear power plant[LOCA; RELAP-5/MOD3.2.2g; nodalization]; Calculo do acidente postulado de perda de refrigerante por uma ruptura de 160 cm{sup 2} na perna fria da central nuclear Angra 2

    Energy Technology Data Exchange (ETDEWEB)

    Azevedo, Carlos Vicente Goulart de; Palmieri, Elcio Tadeu; Aronne, Ivan Dionysio [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), Belo Horizonte, MG (Brazil)

    2002-07-01

    The development of a qualified full nodalization of Angra2 NPP for RELAP5/Mod 3.2.2 gamma, aiming at the evaluation of a comprehensive number of accidents and transients, thus providing suitable safety analysis support for licensing purposes, is being carried out within the framework of CNEN internal technical cooperation, involving some of its institutes (CDTN, IPEN and IEN) and the Reactors Coordination (CODRE). This work presents a simulation of a postulated Angra2 small cold leg break loss of coolant accident (SBLOCA). A 160 cm{sup 2} break is supposed to occur at one cold leg between the main coolant pump and the reactor vessel and is described in the Angra2 Final Safety Analysis Report, section 15.6.4.1.3.4. The simulation of several types of transients and accidents is necessary to verify the adequate performance of the modeled logic and systems. In general, the analysis of such and accident allows to demonstrate the safety Injection System performance and the reliable transition between the high pressure safety injection, the accumulator injection and the residual heat removal phases. Furthermore, it is assumed that some components are out of service due to fail or repair in order to make a conservative analysis. The results showed a compatible behavior of the molded systems and that the simulated Emergency Core Cooling System was able to provide sufficient cooling to avoid any damage to the core. (author)

  4. [Tonic pupil caused by ischemia].

    Science.gov (United States)

    Wilhelm, H

    1989-01-01

    Tonic pupil is usually an idiopathic condition. In some cases, the cause of the ciliary ganglion lesion leading to tonic pupils is obvious. Rarely ischemia causes a lesion of the ciliary ganglion or the short ciliary nerves due to the good blood supply of the ciliary ganglion. Only two cases of tonic pupils in the course of giant cell arteritis are mentioned in the literature, but tonic pupils are probably much more common with this disease. Five cases are demonstrated here. All had associated ischemic optic neuropathy, and stagnation of the blood flow in the supratrochlear artery could be demonstrated in two cases by Doppler sonography. Tonic pupils may also occur when an oclusion of the internal carotid artery resolves, probably because of transient stasis of the orbital blood flow. In another case, tonic pupils were associated with choroidal ischemia (proved by video fluorescent angiography) of unknown origin. The diagnosis of tonic pupils was made by pharmacological testing for cholinergic hypersensitivity with 0.1% pilocarpine.

  5. Silent ischemia and severity of pain in acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, F E; Nielsen, S L; Knudsen, F

    1991-01-01

    An overall low tendency to complain of pain, due to a low perception of pain, has been suggested in the pathogenesis of silent ischemia, independent of the extent of the diseased coronaries and a history of previous acute myocardial infarction. This hypothesis has been tested indirectly...... in this retrospective study by comparison of the use of analgesics during admission for a first acute myocardial infarction with the occurrence of silent ischemia at exertion tests four weeks after discharge from hospital. The study did not show a lower use of analgesics in patients with silent ischemia, but this may...

  6. Differentiating nocturnal leg cramps and restless legs syndrome.

    Science.gov (United States)

    Rana, Abdul Qayyum; Khan, Fatima; Mosabbir, Abdullah; Ondo, William

    2014-07-01

    Leg pain and discomfort are common complaints in any primary physician's clinic. Two common causes of pain or discomfort in legs are nocturnal leg cramps (NLC) and restless leg syndrome (RLS). NLC present as painful and sudden contractions mostly in part of the calf. Diagnosis of NLC is mainly clinical and sometimes involves investigations to rule out other mimics. RLS is a condition characterized by the discomfort or urge to move the lower limbs, which occurs at rest or in the evening/night. The similarity of RLS and leg cramps poses the issue of errors in diagnosing and differentiating the two. In this paper we review the pathopysiology of each entity and their diagnosis as well as treatment. The two conditions are then compared to appreciate the differences and similarities. Finally, suggestions are recommended for complete assessment.

  7. [Restless-legs syndrome].

    Science.gov (United States)

    Karroum, E; Konofal, E; Arnulf, I

    2008-01-01

    Restless-legs syndrome (RLS) is a sensorimotor disorder, characterized by an irresistible urge to move the legs usually accompanied or caused by uncomfortable and unpleasant sensations. It begins or worsens during periods of rest or inactivity, is partially or totally relieved by movements and is exacerbated or occurs at night and in the evening. RLS sufferers represent 2 to 3% of the general population in Western countries. Supportive criteria include a family history, the presence of periodic-leg movements (PLM) when awake or asleep and a positive response to dopaminergic treatment. The RLS phenotypes include an early onset form, usually idiopathic with a familial history and a late onset form, usually secondary to peripheral neuropathy. Recently, an atypical RLS phenotype without PLM and l-DOPA resistant has been characterized. RLS can occur in childhood and should be distinguished from attention deficit/hyperactivity disorder, growing pains and sleep complaints in childhood. RLS should be included in the diagnosis of all patients consulting for sleep complaints or discomfort in the lower limbs. It should be differentiated from akathisia, that is, an urge to move the whole body without uncomfortable sensations. Polysomnographic studies and the suggested immobilization test can detect PLM. Furthermore, an l-DOPA challenge has recently been validated to support the diagnosis of RLS. RLS may cause severe-sleep disturbances, poor quality of life, depressive and anxious symptoms and may be a risk factor for cardiovascular disease. In most cases, RLS is idiopathic. It may also be secondary to iron deficiency, end-stage renal disease, pregnancy, peripheral neuropathy and drugs, such as antipsychotics and antidepressants. The small-fiber neuropathy can mimic RLS or even trigger it. RLS is associated with many neurological and sleep disorders including Parkinson's disease, but does not predispose to these diseases. The pathophysiology of RLS includes an altered brain

  8. Klinefelter Syndrome With Leg Ulcers

    Directory of Open Access Journals (Sweden)

    Narendra G

    1999-01-01

    Full Text Available Leg ulcers are frequently caused by venous insufficiency, arterial insufficiency, neuropathy, or a combination of these factors. Klinefelter syndrome in association with chronic leg ulcers have been reported earlier. We report a case of Klinefelter syndrome with non- healing ulcer. The diagnosis of the Klinefelter syndrome was confirmed by karyotyping.

  9. Biomechanics of Counterweighted One-Legged Cycling.

    Science.gov (United States)

    Elmer, Steven J; McDaniel, John; Martin, James C

    2016-02-01

    One-legged cycling has served as a valuable research tool and as a training and rehabilitation modality. Biomechanics of one-legged cycling are unnatural because the individual must actively lift the leg during flexion, which can be difficult to coordinate and cause premature fatigue. We compared ankle, knee, and hip biomechanics between two-legged, one-legged, and counterweighted (11.64 kg) one-legged cycling. Ten cyclists performed two-legged (240 W), one-legged (120 W), and counterweighted one-legged (120 W) cycling (80 rpm). Pedal forces and limb kinematics were recorded to determine work during extension and flexion. During counterweighted one-legged cycling relative ankle dorsiflexion, knee flexion, and hip flexion work were less than one-legged but greater than two-legged cycling (all P cycling were greater than one-legged but less than two-legged cycling (all P cycling reduced but did not eliminate differences in joint flexion and extension actions between one- and two-legged cycling. Even with these differences, counterweighted one-legged cycling seemed to have advantages over one-legged cycling. These results, along with previous work highlighting physiological characteristics and training adaptations to counterweighted one-legged cycling, demonstrate that this exercise is a viable alternative to one-legged cycling.

  10. Genetics Home Reference: restless legs syndrome

    Science.gov (United States)

    ... Johns Hopkins Medicine MalaCards: restless legs syndrome Merck Manual Professional Version Patient Support and Advocacy Resources (3 links) European Alliance for Restless Legs Syndrome National Organization for Rare Disorders (NORD) Restless Leg Syndrome Foundation ...

  11. Diagnosis and management of splanchnic ischemia

    Institute of Scientific and Technical Information of China (English)

    Jeroen J Kolkman; Marloes Bargeman; Ad B Huisman; Robert H Geelkerken

    2008-01-01

    Splanchnic or gastrointestinal ischemia is rare and randomized studies are absent.This review focuses on new developments in clinical presentation,diagnostic approaches,and treatments.Splanchnic ischemia can be caused by occlusions of arteries or veins and by physiological vasoconstriction during low-flow states.The prevalence of significant splanchnic arterial stenoses is high,but it remains mostly asymptomatic due to abundant collateral circulation.This is known as chronic splanchnic disease (CSD).Chronic splanchnic syndrome (CSS) occurs when ischemic symptoms develop.Ischemic symptoms are characterized by postprandial pain,fear of eating and weight loss.CSS is diagnosed by a test for actual ischemia.Recently,gastro-intestinal tonometry has been validated as a diagnostic test to detect splanchnic ischemia and to guide treatment.In singlevessel CSD,the complication rate is very low,but some patients have ischemic complaints,and can be treated successfully.In multi-vessel stenoses,the complication rate is considerable,while most have CSS and treatment should be strongly considered.CT and MR-based angiographic reconstruction techniques have emerged as alternatives for digital subtraction angiography for imaging of splanchnic vessels.Duplex ultrasound is still the first choice for screening purposes.The strengths and weaknesses of each modality will be discussed.CSS may be treated by minimally invasive endoscopic treatment of the celiac axis compression syndrome,endovascular antegrade stenting,or laparotomy-assisted retrograde endovascular recanalization and stenting.The treatment plan is highly individualized and is mainly based on precise vessel anatomy,body weight,comorbidity and severity of ischemia.

  12. Prognosis of critical limb ischemia: Major vs. minor amputation comparison.

    Science.gov (United States)

    Matsuzaki, Kyoichi; Hayashi, Ruka; Okabe, Keisuke; Aramaki-Hattori, Noriko; Kishi, Kazuo

    2015-09-01

    Healthcare providers treating wounds have difficulties assessing the prognosis of patients with critical limb ischemia who had been discharged after complete healing of major amputation wounds. The word "major" in "major amputation" gives the impression of "being more severe" than "minor amputation." Therefore, even if wounds are healed after major amputation, they imagine that prognosis after major amputation would be poorer than that after minor amputation. We investigated the prognosis of diabetic nephropathy patients 2 years after amputations. Those patients underwent dialysis as well as amputation following percutaneous transluminal angioplasty for their foot wounds. They were ambulatory prior to these surgeries. Among 56 cases of minor amputation, 45 were males and 11 were females, and mortality was 41.1%. The mortality of cases with and without a coronary intervention history was 53.1% and 25.0%, respectively (p = 0.034). Among 10 cases of major amputation, 9 were males and 1 was female, and mortality was 60%. The mortality of cases with and without a coronary intervention history was 75.0% and 0%, respectively. Although we predicted poor prognosis in cases with major amputation, there was no significant difference in mortality 2 years after amputations (p = 0.267). Thus far poor prognosis has been reported for major amputation. It might be due to inclusion of the following patients: patients with wounds proximal to ankle joints, patients with extensive gangrene spreading to the lower legs, patients with septicemia from wound infection and who died around the time of operation, and patients with malnutrition. The results of our present study showed that the outcomes at 2 years postoperatively were similar between patients with major amputations and those with minor amputations, if surgical wounds were able to heal. We should not estimate the prognosis by the level of amputation, rather we should consider the effect of coronary intervention history on

  13. Restless legs syndrome: literature review

    Directory of Open Access Journals (Sweden)

    Emmanouil Symvoulakis

    Full Text Available Restless legs syndrome is a distressing condition, with negative effects on sleep and daytime activities that affect personal, family and occupational life. The overall impact of restless legs syndrome on quality of life is comparable to that of chronic and frustrating conditions such as depression and diabetes. Misdiagnosis and inappropriate treatment may increase patients' suffering in terms of uncertainty, overuse or misuse of care services and lack of trust. Presenting a synthesis of the main topics in the literature on restless legs syndrome facilitates for a better understanding and its management in primary care settings.

  14. [Functional role of dragonfly legs before and after hatching: reorganization of coordinating interactions].

    Science.gov (United States)

    Sviderskiĭ, V L; Plotnikova, S I; Gorelkin, V S; Severina, I Iu; Isavnina, I L

    2012-11-01

    The characteristics of a structure-functional organization of leg apparatus were examined in the dragonfly Aeshna grandis: larvae of the final stadium, which legs perform a locomotion function and adults (imago) rising on a wing, which legs lose a locomotion function and are used mainly for catching a prey in the air. It has been demonstrated that legs of the imago practically do not differ from those of the larva either in shape or in proportion of segments of the leg and all changes in the functional role of legs of the imago are implemented due to modifications of mechanisms of limb muscle control and an appropriate reorganization or coordinating interactions. As it is proved by the obtained data, this reorganization concerns mechanisms of the generation of motor commands as well as close coordination of the activity of wing and leg apparatus and some others. The abovementioned mechanisms are discussed.

  15. Restless legs syndrome

    Directory of Open Access Journals (Sweden)

    Ovallath S

    2012-10-01

    Full Text Available Sujith Ovallath, P DeepaJames Parkinson's Movement Disorder Research Centre, Kannur Medical College, Kerala, IndiaBackground: Restless legs syndrome (RLS is a common sleep-related disorder characterized by abnormal sensation and an urge to move the lower limbs. Symptoms occur at rest in the evening or at night, and they are alleviated by moving the affected extremity or by walking. Although the exact etiopathogenesis of RLS remains elusive, the rapid improvement of symptoms with dopaminergic agents suggests that dopaminergic system dysfunction may be a basic mechanism. Dopaminergic agents are the best-studied agents, and are considered first-line treatment of RLS.Objective: To review the diagnostic criteria, clinical features, etiopathogenesis, and the treatment options of RLS.Methods: The suggestions are based on evidence from studies published in peer-reviewed journals, or upon a comprehensive review of the medical literature.Results/conclusion: Extensive data are available for proving the link between the dopaminergic system and RLS. A possible genetic link also has been studied extensively. Dopamine agonists, especially pramipexole and ropinirole, are particularly useful in the treatment of RLS. Pharmacological treatment should however be limited to those patients who suffer from clinically relevant RLS with impaired sleep quality or quality of life.Keywords: dopamine, levodopa, pramipexole

  16. Man with leg rash.

    Science.gov (United States)

    Hwang, Michael Huynh; Khesbak, Ziyad; Liu, Yiju Teresa

    2017-10-01

    A 51-year-old male presented to the ED with a rash to his left thigh (figure 1) with erythema, swelling and pain. He endorsed paraesthesias, pruritus, fevers, vomiting and diarrhoea. Initial vitals were unremarkable. He was well appearing with an 8×8 cm violaceous patch on his left medial thigh with vesicles, surrounding erythema and induration with a second, smaller lesion on the right thigh. Both rashes were extremely tender.emermed;34/10/686/F1F1F1Figure 1Erythematosus and vesicular rash in bilateral legs.A bedside ultrasound image of the rash was obtained (figure 2).emermed;34/10/686/F2F2F2Figure 2Bedside ultrasound of rash. What is the most likely cause of the patient's rash?A. Herpes zosterB. CellulitisC. Necrotising fasciitisD. Bullous pemphigoid. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Loss of legs: is it or not a handicap for an orb-weaving spider?

    Science.gov (United States)

    Pasquet, Alain; Anotaux, Mylène; Leborgne, Raymond

    2011-07-01

    Leg loss is a common phenomenon in spiders, and according to the species 5% to 40% of the adults can present at least one missing leg. There is no possibility of regeneration after adult moult and the animal must manage with its missing appendages until its death. With the loss of one or more legs, female orb-weaving spiders can be penalized twice: firstly, because the legs are necessary for web construction and secondly, the legs are essential for the control of the prey after its interception by the web. During development, spiders may be also penalized because regeneration has energetic costs that take away resources for survival, growth and reproduction. All these consequences should influence negatively the development of the spider and thus its fitness. We investigated the impact of leg loss in the orb-weaving spider, Zygiella x-notata by studying its frequency in a natural population and web building and prey capture behaviours in laboratory. In field populations, 9.5% to 13%, of the adult females presented the loss of one or more legs; the majority of individuals had lost only one leg (in 48% of cases, a first one). Leg loss seems to affect all the adult spiders, as there is no difference of mass between intact spiders and those with missing leg. Data obtained with laboratory-reared spiders, showed that the loss of legs due to the moult is rare (less than 1%). Considering changes in web design, spiders with missing legs decreased their silk investment, increased the distance between spiral turns but did not change the capture surface of the web. Under our laboratory experimental conditions, spiders with one or two lost legs did not present any difference in prey capture efficiency. In laboratory conditions, spiders with lost leg(s) did not show any difference in egg sac production or in longevity (adult lifespan) compared to intact spiders.

  18. [Restless legs syndrome - a review].

    Science.gov (United States)

    Sveinsson, Olafur Arni; Sigurdsson, Albert Pall

    2012-01-01

    Restless legs syndrome (RLS) is a common disorder with a prevalence between 10-20% in Iceland. There are two forms of RLS, idiopathic and secondary. Symptom onset of RLS before the age of 45 suggests an idiopathic form with no known underlying cause but inheritance. Symptom onset after age of 45 indicates a secondary form with an underlying cause without inheritance. Causes for secondary forms are for example: iron depletion, uraemia and polyneuropathy. Symptoms of RLS are uncomfortable and unpleasant deep sensations in the legs that are felt at rest, accompanied by an urge to move the legs, typically just before sleep. Accompanying RLS is a sleep disturbance that can lead to daytime somnolence, decreased quality of life, poor concentration, memory problems, depression and decreased energy. Dopamine agonists are currently the first line treatment for RLS. restless legs, periodic limb movements, sleep disturbance, dopamine agonists.

  19. Restless leg syndrome in pregnancy.

    Science.gov (United States)

    Grover, Aarti; Clark-Bilodeau, Courtney; D'Ambrosio, Carolyn M

    2015-09-01

    Restless leg syndrome, more recently renamed Willis-Ekbom disease, is a condition that disrupts sleep and occurs more frequently in the pregnant population. We present a 39-year-old woman with restless legs syndrome in the third trimester and discuss the epidemiology, pathophysiology and therapeutic options in the pregnant population while highlighting the challenges posed by the lack of safety data of approved drugs.

  20. Restless legs syndrome.

    Science.gov (United States)

    Miletić, Vladimir; Relja, Maja

    2011-12-01

    Being of the most frequent causes of insomnia, which in the end leads to chronic fatigue, inadequate performance of daily activities, and serious disruption of quality of living, restless legs syndrome (RLS) is nowadays not only a serious medical problem but a socio-economical one as well. Prevalence of the disorder in general population is estimated at 5 to 15%. Family history is positive in over 50% of idiopathic RLS patients which points to genetic basis of the disorder. The characteristics of the secondary or acquired form of RLS are symptoms that start later in life as well as a rapid progression of the disease. On the other hand, idiopathic RLS more often starts at a younger age and the prognoses are better. Over twenty disorders and conditions are brought in connection with secondary RLS. Although the cause of primary RLS is still unknown, there is a strong connection between central metabolism of iron as well as dopamine levels and RLS manifestation. A differential diagnosis of RLS includes a wide specter of motor and sensory disorders. Diagnosis is based on clinical features and the history of disease. To correctly diagnose idiopathic RLS one must first eliminate secondary causes of RLS and then also exclude any disorders with clinical features that mimic those of RLS. It has been estimated that some 20 to 25% of patients need pharmacological therapy. Best initial therapy is the application of nonergot dopamine agonists. Anticonvulsants, benzodiazepines and opioides can be given to patients who are refractory to dopaminergic therapy, those suffering from RLS with emphasized painful sensory component and those with RLS connected with insomnia.

  1. Delayed ischemic electrocortical suppression during rapid repeated cerebral ischemia and kainate-induced seizures in rat

    DEFF Research Database (Denmark)

    Ilie, Andrei; Spulber, Stefan; Avramescu, Sinziana;

    2006-01-01

    Global cerebral ischemia induces, within seconds, suppression of spontaneous electrocortical activity, partly due to alterations in synaptic transmission. In vitro studies have found that repeated brief hypoxic episodes prolong the persistence of synaptic transmission due to weakened adenosine re...

  2. Ischemia causes muscle fatigue

    Science.gov (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D. M.

    2001-01-01

    The purpose of this investigation was to determine whether ischemia, which reduces oxygenation in the extensor carpi radialis (ECR) muscle, causes a reduction in muscle force production. In eight subjects, muscle oxygenation (TO2) of the right ECR was measured noninvasively and continuously using near infrared spectroscopy (NIRS) while muscle twitch force was elicited by transcutaneous electrical stimulation (1 Hz, 0.1 ms). Baseline measurements of blood volume, muscle oxygenation and twitch force were recorded continuously, then a tourniquet on the upper arm was inflated to one of five different pressure levels: 20, 40, 60 mm Hg (randomized order) and diastolic (69 +/- 9.8 mm Hg) and systolic (106 +/- 12.8 mm Hg) blood pressures. Each pressure level was maintained for 3-5 min, and was followed by a recovery period sufficient to allow measurements to return to baseline. For each respective tourniquet pressure level, mean TO2 decreased from resting baseline (100% TO2) to 99 +/- 1.2% (SEM), 96 +/- 1.9%, 93 +/- 2.8%, 90 +/- 2.5%, and 86 +/- 2.7%, and mean twitch force decreased from resting baseline (100% force) to 99 +/- 0.7% (SEM), 96 +/- 2.7%, 93 +/- 3.1%, 88 +/- 3.2%, and 86 +/- 2.6%. Muscle oxygenation and twitch force at 60 mm Hg tourniquet compression and above were significantly lower (P ischemia leading to a 7% or greater reduction in muscle oxygenation causes decreased muscle force production in the forearm extensor muscle. Thus, ischemia associated with a modest decline in TO2 causes muscle fatigue.

  3. Ischemia causes muscle fatigue

    Science.gov (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D. M.

    2001-01-01

    The purpose of this investigation was to determine whether ischemia, which reduces oxygenation in the extensor carpi radialis (ECR) muscle, causes a reduction in muscle force production. In eight subjects, muscle oxygenation (TO2) of the right ECR was measured noninvasively and continuously using near infrared spectroscopy (NIRS) while muscle twitch force was elicited by transcutaneous electrical stimulation (1 Hz, 0.1 ms). Baseline measurements of blood volume, muscle oxygenation and twitch force were recorded continuously, then a tourniquet on the upper arm was inflated to one of five different pressure levels: 20, 40, 60 mm Hg (randomized order) and diastolic (69 +/- 9.8 mm Hg) and systolic (106 +/- 12.8 mm Hg) blood pressures. Each pressure level was maintained for 3-5 min, and was followed by a recovery period sufficient to allow measurements to return to baseline. For each respective tourniquet pressure level, mean TO2 decreased from resting baseline (100% TO2) to 99 +/- 1.2% (SEM), 96 +/- 1.9%, 93 +/- 2.8%, 90 +/- 2.5%, and 86 +/- 2.7%, and mean twitch force decreased from resting baseline (100% force) to 99 +/- 0.7% (SEM), 96 +/- 2.7%, 93 +/- 3.1%, 88 +/- 3.2%, and 86 +/- 2.6%. Muscle oxygenation and twitch force at 60 mm Hg tourniquet compression and above were significantly lower (P < 0.05) than baseline value. Reduced twitch force was correlated in a dose-dependent manner with reduced muscle oxygenation (r = 0.78, P < 0.001). Although the correlation does not prove causation, the results indicate that ischemia leading to a 7% or greater reduction in muscle oxygenation causes decreased muscle force production in the forearm extensor muscle. Thus, ischemia associated with a modest decline in TO2 causes muscle fatigue.

  4. Oligodendrogenesis after Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Ruilan eZhang

    2013-10-01

    Full Text Available AbstractNeural stem cells in the subventricular zone (SVZ of the lateral ventricle of adult rodent brain generate oligodendrocyte progenitor cells (OPCs that disperse throughout the corpus callosum and striatum where some of OPCs differentiate into mature oligodendrocytes. Studies in animal models of stroke demonstrate that cerebral ischemia induces oligodendrogenesis during brain repair processes. This article will review evidence of stroke-induced proliferation and differentiation of OPCs that are either resident in white matter or are derived from SVZ neural progenitor cells and of therapies that amplify endogenous oligodendrogenesis in ischemic brain.

  5. Restless Legs Syndrome and Leg Motor Restlessness in Parkinson's Disease

    Science.gov (United States)

    Miyamoto, Masayuki; Miyamoto, Tomoyuki; Hirata, Koichi

    2015-01-01

    Sleep disturbances are important nonmotor symptoms in Parkinson's disease (PD) that are associated with a negative impact on quality of life. Restless legs syndrome (RLS), which is characterized by an urge to move the legs accompanied by abnormal leg sensations, can coexist with PD, although the pathophysiology of these disorders appears to be different. RLS and PD both respond favorably to dopaminergic treatment, and several investigators have reported a significant relationship between RLS and PD. Sensory symptoms, pain, motor restlessness, akathisia, and the wearing-off phenomenon observed in PD should be differentiated from RLS. RLS in PD may be confounded by chronic dopaminergic treatment; thus, more studies are needed to investigate RLS in drug-naïve patients with PD. Recently, leg motor restlessness (LMR), which is characterized by an urge to move the legs that does not fulfill the diagnostic criteria for RLS, has been reported to be observed more frequently in de novo patients with PD than in age-matched healthy controls, suggesting that LMR may be a part of sensorimotor symptoms intrinsic to PD. In this paper, we provide an overview of RLS, LMR, and PD and of the relationships among these disorders. PMID:26504610

  6. Mesenteric Ischemia:An unusual presentation of fistula between superior mesenteric artery and common hepatic artery

    Institute of Scientific and Technical Information of China (English)

    Ertugrul Kayacetin; Serdar Karak(o)se; Aydin Karabacakoglu; Dilek Emlik

    2004-01-01

    Chronic mesenteric ischemia is an uncommon condition associated with a high morbidity and mortality. We reported a 36-year old women with postprandial abdominal pain due to chronic mesenteric ischemia caused by a fistula between superior mesenteric and common hepatic artery.

  7. Restless abdomen: a phenotypic variant of restless legs syndrome.

    Science.gov (United States)

    Pérez-Díaz, Hernando; Iranzo, Alex; Rye, David B; Santamaría, Joan

    2011-09-27

    A diagnosis of restless legs syndrome (RLS) requires an urge to move the legs in combination with sensory leg discomfort. Localization of the symptoms to other body areas in the absence of leg involvement is not recognized as part of the phenotypic spectrum of RLS. We describe 3 patients who presented with sensorimotor symptoms confined to the abdominal wall and, with the exception of not involving the legs, satisfied the primary and secondary diagnostic criteria for RLS. Patients underwent detailed clinical history, video-polysomnography, abdominal imaging, and serologic and genotyping assessment. Unpleasant abdominal symptoms emerged at night during periods of rest and were accompanied by an urge to move and temporized by movement. Patients reported sleep onset and sleep maintenance insomnia due to their abdominal symptomatology. Abdominal imaging was normal. Secondary features included periodic leg movements of sleep (PLMS), and dramatic symptom amelioration with the D(2)-D(3) dopaminergic agonist pramipexole. Two subjects were anemic. Conventional RLS emerged in one subject and resolved after dose escalation. Each subject was homozygous for the most common RLS/PLMS-associated risk allele in the BTBD9 gene. Our observations indicate that the restricted abdominal symptomatology manifest in our subjects represents a phenotypic variant of RLS. Physicians should be vigilant to the existence of this unique phenotype when encountering subjects who present with insomnia and abnormal abdominal sensations. Our experience emphasizes the importance of supportive clinical features in rendering a correct diagnosis such that the most cost-effective workups and treatment can be realized.

  8. Leg length, proportion, health and beauty: a review.

    Science.gov (United States)

    Bogin, Barry; Varela-Silva, Maria Inês

    2009-12-01

    Decomposing stature into its major components is proving to be a useful strategy to assess the antecedents of disease, morbidity and death in adulthood. Human leg length (foot + tibia + femur), sitting height (trunk length + head length) and their proportions (for example the relative leg length in proportion to stature, and the sitting height ratio [sitting height/stature x 100], among others) are used as epidemiological markers of risk for overweight (fatness), coronary heart disease, diabetes and certain cancers. There is also wide support for the use of relative leg length as an indicator of the quality of the environment for growth during infancy, childhood and the juvenile years of development. Human beings follow a cephalo-caudal gradient of growth, the pattern of growth common to all mammals. A special feature of the human pattern is that between birth and puberty the legs grow relatively faster than other post-cranial body segments. For groups of children and youth, short stature due to relatively short legs (i.e. a high sitting height ratio) is generally a marker of an adverse environment. The development of human body proportions is the product of environmental x genomic interactions, although few if any specific genes are known. The short stature homeobox-containing gene (SHOX) is the first genomic region that may be relevant to human body proportions. For example, one of the SHOX related disorders is Turner syndrome. However, in most cases research has been showing that environment is a more powerful force to shape leg length and body proportions than genes. Leg length and proportion are important in the perception of human beauty, which is often considered a sign of health and fertility. There are a variety of cosmetic, fashion, and surgical interventions to enhance perceived or actual leg length.

  9. Coordinated intelligent adaptive control of legged robots

    Science.gov (United States)

    McLauchlan, Lifford; Mehrübeoğlu, Mehrübe

    2006-05-01

    In planetary or hazardous environment exploration, there will be unforseen environmental circumstances which can not be planned. To overcome telerobotic control issues due to communication delays, autonomous robot control becomes necessary. Autonomously controlled landers and instrumentation can be used in exploration, such as lunar and martian missions. However, wheeled robots have difficulty in exploring uneven terrain; thus, legged robots can be used in such situations. This research develops intelligent and adaptive control of mobile robots to perform functions such as environmental exploration in coordination and obstacle avoidance. The coordinated control is demonstrated in simulations.

  10. Restless legs syndrome and periodic leg movements of sleep.

    Science.gov (United States)

    Rye, David B; Trotti, Lynn Marie

    2012-11-01

    Women are more commonly affected than men by restless legs syndrome, and prevalence is highest amongst those of northern European heritage. The motor manifestations include nonvolitional myoclonus (periodic leg movements). Disinhibition of spinal sensorimotor circuits may underlie these primary features and can be affected by peripheral as well as supraspinal networks. Insufficient mobilizable iron stores increase expressivity in some individuals. The sensorimotor features are relieved by dopamine, especially dopamine agonists, gabapentin and its derivatives, and opioids. A diagnosis relies on recognition of key primary and supportive features, and treatments are generally well tolerated, efficacious, and life-changing. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Oxaliplatin Induced Digital Ischemia and Necrosis

    Directory of Open Access Journals (Sweden)

    Kubilay Karabacak

    2015-01-01

    Full Text Available Introduction. Digital ischemia is a rare complication of several chemotherapeutic medications. We aimed to present a patient with digital ischemia, secondary to a new generation chemotherapeutic drug, oxaliplatin. Case Report. 62-year-old woman presented to our department with severe pain, paresthesia, and distal acrocyanosis on her right hand fingertips. Her complaints started five days after the third cycle of a chemotherapy protocol consisting of 5-fluorourasil (5-FU, folinic acid, and oxaliplatin due to advanced colon carcinoma. On physical examination, hemorrhagic and partly ulcerative lesions were detected at her right hand fingertips. Radial and ulnar pulses were absent at affected side. Digital subtraction angiography revealed severe vascular resistance in the affected extremity. Iloprost trometamol treatment was started with the dosage of 1 ng/kg/min. In addition, low-molecule-weight heparin was used for preventing possible microemboli. Symptomatic relief was provided after five days, and patient was discharged on 7th day of treatment. Discussion. The pathogenesis of oxaliplatin induced vascular toxicity remains unclear. Endothelial damage, increased adherence of platelets, deposition of immune complexes as an immunologic effect of oxaliplatin, and hypercoagulable state may be the reason for arterial thrombosis, digital microemboli, possible digital ischemia, and their several consequences.

  12. Post-Traumatic Late Onset Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Gencer Genc

    2014-03-01

    Full Text Available Artery-to-artery emboli or occlusion of craniocervical arteries mostly due to dissection are the most common causes of ischemia after trauma. A 29 year-old male had been admitted to another hospital with loss of consciousness lasting for about 45 minutes after a hard parachute landing without head trauma three days ago. As his neurological examination and brain CT were normal, he had been discharged after 24 hours of observation. Two days after his discharge, he was admitted to our department with epileptic seizure. His neurological examination revealed left hemianopia. After observing occipital subacute ischemia at right side in brain magnetic resonance imaging (MRI, we performed cerebral angiography and no dissection was observed. Excluding the rheumatologic, cardiologic and vascular events, our final diagnosis was late onset cerebral ischemia. Anti-edema and antiepileptic treatment was initiated. He was discharged with left hemianopia and mild cognitive deficit. We suggest that it will be wise to hospitalize patients for at least 72 hours who has a history of unconsciousness following trauma.

  13. Myocardic extended ischemia after scombroid syndrome

    Directory of Open Access Journals (Sweden)

    Maria Serena Bassoni

    2006-08-01

    Full Text Available We describe a case of a healthy woman, presenting to the emergency department because of sudden onset of diffuse pruriginous erythema, profound arterial hypotension and anginal chest pain, just after consuing a meal with cooked fresh tuna fish. She developed progressive ECG signs of myocardial ischemia suggesting subendocardial infarction and increased serum level of troponin I. After vigourous fluid resuscitation with iv fluids and treatment with anti-hystamine drugs, corticosteroids, beta-blockers and calcium-channell blockers she progressively recovered. A clinical diagnosis of sgombroid syndrome was established: it is a syndrome which may follow the ingestion of some spoiled fish, characterized by urticara, headhache, gastrointestinal upset and rarely bronchospasm, shock, coronary ischemia and arrythmias. A sample of the consumed fish could be analysed, finding a very high level of hystamine concentration, conferming the diagnosis of sgombroid syndrome. A coronary angiography was performed and confermed the patient had a normal coronary tree, devoid of atherosclerotic lesions. Her anginal symptoms and ECG signs were probably due to functional ischemia determined by hystamine mediated vasoconstriction and hypotension. This not so rare but not well known syndrome is further discussed and addressed to the emergency physicians’ attention, because of its importance in the differential diagnoses of suspected food allergies

  14. Promethus Hot Leg Piping Concept

    Energy Technology Data Exchange (ETDEWEB)

    AM Girbik; PA Dilorenzo

    2006-01-24

    The Naval Reactors Prime Contractor Team (NRPCT) recommended the development of a gas cooled reactor directly coupled to a Brayton energy conversion system as the Space Nuclear Power Plant (SNPP) for NASA's Project Prometheus. The section of piping between the reactor outlet and turbine inlet, designated as the hot leg piping, required unique design features to allow the use of a nickel superalloy rather than a refractory metal as the pressure boundary. The NRPCT evaluated a variety of hot leg piping concepts for performance relative to SNPP system parameters, manufacturability, material considerations, and comparison to past high temperature gas reactor (HTGR) practice. Manufacturability challenges and the impact of pressure drop and turbine entrance temperature reduction on cycle efficiency were discriminators between the piping concepts. This paper summarizes the NRPCT hot leg piping evaluation, presents the concept recommended, and summarizes developmental issues for the recommended concept.

  15. Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report

    Directory of Open Access Journals (Sweden)

    Van De Winkel Nele

    2012-02-01

    Full Text Available Abstract Introduction Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs. Case presentation We report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study. Conclusion Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.

  16. Reconstruction of an external hemipelvectomy defect with a two-stage fillet of leg-free flap.

    Science.gov (United States)

    Boehmler, James H; Francis, Stacey H; Grawe, Roxanne K; Mayerson, Joel L

    2010-05-01

    The defect created by external hemipelvectomy for bone and soft tissue tumor resection is a challenge to reconstruct because of the exposure of bone, neurovascular structures, and peritoneal contents, particularly in the setting of previous radiotherapy. In a nonsalvageable limb with extensive tumor involvement and radiation damage, a free fillet of leg flap can be used to provide the necessary large volume of tissue for reconstruction without donor site morbidity. Because of the lengthy operative time for the hemipelvectomy procedure, the fillet of leg flap may be subject to long ischemia time and a subsequently compromised outcome. A two-stage fillet of leg flap for a hemipelvectomy defect was performed with two goals: to decrease ischemia time and to allow the necessary resuscitation of the patient between operative stages. Stage one was dissection of a lower fillet of leg flap, transfer and anastomosis to the contralateral femoral vessels, and temporary inset in the groin. The patient and flap were observed in the intensive care unit for several days. The patient returned to the operating room 3 days later for staged external hemipelvectomy and inset of the viable fillet of leg flap. Throughout follow-up, the reconstructive results and functional outcome were excellent.

  17. Adipose derived stem cell transplantation is better than bone marrow mesenchymal stem cell transplantation in treating hindlimb ischemia in mice

    Directory of Open Access Journals (Sweden)

    Ngoc Bich Vu

    2016-09-01

    Full Text Available Introduction: Bone marrow derived MSCs (BM-MSCs and adipose derived MSCs (AD-MSCs are among the types of stem cells most commonly studied. Our study aims to compare the therapeutic efficacy of allograft AD-MSCs versus BM-MSCs in a mouse model of hindlimb ischemia. Methods: AD-MSCs were isolated from belly fat and BM-MSCs were isolated from femur bone marrow. They were used to treat mice with acute hindlimb ischemia. Treatment efficacy was compared among 4 groups: injected with BM-MSCs, injected with AD-MSCs, non-treated and injected with phosphate buffered saline. Mice in the groups were evaluated for the following: necrosis grade of leg, leg edema, blood flow, muscle cell restructure and new blood vessel formation. Results: Results showed that AD-MSC transplantation significantly recovered acute limb ischemia, with 76.5% of mice fully recovered, while the ratio was only 48.5% in BM-MSC transplanted group, and 0% in the non-treated and PBS groups. Evaluation of leg edema, blood flow, muscle cell restructure and new blood vessel formation also supported the observation that AD-MSC transplantation was superior over BM-MSC transplantation. Conclusion: Therefore, AD-MSCs may serve as the more suitable MSC for hindlimb ischemia treatment and angiogenesis therapy. [Biomed Res Ther 2016; 3(9.000: 844-856

  18. The Acute Compartment Syndrome of the Lower Leg: A Difficult Diagnosis?

    NARCIS (Netherlands)

    J. Vlot; M.G. Eversdijk (Martin); D. den Hartog (Dennis); P.P. Oprel (Pim); W.E. Tuinebreijer (Wim)

    2010-01-01

    textabstractThree patients, two adults and one child, developed an acute compartment syndrome of the lower leg. Due to delay in diagnosis, severe complications developed, resulting in two transfemoral amputations. In the youngest patient, the lower leg was able to be saved after extensive reconstruc

  19. The Acute Compartment Syndrome of the Lower Leg: A Difficult Diagnosis?

    NARCIS (Netherlands)

    J. Vlot; M.G. Eversdijk (Martin); D. den Hartog (Dennis); P.P. Oprel (Pim); W.E. Tuinebreijer (Wim)

    2010-01-01

    textabstractThree patients, two adults and one child, developed an acute compartment syndrome of the lower leg. Due to delay in diagnosis, severe complications developed, resulting in two transfemoral amputations. In the youngest patient, the lower leg was able to be saved after extensive

  20. The training stimulus experienced by the leg muscles during cycling in humans.

    Science.gov (United States)

    McPhee, Jamie S; Williams, Alun G; Stewart, Claire; Baar, Keith; Schindler, Joaquin Perez; Aldred, Sarah; Maffulli, Nicola; Sargeant, Anthony J; Jones, David A

    2009-06-01

    Considerable variability exists between people in their health- and performance-related adaptations to conventional endurance training. We hypothesized that some of this variability might be due to differences in the training stimulus received by the working muscles. In 71 young sedentary women we observed large variations in the ratio of one-leg cycling muscle aerobic capacity (V(O2peak)) to two-leg cycling whole-body maximal oxygen uptake (V(O2max); Ratio(1:2); range 0.58-0.96). The variability in Ratio(1:2) was primarily due to differences between people in one-leg V(O2peak) (r = 0.71, P < 0.0005) and was not related to two-leg V(O2max) (r = 0.15, P = 0.209). Magnetic resonance imaging (n = 30) and muscle biopsy sampling (n = 20) revealed that one-leg V(O2peak) was mainly determined by muscle volume (r = 0.73, P < 0.0005) rather than muscle fibre type or oxidative capacity. A high one-leg V(O2peak) was associated with favourable lipoprotein profiles (P = 0.033, n = 24) but this was not the case for two-leg V(O2max). Calculations based on these data suggest that conventional two-leg exercise at 70% V(O2max) requires subjects with the lowest Ratio(1:2) to work their legs at 60% of single-leg V(O2peak), whilst those with the highest Ratio(1:2) work their legs at only 36% of maximum. It was concluded that endurance training carried out according to current guidelines will result in highly variable training stimuli for the leg muscles and variable magnitudes of adaptation. These conclusions have implications for the prescription of exercise to improve health and for investigations into the genetic basis of muscle adaptations.

  1. FAQs on leg ulcer care.

    Science.gov (United States)

    Anderson, Irene; King, Brenda; Knight, Susan; Keynes, Milton

    In a webchat on leg ulcer management issues, hosted by Nursing Times, participants raised three key areas of care: the role of healthcare assistants in compression bandaging; reporting and investigating damage caused by compression therapy; and recommendations for dressings to be used under compression. This article discusses each of these in turn.

  2. The ArtAssist Device in chronic lower limb ischemia. A pilot study.

    Science.gov (United States)

    Louridas, G; Saadia, R; Spelay, J; Abdoh, A; Weighell, W; Arneja, A S; Tanner, J; Guzman, R

    2002-03-01

    Patients with chronic critical limb ischemia following a failed bypass graft or with non-reconstructable distal disease diagnosed angiographically, have a very poor prognosis. This is a prospective pilot study to assess the influence of the ArtAssist Device on pedal blood flow and amputation rate. Thirty-three legs in 25 patients were evaluated. Ten legs presented with rest pain, and 23 legs with tissue loss. Nine legs had previously undergone bypass surgery. At a mean follow-up of 3 months, 14 (42%) legs were amputated, and 19 (58%) were saved. Eleven of the amputated legs were in patients with chronic renal failure, a known risk factor. The amputation rate, excluding this group, was 13.6% (3/22). Toe pressures measured initially and after 3 months on the pump showed a significant improvement (p=0.03). Forty percent of patients presenting with rest pain improved, while 26% of foot ulcers healed on the pump. Mortality rate was 12%. The results from this prospective study are encouraging but need to be validated in a larger prospective randomized study.

  3. Bed rest attenuates sympathetic and pressor responses to isometric exercise in antigravity leg muscles in humans.

    Science.gov (United States)

    Kamiya, Atsunori; Michikami, Daisaku; Shiozawa, Tomoki; Iwase, Satoshi; Hayano, Junichiro; Kawada, Toru; Sunagawa, Kenji; Mano, Tadaaki

    2004-05-01

    Although spaceflight and bed rest are known to cause muscular atrophy in the antigravity muscles of the legs, the changes in sympathetic and cardiovascular responses to exercises using the atrophied muscles remain unknown. We hypothesized that bed rest would augment sympathetic responses to isometric exercise using antigravity leg muscles in humans. Ten healthy male volunteers were subjected to 14-day 6 degrees head-down bed rest. Before and after bed rest, they performed isometric exercises using leg (plantar flexion) and forearm (handgrip) muscles, followed by 2-min postexercise muscle ischemia (PEMI) that continues to stimulate the muscle metaboreflex. These exercises were sustained to fatigue. We measured muscle sympathetic nerve activity (MSNA) in the contralateral resting leg by microneurography. In both pre- and post-bed-rest exercise tests, exercise intensities were set at 30 and 70% of the maximum voluntary force measured before bed rest. Bed rest attenuated the increase in MSNA in response to fatiguing plantar flexion by approximately 70% at both exercise intensities (both P antigravity leg muscles.

  4. Restless Legs Syndrome -- Causes and Symptoms

    Science.gov (United States)

    ... Overview & Facts Causes & Symptoms Self-Tests & Diagnosis Treatment Restless Legs Syndrome - Causes & Symptoms Causes What causes of restless legs syndrome varies from person to person. In some cases ...

  5. Extracorporeal Free Flap Perfusion in Case of Prolonged Ischemia Time

    OpenAIRE

    Taeger, C. D.; Präbst, K; Beier, J P; Meyer, A; Horch, R E

    2016-01-01

    Summary: In free flap surgery, a clinically established concept still has to be found for the reduction of ischemia-related cell damage in the case of prolonged ischemia. Although promising results using extracorporeal free flap perfusion in the laboratory have been published in the past, until now this concept has not yet paved its way into clinical routine. This might be due to the complexity of perfusion systems and a lack of standardized tools. Here, we want to present the results of the ...

  6. Efeitos metabólicos da L-alanil-glutamina em ratos submetidos à isquemia da pata traseira esquerda seguida de reperfusão Metabolic effects of L-alanyl-glutamine in rats subjected to left hind leg ischemia and reperfusion

    Directory of Open Access Journals (Sweden)

    João Martins de Souza Torres

    2003-01-01

    Full Text Available OBJETIVO: Objetivou-se investigar os efeitos metabólicos da L-alanil glutamina no tecido muscular e sangue arterial de ratos Wistar submetidos à isquemia aguda da pata traseira. MÉTODOS: Utilizaram-se 48 ratos machos distribuídos em 4 grupos (1- controle / 2 - experimento, redistribuídos em 2 subgrupos (n=06. Trinta minutos após a injeção de uma solução a 20% de L-alanil-glutamina (0,75mg/ grupo 2 ou solução salina (grupo 1 na veia jugular direita ocluiu-se a artéria ilíaca comum esquerda por 30 minutos, por pinçamento. Amostras musculares e de sangue arterial foram obtidas logo após a remoção da pinça (tempo 0 e 5, 15 e 30 mais tarde. RESULTADOS: Observou-se redução significativa (p PURPOSE: An experimental study has been conducted to investigate acute ischemic changes in concentrations of glucose, piruvate, lactate and ketone bodies in rat hind leg muscle and arterial blood after intravenous injection of l-alanil-glutamine solution. METHODS: Forty-eight male Wistar rats were distributed into two groups: Group 1 (Control and Group 2 (Experiment. Each group was divided into 4 subgroups (n=6. Thirty minutes after administration of 20% solution of L-alanil-glutamine (0,75g/Kg, group 1 or saline solution (group 2 into right jugular vein, a clamp was placed across left common iliac artery for 30 minutes. Samples from left thigh muscle and arterial blood from abdominal aorta were collected at the end of ischemic period (subgroup 0 and 5, 15 and 30 minutes later. RESULTS: Glucose concentrations were decreased (p<0.05 in experiment group muscles, compared to respective control (subgroup 15 min and significantly increased in subgroups 15 and 30 min as compared to subgroup 0 min. There was no difference in glycemia and pyruvate concentrations when comparing experiment versus control rats. Decreased lactate concentrations might be related to L-alanyl glutamine effects. CONCLUSIONS: Increased availability of L

  7. [Restless legs syndrome and nocturnal leg pain : Differential diagnosis and treatment].

    Science.gov (United States)

    Hornyak, M; Stiasny-Kolster, K; Evers, S; Happe, S

    2011-09-01

    Pain in the legs belongs to the five most frequent regional pain symptoms. Restless legs syndrome (RLS) presents a particular differential diagnosis for pain in the legs, which is characterized by a nocturnal urge to move the legs often associated with painful sensations in the legs. It is one of the most common neurological disorders and probably the leading cause of nocturnal pain in the legs. In this overview, the diagnosis and therapy of RLS as well as aspects of pain therapy of the disorder are presented. In addition, the differential diagnoses for exclusion of other specific causes of nocturnal pain in the legs are discussed.

  8. Running over unknown rough terrain with a one-legged planar robot.

    Science.gov (United States)

    Andrews, Ben; Miller, Bruce; Schmitt, John; Clark, Jonathan E

    2011-06-01

    The ability to traverse unknown, rough terrain is an advantage that legged locomoters have over their wheeled counterparts. However, due to the complexity of multi-legged systems, research in legged robotics has not yet been able to reproduce the agility found in the animal kingdom. In an effort to reduce the complexity of the problem, researchers have developed single-legged models to gain insight into the fundamental dynamics of legged running. Inspired by studies of animal locomotion, researchers have proposed numerous control strategies to achieve stable, one-legged running over unknown, rough terrain. One such control strategy incorporates energy variations into the system during the stance phase by changing the force-free leg length as a sinusoidal function of time. In this research, a one-legged planar robot capable of implementing this and other state-of-the-art control strategies was designed and built. Both simulated and experimental results were used to determine and compare the stability of the proposed controllers as the robot was subjected to unknown drop and raised step perturbations equal to 25% of the nominal leg length. This study illustrates the relative advantages of utilizing a minimal-sensing, active energy removal control scheme to stabilize running over rough terrain.

  9. Restless Legs Syndrome with Current Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Meral Bilgilisoy Filiz

    2015-08-01

    Full Text Available Restless legs syndrome (RLS, also known as Willis-Ekbom disease, is a chronic movement disorder, characterized by an urge to move legs usually accompanied by uncomfortable sensations and sleep disorders. The prevalence of the syndrome ranges from 1% to 15% in the general population, and about 2% during childhood. RLS is the most common movement disorder in pregnancy. However RLS still remains underdiagnosed probably due to lack of accurate information about the disease. Family history is positive in 50-70% of the primary RLS patients. The secondary form of the syndrome is associated with iron deficiency, renal failure, pregnancy, diabetes mellitus and many rheumatologic disorders. Secondary forms generally manifest at older ages and have a rapid progression with a poorer prognosis. The pathophysiology of RLS is focused on the dopaminergic system, reduced central nervous system iron levels and genetic linkages. Diagnosis is based on clinical features and the diagnostic criteria suggested by International RLS Study Group. Secondary causes must be carefully investigated before the treatment. In mild forms of the disease non-pharmacologic therapies might be useful, while in moderate or severe forms of the disease generally pharmacologic therapies such as dopamine agonists, anticonvulsants, opioids and benzodiazepines are required. (Turkish Journal of Osteoporosis 2015;21: 87-95

  10. Restless legs syndrome in multiple system atrophy.

    Science.gov (United States)

    Ghorayeb, Imad; Dupouy, Sandrine; Tison, François; Meissner, Wassilios G

    2014-12-01

    The purpose of the study was to evaluate the frequency of restless legs syndrome in 30 patients with multiple system atrophy. Eight patients complained from restless legs syndrome, their severity score was 19.4 ± 4.1. Pittsburgh Sleep Quality Index scores were significantly higher in patients with restless legs syndrome than those without (9.3 ± 3.7 vs. 4.8 ± 2.9, p = 0.00165). Periodic limb movements were found in 75% of patients with restless legs syndrome. Restless legs syndrome is more prevalent in multiple system atrophy as compared to the acknowledged prevalence in the general population.

  11. Elastic actuation for legged locomotion

    Science.gov (United States)

    Cao, Chongjing; Conn, Andrew

    2017-04-01

    The inherent elasticity of dielectric elastomer actuators (DEAs) gives this technology great potential in energy efficient locomotion applications. In this work, a modular double cone DEA is developed with reduced manufacturing and maintenance time costs. This actuator can lift 45 g of mass (5 times its own weight) while producing a stroke of 10.4 mm (23.6% its height). The contribution of the elastic energy stored in antagonistic DEA membranes to the mechanical work output is experimentally investigated by adding delay into the DEA driving voltage. Increasing the delay time in actuation voltage and hence reducing the duty cycle is found to increase the amount of elastic energy being recovered but an upper limit is also noticed. The DEA is then applied to a three-segment leg that is able to move up and down by 17.9 mm (9% its initial height), which demonstrates the feasibility of utilizing this DEA design in legged locomotion.

  12. Antiangiogenic effect of angiotensin II type 2 receptor in ischemia-induced angiogenesis in mice hindlimb.

    Science.gov (United States)

    Silvestre, Jean-Sébastien; Tamarat, Radia; Senbonmatsu, Takaaki; Icchiki, Toshihiro; Ebrahimian, Teni; Iglarz, Marc; Besnard, Sandrine; Duriez, Micheline; Inagami, Tadashi; Lévy, Bernard I

    2002-05-31

    This study examined the potential role of angiotensin type 2 (AT(2)) receptor on angiogenesis in a model of surgically induced hindlimb ischemia. Ischemia was produced by femoral artery ligature in both wild-type and AT(2) gene-deleted mice (Agtr2(-)/Y). After 28 days, angiogenesis was quantitated by microangiography, capillary density measurement, and laser Doppler perfusion imaging. Protein levels of vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), Bax, and Bcl-2 were determined by Western blot analysis in hindlimbs. The AT(2) mRNA level (assessed by semiquantitative RT-PCR) was increased in the ischemic hindlimb of wild-type mice. Angiographic vessel density and laser Doppler perfusion data showed significant improvement in ischemic/nonischemic leg ratio, 1.9- and 1.7-fold, respectively, in Agtr2(-)/Y mice compared with controls. In ischemic leg of Agtr2(-)/Y mice, revascularization was associated with an increase in the antiapoptotic protein content, Bcl-2 (211% of basal), and a decrease (60% of basal) in the number of cell death, determined by TUNEL method. Angiotensin II treatment (0.3 mg/kg per day) raised angiogenic score, blood perfusion, and both VEGF and eNOS protein content in ischemic leg of wild-type control but did not modulate the enhanced angiogenic response observed in untreated Agtr2(-)/Y mice. Finally, immunohistochemistry analysis revealed that VEGF was mainly localized to myocyte, whereas eNOS-positive staining was mainly observed in the capillary of ischemic leg of both wild-type and AT(2)-deficient mice. This study demonstrates for the first time that the AT(2) receptor subtype may negatively modulate ischemia-induced angiogenesis through an activation of the apoptotic process.

  13. Neuronal autophagy in cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Feng Xu; Jin-Hua Gu; Zheng-Hong Qin

    2012-01-01

    Autophagy has evolved as a conserved process for the bulk degradation and recycling of cytosolic components,such as long-lived proteins and organelles.In neurons,autophagy is important for homeostasis and protein quality control and is maintained at relatively low levels under normal conditions,while it is upregulated in response to pathophysiological conditions,such as cerebral ischemic injury.However,the role of autophagy is more complex.It depends on age or brain maturity,region,severity of insult,and the stage of ischemia.Whether autophagy plays a beneficial or a detrimental role in cerebral ischemia depends on various pathological conditions.In this review,we elucidate the role of neuronal autophagy in cerebral ischemia.

  14. Animal models of cerebral ischemia

    Science.gov (United States)

    Khodanovich, M. Yu.; Kisel, A. A.

    2015-11-01

    Cerebral ischemia remains one of the most frequent causes of death and disability worldwide. Animal models are necessary to understand complex molecular mechanisms of brain damage as well as for the development of new therapies for stroke. This review considers a certain range of animal models of cerebral ischemia, including several types of focal and global ischemia. Since animal models vary in specificity for the human disease which they reproduce, the complexity of surgery, infarct size, reliability of reproduction for statistical analysis, and adequate models need to be chosen according to the aim of a study. The reproduction of a particular animal model needs to be evaluated using appropriate tools, including the behavioral assessment of injury and non-invasive and post-mortem control of brain damage. These problems also have been summarized in the review.

  15. 设计师访谈:Three Legged Legs

    Institute of Scientific and Technical Information of China (English)

    JOE; RUSS

    2007-01-01

    Greg Gunn、Casey Hunt和Reza Rasoli,又称Three Legged Legs。于2006年获得了全球学生动画奖(Global Student Animation Award)。现在他们又带回了一个精彩的新短片《Samurai》。我们自然也不会放过这次机会,看看能不能了解到更多内幕信息。

  16. Aqueous extract of Cordyceps alleviates cerebral ischemia-induced short-term memory impairment in gerbils.

    Science.gov (United States)

    Lee, Sang-Hak; Ko, Il-Gyu; Kim, Sung-Eun; Hwang, Lakkyong; Jin, Jun-Jang; Choi, Hyun-Hee; Kim, Chang-Ju

    2016-04-01

    Cerebral ischemia is caused by reduced cerebral blood flow due to a transient or permanent cerebral artery occlusion. Ischemic injury in the brain leads to neuronal cell death, and eventually causes neurological impairments. Cordyceps, the name given to the fungi on insects, has abundant useful natural products with various biological activities. Cordyceps is known to have nephroprotective, hepatoprotective, anti-inflammatory, antioxidative, and antiapoptotic effects. We investigated the effects of Cordyceps on short-term memory, neuronal apoptosis, and cell proliferation in the hippocampal dentate gyrus following transient global ischemia in gerbils. For this study, a step-down avoidance test, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay, immunohistochemistry for caspase-3 and 5-bromo-2'-de-oxyuridine, and western blot for Bax, Bcl-2, brain-derived neurotrophic factor (BDNF), and tyrosin kinase B were performed. In the present study, Cordyceps alleviated cerebral ischemia-induced short-term memory impairment. Cordyceps showed therapeutic effects through inhibiting cerebral ischemia-induced apoptosis in the hippocampus. Cordyceps suppressed cerebral ischemia-induced cell proliferation in the hippocampal dentate gyrus due to the reduced apoptotic neuronal cell death. Cordyceps treatment also enhanced BDNF and TrkB expressions in the hippocampus of ischemic gerbils. It can be suggested that Cordyceps overcomes cerebral ischemia-induced neuronal apoptosis, thus facilitates recovery following cerebral ischemia injury.

  17. Association between venous leg ulcers and sex chromosome anomalies in men.

    Science.gov (United States)

    Gattringer, Cornelia; Scheurecker, Christine; Höpfl, Reinhard; Müller, Hansgeorg

    2010-11-01

    We report here two cases of men, aged 46 and 23 years, with refractory chronic venous leg ulcers in association with sex chromosome aberrations: one with a 47,XXY/48,XXXY karyotype (Klinefelter syndrome) and the other with a 47,XYY karyotype (Jacob syndrome). In both patients, the occurrence of leg ulcers was the reason for seeking medical care; their medical history was other-wise unremarkable. Chromosomal analyses were performed due to the unusually young age for development of venous leg ulcers. The pathophysiology behind the occurrence of venous leg ulcers in patients with numerical aberrations of the sex chromosomes is incompletely understood. Involvement of elevated plasminogen activator inhibitor-1 levels in the pathogenesis of venous leg ulcers has been reported in patients with Klinefelter syndrome. Notably, our patient with 47,XXY/48,XXXY presented with androgen deficiency but normal plasminogen activator inhibitor-1 activity.

  18. Controversies in cardiovascular care: silent myocardial ischemia

    Science.gov (United States)

    Hollenberg, N. K.

    1987-01-01

    The objective evidence of silent myocardial ischemia--ischemia in the absence of classical chest pain--includes ST-segment shifts (usually depression), momentary left ventricular failure, and perfusion defects on scintigraphic studies. Assessment of angina patients with 24-hour ambulatory monitoring may uncover episodes of silent ischemia, the existence of which may give important information regarding prognosis and may help structure a more effective therapeutic regimen. The emerging recognition of silent ischemia as a significant clinical entity may eventually result in an expansion of current therapy--not only to ameliorate chest pain, but to minimize or eliminate ischemia in the absence of chest pain.

  19. The effect of age on result of straight leg raising test in patients suffering lumbar disc herniation and sciatica

    OpenAIRE

    2015-01-01

    Background: Ninety percent of all people sometimes during their lives experience low back pain, and 30-40% develops radicular leg pain with the sciatica characteristics. Although for clinical diagnosis of lumbar disc herniation (LDH) straight leg raising (SLR) test in 85-90% of cases indicates LDH, but in our practice with LDH patients this test is frequently negative despite radicular leg pain due to LDH. Hence, we decided to evaluate this test in LDH in different age groups. Materials and M...

  20. Epilepsy and restless legs syndrome.

    Science.gov (United States)

    Geyer, James D; Geyer, Emery E; Fetterman, Zachary; Carney, Paul R

    2017-03-01

    Restless legs syndrome (RLS) is a common neurological movement disorder occurring in approximately 10% of the general population. The prevalence of moderately severe RLS is 2.7% overall (3.7% for women and 1.7% for men). Epilepsy is also a common neurological disorder with significant associated morbidity and impact on quality of life. We evaluated the severity and frequency of primary RLS in patients with localization-related temporal lobe epilepsy (TLE) and investigated the role of prodromal RLS symptoms as a warning sign and lateralizing indicator. All epilepsy patients seen in the outpatient clinic were screened for movement disorders from 2005 to 2015. Ninety-eight consecutive patients with localization-related TLE (50 right TLE and 48 left TLE) who met inclusion criteria were seen in the outpatient clinic. The control group consisted of 50 individuals with no history or immediate family history of epilepsy. Each patient was evaluated with the International Restless Legs Study Group (IRLSSG) questionnaire, NIH RLS diagnostic criteria, ferritin level, and comprehensive sleep screening including polysomnography. Furthermore, patients with obstructive sleep apnea or a definite cause of secondary restless legs syndrome such as low serum ferritin or serum iron levels were also excluded from the study. There was a significant association between the type of epilepsy and whether or not patients had RLS χ(2) (1)=10.17, prestlessness was typically described as moderately severe. The RLS symptoms were more common and somewhat more severe in the right TLE group than the left TLE group. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. [Epidemiology of restless legs syndrome].

    Science.gov (United States)

    Ghorayeb, I; Tison, F

    2009-01-01

    Restless legs syndrome (RLS) is a chronic sensorimotor disorder where patients complain of an almost irresistible urge to move their legs. This urge can often be accompanied by pain or other unpleasant sensations, it either occurs or worsens with rest particularly at night, and improves with activity. The International Restless Legs Syndrome Study Group has established four essential criteria for clinical diagnosis of RLS. Affecting an estimated 7.2 to 11.5% of the adult population, the symptoms of RLS may be associated with significant sleep disturbance and may have a negative impact on quality of life. The prevalence of RLS increases with age, and women are more frequently affected than men. In France, the estimated prevalence is 8.5%. Among sufferers, 4.4% complain of very severe symptoms. Although RLS is mainly idiopathic, several clinical conditions have been associated with it, especially iron deficiency with or without anemia, end-stage renal disease and pregnancy. These conditions may share a common pathophysiological mechanism involving a disorder of iron metabolism. By contrast, controversy persists as to whether polyneuropathy, particularly when associated with diabetes, is to be considered as an important cause of secondary RLS. This association is difficult to demonstrate as conventional electromyography is not adequate to detect small fiber neuropathy often associated with diabetes. RLS is often underdiagnosed and few subjects receive recommended RLS drug treatment. There is a clear need for complementary education to improve the accurate diagnosis of RLS. Indeed, better knowledge of this syndrome is a prerequisite to prompt an appropriate therapeutic management.

  2. Neuroimaging in Restless Legs Syndrome.

    Science.gov (United States)

    Provini, Federica; Chiaro, Giacomo

    2015-09-01

    Neuroimaging studies are of crucial relevance in defining the pathophysiology of restless legs syndrome (RLS). MRI studies showed no structural brain lesions and confirmed a central iron deficiency. Structural and functional studies showed an involvement of the thalamus, sensorimotor cortical areas, and cerebellum in RLS and assessed neurotransmission abnormalities in the dopaminergic and opiate systems. Finally, glutamatergic hyperactivity has been proposed as a cause of disrupted and shortened sleep in RLS. Differences among the results of the studies make it difficult to draw any definitive conclusions, thus, suggesting the need for future research.

  3. Sirt1 in cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Kevin B Koronowski

    2015-01-01

    Full Text Available Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD +-dependent deacylases has been shown to govern several processes within the central nervous system as well as to possess neuroprotective properties in a variety of pathological conditions such as Alzheimer′s Disease, Parkinson′s Disease, and Huntington′s Disease, among others. Recently, Sirt1 in particular has been identified as a mediator of cerebral ischemia, with potential as a possible therapeutic target. To gather studies relevant to this topic, we used PubMed and previous reviews to locate, select, and resynthesize the lines of evidence presented here. In this review, we will first describe some functions of Sirt1 in the brain, mainly neurodevelopment, learning and memory, and metabolic regulation. Second, we will discuss the experimental evidence that has implicated Sirt1 as a key protein in the regulation of cerebral ischemia as well as a potential target for the induction of ischemic tolerance.

  4. Sirt1 in cerebral ischemia

    Science.gov (United States)

    Koronowski, Kevin B.; Perez-Pinzon, Miguel A.

    2015-01-01

    Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD+)-dependent deacylases has been shown to govern several processes within the central nervous system as well as to possess neuroprotective properties in a variety of pathological conditions such as Alzheimer’s Disease, Parkinson’s Disease, and Huntington’s Disease, among others. Recently, Sirt1 in particular has been identified as a mediator of cerebral ischemia, with potential as a possible therapeutic target. To gather studies relevant to this topic, we used PubMed and previous reviews to locate, select, and resynthesize the lines of evidence presented here. In this review, we will first describe some functions of Sirt1 in the brain, mainly neurodevelopment, learning and memory, and metabolic regulation. Second, we will discuss the experimental evidence that has implicated Sirt1 as a key protein in the regulation of cerebral ischemia as well as a potential target for the induction of ischemic tolerance. PMID:26819971

  5. Sympathetic adaptations to one-legged training

    Science.gov (United States)

    Ray, C. A.

    1999-01-01

    The purpose of the present study was to determine the effect of leg exercise training on sympathetic nerve responses at rest and during dynamic exercise. Six men were trained by using high-intensity interval and prolonged continuous one-legged cycling 4 day/wk, 40 min/day, for 6 wk. Heart rate, mean arterial pressure (MAP), and muscle sympathetic nerve activity (MSNA; peroneal nerve) were measured during 3 min of upright dynamic one-legged knee extensions at 40 W before and after training. After training, peak oxygen uptake in the trained leg increased 19 +/- 2% (P leg exercise and indicates that attenuation of MSNA to exercise reported with forearm training also occurs with leg training.

  6. Restless legs syndrome and periodic leg movements in patients with movement disorders: Specific considerations.

    Science.gov (United States)

    Högl, Birgit; Stefani, Ambra

    2017-05-01

    Restless legs syndrome is a frequent neurological disorder with potentially serious and highly distressing treatment complications. The role and potential implications of periodic leg movements during sleep range from being a genetic risk marker for restless legs syndrome to being a cardiovascular risk factor. The diagnosis of restless legs syndrome in patients with daytime movement disorders is challenging and restless legs syndrome needs to be differentiated from other sleep-related movement disorders. This article provides an update on the diagnosis of restless legs syndrome as an independent disorder and the role of periodic leg movements and reviews the association of restless legs syndrome with Parkinson's disease and other movement disorders. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  7. Treatment of restless legs syndrome.

    Science.gov (United States)

    Comella, Cynthia L

    2014-01-01

    Restless legs syndrome (RLS) is a common disorder diagnosed by the clinical characteristics of restlessness in the legs associated often with abnormal sensations that start at rest and are improved by activity, occurring with a diurnal pattern of worsened symptoms at night and improvement in the morning. RLS is the cause of impaired quality of life in those more severely afflicted. Treatment of RLS has undergone considerable change over the last few years. Several classes of medications have demonstrated efficacy, including the dopaminergic agents and the alpha-2-delta ligands. Levodopa was the first dopaminergic agent found to be successful. However, chronic use of levodopa is frequently associated with augmentation that is defined as an earlier occurrence of symptoms frequently associated with worsening severity and sometimes spread to other body areas. The direct dopamine agonists, including ropinirole, pramipexole, and rotigotine patch, are also effective, although side effects, including daytime sleepiness, impulse control disorders, and augmentation, may limit usefulness. The alpha-2-delta ligands, including gabapentin, gabapentin enacarbil, and pregabalin, are effective for RLS without known occurrence of augmentation or impulse control disorders, although sedation and dizziness can occur. Other agents, including the opioids and clonazepam do not have sufficient evidence to recommend them as treatment for RLS, although in an individual patient, they may provide benefit.

  8. Targinact for restless legs syndrome.

    Science.gov (United States)

    2016-04-01

    Idiopathic restless legs syndrome (RLS)--also known as Willis-Ekbom disease--is a neurological condition characterised by an overwhelming urge to move the legs, occurring during rest or inactivity, especially at night. Symptoms are highly variable in frequency and severity, and can affect sleep and quality of life. First-line management includes addressing precipitating or aggravating factors and providing explanation, reassurance and advice on self-help strategies. Drug therapy (e.g. a dopamine agonist) is used for patients with more severe symptoms. In December 2014, the marketing authorisation for a modified-release preparation containing oxycodone and naloxone (Targinact-Napp Pharmaceuticals) was expanded to include use in the treatment of severe to very severe RLS after failure of dopaminergic therapy.(10)Here we review the management of adults with RLS, including the place of oxycodone/naloxone. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. 依达拉奉对深低温冻存大鼠断肢再植后缺血再灌注损伤骨骼肌细胞膜及线粒体的保护效应%Protective influence of edaravone on cellular membrane and mitochondria of replanted rat extremities following ischemia/reperfusion injury due to cryopreservation and rewarming

    Institute of Scientific and Technical Information of China (English)

    段永壮; 钟世镇; 王增涛; 徐达传; 丁自海; 付庆林; 郝丽文; 何波

    2007-01-01

    肌缺血再灌注损伤,对骨骼肌细胞膜及线粒体有保护作用.其作用可能与依达拉奉直接抑制羟自由基、提高骨骼肌超氧化物歧化酶活性、减少丙二醛的产生,使细胞进行正常的氧化磷酸化有关.%BACKGROUND: A lot of important organs are worthless for clinical application because they are hard to store for a long time. In addition, tissues or organs which are dealt with cryopreservation also attack ischemia/reperfusion injury with the recovery of blood flow; especially, skeletal muscle is the most involved tissue.OBJECTIVE: To observe the protective influence of edaravone on cellular membrane and mitochondria of replanted rat extremities following ischemia/reperfusion injury due to cryopreservation and rewarming.DESIGN: Randomized contrast animal study.SETTING: Basic Medical College of Southern Medical University; Department of Hand and Foot Surgery, Shandong Provincial Hospital.MATERIALS: The experiment was carried out in the Cryopreservation Laboratory, Shandong Provincial Hospital from April to November 2006. A total of 36 healthy adult male Wistar rats were provided by Experimental Animal Center of Medical College of Shandong University. All rats were randomly divided into control group, cryopreservation group and edaravone group with 12 in each group.METHODS: Femoral artery and vein of rats in control group were exposured, but extremities were not blocked. Rats in other two groups were used to establish ischemia/reperfusion injury models of replanted extremities. Before cryopreservation, their right hindlimbs were cut off and maintained in liquid nitrogen container for 1 month. After the operation mentioned above, the broken limbs were rewarmed, perfused with routine eluant and replanted. Four hours later, blood supply of extremities was recirculated and the samples were selected. Eluant in edaravone group contained 0.5 mg/kg edaravone. Samples of skeletal muscle were selected at the same time point to

  10. Fabrication of Biomimetic Water Strider Legs Covered with Setae

    Institute of Scientific and Technical Information of China (English)

    Zhi-guo Zhou; Zhi-wen Liu

    2009-01-01

    Water striders have remarkable water-repellent legs that enable them to stand effortlessly and move quickly on water. Fluid physics indicates this feature is due to a surface-tension effect caused by the special hierarchical structure of the legs, which are covered with a large number of inclined setae with fine nanogrooves inducing water resistance. This inspires us to fabricate special water-repellent structure on functional surfaces through the cooperation between the surface treatment and the surface micro- and nanostructures, which may bring great advantages in a wide variety of applications. In this paper we present a procedure for fabricating biomimetic water strider legs covered with setae using Polycarbonate Track-Etched (PCTE) membranes as templates. By choosing appropriate membrane lengths, diameters, pitches and densities of the setae, the biomimetic legs can be fabricated conveniently and at a low cost. Furthermore we investigated the relationship between stiffness of the molding materials, high aspect ratio and density, which affect the fidelity of fabrication and self adhesion, to optimize the stability of setae. The knowledge we gained from this study will offer important insights into the biomimetic design and fabrication of water strider setae.

  11. Blockade of advanced glycation end-product formation restores ischemia-induced angiogenesis in diabetic mice.

    Science.gov (United States)

    Tamarat, Radia; Silvestre, Jean-Sébastien; Huijberts, Maya; Benessiano, Joelle; Ebrahimian, Teni G; Duriez, Micheline; Wautier, Marie-Paule; Wautier, Jean Luc; Lévy, Bernard I

    2003-07-08

    We hypothesized that formation of advanced glycation end products (AGEs) associated with diabetes reduces matrix degradation by metalloproteinases (MMPs) and contributes to the impairment of ischemia-induced angiogenesis. Mice were treated or not with streptozotocin (40 mg/kg) and streptozotocin plus aminoguanidine (AGEs formation blocker, 50 mg/kg). After 8 weeks of treatment, hindlimb ischemia was induced by right femoral artery ligature. Plasma AGE levels were strongly elevated in diabetic mice when compared with control mice (579 +/- 21 versus 47 +/- 4 pmol/ml, respectively; P < 0.01). Treatment with aminoguanidine reduced AGE plasma levels when compared with untreated diabetic mice (P < 0.001). After 28 days of ischemia, ischemic/nonischemic leg angiographic score, capillary density, and laser Doppler skin-perfusion ratios were 1.4-, 1.5-, and 1.4-fold decreased in diabetic mice in reference to controls (P < 0.01). Treatment with aminoguanidine completely normalized ischemia-induced angiogenesis in diabetic mice. We next analyzed the role of proteolysis in AGE formation-induced hampered neovascularization process. After 3 days of ischemia, MMP-2 activity and MMP-3 and MMP-13 protein levels were increased in untreated and aminoguanidine-treated diabetic mice when compared with controls (P < 0.05). Despite this activation of the MMP pathway, collagenolysis was decreased in untreated diabetic mice. Conversely, treatment of diabetic mice with aminoguanidine restored collagenolysis toward levels found in control mice. In conclusion, blockade of AGE formation by aminoguanidine normalizes impaired ischemia-induced angiogenesis in diabetic mice. This effect is probably mediated by restoration of matrix degradation processes that are disturbed as a result of AGE accumulation.

  12. Skin and mucosal ischemia as a complication after inferior alveolar nerve block

    Science.gov (United States)

    Aravena, Pedro Christian; Valeria, Camila; Nuñez, Nicolás; Perez-Rojas, Francisco; Coronado, Cesar

    2016-01-01

    The anesthetic block of the inferior alveolar nerve (IAN) is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block.

  13. Painful legs and moving toes syndrome responsive to pregabalin

    Directory of Open Access Journals (Sweden)

    F H Rossi

    2015-01-01

    Full Text Available Report three cases of painful legs and moving toes (PLMT syndrome responsive to pregabalin along with a review of its literature. Three patients with PLMT syndrome improved with pregabalin. The first and third patient reported improvement in pain scores, quality of life, and quality of sleep sustained over time. The second and third patient had near complete remission of toe movements, but pregabalin was discontinued in the second patient due to aggravation of leg edema. PLMT is a rare and debilitating disorder characterized by lower limb pain and involuntary toes or feet movements. Its pathophysiology remains unknown and its therapy refractory to most drugs, except for pregabalin, as shown in this case series. PLMT is a rare and incapacitating syndrome due to the lack of an effective pain therapy. We report three patients with PLMT who favorable responded to pregabalin. We propose pregabalin be considered in the management of PLMT.

  14. Effect of whole body heat stress on peripheral vasoconstriction during leg dependency

    Science.gov (United States)

    Brothers, R. Matthew; Wingo, Jonathan E.; Hubing, Kimberly A.; Del Coso, Juan

    2009-01-01

    The venoarteriolar response (VAR) increases vascular resistance upon increases in venous transmural pressure in cutaneous, subcutaneous, and muscle vascular beds. During orthostasis, it has been proposed that up to 45% of the increase in systemic vascular tone is due to VAR-related local mechanism(s). The objective of this project was to test the hypothesis that heat stress attenuates VAR-mediated cutaneous and whole leg vasoconstriction. During normothermic conditions, measurements of cutaneous blood flow (laser-Doppler flowmetry) and femoral artery blood flow (Doppler ultrasound) were obtained from both legs during supine and leg-dependent conditions. These measurements were repeated following a whole body heat stress (increase in internal temperature of 1.4 ± 0.2°C). Before leg dependency, cutaneous (CVC) and femoral vascular conductances (FVC) were significantly elevated in both legs during heat stress relative to normothermia (P < 0.001). During leg dependency the absolute decrease in CVC was attenuated during heat stress (P < 0.01) while the absolute decrease in FVC was unaffected (P = 0.90). When CVC and FVC data were analyzed as a relative change from their respective baseline values, heat stress significantly attenuated the magnitude of vasoconstriction due to leg dependency in the cutaneous and femoral circulations (P < 0.001 for both variables). These data suggest that an attenuated local vasoconstriction, evoked via the venoarteriolar response, may contribute to reduced blood pressure control and thus reduced orthostatic tolerance that occurs in heat-stressed individuals. PMID:19815719

  15. Klinefelter's syndrome presenting with leg ulcers.

    Science.gov (United States)

    De Morentin, Helena Martinez; Dodiuk-Gad, Roni P; Brenner, Sarah

    2004-01-01

    , compatible with a healing process. Direct immunofluorescence of the biopsy revealed granular IgM in the dermo-epidermal junction. Indirect immunofluorescence was negative. Thyroid function tests showed normal thyroid stimulating hormone and free throxine4. Multinodular goiter was seen on thyroid scan and ultrasound. Thyroid fine needle aspiration was compatible with multinodular goiter (normal follicular cells, free colloid, macrophages with pigment). IV treatment with amoxicillin-clavulanic acid 1 g t.i.d. was administered for 2 weeks, with a decrease in temperature and normalization of the leukocyte level. Oral antibiotic treatment with amoxicillin-clavulanic acid was continued for 10 more days, followed by 25 days of ciprofloxacin for the osteomyelitis. Local treatment included saline soakings followed by application of Promogran (Johnson & Johnson, New Brunswick, NJ) and Kaltostat (ConvaTec Ltd., a Bristol-Myers Squibb Company, New York, NY) with slight improvement. At the same time, the patient was treated with warfarin sodium due to deep vein thrombosis under international normalized ratio 2-3. The patient was treated with IM testosterone once monthly for 1 year, which resulted in a reduction in the diameter and depth of the leg ulcers (Figure 3). Blood tests were not performed for follow-up of the immune state.

  16. Material Parameter Sensitivity of Predicted Injury in the Lower Leg

    Science.gov (United States)

    2015-06-01

    rupture, the neck of the talus to impact against the leading anterior edge of the distal tibia, and a fracture line to develop.25,26 Due to the...leg under high rate loading. In: International Re- search Council on Biomechanics of Injury; 2013 Sep 11–13; Gothenburg, Swe- den. 4. Ramasamy A...Bull AMJ, Clasper JC. Blast- related fracture patterns: a forensic biomechanical approach. Journal of the Royal Society Interface. 2011;8(58):689–698

  17. Comparison of whole-body vertical stiffness and leg stiffness during single-leg hopping in place in children and adults.

    Science.gov (United States)

    Beerse, Matthew; Wu, Jianhua

    2017-05-03

    In the hopping literature, whole-body vertical stiffness and leg stiffness are used interchangeably, due to most of the movement occurring in the vertical direction. However, there is some anterior/posterior movement of the center of mass and displacements of the foot during hopping in place in both children and adults. Further it is not understood if leg stiffness show a similar pattern as whole-body vertical stiffness when increasing hopping frequency. The purpose of this study was to test if whole-body vertical stiffness and leg stiffness are different during single-leg hopping in-place in children and adults, across a range of frequencies. Seventeen children aged 5-11years and 16 young adults participated in this study. The subjects hopped at their preferred frequency as well as 20% below, 20% above and 40% above preferred frequency. Our results demonstrate that both whole-body vertical stiffness and leg stiffness increase when increasing hopping frequency for children and adults. However, whole-body vertical stiffness consistently overestimates leg stiffness due to a similar peak force but a greater leg length change compared to vertical COM displacement. This suggests a considerable horizontal COM movement from landing to mid-stance during hopping. Children aged 5-11years old showed lower absolute values but higher normalized values of two stiffness measures than adults. This suggests somewhat adult-like stiffness control in children, but a reduced ability to manipulate the horizontal movement during single-leg hopping in place when compared to adults. Published by Elsevier Ltd.

  18. [Long term results after invasive treatment of critical limb ischemia].

    Science.gov (United States)

    Ruzsa, Zoltán; Kuti, Ferenc; Berta, Balázs; Tóth, Károly; Bánsághi, Zoltán; Vámosi, Zoltán; Hüttl, Kálmán

    2017-03-01

    Surgical tibial bypass for critical limb ischemia is associated with significant morbidity, mortality, and graft failure, whereas percutaneous angioplasty and stenting has promising results. The objective of this study was the investigation of the long term results of below-knee percutaneous angioplasty for restoring straight inline arterial flow in patients with critical limb ischemia. The clinical and angiographic data of 281 consecutive patients with critical limb ischemia treated by PTA between 2008 and 2011 was evaluated in a prospective register. The aim of the revascularization was to achieve a straight inline flow to the wound with balloon angioplasty. Stent implantation was done in the case of recoil and flow limiting dissection. Primary end points were clinical success (relief of resting pain, healing of ulceration, limb survival) and major adverse events (death, myocardial infarction, major unplanned amputation, need for surgical revascularization, or major bleeding). Secondary end points were the angiographic result of the intervention, procedural data and consumption of angioplasty equipment. The impact of diabetic leg syndrome and the result of the angioplasty on the limb salvage was also investigated. We have analysed the impact of major amputation on long term mortality. Mean age of patients was 72.5 ± 10.6 years and the follow-up period was 40.8 ± 9.7 months. Technical success was reached in 255 (90.7%) of the patient's: 255 limbs straight inline flow with good angiographic result was restored to at least one tibial vessel. Balloon angioplasty, stent implantation and rotational atherectomy was performed in 278 (98.9%), 74 (26.3%) and 2 patients (0.7%). From clinical end points the rest pain was ceased in 56.6%, the ulcer and the gangrena was healed in 73.5% and 46.5%. The long term limb survival was 73.5%; 65.8% in diabetic and 89.6% in non-diabetic leg syndrome (p = 0.001). The major adverse events at long-term follow-up occured in 122 (43

  19. Pediatric restless legs syndrome diagnostic criteria: an update by the International Restless Legs Syndrome Study Group.

    Science.gov (United States)

    Picchietti, Daniel L; Bruni, Oliviero; de Weerd, Al; Durmer, Jeffrey S; Kotagal, Suresh; Owens, Judith A; Simakajornboon, Narong

    2013-12-01

    Specific diagnostic criteria for pediatric restless legs syndrome (RLS) were published in 2003 following a workshop at the National Institutes of Health. Due to substantial new research and revision of the adult RLS diagnostic criteria, a task force was chosen by the International Restless Legs Syndrome Study Group (IRLSSG) to consider updates to the pediatric diagnostic criteria. A committee of seven pediatric RLS experts developed a set of 15 consensus questions to review, conducted a comprehensive literature search, and extensively discussed potential revisions. The committee recommendations were approved by the IRLSSG executive committee and reviewed by the IRLSSG membership. The pediatric RLS diagnostic criteria were simplified and integrated with the newly revised adult RLS criteria. Specific recommendations were developed for pediatric application of the criteria, including consideration of typical words used by children to describe their symptoms. Pediatric aspects of differential diagnosis, comorbidity, and clinical significance were then defined. In addition, the research criteria for probable and possible pediatric RLS were updated and criteria for a related condition, periodic limb movement disorder (PLMD), were clarified. Revised diagnostic criteria for pediatric RLS have been developed, which are intended to improve clinical practice and promote further research. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  20. Arachidonic Acid and Cerebral Ischemia Risk: A Systematic Review of Observational Studies

    Directory of Open Access Journals (Sweden)

    Mai Sakai

    2014-11-01

    Full Text Available Background: Arachidonic acid (ARA is a precursor of various lipid mediators. ARA metabolites such as thromboxane A2 cause platelet aggregation and vasoconstriction, thus may lead to atherosclerotic disease. It is unclear whether dietary ARA influences the ARA-derived lipid mediator balance and the risk for atherosclerotic diseases, such as cerebral ischemia. Considering the function of ARA in atherosclerosis, it is reasonable to focus on the atherothrombotic type of cerebral ischemia risk. However, no systematic reviews or meta-analyses have been conducted to evaluate the effect of habitual ARA exposure on cerebral ischemia risk. We aimed to systematically evaluate observational studies available on the relationship between ARA exposure and the atherothrombotic type of cerebral ischemia risk in free-living populations. Summary: The PubMed database was searched for articles registered up to June 24, 2014. We designed a PubMed search formula as follows: key words for humans AND brain ischemia AND study designs AND ARA exposure. Thirty-three articles were reviewed against predefined criteria. There were 695 bibliographies assessed from the articles that included both ARA and cerebral ischemia descriptions. Finally, we identified 11 eligible articles and categorized them according to their reporting and methodological quality. We used the Strengthening the Reporting of Observational Studies in Epidemiology Statement (STROBE checklist to score the reporting quality. The methodological quality was qualitatively assessed based on the following aspects: subject selection, ARA exposure assessment, outcome diagnosis, methods for controlling confounders, and statistical analysis. We did not conduct a meta-analysis due to the heterogeneity among the studies. All eligible studies measured blood ARA levels as an indicator of exposure. Our literature search did not identify any articles that evaluated dietary ARA intake and tissue ARA as assessments of

  1. Why do flamingos stand on one leg?

    Science.gov (United States)

    Anderson, Matthew J; Williams, Sarah A

    2010-01-01

    A series of observational studies of captive Caribbean flamingos Phoenicopterus ruber were conducted to determine why flamingos rest on one leg. While frequently asked by the general public, this basic question has remained unanswered by the scientific community. Here we suggest that the latency of flamingos to initiate forward locomotion following resting on one leg is significantly longer than following resting on two, discounting the possibility that unipedal resting reduces muscle fatigue or enhances predatory escape. Additionally, we demonstrate that flamingos do not display lateral preferences at the individual or group levels when resting on one leg, with each bird dividing its resting time across both legs. We show that while flamingos prefer resting on one leg to two regardless of location, the percentage of birds resting on one leg is significantly higher among birds standing in the water than among those on land. Finally, we demonstrate a negative relationship between temperature and the percentage of observed birds resting on one leg, such that resting on one leg decreases as temperature rises. Results strongly suggest that unipedal resting aids flamingos in thermoregulation. (c) 2009 Wiley-Liss, Inc.

  2. X-Ray Exam: Femur (Upper Leg)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Femur (Upper Leg) KidsHealth > For Parents > X-Ray Exam: Femur (Upper Leg) A A A ... español Radiografía: fémur What It Is A femur X-ray is a safe and painless test that ...

  3. Ropinirole treatment for restless legs syndrome.

    Science.gov (United States)

    Molnar, Miklos Zsolt; Fornadi, Katalin; Shapiro, Colin M

    2006-09-01

    In this paper we discuss therapy with ropinirole (known as adartrel in the United Kingdom) in patients with restless legs syndrome. Restless legs syndrome is characterized by an urge to move the legs, uncomfortable sensations in the legs and worsening of these symptoms during rest with at least temporary relief brought on by activity. Current recommendations suggest dopaminergic therapy (levodopa or dopamine receptor agonists like ropinirole) as the first-line treatment for restless legs syndrome. Based on the results of randomized, placebo-controlled, double-blind trials, we conclude that ropinirole is effective in reducing symptoms of restless legs syndrome in the general population. Ropinirole has no serious or common side effects that would limit its use significantly. Rebound and augmentation problems are relatively rarely seen with ropinirole, although properly designed comparative trials are still needed to address this question. It must be noted, however, that most published studies with ropinirole compare this drug with placebo. Very few studies have compared ropinirole with other drugs (L-dopa, gabapentin, opioids, benzodiazepines, other dopaminergic agents and selegiline hydrochloride). No cost-effectiveness trial has been published yet. Treatment of restless legs syndrome with ropinirole shows it to be effective, well-tolerated and safe and it can be used in restless legs syndrome in general.

  4. Diagnosis and treatment of restless legs syndrome.

    Science.gov (United States)

    Sales, Samantha; Sanghera, Manjit K; Klocko, David J; Stewart, R Malcolm

    2016-07-01

    Restless legs syndrome (RLS) is a disorder characterized by an irresistible urge to move the legs during rest, usually accompanied by uncomfortable sensations in the affected extremity or extremities. RLS can manifest at any age but prevalence increases with advancing age. This article describes the symptoms of RLS, associated comorbidities, and how to diagnose and manage RLS.

  5. Opioids for restless legs syndrome.

    Science.gov (United States)

    de Oliveira, César Osório; Carvalho, Luciane Bc; Carlos, Karla; Conti, Cristiane; de Oliveira, Marcio M; Prado, Lucila Bf; Prado, Gilmar F

    2016-06-29

    Restless legs syndrome (RLS) is a distressing and common neurological disorder that may have a huge impact in the quality of life of those with frequent and intense symptoms. Patients complain of unpleasant sensations in the legs, at or before bedtime, and feel an urge to move the legs, which improves with movement, such as walking. Symptoms start with the patient at rest (e.g. sitting or lying down), and follow a circadian pattern, increasing during the evening or at night. Many pharmacological intervention are available for RLS, including drugs used to treat Parkinson's disease (L-Dopa and dopaminergic agonists), epilepsy (anticonvulsants), anxiety (benzodiazepines), and pain (opioids). Dopaminergic drugs are those most frequently used for treatment of RLS, but some patients do not respond effectively and require other medication. Opioids, a class of medications used to treat severe pain, seem to be effective in treating RLS symptoms, and are recommended for patients with severe symptoms, because RLS and pain appear to share the same mechanism in the central nervous system. All available drugs are associated to some degree with side effects, which can impede treatment. Opioids are associated with adverse events such as constipation, tolerance, and dependence. This justifies the conduct of a systematic review to ascertain whether opioids are safe and effective for treatment of RLS. To asses the effects of opioids compared to placebo treatment for restless legs syndrome in adults. We searched the Cochrane Central Register of Controlled trials, CENTRAL 2016, issue 4 and MEDLINE, EMBASE, and LILACS up to April 2016, using a search strategy adapted by Cochraneto identify randomised clinical trials. We checked the references of each study and established personal communication with other authors to identify any additional studies. We considered publications in all languages. Randomised controlled clinical trials of opioid treatment in adults with idiopathic RLS. Two

  6. [When to worry about before a vascular chronic leg ulcer?].

    Science.gov (United States)

    Lazareth, I

    2016-09-01

    Leg ulcers are a chronic condition. Healing can be long for venous ulcers and the risk of complications is significant. Infection is the most severe complication and can occur in the form of easily diagnosed acute bacterial dermohypodermitis that generally responds well to antibiotic treatment if given at an appropriate dose or in the form of localized infection that is more difficult to diagnosis. Indeed, no consensus has been reached in the literature on the clinical criteria to retain for the diagnosis of localized infection. Similarly, the most appropriate treatment remains to be established. Local care would be a logical starting point, followed by systemic antibiotics if this approach is unsuccessful. Individual conditions also should be taken into consideration (immunodepression, severe arteriopathy warranting more rapid use of systemic antibiotics). The second most frequent complication is an allergic reaction to a topical agent used for wound care. The rate of sensitivization in patients with leg ulcers is high (60 %), although the rate is declining with modern dressings. No product can be considered perfectly safe for these polysensitized patients. Dermocorticoid therapy can be very effective. Allergology tests are needed. Certain leg ulcers require special care from diagnosis. An arterial origin must be suspected for deep, or necrotic ulcers. Arterial supply must be explored rapidly, followed by a revascularization procedure when necessary. Highly painful superficial extensive necrotic ulcers due to necrotic angiodermitis require hospital care for skin grafts that will control the antiodermitis and provide pain. Carcinoma should be suspected in cases of leg ulcers with an atypical localization exhibiting excessive budding. A biopsy is mandatory for leg ulcers with an unusual course (absence of healing despite well-conducted care).

  7. Intensive treatment of leg lymphedema

    Directory of Open Access Journals (Sweden)

    Pereira de Godoy Jose

    2010-01-01

    Full Text Available Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value < 0.05 being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value < 0.001. Losses of more than 90% of the lymphedema occurred in 9 (39.13% patients; losses of more than 80% in 13 (56.52%, losses of more than 70% in 17 (73.91% and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9% of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.

  8. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji [Nakamura Memorial Hospital, Sapporo (Japan)

    1999-06-01

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  9. Predictive Modeling of Cardiac Ischemia

    Science.gov (United States)

    Anderson, Gary T.

    1996-01-01

    The goal of the Contextual Alarms Management System (CALMS) project is to develop sophisticated models to predict the onset of clinical cardiac ischemia before it occurs. The system will continuously monitor cardiac patients and set off an alarm when they appear about to suffer an ischemic episode. The models take as inputs information from patient history and combine it with continuously updated information extracted from blood pressure, oxygen saturation and ECG lines. Expert system, statistical, neural network and rough set methodologies are then used to forecast the onset of clinical ischemia before it transpires, thus allowing early intervention aimed at preventing morbid complications from occurring. The models will differ from previous attempts by including combinations of continuous and discrete inputs. A commercial medical instrumentation and software company has invested funds in the project with a goal of commercialization of the technology. The end product will be a system that analyzes physiologic parameters and produces an alarm when myocardial ischemia is present. If proven feasible, a CALMS-based system will be added to existing heart monitoring hardware.

  10. Acute limb ischemia in cancer patients: should we surgically intervene?

    LENUS (Irish Health Repository)

    Tsang, Julian S

    2012-02-01

    BACKGROUND: Cancer patients have an increased risk of venous thromboembolic events. Certain chemotherapeutic agents have also been associated with the development of thrombosis. Reported cases of acute arterial ischemic episodes in cancer patients are rare. METHODS: Patients who underwent surgery for acute limb ischemia associated with malignancy in a university teaching hospital over a 10-year period were identified. Patient demographics, cancer type, chemotherapy use, site of thromboembolism, treatment and outcome were recorded. RESULTS: Four hundred nineteen patients underwent surgical intervention for acute arterial ischemia, 16 of these patients (3.8%) had associated cancer. Commonest cancer sites were the urogenital tract (n = 5) and the lungs (n = 5). Eight patients (50%) had been recently diagnosed with cancer, and four (25%) of these cancers were incidental findings after presentation with acute limb ischemia. Four patients (25%) developed acute ischemia during chemotherapy. The superficial femoral artery was the most frequent site of occlusion (50%), followed by the brachial (18%) and popliteal (12%) arteries. All patients underwent thromboembolectomy, but two (12%) patients subsequently required a bypass procedure. Six patients (37%) had limb loss, and in-patient mortality was 12%. Histology revealed that all occlusions were due to thromboembolism, with no tumor cells identified. At follow-up, 44% of patients were found to be alive after 1 year. CONCLUSION: Cancer and chemotherapy can predispose patients to acute arterial ischemia. Unlike other reports that view this finding as a preterminal event most appropriately treated by palliative measures, in this series, early diagnosis and surgical intervention enabled limb salvage and patient survival.

  11. Diabetes Drug Gets FDA Warning Due to Amputation Risk

    Science.gov (United States)

    ... html Diabetes Drug Gets FDA Warning Due to Amputation Risk Canagliflozin tied to a doubling of amputations of legs, feet, agency says To use the ... to increase the risk of leg and foot amputations, the U.S. Food and Drug Administration says. The ...

  12. Neurobiology: reconstructing the neural control of leg coordination.

    Science.gov (United States)

    Zill, Sasha N; Keller, Bridget R

    2009-05-12

    Walking is adaptable because the timing of movements of individual legs can be varied while maintaining leg coordination. Recent work in stick insects shows that leg coordination set by interactions of pattern generating circuits can be overridden by sensory feedback.

  13. Popliteal artery puncture in the assessment of patients with severe leg ischemia

    DEFF Research Database (Denmark)

    Agerskov, K; Faris, I; Tønnesen, K H

    1983-01-01

    , the pressure difference exceeded 10 mmHg in 2/58 limbs (3%). One month following above knee femoropopliteal bypass (48 limbs), patients with a popliteal-ankle difference less than 10 mmHg obtained a significantly higher ankle pressure index (PI 0.86, range 0.56-1.20) (p less than 0.01) than those...... with a pressure difference exceeding 10 mmHg (PI 0.66, range 0.40-0.91). The clinical state 6 months following femoropopliteal bypass did not demonstrate that patients with a low popliteal-ankle difference fared better than patients with a higher pressure difference; however, the PI appeared significantly lower...

  14. Glutathione and ascorbate during ischemia and postischemic reperfusion in rat brain.

    Science.gov (United States)

    Cooper, A J; Pulsinelli, W A; Duffy, T E

    1980-11-01

    Thirty minutes of total cerebral ischemia (decapitation) decreased total glutathione (GSH + GSSG) by 7% but had no detectable effect on the concentration of oxidized glutathione (GSSG), reduced ascorbate, or total ascorbate, In a model of reversible, bilateral hemispheric ischemia (four-vessel occlusion) no changes in glutathione or ascorbate were detected after 30 min of ischemia. During 24 h of reperfusion following such an insult no detectable change in total ascorbate, reduced ascorbate, or oxidized glutathione was noted: however, total brain glutathione declined by 25%. The findings are discussed in relation to the hypothesis that the deleterious effects of ischemia are due to an increase in free radical production which in turn leads to increased lipid peroxidation.

  15. Steerable Hopping Six-Legged Robot

    Science.gov (United States)

    Younse, Paulo; Aghazarian, Hrand

    2010-01-01

    The figure depicts selected aspects of a six-legged robot that moves by hopping and that can be steered in the sense that it can be launched into a hop in a controllable direction. This is a prototype of hopping robots being developed for use in scientific exploration of rough terrain on remote planets that have surface gravitation less than that of Earth. Hopping robots could also be used on Earth, albeit at diminished hopping distances associated with the greater Earth gravitation. The upper end of each leg is connected through two universal joints to an upper and a lower hexagonal frame, such that the tilt of the leg depends on the relative position of the two frames. Two non-back-driveable worm-gear motor drives are used to control the relative position of the two frames along two axes 120 apart, thereby controlling the common tilt of all six legs and thereby, further, controlling the direction of hopping. Each leg includes an upper and a lower aluminum frame segment with a joint between them. A fiberglass spring, connected via hinges to both segments, is used to store hopping energy prior to launch into a hop and to cushion the landing at the end of the hop. A cable for loading the spring is run into each leg through the center of the universal joints and then down along the center lines of the segments to the lower end of the leg. A central spool actuated by a motor with a harmonic drive and an electromagnetic clutch winds in all six cables to compress all six springs (thereby also flexing all six legs) simultaneously. To ensure that all the legs push off and land in the same direction, timing- belt pulley drives are attached to the leg segments, restricting the flexing and extension of all six legs to a common linear motion. In preparation for a hop, the spool can be driven to load the spring legs by an amount corresponding to a desired hop distance within range. The amount of compression can be computed from the reading of a shaft-angle encoder that

  16. [Lower limb salvage with a free fillet fibula flap harvested from the contralateral amputated leg].

    Science.gov (United States)

    Bouyer, M; Corcella, D; Forli, A; Mesquida, V; Semere, A; Moutet, F

    2015-06-01

    We report a unusual case of "fillet flap" to reconstruct the lower limb with the amputated contralateral leg. This kind of procedure was first described by Foucher et al. in 1980 for traumatic hand surgery as the "bank finger". A 34-year-old man suffered a microlight accident with bilateral open legs fractures. A large skin defect of the left leg exposed the ankle, the calcaneus and a non-vascularized part of the tibial nerve (10 cm). The patient came to the OR for surgical debridement and had massive bone resection of the left calcaneus. The right leg showed limited skin defect at the lower part, exposing the medial side of the ankle and a tibial bone defect, measuring 10 cm. Salvage the left leg was impossible due to complex nerve, bones and skin associated injuries, so this leg was sacrificed and used as a donor limb, to harvest a free fibula flap for contralateral tibial reconstruction. At 18 months of follow-up, the patient was very satisfied, the clinical result was very good on both lower limbs and X-rays showed excellent integration of the free fibula flap. The patient had normal dailies occupations, can run and have bicycle sport practice with a functional left leg fit prosthesis. This case showed an original application of the "fillet flap concept" to resolve complex and rare traumatic situations interesting the both lower limbs. In our opinion, this strategy must be a part of the plastic surgeon skills in uncommon situations.

  17. Possibility of leg muscle hypertrophy by ambulation in older adults: a brief review.

    Science.gov (United States)

    Ozaki, Hayao; Loenneke, Jeremy P; Thiebaud, Robert S; Stager, Joel M; Abe, Takashi

    2013-01-01

    It is known that ambulatory exercises such as brisk walking and jogging are potent stimuli for improving aerobic capacity, but it is less understood whether ambulatory exercise can increase leg muscle size and function. The purpose of this brief review is to discuss whether or not ambulatory exercise elicits leg muscle hypertrophy in older adults. Daily ambulatory activity with moderate (>3 metabolic equivalents [METs], which is defined as the ratio of the work metabolic rate to the resting metabolic rate) intensity estimated by accelerometer is positively correlated with lower body muscle size and function in older adults. Although there is conflicting data on the effects of short-term training, it is possible that relatively long periods of walking, jogging, or intermittent running for over half a year can increase leg muscle size among older adults. In addition, slow-walk training with a combination of leg muscle blood flow restriction elicits muscle hypertrophy only in the blood flow restricted leg muscles. Competitive marathon running and regular high intensity distance running in young and middle-aged adults may not produce leg muscle hypertrophy due to insufficient recovery from the damaging running bout, although there have been no studies that have investigated the effects of running on leg muscle morphology in older subjects. It is clear that skeletal muscle hypertrophy can occur independently of exercise mode and load.

  18. Cardiac Ischemia and Ischemia/Reperfusion Cause Wide Proteolysis of the Coronary Endothelial Luminal Membrane: Possible Dysfunctions

    Science.gov (United States)

    Arroyo-Flores, Blanca; Chi-Ahumada, Erika; Briones-Cerecero, Erika; Barajas-Espinosa, Alma; Perez-Aguilar, Sandra; de la Rosa, Ana Barba; Knabb, Maureen; Rubio, Rafael

    2011-01-01

    Background: Ischemia and ischemia-reperfusion (I/R) are common clinical insults that disrupt the molecular structure of coronary vascular endothelial luminal membrane (VELM) that result in diverse microvasculature dysfunctions. However, the knowledge of the associated biochemical changes is meager. We hypothesized that ischemia and I/R-induced structural and functional VELM alterations result from biochemical changes. First, these changes need to be described and later the mechanisms behind be identified. Methods: During control conditions, in isolated perfused rat hearts VELM proteins were labeled with biotin. The groups of hearts were: control (C), no flow ischemia (I; 25 min), and I/R (I; 25 min, reperfusion 30 min). The biotinylated luminal endothelial membrane proteins in these three different groups were examined by 2-D electrophoresis and identified. But, it must be kept in mind the proteins were biotin-labeled during control. Results: A comparative analysis of the protein profiles under the 3 conditions following 2D gel electrophoresis showed differences in the molecular weight distribution such that MWC > MWI > MWI/R. Similar analysis for isoelectric points (pHi) showed a shift toward more acidic pHi under ischemic conditions. Of 100 % proteins identified during control 66% and 88% changed their MW-pHi during ischemia and I/R respectively. Among these lost proteins there were 9 proteins identified as adhesins and G-protein coupled receptors. General significance: I and I/R insults alter MW-pHi of most luminal glycocalyx proteins due to the activation of nonspecific hydrolizing mechanisms; suspect metalloproteases and glycanases. This makes necessary the identification of hydrolyzing enzymes reponsible of multiple microvascular dysfunctions in order to maintain the integrity of vascular endothelial membrane. VELM must become a target of future therapeutics. PMID:22262983

  19. Repair of a large soft tissue defect in the leg with cross-leg bridge free transfer of a latissimus dorsi myocutaneous flap: a case report

    Directory of Open Access Journals (Sweden)

    ZHANG Gong-lin

    2012-12-01

    Full Text Available 【Abstract】A 48-year-old man sustained a traffic accident injury to his left leg. It was an open fracture of the left tibia and fibula accompanied by a large soft tissue de-fect (27 cm×7 cm. Doppler examination revealed the poste-rior tibial artery was occluded due to thrombosis. Three weeks after injury, the latissimus dors myocutaneous flap was elevated with a T-shaped vascular pedicle and was in-terposed between the two vascular ends of the posterior tibial vessel of the contralateral leg. Two end to end anasto-moses were performed between the two vascular ends of the posterior tibial vessel of the contralateral leg and the latissimus dors myocutaneous flap’s T-shaped vascular pedicle. The latissimus dorsi myocutaneous flap was used for repair of a large soft tissue defect of the left leg. The vascular pedicle was cut off after 28 days and the flap sur-vived completely. After 3-years’ follow-up postoperatively, a good contour was confirmed at the recipient area. The right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was demonstrated patent by clinical and Doppler examinations. Key words: Surgical flaps; Leg injuries; Soft tissue injuries; Wound healing

  20. Expansion Compression Contacts for Thermoelectric Legs

    Science.gov (United States)

    Sakamoto, Jeffrey

    2009-01-01

    In a proposed alternative to previous approaches to making hot-shoe contacts to the legs of thermoelectric devices, one relies on differential thermal expansion to increase contact pressures for the purpose of reducing the electrical resistances of contacts as temperatures increase. The proposed approach is particularly applicable to thermoelectric devices containing p-type (positive-charge-carrier) legs made of a Zintl compound (specifically, Yb14MnSb11) and n-type (negative charge-carrier) legs made of SiGe. This combination of thermoelectric materials has been selected for further development, primarily on the basis of projected thermoelectric performance. However, it is problematic to integrate, into a practical thermoelectric device, legs made of these materials along with a metal or semiconductor hot shoe that is required to be in thermal and electrical contact with the legs. This is partly because of the thermal-expansion mismatch of these materials: The coefficient of thermal expansion (CTE) of SiGe is 4.5 x 10(exp -6) C (exp -1), while the CTE of Yb14MnSb11 is 20 x 10(exp -6) C(exp -1). Simply joining a Yb14MnSb11 and a SiGe leg to a common hot shoe could be expected to result in significant thermal stresses in either or both legs during operation. Heretofore, such thermal stresses have been regarded as disadvantageous. In the proposed approach, stresses resulting from the CTE mismatch would be turned to advantage.

  1. The treatment of chronic intestinal ischemia.

    Science.gov (United States)

    Illuminati, G; Caliò, F G; D'Urso, A; Papaspyropoulos, V; Mancini, P; Ceccanei, G; Vietri, F

    2004-01-01

    Due to the rarity of the condition, large and prospective series defining the optimal method of digestive arteries revascularization, for the treatment of chronic intestinal ischemia, are lacking. The aim of this consecutive sample clinical study was to test the hypothesis that flexible application of different revascularization methods, according to individual cases, will yield the best results in the management of chronic intestinal ischemia. Eleven patients, of a mean age of 57 years, underwent revascularization of 11 digestive arteries for symptomatic chronic mesenteric occlusive disease. Eleven superior mesenteric arteries and one celiac axis were revascularized. The revascularization techniques included retrograde bypass grafting in 7 cases, antegrade bypass grafting in 2, percutaneous arterial angioplasty in 1, and arterial reimplantation in one case. The donor axis for either reimplantation or bypass grafting was the infrarenal aorta in 4 cases, an infrarenal Dacron graft in 4, and the celiac aorta in one case. Grafting materials included 5 polytetrafluoroethylene (PTFE) and 3 Dacron grafts. Concomitant procedures included 3 aorto-ilio-femoral grafts and one renal artery revascularization. Mean follow-up length was 31 months. There was no operative mortality. Cumulative survival rate was 88.9% at 36 months (SE 12.1%). Primary patency rate was 90% at 36 months (SE 11.6%). The symptom free rate was 90% at 36 months (SE 11.6%). Direct reimplantation, antegrade and retrograde bypass grafting, all allow good mid-term results: the choice of the optimal method depends on the anatomic and general patients status. Associated infrarenal and renal arterial lesions can be safely treated in the same time of digestive revascularization. Angioplasty alone yields poor results and should be limited to patients at poor risk for surgery.

  2. Radial forearm free flap morbidity: A rare case of a normal preoperative arteriogram and acute intraoperative hand ischemia

    OpenAIRE

    Bruner, Terrence W.; Hanasono, Matthew M.; Skoracki, Roman J

    2011-01-01

    The radial forearm free flap is ideal for reconstructive microsurgery due to its thin, pliable fasciocutaneous tissue, reliable anatomy and ease and simplicity of flap elevation. However, one of the major complications is hand ischemia due to sacrifice of the radial artery, although it is a rare occurrence. A case involving a 73-year-old man who developed intraoperative hand ischemia after elevation of a radial forearm free flap is presented.

  3. The relationship of leg volume and leg mass with anaerobic performance and knee strength in wrestlers

    Directory of Open Access Journals (Sweden)

    Erdal ZORBA

    2010-01-01

    Full Text Available The purpose of the present study was to determination of the relationship between leg volume, leg mass with anaerobic performance and knee strength in wrestlers. 31 wrestlers from a university students participated in this study voluntarily (age: 21.09 ± 0.99 yrs. Circumferential measurement were used for the determination of leg volume by Frustum Method and after that, a regression formula was used. For this formulas, while the R square (R2 value was .95 and the standart error value was .056. Leg mass was determined by the Hanavan Method. Wingate Anaerobic Power Test (WAnT was used for the determination of anaerobic performance and Isometric Knee Dynamometer was used for the determination of knee strength. Results of Pearson Product Moment correlation analysis, leg volume was significantly correlated with leg mass (r=.993; p<0.01, peak power (r=.523; p<0.01 and mean power (r=.585; p<0.01. Similarly leg mass was significantly correlated with peak power (r=.654; p<0.01 and mean power (r=.704; p<0.01. In addition, peak power was found to be significantly correlated with leg strength (r=.430; p<0.05 and mean power (r=.613; p<0.01. As a conclusion, the findings of the present study indicated that leg volume and leg mass plays important role in anaerobic performance in wrestlers and isometric knee strength was found to be correlated with anaerobic performance.

  4. Transiliac Leg Lengthening in Poliomyelitis

    Directory of Open Access Journals (Sweden)

    Baghdadi Taghi

    2009-10-01

    Full Text Available The development and widespread use of a prophylactic vaccine significantly reduced the incidence of poliomyelitis. At present we more commonly encounter with poliomyelitis sequelae especially in developing countries. We evaluate the results of a modified innominate osteotomy for leg length discrepancy in poliomyelitis. Instead of triangular bone graft as in Salter’s innominate osteotomy , a trapezoidal bone graft from the ilium is inserted in the site of osteotomy after gradual distraction of the limb. 25 patients (9 males and 16 females with mean age of 25 years (17-37 years were treated by this method. All of them had poliomyelitis with limb shortening. At a mean follow-up of 7 years (3 months to 17 years an average of 3 cm (2.5-3.5 was achieved. Complication was seen in three patients including injury to the lateral cutaneouns nerve of thigh and displacement of osteotomy in two patients .except in one all of the patients satisfied with the operation. We believe this method is safe, effective and cost-benefit for treating of moderate shortening of the lower limb in poliomyelitis.

  5. Pharmacotherapy for restless legs syndrome.

    Science.gov (United States)

    Ferini-Strambi, Luigi; Marelli, Sara

    2014-06-01

    Restless legs syndrome (RLS) is a common condition characterized by paresthesia and an urge to move. Predominantly, symptoms occur at rest in the evening or at night, and they are alleviated by moving the affected extremity. RLS prevalence in the general population has been estimated to be approximately 5%. This review presents all options for the treatment of RLS. Pharmacological treatment should be limited to those patients who suffer from clinically relevant RLS, that is, when symptoms impair the patient's quality of life, daytime functioning, social functioning or sleep. Treatment on demand is a clinical need in some RLS patients, and medications include carbidopa/levodopa, pramipexole, ropinirole, oxycodone, methadone, codeine and tramadol. Chronic RLS should be treated with either a nonergot dopamine agonist or an α-2-δ calcium channel ligand. A dopamine agonist is a more appropriate choice in the presence of depression and overweight. As α-2-δ ligands can alleviate chronic pain and may be helpful in treating anxiety and insomnia, the presence of any of these comorbidities may favor their use. For RLS present through much of the day and night, the use of long-acting agents, such as the rotigotine patch or gabapentin enacarbil should be considered. In refractory RLS, oral prolonged release oxycodone-naloxone should be considered.

  6. IDENTIFIKASI SINYAL ECG IRAMA MYOCARDIAL ISCHEMIA DENGAN PENDEKATAN FUZZY LOGIC

    Directory of Open Access Journals (Sweden)

    Azhar A N

    2009-07-01

    Full Text Available The heart is one of vital organs in human body. Incidence of heart disease can be fatal for the patient. Myocardial ischemia, the disease that is often suffered by the human, is a disease due to clogged heart arteries blood vessels. One of the ways to detect this disease is by reading the graph output of electrocardiogram (ECG signal. ECG signal represents the condition and activity of the heart. Specialized knowledge, accuration and expertise are required to read ECG graph. To help expert or doctor, expert system based on artificial intelligent, such as Fuzzy Logic approach, can be applied to improve diagnostic accuracy and thoroughness. Fuzzy logic can be applied because of it flexibility to understand the linguistic variables used in identifying myocardial ischemia disease.

  7. Expressional changes in cerebrovascular receptors after experimental transient forebrain ischemia

    DEFF Research Database (Denmark)

    Johansson, Sara; Povlsen, Gro Klitgaard; Edvinsson, Lars

    2012-01-01

    of vasoconstrictive endothelin and 5-hydroxytryptamine receptors in cerebral arteries. Experimental transient forebrain ischemia of varying durations was induced in male wistar rats, followed by reperfusion for 48 hours. Neurological function was assessed daily by three different tests and cerebrovascular expression......Global ischemic stroke is one of the most prominent consequences of cardiac arrest, since the diminished blood flow to the brain results in cell damage and sometimes permanently impaired neurological function. The post-arrest period is often characterised by cerebral hypoperfusion due to subacute...... the insult, a phenomenon that leads to increased contraction of cerebral arteries, reduced perfusion of the affected area and worsened ischemic damage. Based on these findings, the aim of the present study was to investigate if transient global cerebral ischemia is associated with upregulation...

  8. Oxidative Stress and Lung Ischemia-Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Renata Salatti Ferrari

    2015-01-01

    Full Text Available Ischemia-reperfusion (IR injury is directly related to the formation of reactive oxygen species (ROS, endothelial cell injury, increased vascular permeability, and the activation of neutrophils and platelets, cytokines, and the complement system. Several studies have confirmed the destructiveness of the toxic oxygen metabolites produced and their role in the pathophysiology of different processes, such as oxygen poisoning, inflammation, and ischemic injury. Due to the different degrees of tissue damage resulting from the process of ischemia and subsequent reperfusion, several studies in animal models have focused on the prevention of IR injury and methods of lung protection. Lung IR injury has clinical relevance in the setting of lung transplantation and cardiopulmonary bypass, for which the consequences of IR injury may be devastating in critically ill patients.

  9. Hypoxia-Induced miR-210 Modulates Tissue Response to Acute Peripheral Ischemia

    Science.gov (United States)

    Zaccagnini, Germana; Maimone, Biagina; Di Stefano, Valeria; Fasanaro, Pasquale; Greco, Simona; Perfetti, Alessandra; Capogrossi, Maurizio C.; Gaetano, Carlo

    2014-01-01

    Abstract Aims: Peripheral artery disease is caused by the restriction or occlusion of arteries supplying the leg. Better understanding of the molecular mechanisms underpinning tissue response to ischemia is urgently needed to improve therapeutic options. The aim of this study is to investigate hypoxia-induced miR-210 regulation and its role in a mouse model of hindlimb ischemia. Results: miR-210 expression was induced by femoral artery dissection. To study the role of miR-210, its function was inhibited by the systemic administration of a miR-210 complementary locked nucleic acid (LNA)-oligonucleotide (anti-miR-210). In the ischemic skeletal muscle, anti-miR-210 caused a marked decrease of miR-210 compared with LNA-scramble control, while miR-210 target expression increased accordingly. Histological evaluation of acute tissue damage showed that miR-210 inhibition increased both apoptosis at 1 day and necrosis at 3 days. Capillary density decrease caused by ischemia was significantly more pronounced in anti-miR-210-treated mice; residual limb perfusion decreased accordingly. To investigate the molecular mechanisms underpinning the increased damage triggered by miR-210 blockade, we tested the impact of anti-miR-210 treatment on the transcriptome. Gene expression analysis highlighted the deregulation of mitochondrial function and redox balance. Accordingly, oxidative damage was more severe in the ischemic limb of anti-miR-210-treated mice and miR-210 inhibition increased oxidative metabolism. Further, oxidative-stress resistant p66Shc-null mice displayed decreased tissue damage following ischemia. Innovation: This study identifies miR-210 as a crucial element in the adaptive mechanisms to acute peripheral ischemia. Conclusions: The physiopathological significance of miR-210 is context dependent. In the ischemic skeletal muscle it seems to be cytoprotective, regulating oxidative metabolism and oxidative stress. Antioxid. Redox Signal. 21, 1177–1188. PMID:23931770

  10. Recipient twin limb ischemia with postnatal onset.

    Science.gov (United States)

    Broadbent, Roland Spencer

    2007-02-01

    After the occurrence of 3 local cases of limb ischemia in newborn twins, we reviewed the literature to investigate this combination systematically. This review reveals a distinct condition: postnatal onset limb ischemia affecting recipient twins in twin-twin transfusion syndrome.

  11. Retinal ischemia and embolism. Causes and outcomes

    NARCIS (Netherlands)

    Wijman, C.A.C.

    2007-01-01

    The ocular fundus allows direct visualization of the retinal vasculature, blood vessels that are part of the cerebral circulation. Unraveling the causes of retinal ischemia may provide further insight in the pathophysiological processes that underlie cerebral ischemia. The primary aim of the studies

  12. The relationship of leg volume and leg mass with anaerobic performance and knee strength in wrestlers

    Directory of Open Access Journals (Sweden)

    Erdal Zorba

    2010-01-01

    Full Text Available The purpose of the present study was to determination of the relationship between leg volume, leg mass with anaerobic performance and knee strength in wrestlers. 31 wrestlers from a university students participated in this study voluntarily (X age: 21.09 ± 0.99 yrs. Circumferential measurement were used for the determination of leg volume by Frustum Method and after that, a regression formula was used. For this formulas, while the R square (R2 value was .95 and the standart error value was .056. Leg mass was determined by the Hanavan Method. Wingate Anaerobic Power Test (WAnT was used for the determination of anaerobic performance and Isometric Knee Dynamometer was used for the determination of knee strength. Results of Pearson Product Moment correlation analysis, leg volume was significantly correlated with leg mass (r=.993; pnee strength was found to be correlated with anaerobic performance.

  13. Late sodium current and intracellular ionic homeostasis in acute ischemia.

    Science.gov (United States)

    Ronchi, Carlotta; Torre, Eleonora; Rizzetto, Riccardo; Bernardi, Joyce; Rocchetti, Marcella; Zaza, Antonio

    2017-03-01

    Blockade of the late Na(+) current (I NaL) protects from ischemia/reperfusion damage; nevertheless, information on changes in I NaL during acute ischemia and their effect on intracellular milieu is missing. I NaL, cytosolic Na(+) and Ca(2+) activities (Nacyt, Cacyt) were measured in isolated rat ventricular myocytes during 7 min of simulated ischemia (ISC); in all the conditions tested, effects consistently exerted by ranolazine (RAN) and tetrodotoxin (TTX) were interpreted as due to I NaL blockade. The results indicate that I NaL was enhanced during ISC in spite of changes in action potential (AP) contour; I NaL significantly contributed to Nacyt rise, but only marginally to Cacyt rise. The impact of I NaL on Cacyt was markedly enhanced by blockade of the sarcolemmal(s) Na(+)/Ca(2+) exchanger (NCX) and was due to the presence of (Na(+)-sensitive) Ca(2+) efflux through mitochondrial NCX (mNCX). sNCX blockade increased Cacyt and decreased Nacyt, thus indicating that, throughout ISC, sNCX operated in the forward mode, in spite of the substantial Nacyt increment. Thus, a robust Ca(2+) source, other than sNCX and including mitochondria, contributed to Cacyt during ISC. Most, but not all, of RAN effects were shared by TTX. (1) The paradigm that attributes Cacyt accumulation during acute ischemia to decrease/reversal of sNCX transport may not be of general applicability; (2) I NaL is enhanced during ISC, when the effect of Nacyt on mitochondrial Ca(2+) transport may substantially contribute to I NaL impact on Cacyt; (3) RAN may act mostly, but not exclusively, through I NaL blockade during ISC.

  14. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

    Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T

    2005-01-01

    In the clinical setting, diagnosis and treatment of venous leg ulcers can vary considerably from patient to patient. The first step to reducing this variation is to document venous leg ulcer care through use of quantitative scientific documentation principles. This requires the development of valid...... and reliable evidence-based quality indicators of venous leg ulcer care. A Scandinavian multidisciplinary, cross-sectional panel of wound healing experts developed clinical quality indicators on the basis of scientific evidence from the literature and subsequent group nominal consensus of the panel......; an independent medical doctor tested the feasibility and reliability of these clinical indicators, assessing the quality of medical technical care on 100 consecutive venous leg ulcer patients. Main outcome measures were healing, recurrence, pain, venous disease diagnosis, differential diagnosis and treatment...

  15. Poison ivy on the leg (image)

    Science.gov (United States)

    This is a typical early appearance of a poison ivy rash, located on the leg. These early lesions ... line where the skin has brushed against the poison ivy plant. The rash is caused by skin contact ...

  16. Support Leg Loading in Punt Kicking

    Science.gov (United States)

    Kermond, John; Konz, Stephen

    1978-01-01

    Maximum distance in football punt kicking is associated with a maximum force transfer to the ball rather than a maximum force transfer through the ground via the support leg. For maximum distance, tred lightly. (Author)

  17. Leg or foot amputation - dressing change

    Science.gov (United States)

    ... gov/ency/patientinstructions/000018.htm Leg or foot amputation - dressing change To use the sharing features on ... guideline for management for rehabilitation of lower limb amputation. January 2008. www.healthquality.va.gov/guidelines/Rehab/ ...

  18. Transient myocardial ischemia after myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H

    1995-01-01

    Ambulatory ST-segment monitoring is a relatively new device in the evaluation of myocardial ischemia. The method is unique in allowing us to continuously examine the patient over an extended period of time in a changing environmental milieu. In survivors of acute myocardial infarction...... the prevalence of ambulatory or transient myocardial ischemia is lower than in patients with chronic, stable coronary artery disease. A greater proportion of ischemic episodes, however, are silent than in other subgroups with ischemic heart disease. Early after the infarction, transient myocardial ischemia...... exhibits a circadian variation with a peak activity occurring in the late evening hours. Patients with non-Q wave infarction have more transient myocardial ischemia, whereas thrombolytic therapy seems to result in less residual ischemia. Exercise testing is more sensitive than ambulatory monitoring...

  19. Transient myocardial ischemia after myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H

    1995-01-01

    Ambulatory ST-segment monitoring is a relatively new device in the evaluation of myocardial ischemia. The method is unique in allowing us to continuously examine the patient over an extended period of time in a changing environmental milieu. In survivors of acute myocardial infarction...... the prevalence of ambulatory or transient myocardial ischemia is lower than in patients with chronic, stable coronary artery disease. A greater proportion of ischemic episodes, however, are silent than in other subgroups with ischemic heart disease. Early after the infarction, transient myocardial ischemia...... exhibits a circadian variation with a peak activity occurring in the late evening hours. Patients with non-Q wave infarction have more transient myocardial ischemia, whereas thrombolytic therapy seems to result in less residual ischemia. Exercise testing is more sensitive than ambulatory monitoring...

  20. Microgravity, Mesh-Crawling Legged Robots

    Science.gov (United States)

    Behar, Alberto; Marzwell, Neville; Matthews, Jaret; Richardson, Krandalyn; Wall, Jonathan; Poole, Michael; Foor, David; Rodgers, Damian

    2008-01-01

    The design, fabrication, and microgravity flight-testing are part of a continuing development of palm-sized mobile robots that resemble spiders (except that they have six legs apiece, whereas a spider has eight legs). Denoted SpiderBots (see figure), they are prototypes of proposed product line of relatively inexpensive walking robots that could be deployed in large numbers to function cooperatively in construction, repair, exploration, search, and rescue activities in connection with exploration of outer space and remote planets.

  1. Suppression of cardiocirculatory responses to orthostatic stress by passive walking-like leg movement in healthy young men

    National Research Council Canada - National Science Library

    Ogata, Hisayoshi; Fujimaru, Ikuyo; Yamada, Keiko; Kondo, Takaharu

    2012-01-01

    Although passive walking-like leg movement in the standing posture (PWM) has been used in the clinical field, the safety of PWM has not been fully determined despite the risks of orthostatic intolerance due to standing posture...

  2. Three cross leg flaps for lower leg reconstruction of Gustilo type III C open fracture

    Directory of Open Access Journals (Sweden)

    Kazufumi Sano

    2016-01-01

    Full Text Available A 60 year old male had Gustilo type III C open fracture of the right lower leg. After radical debridement, the large open defect including certain loss of the bone tissue was successfully augmented and covered, by consecutive three cross-leg flaps, which consisted of the free rectus abdominis musculocutaneous flap, the fibula osteocutaneous flap and the conventional sural flap. Although indication for amputation or preservation is decided with multiple factors in each case, a strategic combination of cross-leg flap, free flap, external fixation and vascular delay could increase the potential of preservation of the lower leg with even disastrous Gustilo type III C.

  3. Passive legged, multi-segmented, robotic vehicle.

    Energy Technology Data Exchange (ETDEWEB)

    Hayward, David R.

    2003-11-01

    The Passive-legged, Multi-segmented, Robotic Vehicle concept is a simple legged vehicle that is modular and scaleable, and can be sized to fit through confined areas that are slightly larger than the size of the vehicle. A specific goal of this project was to be able to fit through the opening in the fabric of a chain link fence. This terrain agile robotic platform will be composed of multiple segments that are each equipped with appendages (legs) that resemble oars extending from a boat. Motion is achieved by pushing with these legs that can also flex to fold next to the body when passing through a constricted area. Each segment is attached to another segment using an actuated joint. This joint represents the only actuation required for mobility. The major feature of this type of mobility is that the terrain agility advantage of legs can be attained without the complexity of the multiple-actuation normally required for the many joints of an active leg. The minimum number of segments is two, but some concepts require three or more segments. This report discusses several concepts for achieving this type of mobility, their design, and the results obtained for each.

  4. Sympathetic adaptations to one-legged training

    Science.gov (United States)

    Ray, C. A.

    1999-01-01

    The purpose of the present study was to determine the effect of leg exercise training on sympathetic nerve responses at rest and during dynamic exercise. Six men were trained by using high-intensity interval and prolonged continuous one-legged cycling 4 day/wk, 40 min/day, for 6 wk. Heart rate, mean arterial pressure (MAP), and muscle sympathetic nerve activity (MSNA; peroneal nerve) were measured during 3 min of upright dynamic one-legged knee extensions at 40 W before and after training. After training, peak oxygen uptake in the trained leg increased 19 +/- 2% (P training (108 +/- 5 to 96 +/- 5 beats/min and 132 +/- 8 to 119 +/- 4 mmHg, respectively, during the third minute of exercise; P training. However, MSNA was significantly less during the third minute of exercise after training (32 +/- 2 to 22 +/- 3 bursts/min; P training effect on MSNA remained when MSNA was expressed as bursts per 100 heartbeats. Responses to exercise in five untrained control subjects were not different at 0 and 6 wk. These results demonstrate that exercise training prolongs the decrease in MSNA during upright leg exercise and indicates that attenuation of MSNA to exercise reported with forearm training also occurs with leg training.

  5. Metabolic Adaptation to Muscle Ischemia

    Science.gov (United States)

    Cabrera, Marco E.; Coon, Jennifer E.; Kalhan, Satish C.; Radhakrishnan, Krishnan; Saidel, Gerald M.; Stanley, William C.

    2000-01-01

    Although all tissues in the body can adapt to varying physiological/pathological conditions, muscle is the most adaptable. To understand the significance of cellular events and their role in controlling metabolic adaptations in complex physiological systems, it is necessary to link cellular and system levels by means of mechanistic computational models. The main objective of this work is to improve understanding of the regulation of energy metabolism during skeletal/cardiac muscle ischemia by combining in vivo experiments and quantitative models of metabolism. Our main focus is to investigate factors affecting lactate metabolism (e.g., NADH/NAD) and the inter-regulation between carbohydrate and fatty acid metabolism during a reduction in regional blood flow. A mechanistic mathematical model of energy metabolism has been developed to link cellular metabolic processes and their control mechanisms to tissue (skeletal muscle) and organ (heart) physiological responses. We applied this model to simulate the relationship between tissue oxygenation, redox state, and lactate metabolism in skeletal muscle. The model was validated using human data from published occlusion studies. Currently, we are investigating the difference in the responses to sudden vs. gradual onset ischemia in swine by combining in vivo experimental studies with computational models of myocardial energy metabolism during normal and ischemic conditions.

  6. Acute mesenteric ischemia in young adults.

    Science.gov (United States)

    Ozturk, Gurkan; Aydinli, Bulent; Atamanalp, S Selcuk; Yildirgan, M Ilhan; Ozoğul, Bünyami; Kısaoğlu, Abdullah

    2012-08-01

    Acute mesenteric ischemia is commonly seen in old patients. This study was undertaken to show that mesenteric ischemia might be seen in individuals under 40 years of age and that its diagnosis is challenging. Twenty-six patients with acute mesenteric ischemia under the age of 40 were studied. The main symptom on admission was abdominal pain. Symptom duration varied between 12 h and 5 days. The medical history of the patients revealed that 9 had no previous diseases. Other 17 had predisposing factors in the first evaluation. None of the patients had any history of narcotic or drug abuse. Ten patients presented with signs and symptoms of sepsis and septic shock. Preoperative diagnosis was acute intestinal ischemia only in 6 patients. Preoperatively, all the patients had intestinal or colonic ischemia and necrosis; one had additional ischemia of the liver, stomach, duodenum, and pancreas. Six patients had massive intestinal necrosis. The overall postoperative complication and overall mortality rates were 61.5 and 26.9 %, respectively. Complications and mortality were determined to be associated with previous pulmonary disease, acidosis, presence of septic shock, acute renal failure, extent of the ischemia and extent of resection, second look operations, previous cardiac events, and the kind of affected bowel (colon involvement).

  7. Dynamic Stress Analysis of the Leg Joints of Self-Elevating Platform

    Institute of Scientific and Technical Information of China (English)

    HUANG Zhao-yu; TANG Wen-yong; WANG Yi; WANG Wen-tao

    2011-01-01

    Since a self-elevating platform often works in water for a long time, the lattice leg is largely influenced by wave and current. The amplitude of leg joint stresses is a very important factor for the fatigue life of the platform. However, there are not many researches having been done on the mechanism and dynamic stress analysis of these leg joints. This paper focuses on the dynamic stress analysis and suppression methods of the leg joints of self-elevating platforms. Firstly, the dynamic stresses of the lattice leg joints are analyzed for a self-elevating platform by use of the 5th-order Stokes wave theory. Secondly, the axial and bending stresses are studied due to their large contributions to total stresses. And then, different joint types are considered and the leg-hull interface stiffness is analyzed for the improvement of the joint dynamic stress amplitude. Finally, some useful conclusions are drawn for the optimization design of the self-elevating platform.

  8. The Effect of Stretching Exercises on Severity of Restless Legs Syndrome in Patients on Hemodialysis

    Directory of Open Access Journals (Sweden)

    Aliasgharpour

    2016-06-01

    Full Text Available Background The restless legs syndrome is a sensorimotor disorder that is very common in patients on hemodialysis. Due to pharmacological treatments which have their own side effects, nowadays, studies have turned to non-pharmacological treatments. Objectives The present study aims to assess the effect of stretching exercises on the severity of restless legs syndrome in patients on hemodialysis. Patients and Methods This clinical trial study was conducted on 33 patients who had been identified using diagnostic criteria from the hemodialysis ward of Hasheminejad Hospital in Tehran. Participants were randomly divided into the intervention group (n = 17 and control group (n = 16. Stretching exercises were performed on legs during the dialysis for half an hour, three times a week for 8 weeks in intervention group. Data were collected by using the international restless legs syndrome study group scale. Results The results showed that the majority of participants were suffering from moderate restless legs syndrome. The symptom severity of this syndrome meaningfully changed eight weeks after intervention in the intervention group compared to the control group (P < 0.001. Conclusions The results highlighted the significance of training and performing the stretching exercises during dialysis for the purpose of improving restless legs syndrome symptoms and the quality of care of hemodialysis patients.

  9. Middle cerebral artery flow velocity and blood flow during exercise and muscle ischemia in humans

    DEFF Research Database (Denmark)

    Jørgensen, L G; Perko, M; Hanel, B

    1992-01-01

    ," mechanoreceptors, and/or muscle "metaboreceptors" on cerebral perfusion. Ten healthy subjects performed two levels of dynamic exercise corresponding to a heart rate of 110 (range 89-134) and 148 (129-170) beats/min, respectively, and exhaustive one-legged static knee extension. Measurements were continued during 2......-2.5 min of muscle ischemia. MAP increased similarly during static [114 (102-133) mmHg] and heavy dynamic exercise [121 (104-136) mmHg] and increased during muscle ischemia after dynamic exercise. During heavy dynamic exercise, Vmean increased 24% (10-47%; P less than 0.01) over approximately 3 min despite...... constant arterial carbon dioxide tension. In contrast, static exercise with a higher rate of perceived exertion [18 (13-20) vs. 15 (12-18) units; P less than 0.01] was associated with no significant change in Vmean. Muscle ischemia after exercise was not associated with an elevation in Vmean, and it did...

  10. Sodium Hypochlorite-Modified Hemosorbents in the Treatment of Limb Ischemia-Reperfusion Syndrome: Experimental Study

    Directory of Open Access Journals (Sweden)

    V. I. Sergiyenko

    2007-01-01

    Full Text Available Objective: to enhance the efficiency of treatment for limb ischemia-reperfusion syndrome in an experiment, by using the modified hemosorbents that have oxidative properties.Materials and methods. The investigation was conducted on 94 mongrel male dogs divided into 3 groups: 1 intact animals (n=20; 2 animals treated with hemocarboperfusion on the standard sorbent CKH-1K (n=36; 3 animals received hemocarboperfusion on sodium hypochloride-modified sorbent CKH-1K (n=38. A model of acute ischemia-reperfusion syndrome was created by the method of V. D. Pasechnikov et al. Partial oxygen tension (pO2 was determined by pin polarography. The levels of vasoactive eicosanoids were measured by enzyme immunoassay.Results. In the animals with leg ischemia syndrome, there is a significant pO2 reduction in the muscles of the hip and shin, which does not completely recover after reperfusion. Standard CKN-1K sorbent hemocarboperfusion reduces pO2 as compared with the reperfusion period while the use of modified CKH-1K hemosorbent increased pO2 in the study hind limb muscles to the level observed in intact animals. The development of ischemia and reperfusion is accompanied by the elevated levels of inflammatory mediators that have vasoconstrictive properties (thromboxane B2, endothelin-1, leukotrienes C4/D4/E4 and the lower concentration of the vasodilator prostacyclin. Standard CKN-1K sorbent hemocarboperfusion results in a further increase in the concentrations of thromboxane B2 and leukotrienes C4/D4/E4, a decrease in the concentration of endothelin-1, and an elevation of the levels of prostacyclin and prostaglandin E2. When sodium hypochlorite-modified CKN-1K sorbent hemocarboperfusion is employed, the concentrations of thromboxane B2, endothelin-1, and leukotrienes C4/D4/E4 decrease, and the level of prostacyclin increases.Conclusion. Hemocarboperfusion used in the treatment of leg ischemia-reperfusion syndrome leads to restoration of tissue oxygenation and

  11. 不同剂量脑醒喷鼻剂对再灌注损伤脑组织自由基及一氧化氮合酶变化的干预%Changes of free radicals and nitric oxide synthase in rat brain following ischemia-reperfusion injury due to different dosage brain-awakening nasal sprayer intervention

    Institute of Scientific and Technical Information of China (English)

    李荣; 吴伟; 陈宏珪; 黄衍寿; 刘煜德; 杨开清

    2005-01-01

    BACKGROUND: Brain-awakening nasal sprayer is composed of many herbs,such as Chuanxiong and Shichangpu, which were regarded by "Shennong Bencaojing" as having the function of "preventing stroke in the brain".OBJECTIVE: To observe the changes of free radicals and nitric oxide synthase in rat brain following focal ischemic-reperfusional injury due to brain-awakening nasal sprayer intervention and compare with that due to classical nimodipine.DESIGN: A randomized controlled study.SETTING: Department of internal medicine of a hospital affiliated to a traditional Chinese medical university.MATERIALS: Seventy adult male Wistar rats of clean grade, were randomly divided into seven groups: brain-awakening nasal sprayer of higher dosage group, moderate dosage group, lower dosage group, nimodipine intraperitoneal injection group, physical saline nasal sprayer group, menstruum nasal sprayer group, and sham operation group with 10 rats in each.METHODS: Focal brain ischemia-reperfusion model was established by blocking the left cerebral middle artery in rats of all the groups except sham operation group. Three days before model establishment and during reperfusion, rats were given different dosages of brain-awakening nasal sprayer composed of Chuanxiongqin and Shichangpu of 5.4, 2.7, 1.08 mg/(kg · d) and 1.35, 0. 54, 0.27 g/(kg· d), respectively, three times a day; which was replaced by physical saline and menstruum nasal sprayer of 0. 18 mL/ (kg · d),three times a day in physical saline nasal sprayer group and menstruum nasal sprayer group; rats in nimodipine intraperitoneal injection group received intraperitoneal injection of nimodipine by 0. 8 mg/(kg · d) twice a day. Rats in sham operation group were routinely raised. The content of prodialdehyde, superoxide dismutase and nitric oxide synthase were measured with colorimetric method.MAIN OUTCOME MEASURES: ① The changes of prodialdehyde content, superoxide dismutase and nitric oxide synthase activity in rat brain

  12. Genetic parameters for claw and leg health, foot and leg conformation, and locomotion in Danish Holsteins

    DEFF Research Database (Denmark)

    Laursen, M. V.; Boelling, D.; Mark, Thomas

    2009-01-01

    The purpose of this study was to estimate the genetic correlations among claw and leg health and potential indicator traits. Claw health was defined as absence of heel horn erosion, interdigital dermatitis, interdigital phlegmon, interdigital hyperplasia, laminitis, and sole ulcer. Leg health...

  13. Obstacle avoidance during human walking: transfer of motor skill from one leg to the other.

    Science.gov (United States)

    van Hedel, H J A; Biedermann, M; Erni, T; Dietz, V

    2002-09-01

    The aim of this study was to evaluate whether a newly acquired locomotor skill can be transferred to the mirror condition. Subjects were trained to step over an obstacle on a treadmill, the appearance of which was signalled by an acoustic stimulus, while visual information was prevented. Feedback information about foot clearance was provided by acoustic signals. During two successive runs (each consisting of 100 steps over the obstacle) the same leg was leading (i.e. the leg crossing the obstacle first). In the following third run, the leading and trailing legs were changed. During each of the three successive runs the adaptational changes were analysed by recording leg muscle electromyographic (EMG) activity, joint angle trajectories and foot clearance over the obstacle. The training effect gained between the first and second runs and the transfer to the mirror condition (third run) were evaluated. Adaptational changes of all measures, except ankle joint trajectory, could to a significant extent be transferred to the mirror condition. No side-specific differences in the amount of transfer were found, neither from the right to the left side, nor vice versa. These observations are at variance with adaptational changes observed during split-belt walking or one-legged hopping on a treadmill, where no transfer to the mirror condition occurred. It is assumed that this might be due to the specific requirements of the tasks and the leg muscles involved. While in the split-belt and hopping experiments leg extensor muscles are mainly involved, leg flexors predominate in the performance of the present task. It is hypothesised that the learning effects observed in the present experiments are mediated at a higher level (e.g. brainstem) of locomotor control.

  14. Locomotor-like leg movements evoked by rhythmic arm movements in humans.

    Directory of Open Access Journals (Sweden)

    Francesca Sylos-Labini

    Full Text Available Motion of the upper limbs is often coupled to that of the lower limbs in human bipedal locomotion. It is unclear, however, whether the functional coupling between upper and lower limbs is bi-directional, i.e. whether arm movements can affect the lumbosacral locomotor circuitry. Here we tested the effects of voluntary rhythmic arm movements on the lower limbs. Participants lay horizontally on their side with each leg suspended in an unloading exoskeleton. They moved their arms on an overhead treadmill as if they walked on their hands. Hand-walking in the antero-posterior direction resulted in significant locomotor-like movements of the legs in 58% of the participants. We further investigated quantitatively the responses in a subset of the responsive subjects. We found that the electromyographic (EMG activity of proximal leg muscles was modulated over each cycle with a timing similar to that of normal locomotion. The frequency of kinematic and EMG oscillations in the legs typically differed from that of arm oscillations. The effect of hand-walking was direction specific since medio-lateral arm movements did not evoke appreciably leg air-stepping. Using externally imposed trunk movements and biomechanical modelling, we ruled out that the leg movements associated with hand-walking were mainly due to the mechanical transmission of trunk oscillations. EMG activity in hamstring muscles associated with hand-walking often continued when the leg movements were transiently blocked by the experimenter or following the termination of arm movements. The present results reinforce the idea that there exists a functional neural coupling between arm and legs.

  15. Myocardial Ischemia Caused by Subepicardial Hematoma

    Science.gov (United States)

    Grieshaber, Philippe; Nef, Holger; Böning, Andreas; Niemann, Bernd

    2017-01-01

    Background Bleeding from bypass anastomosis leakage occurs early after coronary artery bypass grafting. Later, once the anastomosis is covered by intima, spontaneous bleeding is unlikely. Case Description A 63-year-old male patient developed a pseudoaneurysm-like, subepicardial late-term bleeding resulting in a hematoma that compromised coronary artery flow by increasing extracoronary pressure. This resulted in severe angina pectoris (Canadian Cardiovascular Society IV) and myocardial ischemia within the affected area. After surgical removal of the hematoma and repair of the anastomosis, the patient's symptoms disappeared and no signs of myocardial ischemia were present. Conclusion Surgical removal is an efficient therapy for subepicardial hematoma inducing myocardial ischemia.

  16. Alterações metabólicas induzidas por isquemia hepática normotérmica experimental e o efeito hepatoprotetor da ciclosporina Induced metabolic alterations due to experimental normothermic hepatic ischemia and the hepatoprotector effect of cyclosporin

    Directory of Open Access Journals (Sweden)

    José Huygens Parente Garcia

    2004-03-01

    Full Text Available RACIONAL: Transplante de fígado é inevitavelmente associado com períodos de isquemia completa. No entanto, o tempo de oclusão do pedículo hepático é limitado pelas conseqüências da injúria pós-isquêmica do fígado. OBJETIVO: Determinar as principais alterações metabólicas ocasionadas pela isquemia hepática e a provável ação hepatoprotetora da ciclosporina. MÉTODOS: Isquemia hepática normotérmica por 60 minutos foi induzida em ratos. Em seguida, as alterações com o tempo (0, 1, 6, 24 horas das concentrações sangüíneas e hepáticas de lactato, piruvato, glicose, corpos cetônicos e razão acetoacetato/3-hidroxibutirato, bem como o estado redox citoplasmático e mitocondrial do tecido hepático foram determinados. Outro grupo de animais foi pré-tratado com ciclosporina (10 mg/kg, sendo estudadas as alterações metabólicas no tempo 1 hora após revascularização hepática. RESULTADOS: A isquemia hepática causou elevação da concentração de lactato no fígado, sugerindo que pronunciado grau de metabolismo anaeróbico ocorreu durante o período de isquemia. Isquemia hepática acarretou ainda queda da concentração e da razão dos corpos cetônicos (acetoacetato/3-hidroxibutirato no sangue arterial no tempo de 1 hora após revascularização. Tal fato reflete que a injuria isquêmica do fígado interfere na cetogênese. CONCLUSÃO: O tratamento com ciclosporina causa elevação das concentrações dos corpos cetônicos e da razão acetoacetato/3-hidroxibutirato no sangue arterial após 1 hora de reperfusão hepática, sugerindo que esta droga acelera a cetogênese e, conseqüentemente, a recuperação da lesão isquêmica do fígado.BACKGROUND: Hepatic transplantation is inevitably associated with periods of complete ischemia. However, the clamping of hepatic vascular pedicle is limited by the consequences of the post-ischemic injury to the liver. AIM: To determine the main metabolic alterations caused for the

  17. Repair of a large soft tissue defect in the leg with cross-leg bridge free transfer of a latissimus dorsi myocutaneous flap: a case report

    Institute of Scientific and Technical Information of China (English)

    ZHANG Gong-lin; CHEN Ke-ming; ZHANG Jun-hua; WANG Shi-yong

    2012-01-01

    A 48-year-old man sustained a traffic accident injury to his left leg.It was an open fracture of the left tibia and fibula accompanied by a large soft tissue defect (27 cm×7 cm).Doppler examination revealed the posterior tibial artery was occluded due to thrombosis.Three weeks after injury,the latissimus dors myocutaneous flap was elevated with a T-shaped vascular pedicle and was interposed between the two vascular ends of the posterior tibial vessel of the contralateral leg.Two end to end anastomoses were performed between the two vascular ends of the posterior tibial vessel of the contralateral leg and the latissimus dors myocutaneous flap's T-shaped vascular pedicle.The latissimus dorsi myocutaneous flap was used for repair of a large soft tissue defect of the left leg.The vascular pedicle was cut offafter 28 days and the flap survived completely.After 3-years' follow-up postoperatively,a good contour was confirmed at the recipient area.The right tibia and fibula fractures were confirmed healing radiologically.The posterior tibial artery of contralateral leg was demonstrated patent by clinical and Doppler examinations.

  18. One-legged endurance training: leg blood flow and oxygen extraction during cycling exercise

    DEFF Research Database (Denmark)

    Rud, B; Foss, O; Krustrup, Peter

    2012-01-01

    Aim: As a consequence of enhanced local vascular conductance, perfusion of muscles increases with exercise intensity to suffice the oxygen demand. However, when maximal oxygen uptake (VO(2) max) and cardiac output are approached, the increase in conductance is blunted. Endurance training increases...... muscle metabolic capacity, but to what extent that affects the regulation of muscle vascular conductance during exercise is unknown. Methods: Seven weeks of one-legged endurance training was carried out by twelve subjects. Pulmonary VO(2) during cycling and one-legged cycling was tested before and after...... training, while VO(2) of the trained leg (TL) and control leg (CL) during cycling was determined after training. Results: VO(2) max for cycling was unaffected by training, although one-legged VO(2) max became 6.7 (2.3)% (mean ± SE) larger with TL than with CL. Also TL citrate synthase activity was higher...

  19. Task failure during exercise to exhaustion in normoxia and hypoxia is due to reduced muscle activation caused by central mechanisms while muscle metaboreflex does not limit performance

    Directory of Open Access Journals (Sweden)

    Rafael eTorres-Peralta

    2016-01-01

    Full Text Available To determine whether task failure during incremental exercise to exhaustion (IE is principally due to reduced neural drive and increased metaboreflex activation eleven men (22±2 years performed a 10s control isokinetic sprint (IS; 80 rpm after a short warm-up. This was immediately followed by an IE in normoxia (Nx, PIO2:143 mmHg and hypoxia (Hyp, PIO2:73 mmHg in random order, separated by a 120 min resting period. At exhaustion, the circulation of both legs was occluded instantaneously (300 mmHg during 10 or 60s to impede recovery and increase metaboreflex activation. This was immediately followed by an IS with open circulation. Electromyographic recordings were obtained from the vastus medialis and lateralis. Muscle biopsies and blood gases were obtained in separate experiments. During the last 10s of the IE, pulmonary ventilation, VO2, power output and muscle activation were lower in hypoxia than in normoxia, while pedaling rate was similar. Compared to the control sprint, performance (IS-Wpeak was reduced to a greater extent after the IE-Nx (11% lower P<0.05 than IE-Hyp. The root mean square (EMGRMS was reduced by 38 and 27% during IS performed after IE-Nx and IE-Hyp, respectively (Nx vs. Hyp: P<0.05. Post-ischemia IS-EMGRMS values were higher than during the last 10s of IE. Sprint exercise mean (IS-MPF and median (IS-MdPF power frequencies, and burst duration, were more reduced after IE-Nx than IE-Hyp (P<0.05. Despite increased muscle lactate accumulation, acidification, and metaboreflex activation from 10 to 60s of ischemia, IS-Wmean (+23% and burst duration (+10% increased, while IS-EMGRMS decreased (-24%, P<0.05, with IS-MPF and IS-MdPF remaining unchanged. In conclusion, close to task failure, muscle activation is lower in hypoxia than in normoxia. Task failure is predominantly caused by central mechanisms, which recover to great extent within one minute even when the legs remain ischemic. There is dissociation between the recovery of

  20. The Neuropeptide Systems and their Potential Role in the Treatment of Mammalian Retinal Ischemia: A Developing Story

    OpenAIRE

    Cervia, D; Casini, G.

    2013-01-01

    The multiplicity of peptidergic receptors and of the transduction pathways they activate offers the possibility of important advances in the development of specific drugs for clinical treatment of central nervous system disorders. Among them, retinal ischemia is a common clinical entity and, due to relatively ineffective treatment, remains a common cause of visual impairment and blindness. Ischemia is a primary cause of neuronal death, and it can be considered as a sort of final common pathwa...

  1. Non-contrast-enhanced MR angiography in critical limb ischemia: performance of quiescent-interval single-shot (QISS) and TSE-based subtraction techniques.

    Science.gov (United States)

    Altaha, Mustafa A; Jaskolka, Jeffrey D; Tan, Kongteng; Rick, Manuela; Schmitt, Peter; Menezes, Ravi J; Wintersperger, Bernd J

    2017-03-01

    The aim of this study was to evaluate diagnostic performance of non-contrast-enhanced 2D quiescent-interval single-shot (QISS) and 3D turbo spin-echo (TSE)-based subtraction magnetic resonance angiography (MRA) in the assessment of peripheral arteries in patients with critical limb ischemia (CLI). Nineteen consecutive patients (74 % male, 72.8 ± 9.9 years) with CLI underwent 2D QISS and 3D TSE-based subtraction MRA at 1.5 T. Axial-overlapping QISS MRA (3 mm/2 mm; 1 × 1 mm(2)) covered from the toes to the aortic bifurcation while coronal 3D TSE-based subtraction MRA (1.3 × 1.2 × 1.3 mm(3)) was restricted to the calf only. MRA data sets (two readers) were evaluated for stenosis (≥50 %) and image quality. Results were compared with digital subtraction angiography (DSA). Two hundred and sixty-seven (267) segments were available for MRA-DSA comparison, with a prevalence of stenosis ≥50 % of 41.9 %. QISS MRA was rated as good to excellent in 79.5-96.0 % of segments without any nondiagnostic segments; 89.8-96.1 % of segments in 3D TSE-based subtraction MRA were rated as nondiagnostic or poor. QISS MRA sensitivities and specificities (segmental) were 92 % and 95 %, respectively, for reader one and 81-97 % for reader two. Due to poor image quality of 3D TSE-based subtraction MRA, diagnostic performance measures were not calculated. QISS MRA demonstrates excellent diagnostic performance and higher robustness than 3D TSE-based subtraction MRA in the challenging patient population with CLI. • QISS MRA allows reliable diagnosis of peripheral artery stenosis in critical limb ischemia. • Robustness of TSE-based subtraction MRA is limited in critical limb ischemia. • QISS MRA allows robust therapy planning in PAD patients with resting leg pain.

  2. THE ROLE OF LEG AND TRUNK MUSCLES PROPRIOCEPTION ON STATIC AND DYNAMIC POSTURAL CONTROL

    Directory of Open Access Journals (Sweden)

    SEYED Hossein Hosseinimehr

    2010-04-01

    Full Text Available The proprioception information is a prerequisite for balance, body’s navigation system, and the movement coordinator. Due to changes between the angles of ankle, knee, and hip joints the aforementioned information are important in the coordination of the limbs and postural balance. The aim of this study was to investigate therole of leg and trunk muscles proprioception on static and dynamic postural control. Thirty males students of physical education and sport sciences (age =21.23 ± 2.95 years, height = 170.4 ± 5.1 cm, and weight = 70.7 ± 5.6 kg participated in this study volunteered. Vibration (100HZ was used to disturb of proprioception. Vibrationoperated on leg muscle (gasterocnemius and trunk muscles (erector spine muscle, at L1 level. Leg stance time and Star Excursion Balance Test were used for evaluation of static and dynamic postural control respectively.Subjects performed pre and post (with operated vibration leg stance time and star excursion balance test. Paired sample test used for investigation the effect of vibration on leg and trunk muscles in static and dynamic postural control. Result of this study showed in static postural control, there is no significant difference between pre and post test (operated vibration in leg and trunk muscles (p≤0.05. In contrast there is significant difference indynamic postural control between pre and post test in leg muscles in 8 directions of star excursion balance test (p≤0.05 while there is only significant difference in trunk muscle in antrolateral and lateral of star excursion balance test (p≤0.05. During physical training such conditions like fatigue and injury can disturbproprioceptions’ information. Thus, due to the importance of this information we recommend that coaches'additionally specific trainings any sport used specific exercises to enhance the proprioception information

  3. Mitochondrial Targeted Antioxidant in Cerebral Ischemia.

    Science.gov (United States)

    Ahmed, Ejaz; Donovan, Tucker; Yujiao, Lu; Zhang, Quanguang

    There has been much evidence suggesting that reactive oxygen species (ROS) generated in mitochondria during cerebral ischemia play a major role in programming the senescence of organism. Antioxidants dealing with mitochondria slow down the appearance and progression of symptoms in cerebral ischemia and increase the life span of organisms. The mechanisms of mitochondrial targeted antioxidants, such as SKQ1, Coenzyme Q10, MitoQ, and Methylene blue, include increasing adenosine triphosphate (ATP) production, decreasing production of ROS and increasing antioxidant defenses, providing benefits in neuroprotection following cerebral ischemia. A number of studies have shown the neuroprotective role of these mitochondrial targeted antioxidants in cerebral ischemia. Here in this short review we have compiled the literature supporting consequences of mitochondrial dysfunction, and the protective role of mitochondrial targeted antioxidants.

  4. Dimensional synthesis of a leg mechanism

    Science.gov (United States)

    Pop, F.; Lovasz, E.-Ch; Pop, C.; Dolga, V.

    2016-08-01

    An eight bar leg mechanism dimensional synthesis is presented. The mathematical model regarding the synthesis is described and the results obtained after computation are verified with help of 2D mechanism simulation in Matlab. This mechanism, inspired from proposed solution of Theo Jansen, is integrated into the structure of a 2 DOF quadruped robot. With help of the kinematic synthesis method described, it is tried to determine new dimensions for the mechanism, based on a set of initial conditions. These are established by taking into account the movement of the end point of the leg mechanism, which enters in contact with the ground, during walking. An optimization process based on the results obtained can be conducted further in order to find a better solution for the leg mechanism.

  5. Dipoles on a Two-leg Ladder

    DEFF Research Database (Denmark)

    Gammelmark, Søren; Zinner, Nikolaj Thomas

    2013-01-01

    We study polar molecules with long-range dipole-dipole interactions confined to move on a two-leg ladder for different orientations of the molecular dipole moments with respect to the ladder. Matrix product states are employed to calculate the many-body ground state of the system as function...... of lattice filling fractions, perpendicular hopping between the legs, and dipole interaction strength. We show that the system exhibits zig-zag ordering when the dipolar interactions are predominantly repulsive. As a function of dipole moment orientation with respect to the ladder, we find...... that there is a critical angle at which ordering disappears. This angle is slightly larger than the angle at which the dipoles are non-interacting along a single leg. This behavior should be observable using current experimental techniques....

  6. AN EFFECTIVE HUMAN LEG MODELING METHOD

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Digital medicine is a new concept in medical field, and the need for digital human body is increasing these years. This paper used Free Form Deformation (FFD) to model the motion of human leg. It presented the motion equations of knee joint on the basis of anatomic structure and motion characters, then transmitted the deformation to the mesh of leg through a simplified FFD that only used two-order B-spline basis function. The experiments prove that this method can simulate the bend of leg and the deformation of muscles fairly well. Compared with the method of curved patches, this method is more convenient and effective. Further more, those equations can be easily applied to other joint models of human body.

  7. Leg Spasticity and Ambulation in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Swathi Balantrapu

    2014-01-01

    Full Text Available Background. Spasticity of the legs is common in multiple sclerosis (MS, but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal and 4 (contracted. Patients completed the 6-minute walk (6 MW, timed 25 foot walk (T25FW, and timed up-and-go (TUG, and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc. for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12 and wore an accelerometer over a seven-day period. Results. 52% (n=44 of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P=0.0001, d=-0.86, T25FW (P=0.003,d=0.72, TUG (P=0.001, d=0.84, MSWS-12 (P=0.0001,d=1.09, O2 cost of walking (P=0.001, d=0.75, average steps/day (P<0.05, d=-0.45, and walking velocity (P<0.05, d=-0.53 and cadence (P<0.05, d=-0.46. Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking.

  8. Open surgery for chronic limb ischemia: a review.

    Science.gov (United States)

    Ricco, J B; Thanh Phong, L; Belmonte, R; Schneider, F; Valagier, A; Illuminati, G; Regnault De La Mothe, G

    2013-12-01

    This review considers the role of the different revascularization strategies in patients with chronic limb ischemia (CLI) and reveals that clinical evidence guiding therapeutic decision-making in CLI is poor and only careful basic recommendations can be made. For diffuse aortoiliac disease with occlusion of the aorta, aortobifemoral bypass remains the best option if the patient is fit for open surgery. Unilateral iliac occlusion should be treated by primary stenting, but an iliofemoral bypass may be the best option when the disease extends down to the common and deep femoral arteries. For infrainguinal revascularisation, bypass using the saphenous vein remains the best option for patients with occlusion of the superficial femoral artery >25 cm and for patients with multiple occlusions of the infrapopliteal arteries. In the absence of leg veins, arm veins should be used. Prosthetic grafts are the last option. Endovascular techniques are recommended in patients with short arterial lesions and limited life expectancy <2 years. Finally some patients with CLI are best treated by primary amputation. In conclusion, this review demonstrates that neither an endo- first nor a bypass-first attitude is appropriate in patients with CLI and suggests that these patients should be cared for by specialists in a multidisciplinary center in order to preserve their life and limbs, to conduct clinical trials and to control costs.

  9. Six weeks' aerobic retraining after two weeks' immobilization restores leg lean mass and aerobic capacity but does not fully rehabilitate leg strenght in young and older men

    DEFF Research Database (Denmark)

    Vigelsø Hansen, Andreas; Gram, Martin; Wiuff, Caroline

    2015-01-01

    OBJECTIVE: To determine the effect of aerobic retraining as rehabilitation after short-term leg immobilization on leg strength, leg work capacity, leg lean mass, leg muscle fibre type composition and leg capillary supply, in young and older men. SUBJECTS AND DESIGN: Seventeen young (23 ± 1 years)...

  10. The Molecular Genetics of Restless Legs Syndrome.

    Science.gov (United States)

    Rye, David B

    2015-09-01

    Restless legs syndrome (RLS) is a common sensorimotor trait defined by symptoms that interfere with sleep onset and maintenance in a clinically meaningful way. Nonvolitional myoclonus while awake and asleep is a sign of the disorder and an informative endophenotype. The genetic contributions to RLS/periodic leg movements are substantial, are among the most robust defined to date for a common disease, and account for much of the variance in disease expressivity. The disorder is polygenic, as revealed by recent genome-wide association studies. Experimental studies are revealing mechanistic details of how these common variants might influence RLS expressivity.

  11. The mysteries of restless legs syndrome.

    Science.gov (United States)

    Martin, Caren McHenry

    2007-11-01

    Restless legs syndrome (RLS) is a sensorimotor disorder characterized by the uncontrollable urge to move the legs. This urge can often be accompanied by pain or other unpleasant sensations, and it either occurs or worsens with rest. Affecting an estimated 6% to 15% of the adult population, RLS compromises the patient's ability to sleep and can significantly decrease quality of life. Because diagnosis currently relies solely on patient (or caregiver) interview, recognizing the symptoms of RLS and knowing what medications treat this condition--as well as the many that exacerbate it--is important for all health care practitioners.

  12. Ischemia/reperfusion-induced Kidney Injury in Heterozygous PACAP-deficient Mice.

    Science.gov (United States)

    Laszlo, E; Varga, A; Kovacs, K; Jancso, G; Kiss, P; Tamas, A; Szakaly, P; Fulop, B; Reglodi, D

    2015-09-01

    Pituitary adenylate cyclase activating polypeptide (PACAP) is a neuropeptide with very diverse distribution and functions. Among others, PACAP is a potent cytoprotective peptide due to its antiapoptotic, anti-inflammatory, and antioxidant actions. This also has been shown in different kidney pathologies, including ischemia/reperfusion-induced kidney injury. Similar protective effects of the endogenous PACAP are confirmed by the increased vulnerability of PACAP-deficient mice to different harmful stimuli. Kidneys of homozygous PACAP-deficient mice have more severe damages in renal ischemia/reperfusion and kidney cell cultures isolated from these mice show increased sensitivity to renal oxidative stress. In our present study we raised the question of whether the partial lack of the PACAP gene is also deleterious, i.e. whether heterozygous PACAP-deficient mice also display more severe damage after renal ischemia/reperfusion. Mice underwent 45 or 60 minutes of ischemia followed by 2 weeks reperfusion. Histological evaluation of the kidneys was performed and individual histopathological parameters were graded. Furthermore, we investigated apoptotic markers, cytokine expression, and the activity of superoxide dismutase (SOD) enzyme 24 hours after 60 minutes of renal ischemia/reperfusion. We found no difference between the intact kidneys of wild-type and heterozygous mice, but marked differences could be observed following ischemia/reperfusion. Heterozygous PACAP-deficient mice had more severe histological alterations, with significantly higher histopathological scores for most of the tested parameters. Higher level of the proapoptotic pp38 MAPK and of some proinflammatory cytokines, as well as lower activity of the antioxidant SOD could be found in these mice. In conclusion, the partial lack of the PACAP gene results in worse outcomes in cases of renal ischemia/reperfusion, confirming that PACAP functions as an endogenous protective factor in the kidney.

  13. Penile Replantation After Five Hours of Warm Ischemia

    Directory of Open Access Journals (Sweden)

    Fernando N. Facio Jr.

    2015-05-01

    Full Text Available Although a rare occurrence, this event may occur as a result of self-mutilation among individuals with psychiatric disturbances or due to work-related accidents, iatrogenic injuries or the actions of individuals motivated by jealously, rage and feelings of betrayal. In western societies, most penile amputations are the result of self-aggression during a psychotic episode, the treatment of victims involves resuscitation, stabilization and immediate psychiatric support. The amputated tissue must be preserved under hypothermic conditions. Micro-surgery is currently the most widely employed method for penile replantation. This paper describes a successful case of penile replantation following 5 hours of warm ischemia.

  14. The wound/burn guidelines - 5: Guidelines for the management of lower leg ulcers/varicose veins.

    Science.gov (United States)

    Ito, Takaaki; Kukino, Ryuichi; Takahara, Masakazu; Tanioka, Miki; Nakamura, Yasuhiro; Asano, Yoshihide; Abe, Masatoshi; Ishii, Takayuki; Isei, Taiki; Inoue, Yuji; Imafuku, Shinichi; Irisawa, Ryokichi; Ohtsuka, Masaki; Ohtsuka, Mikio; Ogawa, Fumihide; Kadono, Takafumi; Kawakami, Tamihiro; Kawaguchi, Masakazu; Kono, Takeshi; Kodera, Masanari; Sakai, Keisuke; Nakanishi, Takeshi; Hashimoto, Akira; Hasegawa, Minoru; Hayashi, Masahiro; Fujimoto, Manabu; Fujiwara, Hiroshi; Maekawa, Takeo; Matsuo, Koma; Madokoro, Naoki; Yamasaki, Osamu; Yoshino, Yuichiro; Le Pavoux, Andres; Tachibana, Takao; Ihn, Hironobu

    2016-08-01

    Varicose veins are treated at multiple clinical departments, but as patients often visit the dermatology clinic first due to leg ulcers, the present Guidelines for the Management of Lower Leg Ulcers/Varicose Veins were prepared in consideration of the importance of the dermatologist's role. Also, the disease concept of chronic venous insufficiency or chronic venous disorders and the CEAP classification of these disorders are presented. The objective of the present guidelines is to properly guide the diagnosis and treatment of lower leg ulcers/varicose veins by systematically presenting evidence-based recommendations that support clinical decisions.

  15. Intermittent hypoxia attenuates ischemia/reperfusion induced apoptosis in cardiac myocytes via regulating Bcl-2/Bax expression

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Intermittent hypoxia has been shown to provide myocardial protection against ishemia/reperfusion-induced injury.Cardiac myocyte loss through apoptosis has been reported in ischemia/reperfusion injury. Our aim was to investigate whether intermittent hypoxia could attenuate ischemia/reperfusion-induced apoptosis in cardiac myocytes and its potential mechanisms. Adult male Sprague-Dawley rats were exposed to hypoxia simulated 5000 m in a hypobaric chamber for 6 h/day, lasting 42 days. Normoxia group rats were kept under normoxic conditions. Isolated perfused hearts from both groups were subjected to 30 min of global ischemia followed by 60 min reperfusion.Incidence of apoptosis in cardiac myocytes was determined by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) and DNA agarose gel electrophoresis. Expressions of apoptosis related proteins,Bax and Bcl-2, in cytosolic and membrane fraction were detected by Western Blotting. After ischemia/reperfusion,enhanced recovery of cardiac function was observed in intermittent hypoxia hearts compared with normoxia group.Ischemia/reperfusion-induced apoptosis, as evidenced by TUNEL-positive nuclei and DNA fragmentation, was significantly reduced in intermittent hypoxia group compared with normoxia group. After ischemia/reperfusion,expression of Bax in both cytosolic and membrane fractions was decreased in intermittent hypoxia hearts compared with normoxia group. Although ischemia/reperfusion did not induce changes in the level of Bcl-2 expression in cytosolic fraction between intermittent hypoxia and normoxia groups, the expression of Bcl-2 in membrane fraction was upregulated in intermittent hypoxia group compared with normoxia group. These results indicated that the cardioprotection of intermittent hypoxia against ischemia/reperfusion injury appears to be in part due to reduce myocardial apoptosis. Intermittent hypoxia attenuated ischemia/reperfusion-induced apoptosis via increasing the ratio of Bcl

  16. Assessment of the vibration on the foam legged and sheet metal-legged passenger seat

    Directory of Open Access Journals (Sweden)

    L. Dahil

    2015-10-01

    Full Text Available In this study, it was aim ed to decrease the vibration reaching to passenger from the legs of vehicle seats. In order to determine the levels of vibrations reaching at passengers, a test pad placed under the passenger seat was used, and HVM100 device was used for digitizing the information obtained. By transferring the vibration data to system by using HVM100 device, the acceleration graphics were prepared with Blaze software. As a result, it was determined that the acceleration values of seat legs made of foam material were lower than that of seat legs made of 2 mm thick sheet metal, so they damped the vibration better.

  17. Restless legs symptoms in a patient with above knee amputations: a case of phantom restless legs.

    Science.gov (United States)

    Hanna, Philip A; Kumar, Sanjeev; Walters, Arthur S

    2004-01-01

    We describe a 78-year-old gentleman who, following bilateral above-knee amputations, developed symptoms of restless legs syndrome in the absent portions of his lower extremities. These symptoms improved with dopamine agonist therapy. In addition, he later developed parkinsonism with prominent rest tremor on metoclopramide. This suggests that this individual had a dopamine-deficient state which predisposed him to both restless legs syndrome and drug-induced or drug-exacerbated parkinsonism. We propose expanding the spectrum of phantom limb phenomena to include phantom restless legs.

  18. [The influence of the leg load and the support mobility under leg on the anticipatory postural adjustment].

    Science.gov (United States)

    Kazennikov, O V; Kireeva, T B; Shlykov, V Iu

    2015-01-01

    Anticipatory postural adjustment is an essential part of equilibrium maintainance during standing in human. So changes in stance condition could affect both control of equilibrium and anticipatory adjustment. Anticipatory changes in the stabilogram of each leg were studied in standing subject during the early stage of quick right arm lifting while legs were on two separated supports. The center of pressure (CP) movement was analyzed in three variants of experiment: both legs on immovable support, with only right leg on the movable support and with only left leg on the moveable support. In each standing condition subject stood with symmetrical load on two legs or with the load voluntary transferred to one leg. The anticipatory CP shift depended on the mobility of the support under the leg and on loading of the leg. While standing on unmovable supports with symmetrical load on the legs before lifting of the right arm CP of right leg shifted backward and CP of left leg--forward. While standing with one leg on movable support the anticipatory CP shift of this leg was small and did not depend on the load on the leg. However the shift of CP of the leg that was placed on the unmovable support depended on the load in the same way as in the case when both legs were on unmovable supports. Results suggested that since on movable support the support and proprioceptive afferent flow from distal part of the leg that was did not supply unambiguous information about body position, the role of distal joints in posture control is reduced.

  19. Increased ischemia-modified albumin and malondialdehyde levels in videothoracoscopic surgery

    Directory of Open Access Journals (Sweden)

    Mufide Oncel

    2016-01-01

    Conclusions: We can conclude that elevation in MDA and IMA levels after videothoracoscopic surgery was caused by increased oxidative stress due to minimal ischemia-reperfusion injury after the infusion of CO2during the surgical process. Videothoracoscopic sympathectomy operation causes a decrease in NO production, and this should be taken in consideration when evaluating nitrosative stress in videothoracoscopic surgery.

  20. The Cardiovascular Risk Profile of Atherosclerotic Gastrointestinal Ischemia Is Different from Other Vascular Beds

    NARCIS (Netherlands)

    Veenstra, Renzo P.; ter Steege, Rinze W. F.; Geelkerken, Robert H.; Huisman, Ad B.; Kolkman, Jeroen J.

    2012-01-01

    BACKGROUND: The distribution of cardiovascular risk factors in patients with chronic gastrointestinal ischemia due to atherosclerosis of the splanchnic vessels (chronic splanchnic syndrome) is not well studied. The aim of this study was to determine the cardiovascular risk factor pattern in patients

  1. Determinants of tubular bone marrow-derived cell engraftment after renal ischemia/reperfusion in rats

    NARCIS (Netherlands)

    Broekema, M; Harmsen, MC; Koerts, JA; Petersen, AH; van Luyn, MJA; Navis, G; Popa, ER

    2005-01-01

    Background. Ischemia/reperfusion (I/R) injury is a major cause of acute renal failure (ARF). ARF is reversible, due to an innate regenerative process, which is thought to depend partly on bone marrow-derived progenitor cells. The significance of these cells in the repair process has been questioned

  2. Skin and mucosal ischemia as a complication after inferior alveolar nerve block

    Directory of Open Access Journals (Sweden)

    Pedro Christian Aravena

    2016-01-01

    Full Text Available The anesthetic block of the inferior alveolar nerve (IAN is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block.

  3. Computer-assisted detection of nocturnal leg motor activity in patients with restless legs syndrome and periodic leg movements during sleep.

    Science.gov (United States)

    Ferri, Raffaele; Zucconi, Marco; Manconi, Mauro; Bruni, Oliviero; Miano, Silvia; Plazzi, Giuseppe; Ferini-Strambi, Luigi

    2005-08-01

    To assess the performance of a new method for automatic detection of periodic leg movements during sleep. Leg movements during sleep were visually detected in the tibialis anterior muscles recordings of 15 patients with restless legs syndrome and 15 normal controls. Leg movements were detected automatically by means of a new computer method with which electromyogram signals are first digitally band-pass filtered and then rectified; subsequently, the detection of leg movements is performed by using 2 thresholds: one for the starting point and another to detect the end point of each leg movement. Sensitivity and false-positive rate were obtained; the American Sleep Disorders Association parameters were also computed, and the results analyzed by means of the Kendall W coefficient, the linear correlation coefficient and the Bland-Altman plots. N/A. Fifteen patients with restless legs syndrome and periodic leg movements and 15 controls. High values of the Kendall W coefficient of concordance between automatic and visual analysis were found with values close to 1 and the linear correlation coefficient for leg movements index and total leg movements index was > 0.950 (p visual and computer detection, which were -9.01 and +9.89 for the periodic leg movement index. None of the normal controls was found to have periodic leg movement indexes >5 after automatic analysis. Our method can be applied to the clinical evaluation of periodic leg movements during sleep, with some caution in patients with a low periodic leg movement indexes. Large-scale research application is possible and can be considered as reliable.

  4. Tardive akathisia due to sulpiride.

    Science.gov (United States)

    López de Munain, A; Poza, J J; Gorospe, A; Arce, A; Martí Massó, J F

    1994-10-01

    A 56 year-old woman who suffered from parkinsonism, oro-lingual dyskinesia (OLD) and tardive akathisia (TA) due to sulpiride is reported. OLD and TA appeared after sulpiride withdrawal. The patient was successfully treated with tetrabenazine even a mild parkinsonism was present. TA seems to be related with an apparent dopaminergic hyperactivity and it has to be differentiated of other neuroleptic-induced movement disorders such as restless legs syndrome in order of an appropriate treatment. Sulpiride has the same possible side effects than classic neuroleptics.

  5. Top Ten Tiks Far Beautiful Legs

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    HERE experts provide women witha guide In better stocking buys. 1. Brightly-colored stockings suchas flaming red or pure blue suit only tall,slim ladies with elegant legs. 2. Opaque stockings, suit only slimlegs. 3. Dark or thinly striped stockings

  6. Clinical aspects of lower leg compartment syndrome

    NARCIS (Netherlands)

    Brand, Johan Gerard Henric van den

    2004-01-01

    A compartment syndrome is a condition in which increased pressure within a limited space compromises the circulation and function of tissues within that space. Although pathofysiology is roughly similar in chronic exertional and acute compartment syndrome of the lower leg, the clinical presentation

  7. Hereditary spherocytosis presenting as indolent leg ulcers

    Directory of Open Access Journals (Sweden)

    Muhammed K

    1997-01-01

    Full Text Available Indolent leg ulcertation, which is the rarest manifestation of hereditary spherocytosis, started at the age of 5 years affecting a 15-year-old boy and his mother is reported. Review of literature showed very few reports from India and abroad. The response to oral folic acid was excellent

  8. An automatic hinge system for leg orthoses

    NARCIS (Netherlands)

    Rietman, J.S.; Goudsmit, J.; Meulemans, D.; Halbertsma, J.P.K.; Geertzen, J.H.B.

    2004-01-01

    This paper describes a new, automatic hinge system for leg orthoses, which provides knee stability in stance, and allows knee-flexion during swing. Indications for the hinge system are a paresis or paralysis of the quadriceps muscles. Instrumented gait analysis was performed in three patients, fitte

  9. Mechanics of six-legged runners.

    Science.gov (United States)

    Full, R J; Tu, M S

    1990-01-01

    Six-legged pedestrians, cockroaches, use a running gait during locomotion. The gait was defined by measuring ground reaction forces and mechanical energy fluctuations of the center of mass in Blaberus discoidalis (Serville) as they travelled over a miniature force platform. These six-legged animals produce horizontal and vertical ground-reaction patterns of force similar to those found in two-, four- and eight-legged runners. Lateral forces were less than half the vertical force fluctuations. At speeds between 0.08 and 0.66 ms-1, horizontal kinetic and gravitational potential energy changes were in phase. This pattern of energy fluctuation characterizes the bouncing gaits used by other animals that run. Blaberus discoidalis attained a maximum sustainable stride frequency of 13 Hz at 0.35 ms-1, the same speed and frequency predicted for a mammal of the same mass. Despite differences in body form, the mass-specific energy used to move the center of mass a given distance (0.9 J kg-1m-1) was the same for cockroaches, ghost crabs, mammals, and birds. Similarities in force production, stride frequency and mechanical energy production during locomotion suggest that there may be common design constraints in terrestrial locomotion which scale with body mass and are relatively independent of body form, leg number and skeletal type.

  10. Well Leg Compartment Syndrome After Abdominal Surgery

    DEFF Research Database (Denmark)

    Christoffersen, Jens Krogh; Hove, Lars Dahlgaard; Mikkelsen, Kim Lyngby;

    2016-01-01

    BACKGROUND: Well leg compartment syndrome (WLCS) is a complication to abdominal surgery. We aimed to identify risk factors for and outcome of WLCS in Denmark and literature. METHODS: Prospectively collected claims to the Danish Patient Compensation Association (DPCA) concerning WLCS after abdominal...

  11. Leg og læring

    DEFF Research Database (Denmark)

    Pedersen, Annette

    2008-01-01

    Leg synes at have et potentiale som metode til at fremme læring. Men hvordan? Legen har en vis grad af parallelitet med den virkelige verden i dens interaktive og relationelle strukturer. Det bliver muligt at finde nye meninger i interaktioner, som refererer til vante interaktionsformer, men alli...

  12. A completely intramedullary leg lengthening device

    NARCIS (Netherlands)

    Aalsma, A.M.M.; Hekman, E.E.G.; Stapert, J.W.J.L.; Grootenboer, H.J.

    1998-01-01

    The procedure and the external fixator for lengthening long bones was developed by G.A. Ilizarov in the late 1960's. This technique has, despite its proven abilities for leg lengthening and correction of angular deformities, some considerable disadvantages for patients. Discomfort, infections and re

  13. Clinical aspects of lower leg compartment syndrome

    NARCIS (Netherlands)

    Brand, Johan Gerard Henric van den

    2004-01-01

    A compartment syndrome is a condition in which increased pressure within a limited space compromises the circulation and function of tissues within that space. Although pathofysiology is roughly similar in chronic exertional and acute compartment syndrome of the lower leg, the clinical

  14. EVALUATION OF ISCHEMIA MODIFIED ALBUMIN AND NITRIC OXIDE LEVELS AND THEIR INTER - RELATIONSHIP IN HYPERTHYROIDISM

    Directory of Open Access Journals (Sweden)

    Rangaswamy

    2014-02-01

    Full Text Available BACKGROUND: Ischemia Modified Albumin (IMA is an ischemia/reperfusion injury marker which has been considered to be formed under oxidative stress conditions. Endothelial L - Arginine/NO pathway dysfunction can lead to oxidative stress which has deleterious effects seen on the vascular wall causing ischemia. AIM: 1 The study was conducted to estimate the levels of IMA and NO in hyperthyroidism patients. 2 To evaluate the relationship bet ween IMA and NO levels in hyperthyroidism. MATERIALS AND METHODS: A cross sectional study was done with 30 newly diagnosed hyperthyroid patients as cases and 30 age and sex matched healthy controls. Serum levels of IMA and NO were estimated by colorimetric methods and thyroid profile was done by ELIFA methodology. STATISTICAL ANALYSIS: Data were analyzed using SPSS. Values were expressed as Mean±SD. RESULTS: Nitric Oxide levels were significantly decreased in hyperthyroid patients (7.08±1.57μmol/L as compa red to healthy controls (39.76±4.98μmol/L (p=0.001. Ischemia Modified Albumin levels were found to be significantly increased in hyperthyroid patients (0.73±0.10 ODU when compared to healthy controls (0.28±0.01 ODU (p=0.001. CONCLUSION: In our study t here was increase in IMA levels with decreased NO levels which could be due to the consequence of oxidative stress and ischemia which is present in hyperthyroidism

  15. Noscapine protects OLN-93 oligodendrocytes from ischemia-reperfusion damage: Calcium and nitric oxide involvement.

    Science.gov (United States)

    Nadjafi, S; Ebrahimi, S-A; Rahbar-Roshandel, N

    2015-12-01

    This study was carried out to evaluate the effects of noscapine, a benzylisoquinoline alkaloid from opium poppy, on oligodendrocyte during ischemia/reperfusion-induced excitotoxic injury. Changes in intracellular calcium levels due to chemical ischemia and nitric oxide (NO) production during ischemia/reperfusion were evaluated as the hallmarks of ischemia-derived excitotoxic event. OLN-93 cell line (a permanent immature rat oligodendrocyte) was used as a model of oligodendrocyte. 30- or 60-minute-oxygen-glucose deprivation/24 hours reperfusion were used to induce excitotoxicity. MTT (3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide) assay was used to evaluate cell viability. Ratiometric fluorescence microscopy using Ca(2+)-sensitive indicator Fura-2/AM was utilized to assess intracellular calcium levels. NO production was evaluated by Griess method. Noscapine (4 μM) significantly attenuated intracellular Ca(2+) elevation (P noscapine significantly decreased NO production during a 30-minute oxygen-glucose deprivation/reperfusion (P noscapine (4 μM) on intracellular Ca(2+) was greater than ionotropic glutamate receptors antagonists. Noscapine is protective against ischemia/reperfusion-induced excitotoxic injury in OLN-93 oligodendrocyte. This protective effect seems to be related to attenuation of intracellular Ca(2+) overload and NO production.

  16. Effects of lazaroids on intestinal ischemia and reperfusion injury in experimental models.

    Science.gov (United States)

    Flessas, Ioannis I; Papalois, Apostolos E; Toutouzas, Konstantinos; Zagouri, Flora; Zografos, George C

    2011-04-01

    Mesenteric ischemia occurs in a number of clinically relevant pathophysiologic processes, including sepsis, hemorrhage, intestinal transplantation, severe burns, and mesenteric thrombosis. The readmission of molecular oxygen into an ischemic tissue promotes the oxidation of resuscitated tissue with certain pathophysiologic mechanisms. Depending on the duration and the intensity of ischemia, reoxygenation of the intestine that has been reperfused may further induce tissue injury. Intestinal ischemia and reperfusion injury can accelerate complex processes between the endothelium and different cell types leading to microvascular injury, cellular necrosis, and apoptosis. The injury due to reperfusion is found predominantly in the intestinal mucosa and submucosa, causing endothelial detachment. The 21-aminosteroids (lazaroids) are a family of compounds that inhibit lipid membrane peroxidation. Many of the performed studies show conflicting results, which reflect differences in experimental design, evolving time that (I/R) is induced, total or partial vascular occlusion, dosage of the lazaroid, and the exact period of time that the lazaroid is administered.

  17. Recurrent Lower-Extremity Compartment Syndrome after Four-Compartment Fasciotomy Secondary to Acute Limb Ischemia.

    Science.gov (United States)

    Kerkar, Ashwini P; Farber, Alik; Kalish, Jeffrey A; Siracuse, Jeffrey J

    2016-01-01

    Lower-extremity compartment syndrome is a limb-threatening event necessitating emergent treatment using fasciotomy. Recurrent compartment syndrome is rare and has only been reported after trauma and in conjunction with underlying connective tissue disorders. In this report, we present a case of recurrent lower-extremity compartment syndrome caused by ischemia-reperfusion injury, in a patient previously treated with adequate 4-compartment fasciotomies. As such, this is the first reported case of recurrent compartment syndrome in the setting of ischemia-reperfusion injury that required treatment with 4-compartment fasciotomies on both occasions. This case demonstrates that fasciotomy is not protective against the development of recurrent compartment syndrome due to ischemia-reperfusion injury and that patients at high risk require monitoring. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Abdominal Aortic Dissection with Acute Mesenteric Ischemia in a Patient with Marfan Syndrome

    Directory of Open Access Journals (Sweden)

    Chii-Shyan Lay

    2006-07-01

    Full Text Available Marfan syndrome is an autosomal dominant inherited disorder of connective tissue, with various complications manifested primarily in the cardiovascular system. It potentially leads to aortic dissection and rupture, these being the major causes of death. We report a patient who complained of acute abdominal pain, which presented as acute mesenteric ischemia combined with abdominal aortic dissection. Echocardiography showed enlargement of the aortic root and mitral valve prolapse. Abdominal computed tomography scan revealed acute mesenteric ischemia due to abdominal aortic dissection. Finally, the patient underwent surgery of aortic root replacement and had a successful outcome. Therefore, we suggest that for optimal risk assessment and monitoring of patients with Marfan syndrome, both aortic stiffness and the diameter of the superior mesenteric vein compared with that of the superior mesenteric artery are useful screening methods to detect acute mesenteric ischemia secondary to abdominal aortic dissection. Early diagnosis and early treatment can decrease the high mortality rate of patients with Marfan syndrome.

  19. Expression of somatostatin mRNA and peptide in rat hippocampus after cerebral ischemia

    DEFF Research Database (Denmark)

    Bering, Robert; Johansen, Flemming Fryd

    1993-01-01

    Somatostatin, ischemia, hippocampus, rat, in situ hybridisation, immunocytochemistry, neuropathology......Somatostatin, ischemia, hippocampus, rat, in situ hybridisation, immunocytochemistry, neuropathology...

  20. Impact loading response of the MiL-Lx leg fitted with combat boots

    CSIR Research Space (South Africa)

    Pandelani, T

    2016-06-01

    Full Text Available to the injuries more especially during underbelly detonation due to the spatial proximity to the rapid deforming floors. Lower limb surrogate legs, such as the Hybrid III (HIII) or Military Lower Extremity (MiL-Lx) are used to quantify the loading on the lower...

  1. Swelling of the Leg, Deep Venous Thrombosis and the Piriformis Syndrome

    Directory of Open Access Journals (Sweden)

    Sara Bustamante

    2001-01-01

    Full Text Available BACKGROUND: The piriformis syndrome, which was first described 60 years ago, is a well recognized cause of sciatica, leg pain and low back pain, due to the entrapment of the sciatic nerve in the piriformis and other rotator muscles. Very few complications relating to this syndrome have been described.

  2. Aplastic crisis and leg ulceration: two rare complications of hereditary sideroblastic anaemia.

    Science.gov (United States)

    Mehta, J; Singhal, S; Mehta, B C

    1992-07-01

    Aplastic crisis as a result of parvovirus infection is seen in a number of haematologic disorders characterized by decreased red cell survival, and leg ulceration due to unknown causes is seen in a number of haemolytic anaemias. Neither of the two has been reported in a case of sideroblastic anemia. We report one case with each of these complications in association with sideroblastic anaemia.

  3. Clinical performance of a new silver dressing, Contreet Foam, for chronic exuding venous leg ulcers

    DEFF Research Database (Denmark)

    Karlsmark, T; Agerslev, R H; Bendz, S H

    2003-01-01

    OBJECTIVE: This study aimed to evaluate the safety and performance of a new sustained silver-releasing dressing, Contreet Foam (Coloplast A/S), in the treatment of moderately to highly exuding chronic venous leg ulcers in which healing is delayed due to the presence of bacteria. METHOD: The clini...

  4. Iliopsoas bursitis with compression of the common femoral vein resulting in acute lower leg edema

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Seung Bae; Kwak, Hyo Sung; Han, Young Min; Lee, Sang Yong; Jeong, Yeon Jun [Chonbuk National University Medical School, Chonju (Korea, Republic of)

    2006-08-15

    The clinical manifestations related to iliopsoas bursitis can vary due to compression of the adjacent structure such as the common femoral vein, nerve and bladder. We report here on a rare case of iliopsoas bursitis with compression of the common femoral vein that resulted in acute lower leg edema.

  5. Is a long leg a risk for hip or knee osteoarthritis?

    Science.gov (United States)

    Tallroth, Kaj; Ristolainen, Leena; Manninen, Mikko

    2017-10-01

    Background and purpose - 7% of the asymptomatic population has leg-length inequality (LLI) greater than 12 mm. It has been proposed that LLI of >5 mm can be associated with an increased risk of osteoarthritis (OA) of the knee and hip. We studied a possible association between LLI and OA of the knee and hip joint. Patients and methods - We followed 193 individuals (97 women, 96 men) for 29 years. The initial mean age of the participants was 43 (34-54) years, and they had no clinical histories or signs of leg symptoms. The initial standing radiographs of their hips were re-examined and measured for LLI and signs of OA. None had any signs of OA. At the follow-up, data on performed hip or knee arthroplasties were obtained. Results - 24 (12%) of the subjects had no discernible leg-length difference, 62 (32%), had LLIs of 1-4 mm, 74 (38%) of 5-8 mm, 21 (11%) of 9-12 mm, and 12 (6%) of over 12 mm. 16 (8%) of the subjects had undergone arthroplasty for primary OA during follow-up, and of those, 8 for both hip and knee OA. 10 individuals had undergone an arthroplasty of the longer leg and only 3 of the shorter leg. In the group of equal leg length, 3 had had an arthroplasty of hip or knee. Interpretation - We noted that hip or knee arthroplasty due to primary OA had been done 3 times more often to the longer leg than to the shorter.

  6. Mechanical Impedance of the Non-loaded Lower Leg with Relaxed Muscles in the Transverse Plane.

    Science.gov (United States)

    Ficanha, Evandro Maicon; Ribeiro, Guilherme Aramizo; Rastgaar, Mohammad

    2015-01-01

    This paper describes the protocols and results of the experiments for the estimation of the mechanical impedance of the humans' lower leg in the External-Internal direction in the transverse plane under non-load bearing condition and with relaxed muscles. The objectives of the estimation of the lower leg's mechanical impedance are to facilitate the design of passive and active prostheses with mechanical characteristics similar to the humans' lower leg, and to define a reference that can be compared to the values from the patients suffering from spasticity. The experiments were performed with 10 unimpaired male subjects using a lower extremity rehabilitation robot (Anklebot, Interactive Motion Technologies, Inc.) capable of applying torque perturbations to the foot. The subjects were in a seated position, and the Anklebot recorded the applied torques and the resulting angular movement of the lower leg. In this configuration, the recorded dynamics are due mainly to the rotations of the ankle's talocrural and the subtalar joints, and any contribution of the tibiofibular joints and knee joint. The dynamic mechanical impedance of the lower leg was estimated in the frequency domain with an average coherence of 0.92 within the frequency range of 0-30 Hz, showing a linear correlation between the displacement and the torques within this frequency range under the conditions of the experiment. The mean magnitude of the stiffness of the lower leg (the impedance magnitude averaged in the range of 0-1 Hz) was determined as 4.9 ± 0.74 Nm/rad. The direct estimation of the quasi-static stiffness of the lower leg results in the mean value of 5.8 ± 0.81 Nm/rad. An analysis of variance shows that the estimated values for the stiffness from the two experiments are not statistically different.

  7. Possibility of leg muscle hypertrophy by ambulation in older adults: a brief review

    Directory of Open Access Journals (Sweden)

    Ozaki H

    2013-03-01

    Full Text Available Hayao Ozaki,1 Jeremy P Loenneke,2 Robert S Thiebaud,2 Joel M Stager,3 Takashi Abe31Juntendo University, Inzai, Chiba, Japan; 2Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA; 3Department of Kinesiology, Indiana University, Bloomington, IN, USAAbstract: It is known that ambulatory exercises such as brisk walking and jogging are potent stimuli for improving aerobic capacity, but it is less understood whether ambulatory exercise can increase leg muscle size and function. The purpose of this brief review is to discuss whether or not ambulatory exercise elicits leg muscle hypertrophy in older adults. Daily ambulatory activity with moderate (>3 metabolic equivalents [METs], which is defined as the ratio of the work metabolic rate to the resting metabolic rate intensity estimated by accelerometer is positively correlated with lower body muscle size and function in older adults. Although there is conflicting data on the effects of short-term training, it is possible that relatively long periods of walking, jogging, or intermittent running for over half a year can increase leg muscle size among older adults. In addition, slow-walk training with a combination of leg muscle blood flow restriction elicits muscle hypertrophy only in the blood flow restricted leg muscles. Competitive marathon running and regular high intensity distance running in young and middle-aged adults may not produce leg muscle hypertrophy due to insufficient recovery from the damaging running bout, although there have been no studies that have investigated the effects of running on leg muscle morphology in older subjects. It is clear that skeletal muscle hypertrophy can occur independently of exercise mode and load.Keywords: aerobic exercise, muscle mass, aging, strength, sarcopenia

  8. Leg Length, Body Proportion, and Health: A Review with a Note on Beauty

    Directory of Open Access Journals (Sweden)

    Maria Inês Varela-Silva

    2010-03-01

    Full Text Available Decomposing stature into its major components is proving to be a useful strategy to assess the antecedents of disease, morbidity and death in adulthood. Human leg length (femur + tibia, sitting height (trunk length + head length and their proportions, for example, (leg length/stature, or the sitting height ratio (sitting height/stature × 100, among others are associated with epidemiological risk for overweight (fatness, coronary heart disease, diabetes, liver dysfunction and certain cancers. There is also wide support for the use of relative leg length as an indicator of the quality of the environment for growth during infancy, childhood and the juvenile years of development. Human beings follow a cephalo-caudal gradient of growth, the pattern of growth common to all mammals. A special feature of the human pattern is that between birth and puberty the legs grow relatively faster than other post-cranial body segments. For groups of children and youth, short stature due to relatively short legs (i.e., a high sitting height ratio is generally a marker of an adverse environment. The development of human body proportions is the product of environmental x genomic interactions, although few if any specific genes are known. The HOXd and the short stature homeobox-containing gene (SHOX are genomic regions that may be relevant to human body proportions. For example, one of the SHOX related disorders is Turner syndrome. However, research with non-pathological populations indicates that the environment is a more powerful force influencing leg length and body proportions than genes. Leg length and proportion are important in the perception of human beauty, which is often considered a sign of health and fertility.

  9. Leg length, body proportion, and health: a review with a note on beauty.

    Science.gov (United States)

    Bogin, Barry; Varela-Silva, Maria Inês

    2010-03-01

    Decomposing stature into its major components is proving to be a useful strategy to assess the antecedents of disease, morbidity and death in adulthood. Human leg length (femur + tibia), sitting height (trunk length + head length) and their proportions, for example, (leg length/stature), or the sitting height ratio (sitting height/stature x 100), among others) are associated with epidemiological risk for overweight (fatness), coronary heart disease, diabetes, liver dysfunction and certain cancers. There is also wide support for the use of relative leg length as an indicator of the quality of the environment for growth during infancy, childhood and the juvenile years of development. Human beings follow a cephalo-caudal gradient of growth, the pattern of growth common to all mammals. A special feature of the human pattern is that between birth and puberty the legs grow relatively faster than other post-cranial body segments. For groups of children and youth, short stature due to relatively short legs (i.e., a high sitting height ratio) is generally a marker of an adverse environment. The development of human body proportions is the product of environmental x genomic interactions, although few if any specific genes are known. The HOXd and the short stature homeobox-containing gene (SHOX) are genomic regions that may be relevant to human body proportions. For example, one of the SHOX related disorders is Turner syndrome. However, research with non-pathological populations indicates that the environment is a more powerful force influencing leg length and body proportions than genes. Leg length and proportion are important in the perception of human beauty, which is often considered a sign of health and fertility.

  10. A colored leg banding technique for Amazona parrots

    Science.gov (United States)

    Meyers, J.M.

    1995-01-01

    A technique for individual identification of Amazona was developed using plastic leg bands. Bands were made from 5- and 7-mm-wide strips of laminated PVC coiled 2.5 times with an inside diameter 4-5 mm gt the maximum diameter of the parrot's leg. Seventeen parrots were captured in Puerto Rico, marked with individual plastic leg bands, and observed for 204-658 d with only one lost or damaged plastic band. Plastic leg bands did not cause injury to or calluses on parrots' legs. The plastic material used for making leg bands was available in 18 colors in 1994, which would allow unique marking of 306 individuals using one plastic leg band on each leg.

  11. [Critical limb ischemia--update].

    Science.gov (United States)

    Melamed, Eitan; Kotyba, Baydousi; Galili, Offer; Karmeli, Ron

    2010-12-01

    Critical limb ischemia (CLI) is the most severe manifestation of peripheral artery occlusive disease. Without timely diagnosis and revascularization, patients with CLI are at risk of devastating complications including loss of limb and life. Therapeutic goals in treating patients with CLI include reducing cardiovascular risk factors, relieving ischemic pain, heating ulcers, preventing major amputation, improving quality of life and increasing survival. These aims may be achieved through medical therapy, revascularization or amputation. The past decade has seen substantial growth in endovascular therapies and options now exist for treating long segment occlusive disease, but surgical bypass may still yield more durable results. Patients who are younger, more active, and at low risk for surgery, may have better outcomes undergoing an operation. This is also indicated for endovascular failures, which may include technical failures or late occlusions after stents or other procedures. In contrast, frail patients with a limited life expectancy may experience better outcomes with endovascular therapy. For patients who are non-ambulatory, demented, or unfit to undergo revascularization, an amputation should be considered.

  12. [Diagnosis and symptom rating scale of restless legs syndrome].

    Science.gov (United States)

    Inoue, Yuichi

    2009-05-01

    Restless legs syndrome (RLS) is a sensorimotor disorder, characterized by an irresistible urge to move the legs and usually accompanied or caused by uncomfortable and unpleasant sensations. It begins or worsens during periods of rest or inactivity, is partially or totally relieved by movement and is exacerbated or occurs mainly in the evening or night. People suffering from RLS are estimated to represent 2-3% of the general Japanese population, which is relatively lower than the estimated prevalence in western countries. Supportive diagnostic critevia include family history, the presence of periodic-leg movements (PLM) when awake or asleep, and a positive response to dopaminergic treatment. RLS phenotypes include an early onset form that is usually idiopathic with frequent familial history and a late onset form that is usually secondary to other somatic conditions that are causative factors in RLS occurrence. In all patients presenting with complaints of insomnia or discomfort in the lower limbs, diagnosis of RLS should be considered. RLS should be differentiated from akathisia, which is an urge to move the whole body in the absence of uncomfortable sensations. Polysomnographic studies and the suggested immobilization test (SIT) can detect PLM in patients that are asleep or awake. RLS may cause severe sleep disturbances, poor quality of life, depressive and anxious symptoms, and may be a risk factor for cardiovascular disease. Secondary RLS may occur due to iron deficiency, end-stage renal disease, pregnancy, peripheral neuropathy and drug use including antipsychotics and antidepressants. Small fiber neuropathy can trigger RLS or mimic its symptoms. RLS is associated with many neurological disorders, including Parkinson disease and multiple system atrophy; althoughit does not predispose to these diseases. A symptom rating scale for RLS authorized by the International RLS Study Group (IRLS) would facilitate accurate diagnosis of this condition.

  13. How to Treat Restless Leg Syndrome with Traditional Chinese Medicine?

    Institute of Scientific and Technical Information of China (English)

    林宗广

    2003-01-01

    @@ In clinic, restless leg syndrome manifests to have thesymptoms of unbearable soreness, numbness,insect-crawling like itching and electric-shock likeburning sensation in the deep muscles of both legs,which generally appear symmetrically, or severer inone leg, and attack mostly in the night before sleep,but rarely in the day time.

  14. Leg intravenous pressure during head-up tilt.

    NARCIS (Netherlands)

    Groothuis, J.T.; Poelkens, F.; Wouters, C.W.; Kooijman, M.; Hopman, M.T.E.

    2008-01-01

    Leg vascular resistance is calculated as the arterial-venous pressure gradient divided by blood flow. During orthostatic challenges it is assumed that the hydrostatic pressure contributes equally to leg arterial, as well as to leg venous pressure. Because of venous valves, one may question whether,

  15. Lower leg electrical impedance after distal bypass surgery

    DEFF Research Database (Denmark)

    Belanger, G K; Bolbjerg, M L; Heegaard, N H;

    1998-01-01

    Electrical impedance was determined in 13 patients following distal bypass surgery to evaluate lower leg oedema as reflected by its circumference. Tissue injury was assessed by the plasma concentration of muscle enzymes. After surgery, the volume of the control lower leg increased from 1250 (816...... to be a useful method for the evaluation of lower leg oedema after distal bypass surgery....

  16. Protection against high intravascular pressure in giraffe legs

    DEFF Research Database (Denmark)

    Petersen, Karin K; Hørlyck, Arne; Østergaard, Kristine Hovkjær

    2013-01-01

    The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination...

  17. The clinical relevance of cerebral microbleeds in patients with cerebral ischemia and atrial fibrillation.

    Science.gov (United States)

    Haji, Shamir; Planchard, Ryan; Zubair, Adeel; Graff-Radford, Jonathan; Rydberg, Charlotte; Brown, Robert D; Flemming, Kelly D

    2016-02-01

    The clinical significance of cerebral microbleeds (CMB) in patients hospitalized with atrial fibrillation (AF) and cerebral ischemia is unclear. We aimed to determine the prevalence of CMB in this population and determine the future risk of intracerebral hemorrhage (ICH) and cerebral infarction (CI). The medical records and brain imaging of patients hospitalized with cerebral ischemia due to AF between 2008 and 2011 were reviewed. Followup was obtained through medical record review, mailed survey, and acquisition of death certificates. Prevalence was calculated from those patients with a hemosiderin-sensitive MRI sequence. Recurrent CI and ICH were calculated using Kaplan-Meier curves censored at 3 years. Among 426 patients hospitalized with cerebral ischemia due to AF, 134 had an MRI with hemosiderin-sensitive sequences. The prevalence of CMB was 27.6%. At 3 years, 90.6% of CMB-negative patients were overall stroke free (ICH and CI) compared to 78.6% CMB-positive patients (p = 0.0591). Only one patient in the CMB-positive group had an ICH distant to the CMB. There was a nonsignificant trend toward higher recurrent CI, recurrent overall stroke rate, and mortality in patients with 5 or more CMB compared to 0-4 CMB. The rate of prospective CI in patients with prior cerebral ischemia due to AF is higher than the rate of ICH in patients with CMB. Further study is warranted to assess larger numbers of patients to determine appropriate antithrombotic use in this high-risk population.

  18. A review of current treatment strategies for restless legs syndrome (Willis-Ekbom disease).

    Science.gov (United States)

    Klingelhoefer, Lisa; Cova, Ilaria; Gupta, Sheena; Chaudhuri, Kallol Ray

    2014-10-01

    Restless legs syndrome (RLS), recently renamed Willis-Ekbom disease (WED), is a common movement disorder. It is characterised by the need to move mainly the legs due to uncomfortable, sometimes painful sensations in the legs, which have a diurnal variation and a release with movement. Management is complex. First, centres should establish the severity of RLS using a simple 10-item RLS severity rating scale (IRLS). They should also exclude secondary causes, in particular ensuring normal iron levels. Mild cases can be managed by lifestyle changes, but patients with a IRLS score above 15 usually require pharmacological treatment. Dopaminergic therapies remain the mainstay of medical therapies, with recent evidence suggesting opioids may be particularly effective. This article focuses on the different treatment strategies in RLS, their associated complications and ways to manage them. © 2014 Royal College of Physicians.

  19. Genetic association between leg conformation in young pigs and sow reproduction

    DEFF Research Database (Denmark)

    Le, Thu Hong; Nilsson, Katja; Norberg, Elise

    2015-01-01

    Lameness is an issue of concern in pig production due both to animal welfare and to economical aspects. Lame sows are believed to suffer from pain and stress which is reported to have a negative influence on reproduction. Leg conformation and locomotion traits in young animals are associated....... Estimates of heritabilities and genetic correlations between traits were obtained using a multi-trait linear animal mixed model. The heritability estimates were low to moderate, ranging from 0.02 to 0.20 for conformation traits and from 0.06 to 0.10 for reproduction traits. Significant genetic correlations...... with the risk of lameness at higher age. The purpose of this study was to estimate the genetic parameters of leg conformation traits recorded at performance testing (around 5 months of age) and their genetic correlations with reproduction traits. Information on leg conformation traits from 123,307 pigs scored...

  20. Assessment of Renal Ischemia By Optical Spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Fitzgerald, J T; Demos, S; Michalopoulou, A; Pierce, J L; Troppmann, C

    2004-01-07

    Introduction: No reliable method currently exists for quantifying the degree of warm ischemia in kidney grafts prior to transplantation. We describe a method for evaluating pretransplant warm ischemia time using optical spectroscopic methods. Methods: Lewis rat kidney vascular pedicles were clamped unilaterally in vivo for 0, 5, 10, 20, 30, 60, 90 or 120 minutes; 8 animals were studied at each time point. Injured and contra-lateral control kidneys were then flushed with Euro-Collins solution, resected and placed on ice. 335 nm excitation autofluorescence as well as cross polarized light scattering images were taken of each injured and control kidney using filters of various wavelengths. The intensity ratio of the injured to normal kidneys was compared to ischemia time. Results: Autofluorescence intensity ratios through a 450 nm filter and light scattering intensity ratios through an 800 nm filter both decreased significantly with increasing ischemia time (p < 0.0001 for each method, one-way ANOVA). All adjacent and non-adjacent time points between 0 and 90 minutes were distinguishable using one of these two modalities by Fisher's PLSD. Conclusions: Optical spectroscopic methods can accurately quantify warm ischemia time in kidneys that have been subsequently hypothermically preserved. Further studies are needed to correlate results with physiological damage and posttransplant performance.

  1. Proper Treatment of Acute Mesenteric Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Kwan; Han, Young Min [Dept. of Radiology, Chonbuk National University Hospital and School of Medicine, Jeonju (Korea, Republic of); Kwak, Hyo Sung [Research Institue of Clinical Medicine, Chonbuk National University Hospital and School of Medicine, Jeonju (Korea, Republic of); Yu, Hee Chul [Dept. of Radiology, Chonbuk National University Hospital and School of Medicine, Jeonju (Korea, Republic of)

    2011-10-15

    To evaluate the effectiveness of treatment options for Acute Mesenteric Ischemia and establish proper treatment guidelines. From January 2007 to May 2010, 14 patients (13 men and 1 woman, mean age: 52.1 years) with acute mesenteric ischemia were enrolled in this study. All of the lesions were detected by CT scan and angiography. Initially, 4 patients underwent conservative treatment. Eleven patients were managed by endovascular treatment. We evaluated the therapeutic success and survival rate of each patient. The causes of ischemia included thromboembolism in 6 patients and dissection in 8 patients. Nine patients showed bowel ischemia on CT scans, 4 dissection patients underwent conservative treatment, 3 patients had recurring symptoms, and 5 dissection patients underwent endovascular treatment. Overall success and survival rate was 100%. However, overall success was 83% and survival rate was 40% in the 6 thromboembolism patients. The choice of 20 hours as the critical time in which the procedure is ideally performed was statistically significant (p = 0.0476). A percutaneous endovascular procedure is an effective treatment for acute mesenteric ischemia, especially in patients who underwent treatment within 20 hours. However, further study and a long term follow-up are needed.

  2. Reparative neurogenesis after cerebral ischemia: Clinical application prospects

    Science.gov (United States)

    Khodanovich, M. Yu.

    2015-11-01

    At the present time two main approaches are in the focus of neurobiological studies of brain recovery after a stroke. One of them is concerned with the infusion of stem cells in damaged brain. The second approach is directed at the stimulation of endogenous reparative processes, in particular, adult neurogenesis. This review considers alterations of adult neurogenesis caused by cerebral ischemia and possible pathways of its regulation. Multiple studies on animal models have shown that adult neurogenesis is mostly increased by cerebral ischemia. In spite of increasing proliferation and moving neural progenitors to infarct zone, most newborn neurons die before reaching maturity. Besides, an increase of neurogenesis in pathological conditions is mainly due to recruitment of new stem cells, but not due to an additional precursor-cells division that results in an overall decline of the regeneration capacity. Thus, the endogenous reparative mechanisms are not sufficient, and the search for new targets to promote proliferation, survival, and maturation of new neurons after a stroke is needed. Neurotransmitter systems and anti-inflammatory drugs are considered as potential regulators of post-ischemic neurogenesis growth factors.

  3. Reparative neurogenesis after cerebral ischemia: Clinical application prospects

    Energy Technology Data Exchange (ETDEWEB)

    Khodanovich, M. Yu., E-mail: khodanovich@mail.tsu.ru [Tomsk State University, Research Institute of Biology and Biophysics, Laboratory of Neurobiology (Russian Federation)

    2015-11-17

    At the present time two main approaches are in the focus of neurobiological studies of brain recovery after a stroke. One of them is concerned with the infusion of stem cells in damaged brain. The second approach is directed at the stimulation of endogenous reparative processes, in particular, adult neurogenesis. This review considers alterations of adult neurogenesis caused by cerebral ischemia and possible pathways of its regulation. Multiple studies on animal models have shown that adult neurogenesis is mostly increased by cerebral ischemia. In spite of increasing proliferation and moving neural progenitors to infarct zone, most newborn neurons die before reaching maturity. Besides, an increase of neurogenesis in pathological conditions is mainly due to recruitment of new stem cells, but not due to an additional precursor-cells division that results in an overall decline of the regeneration capacity. Thus, the endogenous reparative mechanisms are not sufficient, and the search for new targets to promote proliferation, survival, and maturation of new neurons after a stroke is needed. Neurotransmitter systems and anti-inflammatory drugs are considered as potential regulators of post-ischemic neurogenesis growth factors.

  4. Scattering of a legged robot in a heterogeneous granular terrain

    Science.gov (United States)

    Qian, Feifei; Goldman, Daniel

    2015-03-01

    Many granular substrates are composed of particulates of varying size, from fine sand to pebbles and boulders. Ambulatory locomotion on such heterogeneous substrates is complicated in part due to fluctuations introduced by heterogeneities. To discover principles of movement in such substrates, we developed an automated system, the ``Systematic Creation of Arbitrary Terrain and Testing of Exploratory Robots'' (SCATTER), to create heterogeneous granular substrates of varying properties such as compaction, inclination, obstacle shape/size/distribution and obstacle mobility within the substrate. We investigate how the presence of a single ``boulder'' affects the locomotion of a 6-legged robot (15cm, 150g). The robot's trajectory is straight before boulder interaction, and is scattered to an angle after the interaction. Surprisingly, the interactions with the boulder can lead to both negative and positive scattering angles-an effective attraction and repulsion between the robot and the boulder. The scattering pattern depends sensitively on the leg-boulder contact position and the boulder mobility within the fine sand. However, the scattering pattern dependence upon contact position on the boulder is insensitive to boulder shape (created using 3D printing), orientation and roughness. This work is funded by DARPA Young Faculty Award and Army Research Laboratory (ARL).

  5. [Chronic cerebral ischemia associated with Raynaud's syndrome].

    Science.gov (United States)

    Putilina, M V

    2015-01-01

    Over the last years, a number of patients with chronic cerebral ischemia has been increased significantly. Compensatory possibilities of the brain and cerebral circulatory system are so great that even serious disturbances of blood circulation could not cause clinical signs of brain dysfunction for a long time. At the same time, long-term ischemia can lead to peripheral local disturbances of microcirculation that is appears to be a first signal of the problems with homeostasis. Therefore, Raynaud's syndrome may be one of the predictors of standard symptoms of chronic cerebral ischemia (CCI). This phenomenon is explicitly considered as a sign of blood circulation impairment while the pathogenetic mechanism of vascular arterial bed instability is completely ignored. Detailed study of clinical correlations of Raynaud's syndrome in CCI would help to develop a common pharmacotherapeutic approach to its treatment.

  6. Adaptation to altered balance conditions in unilateral amputees due to atherosclerosis: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Bretz Éva

    2011-05-01

    Full Text Available Abstract Background Amputation impairs the ability to balance. We examined adaptation strategies in balance following dysvascularity-induced unilateral tibial amputation in skilled prosthetic users (SPU and first fitted amputees (FFA (N = 28. Methods Excursions of center of pressure (COP were determined during 20 s quiet standing using a stabilometry system with eyes-open on both legs or on the non-affected leg(s. Main measures: COP trajectories and time functions; distribution of reaction forces between the two legs; inclination angles obtained through second order regression analysis using stabilogram data. Results FFA vs SPU demonstrated 27.8% greater postural sway in bilateral stance (p = 0.0004. Postural sway area was smaller in FFA standing on the non-affected leg compared with SPU (p = 0.028. The slope of the regression line indicating postural stability was nearly identical in FFA and SPU and the direction of regression line was opposite for the left and right leg amputees. Conclusion Of the two adaptation strategies in balance, the first appears before amputation due to pain and fatigue in the affected leg. This strategy appears in the form of reduced postural sway while standing on the non-affected leg. The second adaptation occurs during rehabilitation and regular use of the prosthesis resulting in normal weightbearing associated with reduced postural sway on two legs and return to the normal postural stability on one leg.

  7. Single Phase Online UPS Design Using Three Leg Converters

    Directory of Open Access Journals (Sweden)

    R. Ramesh,

    2014-03-01

    Full Text Available The single phase online UPS integrate with the three leg type converter which operate with battery charger and the inverter. The first leg controls the ability of charging battery. The third leg controls the output voltage. The common leg is used to control the line frequency. The battery charger has the ability of making the correction of power factor during the battery charging. The inverter is used to maintain the output voltage and to limit the output current. The main feature of the three leg converter is used to reduce the number of switching devices. So that the system has the low value of power loss and low cost.

  8. CSF transthyretin neuroprotection in a mouse model of brain ischemia

    DEFF Research Database (Denmark)

    Santos, Sofia Duque; Lambertsen, Kate Lykke; Clausen, Bettina Hjelm

    2010-01-01

    Brain injury caused by ischemia is a major cause of human mortality and physical/cognitive disability worldwide. Experimentally, brain ischemia can be induced surgically by permanent middle cerebral artery occlusion. Using this model, we studied the influence of transthyretin in ischemic stroke...... neuronal cell death, edema and inflammation, thereby influencing the survival of endangered neurons in cerebral ischemia....

  9. Pyruvate-Enhanced Resuscitation for Hemorrhagic Shock and Hindlimb Ischemia

    Science.gov (United States)

    2015-06-06

    Pyruvate-Enhanced Resuscitation for Hemorrhagic Shock and Hindlimb Ischemia The overall goals of this investigation were to test the ability of...Final Report: Pyruvate-Enhanced Resuscitation for Hemorrhagic Shock and Hindlimb Ischemia Report Title The overall goals of this investigation were to...during ischemia -reperfusion injury and cause cellular damage which likely contributes to myocardial contractile dysfunction. ROS oxidize and

  10. Multi-leg heat pipe evaporator

    Science.gov (United States)

    Alario, J. P.; Haslett, R. A. (Inventor)

    1986-01-01

    A multileg heat pipe evaporator facilitates the use and application of a monogroove heat pipe by providing an evaporation section which is compact in area and structurally more compatible with certain heat exchangers or heat input apparatus. The evaporation section of a monogroove heat pipe is formed by a series of parallel legs having a liquid and a vapor channel and a communicating capillary slot therebetween. The liquid and vapor channels and interconnecting capillary slots of the evaporating section are connected to the condensing section of the heat pipe by a manifold connecting liquid and vapor channels of the parallel evaporation section legs with the corresponding liquid and vapor channels of the condensing section.

  11. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

    Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T

    2005-01-01

    and reliable evidence-based quality indicators of venous leg ulcer care. A Scandinavian multidisciplinary, cross-sectional panel of wound healing experts developed clinical quality indicators on the basis of scientific evidence from the literature and subsequent group nominal consensus of the panel......%) were assessed for venous surgery. Distal arterial pressure was measured following initial examination in 33 of the patients (34%). All patients (100%) were prescribed compression therapy. Of the 98 patients, 11 (11%) had ulcers recur in 3 months and 72 (73%) healed in 12 months, which is in line......; an independent medical doctor tested the feasibility and reliability of these clinical indicators, assessing the quality of medical technical care on 100 consecutive venous leg ulcer patients. Main outcome measures were healing, recurrence, pain, venous disease diagnosis, differential diagnosis and treatment...

  12. Multi-leg heat pipe evaporator

    Science.gov (United States)

    Alario, J. P.; Haslett, R. A.

    1986-04-01

    A multileg heat pipe evaporator facilitates the use and application of a monogroove heat pipe by providing an evaporation section which is compact in area and structurally more compatible with certain heat exchangers or heat input apparatus. The evaporation section of a monogroove heat pipe is formed by a series of parallel legs having a liquid and a vapor channel and a communicating capillary slot therebetween. The liquid and vapor channels and interconnecting capillary slots of the evaporating section are connected to the condensing section of the heat pipe by a manifold connecting liquid and vapor channels of the parallel evaporation section legs with the corresponding liquid and vapor channels of the condensing section.

  13. Pharmacologic treatment of venous leg ulcers.

    Science.gov (United States)

    Dormandy, J A

    1995-01-01

    In terms of prevalence, total cost and morbidity, venous leg ulcers are probably by far the most important type of ulcerations in the leg. The macrocirculatory defect leading to a raised ambulatory venous pressure is now accepted as a common initial pathologic pathway. Most current treatment modalities, such as surgery or external compression, are designed to control the macrovascular defect. However, it is the microcirculatory consequences of the venous hypertension that give rise to the trophic skin changes and ultimately to ulceration. At this microcirculatory level, pharmacotherapy may be a useful adjunct in the treatment of venous leg ulcers. The microcirculatory pathophysiologic changes include decreased fibrinolytic activity, elevated plasma fibrinogen, microcirculatory thrombi, and inappropriate activation of the white blood cells. The oxidative burst from the activated white cells probably plays a key role by releasing locally leukocyte-derived free radicals, proteolytic enzymes, cytokines, platelet-activating factor, and a number of other noxious mediators. An important additional component in recalcitrant venous ulcers is co-existing arterial disease, which is probably present in 15-20% of cases. Decreased arterial perfusion pressure will further aggravate the ischemic changes caused by the venous hypertension. Pentoxifylline downregulates leukocyte activation, reduces leukocyte adhesion, and also has fibrinolytic effects. A number of clinical studies have therefore been carried out to examine the clinical efficacy of pentoxifylline in treatment of venous leg ulcers. Probably the largest published placebo-controlled, double-blind randomized study was reported in 1990. In this study, 80 patients received either pentoxifylline 400 mg three times a day orally or matching placebo for 6 months or until their reference ulcer healed if this occurred sooner. Complete healing of the reference ulcer occurred in 23 of the 38 patients treated with pentoxifylline

  14. Restless Legs Syndrome and Psychiatric Disorders.

    Science.gov (United States)

    Mackie, Susan; Winkelman, John W

    2015-09-01

    There are strong epidemiologic ties between restless legs syndrome (RLS) and a wide array of psychiatric conditions. Although the mechanism of this association is not fully understood, there are likely bidirectional cause-and-effect relationships. Appreciation of psychiatric comorbidity is an essential component of the treatment of RLS. Clinicians should be prepared to facilitate appropriate psychiatric treatment and consider the complex interactions between psychiatric medications, RLS medications, and the clinical course of both illnesses.

  15. Visual based localization for a Legged Robot

    OpenAIRE

    Martín Rico, Francisco; Matellán Olivera, Vicente; González-Careaga, Rafaela; Barrera González, Pablo; Cañas, José María

    2006-01-01

    P. 708-715 This paper presents a visual based localization mechanism for a legged robot. Our proposal, fundamented on a probabilistic approach, uses a precompiled topological map where natural landmarks like doors or ceiling lights are recognized by the robot using its on-board camera. Experiments have been conducted using the AIBO Sony robotic dog showing that it is able to deal with noisy sensors like vision and to approximate world models representing indoor of c...

  16. Vision based behaviors for a legged robot

    OpenAIRE

    Ruiz, Juan V.; Montero, Pablo; Martín Rico, Francisco; Matellán Olivera, Vicente

    2005-01-01

    This article describes two vision-based behaviors designed for an autonomous legged robot. These behaviors have been designed in a modular way in order to be able to integrate them in an architecture named DSH (Dynamic Schema Hierarchies), which is also briefly described. These behaviors have been tested in office indoor environments and experiments carried out are also described in this paper. The platform used in these experiments carried out are also described in theis paper. The platform ...

  17. Leg contracture in mice: an assay of normal tissue response

    Energy Technology Data Exchange (ETDEWEB)

    Stone, H.B.

    1984-07-01

    Leg contracture, defined as the difference in extensibility of the control and irradiated hind legs of mice, was found to correlate with single doses of radiation from about 20 to 80 Gy. The time of development of the early phase of the response coincided with that reported for the appearance of the acute skin response, and in some cases, partially reversed as this reaction healed. The contracture then progressed again at a moderate rate through 90 days, and then more slowly through one year. Skin contraction, measured by decrease in intertattoo distance, was assayed in the same mice. It followed the same time course as leg contracture, but had a different dose-response relationship. To determine the contribution of skin contraction to the overall leg contracture response, mice were sacrificed and the leg contracture measured before and after the removal of the skin of the leg. After doses of up to 30 Gy, little contracture remained from skinning the leg, indicating that skin contraction was largely responsible for leg contracture in this dose range. After doses of about 45 Gy and above, some contracture remained in the skinned legs, although less than in intact legs. There was little or no enhancement of either skin contraction or leg contracture by the hypoxic cell sensitizers metronidazole or misonidazole.

  18. Legged-locomotion on inclined granular media

    Science.gov (United States)

    Rieser, Jennifer; Qian, Feifei; Goldman, Daniel

    Animals traverse a wide variety of complex environments, including situations in which the ground beneath them can yield (e.g. dry granular media in desert dunes). Locomotion strategies that are effective on level granular media can fail when traversing a granular slope. Taking inspiration from successful legged-locomotors in sandy, uneven settings, we explore the ability of a small (15 cm long, 100 g), six-c-shaped legged robot to run uphill in a bed of 1-mm-diameter poppy seeds, using an alternating tripod gait. Our fully automated experiments reveal that locomotor performance can depend sensitively on both environmental parameters such as the inclination angle and volume fraction of the substrate, and robot morphology and control parameters like leg shape, step frequency, and the friction between the feet of the robot and the substrate. We assess performance by measuring the average speed of the robot, and we find that the robot tends to perform better at higher step frequency and lower inclination angles, and that average speed decreases more rapidly with increasing angle for higher step frequency.

  19. Proprioceptive Actuation Design for Dynamic Legged locomotion

    Science.gov (United States)

    Kim, Sangbae; Wensing, Patrick; Biomimetic Robotics Lab Team

    Designing an actuator system for highly-dynamic legged locomotion exhibited by animals has been one of the grand challenges in robotics research. Conventional actuators designed for manufacturing applications have difficulty satisfying challenging requirements for high-speed locomotion, such as the need for high torque density and the ability to manage dynamic physical interactions. It is critical to introduce a new actuator design paradigm and provide guidelines for its incorporation in future mobile robots for research and industry. To this end, we suggest a paradigm called proprioceptive actuation, which enables highly- dynamic operation in legged machines. Proprioceptive actuation uses collocated force control at the joints to effectively control contact interactions at the feet under dynamic conditions. In the realm of legged machines, this paradigm provides a unique combination of high torque density, high-bandwidth force control, and the ability to mitigate impacts through backdrivability. Results show that the proposed design provides an impact mitigation factor that is comparable to other quadruped designs with series springs to handle impact. The paradigm is shown to enable the MIT Cheetah to manage the application of contact forces during dynamic bounding, with results given down to contact times of 85ms and peak forces over 450N. As a result, the MIT Cheetah achieves high-speed 3D running up to 13mph and jumping over an 18-inch high obstacle. The project is sponsored by DARPA M3 program.

  20. Aloe Vera and Infected Leg Ulcers

    Directory of Open Access Journals (Sweden)

    Asima Banu

    2012-06-01

    Full Text Available Background Infected leg ulcers are major health problems resulting in morbidity and disability and are usually chronic and refractory to antimicrobial treatment. Aims The present study is aimed at determining the bacteria involved in leg ulcers and their resistance patterns to commonly used antibiotics as well as to determine whether Aloe Vera has antibacterial activity against multi-drug resistant organisms and promotes wound healing. Method A total of 30 cases with leg ulcers infected with multi-drug resistant organisms were treated with topical aloe vera gel and 30 age and sex-matched controls were treated with topical antibiotics. Culture and sensitivity was done from the wounds on alternate days and the ulcer was clinically and microbiologically assessed after 10 days. The results were compiled and statistically analysed. Results Cultures of the study group who were using aloe vera dressings showed no growth by the fifth day in 10 (33.3% cases, seventh day in another 16 (53.3% and ninth day in two of the remaining four cases (6.7% while in two (6.7% cases there was no decrease in the bacterial count. This means that of the 30 cases, 28 showed no growth by the end of 11 days while two cases showed no decrease in bacterial count. Growth of bacteria in study group is decreased from 100% (30 cases to 6.7% (2 cases by day 11 with P

  1. Leg edema from intrathecal opiate infusions.

    Science.gov (United States)

    Aldrete, J A; Couto da Silva JM

    2000-01-01

    Despite the increasing popularity of intrathecal infusions to treat patients with long-term non-cancer-related pain, this therapy is not without serious side-effects. Five out of 23 patients who had intrathecal infusions of opiates for longer than 24 months developed leg and feet edema. As predisposing factors, cardiovascular disease, deep venous thrombosis, peripheral vascular disease, and venous stasis of the lower extremities were considered. Every patient who developed pedal and leg edema after the implantation of an infusion pump was also found to have leg edema and venous stasis prior to the time when the pump was inserted. This complication was severe enough to limit their physical activity, and to produce lymphedema, ulcerations and hyperpigmentation of the skin. Reduction of the edema occurred when the dose of the opiate was decreased, and in two cases in which the infusion was discontinued, there was almost complete resolution of the syndrome. It appears that the pre-existence of pedal edema and of venous stasis is a relative contraindication to the long-term intrathecal infusion of opiates in patients with chronic non-cancer pain. Copyright 2000 European Federation of Chapters of the International Association for the Study of Pain.

  2. Paracrine systems in the cardioprotective effect of angiotensin-converting enzyme inhibitors on myocardial ischemia/reperfusion injury in rats.

    Science.gov (United States)

    Liu, Y H; Yang, X P; Sharov, V G; Sigmon, D H; Sabbath, H N; Carretero, O A

    1996-01-01

    After transient episodes of ischemia, benefits of thrombolytic or angioplastic therapy may be limited by reperfusion injury. Angiotensin-converting enzyme inhibitors protect the heart against ischemia/reperfusion injury, an effect mediated by kinins. We examined whether the protective effect of the angiotensin-converting enzyme inhibitor ramiprilat on myocardial ischemia/reperfusion is due to kinin stimulation of prostaglandin and/or nitric oxide release. The left anterior descending coronary artery of Lewis inbred rats was occluded for 30 minutes, followed by 120 minutes of reperfusion. Immediately before reperfusion rats were treated with vehicle, ramiprilat, or the angiotensin II type 1 receptor antagonist losartan. We tested whether pretreatment with the kinin receptor antagonist Hoe 140, the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester, or the cyclooxygenase inhibitor indomethacin blocked the effect of ramiprilat on infarct size and reperfusion arrhythmias. In controls, infarct size as a percentage of the area at risk was 79 +/- 3%; ramiprilat reduced this to 49 +/- 4% (P < .001), but losartan had little effect (74 +/- 6%, P = NS). Pretreatment with Hoe 140, NG-nitro-L-arginine methyl ester, or indomethacin abolished the beneficial effect of ramiprilat. Compared with the 30-minute ischemia/120-minute reperfusion group, nonreperfused hearts with 30 minutes of ischemia had significantly smaller infarct size as a percentage of the area at risk, whereas in the 150-minute ischemia group it was significantly larger. This suggests that reperfusion caused a significant part of the myocardial injury, but it also suggests that compared with prolonged ischemia, reperfusion salvaged some of the myocardium. Ventricular arrhythmias mirrored the changes in infarct size. Thus, angiotensin-converting enzyme inhibitors protect the myocardium against ischemia/reperfusion injury and arrhythmias; these beneficial effects are mediated primarily by a kinin

  3. Riluzole improves outcome following ischemia-reperfusion injury to the spinal cord by preventing delayed paraplegia.

    Science.gov (United States)

    Wu, Y; Satkunendrarajah, K; Fehlings, M G

    2014-04-18

    The spinal cord is vulnerable to ischemic injury due to trauma, vascular malformations and correction of thoracic aortic lesions. Riluzole, a sodium channel blocker and anti-glutamate drug has been shown to be neuroprotective in a model of ischemic spinal cord injury, although the effects in clinically relevant ischemia/reperfusion models are unknown. Here, we examine the effect of riluzole following ischemia-reperfusion injury to the spinal cord. Female rats underwent high thoracic aortic balloon occlusion to produce an ischemia/reperfusion injury. Tolerance to ischemia was evaluated by varying the duration of occlusion. Riluzole (8mg/kg) was injected intraperitoneally 4h after injury. Locomotor function (Basso, Beattie and Bresnahan (BBB) scale) was assessed at 4h, 1day, and 5days post-ischemia. Spinal cords were extracted and evaluated for neuronal loss using immunohistology (choline acetyltransferase (ChAT) and neuronal nuclei (NeuN)), inflammation (CD11b), astrogliosis (glial fibrillary acidic protein - GFAP) and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL). Ischemic injury lasting between 5.5 and 6.75min resulted in delayed paraplegia, whereas longer ischemia induced immediate paraplegia. When riluzole was administered to rats that underwent 6min of occlusion, delayed paraplegia was prevented. The BBB score of riluzole-treated rats was 11.14±4.85 compared with 1.86±1.07 in control animals. Riluzole also reduced neuronal loss, infiltration of microglia/macrophages and astrogliosis in the ventral horn and intermediate zone of the gray matter. In addition, riluzole reduced apoptosis of neurons in the dorsal horn of the gray matter. Riluzole has a neuroprotective effect in a rat model of spinal cord injury/reperfusion when administered up to 4h post-injury, a clinically relevant therapeutic time window.

  4. Do anti-embolism stockings fit our legs? Leg survey and data analysis.

    Science.gov (United States)

    Macintyre, Lisa; Kent, Kimberly; McPhee, Donna

    2013-07-01

    Anti-embolism stockings are commonly used worldwide to prevent the development of thrombosis in hospitalised patients. Patients are typically measured for, and fitted with, anti-embolism stockings during extended periods of non-ambulation. Anti-embolism stockings must critically fit the leg to achieve optimum blood flow and thus success of prophylaxis. Therefore, hospitals endeavour to maintain stock of anti-embolism stockings that fit the majority of their patients. The objective of this study was to establish whether popular styles/brands of anti-embolism stockings "fitted" the legs of convenience sampled volunteers. Volunteer's legs were measured at ankle, calf and thigh following guidance from British nurses and in accordance with brand instructions. Leg measurements were subsequently compared to the size charts of 10 anti-embolism stocking styles made by 4 different manufacturers. "Fit" is defined as a volunteer's leg measurements matching any stocking size in a range at all measurement points. Volunteers were measured in different settings around Scotland, including private homes, work places and shopping centres. A convenience sample of 471 volunteers (283 female, 188 male) were recruited on the basis of willingness to participate and being over 16 years old. Volunteers ranged from 17 years to 82 years old with an average age of 35. The 10 different styles of anti-embolism stockings, made by 4 different brands, examined for this paper had a size match coefficient ranging from 0% to 100% for our volunteer's legs. The size match coefficient is strongly influenced by the Brand's sizing policy. The proportion of legs that "fit" a particular brand of anti-embolism stockings can be increased through: (1) the reduction of the number of leg measurement points that need to be matched to the size chart of the stockings; (2) the use of open-ended size ranges; (3) the use of increased size range width and (4) the use of increased overlap between sizes. However, all but

  5. Maximal loads acting on legs of powered roof support unit in longwalls with bumping hazards

    Institute of Scientific and Technical Information of China (English)

    StanislawSzweda

    2001-01-01

    during blasting. The majority of recorded force changes in the legs has been caused by a dynamic interaction of the roof. They are characterized by a load increase coefficient Kd, satisfying the inequality i .06 < Kd = Fm/Fst.p < 1.24. A much smeller number of cases, when the external load acted on the bases, was recorded. Individual, recorded results of measurements indicate that changes of the force in the legs, caused by external loads of this type, run more intensively due to roof loads (1.08 < Kd< l. 80), particularly in these cases when the nearthe-roof layer of the seam Is under mining. A determination of more precise relations among the changes of forces in the legs, caused by a dynamic interaction of the floor and the bases and the mining and geological conditions requires a performance of additional underground tests. Keywords longwall, bumping hazard, powered roof support unit

  6. Maximal loads acting on legs of powered roof support unit in longwalls with bumping hazards

    Institute of Scientific and Technical Information of China (English)

    Stanislaw Szweda

    2001-01-01

    acting on a unit du ring blasting. The majority of recorded force changes in the legs has been caused by a dyna mic interaction of the roof. They are characterized by a load increase coefficie nt Kd, satisfying the inequality 1.06legs, caused by external loads of this type, run more inten sively due to roof loads (1.08legs, caused by a dynamic interacti on of the floor and the bases and the mining and geological conditions requires a performance of additional underground tests.

  7. Different effects of thiopental in severe hypoxia, total ischemia and low-flow ischemia in rat heart muscle

    NARCIS (Netherlands)

    Ruigrok, T.J.C.; Slade, A.M.; Meer, P. van der; Moes, D. de; Sinclair, D.M.; Poole-Wilson, P.A.; Meijler, F.L.

    1985-01-01

    The effect of thiopental (100 mg .1-1) during total ischemia, low-flow ischemia, and severe hypoxia with maintained flow was investigated in the isolated perfused rat heart. During total ischemia the rate of decline of tissue creatine phosphate and adenosine triphosphate was no different in thiopent

  8. Effect of Renal Transplantation in Restless Legs Syndrome.

    Science.gov (United States)

    Kahvecioglu, Serdar; Yildiz, Demet; Buyukkoyuncu, Nilufer; Celik, Huseyin; Tufan, Fatih; Kılıç, Ahmet Kasım; Gul, Bulent; Yildiz, Abdulmecid

    2016-02-01

    Restless legs syndrome is a disorder in which patients have irresistible urge to move legs during rest. Restless legs syndrome seems to be common in end-stage renal disease. After a successful renal transplant, symptoms ameliorate with renal function improvement and restless legs syndrome is seen less in this population. Here, we aimed to investigate restless legs syndrome frequency and associated factors in renal transplant patients. In a cross-sectional study with 193 patients (116 hemodialysis patients, 45 transplant patients, and 32 controls), the presence of restless legs syndrome was assessed using the Restless Legs Syndrome Questionnaire. Medical history, demographic, and laboratory data were collected from the patients' medical records. Patients were questioned about the presence of restless legs syndrome using the Restless Legs Syndrome Questionnaire. Patients were evaluated with Beck Depression Scale for depression and Pittsburgh tests for sleep disturbances. While the rate of restless legs syndrome was similar between transplants and controls, it was significantly greater in hemodialysis patients. Hemodialysis patients and controls had similar depression scores that were higher compared with transplant patients. Pittsburgh score was similar in transplant patients and controls and significantly increased in the hemodialysis patients. The rate of insomnia was significantly higher in the hemodialysis patients compared with the other 2 groups. Logistic regression analysis revealed independent correlates of restless legs syndrome as insomnia, Beck depression score, and being on hemodialysis. Linear regression analysis showed that independent correlates of higher Pittsburgh score were higher depression score, higher age, and presence of restless legs syndrome. The prevalence of restless legs syndrome is significantly lower in transplant patients than it is in patients on maintenance dialysis. In renal transplant patients, restless legs syndrome frequency was

  9. What's new: Management of venous leg ulcers: Approach to venous leg ulcers.

    Science.gov (United States)

    Alavi, Afsaneh; Sibbald, R Gary; Phillips, Tania J; Miller, O Fred; Margolis, David J; Marston, William; Woo, Kevin; Romanelli, Marco; Kirsner, Robert S

    2016-04-01

    Leg ulcerations are a common problem, with an estimated prevalence of 1% to 2% in the adult population. Venous leg ulcers are primarily treated in outpatient settings and often are managed by dermatologists. Recent advances in the diagnosis and treatment of leg ulcers combined with available evidence-based data will provide an update on this topic. A systematized approach and the judicious use of expensive advanced therapeutics are critical. Specialized arterial and venous studies are most commonly noninvasive. The ankle brachial pressure index can be performed with a handheld Doppler unit at the bedside by most clinicians. The vascular laboratory results and duplex Doppler findings are used to identify segmental defects and potential operative candidates. Studies of the venous system can also predict a subset of patients who may benefit from surgery. Successful leg ulcer management requires an interdisciplinary team to make the correct diagnosis, assess the vascular supply, and identify other modifiable factors to optimize healing. The aim of this continuing medical education article is to provide an update on the management of venous leg ulcers. Part I is focused on the approach to venous ulcer diagnostic testing.

  10. LEG CONQUASATION CAUSED BY PETROL TILLER WITH OPEN LOWER LEG FRACTURE

    Directory of Open Access Journals (Sweden)

    Ivan Golubović

    2014-03-01

    Full Text Available We present a 71-year old patient admitted to Plastic and Reconstructive Surgery Clinic, Clinical Center Niš for the right leg conquasation. The patient was injured accidentally by a petrol tiller. On admission, both thigh and lower leg conquasation was observed with large wound on anteromedial thigh and one on medial side of the lower leg. Soft tissue and bones were covered with dirt and pieces of clothing. The wounds were thoroughly rinsed and dirt was removed followed by detailed debridement. After primary surgical treatment of the wound, open proximal lower leg fracture was stabilized with external skeletal fixation using two nails in the proximal and two nails in the distal fragment. Soft tissue defect was treated by plastic surgeon. The patient was administered anti-tetanus protection, antibiotic treatment and anticoagulant prophylaxis of deep vein thrombosis and pulmonary thromboembolism. Physical therapy was initiated subsequent to successful healing of the soft tissue wounds. External skeletal fixation was removed after three months for infection around the proximal nails and the treatment was contuinued using functional Sarmiento’s plaster imobilization leading to full recovery of open lower leg fracture.

  11. Restless Legs Syndrome and Leg Motor Restlessness in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Keisuke Suzuki

    2015-01-01

    Full Text Available Sleep disturbances are important nonmotor symptoms in Parkinson’s disease (PD that are associated with a negative impact on quality of life. Restless legs syndrome (RLS, which is characterized by an urge to move the legs accompanied by abnormal leg sensations, can coexist with PD, although the pathophysiology of these disorders appears to be different. RLS and PD both respond favorably to dopaminergic treatment, and several investigators have reported a significant relationship between RLS and PD. Sensory symptoms, pain, motor restlessness, akathisia, and the wearing-off phenomenon observed in PD should be differentiated from RLS. RLS in PD may be confounded by chronic dopaminergic treatment; thus, more studies are needed to investigate RLS in drug-naïve patients with PD. Recently, leg motor restlessness (LMR, which is characterized by an urge to move the legs that does not fulfill the diagnostic criteria for RLS, has been reported to be observed more frequently in de novo patients with PD than in age-matched healthy controls, suggesting that LMR may be a part of sensorimotor symptoms intrinsic to PD. In this paper, we provide an overview of RLS, LMR, and PD and of the relationships among these disorders.

  12. Dynamic Tracking of Ischemia in the Surface Electrocardiogram

    Science.gov (United States)

    Shusterman, Vladimir; Goldberg, Anna; Schindler, Daniel M.; Fleischmann, Kirsten E.; Lux, Robert L.; Drew, Barbara J.

    2007-01-01

    Accurate detection of the earliest signs of ischemia on the surface electrocardiogram (ECG) is essential for timely diagnosis and management of potentially life-threatening ischemic events. Yet, accuracy of ischemia analysis in ECG monitors remains suboptimal due to a number of confounding factors, including changes in body position and other artifacts. Hence, the goals of this study were 1) to examine the duration and time course of ischemic events and 2) to compare ECG changes caused by “true” ischemic events with those caused by changes in body position. Continuous, 12-lead Holter ECGs obtained from patients who presented to the Emergency Department (ED) with chest pain and enrolled in the IMMEDIATE AIM Study were analyzed. Holter recordings were initiated within the 1st 40 min after patients' arrival to the ED. Here we present preliminary results. Methods Twelve patients (age:59±16, 5 female, 2 with a final diagnosis of non-STEMI, 4 with unstable angina, and 6 with other cardiovascular disease) in whom ischemic ST-deviations were identified on Holter data, underwent four consecutive, 2-min recordings in the following body positions: 1) supine, 2) on the left side, 3) on the right side, and 4) sitting (or standing) upright. After baseline correction, beat-to-beat changes in QRS and STT-segments were examined in all 8 channels and the root-mean-square (RMS)-curve using an adaptive algorithm that computes the slope, amplitude, duration, area, and the Karhunen-Loeve derived representation of the corresponding segment. To prevent possible biases towards patients with more frequent ischemic events, a single, index event was chosen for analysis in each patient. There were 3 ST-elevation events and 9 ST-depression events; these events reached the maximum ST-deviation 11±8 hours (mean ± standard deviation) after the beginning of the recording. Results and Conclusions In most patients with transient myocardial ischemia, the microvolt-level, sub-threshold deviation

  13. Clinical performance of a new silver dressing, Contreet Foam, for chronic exuding venous leg ulcers

    DEFF Research Database (Denmark)

    Karlsmark, T; Agerslev, R H; Bendz, S H

    2003-01-01

    OBJECTIVE: This study aimed to evaluate the safety and performance of a new sustained silver-releasing dressing, Contreet Foam (Coloplast A/S), in the treatment of moderately to highly exuding chronic venous leg ulcers in which healing is delayed due to the presence of bacteria. METHOD: The clini......OBJECTIVE: This study aimed to evaluate the safety and performance of a new sustained silver-releasing dressing, Contreet Foam (Coloplast A/S), in the treatment of moderately to highly exuding chronic venous leg ulcers in which healing is delayed due to the presence of bacteria. METHOD......: The clinical performance of Contreet Foam was studied for four weeks in 25 patients with moderately to highly exuding delayed-healing venous leg ulcers. Healing was assessed on a weekly basis with reference to the wound-bed tissue composition, degree of odour and pain, dressing performance and the dressing......: Contreet Foam was found to be safe and performed well when used in the treatment of delayed-healing chronic venous leg ulcers, combining effective antibacterial properties with excellent exudate management. DECLARATION OF INTEREST: This study was supported by Coloplast A/S, Humlebaek, Denmark....

  14. [Rest-activity rhythm, sleep pattern and quality of life in patients with restless legs syndrome].

    Science.gov (United States)

    Lee, Eun Ju

    2009-06-01

    In this study rest-activity rhythm, sleep pattern and quality of life of patients with restless legs syndrome were compared with those of a normal group. The participants in this study were 36 patients with restless legs syndrome diagnosed by a neurologist and 36 participants in the normal group. An actigraph, sleep diary, Pittsburgh Sleep Quality Index and Insomnia Severity Index scale were used as measurement tools for the study. Chi-square test, Lamda test, t-test and Kendall's correlation with SPSS 12.0 program were used to analyze the data. Patients with restless legs syndrome had a higher rest-activity rhythm curve of Least 5 hr's activity (L5) and Most 10 hr's activity (M10) than those of normal group and sleep problems included decreased sleep efficiency and increased sleep latency, wake time and number of awakenings. The scores for the subscales of quality of life in patients with restless legs syndrome were lower than the normal group for general health, physical functioning, role limitations due to emotional problems, role limitation due to physical problems, social functioning, bodily pain, vitality and mental health. The results suggest that further studies are needed to identify rest-activity rhythm according to symptom severity and to develop nursing interventions which consider rest-activity rhythm.

  15. Protective role of fibrates in cardiac ischemia/reperfusion

    Directory of Open Access Journals (Sweden)

    G Singh

    2012-01-01

    Full Text Available Prevention of myocardial injury has been considered as the most important therapeutic challenge of today. Fibrates, the agonists of the peroxisome proliferator-activated receptor (PPAR-a receptor, have been regarded as potent therapeutic agents in this context. Hence, the present study has been designed to investigate the effect of fibrates, i.e., Clofibrate and Fenofibrate, the potent agonists PPAR-a, on ischemia-reperfusion (I/R-induced myocardial injury. The isolated Langendorff-perfused rat hearts were subjected to global ischemia for 30 minutes followed by reperfusion for 120 minutes. Myocardial infarct size and the release of lactate dehydrogenase (LDH and creatine kinase (CK in coronary effluent have been conducted to assess the degree of cardiac injury. Moreover, the oxidative stress in the heart was assessed by measuring lipid peroxidation, superoxide anion generation, and reduced glutathione. Clofibrate and Fenofibrate showed cardioprotection against I/R-induced myocardial injury in rat hearts as assessed in terms of reductions in myocardial infarct size, LDH, and CK levels in coronary effluent along with reduction in I/R-induced oxidative stress. It may be concluded that the observed cardioprotective potential of Clofibrate and Fenofibrate against I/R-induced myocardial injury was due to the reductions in infarct size and oxidative stress.

  16. Computational simulation of passive leg-raising effects on hemodynamics during cardiopulmonary resuscitation.

    Science.gov (United States)

    Shin, Dong Ah; Park, Jiheum; Lee, Jung Chan; Shin, Sang Do; Kim, Hee Chan

    2017-03-01

    The passive leg-raising (PLR) maneuver has been used for patients with circulatory failure to improve hemodynamic responsiveness by increasing cardiac output, which should also be beneficial and may exert synergetic effects during cardiopulmonary resuscitation (CPR). However, the impact of the PLR maneuver on CPR remains unclear due to difficulties in monitoring cardiac output in real-time during CPR and a lack of clinical evidence. We developed a computational model that couples hemodynamic behavior during standard CPR and the PLR maneuver, and simulated the model by applying different angles of leg raising from 0° to 90° and compression rates from 80/min to 160/min. The simulation results showed that the PLR maneuver during CPR significantly improves cardiac output (CO), systemic perfusion pressure (SPP) and coronary perfusion pressure (CPP) by ∼40-65% particularly under the recommended range of compression rates between 100/min and 120/min with 45° of leg raise, compared to standard CPR. However, such effects start to wane with further leg lifts, indicating the existence of an optimal angle of leg raise for each person to achieve the best hemodynamic responses. We developed a CPR-PLR model and demonstrated the effects of PLR on hemodynamics by investigating changes in CO, SPP, and CPP under different compression rates and angles of leg raising. Our computational model will facilitate study of PLR effects during CPR and the development of an advanced model combined with circulatory disorders, which will be a valuable asset for further studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Mechanical Impedance of the non-loaded Lower Leg with Relaxed Muscles in the Transverse Plane

    Directory of Open Access Journals (Sweden)

    Evandro Maicon Ficanha

    2015-12-01

    Full Text Available This paper describes the protocols and results of the experiments for the estimation of the mechanical impedance of the humans’ lower leg in the External-Internal (EI direction in the transverse plane under non-load bearing condition and with relaxed muscles. The objectives of the estimation of the lower leg’s mechanical impedance are to facilitate the design of passive and active prostheses with mechanical characteristics similar to the humans’ lower leg, and to define a reference that can be compared to the values from the patients suffering from spasticity. The experiments were performed with 10 unimpaired male subjects using a lower extremity rehabilitation robot (Anklebot, Interactive Motion Technologies, Inc. capable of applying torque perturbations to the foot. The subjects were in a seated position, and the Anklebot recorded the applied torques and the resulting angular movement of the lower leg. In this configuration, the recorded dynamics are due mainly to the rotations of the ankle’s talocrural and the subtalar joints, and any contribution of the tibiofibular joints and knee joint. The dynamic mechanical impedance of the lower leg was estimated in the frequency domain with an average coherence of 0.92 within the frequency range of 0 to 30Hz, showing a linear correlation between the displacement and the torques within this frequency range under the conditions of the experiment. The mean magnitude of the quasi-static stiffness of the lower leg (the impedance magnitude averaged in the range of 0-1 Hz was determined as 4.9±0.74 Nm/rad. The direct estimation of the quasi-static stiffness of the lower leg results in the mean value of 5.8±0.81 Nm/rad. An analysis of variance (ANOVA shows that the estimated values for the quasi-static stiffness from the two experiments are not statistically different.

  18. Leg movements during wakefulness in restless legs syndrome: time structure and relationships with periodic leg movements during sleep.

    Science.gov (United States)

    Ferri, Raffaele; Manconi, Mauro; Plazzi, Giuseppe; Bruni, Oliviero; Cosentino, Filomena I I; Ferini-Strambi, Luigi; Zucconi, Marco

    2012-05-01

    Approximately one third of patients with restless legs syndrome (RLS) also show periodic leg movements (PLM) during relaxed wake fulness (PLMW). In contrast with the large amount of data published on periodic leg movements during sleep (PLMS), PLMW have received less attention from the scientific community. The objective of this study was to evaluate the correlations/differences of time-structure and response to a dopamine-agonist between PLMW and PLMS in patients with RLS. Ninety idiopathic RLS patients and 28 controls were recruited. Subjects underwent clinical and neurophysiological evaluation, hematological screening, and one or two consecutive full-night polysomnographic studies. A subset of patients received 0.25mg of pramipexole or placebo before the second recording. Polysomnographic recordings were scored and LM activity was analyzed during sleep and during the epochs of wakefulness occurring during the first recording hour. RLS patients had higher LM activity during wakefulness than controls, but with a similar periodicity. Even if correlated, the ability of the PLMW index to predict the PLMS index decreased with increasing LM activity. Intermovement intervals during wakefulness showed one peak only at approximately 4s, gradually decreasing with increasing interval in both patients and controls. The effect of pramipexole was very limited and involved the small periodic portion of LM activity during wakefulness. PLMW index and PLMS index were correlated; however, the magnitude of this correlation was not sufficient to suggest that PLMW can be good predictors of PLMS. Short-interval LM activity during wakefulness and sleep might be linked to the severity of sleep disruption in RLS patients and the differences between their features obtained during wakefulness or sleep might be relevant for the diagnosis of sleep disturbances in RLS. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Tenoxicam exerts a neuroprotective action after cerebral ischemia in rats.

    Science.gov (United States)

    Galvão, Rita I M; Diógenes, João P L; Maia, Graziela C L; Filho, Emídio A S; Vasconcelos, Silvânia M M; de Menezes, Dalgimar B; Cunha, Geanne M A; Viana, Glauce S B

    2005-01-01

    In this study we investigated the effects of Tenoxicam, a type 2 cyclooxygenase (COX-2) inhibitor, on brain damage induced by ischemia-reperfusion. Male Wistar rats (18-month old average) were anesthetized and submitted to ischemia occlusion of both common carotid arteries (BCAO) for 45 min. After 24 h of reperfusion, rats were decapitated and hippocampi removed for further assays. Animals were divided into sham-operated, ischemia, ischemia + Tenoxicam 2.5 mg/kg, and ischemia + Tenoxicam 10 mg/kg groups. Tenoxicam was administered intraperitoneally immediately after BCAO. Histological analyses show that ischemia produced significant striatal as well as hippocampal lesions which were reversed by the Tenoxicam treatment. Tenoxicam also significantly reduced, to control levels, the increased myeloperoxidase activity in hippocampus homogenates observed after ischemia. However, nitrite concentrations showed only a tendency to decrease in the ischemia + Tenoxicam groups, as compared to that of ischemia alone. On the other hand, hippocampal glutamate and aspartate levels were not altered by Tenoxicam. In conclusion, we showed that ischemia is certainly related to inflammation and to increased free radical production, and selective COX-2 inhibitors might be neuroprotective agents of potential benefit in the treatment of cerebral brain ischemia.

  20. [Epidemiology of critical ischemia of the limbs].

    Science.gov (United States)

    Estevan, J M; Valle, A; Pacho, J

    1993-01-01

    Authors report their results from a study made during 1991. The study was made in order to analyze the clinical complications (morbidity and mortality) and the socioeconomic consequences that are related to the cure of patients with highly developed ischemic diseases (critical ischemia). Economic expenses mean a 1.5% from the total budget of the Public Sanity into the Asturian Autonomic Community.

  1. Innate immune signaling in cardiac ischemia

    NARCIS (Netherlands)

    Arslan, F.; de Kleijn, D.P.V.; Pasterkamp, G.

    2011-01-01

    Despite advances in treatment of patients who suffer from ischemic heart disease, morbidity related to myocardial infarction is increasing in Western societies. Acute and chronic immune responses elicited by myocardial ischemia have an important role in the functional deterioration of the heart. Res

  2. Profile of altered brain iron acquisition in restless legs syndrome

    Science.gov (United States)

    Ponnuru, Padmavathi; Wang, Xin-Sheng; Patton, Stephanie M.; Allen, Richard P.; Earley, Christopher J.

    2011-01-01

    Restless legs syndrome is a neurological disorder characterized by an urgency to move the legs during periods of rest. Data from a variety of sources provide a compelling argument that the amount of iron in the brain is lower in individuals with restless legs syndrome compared with neurologically normal individuals. Moreover, a significant percentage of patients with restless legs syndrome are responsive to intravenous iron therapy. The mechanism underlying the decreased iron concentrations in restless legs syndrome brains is unknown. We hypothesize that the source of the brain iron deficit is at the blood–brain interface. Thus we analysed the expression of iron management proteins in the epithelial cells of the choroid plexus and the brain microvasculature in post-mortem tissues. The choroid plexus, obtained at autopsy, from 18 neurologically normal controls and 14 individuals who had primary restless legs syndrome was subjected to histochemical staining for iron and immunostaining for iron management proteins. Iron and heavy chain ferritin staining was reduced in the epithelial cells of choroid plexus in restless legs syndrome. Divalent metal transporter, ferroportin, transferrin and its receptor were upregulated in the choroid plexus in restless legs syndrome. Microvessels were isolated from the motor cortex of 11 restless legs syndrome and 14 control brains obtained at autopsy and quantitative immunoblot analyses was performed. Expression of heavy chain ferritin, transferrin and its receptor in the microvessels from restless legs syndrome was significantly decreased compared with the controls but divalent metal protein 1, ferroportin, prohepcidin, mitochondrial ferritin and light-chain ferritin remained unchanged. The presence of an iron regulatory protein was demonstrated in the brain microvasculature and the activity of this protein is decreased in restless legs syndrome; a finding similar to our earlier report in neuromelanin cells from the substantia

  3. Profile of altered brain iron acquisition in restless legs syndrome.

    Science.gov (United States)

    Connor, James R; Ponnuru, Padmavathi; Wang, Xin-Sheng; Patton, Stephanie M; Allen, Richard P; Earley, Christopher J

    2011-04-01

    Restless legs syndrome is a neurological disorder characterized by an urgency to move the legs during periods of rest. Data from a variety of sources provide a compelling argument that the amount of iron in the brain is lower in individuals with restless legs syndrome compared with neurologically normal individuals. Moreover, a significant percentage of patients with restless legs syndrome are responsive to intravenous iron therapy. The mechanism underlying the decreased iron concentrations in restless legs syndrome brains is unknown. We hypothesize that the source of the brain iron deficit is at the blood-brain interface. Thus we analysed the expression of iron management proteins in the epithelial cells of the choroid plexus and the brain microvasculature in post-mortem tissues. The choroid plexus, obtained at autopsy, from 18 neurologically normal controls and 14 individuals who had primary restless legs syndrome was subjected to histochemical staining for iron and immunostaining for iron management proteins. Iron and heavy chain ferritin staining was reduced in the epithelial cells of choroid plexus in restless legs syndrome. Divalent metal transporter, ferroportin, transferrin and its receptor were upregulated in the choroid plexus in restless legs syndrome. Microvessels were isolated from the motor cortex of 11 restless legs syndrome and 14 control brains obtained at autopsy and quantitative immunoblot analyses was performed. Expression of heavy chain ferritin, transferrin and its receptor in the microvessels from restless legs syndrome was significantly decreased compared with the controls but divalent metal protein 1, ferroportin, prohepcidin, mitochondrial ferritin and light-chain ferritin remained unchanged. The presence of an iron regulatory protein was demonstrated in the brain microvasculature and the activity of this protein is decreased in restless legs syndrome; a finding similar to our earlier report in neuromelanin cells from the substantia nigra

  4. Actigraphic assessment of periodic leg movements in patients with restless legs syndrome.

    Science.gov (United States)

    Cippà, Maria A T; Baumann, Christian R; Siccoli, Massimiliano M; Bassetti, Claudio L; Poryazova, Rositsa; Werth, Esther

    2013-10-01

    The diagnosis of restless legs syndrome (RLS) relies upon diagnostic criteria which are based on history only, and dopaminergic treatment is not normally the first choice of treatment for all patients. It would be worthwhile to identify patients non-responsive to dopaminergic treatment beforehand, because they may suffer from a restless legs-like syndrome and may require alternative treatment. We included retrospectively 24 adult patients fulfilling the four essential criteria for restless legs and 12 age-matched healthy controls. They were investigated by ambulatory actigraphy from both legs over three nights, and patients started treatment with dopamine agonists after this diagnostic work-up. We examined 12 responders to dopaminergic treatment and 12 non-responders and studied the association between response to dopaminergic treatment and the periodic limb movement index (PLMI) as assessed with actigraphy. Demographic characteristics, excessive daytime sleepiness and fatigue at baseline were similar in all three groups. Baseline RLS severity was similar between responders and non-responders [International Restless Legs Severity Scale (IRLS): 25 ± 9 and 24 ± 8]. Group comparisons of PLMI before treatment initiation showed significant differences between the three groups. Post-hoc pairwise comparisons revealed that healthy controls had significantly lower PLMI (4.9 ± 4.5) than responders (29.3 ± 22.7) and non-responders (13.3 ± 11.2). Similarly, the PLMI in responders was lower than in non-responders. PLMI day-to-day variability did not differ between responders and non-responders and there was no correlation between treatment effect, as assessed by the decrease of the IRLS and baseline PLMI. Our retrospective study indicates that actigraphy to assess periodic limb movements may contribute to a better diagnosis of dopamine-responsive restless legs syndrome.

  5. The natural shock absorption of the leg spring.

    Science.gov (United States)

    Kim, Wangdo; João, Filipa; Tan, John; Mota, Patricia; Vleck, Veronica; Aguiar, Liliana; Veloso, Antonio

    2013-01-04

    When a human being runs, muscles, tendons, and ligaments together behave like a single linear spring. This "leg spring" can be described remarkably well by spring/mass models. Although leg-stiffness during running (and logically, therefore, in hopping) has been shown to be adjusted in line with the individual characteristics of the external contact surface, the relative contribution of each of the sub-components of the leg spring to the mechanics of running is unclear. We proposed the three-degree-of-freedom leg spring chain in a position of stable equilibrium under the action of the leg stiffness. If the leg spring receives a displacement in hopping, the forces will no longer equilibrate, but the system will be exposed to the action of a force on a leg spring chain. We thus have two corresponding sets of modes, one set being the mode about which the chain is displaced, the other set for the forces which are evoked in consequence of the displacement. We found that if the leg has been displaced from a position of equilibrium about one of harmonic modes, then a vibration about this harmonic mode evokes a system of forces in the leg spring which in its turn tends to produce a motion on the original harmonic mode, and thus produce oscillation about the same harmonic mode. Our results suggest that the desired harmonic mode can be explained in terms of the natural shock absorption ability of the leg.

  6. Leg stiffness of sprinters using running-specific prostheses

    Science.gov (United States)

    McGowan, Craig P.; Grabowski, Alena M.; McDermott, William J.; Herr, Hugh M.; Kram, Rodger

    2012-01-01

    Running-specific prostheses (RSF) are designed to replicate the spring-like nature of biological legs (bioL) during running. However, it is not clear how these devices affect whole leg stiffness characteristics or running dynamics over a range of speeds. We used a simple spring–mass model to examine running mechanics across a range of speeds, in unilateral and bilateral transtibial amputees and performance-matched controls. We found significant differences between the affected leg (AL) of unilateral amputees and both ALs of bilateral amputees compared with the bioL of non-amputees for nearly every variable measured. Leg stiffness remained constant or increased with speed in bioL, but decreased with speed in legs with RSPs. The decrease in leg stiffness in legs with RSPs was mainly owing to a combination of lower peak ground reaction forces and increased leg compression with increasing speeds. Leg stiffness is an important parameter affecting contact time and the force exerted on the ground. It is likely that the fixed stiffness of the prosthesis coupled with differences in the limb posture required to run with the prosthesis limits the ability to modulate whole leg stiffness and the ability to apply high vertical ground reaction forces during sprinting. PMID:22337629

  7. Relationship between Leg Mass, Leg Composition and Foot Velocity on Kicking Accuracy in Australian Football

    Science.gov (United States)

    Hart, Nicolas H.; Nimphius, Sophia; Spiteri, Tania; Cochrane, Jodie L.; Newton, Robert U.

    2016-01-01

    Kicking a ball accurately over a desired distance to an intended target is arguably the most important skill to acquire in Australian Football. Therefore, understanding the potential mechanisms which underpin kicking accuracy is warranted. The aim of this study was to examine the relationship between leg mass, leg composition and foot velocity on kicking accuracy in Australian Football. Thirty-one Australian Footballers (n = 31; age: 22.1 ± 2.8 years; height: 1.81 ± 0.07 m; weight: 85.1 ± 13.0 kg; BMI: 25.9 ± 3.2) each performed ten drop punt kicks over twenty metres to a player target. Athletes were separated into accurate (n = 15) and inaccurate (n = 16) kicking groups. Leg mass characteristics were assessed using whole body DXA scans. Foot velocity was determined using a ten-camera optoelectronic, three-dimensional motion capture system. Interactions between leg mass and foot velocity evident within accurate kickers only (r = -0.670 to -0.701). Relative lean mass was positively correlated with kicking accuracy (r = 0.631), while no relationship between foot velocity and kicking accuracy was evident in isolation (r = -0.047 to -0.083). Given the evident importance of lean mass, and its interaction with foot velocity for accurate kickers; future research should explore speed-accuracy, impulse-variability, limb co-ordination and foot-ball interaction constructs in kicking using controlled with-in subject studies to examine the effects of resistance training and skill acquisition programs on the development of kicking accuracy. Key points Accurate kickers expressed a very strong inverse relationship between leg mass and foot velocity. Inaccurate kickers were unable to replicate this, with greater volatility in their performance, indicating an ability of accurate kickers to mediate foot velocity to compensate for leg mass in order to deliver the ball over the required distance. Accurate kickers exhibited larger quantities of relative lean mass and lower

  8. D-ribose benefits restless legs syndrome.

    Science.gov (United States)

    Shecterle, Linda; Kasubick, Robert; St Cyr, John

    2008-11-01

    Restless legs syndrome is a neurological disorder characterized by unpleasant sensations and pain, predominantly in the lower extremities while at rest, accompanied by an uncontrollable urge for movement for relief. We report on two affected male individuals, a father and son, ages 71 and 47, from a family in which three generations carry the diagnosis. To evaluate any potential benefit of D-ribose in this condition, each individual orally consumed 5-g doses of D-ribose daily at different trial stages. Each stage lasted 3 weeks with a 2-week washout period between stages. The initial stage involved a single 5 gm dose of D-ribose consumed at breakfast. Throughout the second stage, D-ribose was taken at breakfast and lunch. In the third stage, D-ribose was taken at all meals, breakfast, lunch, and dinner. Diaries by the subjects pertaining to their documentation and severity of restless legs syndrome symptoms was compiled. During the initial stage both men reported a general feeling of more energy and less fatigue, most notably after exercise, without any significant changes in their symptoms. With the increase in the daily dose of D-ribose, in the second stage, their leg twitching and the feeling to move during the day was reduced for 1 subject, and rarely present in the other. Both still experienced the unpleasant sensations during the night. However, during the final stage, a further increase in the daily dose of D-ribose eliminated their daily symptoms and the symptoms at night were of a lesser degree and had a later occurrence. Both men reported that D-ribose did not totally eliminate their discomfort, but the severity and onset of symptoms affecting their quality of life was substantially improved with D-ribose without any adverse reactions.

  9. [Bow legged adjectives in ancient literature].

    Science.gov (United States)

    Simon, Frantisek; Steger, Florian

    2011-01-01

    This article addresses the issue of capturing the medical entity called 'curved legs' in a terminologically exact way. In so doing, it refers to the long-lasting process of differentiation of exact nuances of meaning in Ancient Greek and Latin. In the chronological perusal of ancient Greek literature, it becomes evident that the various adjectives employed are often vague when looking at non-medical literature. By contrast, in the Hippocratic corpus these terms are for the first time annotated with explanations intended to lead to a more precise understanding of the described deformity. Further attempts of differentiation can be found in the writings of Galen, who not only distinguishes between outward and inward curvatures, but also between deformities of the thigh and lower leg as well as between pathological and natural curvatures. Latin literature also provides a series of adjectives that were initially often used in the meaning of 'curved' but it was not until Celsus that these were differentiated with respect to the type and direction of the curvature. When comparing Greek and Latin adjectives, it turns out that though the Latin term blaesus can be traced back etymologically to the Greek word beta lambda alpha iota sigma ó zeta, the meaning of beta lambda alpha iota sigma ó zeta does not fully correspond to that of the Latin word. It is not before the later common transliteration of Greek words that this adjective took on the meaning of beta lambda alpha iota sigma ó zeta; however, this was finally lost again. In summary, the article concludes that exact word meanings in ancient literature are often unclear and precise ascriptions of meanings are inconsistent. In the case of "curved legs," this has led to misunderstandings regarding the respective types and directions of the curvature.

  10. Compartment syndrome of thigh and lower leg with disruption of the popliteal vascular bundle after being run over by a 25-ton truck

    Institute of Scientific and Technical Information of China (English)

    Rolf D Burghardt; Thorsten Gehrke; Daniel Kendoff; Ulrich St(o)ckle; Sebastian Siebenlist

    2013-01-01

    Compartment syndrome of the thigh is a rare condition,potentially resulting in devastating functional outcome.Increasing intracompartmental pressure which suppresses micmcirculation and capillary perfusion may lead to cellular anoxia and muscle ischemia.The muscle compartments in the thigh have a more compliant fascia and blend anatomically into the open compartments of the pelvis,thus compensating higher volumes than the compartments in the lower leg.We present a previously unreported case in which the limb of a 36-year-old man was run over by a 25-ton truck.He presented with a sensomotor deficit in his left lower leg with full paralysis of the shank muscles and absence of all foot pulses.CT scan showed a huge haematoma in the thigh with active bleeding out of the popliteal artery into the haematoma which has already expanded into the muscle compartments of the lower leg.The limb had a disastrous compartment syndrome of the thigh and lower leg with disruption of the popliteal neurovascular bundle; however,no bones in the limb were fractured.A complete fasciotomy of all the lower limb muscle compartments was immediately performed.The artery was reconstructed with interposition of the smaller saphenous vein,which was already interrupted through the initial trauma.

  11. Compartment syndrome of thigh and lower leg with disruption of the popliteal vascular bundle after being run over by a 25-ton truck

    Directory of Open Access Journals (Sweden)

    Burghardt Rolf D

    2013-10-01

    Full Text Available 【Abstract】Compartment syndrome of the thigh is a rare condition, potentially resulting in devastating functional outcome. Increasing intracompartmental pressure which suppresses microcirculation and capillary perfusion may lead to cellular anoxia and muscle ischemia. The muscle compartments in the thigh have a more compliant fascia and blend anatomically into the open compartments of the pelvis, thus compensating higher volumes than the compartments in the lower leg. We present a previously unreported case in which the limb of a 36-year-old man was run over by a 25-ton truck. He presented with a sensomotor deficit in his left lower leg with full paralysis of the shank muscles and absence of all foot pulses. CT scan showed a huge haematoma in the thigh with active bleeding out of the popliteal artery into the haematoma which has already expanded into the muscle compartments of the lower leg. The limb had a disastrous compartment syndrome of the thigh and lower leg with disruption of the popliteal neurovascular bundle; however, no bones in the limb were fractured. A complete fasciotomy of all the lower limb muscle compartments was immediately performed. The artery was reconstructed with interposition of the smaller saphenous vein, which was already interrupted through the initial trauma. Key words: Compartment syndromes; Thigh; Hemorrhage; Popliteal artery; Peroneal nerve

  12. Refractory leg ulcers associated with Klinefelter syndrome.

    Science.gov (United States)

    Yabuno, Yuto; Tosa, Mamiko; Iwakiri, Itaru; Nomoto, Shunichi; Kaneko, Mayuko; Kuwahara, Kousuke; Hyakusoku, Hiko; Murakami, Masahiro

    2015-01-01

    We present a man with refractory leg ulcers, bilateral varicosis of the lower extremities, and Buerger disease. Autoimmune work-up was negative. However, chromosome analysis showed Klinefelter syndrome (48 XXY). Ulcerative lesions of the lower extremities are a complication of Klinefelter syndrome. To date, the pathogenesis of ulcers in Klinefelter syndrome has not been clarified, but several factors, such as abnormalities of fibrinolysis and prothrombotic states, might be involved. Our present case emphasizes the importance of considering Klinefelter syndrome in the differential diagnosis of a male patient with nonhealing ulcers of the lower extremities.

  13. Leg ulcer in lepromatous leprosy - Case report*

    Science.gov (United States)

    Fernandes, Tania Rita Moreno de Oliveira; dos Santos, Talita Suzany Siqueira; Lopes, Ramon Rodrigues de Macedo

    2016-01-01

    In Brazil, leprosy is a widespread infectious and contagious disease. Clinicians and specialists view leprosy broadly as a systemic infection, since, in its manifestations, it mimics many conditions, such as rheumatic, vascular, ENT, neurological and dermatological diseases. There are few studies that characterize the factors associated with ulcers in leprosy. These injuries should be prevented and treated promptly to avoid serious problems like secondary infections, sepsis, carcinomatous degeneration and amputations. We describe a patient with ulcers on his legs, involving late diagnosis of lepromatous leprosy. PMID:27828650

  14. Painful legs and moving toes syndrome

    Directory of Open Access Journals (Sweden)

    Qiu-ying Ma

    2015-10-01

    Full Text Available Painful legs and moving toes syndrome (PLMT is a rare movement disorder with low diagnostic rate, which is characterized by lower limb pain with involuntary movements of feet or toes. Etiology and pathogenesis of this disease is still unclear. Patients have different clinical manifestations, so the diagnosis is difficult. Treatment methods for PLMT are numerous, but so far the treatment of this disease is still a major challenge for clinicians. Further research is still needed to guide clinical work. DOI: 10.3969/j.issn.1672-6731.2015.10.013

  15. Effects of dietary roxarsone supplementation, lighting program, and season on the incidence of leg abnormalities in broiler chickens.

    Science.gov (United States)

    Laster, C P; Hoerr, F J; Bilgili, S F; Kincaid, S A

    1999-02-01

    Two 4 x 2 factorial experiments were designed to test the effects of four diets, differing in anticoccidial programs and roxarsone (3-nitro-4-hydroxyphenylarsonic acid) content, and two lighting programs on the incidence of leg abnormalities in 56-d-old male and female broiler chickens. The four diets were: A) basal diet + salinomycin (60.0 g/ton); B) basal diet + salinomycin (60.0 g/ton) + roxarsone (45.4 g/ton); C) basal diet + roxarsone (45.4 g/ton) + live coccidial vaccine; and D) basal diet + live coccidial vaccine. The light treatments were: 1) restricted (R) [18 h light (L): 6 h dark (D)] and 2) standard (S) [23L:1D]. The respective experiments were conducted during winter (Experiment 1, November to January) and summer (Experiment 2, June to August) growing conditions in the southeastern U.S. Light treatment had no significant (P > 0.10) effect on the incidence of leg abnormalities in either experiment. However, in Experiment 1, there was a light treatment by sex interaction; leg abnormalities were greater for males on Treatment R than Treatment S. In Experiment 2, females had a higher incidence of leg abnormalities than males (8.29 vs 4.73%). There was a diet by sex interaction for the incidence of leg abnormalities in Experiment 2; females had a greater incidence of leg abnormalities than males on Treatment A. In both experiments, the incidence was greater with dietary treatments containing roxarsone (P < 0.10). The percentage of leg abnormalities was greater in Experiment 2 than Experiment 1. Leg abnormalities were primarily due to fibrosis of the gastrocnemius tendons and tendon sheaths.

  16. Restless Legs Syndrome After Single Low Dose Quetiapine Administration.

    Science.gov (United States)

    Soyata, Ahmet Z; Celebi, Fahri; Yargc, Lutfi I

    2016-01-01

    Restless legs syndrome is an underdiagnosed sensori-motor disorder and psychotropic drugs are one of the main secondary causes of the illness. The most common psychotropic agents that cause restless legs syndrome are antidepressants; however, antipsychotics have also been reported to induce restless legs syndrome. The prevalence, vulnerability factors and the underlying mechanism of antipsychotic-induced restless legs syndrome are unclear. A possible explanation is that dopaminergic blockade is the main precipitator of the syndrome. Quetiapine-induced restless legs syndrome is another point of interest because of its low binding to D2 receptors. We herein report the case of a restless legs syndrome that emerged after a single low dose quetiapine administration.

  17. Mechanical Engineering of Leg Joints of Anthropomorphic Robot

    Directory of Open Access Journals (Sweden)

    Pavluk Nikita

    2016-01-01

    Full Text Available The problem of design engineering of anthropomorphic robot legs is considered. An overview of the existing anthropomorphic robots and an analysis of servomechanisms and bearing parts involved in the assembly of robot legs are presented. We propose an option for constructing the legs of the robot Antares under development. A two-motor layout, used in the knee, ensures higher joint power along with independent interaction with the neighboring upper and lower leg joints when bending. To reduce the electrical load on the main battery of the robot, the upper legs are provided with a mounting pad for additional batteries powering servos. Direct control of the servos is also carried out through the sub-controllers, responsible for all 6 engines installed in the articular joints of the robot legs.

  18. Molecular Characterization of Reactive Oxygen Species in Myocardial Ischemia-Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Tingyang Zhou

    2015-01-01

    Full Text Available Myocardial ischemia-reperfusion (I/R injury is experienced by individuals suffering from cardiovascular diseases such as coronary heart diseases and subsequently undergoing reperfusion treatments in order to manage the conditions. The occlusion of blood flow to the tissue, termed ischemia, can be especially detrimental to the heart due to its high energy demand. Several cellular alterations have been observed upon the onset of ischemia. The danger created by cardiac ischemia is somewhat paradoxical in that a return of blood to the tissue can result in further damage. Reactive oxygen species (ROS have been studied intensively to reveal their role in myocardial I/R injury. Under normal conditions, ROS function as a mediator in many cell signaling pathways. However, stressful environments significantly induce the generation of ROS which causes the level to exceed body’s antioxidant defense system. Such altered redox homeostasis is implicated in myocardial I/R injury. Despite the detrimental effects from ROS, low levels of ROS have been shown to exert a protective effect in the ischemic preconditioning. In this review, we will summarize the detrimental role of ROS in myocardial I/R injury, the protective mechanism induced by ROS, and potential treatments for ROS-related myocardial injury.

  19. Oxygen or cooling, to make a decision after acute ischemia stroke

    Directory of Open Access Journals (Sweden)

    Wen-cao Liu

    2016-01-01

    Full Text Available The presence of a salvageable penumbra, a region of ischemic brain tissue with sufficient energy for short-term survival, has been widely agreed as the premise for thrombolytic therapy with tissue plasminogen activator (tPA, which remains the only United States Food and Drug Administration (FDA approved treatment for acute ischemia stroke. However, the use of tPA has been profoundly constrained due to its narrow therapeutic time window and the increased risk of potentially deadly hemorrhagic transformation (HT. Blood brain barrier (BBB damage within the thrombolytic time window is an indicator for tPA-induced HT and both normobaric hyperoxia (NBO and hypothermia have been shown to protect the BBB from ischemia/reperfusion injury. Therefore, providing the O2 as soon as possible (NBO treatment, freezing the brain (hypothermia treatment to slow down ischemia-induced BBB damage or their combined use may extend the time window for the treatment of tPA. In this review, we summarize the protective effects of NBO, hypothermia or their use combined with tPA on ischemia stroke, based on which, the combination of NBO and hypothermia may be an ideal early stroke treatment to preserve the ischemic penumbra. Given this, there is an urge for large randomized controlled trials to address the effect.

  20. Amputation-Free Survival after Crural Percutaneous Transluminal Angioplasty for Critical Limb Ischemia.

    Science.gov (United States)

    Strøm, M; Konge, L; Lönn, L; Schroeder, T V; Rørdam, P

    2016-03-01

    To evaluate the amputation-free survival after below the knee percutaneous transluminal angioplasty in a consecutive group of patients with critical ischemia of the lower extremity. A total of 70 consecutive patients with critical ischemia were treated with below the knee percutaneous transluminal angioplasty at the vascular center at Rigshospitalet with the purpose of limb salvage. All patients were deemed unfit for major surgery due to anatomical limitations or severe co-morbidity, and no prior attempts of revascularization were performed. Follow-up clinical examinations were performed within 6 weeks and after 1 year. All medical records were crosschecked with the national vascular registry ensuring a valid 1-year status in 97% of the patients. A total of 15 major amputations were performed during follow-up, with 11 amputations performed within the first year. Complications after percutaneous transluminal angioplasty were rare. Cumulative mortality after 1 and 2 years was 22% and 34%, respectively. Amputation-free survival at 1 and 2 years of follow-up was 68% and 58%, respectively. There were no association between known risk factors such as diabetes, ischemic ulcers, cardiac disease, history of smoking, major amputation, or overall amputation. Below the knee percutaneous transluminal angioplasty in patients with end-stage peripheral arterial disease and critical limb ischemia is a safe procedure in relieving critical ischemia, reducing the short-term rate of a major amputation as opposed to best medical treatment alone. © The Finnish Surgical Society 2015.

  1. Stable bipedal walking with a swing-leg protraction strategy.

    Science.gov (United States)

    Bhounsule, Pranav A; Zamani, Ali

    2017-01-25

    In bipedal locomotion, swing-leg protraction and retraction refer to the forward and backward motion, respectively, of the swing-leg before touchdown. Past studies have shown that swing-leg retraction strategy can lead to stable walking. We show that swing-leg protraction can also lead to stable walking. We use a simple 2D model of passive dynamic walking but with the addition of an actuator between the legs. We use the actuator to do full correction of the disturbance in a single step (a one-step dead-beat control). Specifically, for a given limit cycle we perturb the velocity at mid-stance. Then, we determine the foot placement strategy that allows the walker to return to the limit cycle in a single step. For a given limit cycle, we find that there is swing-leg protraction at shallow slopes and swing-leg retraction at steep slopes. As the limit cycle speed increases, the swing-leg protraction region increases. On close examination, we observe that the choice of swing-leg strategy is based on two opposing effects that determine the time from mid-stance to touchdown: the walker speed at mid-stance and the adjustment in the step length for one-step dead-beat control. When the walker speed dominates, the swing-leg retracts but when the step length dominates, the swing-leg protracts. This result suggests that swing-leg strategy for stable walking depends on the model parameters, the terrain, and the stability measure used for control. This novel finding has a clear implication in the development of controllers for robots, exoskeletons, and prosthetics and to understand stability in human gaits. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Leg stiffness of sprinters using running-specific prostheses

    OpenAIRE

    McGowan, Craig P.; Grabowski, Alena M.; McDermott, William J.; Herr, Hugh M.; Kram, Rodger

    2012-01-01

    Running-specific prostheses (RSF) are designed to replicate the spring-like nature of biological legs (bioL) during running. However, it is not clear how these devices affect whole leg stiffness characteristics or running dynamics over a range of speeds. We used a simple spring–mass model to examine running mechanics across a range of speeds, in unilateral and bilateral transtibial amputees and performance-matched controls. We found significant differences between the affected leg (AL) of uni...

  3. Monitored extended secondary arterial ischemia in a free muscle transfer.

    Science.gov (United States)

    Sværdborg, Mille; Birke-Sørensen, Hanne

    2012-02-01

    In reconstructive microsurgery, flap failure can be catastrophic to the patient. Different monitoring methods have been implemented in an attempt to recognize secondary ischemia during its early stages. However, the exact onset of secondary ischemia can be difficult to determine because there are no well-documented and reliable monitoring techniques that offer true continuous monitoring in a clinical setting. Because of the uncertain time in terms of the onset of secondary ischemia, the exact length of ischemia before revascularization, the secondary ischemia time, cannot be obtained. This is probably part of the reason why not much has been published regarding the effect of secondary ischemia time in reference to flap survival. We present a case of a free gracilis muscle flap that was salvaged despite more than 11 hours of arterial ischemia. The flap was monitored using microdialysis and at no time was the ischemia clearly demonstrated by clinical inspection. We conclude that clinical monitoring in some cases can be an unreliable method for monitoring free muscle transfers suffering from arterial ischemia and that further studies are needed for more specific guidelines regarding the critical secondary ischemia time in muscle flaps.

  4. Lower leg electrical impedance after distal bypass surgery

    DEFF Research Database (Denmark)

    Belanger, G K; Bolbjerg, M L; Heegaard, N H

    1998-01-01

    Electrical impedance was determined in 13 patients following distal bypass surgery to evaluate lower leg oedema as reflected by its circumference. Tissue injury was assessed by the plasma concentration of muscle enzymes. After surgery, the volume of the control lower leg increased from 1250 (816...... of troponin I (n = 8). In conclusion, tissue injury was reflected by increases in muscle enzymes in plasma. We found an inverse correlation between lower leg electrical impedance and volume, but the deviation in electrical impedance was approximately twice that of the leg volume. Electrical impedance appears...

  5. Protection against high intravascular pressure in giraffe legs

    DEFF Research Database (Denmark)

    Petersen, Karin K; Hørlyck, Arne; Østergaard, Kristine Hovkjær

    2013-01-01

    The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination....... All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure....... revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along...

  6. Passive mechanical properties of legs from running insects.

    Science.gov (United States)

    Dudek, Daniel M; Full, Robert J

    2006-04-01

    While the dynamics of running arthropods have been modeled as a spring-mass system, no such structures have been discovered that store and return energy during bouncing. The hindleg of the cockroach Blaberus discoidalis is a good candidate for a passive, vertical leg spring because its vertically oriented joint axes of rotation limit the possibility of active movements and contributions of muscle properties. We oscillated passive legs while measuring force to determine the leg's dynamic, mechanical properties. The relative dimensionless stiffness of an individual cockroach leg was equal to that estimated for a single leg of a biped or quadruped. Leg resilience ranged from 60 to 75%, affording the possibility that the leg could function as a spring to store and return the mechanical energy required to lift and accelerate the center of mass. Because hysteresis was independent of oscillation frequency, we rejected the use of a Voigt model - a simple spring in parallel with a viscous damper. A hysteretic damping model fit the cockroach leg force-displacement data over a wide range of frequencies and displacement using just two parameters. Rather than simply acting as a spring to minimize energy, we hypothesize that legs must manage both energy storage and absorption for rapid running to be most effective.

  7. Tennis leg: mechanism of injury and radiographic presentation.

    Science.gov (United States)

    Pacheco, Rafael A; Stock, Harlan

    2013-08-01

    As summer is upon us, we thought a discussion of tennis leg would be beneficial to our fellow clinicians. Tennis leg is a relatively common clinical condition, classically manifesting as acute, sports-related pain in the mid-calf. First described in 1883, the pathogenesis has been debated--tennis leg was first attributed to rupture of the plantaris tendon, though more recent investigations have implicated rupture of the medial head of the gastrocnemius at its myotendinous junction. For simplicity, many authors use the term tennis leg to describe all such acute muscle injuries in the superficial calf.

  8. Compression Stockings for Treating Venous Leg Ulcers

    Directory of Open Access Journals (Sweden)

    J. P. Benigni

    2013-01-01

    Full Text Available Background. In order to treat venous leg ulcers, it is recommended to use high pressure compression (30–40 mmHg at the ankle. Compression stockings which are not operator dependant could be the best option because of their pressure control. However 30–40 mmHg compression stockings are often hard to put on. Putting two lower pressure compression stockings over each other could be a good therapeutic alternative. Objectives. To compare the in vitro pressures given by the manufacturers of 2 antiulcer kits with the in vivo interface pressures measured in healthy subjects and to evaluate the stiffness and friction indices from those kits based on the interface pressure in order to assess their clinical properties. Material and Methods. Using a Kikuhime pressure device, interface pressure was measured in 12 healthy subjects at the reference point B1. One stiffness index (Static Stiffness Index (SSI and a friction index have been calculated. Results. Mediven Ulcer kit gets the recommended pressures whereas Jobst’s Ulcer Care kit does not for treating a venous leg ulcer. Jobst’s Ulcer Care transmits entirely the pressure in relation to a friction index close to 1. Conclusion. This antiulcer kit study underlines that in vivo and in vitro pressures can be different (Jobst’s Ulcer Care kit and Mediven Ulcer kit. In order not to lose pressure, it is important to take into account the friction index when superimposing two stockings.

  9. Lower leg musculoskeletal geometry and sprint performance.

    Science.gov (United States)

    Karamanidis, Kiros; Albracht, Kirsten; Braunstein, Bjoern; Moreno Catala, Maria; Goldmann, Jan-Peter; Brüggemann, Gert-Peter

    2011-05-01

    The purpose of this study was to investigate whether sprint performance is related to lower leg musculoskeletal geometry within a homogeneous group of highly trained 100-m sprinters. Using a cluster analysis, eighteen male sprinters were divided into two groups based on their personal best (fast: N=11, 10.30±0.07s; slow: N=7, 10.70±0.08s). Calf muscular fascicle arrangement and Achilles tendon moment arms (calculated by the gradient of tendon excursion versus ankle joint angle) were analyzed for each athlete using ultrasonography. Achilles tendon moment arm, foot and ankle skeletal geometry, fascicle arrangement as well as the ratio of fascicle length to Achilles tendon moment arm showed no significant (p>0.05) correlation with sprint performance, nor were there any differences in the analyzed musculoskeletal parameters between the fast and slow sprinter group. Our findings provide evidence that differences in sprint ability in world-class athletes are not a result of differences in the geometrical design of the lower leg even when considering both skeletal and muscular components.

  10. Restless legs syndrome in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Shahram Rafie

    2016-01-01

    Full Text Available Restless legs syndrome (RLS is a neurological disorder characterized by uncomfortable sensation of paresthesia in legs that subsequently causes involuntary and continuous movement of the lower limbs, especially at rest. Its prevalence in hemodialysis is more than that in the general population. Different risk factors have been suggested for RLS. We studied the prevalence and risk factors of RLS in 137 hemodialysis patients followed up at our center. The patients completed at least three months on dialysis and fulfilled four criteria for the diagnosis of RLS. We compared the patients with and without RLS, and the odds ratios (ORs were estimated by the logistic regression models. The prevalence of RLS was 36.5% in the study patients. Among the variables, diabetes was the only predicting factor for the development of RLS. The diabetic patients may be afflicted with RLS 2.25 times more than the non-diabetics. Women developed severe RLS 5.23 times more than men. Neurodegeneration, decrease in dopamine level, higher total oxidant status, and neuropathy in diabetic patients may explain the RLS symptoms.

  11. Migraine and restless legs syndrome: current perspectives

    Directory of Open Access Journals (Sweden)

    Ferreira KS

    2015-12-01

    Full Text Available Karen dos Santos Ferreira, Fabíola Dach, Alan L Eckeli, José Geraldo SpecialiDepartment of Neurosciences and Behavioral Sciences, Division of Neurology, University Hospital, Medical School of Ribeirao Preto, University of São Paulo, São Paulo, BrazilAbstract: The relationship between migraine and restless legs syndrome (RLS has been described in the literature for some years, based on clinical findings and pathophysiological considerations. There are some possible factors relating migraine and RLS. Both are diseases involving the central nervous system, the two diseases seem to share a dopaminergic mechanism, and it is also believed that they may share a genetic origin. At present, doctors who work with these two diseases should be encouraged not to simply investigate the simultaneous presence of both, but should also apply a treatment better adapted to this possibility. Research should be directed at some still unanswered questions for a better understanding of the association between migraine and RLS.Keywords: migraine, restless legs syndrome, physiopathology, comorbidities

  12. [RESTLESS LEGS SYNDROME--WILLIS-EKBOM DISEASE].

    Science.gov (United States)

    Ruppert, Élisabeth; Bataillard, Marc; Bourgin, Patrice

    2015-09-01

    Restless legs syndrome (RLS) is a sensorimotor disorder with a high prevalence (10% in Caucasian populations). It is a purely clinical diagnosis characterized by an urge to move the lower limbs usually accompanied or caused by unpleasant sensations in the legs with an improvement in symptoms with movement. These sensations occur during inactivity or at rest and worsen in the evening or at night. RLS may not only impact the quality of life for an individual, but may also increase mortality. Disease markers such as genetic predispositions have been identified, as well as reduced iron stores with altered intracerebral iron homeostasis and dopaminergic dysfunction. Medication is often necessary in severe forms, with low doses of dopaminergic agonists being the first-line of treatment. The use of α2δ ligands is an alternative. Finally benzodiazepines and opioid medications can be effective in refractory cases. In less severe forms of RLS, a non-pharmacological approach is usually sufficient with avoidance of stimulants and correction of contributing factors.

  13. Restless legs syndrome in hemodialysis patients.

    Science.gov (United States)

    Rafie, Shahram; Jafari, Majid; Azizi, Mostafa; Bahadoram, Mohammad; Jafari, Shima

    2016-03-01

    Restless legs syndrome (RLS) is a neurological disorder characterized by uncomfortable sensation of paresthesia in legs that subsequently causes involuntary and continuous movement of the lower limbs, especially at rest. Its prevalence in hemodialysis is more than that in the general population. Different risk factors have been suggested for RLS. We studied the prevalence and risk factors of RLS in 137 hemodialysis patients followed up at our center. The patients completed at least three months on dialysis and fulfilled four criteria for the diagnosis of RLS. We compared the patients with and without RLS, and the odds ratios (ORs) were estimated by the logistic regression models. The prevalence of RLS was 36.5% in the study patients. Among the variables, diabetes was the only predicting factor for the development of RLS. The diabetic patients may be afflicted with RLS 2.25 times more than the non-diabetics. Women developed severe RLS 5.23 times more than men. Neurodegeneration, decrease in dopamine level, higher total oxidant status, and neuropathy in diabetic patients may explain the RLS symptoms.

  14. Dynamics of underwater legged locomotion: modeling and experiments on an octopus-inspired robot.

    Science.gov (United States)

    Calisti, M; Corucci, F; Arienti, A; Laschi, C

    2015-07-30

    This paper studies underwater legged locomotion (ULL) by means of a robotic octopus-inspired prototype and its associated model. Two different types of propulsive actions are embedded into the robot model: reaction forces due to leg contact with the ground and hydrodynamic forces such as the drag arising from the sculling motion of the legs. Dynamic parameters of the model are estimated by means of evolutionary techniques and subsequently the model is exploited to highlight some distinctive features of ULL. Specifically, the separation between the center of buoyancy (CoB)/center of mass and density affect the stability and speed of the robot, whereas the sculling movements contribute to propelling the robot even when its legs are detached from the ground. The relevance of these effects is demonstrated through robotic experiments and model simulations; moreover, by slightly changing the position of the CoB in the presence of the same feed-forward activation, a number of different behaviors (i.e. forward and backward locomotion at different speeds) are achieved.

  15. [Restless legs syndrome in patients with high serum ferritin and normal iron levels].

    Science.gov (United States)

    Peraita-Adrados, Rosa; Duque-Ramírez, Luis G; Vela-Bueno, Antonio

    2011-10-01

    To document the association between restless legs syndrome (RLS) and high ferritin levels in five patients. The five patients were male, mean age: 59 years (range: 36-73 years). The patients were referred for RLS (two of them blood donors), in two cases associated with obstructive sleep apnea. Patients underwent a video-PSG recording. Serum iron and serum ferritin were determined. All patients fulfilled the clinical criteria for RLS: leg paresthesias associated with an urge to move, motor restless-ness, worsening of symptoms during the evening and night, and partial relief with activity, difficulty falling asleep, and presence of nocturnal awakenings due to RLS. Neurological examination, EEGs, EMGs and MRIs were normal. Video-PSGs recordings showed a disturbed and fragmented sleep with a reduction in total sleep time, low sleep efficiency, respiratory abnormalities with an apnea-hipopnea index > 10/h in two cases, and in all of them a periodic leg movements index > 5/h. The serum iron levels were within the normal range in all cases, whereas those in serum ferritin levels were high. To our knowledge the association of normal serum iron with high serum ferritin levels in patients diagnosed clinically and polygraphically as having RLS with periodic leg movements has not been described before. The notion of an involvement of a dopaminergic mechanism in the pathophysiology of RLS is supported by the decrease in the values of serum ferritin concentration observed in one patient during follow-up while being treated with dopaminergic agents.

  16. The scaling of uphill and downhill locomotion in legged animals.

    Science.gov (United States)

    Birn-Jeffery, Aleksandra V; Higham, Timothy E

    2014-12-01

    Animals must continually respond dynamically as they move through complex environments, and slopes are a common terrain on which legged animals must move. Despite this, non-level locomotion remains poorly understood. In this study, we first review the literature on locomotor mechanics, metabolic cost, and kinematic strategies on slopes. Using existing literature we then performed scaling analyses of kinematic variables, including speed, duty factor, and stride-length across a range of body sizes from ants to horses. The studies that examined locomotion on inclines vastly outnumbered those focusing on declines. On inclines, animals tend to reduce speed and increase duty factor, but a similar consensus could not be reached for declines. Remarkably, stride-length did not differ between locomotion on inclines and on level terrain, but this may have resulted from data only being available for low slopes (animals tended to use shorter strides than on level terrain, and the opposite occurred at larger body masses. Therefore, possibly due to stability issues, body mass plays a significant role in the locomotor strategy used when traveling downhill. Although we currently lack sufficient data, differential leg function is likely to be critical for locomotion on slopes, with mechanical demands differing on limbs during movement on level, inclined, and declined surfaces. Our scaling analysis not only highlights areas that require future work, but also suggests that body size is important for determining the mechanics and strategies animals use to negotiate non-level terrain. It is clear that selection has resulted in an incredible range of body size among animals, both extant and extinct, and it is likely that the ability to move up and down slopes has constrained or relaxed these mechanical pressures. Given the lack of integration of ecological data with laboratory experiments, future work should first determine which inclines animals actually use in nature, as this likely

  17. Comparison of Electric- and Magnetic-Cardiograms Produced by Myocardial Ischemia in Models of the Human Ventricle and Torso

    Science.gov (United States)

    Alday, Erick A. Perez; Ni, Haibo; Zhang, Chen; Colman, Michael A.; Gan, Zizhao; Zhang, Henggui

    2016-01-01

    Myocardial ventricular ischemia arises from a lack of blood supply to the heart, which may cause abnormal repolarization and excitation wave conduction patterns in the tissue, leading to cardiac arrhythmias and even sudden death. Current diagnosis of cardiac ischemia by the 12-lead electrocardiogram (ECG) has limitations as they are insensitive in many cases and may show unnoticeable differences to normal patterns. As the magnetic field provides extra information on cardiac excitation and is more sensitive to tangential currents to the surface of the chest, whereas the electric field is more sensitive to flux currents, it has been hypothesized that the magnetocardiogram (MCG) may provide a complementary method to the ECG in ischemic diagnosis. However, it is unclear yet about the differences in sensitivity regions of body surface ECG and MCG signals to ischemic conditions. The aim of this study was to investigate such differences by using 12-, 36- ECG and 36-MCG computed from multi-scale biophysically detailed computational models of the human ventricles and torso in both control and ischemic conditions. It was shown that ischemia produced changes in the ECG and MCG signals in the QRS complex, T-wave and ST-segment, with greater relative differences seen in the 36-lead ECG and MCG as compared to the 12-leads ECG (34% and 37% vs 26%, respectively). The 36-lead ECG showed more averaged sensitivity than the MCG in the change of T-wave due to ischemia (37% vs 32%, respectively), whereas the MCG showed greater sensitivity than the ECG in the change of the ST-segment (50% vs 40%, respectively). In addition, both MCG and ECG showed regional-dependent changes to ischemia, but with MCG showing a stronger correlation between ischemic region in the heart. In conclusion, MCG shows more sensitivity than ECG in response to ischemia, which may provide an alternative method for the diagnosis of ischemia. PMID:27556808

  18. Sensory signals of unloading in one leg follow stance onset in another leg: transfer of load and emergent coordination in cockroach walking.

    Science.gov (United States)

    Zill, Sasha N; Keller, Bridget R; Duke, Elizabeth R

    2009-05-01

    The transfer of load from one leg to another is an essential component in walking, but sense organs that signal this process have rarely been identified. We used high-speed digital imaging and neurophysiological recordings to characterize activities of tibial campaniform sensilla, receptors that detect forces via cuticular strains, in the middle legs of cockroaches during walking. Previous studies demonstrated that the distal tibial sensilla discharge when body load is suddenly decreased in freely standing animals. Sensory recordings during walking showed that distal receptors in the middle leg fired an intense burst near the end of the stance phase. We tested the hypothesis that initiation of distal firing resulted from the action of other legs entering stance. Analysis of leg movements in slow walking showed that sensory bursts in the middle leg closely followed stance onset of the ipsilateral hind leg while the ipsilateral front leg entered stance earlier in phase. Similar phases of leg movement were found in slow walking in experiments in which animals had no implanted recording wires. Those studies also demonstrated that the opposite middle leg entered stance earlier in phase. Measurements of leg positions in walking showed that the hind leg tarsus was placed closest to the middle leg, in keeping with a "targeting" strategy. Triggering of distal bursts in the middle leg by mechanical action of the hind leg could facilitate the onset of swing in the middle leg through local reflex effects and contribute to emergent coordination of leg movements in metachronal gaits.

  19. Endovascular management of acute limb ischemia.

    Science.gov (United States)

    Peeters, P; Verbist, J; Keirse, K; Deloose, K; Bosiers, M

    2010-06-01

    Acute limb ischemia (ALI) refers to a rapid worsening of limb perfusion resulting in rest pain, ischemic ulcers or gangrene. With an estimated incidence of 140 million/year, ALI is serious limb-threatening and life-threatening medical emergency demanding prompt action. Three prospective, randomized clinical trials provide data on trombolytic therapy versus surgical intervention in patients with acute lower extremity ischemia. Although they did not give us the final answer, satisfactory results are reported for percutaneous thrombolysis compared with surgery. Moreover, they suggest an important advantage of thrombolysis in acute bypass graft occlusions. Therefore, we believe thrombolytic therapy should be a part of the vascular surgeon's armamentarium to safely and successfully treat ALI patients.

  20. Spinal cord ischemia secondary to hypovolemic shock.

    Science.gov (United States)

    Oh, Jacob Yl; Kapoor, Siddhant; Koh, Roy Km; Yang, Eugene Wr; Hee, Hwan-Tak

    2014-12-01

    A 44-year-old male presented with symptoms of spinal cord compression secondary to metastatic prostate cancer. An urgent decompression at the cervical-thoracic region was performed, and there were no complications intraoperatively. Three hours postoperatively, the patient developed acute bilateral lower-limb paralysis (motor grade 0). Clinically, he was in class 3 hypovolemic shock. An urgent magnetic resonance imaging (MRI) was performed, showing no epidural hematoma. He was managed aggressively with medical therapy to improve his spinal cord perfusion. The patient improved significantly, and after one week, he was able to regain most of his motor functions. Although not commonly reported, spinal cord ischemia post-surgery should be recognized early, especially in the presence of hypovolemic shock. MRI should be performed to exclude other potential causes of compression. Spinal cord ischemia needs to be managed aggressively with medical treatment to improve spinal cord perfusion. The prognosis depends on the severity of deficits, and is usually favorable.

  1. Update in management of mesenteric ischemia

    Institute of Scientific and Technical Information of China (English)

    Robert W Chang; John B Chang; Walter E Longo

    2006-01-01

    Mesenteric ischemia disorders are precipitated by a circulation insufficiency event that deprives one or several abdominal organs of adequate respiration to meet metabolic demands. Although mesenteric ischemia occurs infrequently, the mortality rate is from 60% to 100%, depending on the source of obstruction. The successful outcome is dependent upon a high index of suspicion and prompt management. We briefly review the pathophysiology and presentation of the various ischemic entities and review the current state of the art in diagnosis and treatment. Despite advances in both diagnosis and treatment, prompt diagnosis and supportive care remain critical for successful outcome.New imaging techniques, endovascular therapy and emerging research may improve our approach to this deadly condition.

  2. [Acute cerebral ischemia: an unusual clinical presentation of isolated left ventricular noncompaction in an adult patient].

    Science.gov (United States)

    Fiorencis, Andrea; Quadretti, Laura; Bacich, Daniela; Chiodi, Elisabetta; Mele, Donato; Fiorencis, Roberto

    2013-01-01

    Isolated left ventricular noncompaction in adults is uncommon. The most frequent clinical manifestations are heart failure due to left ventricular systolic dysfunction and supraventricular and ventricular arrhythmias, which may be sustained and associated with sudden death. Thromboembolic complications are also possible. We report the case of an adult patient with isolated left ventricular noncompaction who came to our observation because of acute cerebral ischemia, an initial presentation of the disease only rarely described.

  3. Effect of stochastic modulation of inter-pulse interval during stimulated isokinetic leg extension

    OpenAIRE

    Efe Anil Aksöz; Marco Laubacher; Stuart Binder-Macleod; Hunt, Kenneth J

    2016-01-01

    Recumbent cycling exercise achieved by functional electrical stimulation (FES) of the paralyzed leg muscles is effective for cardiopulmonary and musculoskeletal conditioning after spinal cord injury, but its full potential has not yet been realized. Mechanical power output and efficiency is very low and endurance is limited due to early onset of muscle fatigue. The aim of this work was to compare stochastic modulation of the inter-pulse interval (IPI) to constant-frequency stimulation during ...

  4. Selective gene expression in focal cerebral ischemia.

    Science.gov (United States)

    Jacewicz, M; Kiessling, M; Pulsinelli, W A

    1986-06-01

    Regional patterns of protein synthesis were examined in rat cortex made ischemic by the occlusion of the right common carotid and middle cerebral arteries. At 2 h of ischemia, proteins were pulse labeled with intracortical injections of a mixture of [3H]leucine, [3H]isoleucine, and [3H]proline. Newly synthesized proteins were analyzed by two-dimensional gel fluorography, and the results correlated with local CBF, measured with [14C]iodoantipyrine as tracer. Small blood flow reductions (CBF = 50-80 ml 100 g-1 min-1) were accompanied by a modest inhibition in synthesis of many proteins and a marked increase in one protein (Mr 27,000). With further reduction in blood flow (CBF = 40 ml 100 g-1 min-1), synthesis became limited to a small group of proteins (Mr 27,000, 34,000, 73,000, 79,000, and actin) including two new polypeptides (Mr 55,000 and 70,000). Severe ischemia (CBF = 15-25 ml 100 g-1 min-1) caused the isoelectric modification of several proteins (Mr 44,000, 55,000, and 70,000) and induced synthesis of another protein (Mr 40,000). Two polypeptides (Mr 27,000 and 70,000) dominated residual protein synthesis in severe ischemia. The changes in protein synthesis induced by different grades of ischemia most likely comprise a variation of the so-called "heat shock" or "stress" response found in all eukaryotic cells subjected to adverse conditions. Since heat shock genes are known to confer partial protection against anoxia and a variety of other noxious insults, their induction may be a factor in limiting the extent of ischemic tissue damage.

  5. Urticarial Vasculitis-Associated Intestinal Ischemia

    Directory of Open Access Journals (Sweden)

    Uni Wong

    2016-01-01

    Full Text Available Urticarial vasculitis (UV is a rare small vessel vasculitis. UV is often idiopathic but can also present in the context of autoimmune disorders such as systemic lupus erythematosus, drug reactions, infections, or a paraneoplastic syndrome. Extracutaneous complications include intestinal ischemic injuries, in UV patients with nonspecific gastrointestinal symptoms such as abdominal pain and nausea. Prompt recognition and treatment can minimize morbidity and mortality. This paper describes a case of urticarial vasculitis-associated intestinal ischemia.

  6. Endovascular Management of Acute Limb Ischemia.

    LENUS (Irish Health Repository)

    Hynes, Brian G

    2011-09-14

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

  7. Is longer sevoflurane preconditioning neuroprotective in permanent focal cerebral ischemia?

    Institute of Scientific and Technical Information of China (English)

    Caiwei Qiu; Bo Sheng; Shurong Wang; Jin Liu

    2013-01-01

    Sevoflurane preconditioning has neuroprotective effects in the cerebral ischemia/reperfusion model. However, its influence on permanent cerebral ischemia remains unclear. In the present study, the rats were exposed to sevoflurane for 15, 30, 60, and 120 minutes, fol owed by induction of perma-nent cerebral ischemia. Results demonstrated that 30-and 60-minute sevoflurane preconditioning significantly reduced the infarct volume at 24 hours after cerebral ischemia, and 60-minute lurane preconditioning additional y reduced the number of TUNEL-and caspase-3-positive cel s in the ischemic penumbra. However, 120-minute sevoflurane preconditioning did not show evident neuroprotective effects. Moreover, 60-minute sevoflurane preconditioning significantly attenuated neurological deficits and infarct volume in rats at 4 days after cerebral ischemia. These findings in-dicated that 60-minute sevoflurane preconditioning can induce the best neuroprotective effects in rats with permanent cerebral ischemia through the inhibition of apoptosis.

  8. Purine Metabolism in Acute Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Ye. V. Oreshnikov

    2008-01-01

    Full Text Available Objective: to study the specific features of purine metabolism in clinically significant acute cerebral ischemia. Subjects and materials. Three hundred and fifty patients with the acutest cerebral ischemic stroke were examined. The parameters of gas and electrolyte composition, acid-base balance, the levels of malonic dialdehyde, adenine, guanine, hypox-anthine, xanthine, and uric acid, and the activity of xanthine oxidase were determined in arterial and venous bloods and spinal fluid. Results. In ischemic stroke, hyperuricemia reflects the severity of cerebral metabolic disturbances, hemodynamic instability, hypercoagulation susceptiility, and the extent of neurological deficit. In ischemic stroke, hyperuri-corachia is accompanied by the higher spinal fluid levels of adenine, guanine, hypoxanthine, and xanthine and it is an indirect indicator of respiratory disorders of central genesis, systemic acidosis, hypercoagulation susceptibility, free radical oxidation activation, the intensity of a stressor response to cerebral ischemia, cerebral metabolic disturbances, the depth of reduced consciousness, and the severity of neurological deficit. Conclusion. The high venous blood activity of xanthine oxidase in ischemic stroke is associated with the better neurological parameters in all follow-up periods, the better early functional outcome, and lower mortality rates. Key words: hyperuricemia, stroke, xanthine oxidase, uric acid, cerebral ischemia.

  9. Changes in the permeability of blood brain barrier and endothelial cell damage after cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Ke Liu; Jiansheng Li

    2006-01-01

    OBJECTIVE: To investigate the effect of endothelial cells on the permeability of blood brain barrier (BBB) after brain injury and its effect mechanism.DATA SOURCES: We searched for the articles of permeability of BBB and endothelial cell injury after brain ischemia, which were published between January 1982 and December 2005, with the key words of "cerebral ischemia damage,blood brain barrier ( BBB),permeability,effect of endothelial cell (EC) and its variation mechanism"in English.STUDY SELECTION: The materials were primarily selected. The articles related to the changes in the permeability of BBB and the effect of endothelial cells as well as the change mechanism after cerebral ischemia damage were chosen. Repetitive studies or review articles were excluded.DATA EXTRACTION: Totally 55 related articles were collected, and 35 were excluded due to repetitive or review articles, finally 20 articles were involved.DATA SYNTHESIS: The content or viewpoints of involved literatures were analyzed. Cerebral ischemia had damage for endothelial cells, such as the inflow of a lot of Ca2+, the production of nitrogen monoxide and oxygen free radical, and aggravated destruction of BBB. After acceptors of inflammatory mediators on cerebrovascular endothelial cell membrane, such as histamine, bradykinin , 5-hydroxytryptamine and so on are activated, endothelial cells shrink and the permeability of BBB increases. Its mechanism involves in the inflow of extracellular Ca2+and the release of intracellular Ca2+ in the cells. Glycocalyx molecule on the surface of endothelial cell, having structural polytropy, is the determinative factor of the permeability of BBB. VEGF, intensively increasing the vasopermeability and mainly effecting on postcapillary vein and veinlet, is the strongest known blood vessel permeation reagent. Its chronic overexpression in the brain can lead the destruction of BBB.CONCLUSION: The injury of endothelial cell participants in the pathological mechanism of BBB

  10. Effect of heat shock protein 70 on cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Wen Yan; Xiulian Chen; Rui Chen; Shiming Xu; Lijuan Zhang; Hongjuan Wang; Chunyue Huo

    2006-01-01

    OBJECTIVE: To summarize the relationship between heat shock protein 70 (HSP70) and cerebral ischemia.DATA SOURCES: An online search of Medline database was undertaken to identify relevant articles published in English from January 1980 to December 2005 by using the keywords of "heat shock protein 70, ischemia". Meanwhile, Chinese relevant articles published from January 2000 to December 2005 were searched in China National Knowledge Infrastructure (CNKI) database and Chinese Journal of Clinical Rehabilitation with the keywords of "heat shock protein 70, cerebral ischemia" in Chinese.STUDY SELECTION: More than 100 related articles were screened, and 29 references mainly about HSP70and cerebral ischemia were selected, including basic and clinical researches. As to the articles with similar content, those published in the authoritative journals in recent 3 years were preferential.DATA EXTRACTION : A total of 29 articles were collected and classified according to the structure, function and clinical application of HSP70. Among them, 1 article is about the structure of HSP70, 27 about the relationship between HSP70 and cerebral ischemia, and 2 about the clinical application of HSP70.DATA SYNTHESTS: HSP70 is one of the most conservative proteins during biological evolution. Experiments in cerebral ischemia revealed that HSP70 expression was time-dependent, also correlated with the injured site and severity. The cerebral ischemia induced HSP70 gene expression in hippocampus of gerbil had protection to tolerance of fatal ischemic injury for neurons. The increase of HSP70 expression may be one of the endogenous protective mechanisms during cerebral ischemia, and can effectively alleviate cerebral ischemia. Thus HSP70 protein and HSP70 mRNA have been taken as important indexes extensively applied in the basic study of cerebral ischemia by some scholars abroad.CONCLUSTON: HSP70 plays a protective role in cerebral ischemia, and a deeper research into the biological function of

  11. Enhanced Endothelin-1 Mediated Vasoconstriction of the Ophthalmic Artery May Exacerbate Retinal Damage after Transient Global Cerebral Ischemia in Rat

    DEFF Research Database (Denmark)

    Blixt, Frank W; Johansson, Sara Ellinor; Johnson, Leif

    2016-01-01

    Cerebral vasculature is often the target of stroke studies. However, the vasculature supplying the eye might also be affected by ischemia. The aim of the present study was to investigate if the transient global cerebral ischemia (GCI) enhances vascular effect of endothelin-1 (ET-1) and 5...... decreased function at 72 hours, but recovered almost completely after 7 days. In conclusion, we propose that the increased contractile response via ET-1 receptors in the ophthalmic artery after 48 hours may elicit negative retinal consequences due to a second ischemic period. This may exacerbate retinal...

  12. Acute ischemia of bilateral lower extremities as a presenting feature of disseminated mucormycosis endocarditis: A case report

    Directory of Open Access Journals (Sweden)

    Niranjan Tachamo

    2016-12-01

    Full Text Available Disseminated mucormycosis endocarditis is extremely rare, and only a few cases have actually been reported in the literature. It is almost universally fatal despite aggressive surgical and medical management. In this article, we present the case of a 48-year-old immunocompromised male with mucormycosis endocarditis, who presented with acute bilateral lower extremity ischemia and passed away due to subsequent multi-organ failure. To our knowledge, this is the first case report of disseminated mucormycosis native valve endocarditis presenting as acute bilateral lower extremity ischemia.

  13. Acute ischemia of bilateral lower extremities as a presenting feature of disseminated mucormycosis endocarditis: A case report

    Science.gov (United States)

    Tachamo, Niranjan; Rajagopalan, Priya; Nazir, Salik; Lohani, Saroj; Le, Brian; Patel, Nitin

    2016-01-01

    Disseminated mucormycosis endocarditis is extremely rare, and only a few cases have actually been reported in the literature. It is almost universally fatal despite aggressive surgical and medical management. In this article, we present the case of a 48-year-old immunocompromised male with mucormycosis endocarditis, who presented with acute bilateral lower extremity ischemia and passed away due to subsequent multi-organ failure. To our knowledge, this is the first case report of disseminated mucormycosis native valve endocarditis presenting as acute bilateral lower extremity ischemia. PMID:27987284

  14. May 2015 critical care case of the month: an infected leg

    Directory of Open Access Journals (Sweden)

    Till SL

    2015-05-01

    Full Text Available No abstract available. Article truncated at 150 words. History of Present Illness: A 46-year-old transferred due to concern for necrotizing fasciitis. One the day prior to transfer purple discoloration was not noted in the lower portion of the left leg. On the day of transfer the leg became more purple, painful, and swollen. She presented to a pain clinic that advised her to go to an emergency room. The emergency room performed arterial Doppler ultrasound, which was normal and transferred her due to concern of necrotizing fasciitis. Past Medical History, Social History and Family History: She has a past medical history of fibromyalgia. She had an extensive surgical history including an appendectomy, bladder implant, cholecystectomy, dilatation and curettage, esophageal repair, left femoral artery repair due to a motor vehicle accident, partial hysterectomy, left knee surgery, and several left leg operations with grafting. Family history was non-contributory. The patient was single with two children, and smoked 1-2 packs of ...

  15. 2D motion analysis of rabbits after Achilles tendon rupture repair and histological analysis of extracted tendons: can the number of animals be reduced by operating both hind legs simultaneously?

    Science.gov (United States)

    Buschmann, Johanna; Müller, Angela; Nicholls, Flora; Achermann, Rita; Bürgisser, Gabriella Meier; Baumgartner, Walter; Calcagni, Maurizio; Giovanoli, Pietro

    2013-10-01

    Considering the 3Rs principle in animal experiments, there is a demand to perform research experiments with the fewest number of animals possible while warranting the welfare of the animals. Orthopaedic experimental studies involving operations on the hind legs of rabbits are either performed on one hind leg with the second hind leg serving as control or on both hind legs simultaneously (control: rabbits with no operations at all). The Achilles tendon of rabbits was transected and sutured, and the two-dimensional motion pattern of animals having only one leg operated was compared to rabbits having both hind legs operated (control: non-treated animals). Step length, maximum ankle angle, minimum ankle angle and the resulting range of motion of both hind legs were determined weekly over a time span from 3 weeks to 12 weeks post-operation. The results were fitted by a linear mixed effects model including time dependency. Moreover, all tendon specimen were analysed histologically. Tenocyte and tenoblast density, tenocyte and tenoblast nuclei width, inflammation level and collagen fibre alignment were determined. Statistically significant differences in the motion pattern were found when one-leg treated and two-leg treated animals were compared. However, the absolute differences were on average less than 20%. Histologically, 1-leg treated animals had tendon tissue with higher cell density, but lower inflammation and less ondulated collagen fibres compared to 2-leg treated animals; the nuclei width was the same for both groups. With regard to welfare, all animals were fine during the experiments. While comparative studies should be performed with one-leg treated animals due to interaction effects, for proof-of-principle studies, operating two legs per animal may be justified as the welfare of the animals is warranted. This is a great benefit in the sense of the 3Rs because up to 50% of animals can be spared. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Adult midgut malrotation presented with acute bowel obstruction and ischemia

    Directory of Open Access Journals (Sweden)

    Akile Zengin

    2016-01-01

    Conclusion: Malrotation should be considered in differential diagnosis in patients presented with acute abdomen and intestinal ischemia. Surgical intervention should be prompt to limit morbidity and mortality.

  17. Treatment of sickle cell leg ulcers with pentoxifylline.

    Science.gov (United States)

    Frost, M L; Treadwell, P

    1990-06-01

    A 58-year-old black man with leg ulcers of 43 years duration responded to pentoxifylline 400 mg tid in 8 months. The ability of pentoxifylline to increase erythrocyte flexibility and decrease blood viscosity was the basis for our use of this agent. Oral pentoxifylline may be a useful adjunct in healing sickle cell leg ulcers and preventing their recurrence.

  18. A Brief Survey Paper on Multi-Legged Robots

    Directory of Open Access Journals (Sweden)

    Mohammad Behmanesh

    2015-03-01

    Full Text Available This paper presents a brief survey on multi-legged robots and their applications in agriculture such as for harvesting. Multi-legged robots have the benefit of more flexibility and adapt to different rough terrain in a better way. They also have very important applications in fulfilling the dangerous tasks such as mine detecting.

  19. Ubx Regulates Differential Enlargement and Diversification of Insect Hind Legs

    Science.gov (United States)

    Mahfooz, Najmus; Turchyn, Nataliya; Mihajlovic, Michelle; Hrycaj, Steven; Popadić, Aleksandar

    2007-01-01

    Differential enlargement of hind (T3) legs represents one of the hallmarks of insect evolution. However, the actual mechanism(s) responsible are yet to be determined. To address this issue, we have now studied the molecular basis of T3 leg enlargement in Oncopeltus fasciatus (milkweed bug) and Acheta domesticus (house cricket). In Oncopeltus, the T3 tibia displays a moderate increase in size, whereas in Acheta, the T3 femur, tibia, and tarsus are all greatly enlarged. Here, we show that the hox gene Ultrabithorax (Ubx) is expressed in the enlarged segments of hind legs. Furthermore, we demonstrate that depletion of Ubx during embryogenesis has a primary effect in T3 legs and causes shortening of leg segments that are enlarged in a wild type. This result shows that Ubx is regulating the differential growth and enlargement of T3 legs in both Oncopeltus and Acheta. The emerging view suggests that Ubx was co-opted for a novel role in regulating leg growth and that the transcriptional modification of its expression may be a universal mechanism for the evolutionary diversification of insect hind legs. PMID:17848997

  20. Restless Legs Syndrome -- Self-Tests and Diagnosis

    Science.gov (United States)

    ... Overview & Facts Causes & Symptoms Self-Tests & Diagnosis Treatment Restless Legs Syndrome - Self-Tests & Diagnosis Self-Tests Do you have ... to any of these questions you may have restless legs syndrome Diagnosis Talk to a board certified sleep medicine ...

  1. Criteria in diagnosing nocturnal leg cramps : a systematic review

    NARCIS (Netherlands)

    Hallegraeff, Joannes; de Greef, Mathieu; Krijnen, Wim; van der Schans, Cees

    2017-01-01

    Background: Up to 33% of the general population over 50 years of age are affected by nocturnal leg cramps. Currently there are no generally accepted clinical characteristics, which identify nocturnal leg cramps. This study aims to identify these clinical characteristics and to differentiate between

  2. Leg strength is associated with ventilatory efficiency in older women.

    Science.gov (United States)

    Gonzales, J U; Tucker, S H; Kalasky, M J; Proctor, D N

    2012-07-01

    The aim of the present study was to determine if leg function is associated with ventilatory efficiency during exercise in healthy older adults. 24 women and 18 men aged 60-80 years performed treadmill exercise to fatigue for calculation of ventilatory efficiency using the ratio of ventilation to carbon dioxide at the anaerobic threshold (VE/VCO₂@AT). On a separate day, participants performed leg strength testing and graded single-leg knee extension exercise. The VE/VCO₂@AT was higher in women than men (33±3 vs. 30±3; p=0.03). After adjustment for age and VO(₂max), leg strength (knee extensor isometric force) was inversely associated with VE/VCO₂@AT in women (r= - 0.44, p=0.03) while no relationships were found for men. Strength-matched women and men had similar VE/VCO₂@AT indicating that the correlation between leg strength and VE/VCO₂@AT was strength- but not sex-specific. During knee extensor exercise, women with lower leg strength had increased VE/VCO₂ slope across 0-15 W as compared to higher strength women (38±8 vs. 31±3; p<0.05), while no differences were found for men. These results find leg strength to be associated with ventilatory responses to exercise in healthy older women, a finding that might be related to lower leg strength in women than men.

  3. X-Ray Exam: Lower Leg (Tibia and Fibula)

    Science.gov (United States)

    ... 2-Year-Old X-Ray Exam: Lower Leg (Tibia and Fibula) KidsHealth > For Parents > X-Ray Exam: Lower Leg (Tibia and Fibula) A A A What's in this ... Child If You Have Questions en español Radiografía: tibia y peroné What It Is An X-ray ...

  4. Beengebrekenonderzoek bij varkens = Research on leg weakness / osteochondrosis in swine

    NARCIS (Netherlands)

    Wal, van der P.G.

    1983-01-01

    Uit onderzoek bleek dat leg weakness, de uiterlijke verschijnselen van beengebreken, niet het resultaat is van osteochondrosis, een verstoring van het verbeningsproces van kraakbeen. De ontwikkeling van de symptomen van leg weakness kunnen onderdrukt worden door natriumbicarbonaat aan het voer toe

  5. Leg length, sitting height and postmenopausal breast cancer risk

    DEFF Research Database (Denmark)

    Mellemkjær, L; Christensen, J; Frederiksen, K

    2012-01-01

    Tallness has consistently been associated with an increased risk of breast cancer. We investigated the association further by decomposing height into leg length and sitting height.......Tallness has consistently been associated with an increased risk of breast cancer. We investigated the association further by decomposing height into leg length and sitting height....

  6. Ubx regulates differential enlargement and diversification of insect hind legs.

    Directory of Open Access Journals (Sweden)

    Najmus Mahfooz

    Full Text Available Differential enlargement of hind (T3 legs represents one of the hallmarks of insect evolution. However, the actual mechanism(s responsible are yet to be determined. To address this issue, we have now studied the molecular basis of T3 leg enlargement in Oncopeltus fasciatus (milkweed bug and Acheta domesticus (house cricket. In Oncopeltus, the T3 tibia displays a moderate increase in size, whereas in Acheta, the T3 femur, tibia, and tarsus are all greatly enlarged. Here, we show that the hox gene Ultrabithorax (Ubx is expressed in the enlarged segments of hind legs. Furthermore, we demonstrate that depletion of Ubx during embryogenesis has a primary effect in T3 legs and causes shortening of leg segments that are enlarged in a wild type. This result shows that Ubx is regulating the differential growth and enlargement of T3 legs in both Oncopeltus and Acheta. The emerging view suggests that Ubx was co-opted for a novel role in regulating leg growth and that the transcriptional modification of its expression may be a universal mechanism for the evolutionary diversification of insect hind legs.

  7. Ontogenetic shifts in functional morphology of dragonfly legs (Odonata: Anisoptera).

    Science.gov (United States)

    Leipelt, Klaus Guido; Suhling, Frank; Gorb, Stanislav N

    2010-12-01

    Anisopteran leg functions change dramatically from the final larval stadium to the adult. Larvae use legs mainly for locomotion, walking, climbing, clinging, or burrowing. Adults use them for foraging and grasping mates, for perching, clinging to the vegetation, and for repelling rivals. In order to estimate the ontogenetic shift in the leg construction from the larva to the adult, this study quantitatively compared lengths of fore, mid, and hind legs and the relationships between three leg segments, femur, tibia, and tarsus, in larval and adult Anisoptera of the families Gomphidae, Aeshnidae, Cordulegastridae, Corduliidae, and Libellulidae, represented by two species each. We found that leg segment length ratio as well as ontogenetic shift in length ratios was different between families, but rather similar within the families. While little ontogenetic shift occurred in Aeshnidae, there were some modifications in Corduliidae and Libellulidae. The severest shift occurred in Gomphidae and Cordulegastridae, both having burrowing larvae. These two families form a cluster, which is in contrast to their taxonomic relationship within the Anisoptera. Cluster analysis implies that the function of larval legs is primarily responsible for grouping, whereas adult behavior or the taxonomic relationships do not explain the grouping. This result supports the previous hypothesis about the convergent functional shift of leg characters in the dragonfly ontogenesis.

  8. The recalcitrant venous leg ulcer - A never ending story?

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan); M.B. Maessen-Visch (Birgitte); S.I. Langendoen; K.P. de Roos; H.A.M. Neumann (Martino)

    2013-01-01

    textabstractIntroduction: In general, four particular causes of recalcitrant venous leg ulcers may be distinguished. These are foot pump insufficiency, chronic venous compartment syndrome and non-re-canalized popliteal vein thrombosis. The fourth cause of recalcitrant venous leg ulcers is lipodermat

  9. Restless legs syndrome in opioid dependent patients

    Directory of Open Access Journals (Sweden)

    Abhishek Ghosh

    2014-01-01

    Full Text Available Although frequently underdiagnosed, several epidemiological studies have estimated the prevalence of restless legs syndrome (RLS in western countries at 5-15% of the general population. The diagnosis is usually made on a clinical basis, according to the criteria established by the international RLS study group. There are case reports of transient RLS in opiate withdrawal. We describe three opiate (dextropropoxyphene (DPP dependent young male patients; two of them had DPP intoxication/withdrawal seizure developing RLS during opiate withdrawal. However, their RLS persisted even after the remission of other withdrawal symptoms. Thyroid function test, hemogram, serum ferritin were normal in all of them. The cases responded well to a treatment with ropinirole. Hence, there might be a causal association, which required further well-designed studies to substantiate. The sleep disturbances and use of benzodiazepines can be minimized by increasing clinician′s sensitivity to diagnose RLS.

  10. Series Elastic Actuators for legged robots

    Science.gov (United States)

    Pratt, Jerry E.; Krupp, Benjamin T.

    2004-09-01

    Series Elastic Actuators provide many benefits in force control of robots in unconstrained environments. These benefits include high force fidelity, extremely low impedance, low friction, and good force control bandwidth. Series Elastic Actuators employ a novel mechanical design architecture which goes against the common machine design principal of "stiffer is better." A compliant element is placed between the gear train and driven load to intentionally reduce the stiffness of the actuator. A position sensor measures the deflection, and the force output is accurately calculated using Hooke"s Law (F=Kx). A control loop then servos the actuator to the desired output force. The resulting actuator has inherent shock tolerance, high force fidelity and extremely low impedance. These characteristics are desirable in many applications including legged robots, exoskeletons for human performance amplification, robotic arms, haptic interfaces, and adaptive suspensions. We describe several variations of Series Elastic Actuators that have been developed using both electric and hydraulic components.

  11. Acute Compartment Syndrome of the Leg.

    Science.gov (United States)

    Konda, Sanjit R; Kester, Benjamin S; Fisher, Nina; Behery, Omar A; Crespo, Alexander M; Egol, Kenneth A

    2017-08-01

    Acute compartment syndrome (ACS) is well known among orthopaedic surgeons. The timely diagnosis and management of ACS is crucial to avoiding its sequelae, including renal failure, ischemic contractures, and limb loss. Despite its relative importance, ACS poses a challenge to many residents and clinicians as diagnosis relies largely on clinical judgment. Timely diagnosis and thorough compartment release are essential to optimizing outcomes in ACS. This video highlights a clinical case in which compartment syndrome of the leg was considered, diagnosed, and surgically managed. This video will present the indications for compartment release and a video-guided demonstration of compartment checks using an arterial line transducer, a 4-compartment fasciotomy with 2 incisions, and temporizing vessel loop closure. Compartment syndrome can be a devastating complication of common fractures. It is essential that orthopaedic practitioners understand the immediacy of intervention. We have a responsibility to provide timely, accurate diagnosis along with expedient surgical management.

  12. Integrated design of legged mechatronic system

    Institute of Scientific and Technical Information of China (English)

    ChinYin CHEN; IMing CHEN; ChiCheng CHENG

    2009-01-01

    This paper presents a system based on the integrated design and experiment for a one degree-of-freedom (DOF) legged mechatronic system (LMTS). A six-bar linkage mechanism, which is derived from a four-bar linkage with a symmetrical coupler point and pantograph into one, is designed, and common controllers are used to control the velocity and position loops.For system-based dynamic optimization, the design for control (DFC) approach is used to integrate the structure and control for improving dynamic performance with reduced control torque.Finally, for a rapid 3D graphical based implementation of the system, high-level computer-aided rapid system integration (CARSI) technology is used to integrate the structure design, controller design, and system implemen-tation into the design and analytical software environment based on Pro/engineer, XML syntax, Simmechanics, and Simulink. Thus, the development time for the LMTS is reduced.

  13. Erysipelas of the leg (cellulitis in sub-Saharan Africa: A multicentric study of 562 cases

    Directory of Open Access Journals (Sweden)

    Bayaki Saka

    2017-01-01

    Full Text Available Introduction: Erysipelas of the leg is a common and serious infection. We carried out this study aiming at describing the epidemiological and clinical characteristics, and assessing the risks factors associated with the local complications of erysipelas of the leg in sub-Saharan Africa. Methods: This was a prospective multicentric study carried out in the dermatology units of Hospitals located in seven sub-Saharan African countries during a period of 12 months. Patients aged 15 and above with a first episode of erysipelas of the leg were recruited. Results: In this study, 562 patients were recruited, having a mean age of 43.7±16.9 years and a sex-ratio (M/F of 0.67. Patients infected on one leg were 562 while those infected with two were 27. Bullous forms of the disease were observed in 95 patients, while purpuric forms were observed in 167 patients. The existence of a point of entry (485 cases, obesity (230, lymph edema (130 and the use of bleaching agents (97 were the mains risk factors. Complications during the course of the infection such as necrotizing fasciitis (34 cases and abscesses (63 cases were observed. They were due to the use of antibiotics and non-steroidal anti-inflammatory treatments, and the use of cataplasm. Conclusion: This study reveals that existence of a point of entry, obesity and lymph edema, and the use of bleaching agents were the mains risk factors influencing the local complications of erysipelas of the leg. Necrotizing fasciitis and abscesses were influenced by the use of antibiotics and non-steroidal anti-inflammatory treatments, and the use of cataplasm.

  14. Acute effect of stretching one leg on regional arterial stiffness in young men.

    Science.gov (United States)

    Yamato, Yosuke; Hasegawa, Natsuki; Fujie, Shumpei; Ogoh, Shigehiko; Iemitsu, Motoyuki

    2017-06-01

    Our previous study demonstrated that a single bout of stretching exercises acutely reduced arterial stiffness. We hypothesized that this acute vascular response is due to regional mechanical stimulation of the peripheral arteries. To test this hypothesis, we examined the effect of a single bout of passive one leg stretching on arterial stiffness, comparing the stretched and the non-stretched leg in the same subject. Twenty-five healthy young men (20.9 ± 0.3 years, 172.5 ± 1.4 cm, 64.1 ± 1.2 kg) volunteered for the study. Subjects underwent a passive calf stretching on one leg (six repetitions of 30-s static stretch with a 10-s recovery). Pulse wave velocity (PWV, an index of arterial stiffness), blood pressure (BP), and heart rate (HR) were measured before and immediately, 15, and 30 min after the stretching. Femoral-ankle PWV (faPWV) in the stretched leg was significantly decreased from baseline (835.0 ± 15.9 cm/s) to immediately (802.9 ± 16.8 cm/s, P stretching, despite no changes in systolic and diastolic BP, or HR. However, faPWV in the non-stretched leg was not significantly altered at any time. Brachial-ankle PWV (baPWV) also showed similar responses with faPWV, but this response was not significant. Additionally, the passive stretching did not alter carotid-femoral PWV (cfPWV). These results suggest that mechanical stimulation to peripheral arteries as induced by static passive stretch may modulate arterial wall properties directly, rather than resulting in a systemic effect.

  15. Leg length discrepancy in scoliotic patients.

    Science.gov (United States)

    D'Amico, Moreno; Roncoletta, Piero; Di Felice, Francesca; Porto, Daniele; Bellomo, Rosagrazia; Saggini, Raoul

    2012-01-01

    The aetiological aspects as well as postural attitude implications represent an open question in scoliosis evaluation and treatment. Leg length discrepancy (LLD) is often recognised in scoliotic patients, but surprisingly still controversial is the use of underfoot wedge corrections in order to compensate pelvis tilt. In fact, literature reports conflicting results on the efficacy of LLD equalization also given the argued uncertainty of LLD clinical assessment and limitations related to X-ray measurements. Moreover concern is about anatomic and functional LLD and associated estimation of the pelvic torsion. In such a topic, a significant helpful tool has been demonstrated to be 3D kinematic optoelectronic measurements and other useful data obtained from force platforms and/or baropodographic systems. 135 (94.4%) out of 143 Scoliotic patients sample (av. age 16.4±10.2 Y range 4-66 Y), have been found to improve posture when LLD was corrected. The 143 patients showed a mean lower limb discrepancy of μ=10.2±5.2mm associated to a mean main scoliotic curve μ=16.4°±9.4° Cobb (frontal plane), mean Spinal offset μ=7.5±5.5mm and mean Global offset μ=10.1±7.1mm. The applied paired t-test comparison (indifferent vs. corrected orthostasis) showed significant (p < 0.05) postural improvements could be obtained in the whole or in a part of the considered postural parameters, after the application of suitable under-foot wedge. The present investigation confirm results of a previous study demonstrating the efficacy of under-foot wedge use in leg asymmetry correction, posture re-balancing and spine deformities reduction, pointing out the significant contribution of the 3D opto-electronic measurement approach in the critical process of assessing the correct under-foot wedge size, therapy planning and monitoring.

  16. Restless legs syndrome in patients on hemodialysis

    Directory of Open Access Journals (Sweden)

    Saleh Mohammad Yaser Salman

    2011-01-01

    Full Text Available Restless legs syndrome (RLS is common among dialysis patients, with a reported prevalence of 6-60%. The prevalence of RLS in Syrian patients on hemodialysis (HD is not known. The purpose of this study is to determine the prevalence of RLS in patients on regular HD, and to find the possible correlation between the presence of RLS and demographic, clinical, and biochemical factors. One hundred and twenty-three patients (male/female = 70/53, mean age = 41.95 ± 15.11 years on HD therapy at the Aleppo University Hospital were enrolled into the study. RLS was diagnosed based on criteria established by the International Restless Legs Syn-drome Study Group (IRLSSG. Data procured were compared between patients with and without RLS. Applying the IRLSSG criteria for the diagnosis, RLS was seen in 20.3% of the study pa-tients. No significant difference in age, gender, and intake of nicotine and caffeine was found between patients with and without the RLS. Similarly, there was no difference between the two groups in the duration of end-stage renal disease (ESRD, the period of dialysis dependence, dialysis adequacy, urea and creatinine levels, and the presence of anemia. The co-morbidities and the use of drugs also did not differ in the two groups. Our study suggests that the high prevalence of RLS among patients on HD requires careful attention and correct diagnosis can lead to better therapy and better quality of life. The pathogenesis of RLS is not clear and further studies are required to identify any possible cause as well as to discover the impact of this syndrome on sleep, quality of life, and possibly other complications such as cardiovasculare disease.

  17. Restless legs syndrome in patients on hemodialysis.

    Science.gov (United States)

    Salman, Saleh Mohammad Yaser

    2011-03-01

    Restless legs syndrome (RLS) is common among dialysis patients, with a reported prevalence of 6-60%. The prevalence of RLS in Syrian patients on hemodialysis (HD) is not known. The purpose of this study is to determine the prevalence of RLS in patients on regular HD, and to find the possible correlation between the presence of RLS and demographic, clinical, and biochemical factors. One hundred and twenty-three patients (male/female = 70/53, mean age = 41.95 ± 15.11 years) on HD therapy at the Aleppo University Hospital were enrolled into the study. RLS was diagnosed based on criteria established by the International Restless Legs Syn-drome Study Group (IRLSSG). Data procured were compared between patients with and without RLS. Applying the IRLSSG criteria for the diagnosis, RLS was seen in 20.3% of the study pa-tients. No significant difference in age, gender, and intake of nicotine and caffeine was found between patients with and without the RLS. Similarly, there was no difference between the two groups in the duration of end-stage renal disease (ESRD), the period of dialysis dependence, dialysis adequacy, urea and creatinine levels, and the presence of anemia. The co-morbidities and the use of drugs also did not differ in the two groups. Our study suggests that the high prevalence of RLS among patients on HD requires careful attention and correct diagnosis can lead to better therapy and better quality of life. The pathogenesis of RLS is not clear and further studies are required to identify any possible cause as well as to discover the impact of this syndrome on sleep, quality of life, and possibly other complications such as cardiovasculare disease.

  18. Short-interval leg movements during sleep entail greater cardiac activation than periodic leg movements during sleep in restless legs syndrome patients.

    Science.gov (United States)

    Ferri, Raffaele; Rundo, Francesco; Silvani, Alessandro; Zucconi, Marco; Aricò, Debora; Bruni, Oliviero; Lanuzza, Bartolo; Ferini-Strambi, Luigi; Manconi, Mauro

    2017-10-01

    Periodic leg movements during sleep (PLMS) are sequences of ≥4 motor events with intermovement intervals (IMI) of 10-90 s. PLMS are a supportive diagnostic criterion for restless legs syndrome (RLS) and entail cardiac activation, particularly when associated with arousal. RLS patients also over-express short-interval leg movements during sleep (SILMS), which have IMI leg movements. We found that the duration of the R-R interval decrease with SILMS doublets was significantly longer than that with PLMS, whereas the maximal decrease in R-R interval was similar. Scoring SILMS in RLS patients may therefore be relevant from a cardiac autonomic perspective. © 2017 European Sleep Research Society.

  19. A Terradynamics of Legged Locomotion on Granular Media

    CERN Document Server

    Li, Chen; Goldman, Daniel I; 10.1126/science.1229163

    2013-01-01

    The theories of aero- and hydrodynamics predict animal movement and device design in air and water through the computation of lift, drag, and thrust forces. Although models of terrestrial legged locomotion have focused on interactions with solid ground, many animals move on substrates that flow in response to intrusion. However, locomotor-ground interaction models on such flowable ground are often unavailable. We developed a force model for arbitrarily-shaped legs and bodies moving freely in granular media, and used this "terradynamics" to predict a small legged robot's locomotion on granular media using various leg shapes and stride frequencies. Our study reveals a complex but generic dependence of stresses in granular media on intruder depth, orientation, and movement direction and gives insight into the effects of leg morphology and kinematics on movement.

  20. Why do arms extract less oxygen than legs during exercise?

    DEFF Research Database (Denmark)

    Calbet, J A L; Holmberg, H-C; Rosdahl, H;

    2005-01-01

    To determine whether conditions for O2 utilization and O2 off-loading from the hemoglobin are different in exercising arms and legs, six cross-country skiers participated in this study. Femoral and subclavian vein blood flow and gases were determined during skiing on a treadmill at approximately 76......% maximal O2 uptake (V(O2)max) and at V(O2)max with different techniques: diagonal stride (combined arm and leg exercise), double poling (predominantly arm exercise), and leg skiing (predominantly leg exercise). The percentage of O2 extraction was always higher for the legs than for the arms. At maximal...... exercise (diagonal stride), the corresponding mean values were 93 and 85% (n = 3; P

  1. Hemodynamic Changes in Rat Leg Muscles during Tourniquet-induced Ischemia-reperfusion Injury Observed by Near-infrared Spectroscopy

    Science.gov (United States)

    2009-07-01

    Kim (2005). Briefly, the CWNIRS system consists of a tungsten– halogen light source (HL 2000, Ocean Optics, FL), a CCD spectrometer (BTC111E, BwTek, Kim...scattering does not change and oxygenated hemoglobin ([HbO2]) and deoxygenated hemoglobin ([Hb]) are the only major molecules in tissues with changing

  2. Detection of Periodic Leg Movements by Machine Learning Methods Using Polysomnographic Parameters Other Than Leg Electromyography

    Directory of Open Access Journals (Sweden)

    İlhan Umut

    2016-01-01

    Full Text Available The number of channels used for polysomnographic recording frequently causes difficulties for patients because of the many cables connected. Also, it increases the risk of having troubles during recording process and increases the storage volume. In this study, it is intended to detect periodic leg movement (PLM in sleep with the use of the channels except leg electromyography (EMG by analysing polysomnography (PSG data with digital signal processing (DSP and machine learning methods. PSG records of 153 patients of different ages and genders with PLM disorder diagnosis were examined retrospectively. A novel software was developed for the analysis of PSG records. The software utilizes the machine learning algorithms, statistical methods, and DSP methods. In order to classify PLM, popular machine learning methods (multilayer perceptron, K-nearest neighbour, and random forests and logistic regression were used. Comparison of classified results showed that while K-nearest neighbour classification algorithm had higher average classification rate (91.87% and lower average classification error value (RMSE = 0.2850, multilayer perceptron algorithm had the lowest average classification rate (83.29% and the highest average classification error value (RMSE = 0.3705. Results showed that PLM can be classified with high accuracy (91.87% without leg EMG record being present.

  3. Effects of gabapentin enacarbil on restless legs syndrome and leg pain in dementia with Lewy bodies.

    Science.gov (United States)

    Fujishiro, Hiroshige

    2014-06-01

    Restless legs syndrome (RLS) is a common neurological disorder. Dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia after Alzheimer's disease. Both RLS and DLB can be effectively treated by dopaminergic medications, suggesting the role of dopamine dysfunction in the pathogenesis of both diseases. Here, I report on a Japanese woman with probable DLB and RLS who was treated with gabapentin enacarbil, a non-dopaminergic agent. Because a dopamine agonist, a first-line therapy for moderate to severe RLS, caused the occurrence of metamorphopsia, an alternative treatment of gabapentin enacarbil was used; this treatment improved the patient's RLS without worsening her psychiatric symptoms. An alternative treatment is desirable for DLB patients with RLS because they often experience intolerable side-effects with a dopamine agonist, especially visual hallucinations. Administering gabapentin enacarbil also improved the continuous leg pain that occurred in conjunction with the development of RLS. Although the neurobiological mechanism in the development of pain remains unclear, a range of non-dopaminergic structures likely mediated pain processing in DLB in the present case based on neuropharmacological results. This is the first report reporting the effects of gabapentin enacarbil for RLS and leg pain in a DLB patient with psychiatric symptoms.

  4. Validation of a leg movements count and periodic leg movements analysis in a custom polysomnography system.

    Science.gov (United States)

    Stefani, Ambra; Heidbreder, Anna; Hackner, Heinz; Högl, Birgit

    2017-02-23

    Periodic leg movements (PLM) during sleep (PLMS) are considered strongly related to restless legs syndrome (RLS), and are associated with polymorphisms in RLS risk genes. Various software for automatic analysis of PLMS are available, but only few of them have been validated. Aim of this study was to validate a leg movements count and analysis integrated in a commercially available polysomnography (PSG) system against manual scoring. Twenty RLS patients with a PLMS index > 20/h and 20 controls with a PLMS index PLM was performed according to the standard American Academy of Sleep Medicine (AASM) criteria. LM and PLM indices during sleep and wakefulness, the rate of PLMS associated with respiratory events, intermovement interval and periodicity indices were manually and automatically scored. The correlation between manual and computerized scoring was high for all investigated parameters (Spearman correlation coefficients 0.751-0.996, p PLM analysis against the gold standard manual scoring according to AASM criteria. The data demonstrate that the software used in this study has an outstanding performance for computerized LM and PLM scoring, and LM and PLM indices generated with this software can be reliably integrated in the routine PSG report. This automatic analysis is also an excellent tool for research purposes.

  5. Investigation into the correlation between sensation and leg movement in restless legs syndrome.

    Science.gov (United States)

    Birinyi, Paul V; Allen, Richard P; Lesage, Susan; Dean, Terry; Earley, Christopher J

    2005-09-01

    We evaluated rest effects on restless legs syndrome (RLS) sensory and motor symptoms. During two 60-minute Suggested Immobilization Tests (SIT) subject's signals of RLS leg sensations and periodic leg movements while awake (PLMW) were recorded. Sensations, PLMW, sensations preceding or after PLMW, sensations occurring without following PLMW, and PLMW occurring without preceding sensation were determined. The RLS patients were divided into equal-sized high and low PLMW groups for further analysis. Data from 46 subjects (28 RLS and 18 controls) revealed sensations increased linearly with rest in RLS patients and controls. Movement rate increased linearly with rest for controls but increased rapidly for the first 45 minutes for all RLS patients. PLMW/hour increased with further rest for low but not high PLMW patients. Sensations followed by PLMW and PLMW without preceding sensations followed similar patterns. Sensations without subsequent PLMW increased dramatically in the last 15 minutes of the SITs. Whereas both sensory and motor signs of RLS increase with rest, there is minimal increase for controls. Patients with higher but not lower PLMW rates reached a ceiling for PLMW after 35 to 40 minutes. The temporal dissociation between sensory and motor events supports viewing these motor and sensory events as separate but loosely linked manifestations of RLS. (c) 2005 Movement Disorder Society.

  6. Leg stiffness and stride frequency in human running.

    Science.gov (United States)

    Farley, C T; González, O

    1996-02-01

    When humans and other mammals run, the body's complex system of muscle, tendon and ligament springs behaves like a single linear spring ('leg spring'). A simple spring-mass model, consisting of a single linear leg spring and a mass equivalent to the animal's mass, has been shown to describe the mechanics of running remarkably well. Force platform measurements from running animals, including humans, have shown that the stiffness of the leg spring remains nearly the same at all speeds and that the spring-mass system is adjusted for higher speeds by increasing the angle swept by the leg spring. The goal of the present study is to determine the relative importance of changes to the leg spring stiffness and the angle swept by the leg spring when humans alter their stride frequency at a given running speed. Human subjects ran on treadmill-mounted force platform at 2.5ms-1 while using a range of stride frequencies from 26% below to 36% above the preferred stride frequency. Force platform measurements revealed that the stiffness of the leg spring increased by 2.3-fold from 7.0 to 16.3 kNm-1 between the lowest and highest stride frequencies. The angle swept by the leg spring decreased at higher stride frequencies, partially offsetting the effect of the increased leg spring stiffness on the mechanical behavior of the spring-mass system. We conclude that the most important adjustment to the body's spring system to accommodate higher stride frequencies is that leg spring becomes stiffer.

  7. Microtubule-associated protein 2 (MAP2)--a promising approach to diagnosis of forensic types of hypoxia-ischemia.

    Science.gov (United States)

    Kühn, Johanna; Meissner, Christoph; Oehmichen, Manfred

    2005-12-01

    The loss of neuronal immunoreactivity of the cytoskeletal microtubule-associated protein 2 (MAP2) is known to be a marker of--at least--transient functional failure of neurons following ischemia. Because there are no specific neuropathological findings in forensic types of acute hypoxia-ischemia, detection of this relevant cause of death is often complicated and a reliable ischemic biomarker would be of great importance. We therefore investigated the neuronal immunoreactivity of MAP2 in human cases of forensic significance. A control group (n=27) was compared to a group of cases of hypoxia-ischemia (n=45), comprising death due to hanging (n=19), drowning (n=14) and carbon monoxide (CO) poisoning (n=12). Using immunohistochemical staining, the percentage of MAP2-positive neurons in the hippocampus (areas CA1-CA4) and frontal cortex (layers II-VI) was evaluated and compared. The hypoxia-ischemia group showed decreased MAP2 immunostaining in the hippocampal areas CA2-CA4 (P<0.05) and in cortical layers II-VI (P<0.001) compared to controls. Most vulnerable regions seem to be the hippocampal CA4 area and cortical layers III-V. Within the hypoxia-ischemia group, death due to CO poisoning was characterized by the lowest MAP2 immunoreactivity. The hypoxic-ischemic groups differ from controls by a distinct decrease of MAP2 immunostaining. Thus, the loss of MAP2 immunoreactivity may support the diagnosis of neuronal injury in forensic types of hypoxia-ischemia, although investigations on postmortem tissue must be interpreted cautiously.

  8. The AMPA antagonist, NBQX, protects against ischemia-induced loss of cerebellar Purkinje cells

    DEFF Research Database (Denmark)

    Balchen, T.; Diemer, Nils Henrik

    1992-01-01

    Neuropathology, NBQX, AMPA antagonist, cerebellar cells, ischemia, rats, Purkinje, neuronal death......Neuropathology, NBQX, AMPA antagonist, cerebellar cells, ischemia, rats, Purkinje, neuronal death...

  9. 78 FR 68909 - Agency Information Collection (Knee and Lower Leg Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-11-15

    ... AFFAIRS Agency Information Collection (Knee and Lower Leg Conditions Disability Benefits Questionnaire... Leg Conditions Disability Benefits Questionnaire)'' in any correspondence. FOR FURTHER INFORMATION... Control No. 2900-NEW (Knee and Lower Leg Conditions Disability Benefits Questionnaire)''....

  10. Single-leg squats can predict leg alignment in dancers performing ballet movements in “turnout”

    Directory of Open Access Journals (Sweden)

    Hopper LS

    2016-11-01

    Full Text Available Luke S Hopper,1 Nahoko Sato,2 Andries L Weidemann1 1Western Australian Academy of Performing Arts, Edith Cowan University, Mt Lawley, WA, Australia; 2Department of Physical Therapy, Nagoya Gakuin University, Seto, Japan Abstract: The physical assessments used in dance injury surveillance programs are often adapted from the sports and exercise domain. Bespoke physical assessments may be required for dance, particularly when ballet movements involve “turning out” or external rotation of the legs beyond that typically used in sports. This study evaluated the ability of the traditional single-leg squat to predict the leg alignment of dancers performing ballet movements with turnout. Three-dimensional kinematic data of dancers performing the single-leg squat and five ballet movements were recorded and analyzed. Reduction of the three-dimensional data into a one-dimensional variable incorporating the ankle, knee, and hip joint center positions provided the strongest predictive model between the single-leg squat and the ballet movements. The single-leg squat can predict leg alignment in dancers performing ballet movements, even in “turned out” postures. Clinicians should pay careful attention to observational positioning and rating criteria when assessing dancers performing the single-leg squat. Keywords: injury, motion capture, clinical assessment

  11. Single-leg squats can predict leg alignment in dancers performing ballet movements in “turnout”

    Science.gov (United States)

    Hopper, Luke S; Sato, Nahoko; Weidemann, Andries L

    2016-01-01

    The physical assessments used in dance injury surveillance programs are often adapted from the sports and exercise domain. Bespoke physical assessments may be required for dance, particularly when ballet movements involve “turning out” or external rotation of the legs beyond that typically used in sports. This study evaluated the ability of the traditional single-leg squat to predict the leg alignment of dancers performing ballet movements with turnout. Three-dimensional kinematic data of dancers performing the single-leg squat and five ballet movements were recorded and analyzed. Reduction of the three-dimensional data into a one-dimensional variable incorporating the ankle, knee, and hip joint center positions provided the strongest predictive model between the single-leg squat and the ballet movements. The single-leg squat can predict leg alignment in dancers performing ballet movements, even in “turned out” postures. Clinicians should pay careful attention to observational positioning and rating criteria when assessing dancers performing the single-leg squat. PMID:27895518

  12. CT perfusion during delayed cerebral ischemia after subarachnoid hemorrhage: distinction between reversible ischemia and ischemia progressing to infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cremers, Charlotte H.P. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vos, Pieter C. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Schaaf, Irene C. van der; Velthuis, Birgitta K.; Dankbaar, Jan Willem [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vergouwen, Mervyn D.I.; Rinkel, Gabriel J.E. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands)

    2015-09-15

    Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) can be reversible or progress to cerebral infarction. In patients with a deterioration clinically diagnosed as DCI, we investigated whether CT perfusion (CTP) can distinguish between reversible ischemia and ischemia progressing to cerebral infarction. From a prospectively collected series of aSAH patients, we included those with DCI, CTP on the day of clinical deterioration, and follow-up imaging. In qualitative CTP analyses (visual assessment), we calculated positive and negative predictive value (PPV and NPV) with 95 % confidence intervals (95%CI) of a perfusion deficit for infarction on follow-up imaging. In quantitative analyses, we compared perfusion values of the least perfused brain tissue between patients with and without infarction by using receiver-operator characteristic curves and calculated a threshold value with PPV and NPV for the perfusion parameter with the highest area under the curve. In qualitative analyses of 33 included patients, 15 of 17 patients (88 %) with and 6 of 16 patients (38 %) without infarction on follow-up imaging had a perfusion deficit during clinical deterioration (p = 0.002). Presence of a perfusion deficit had a PPV of 71 % (95%CI: 48-89 %) and NPV of 83 % (95%CI: 52-98 %) for infarction on follow-up. Quantitative analyses showed that an absolute minimal cerebral blood flow (CBF) threshold of 17.7 mL/100 g/min had a PPV of 63 % (95%CI: 41-81 %) and a NPV of 78 % (95%CI: 40-97 %) for infarction. CTP may differ between patients with DCI who develop infarction and those who do not. For this purpose, qualitative evaluation may perform marginally better than quantitative evaluation. (orig.)

  13. Role of ultrasound-guided continuous brachial plexus block in the management of neonatal ischemia in upper limb

    Directory of Open Access Journals (Sweden)

    Vrushali C Ponde

    2012-01-01

    Full Text Available Neonatal upper limb ischemia due to accidental arterial damage remains a major concern, which can lead to devastating complications if untreated. The primary objective of this case report is to emphasize the role of continuous infraclavicular brachial plexus block, the issues related with block performance in an ischemic hand, and the importance of ultrasound guidance in this particular case scenario. A 1.1 kg infant suffered from distal forearm ischemia due to accidental arterial damage, which was treated with brachial plexus block. An ultrasound-guided single shot block with 0.5 mL/kg of 0.25% bupivacaine was followed by ultrasound-guided catheter placement in the target area. A continuous infusion of 0.03% of bupivacaine at the rate of 0.5 mL/kg/hr (approx. 0.15 mg/kg/h of bupivacaine was administered for 36 h. This treatment resulted in reversal of ischemia. Permanent ischemic damage was eventually confined to the tips of 4 fingers. We conclude that ultrasound-guided continuous infraclavicular block has a therapeutic role to play in the treatment of hand ischemia due to arterial damage and subsequent arterial spasm in neonates with added benefits.

  14. Outcome of a Specific Compartment Fasciotomy Versus a Complete Compartment Fasciotomy of the Leg in One Patient With Bilateral Anterior Chronic Exertional Compartment Syndrome: A Case Report.

    Science.gov (United States)

    Tjeerdsma, Jason

    2016-01-01

    Chronic exertional compartment syndrome of the leg is a debilitating lower extremity condition in which increased intracompartmental pressure impedes blood flow to the involved compartments of the distal lower extremity, resulting in ischemia and pain. Owing to the lack of success with conservative management, most surgeons perform complete release fasciotomy as the preferred method of fasciotomy to avoid an unsuccessful release or outcome. Studies have been performed regarding the outcomes of complete compartmental release versus specific compartmental release, but no study has been performed comparing complete fasciotomy and compartment-specific fasciotomy in a single patient. The purpose of the present case report was to compare the efficacy of a complete fasciotomy versus a specific fasciotomy in 1 patient with properly diagnosed bilateral anterior compartment chronic exertional compartment syndrome with an 18-month follow-up period. The Lower Extremity Functional Scale and both subscales of the Foot and Ankle Ability Measure were administered to assess the functional outcomes. Circumferential measurements and range of motion photographs were taken to compare the objective data throughout the recovery process. In general, the range of motion, circumferential measurements, and functional outcome measure scores were better for the specific compartmental fasciotomy leg than for the complete fasciotomy leg during the recovery period. The overall functional outcomes were the same for both surgical approaches, with the specific fasciotomy leg returning to baseline function 13 to 23 days before the complete fasciotomy leg. The outcomes remained unchanged 18 months after surgery. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Artificial Leg Design and Control Research of a Biped Robot with Heterogeneous Legs Based on PID Control Algorithm

    Directory of Open Access Journals (Sweden)

    Hualong Xie

    2015-04-01

    Full Text Available A biped robot with heterogeneous legs (BRHL is proposed to provide an ideal test-bed for intelligent bionic legs (IBL. To make artificial leg gait better suited to a human, a four-bar mechanism is used as its knee joint, and a pneumatic artificial muscle (PAM is used as its driving source. The static mathematical model of PAM is established and the mechanical model of a single degree of freedom of a knee joint driven by PAM is analyzed. A control simulation of an artificial leg based on PID control algorithm is carried out and the simulation results indicate that the artificial leg can simulate precisely a normal human walking gait.

  16. A rare cause of chronic mesenteric ischemia from fibromuscular dysplasia: a case report

    Directory of Open Access Journals (Sweden)

    Senadhi Viplove

    2010-11-01

    Full Text Available Abstract Introduction Chronic mesenteric ischemia is a condition that is classically associated with significant atherosclerosis of the abdominal arteries, causing postprandial abdominal pain out of proportion to physical examination. The abdominal pain is exacerbated after meals due to the shunting of blood away from the intestines to the stomach, causing relative ischemia. More than 95% of chronic mesenteric ischemia cases are due to atherosclerosis. We report the first known case of chronic mesenteric ischemia from fibromuscular dysplasia. To the best of our knowledge, this is also the first known case in the literature where postprandial abdominal pain was the presenting symptom of fibromuscular dysplasia. Case presentation A 44-year-old Caucasian woman with a history of hypertension and preeclampsia, who had taken oral contraceptive pills for 15 years, presented with an intractable, colicky abdominal pain of two weeks duration. This abdominal pain worsened with oral intake. It was also associated with diarrhea and vomiting. Physical examination revealed stage III hypertension out of proportion to her risk factors and diffuse abdominal pain without peritoneal signs. An abdominal computed tomography scan, completed in the emergency room, revealed nonspecific colitis. Laboratory work revealed leukocytosis with a left shift, an erythrocyte sedimentation rate of 79 and a C-reactive protein level of 100. She was started on intravenous flagyl and intravenous ciprofloxacin. However, all microbial cultures were negative including three cultures for clostridium difficile. Urine analysis revealed nephritic range proteinuria. The laboratory profile was within normal limits for perinuclear-anti-neutrophil cytoplasmic antibody, cytoplasmic-anti-neutrophil cytoplasmic antibody, anti-saccharomyces cerevisiae antibody, antinuclear antibody test, celiac profile, lactate, carbohydrate antigen-125 and thyroid stimulating hormone. A colonoscopy was completed

  17. Association of Restless Legs Syndrome Variants in Korean Patients with Restless Legs Syndrome

    Science.gov (United States)

    Kim, Myeong-Kyu; Cho, Yong Won; Shin, Won Chul; Cho, Jae Wook; Shon, Young Min; Kim, Jee Hyun; Yang, Kwang Ik; Earley, Christopher J.; Allen, Richard P.

    2013-01-01

    Study Objectives: Recent genome-wide association studies (GWAS) for Caucasians identified several allelic variants associated with increased risk of developing restless legs syndrome (RLS), also known as Willis-Ekbom disease. Although the pathogenic mechanisms of RLS are not entirely understood, it is becoming increasingly evident that many diseases such as RLS can be attributed to an epistasis. The study objectives were to evaluate whether the associations of RLS with all loci determined in previous GWAS for Caucasians can be replicated significantly for the Korean population and to elucidate whether an epistasis plays a role in the pathogenesis of RLS. Design, Setting, and Participants: DNA from 320 patients with RLS and 320 age- and sex-matched controls were genotyped for variants in the RLS loci. Measurements and Results: A significant association was found for rs3923809 and rs9296249 in BTBD9 (P < 0.0001 and P = 0.001, respectively); the odds ratio (OR) for rs3923809 was 1.61 (P < 0.0001) to 1.88 (P < 0.0001) and the OR for rs9296249 was 1.44 (P = 0.001) to 1.73 (P = 0.002), according to the model of inheritance. The OR for the interaction between rs3923809 in BTBD9 and rs4626664 in PTPRD was 2.05 (P < 0.0001) in the additive model, 1.80 (P = 0.002) in the dominant model and 2.47 (P = 0.004) in the recessive model. There was no significant association between genotypes of all tested single nucleotide polymorphisms and the mean value of serum iron parameters. Conclusions: Our results suggest that the role of BTBD9 in the pathogenesis of restless legs syndrome is more universal across populations than previously reported and more efforts should be focused on the role of epistasis in the genetic architecture of restless legs syndrome. Citation: Kim MK; Cho YW; Shin WC; Cho JW; Shon YM; Kim JH; Yang KI; Earley CJ; Allen RP. Association of restless legs syndrome variants in Korean patients with restless legs syndrome. SLEEP 2013;36(12):1787-1791. PMID:24293752

  18. Cardiac MRI for myocardial ischemia.

    LENUS (Irish Health Repository)

    Daly, Caroline

    2013-01-01

    Proper assessment of the physiologic impact of coronary artery stenosis on the LV myocardium can affect patient prognosis and treatment decisions. Cardiac magnetic resonance imaging (CMR) assesses myocardial perfusion by imaging the myocardium during a first-pass transit of an intravenous gadolinium bolus, with spatial and temporal resolution substantially higher than nuclear myocardial perfusion imaging. Coupled with late gadolinium enhancement (LGE) imaging for infarction during the same imaging session, CMR with vasodilating stress perfusion imaging can qualitatively and quantitatively assess the myocardial extent of hypoperfusion from coronary stenosis independent of infarcted myocardium. This approach has been validated experimentally, and multiple clinical trials have established its diagnostic robustness when compared to stress single-photon emission computed tomography. In specialized centers, dobutamine stress CMR has been shown to have incremental diagnostic value above stress echocardiography due to its high imaging quality and ability to image the heart with no restriction of imaging window. This paper reviews the technical aspects, diagnostic utility, prognostic values, challenges to clinical adaptation, and future developments of stress CMR imaging.

  19. Cerebral ischemia produces laddered DNA fragments distinct from cardiac ischemia and archetypal apoptosis.

    Science.gov (United States)

    MacManus, J P; Fliss, H; Preston, E; Rasquinha, I; Tuor, U

    1999-05-01

    The electrophoretic pattern of laddered DNA fragments which has been observed after cerebral ischemia is considered to indicate that neurons are dying by apoptosis. Herein the authors directly demonstrate using ligation-mediated polymerase chain reaction methods that 99% of the DNA fragments produced after either global or focal ischemia in adult rats, or produced after hypoxia-ischemia in neonatal rats, have staggered ends with a 3' recess of approximately 8 to 10 nucleotides. This is in contrast to archetypal apoptosis in which the DNA fragments are blunt ended as seen during developmental programmed cell death in dying cortical neurons, neuroblastoma, or thymic lymphocytes. It is not simply ischemia that results in staggered ends in DNA fragments because ischemic myocardium is similar to archetypal apoptosis with a vast majority of blunt-ended fragments. It is concluded that the endonucleases that produce this staggered fragmentation of the DNA backbone in ischemic brain must be different than those of classic or type I apoptosis.

  20. A High Percentage of Beef Bull Pictures in Semen Catalogues Have Feet and Lower Legs that Are Not Visible

    Directory of Open Access Journals (Sweden)

    Marcy K. Franks

    2015-07-01

    Full Text Available A total of 1379 beef bull pictures were surveyed to determine visibility of feet and legs from four American semen company websites. Five different breeds were represented: Angus, Red Angus, Hereford (polled and horned, Simmental, and Charolais. In addition to visibility, data on other variables were collected to establish frequencies and correlations. These included breed, color, material that obscured visibility, such as grass, picture taken at livestock show or outside, semen company, photographer, video, and age of bull. A foot and leg visibility score was given to each bull picture. Only 19.4% of the pictures had fully visible feet and legs. Both the hooves and dewclaws were hidden on 32.5% of the pictures. Correlation between bull’s birthdate and the first four visibility scores was statistically significant (P < 0.0001. As age increased the feet and legs were more likely to be visible in the bull’s picture. This may possibly be due to greater availability of both photo editing software and digital photography. One positive finding was that 6% of the bulls had a video of the bull walking which completely showed his feet and legs.

  1. Ischemia induced by coronary steal through a patent mammary artery side branch: a role for embolization.

    Science.gov (United States)

    Moreno, Nuno; da Silva Castro, Alexandra; Pereira, Adriana; Silva, João Carlos; Almeida, Pedro Bernardo; Andrade, Aurora; Maciel, Maria Júlia; Pinto, Paula

    2013-06-01

    Non-occlusion of the internal mammary artery side branches may cause ischemia due to flow diversion after coronary artery bypass grafting. The authors present the case of a 67-year-old man with recurrent angina after undergoing myocardial revascularization with a left internal mammary artery to left anterior descending bypass. He presented with impaired anterior wall myocardial perfusion in the setting of a patent left internal mammary artery side branch. Effective percutaneous treatment was carried out through coil embolization, with improved flow and clinical symptoms, confirmed through ischemia testing. Coronary steal through a patent mammary artery side branch is a controversial phenomenon and this type of intervention should be considered only in carefully selected patients.

  2. Analysis of Foot Slippage Effects on an Actuated Spring-mass Model of Dynamic Legged Locomotion

    Directory of Open Access Journals (Sweden)

    Yizhar Or

    2016-04-01

    Full Text Available The classical model of spring-loaded inverted pendulum (SLIP and its extensions have been widely accepted as a simple description of dynamic legged locomotion at various scales in humans, legged robots and animals. Similar to the majority of models in the literature, the SLIP model assumes ideal sticking contact of the foot. However, there are practical scenarios of low ground friction that causes foot slippage, which can have a significant influence on dynamic behaviour. In this work, an extension of the SLIP model with two masses and torque actuation is considered, which accounts for possible slippage under Coulomb’s friction law. The hybrid dynamics of this model is formulated and numerical simulations under representative parameter values reveal several types of stable periodic solutions with stick slip transitions. Remarkably, it is found that slippage due to low friction can sometimes increase average speed and improve energetic efficiency by significantly reducing the mechanical cost of transport.

  3. Biomimetic Spider Leg Joints: A Review from Biomechanical Research to Compliant Robotic Actuators

    Directory of Open Access Journals (Sweden)

    Stefan Landkammer

    2016-07-01

    Full Text Available Due to their inherent compliance, soft actuated joints are becoming increasingly important for robotic applications, especially when human-robot-interactions are expected. Several of these flexible actuators are inspired by biological models. One perfect showpiece for biomimetic robots is the spider leg, because it combines lightweight design and graceful movements with powerful and dynamic actuation. Building on this motivation, the review article focuses on compliant robotic joints inspired by the function principle of the spider leg. The mechanism is introduced by an overview of existing biological and biomechanical research. Thereupon a classification of robots that are bio-inspired by spider joints is presented. Based on this, the biomimetic robot applications referring to the spider principle are identified and discussed.

  4. Effect of stochastic modulation of inter-pulse interval during stimulated isokinetic leg extension

    Directory of Open Access Journals (Sweden)

    Efe Anil Aksöz

    2016-07-01

    Full Text Available Recumbent cycling exercise achieved by functional electrical stimulation (FES of the paralyzed leg muscles is effective for cardiopulmonary and musculoskeletal conditioning after spinal cord injury, but its full potential has not yet been realized. Mechanical power output and efficiency is very low and endurance is limited due to early onset of muscle fatigue. The aim of this work was to compare stochastic modulation of the inter-pulse interval (IPI to constant-frequency stimulation during an isokinetic leg extension task similar to FES-cycling. Seven able-bodied subjects participated: both quadriceps muscles were stimulated (n = 14 with two activation patterns (P1-constant frequency, P2-stochastic IPI. There was significantly higher power output with P2 during the first 30 s (p = 0.0092, the last 30 s (p = 0.018 and overall (p = 0.0057, but there was no overall effect on fatiguability when stimulation frequency was randomly modulated.

  5. Effect of Stochastic Modulation of Inter-Pulse Interval During Stimulated Isokinetic Leg Extension

    Science.gov (United States)

    Aksöz, Efe Anil; Laubacher, Marco; Binder-Macleod, Stuart; Hunt, Kenneth J.

    2016-01-01

    Recumbent cycling exercise achieved by functional electrical stimulation (FES) of the paralyzed leg muscles is effective for cardiopulmonary and musculoskeletal conditioning after spinal cord injury, but its full potential has not yet been realized. Mechanical power output and efficiency is very low and endurance is limited due to early onset of muscle fatigue. The aim of this work was to compare stochastic modulation of the inter-pulse interval (IPI) to constant-frequency stimulation during an isokinetic leg extension task similar to FES-cycling. Seven able-bodied subjects participated: both quadriceps muscles were stimulated (n = 14) with two activation patterns (P1-constant frequency, P2-stochastic IPI). There was significantly higher power output with P2 during the first 30 s (p = 0.0092), the last 30 s (p = 0.018) and overall (p = 0.0057), but there was no overall effect on fatiguability when stimulation frequency was randomly modulated. PMID:27990242

  6. The relationship among restless legs syndrome (Willis-Ekbom Disease), hypertension, cardiovascular disease, and cerebrovascular disease.

    Science.gov (United States)

    Ferini-Strambi, Luigi; Walters, Arthur S; Sica, Domenic

    2014-06-01

    Untreated sleep disorders may contribute to secondary causes of uncontrolled hypertension, cardiovascular disease (CVD), and stroke. Restless legs syndrome, or Willis-Ekbom Disease (RLS/WED), is a common sensorimotor disorder with a circadian rhythmicity defined by an uncontrollable urge to move the legs that worsens during periods of inactivity or at rest in the evening, often resulting in sleep disruptions. Sleep disorders such as insomnia and obstructive sleep apnea (OSA) are established risk factors for increased risk of hypertension and vascular diseases. This literature review outlines the lessons learned from studies demonstrating insomnia and OSA as risk factors for hypertension and vascular diseases to support the epidemiologic and physiologic evidence suggesting a similar increase in hypertension and vascular disease risk due to RLS. Understanding the relationships between RLS and hypertension, CVD, and stroke has important implications for reducing the risks associated with these diseases.

  7. Leg stiffness primarily depends on ankle stiffness during human hopping.

    Science.gov (United States)

    Farley, C T; Morgenroth, D C

    1999-03-01

    When humans hop in place or run forward, they adjust leg stiffness to accommodate changes in stride frequency or surface stiffness. The goal of the present study was to determine the mechanisms by which humans adjust leg stiffness during hopping in place. Five subjects hopped in place at 2.2 Hz while we collected force platform and kinematic data. Each subject completed trials in which they hopped to whatever height they chose ("preferred height hopping") and trials in which they hopped as high as possible ("maximum height hopping"). Leg stiffness was approximately twice as great for maximum height hopping as for preferred height hopping. Ankle torsional stiffness was 1.9-times greater while knee torsional stiffness was 1.7-times greater in maximum height hopping than in preferred height hopping. We used a computer simulation to examine the sensitivity of leg stiffness to the observed changes in ankle and knee stiffness. Our model consisted of four segments (foot, shank, thigh, head-arms-trunk) interconnected by three torsional springs (ankle, knee, hip). In the model, increasing ankle stiffness by 1.9-fold, as observed in the subjects, caused leg stiffness to increase by 2.0-fold. Increasing knee stiffness by 1.7-fold had virtually no effect on leg stiffness. Thus, we conclude that the primary mechanism for leg stiffness adjustment is the adjustment of ankle stiffness.

  8. Evaluation of Thermoelectric Performance and Durability of Functionalized Skutterudite Legs

    Science.gov (United States)

    Skomedal, Gunstein; Kristiansen, Nils R.; Sottong, Reinhard; Middleton, Hugh

    2017-04-01

    Thermoelectric generators are a promising technology for waste heat recovery. As new materials and devices enter a market penetration stage, it is of interest to employ fast and efficient measurement methods to evaluate the long-term stability of thermoelectric materials in combination with metallization and coating (functionalized thermoelectric legs). We have investigated a method for measuring several thermoelectric legs simultaneously. The legs are put under a common temperature gradient, and the electrical characteristics of each leg are measured individually during thermal cycling. Using this method, one can test different types of metallization and coating applied to skutterudite thermoelectric legs and look at the relative changes over time. Postcharacterization of these initial tests with skutterudite legs using a potential Seebeck microprobe and an electron microscope showed that oxidation and interlayer diffusion are the main reasons for the gradual increase in internal resistance and the decrease in open-circuit voltage. Although we only tested skutterudite material in this work, the method is fully capable of testing all kinds of material, metallization, and coating. It is thus a promising method for studying the relationship between failure modes and mechanisms of functionalized thermoelectric legs.

  9. EEG Monitoring in Cerebral Ischemia: Basic Concepts and Clinical Applications

    NARCIS (Netherlands)

    van Putten, Michel Johannes Antonius Maria; Hofmeijer, Jeannette

    2016-01-01

    EEG is very sensitive to changes in neuronal function resulting from ischemia. The authors briefly review essentials of EEG generation and the effects of ischemia on the underlying neuronal processes. They discuss the differential sensitivity of various neuronal processes to energy limitations, incl

  10. Serum Markers and Intestinal Mucosal Injury in Chronic Gastrointestinal Ischemia

    NARCIS (Netherlands)

    D. van Noord (Désirée); P.B.F. Mensink (Peter); R.J. de Knegt (Robert); M. Ouwendijk (Martine); J. Francke (Jan Paul); A.J. van Vuuren (Hanneke); B.E. Hansen (Bettina); E.J. Kuipers (Ernst)

    2010-01-01

    textabstractBackground: Diagnosing chronic gastrointestinal ischemia (CGI) is a challenging problem in clinical practice. Serum markers for CGI would be of great diagnostic value as a non-invasive test method. Aims: This study investigated serum markers in patients with well-defined ischemia. Furthe

  11. Review on herbal medicine on brain ischemia and reperfusion简

    Institute of Scientific and Technical Information of China (English)

    Nahid; Jivad; Zahra; Rabiei

    2015-01-01

    Brain ischemia and reperfusion is the leading cause of serious and long-range disability in the world. Clinically significant changes in central nervous system function are observed following brain ischemia and reperfusion. Stroke patients exhibit behavioral, cognitive,emotional, affective and electrophysiological changes during recovery phase. Brain injury by transient complete global brain ischemia or by transient incomplete brain ischemia afflicts a very large number of patients in the world with death or permanent disability. In order to reduce this damage, we must sufficiently understand the mechanisms involved in brain ischemia and reperfusion and repair to design clinically effective therapy.Cerebral ischemia and reperfusion is known to induce the generation of reactive oxygen species that can lead to oxidative damage of proteins, membrane lipids and nucleic acids.A decrease in tissue antioxidant capacity, an increase in lipid peroxidation as well as an increase in lipid peroxidation inhibitors have been demonstrated in several models of brain ischemia. This paper reviews the number of commonly used types of herbal medicines effective for the treatment of stroke. The aim of this paper was to review evidences from controlled studies in order to discuss whether herbal medicine can be helpful in the treatment of brain ischemia and reperfusion.

  12. Review on herbal medicine on brain ischemia and reperfusion

    Institute of Scientific and Technical Information of China (English)

    Nahid Jivad; Zahra Rabiei

    2015-01-01

    Brain ischemia and reperfusion is the leading cause of serious and long-range disability in the world. Clinically significant changes in central nervous system function are observed following brain ischemia and reperfusion. Stroke patients exhibit behavioral, cognitive, emotional, affective and electrophysiological changes during recovery phase. Brain injury by transient complete global brain ischemia or by transient incomplete brain ischemia afflicts a very large number of patients in the world with death or permanent disability. In order to reduce this damage, we must sufficiently understand the mechanisms involved in brain ischemia and reperfusion and repair to design clinically effective therapy. Cerebral ischemia and reperfusion is known to induce the generation of reactive oxygen species that can lead to oxidative damage of proteins, membrane lipids and nucleic acids. A decrease in tissue antioxidant capacity, an increase in lipid peroxidation as well as an increase in lipid peroxidation inhibitors have been demonstrated in several models of brain ischemia. This paper reviews the number of commonly used types of herbal medicines effective for the treatment of stroke. The aim of this paper was to review evidences from controlled studies in order to discuss whether herbal medicine can be helpful in the treatment of brain ischemia and reperfusion.

  13. Mesenteric ischemia after abdominal aortic aneurysm repair : a systemic review

    NARCIS (Netherlands)

    Bruggink, J. L. M.; Tielliu, I. F. J.; Zeebregts, C. J.; Pol, R. A.

    2014-01-01

    Mesenteric ischemia after abdominal aneurysm repair is a devastating complication with mortality rates up to 70%. Incidence however is relatively low. The aim of this review was to provide an overview on current insights, diagnostic modalities and on mesenteric ischemia after abdominal aortic aneury

  14. Anterior Segment Ischemia after Strabismus Surgery

    Science.gov (United States)

    Göçmen, Emine Seyhan; Atalay, Yonca; Evren Kemer, Özlem; Sarıkatipoğlu, Hikmet Yavuz

    2017-01-01

    A 46-year-old male patient was referred to our clinic with complaints of diplopia and esotropia in his right eye that developed after a car accident. The patient had right esotropia in primary position and abduction of the right eye was totally limited. Primary deviation was over 40 prism diopters at near and distance. The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle recession. Ten months after the first operation, full-thickness tendon transposition of the superior and inferior rectus muscles (with Foster suture) was performed. On the first postoperative day, slit-lamp examination revealed corneal edema, 3+ cells in the anterior chamber and an irregular pupil. According to these findings, the diagnosis was anterior segment ischemia. Treatment with 0.1/5 mL topical dexamethasone drops (16 times/day), cyclopentolate hydrochloride drops (3 times/day) and 20 mg oral fluocortolone (3 times/day) was initiated. After 1 week of treatment, corneal edema regressed and the anterior chamber was clean. Topical and systemic steroid treatment was gradually discontinued. At postoperative 1 month, the patient was orthophoric and there were no pathologic symptoms besides the irregular pupil. Anterior segment ischemia is one of the most serious complications of strabismus surgery. Despite the fact that in most cases the only remaining sequel is an irregular pupil, serious circulation deficits could lead to phthisis bulbi. Clinical properties of anterior segment ischemia should be well recognized and in especially risky cases, preventative measures should be taken. PMID:28182149

  15. Restless legs syndrome in patients on dialysis

    Directory of Open Access Journals (Sweden)

    Al-Jahdali Hamdan

    2009-01-01

    Full Text Available Restless legs syndrome (RLS is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG. This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH, Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC, Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG′s RLS Questionnaire (RLSQ. Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 ± 17.2 years and mean duration on dialysis 40.4 ± 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM, coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively. Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS (P= < 0.001 and 0.001, respectively. Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis

  16. Restless legs syndrome in patients on dialysis.

    Science.gov (United States)

    Al-Jahdali, Hamdan H; Al-Qadhi, Waleed A; Khogeer, Haithm A; Al-Hejaili, Fayez F; Al-Ghamdi, Saeed M; Al Sayyari, Abdullah A

    2009-05-01

    Restless legs syndrome (RLS) is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG). This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD) on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH), Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC), Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG's RLS Questionnaire (RLSQ). Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 +/- 17.2 years and mean duration on dialysis 40.4 +/- 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM), coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively). Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS) (P= < 0.001 and 0.001, respectively). Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis and

  17. [Pain in venous thrombosis of the leg].

    Science.gov (United States)

    Henriet, J P

    1992-01-01

    According to D. Reinharez, pain and edema are the commonest presenting symptoms in phlebology. Pain is one of the most classical symptoms of an ordinary deep venous thrombosis, a valuable feature when present, in the form of deep tension, heaviness, swelling and a feeling of dead weight. It is often absent or slight. It may consist merely of a dull cramp, or of an "undefinable" (C. Bourde) odd, heavy leg. It generally affects the calf but may involve the sole of the foot, the heel, the thigh, the groin or even the true pelvis. This feeling, although "imprecise and variable" (P. Wallois, P. Griton) is highly suggestive. It increases on standing and walking in the form of unilateral uncomfortable tension, heaviness or painful swelling, which maybe a source of worry or even anxiety to the patient. Tenderness on palpation of venous tracts and their stretching is more suggestive. In the opinion of M. Duruble, Neuhof's sign (feeling of tender fullness of the calf) is more reliable than Homans' sign (pain in the calf caused by passive dorsiflexion of the foot, with the lower limb in extension) which essentially stretches only the posterior tibial venous system. The value of Sigg's sign (pain in the popliteal fossa on passive extension of the knee) is controversial. Far more rare is phlegmasia coerulea dolens or Grégoire's blue leg, complicating phlegmasia alba dolens or of sudden onset, with initial very severe or even "intolerable" pain (J.J. Pinot) in Scarpa's triangle, rapidly spreading to the limb. In varicose phlebitis (M. Perrin) or superficial thrombophlebitis or varico-phlebitis (A.A. Ramelet) or superficial venitis (J.P. Henriet), pain most often consists of moderate burning tension overlying the thrombosed vein(s), increased by palpation and mobilisation. Sometimes severe initially, it is exacerbated by the slightest touch. In total, pain, regardless of its characteristics, its site and/or its severity, is one of the most constant clinical features of venous

  18. Digital Ischemia in Scleroderma Spectrum of Diseases

    Directory of Open Access Journals (Sweden)

    Elena Schiopu

    2010-01-01

    Full Text Available Systemic Sclerosis (Scleroderma, SSc is a disease of unknown etiology characterized by widespread vasculopathy and extracellular matrix deposition leading to fibrosis and autoimmune processes. Digital ischemia (digital ulcers (DUs is the hallmark of SSc-related vasculopathy and is characterized by endothelial dysfunction leading to intimal proliferation and thrombosis. It happens frequently (30% of the patients each year and it is associated with significant morbidity. This paper summarizes the current information regarding pathogenesis, definitions, management, and exploratory therapies in DUs associated with SSc.

  19. Silent ischemia and beta-blockade

    DEFF Research Database (Denmark)

    Egstrup, K

    1991-01-01

    and should also be directed at the other coronary artery risk factors of the patients. The effects of beta-blockers, which reduce the duration and frequency of silent ischemic episodes, is well described. The effect is most pronounced in the morning, when the frequency of ischemia is highest......, and the mechanism of action seems mainly mediated through a reduction in myocardial oxygen demand. beta-Blockers have shown effectiveness in both effort-induced angina and mixed angina, and increased anti-ischemic potency may be achieved by combination therapy with a calcium antagonist. Abrupt withdrawal of beta-blockers...

  20. Intracoronary levosimendan during ischemia prevents myocardial apoptosis.

    Directory of Open Access Journals (Sweden)

    Markus eMalmberg

    2012-02-01

    Full Text Available Background. Levosimendan is a calcium-sensitizing inotropic agent that prevents myocardial contractile depression following cardiac surgery. Levosimendan has also anti-apoptotic properties, but the role of this mechanism is not clear. We studied whether levosimendan prevents cardiomyocyte apoptosis and post-operative stunning after either intracoronary administration or intravenous infusion in an experimental model. Methods. Pigs (n=24 were subjected to 40 minutes of global, cardioplegic ischemia under cardiopulmonary bypass and 240 minutes of reperfusion. L-IV group received intravenous infusion of levosimendan (65 μg/kg 40 minutes before ischemia and L-IC group received levosimendan (65 μg/kg during ischemia administered intracoronary. Control group was operated without levosimendan. Echocardiography was performed to all animals. Apoptosis was determined from transmyocardial biopsies taken from left ventricle using TUNEL assay and immunohistochemistry of active caspace-3. Results. Apoptosis was induced after ischemia-reperfusion in all groups (pre L-IV 0.002±0.004 % vs. post L-IV 0.020±0.017 % p=0.02, pre L-IC 0.001±0.004 % vs. post L-IC 0.020±0.017 % p<0.001, pre control 0.007±0.013 % vs. post control 0.062±0.044 % p=0.01. The amount of apoptosis was higher in the controls, compared with the L-IV (p=0.03 and the L-IC (p=0.03 groups. Longitudinal left ventricular contraction was significantly reduced in the L-IC and the control groups when compared to the L-IV group (L-IV 0.75±0.12 mm vs. L-IC 0.53±0.11 mm p=0.003, L-IV vs. control 0.54±0.11 p=0.01. Conclusions. Both intracoronary administration and pre-ischemic intravenous infusion of levosimendan equally prevented apoptosis, but intravenous administration was required for optimal preservation of the post-operative systolic left ventricle function.

  1. Hydrogen Ion Buffering During Complete Brain Ischemia

    OpenAIRE

    Kraig, Richard P.; PULSINELLI, WILLIAM A.; Plum, Fred

    1985-01-01

    As a first step to quantify [H+] changes in brain during ischemia we used H+-selective microelectrodes and enzyme fluorometric techniques to describe the relationship between interstitial [H+] ([H+]o) and peak tissue lactate after cardiac arrest. We found a step function relationship between [H+]o and tissue lactate rather than the linear titration expected in a homogeneous protein solution. Within a blood glucose range from 3–7 mM, brain lactate rose from 8–13 mmol/kg along with a rise in [H...

  2. Cocaine-associated lower limb ischemia.

    LENUS (Irish Health Repository)

    Collins, Chris G

    2011-07-25

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

  3. Sympathetic nervous system activation reduces contraction-induced rapid vasodilation in the leg of humans independent of age.

    Science.gov (United States)

    Hughes, William E; Kruse, Nicholas T; Casey, Darren P

    2017-07-01

    Contraction-induced rapid vasodilation is attenuated similarly in the upper and lower limbs of older adults. In the forearm, this attenuation is in part due to a greater sympathetic vasoconstriction. We examined whether the age-related reduction in contraction-induced vasodilation in the leg is also due to a sympathetic vasoconstrictive mechanism. Thirteen young (24 ± 1 yr) and twelve older adults (67 ± 1 yr) performed single-leg knee extension at 20 and 40% of work-rate maximum (WRmax) during control and cold-pressor test (CPT) conditions. Femoral artery diameter and blood velocity were measured using Doppler ultrasound. Vascular conductance (VC; ml·min(-1)·mmHg(-1)) was calculated using blood flow (ml/min) and mean arterial pressure (mmHg). Peak (ΔVC from baseline) and total VC were blunted in older adults during control conditions across exercise intensities (P ROV). Within the forearm, this attenuation is partially due to enhanced sympathetic vasoconstriction. In the current study, we found that sympathetic vasoconstriction reduces contraction-induced ROV within the leg of both young and older adults, with the magnitude of change being similar between age groups. Our current results suggest that age-related attenuations in contraction-induced ROV within the leg are not fully explained by a sympathetic vasoconstrictor mechanism. Copyright © 2017 the American Physiological Society.

  4. Ischemia reperfusion injury, ischemic conditioning and diabetes mellitus.

    Science.gov (United States)

    Lejay, Anne; Fang, Fei; John, Rohan; Van, Julie A D; Barr, Meredith; Thaveau, Fabien; Chakfe, Nabil; Geny, Bernard; Scholey, James W

    2016-02-01

    Ischemia/reperfusion, which is characterized by deficient oxygen supply and subsequent restoration of blood flow, can cause irreversible damages to tissue. Mechanisms contributing to the pathogenesis of ischemia reperfusion injury are complex, multifactorial and highly integrated. Extensive research has focused on increasing organ tolerance to ischemia reperfusion injury, especially through the use of ischemic conditioning strategies. Of morbidities that potentially compromise the protective mechanisms of the heart, diabetes mellitus appears primarily important to study. Diabetes mellitus increases myocardial susceptibility to ischemia reperfusion injury and also modifies myocardial responses to ischemic conditioning strategies by disruption of intracellular signaling responsible for enhancement of resistance to cell death. The purpose of this review is twofold: first, to summarize mechanisms underlying ischemia reperfusion injury and the signal transduction pathways underlying ischemic conditioning cardioprotection; and second, to focus on diabetes mellitus and mechanisms that may be responsible for the lack of effect of ischemic conditioning strategies in diabetes.

  5. Optimal Airline Multi-Leg Flight Seat Inventory Control

    Science.gov (United States)

    Nechval, Nicholas A.; Rozite, Kristine; Strelchonok, Vladimir F.

    2006-06-01

    In this paper, the problem of determining optimal booking policy for multiple fare classes in a pool of identical seats for multi-leg flights is considered. For large commercial airlines, efficiently setting and updating seat allocation targets for each passenger category on each multi-leg flight is an extremely difficult problem. This paper presents static and dynamic policies of allocation of airline seats for multi-leg flights with multiple fare classes, which allow one to maximize an expected contribution to profit. The dynamic policy uses the most recent demand and capacity information and allows one to allocate seats dynamically with anticipation over time. A numerical example is given.

  6. Evaluation of leg varicose veins by MR venography

    Energy Technology Data Exchange (ETDEWEB)

    Kojima, Yoshifumi; Shiraishi, Tomokuni; Taira, Mitsuru [Kansai Medical Univ., Neyagawa, Osaka (Japan). Kohri Hospital; Imamura, Atsushi; Yamada, Hitoshi; Okuno, Masafumi; Kamiyama, Yasuo

    1998-11-01

    Preoperative evaluation was conducted on 30 patients with leg varicose veins by MR venography (MRV), and compared with conventional venography, MR images were performed by the 3D-SMASH Method. Compared with venography, MRV could more clearly demonstrate leg varicose veins with perforating veins than venography. It could detected fine varicose veins more than 2 mm in diameter, and deep veins. Furthermore, 3D observation enables accurate detection of the location of perforating vein. In conclusion, MRV is useful for the diagnosis of leg varicose vein. (author)

  7. Restless Leg Syndrome in Neurologic and Medical Disorders.

    Science.gov (United States)

    Askenasy, Nadir; Askenasy, Jean-Jacques

    2015-09-01

    Adopting prior models of sleep-wake transitions, a flip-flop switch in synchronized neurotransmitter activity is proposed to underlie restless leg syndrome onset. In this model, leg quiescence homeostasis sustained through concerted activities of several neurotransmitters in basal ganglia is perturbed and produces striatal motor activity along sensory activity associated with thalamocortical circuits (conscious urge and discomfort). This model explains the association of restless leg syndrome with a wide variety of associated pathologies emphasizing that perturbed function and imbalance may occur under different steady states of neurotransmitter levels. Likewise, this concept links various central and peripheral etiologies and integrates the augmenting and transient effects of therapeutic neuromodulators.

  8. Progress in the research on back and leg pain in fighter pilots%歼击机飞行员腰腿痛研究进展

    Institute of Scientific and Technical Information of China (English)

    刘侃; 任东风; 吴闻文

    2013-01-01

    Back and leg pain is a set of common clinical syndrome in pilots. It is also a kind of common occupational disease which influences pilots’ health and normal training seriously. Back and leg pain is not an independent disease, it is a group of diseases consisting of spine, nerve root and soft tissue. The reasons of back and leg pain include lumbar disc herniation, lumbar muscle strain, bone hyperplasia, benign arthritis, spinal stenosis, lumbar fractures and so on. The prevalence of back and leg pain in pilots is high, especially in fighter pilots due to their special working environment such as the cramped cockpit and aerial aerobatics. Fighter pilots form a major part which could influence combat effectiveness of air force. The cause of back and leg pain in fighter pilots may be the pilot’s position, the high load of fighter plane, flight time, age and so on. Back and leg pain of fighter pilots can lead to the dysphoria and affect the quality of flight directly. It is an important factor which affects combat effectiveness of flight troops and flight safety. Back and leg pain also influences the health, training and implementation tasks of fighter pilots. Therefore, propaganda, education, training of psoas, and research on protective measures are all of great significance. Now in this paper, the works done concerning epidemiology, etiology, and the prevention and treatment of back and leg pain in fighter pilots are reviewed and discussed to attract enough attention of flight surgeons for the enhancement of understanding and treatment of back and leg pain in fighter pilots, and to improve aviation medical support.

  9. Primary headaches in restless legs syndrome patients

    Directory of Open Access Journals (Sweden)

    Ravi Gupta

    2012-01-01

    Full Text Available Earlier studies conducted among migraineurs have shown an association between migraine and restless legs syndrome (RLS. We chose RLS patients and looked for migraine to exclude sample bias. Materials and Methods: 99 consecutive subjects of idiopathic RLS were recruited from the sleep clinic during four months period. Physician diagnosis of headache and depressive disorder was made with the help of ICHD-2 and DSM-IV-TR criteria, respectively. Sleep history was gathered. Severity of RLS and insomnia was measured using IRLS (Hindi version and insomnia severity index Hindi version, respectively. Chi-square test, one way ANOVA and t-test were applied to find out the significance. Results: Primary headache was seen in 51.5% cases of RLS. Migraine was reported by 44.4% subjects and other types of ′primary headaches′ were reported by 7.1% subjects. Subjects were divided into- RLS; RLS with migraine and RLS with other headache. Females outnumbered in migraine subgroup (χ2 =16.46, P<0.001. Prevalence of depression (χ2 =3.12, P=0.21 and family history of RLS (χ2 =2.65, P=0.26 were not different among groups. Severity of RLS (P=0.22 or insomnia (P=0.43 were also similar. Conclusion: Migraine is frequently found in RLS patients in clinic based samples. Females with RLS are prone to develop migraine. Depression and severity of RLS or insomnia do not affect development of headache.

  10. Clinical correlates of the restless legs syndrome

    Directory of Open Access Journals (Sweden)

    Luis Fabiano Marin

    2012-07-01

    Full Text Available OBJECTIVE: To determine the clinical correlates of the restless legs syndrome (RLS in a Brazilian sleep disorders center. METHODS: We retrospectively studied 118 patients with RLS from January, 2004, to December, 2010. The analyzed variables were: age at disease onset, gender, race, years of school instruction, primary and secondary RLS, and treatment options. RESULTS: Among the studied patients, 83.9% were women with a female/male sex ratio of 5:1. Mean age of the patients at symptom onset ± standard deviation was 41.7±17.9 years-old. The primary RLS was found in 85% of patients. The other 15% remainders consisted of secondary forms, and they were associated with neuropathy, iron deficiency anemia, end-stage renal disease, or Parkinson's disease. Drug therapy for RLS was introduced in 67% of patients. CONCLUSIONS: Most patients presented primary RLS with an early disease onset. Further epidemiological studies are welcomed to provide better information on secondary RLS in Brazil.

  11. Restless legs syndrome and pregnancy: A review

    Science.gov (United States)

    Srivanitchapoom, Prachaya; Pandey, Sanjay; Hallett, Mark

    2014-01-01

    Restless legs syndrome (RLS) is a common sensorimotor neurological disorder that is diagnosed according to the revised criteria of the International RLS Study Group (IRLSSG). The pathophysiology of RLS is still unknown and its prevalence is influenced by ethnicity, age, and gender. RLS is divided into two types by etiology: primary or idiopathic and secondary. Primary RLS is strongly influenced by a genetic component while secondary RLS is caused by other associated conditions such as end-stage renal disease or peripheral neuropathy. Another common condition associated with RLS is pregnancy. The prevalence of RLS during pregnancy is two to three times higher than in the normal population and is influenced by the trimester and the number of parity. The main mechanisms that may contribute to the pathophysiology of RLS during pregnancy are hormonal changes and iron and folate status. Standard medications for treating RLS during pregnancy are not established. Most medications have been used according to the evidence from non-pregnant patients. Therefore, consideration of the medical treatment for treating RLS during pregnancy should be balanced between the benefit of relieving the symptoms and maternal and fetal risk. In general, the prognosis of RLS during pregnancy is good and symptoms are usually relieved after delivery. PMID:24768121

  12. Restless legs syndrome associated with major diseases

    Science.gov (United States)

    Allen, Richard; Högl, Birgit; Paulus, Walter

    2016-01-01

    Recent publications on both the genetics and environmental factors of restless legs syndrome (RLS) defined as a clinical disorder suggest that overlapping genetic risk factors may play a role in primary (idiopathic) and secondary (symptomatic) RLS. Following a systematic literature search of RLS associated with comorbidities, we identified an increased prevalence of RLS only in iron deficiency and kidney disease. In cardiovascular disease, arterial hypertension, diabetes, migraine, and Parkinson disease, the methodology of studies was poor, but an association might be possible. There is insufficient evidence for conditions such as anemia (without iron deficiency), chronic obstructive pulmonary disease, multiple sclerosis, headache, stroke, narcolepsy, and ataxias. Based on possible gene–microenvironmental interaction, the classifications primary and secondary RLS may suggest an inappropriate causal relation. We recognize that in some conditions, treatment of the underlying disease should be achieved as far as possible to reduce or eliminate RLS symptoms. RLS might be seen as a continuous spectrum with a major genetic contribution at one end and a major environmental or comorbid disease contribution at the other. PMID:26944272

  13. [Innovative therapy for leg ulcers: Electrostimulation].

    Science.gov (United States)

    Maillard, H

    2015-01-01

    Chronic wounds can take a long time to heal despite appropriate therapy based upon aetiology and use of suitable dressings. The success of electrostimulation is based upon the existence within the skin of the endogenous currents involved in the wound healing process. Where skin continuity is broken by a wound, these electrical potentials are short-circuited, resulting in leakage of electrical current. Woundel(®) therapy is the only such treatment currently available in France and is based on the use of continuous pulsed current that generates an electrical field near the endogenous electrical fields. It utilises a console to deliver the electrical impulses, a dressing electrode and a dispersion electrode. The electrode dressing is left on the wound for 3 days, and venous compression bandaging may be applied to the leg, taking care to leave the connector free. Negative polarity stimulates migration of fibroblasts, resulting in elimination of fibrin. Positive polarity causes keratinocyte migration, which in turn leads to epidermisation. Electrostimulation is of recognised utility in the healing of chronic wounds: it has been assigned a high-level recommendation in the European and American guidelines for the treatment of venous ulcers and bedsores with proof level of A. Further, the analgesic effect of electrostimulation has been demonstrated in several studies. Electrostimulation is already well developed in France among wound specialists, but prospective studies are planned so that it may be used at patients' homes.

  14. Athermal laser treatment of the diabetic leg

    Science.gov (United States)

    Ignat, P.; Suteanu, S.; Brojbeanu, Gabriela; Vasiliu, Virgil V.

    1995-03-01

    This work shows the result obtained in the medical clinic of the `Dr. I. Cantacuzino Hospital' on a lot of 43 diabetic patients using the `LASSIS' devices composed of a He-Ne laser and 4 semiconductor lasers. The 43 patients showed various clinic pictures of a diabetic leg (diabetic arteriopathy and neuropathy) 16 of the lot showed an arteriopathy with claudication and a decrease of pulses oscillometrically measurements, 15 had ulceration and a beginning of gangrene and the other 12 showed a plantary boring ill. There has been achieved an amelioration of the oscillometric index of the claudication while walking the amelioration of local circulation, together with the limitation of the necrosis. For the boring ill, there has been achieved the acceleration of the granulating and epithelization process avoiding surgeries, suppuration and cutaneous plasties. The response to the laser treatment was compared to the response to the classic treatment (vasodilatation surgery unstrapping, antibiotherapy) on a proving lot. We appreciated that the cicatrization and local vasodilatation with athermal laser treatment should be a hope for the treatment of patients suffering of diabetic arteriopathy and neuropathy.

  15. Restless legs syndrome and pregnancy: a review.

    Science.gov (United States)

    Srivanitchapoom, Prachaya; Pandey, Sanjay; Hallett, Mark

    2014-07-01

    Restless legs syndrome (RLS) is a common sensorimotor neurological disorder that is diagnosed according to the revised criteria of the International RLS Study Group (IRLSSG). The pathophysiology of RLS is still unknown and its prevalence is influenced by ethnicity, age, and gender. RLS is divided into two types by etiology: primary or idiopathic and secondary. Primary RLS is strongly influenced by a genetic component while secondary RLS is caused by other associated conditions such as end-stage renal disease or peripheral neuropathy. Another common condition associated with RLS is pregnancy. The prevalence of RLS during pregnancy is two to three times higher than in the normal population and is influenced by the trimester and the number of parity. The main mechanisms that may contribute to the pathophysiology of RLS during pregnancy are hormonal changes and iron and folate status. Standard medications for treating RLS during pregnancy are not established. Most medications have been used according to the evidence from non-pregnant patients. Therefore, consideration of the medical treatment for treating RLS during pregnancy should be balanced between the benefit of relieving the symptoms and maternal and fetal risk. In general, the prognosis of RLS during pregnancy is good and symptoms are usually relieved after delivery.

  16. Pramipexole alters thermoregulation in restless legs syndrome.

    Science.gov (United States)

    Salminen, Aaro V; Rimpilä, Ville; Polo, Olli

    2014-12-15

    Previous studies have associated restless legs syndrome (RLS) with peripheral hypoxia and impaired thermoregulation in the lower extremities. We performed long-term monitoring of skin temperatures in order to investigate whether these findings could be explained by reduced blood flow to the peripheral tissues. 96-hour continuous measurements of skin temperature were performed both in the distal and proximal parts of the body of 15 patients with RLS and 14 healthy controls. During the recording, the patients participated in suggested immobilization tests both with and without pramipexole medication. We found no baseline differences in distal or proximal skin temperature between patients and controls in daytime or during immobilization. However, pramipexole significantly increased distal skin temperature in the patient group during immobilization (31.1°C vs. 32.9°C, p thermoregulation and the previous studies might have been biased by medication. Dopaminergic medication is a major confounding factor when assessing peripheral phenomena in RLS and should be controlled for in the future studies. © 2014 American Academy of Sleep Medicine.

  17. PAH clearance after renal ischemia and reperfusion is a function of impaired expression of basolateral Oat1 and Oat3

    OpenAIRE

    Bischoff, Ariane; Bucher, Michael; Gekle, Michael; Sauvant, Christoph

    2014-01-01

    Abstract Determination of renal plasma flow (RPF) by para‐aminohippurate (PAH) clearance leads to gross underestimation of this respective parameter due to impaired renal extraction of PAH after renal ischemia and reperfusion injury. However, no mechanistic explanation for this phenomenon is available. Based on our own previous studies we hypothesized that this may be due to impairment of expression of the basolateral rate limiting organic anion transporters Oat1 and Oat3. Thus, we investigat...

  18. Mangafodipir protects against hepatic ischemia-reperfusion injury in mice.

    Directory of Open Access Journals (Sweden)

    Romain Coriat

    Full Text Available INTRODUCTION AND AIM: Mangafodipir is a contrast agent used in magnetic resonance imaging that concentrates in the liver and displays pleiotropic antioxidant properties. Since reactive oxygen species are involved in ischemia-reperfusion damages, we hypothesized that the use of mangafodipir could prevent liver lesions in a mouse model of hepatic ischemia reperfusion injury. Mangafodipir (MnDPDP was compared to ischemic preconditioning and intermittent inflow occlusion for the prevention of hepatic ischemia-reperfusion injury in the mouse. METHODS: Mice were subjected to 70% hepatic ischemia (continuous ischemia for 90 min. Thirty minutes before the ischemic period, either mangafodipir (10 mg/kg or saline was injected intraperitoneally. Those experimental groups were compared with one group of mice preconditioned by 10 minutes' ischemia followed by 15 minutes' reperfusion, and one group with intermittent inflow occlusion. Hepatic ischemia-reperfusion injury was evaluated by measurement of serum levels of aspartate aminotransferase (ASAT activity, histologic analysis of the livers, and determination of hepatocyte apoptosis (cytochrome c release, caspase 3 activity. The effect of mangafodipir on the survival rate of mice was studied in a model of total hepatic ischemia. RESULTS: Mangafodipir prevented experimental hepatic ischemia-reperfusion injuries in the mouse as indicated by a reduction in serum ASAT activity (P<0.01, in liver tissue damages, in markers of apoptosis (P<0.01, and by higher rates of survival in treated than in untreated animals (P<0.001. The level of protection by mangafodipir was similar to that observed following intermittent inflow occlusion and higher than after ischemic preconditioning. CONCLUSIONS: Mangafodipir is a potential new preventive treatment for hepatic ischemia-reperfusion injury.

  19. Effect of renal and non-renal ischemia/reperfusion on cell-mediated immunity in organs and plasma

    DEFF Research Database (Denmark)

    Brøchner, Anne Craveiro; Dagnæs-Hansen, Frederik; Toft, Palle

    2010-01-01

    study, 80 mice were divided into four groups. The following surgeries were performed on the groups compared: bilateral renal I/R by clamping, unilateral renal ischemia, anesthesia only, and unilateral hind leg I/R. Half of the animals were killed after 2 h and the other half after 24 h. To assess...... following renal I/R. All kinds of I/R induced an upregulation of the adhesion molecule CD 11b and a downregulation of MHC II. Renal and non-renal I/R induced neutrophil infiltration in distant organs. Renal I/R does not induce a larger cell-mediated inflammatory response in blood and organs than non-renal I/R....

  20. Balancing Control of AIT Leg Exoskeleton Using ZMP based FLC

    Directory of Open Access Journals (Sweden)

    Narong Aphiratsakun

    2010-02-01

    Full Text Available This paper is focused on the use of Zero Moment Point (ZMP concept for balancing control of the Asian Institute of Technology Leg EXoskeleton-I (ALEX-I. ALEX-I has been developed to assist patients who suffer from paraplegia or immobility due to the loss of power on lower limbs. The balanced posture set-points (joint trajectories under ZMP criterion are generated offline. The ZMP based set points are provided as the desired postures to ALEX-I. Fuzzy Logic Controller (FLC determines the modified set points based on postures balancing sensed by loadcells. Ground Contact Point (GCP is used to find the \\"ZMP-like in real time\\". GCP data is obtained by placing 4 loadcells forming a force plate on each foot of ALEX-I. This GCP data is then compared with the reference ZMP. Uncertainties of the model parameters, backlash, and joint tolerance are considered as disturbance. The differences of ZMP and GCP on x-z plane are used as the inputs to the FLC. The 4 outputs from FLC are the compensated angles of left and right ankles joints in roll and pitch axes that make the actual ZMP locate in the convex hull of the supporting area.

  1. Dissociation of periodic leg movements from arousals in restless legs syndrome.

    Science.gov (United States)

    Manconi, Mauro; Ferri, Raffaele; Zucconi, Marco; Bassetti, Claudio L; Fulda, Stephany; Aricò, Debora; Ferini-Strambi, Luigi

    2012-06-01

    The purpose of this study was to characterize the nature of the relation between periodic leg movements during sleep (PLMS) and cortical arousals to contribute to the debate on the clinical significance and treatment of PLMS. A prospective, placebo-controlled, single-blind, parallel group study was carried out including 46 drug-naive patients with idiopathic restless legs syndrome (RLS). Each patient underwent 2 consecutive full-night polysomnographic studies. The first night was the baseline night. Prior to the second night, 1 group received a single oral dose of 0.25mg pramipexole, whereas a second group received a single oral dose of 0.5mg clonazepam, and the remaining patients received placebo. Sleep stages, cyclic alternating pattern (CAP), and leg movement activity were scored following standard criteria; symptoms of RLS were also assessed. Pramipexole suppressed PLMS without affecting electroencephalographic (EEG) instability (CAP) and arousals (corresponding to CAP A3 and, partially, A2 subtypes), whereas clonazepam did the opposite, reducing non-rapid eye movement sleep EEG instability without effects on PLMS. Both drugs were effective on sensory RLS symptoms. This study demonstrates that a selective pharmacological approach can disconnect PLMS from arousal events, suggesting an indirect relation between each other. These results might weaken the hypothesis of a direct pathological role of PLMS in sleep disruption and can be important for the discussion on the existence of a distinct entity called periodic limb movements disorder. Moreover, the study opens the doors to the possibility of a joint treatment for RLS targeting sensory and motor symptoms, as well as sleep instability. Copyright © 2012 American Neurological Association.

  2. Impact of age on aortic wave reflection responses to metaboreflex activation and its relationship with leg lean mass in post-menopausal women.

    Science.gov (United States)

    Figueroa, Arturo; Jaime, Salvador J; Johnson, Sarah A; Alvarez-Alvarado, Stacey; Campbell, Jeremiah C; Feresin, Rafaela G; Elam, Marcus L; Arjmandi, Bahram H

    2015-10-01

    Wave reflection (augmentation pressure [AP] and index [AIx]) is greater in older women than men. Resting AP is a better wave reflection index than AIx in older adults. The negative relationship between wave reflection and lean mass (LM) has been inconsistent. We investigated the impact of age and LM on aortic hemodynamic responses to metaboreflex activation in post-menopausal women. Post-menopausal women, younger and older (n=20 per group) than 60 years, performed 2-min isometric handgrip at 30% of maximal force followed by 3-min post-exercise muscle ischemia (PEMI). We measured carotid-femoral pulse wave velocity (cfPWV) and femoral-ankle PWV (faPWV) at rest, and aortic systolic blood pressure (aSBP), pulse pressure (aPP), AP, AIx, and AIx-adjusted for heart rate (AIx@75) at rest and during PEMI using tonometry. Arm and leg LM were measured by DEXA. Resting cfPWV, aSBP, and aPP were higher, while AIx@75 and leg LM were lower in older than younger women. aSBP and aPP increased similarly during PEMI in both groups. Increases in AP (Ppost-menopausal women. Our findings suggest that the increased AP response to PEMI is related to leg arterial stiffness and muscle loss in older women.

  3. PAH clearance after renal ischemia and reperfusion is a function of impaired expression of basolateral Oat1 and Oat3.

    Science.gov (United States)

    Bischoff, Ariane; Bucher, Michael; Gekle, Michael; Sauvant, Christoph

    2014-02-01

    Determination of renal plasma flow (RPF) by para-aminohippurate (PAH) clearance leads to gross underestimation of this respective parameter due to impaired renal extraction of PAH after renal ischemia and reperfusion injury. However, no mechanistic explanation for this phenomenon is available. Based on our own previous studies we hypothesized that this may be due to impairment of expression of the basolateral rate limiting organic anion transporters Oat1 and Oat3. Thus, we investigated this phenomenon in a rat model of renal ischemia and reperfusion by determining PAH clearance, PAH extraction, PAH net secretion, and the expression of rOat1 and rOat3. PAH extraction was seriously impaired after ischemia and reperfusion which led to a threefold underestimation of RPF when PAH extraction ratio was not considered. PAH extraction directly correlated with the expression of basolateral Oat1 and Oat3. Tubular PAH secretion directly correlated with PAH extraction. Consequently, our data offer an explanation for impaired renal PAH extraction by reduced expression of the rate limiting basolateral organic anion transporters Oat1 and Oat3. Moreover, we show that determination of PAH net secretion is suitable to correct PAH clearance for impaired extraction after ischemia and reperfusion in order to get valid results for RPF.

  4. Restless Leg Syndrome Across the Globe: Epidemiology of the Restless Legs Syndrome/Willis-Ekbom Disease.

    Science.gov (United States)

    Koo, Brian B

    2015-09-01

    There are more than 50 epidemiologic studies measuring the prevalence of restless legs syndrome/Willis-Ekbom disease (RLS/WED) across 5 of the 6 inhabited continents (not Australia), most conducted in North America and Europe. Sufficient studies have been conducted in Asia, North America, and Europe to make inferences on RLS/WED prevalence by region. RLS/WED prevalence is thought to be highest in North America and Europe and lower in Asia. These differences across regions may be explained by cultural, environmental, and genetic factors. Future investigation is needed to determine to what extent these factors affect expression of RLS/WED according to world region.

  5. Restless legs syndrome, periodic leg movements, and periodic limb movement disorder in children.

    Science.gov (United States)

    Durmer, Jeffrey S; Quraishi, Ghazala H

    2011-06-01

    The characteristic symptoms of restless legs syndrome (RLS) have been known for hundreds of years and were first reported in medicine in the 1600s. Clinicians must consider potential mimics, comorbid, and associated conditions when evaluating children with RLS symptoms. The traditional differentiation of RLS from periodic limb movement disorder (PLMD) is noted in children as well as adults. Because current pediatric RLS research is sparse, this article provides the most up-to-date evidence-based as well as consensus opinion-based information on the subject of childhood RLS and PLMD. Prevalence, pathophysiology, diagnosis, treatment, and clinical associations are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Hydrogen ion buffering during complete brain ischemia.

    Science.gov (United States)

    Kraig, R P; Pulsinelli, W A; Plum, F

    1985-09-09

    As a first step to quantify [H+] changes in brain during ischemia we used H+-selective microelectrodes and enzyme fluorometric techniques to describe the relationship between interstitial [H+] ([H+]o) and peak tissue lactate after cardiac arrest. We found a step function relationship between [H+]o and tissue lactate rather than the linear titration expected in a homogeneous protein solution. Within a blood glucose range from 3-7 mM, brain lactate rose from 8-13 mmol/kg along with a rise in [H+]o of 99 +/- 6 nM(0.44 +/- 0.02 pH). At higher blood glucose levels (17-80 mM), brain lactate accumulated to levels of 16-31 mmol/kg; concurrently [H+]o rose by 608 +/- 16 nM (1.07 +/- 0.02 pH). The unchanging level of [H+]o between 8-13 and 16-31 mmol/kg lactate implies that [H+]o is at a steady-state, but not equilibrium with respect to [H+] in other brain compartments. We propose that ion-transport characteristics of astroglia account for the observed relationship of [H+]o to tissue lactate during complete ischemia and suggest that brain infarction develops after plasma membranes in brain cells can no longer transport ions to regulate [H+].

  7. Autophagy and Liver Ischemia-Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Raffaele Cursio

    2015-01-01

    Full Text Available Liver ischemia-reperfusion (I-R injury occurs during liver resection, liver transplantation, and hemorrhagic shock. The main mode of liver cell death after warm and/or cold liver I-R is necrosis, but other modes of cell death, as apoptosis and autophagy, are also involved. Autophagy is an intracellular self-digesting pathway responsible for removal of long-lived proteins, damaged organelles, and malformed proteins during biosynthesis by lysosomes. Autophagy is found in normal and diseased liver. Although depending on the type of ischemia, warm and/or cold, the dynamic process of liver I-R results mainly in adenosine triphosphate depletion and in production of reactive oxygen species (ROS, leads to both, a local ischemic insult and an acute inflammatory-mediated reperfusion injury, and results finally in cell death. This process can induce liver dysfunction and can increase patient morbidity and mortality after liver surgery and hemorrhagic shock. Whether autophagy protects from or promotes liver injury following warm and/or cold I-R remains to be elucidated. The present review aims to summarize the current knowledge in liver I-R injury focusing on both the beneficial and the detrimental effects of liver autophagy following warm and/or cold liver I-R.

  8. Mixed models in cerebral ischemia study

    Directory of Open Access Journals (Sweden)

    Matheus Henrique Dal Molin Ribeiro

    2016-06-01

    Full Text Available The data modeling from longitudinal studies stands out in the current scientific scenario, especially in the areas of health and biological sciences, which induces a correlation between measurements for the same observed unit. Thus, the modeling of the intra-individual dependency is required through the choice of a covariance structure that is able to receive and accommodate the sample variability. However, the lack of methodology for correlated data analysis may result in an increased occurrence of type I or type II errors and underestimate/overestimate the standard errors of the model estimates. In the present study, a Gaussian mixed model was adopted for the variable response latency of an experiment investigating the memory deficits in animals subjected to cerebral ischemia when treated with fish oil (FO. The model parameters estimation was based on maximum likelihood methods. Based on the restricted likelihood ratio test and information criteria, the autoregressive covariance matrix was adopted for errors. The diagnostic analyses for the model were satisfactory, since basic assumptions and results obtained corroborate with biological evidence; that is, the effectiveness of the FO treatment to alleviate the cognitive effects caused by cerebral ischemia was found.

  9. Acute Occlusive Mesenteric Ischemia in Taif Province, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohamed Al Saeed ** Mohamed Abu Shady *Mohamed Hatem *Khalid Alzahrani

    2012-04-01

    Full Text Available Mesenteric ischemia is relatively a rare disorder seen in the emergency department (ED. Due to the effect of hypobaric hypoxia and higher liability for thrombosis encountered in high altitude areas, acute occlusive mesenteric ischemia (AOMI would represent an actual challenge in Taif and related districts. Another risk factor is that about twenty-five percent of Saudis are victims of diabetes due to the changes in lifestyle and diet leading to increasing levels of obesity. Vague nonspecific clinical findings and limitations of diagnostic studies in addition to cultural and social factors, may lead to late presentation making the diagnosis a significant challenge and in turn higher morbidity and mortality are expected. Objectives: In this study, we review type of AOMI, pattern of presentation, laboratory, radiological, Intraoperative findings and results of treatment in 36 patients who were admitted to King Abdul Aziz Specialist Hospital and King Faisal Hospital, Al Taif, Saudi Arabia from January 2009 to January 2012. Methods: 36 patients with final diagnosis of AOMI were included in this retrospective study by means of review of their files and medical records. Results: The disease was more common in men than women (23 male and 13 females. The mean age of patients was 54 years. The mean time of presentation was 2.4 days after occurrence of symptoms. Abdominal pain was the most common symptom of patients followed by nausea, vomiting, constipation and bloody diarrhea. On physical examination; tachycardia was prevalent, Oliguria was seen in approximately 69.4% of patients, 11.1% of patients were in shock status. All patients had abdominal tenderness and 61.1% of patients had marked peritoneal signs (rebound tenderness with guarding or/and rigidity. Twenty one/36 (58.3% patients were diabetics, 17/36 patients (47.2% were hypertensive and 8/36 patients (22.2% with associated cardiac disorders. In laboratory tests, Leukocytosis was present in all

  10. Emphysematous Pyelonephritis Presenting as Necrotizing Fasciitis of the Leg

    Directory of Open Access Journals (Sweden)

    Yu-Xiong Ye

    2009-03-01

    Full Text Available We report a 50-year-old man with poorly controlled diabetes mellitus who presented with a painful, swollen right leg. He had also experienced right flank pain for 1 week prior to admission. Physical examination was notable for tenderness over the right flank. The right leg was diffusely swollen and exquisitely tender to touch, with palpable crepitance. Laboratory tests revealed leukocytosis and pyuria. Computed tomography showed a right ureteral stone with hydronephrosis and characteristic findings of emphysematous pyelonephritis. Furthermore, a right perirenal gas-forming abscess with extension to the right leg was noted. The patient was successfully treated with antibiotic therapy, aggressive control of blood sugar, percutaneous drainage of the hydronephrosis and perirenal abscess, and aggressive debridement of the leg.

  11. Hereditary Lymphedema of the Leg – A Case Report

    Directory of Open Access Journals (Sweden)

    Birgit Heinig

    2017-07-01

    Full Text Available Primary of hereditary lymphedema is a rare but progressive disease. It is yet not curable. We present a 48-year-old male patient with hereditary lymphedema of his left leg, that was realised by minor trauma (able twist when he was seven years old. He had never been treated for lymphedema but experienced multiple erysipelas during his life. After diagnostic procedures to exclude other causes of leg swelling, the diagnosis of hereditary lymphedema of the leg, stage III was confirmed. We initialized complex decongestive therapy. During two weeks of intensive treatment, the circumference of the left leg could be reduced by 10 cm. This case illustrates the "natural course" hereditary lymphedema. But it raises the hope that even after decades of ignorance, the patients benefits from complex decongestive treatment. Therapeutic nihilism is unnecessary and poses lymphedema patients to risks of infection and secondary malignancies like Stewart-Trewes syndrome.

  12. Eyelash Transplantation Using Leg Hair by Follicular Unit Extraction

    Directory of Open Access Journals (Sweden)

    Sanusi Umar, MD

    2015-03-01

    Full Text Available Summary: Fine hairs of the head and nape areas have been used as donor sources in eyelash transplantation but are straight, coarse, and grow rapidly, requiring frequent eyelash maintenance. This is the first reported case of eyelash transplantation by follicular unit extraction using leg hair as a donor source; findings were compared with that of another patient who underwent a similar procedure with donor hairs from the nape area. Although both patients reported marked improvement in fullness of eyelashes within 3 months postsurgery, the transplanted leg hair eyelashes required less frequent trimming (every 5–6 weeks compared with nape hair eyelashes (every 2–3 weeks. Additionally, in leg hair eyelashes, the need for perming to sustain a natural looking eyelash curl was eliminated. Eyelash transplantation using leg donor hair in hirsute women may result in good cosmetic outcomes and require less maintenance compared with nape donor hair.

  13. Living with clipped wings - patients’ experience of losing a leg

    DEFF Research Database (Denmark)

    Norlyk, Annelise; Martinsen, Bente; Kjaer-Petersen, Klaus

    2013-01-01

    This study explores the lived experience of losing a leg as described by the patients themselves post-discharge. Studies have documented that regardless of aetiology patients are faced with severe physical as well as psychosocial challenges post-amputation. However, only few studies explore in....... The essential meaning of losing a leg is a radical and existential upheaval, which restricts patients' lifestyle and irretrievably alters their lifeworld. Life after the operation is associated with despair, and a painful sense of loss, but also with the hope of regaining personal independence. The consequences...... of losing a leg gradually materialize as the patients realize how the loss of mobility limits their freedom. Patients experience the professional help as primarily directed towards physical care and rehabilitation. The findings show that the loss of a leg and, subsequently, the restricted mobility carry...

  14. Drug No Better Than Placebo for Lower Back, Leg Pain

    Science.gov (United States)

    ... news/fullstory_164223.html Drug No Better Than Placebo for Lower Back, Leg Pain Pregabalin, commonly known ... name: Lyrica) may be no better than a placebo when it comes to treating the back and ...

  15. California Red-Legged Frogs in coastal dune drainages (2015)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — California Red-legged Frogs (Rana draytonii) are typically regarded as inhabitants of permanent ponds, marshes, and slow-moving streams, but their ecology in other...

  16. Using Malaria Medication for Leg Cramps Is Risky

    Science.gov (United States)

    ... Products Vaccines, Blood & Biologics Articulos en Espanol Using Malaria Medication for Leg Cramps is Risky Printer-friendly ... approved only to treat a certain type of malaria (uncomplicated malaria) caused by the parasite Plasmodium falciparum. ...

  17. Doppler ultrasound exam of an arm or leg

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003775.htm Doppler ultrasound exam of an arm or leg To use ... this page, please enable JavaScript. This test uses ultrasound to look at the blood flow in the ...

  18. Leg ulcers in sickle cell patients: management challenges

    Directory of Open Access Journals (Sweden)

    El Khatib AM

    2016-11-01

    Full Text Available Arij M El Khatib,1 Shady N Hayek2 1Division of Plastic and Reconstructive Surgery, Department of Surgery, American University of Beirut Medical Center (AUBMC, 2Private Practice, Cosmetic Surgery Center, Beirut, Lebanon Abstract: Sickle cell disease is an autosomal recessive hemoglobinopathy caused by an amino acid substitution from glutamic acid to valine in the beta hemoglobin chain. One of the common symptoms occurring in sickle cell patients are leg ulcers, which are notoriously painful, difficult to treat, and frequently recurrent. These ulcers pose a therapeutic challenge with multiple modalities proposed for treatment, but with scarce evidence of efficacy of any single modality. Ulcer prevention, rigorous wound care, pain control, and surgery are the current mainstays of sickle cell leg ulcer treatment. Keywords: sickle cell leg ulcer, leg wound, sickle cell disease 

  19. Quality of Life in People with Leg Ulcer, Integrative Review

    Directory of Open Access Journals (Sweden)

    Daniela Alves

    2016-04-01

    Full Text Available Objective: To identify the main changes in the daily life of people with leg ulcer and how that affects the person’s quality of life. Methodology: We used the methodology PI [C] OD and selected four research articles, taken from EBSCO, PubMed, and EWMA. Results: The main changes identified in the people’s daily live with leg ulcers are physical (pain, decreased mobility, presence of exudate, bad smell from the wound and change in the style of clothing, psychological (sleep disorders, depression, anxiety, feelings of rejection and low self-steem, social (isolation, restriction in leisure activities, inability to perform household chores. Conclusions: The literature about the person’s quality of life with leg ulcer reported a significant impact in the daily life. The care provided by nurses should be centered on the person, integrating all the kind of needs and the leg ulcer must not be the sole focus of care

  20. Vibration transmission characteristics of the legs of freely standing honeybees

    DEFF Research Database (Denmark)

    Rohrseitz, Kristin; Kilpinen, Ole

    1997-01-01

    The leg vibrations of honeybees standing on a vibrating substrate were measured with laser Doppler vibrometry, both in freely standing bees and in bees attached to a holder. In both cases, no resonances were found. In the fixed bee preparation, the legs moved with approximately the same amplitude...... as the stimulator. This was also the case in freely standing honeybees, except around 400 Hz, where an average attenuation of approximately 6 dB was observed. In the fixed bee preparation, the vertical movements of the legs were also measured during horizontal stimulation. The vertical vibration amplitude...... of the legs was 15-20 dB lower than the horizontal stimulation amplitude. The electrophysiologically and behaviourally determined thresholds for vibration stimulation increased by approximately 10 dB, when the stimulus direction was changed from vertical to horizontal. These observations support the notion...

  1. Restless legs syndrome: demographics, presentation, and differential diagnosis.

    Science.gov (United States)

    Hening, Wayne; Allen, Richard P; Tenzer, Penny; Winkelman, John W

    2007-09-01

    Restless legs syndrome (RLS) is a sensorimotor disorder characterized by a distressing urge to move the legs and sometimes other parts of the body. Diagnosis is based on clinical features that may be easily remembered with the mnemonic URGE: Urge to move, Rest induced, Gets better with activity, and Evening and night accentuation. RLS is common, its prevalence increases with age, and women are more frequently affected. The course is chronic with often severe sleep disruption, including periodic leg movements. Differential diagnosis includes disorders of restlessness and leg discomfort. Primary RLS is familial and likely to be genetic. Important causes of secondary RLS are end-stage renal disease, pregnancy, and iron deficiency. Every patient should be checked for iron status with a serum ferritin measurement.

  2. Erythema ab igne (Unilateral due to "Chulla"

    Directory of Open Access Journals (Sweden)

    Sumit Kar

    2014-01-01

    Full Text Available Erythema ab igne (EAI is characterized by localized areas of reticulated erythema and hyperpigmentation due to chronic and repeated exposure to infrared radiation. Taking a good history plays an important role in coming to the diagnosis of the disease condition; and at the same time, the particular cultural practices of a place determine its occurrence in the local masses. Herein we report the case of a young lady in her early thirties who presented to us with a dusky hyperpigmentation over her right arm and leg. Her detailed history and cutaneous examination led to the diagnosis of erythema ab igne.

  3. Leg-adjustment strategies for stable running in three dimensions.

    Science.gov (United States)

    Peuker, Frank; Maufroy, Christophe; Seyfarth, André

    2012-09-01

    The dynamics of the center of mass (CoM) in the sagittal plane in humans and animals during running is well described by the spring-loaded inverted pendulum (SLIP). With appropriate parameters, SLIP running patterns are stable, and these models can recover from perturbations without the need for corrective strategies, such as the application of additional forces. Rather, it is sufficient to adjust the leg to a fixed angle relative to the ground. In this work, we consider the extension of the SLIP to three dimensions (3D SLIP) and investigate feed-forward strategies for leg adjustment during the flight phase. As in the SLIP model, the leg is placed at a fixed angle. We extend the scope of possible reference axes from only fixed horizontal and vertical axes to include the CoM velocity vector as a movement-related reference, resulting in six leg-adjustment strategies. Only leg-adjustment strategies that include the CoM velocity vector produced stable running and large parameter domains of stability. The ability of the model to recover from perturbations along the direction of motion (directional stability) depended on the strategy for lateral leg adjustment. Specifically, asymptotic and neutral directional stability was observed for strategies based on the global reference axis and the velocity vector, respectively. Additional features of velocity-based leg adjustment are running at arbitrary low speed (kinetic energy) and the emergence of large domains of stable 3D running that are smoothly transferred to 2D SLIP stability and even to 1D SLIP hopping. One of the additional leg-adjustment strategies represented a large convex region of parameters where stable and robust hopping and running patterns exist. Therefore, this strategy is a promising candidate for implementation into engineering applications, such as robots, for instance. In a preliminary comparison, the model predictions were in good agreement with the experimental data, suggesting that the 3D SLIP is an

  4. The Splay Leg Syndrome in Piglets: A Review

    Directory of Open Access Journals (Sweden)

    Vassilis G. Papatsiros

    2012-01-01

    Full Text Available Problem statement: The splay leg syndrome is the major congenital cause of lameness in suckling piglets. It is characterized by a temporarily impaired functionality of the hind leg muscles immediately after birth, resulting in an ability to stand and walk. Etiology and pathogenesis is complex and remain still poorly understood. Approach: The aim of the present study is to perform the update information about the etiology, clinical signs and control strategies of the syndrome. Results: A sex-affected inheritance of the splay leg syndrome is assumed since higher frequencies have been observed in male piglets. Several biochemical and histomorphological investigations indicate an immaturity of the skeletal muscle in the affected piglets at birth. Splay leg is caused by a reduction of the axonal diameter and myelin sheath thickness of the fiber that innervate the hindlimb adductors. The existence of one or more major genes for congenital splay leg seems possible. Among the fragments strongly displayed in the splay leg muscle, are identified the porcine CDKN3 gene. Various management and genetic factors have been connected with the etiology, such as the farrowing induction, low birth weight, short gestation lengths, slippery floors and breeds (e.g., Large White and Landrace. Moreover, nutrition can play a role to pathogenesis, as choline or methionine deficiency in sow diets and the fusarium toxicity. Furthermore, Porcine Reproductive and Respiratory Syndrome Virus (PRRSV are also involved in etiological factors. Piglets suffering from splay leg should be kept in a warm place and be helped to take colostrums or artificial milk for 2-3 days. Conclusion: Management practices should be applied in order to be avoided the occurrence of splay leg syndrome, such as non-slip floors, use of anti-mycotoxins products in feed, avoiding the farrowing induction before day 113. Finally, a herd health management programme should be applied in order to prevent and

  5. Leg exoskeleton reduces the metabolic cost of human hopping.

    Science.gov (United States)

    Grabowski, Alena M; Herr, Hugh M

    2009-09-01

    During bouncing gaits such as hopping and running, leg muscles generate force to enable elastic energy storage and return primarily from tendons and, thus, demand metabolic energy. In an effort to reduce metabolic demand, we designed two elastic leg exoskeletons that act in parallel with the wearer's legs; one exoskeleton consisted of a multiple leaf (MLE) and the other of a single leaf (SLE) set of fiberglass springs. We hypothesized that hoppers, hopping on both legs, would adjust their leg stiffness while wearing an exoskeleton so that the combination of the hopper and exoskeleton would behave as a linear spring-mass system with the same total stiffness as during normal hopping. We also hypothesized that decreased leg force generation while wearing an exoskeleton would reduce the metabolic power required for hopping. Nine subjects hopped in place at 2.0, 2.2, 2.4, and 2.6 Hz with and without an exoskeleton while we measured ground reaction forces, exoskeletal compression, and metabolic rates. While wearing an exoskeleton, hoppers adjusted their leg stiffness to maintain linear spring-mass mechanics and a total stiffness similar to normal hopping. Without accounting for the added weight of each exoskeleton, wearing the MLE reduced net metabolic power by an average of 6% and wearing the SLE reduced net metabolic power by an average of 24% compared with hopping normally at frequencies between 2.0 and 2.6 Hz. Thus, when hoppers used external parallel springs, they likely decreased the mechanical work performed by the legs and substantially reduced metabolic demand compared with hopping without wearing an exoskeleton.

  6. Insulin action in human thighs after one-legged immobilization

    DEFF Research Database (Denmark)

    Richter, Erik; Kiens, Bente; Mizuno, M.

    1989-01-01

    Insulin action was assessed in thighs of five healthy young males who had one knee immobilized for 7 days by a splint. The splint was not worn in bed. Subjects also used crutches to prevent weight bearing of the immobilized leg. Immobilization decreased the activity of citrate synthase and 3-OH...... was significantly higher in the immobilized than in the control thigh. Seven days of one-legged immobilization causes local decreased insulin action on thigh glucose uptake and net protein degradation....

  7. Fatal pox infection in a rough-legged hawk

    Science.gov (United States)

    Pearson, G.L.; Pass, D.A.; Beggs, E.C.

    1975-01-01

    Natural pox infection occurred in a free-living rough-legged hawk (Buteo lagopus) in northeastern North Dakota. Gross, histological and electron microscopic findings were typical of pox infection, and characteristic lesions developed in red-tailed hawks (Buteo jamaicensis) but not in great horned owls (Bubo virginianus) following inoculation with case material. Death of the rough-legged hawk was attributed to starvation resulting from inability to capture prey and to blood loss from foot lesions.

  8. Well-leg compartment syndrome after gynecological laparoscopic surgery

    DEFF Research Database (Denmark)

    Boesgaard-Kjer, Diana H; Boesgaard-Kjer, Daniel; Kjer, Jens Jørgen

    2013-01-01

    Well-leg compartment syndrome in the lower extremities after surgery in the lithotomy position is a rare but severe complication requiring early diagnosis and intervention. Several circumstances predispose to this condition as a consequence of increased intra-compartmental pressure, such as posit....... Potential risk factors and preventive initiatives are listed to reduce the risk in future patients. We describe two patients who underwent gynecologic laparoscopic surgery and postoperatively developed well-leg compartment syndrome....

  9. Motor Driving Leg Design for Bionic Crab-like Robot

    Institute of Scientific and Technical Information of China (English)

    Wang; Li-quan; Qu; Xiao-rong; Meng; Qing-xin; Yuan; Peng; Wang; Mo-nan

    2002-01-01

    The paper presents the design of walking leg for bionics crab-like robot, which is driven with micro servo motor. The kinematic characteristics of the bionics machine are analysed for optimized structure parameters, which has been used in the robot design. A three closed loop motor control system structure for joint driver is also given, as well as the multi-joint driving system for walking robot leg.

  10. Restless Leg Syndrome/Willis-Ekbom Disease Pathophysiology.

    Science.gov (United States)

    Allen, Richard P

    2015-09-01

    Restless leg syndrome/Willis-Ekbom disease has brain iron deficiency that produces excessive dopamine and known genetic risks, some of which contribute to the brain iron deficiency. Dopamine treatments work temporarily but may eventually produce further postsynaptic down-regulation and worse restless leg syndrome. This article includes sections focused on pathophysiologic findings from each of these areas: genetics, cortical-spinal excitability, and iron and dopamine. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Restless legs syndrome in Parkinson's disease.

    Science.gov (United States)

    Gómez-Esteban, Juan C; Zarranz, Juan J; Tijero, Beatriz; Velasco, Fernando; Barcena, Joseba; Rouco, Idoia; Lezcano, Elena; Lachen, María C; Jauregui, Amaia; Ugarte, Amaia

    2007-10-15

    The present study explores the frequency of RLS in PD and focuses on the clinical differences between patients with and without restless legs syndrome (RLS). A cross-sectional study was designed, comprising 114 patients diagnosed with PD. Those patients positive for RLS were assessed for intensity of the syndrome (IRLS). We compared the clinical characteristics of the patients with and without RLS, using specific scales: Unified Parkinson's Disease Rating Scale (UPDRS I-IV), quality of life (Parkinson's Disease Questionnaire, PDQ 39), sleep symptoms (Parkinson's Disease Sleep Scale, PDSS), and diurnal hypersomnia (Epworth Sleepiness Scale). Twenty-five patients (21.9%) out of a total of 114 subjects diagnosed with PD met the RLS diagnostic criteria. RLS was more frequent in women (68%). The patients with RLS showed poorer scores on the PDSS (PD-RLS+: 102.4 +/- 15.1 vs PD-RLS-: 113.2 +/- 16.4) (P = 0.005) and in the bodily discomfort dimension of the PDQ-39 (PD-RLS+ 6.1 +/- 3.4 vs PD-RLS- 3.8 +/- 2.6) (P = 0.002). Analysis of the subscales of the PDSS showed significant differences (P < 0.001) between both groups of patients in items 4 and 10, and to a lesser degree in items 5 (P = 0.01) and 11 (P = 0.02) There was no increased incidence of diurnal hypersomnia in the group of patients with RLS. There were no differences in the rest of the variables. RLS is frequent in patients with PD, though this condition doesn't apparently affect quality of life or lead to an increased presence of diurnal hypersomnia. It would be advisable to validate the diagnostic criteria of RLS in this specific group of patients.

  12. PERIPHERAL ARTERIAL DISEASE IN THE LEG

    Directory of Open Access Journals (Sweden)

    Nair P

    2014-09-01

    Full Text Available INTRODUCTION: Peripheral arterial disease (PAD is a condition characterized by atherosclerotic occlusive disease of the lower extremities. While PAD is a major risk factor for lower-extremity amputation, it is also accompanied by a high likelihood for symptomatic cardiovascular and cerebrovascular disease. Atherosclerosis accounts for more than 90% of cases of PAD, and uncommon vascular syndromes account for the remaining 10%. The femoral and popliteal arteries are affected in 80% to 90% of symptomatic PAD patients, the tibial and peroneal arteries in 40% to 50%, and the aortoiliac arteries in 30%.Although 65–75% of patients with PAD are asymptomatic, the classic presenting symptom is usually described as muscle cramps, fatigue or pain in the lower legs induced by exercise and rapidly relieved by rest; often the symptom location indicates the level of arterial involvement. RISK FACTORS: Diabetes and smoking are the strongest risk factors for PAD. Other well-known risk factors are advanced age, hypertension, and hyperlipidemia. DIAGNOSIS: PAD can be easily and accurately diagnosed by calculating the ankle-brachial index (ABI.The ABI is defined as the ratio of the systolic blood pressure in the ankle divided by the systolic blood pressure at the arm. The tools required to perform the ABI measurement include a hand-held 5–10 MHz Doppler probe and a blood pressure cuff. MANAGEMENT: Most patients' symptoms improve with optimal medical treatment and invasive intervention is often not required. Smoking cessation and exercise are considered the two most important treatments for PAD. CONCLUSION: Symptomatic PAD often impairs a patient's quality of life and untreated disease can lead to limb loss. Aggressive management of atherosclerotic risk factors, a structured exercise program, use of antiplatelet agents and when indicated percutaneous or surgical revascularizations are the keys for successful management.

  13. Variability of single-leg versus double-leg stance radiographs in the varus knee.

    Science.gov (United States)

    Chen, Andrew; Rich, Valerie; Bain, Elizabeth; Sterett, William I

    2009-07-01

    We evaluated measured radiographic parameter variability between single-leg stance (SLS) and double-leg stance (DLS) radiographs in patients with varus knee malalignment, indicated for high tibial osteotomy. Fifty-three consecutive knees (mean, 49 years; range, 18-79 years) were evaluated for varus thrust. SLS and DLS radiographs were obtained. A single blinded observer measured mechanical axis angles and weight-bearing line (WBL) deviation using a goniometer. Mechanical axis angles averaged 9.1 degrees (DLS) and 11.3 degrees (SLS). SLS radiographs averaged 9% greater WBL medialization than did DLS. Medial opening averaged 16.4 mm (DLS) and 18.8 mm (SLS). DLS and SLS radiographs showed no significant differences in patients without varus thrust. Patients with varus thrust demonstrated differences in mechanical axis angles (DLS, 9.4 degrees; SLS, 12.2 degrees), WBL deviation (12.1% less), medialization (DLS), and medial opening necessary for correction (DLS, 16.6 mm; SLS, 20.3 mm). In varus thrust, SLS radiographs more closely replicate dynamic knee malalignment, possibly providing more accurate measurements of angular deformity.

  14. Coordination of planar cell polarity pathways through Spiny-legs.

    Science.gov (United States)

    Ambegaonkar, Abhijit A; Irvine, Kenneth D

    2015-10-27

    Morphogenesis and physiology of tissues and organs requires planar cell polarity (PCP) systems that orient and coordinate cells and their behaviors, but the relationship between PCP systems has been controversial. We have characterized how the Frizzled and Dachsous-Fat PCP systems are connected through the Spiny-legs isoform of the Prickle-Spiny-legs locus. Two different components of the Dachsous-Fat system, Dachsous and Dachs, can each independently interact with Spiny-legs and direct its localization in vivo. Through characterization of the contributions of Prickle, Spiny-legs, Dachsous, Fat, and Dachs to PCP in the Drosophila wing, eye, and abdomen, we define where Dachs-Spiny-legs and Dachsous-Spiny-legs interactions contribute to PCP, and provide a new understanding of the orientation of polarity and the basis of PCP phenotypes. Our results support the direct linkage of PCP systems through Sple in specific locales, while emphasizing that cells can be subject to and must ultimately resolve distinct, competing PCP signals.

  15. Modeling posture-dependent leg actuation in sagittal plane locomotion

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, J [Department of Mechanical Engineering, Oregon State University, Corvallis, OR 97331 (United States); Clark, J, E-mail: schmitjo@engr.orst.ed [Department of Mechanical Engineering, Florida State University, Tallahassee, FL 32310 (United States)

    2009-12-15

    The spring loaded inverted pendulum template has been shown to accurately model the steady locomotion dynamics of a variety of running animals, and has served as the inspiration for an entire class of dynamic running robots. While the template models the leg dynamics by an energy-conserving spring, insects and animals have structures that dissipate, store and produce energy during a stance phase. Recent investigations into the spring-like properties of limbs, as well as animal response to drop-step perturbations, suggest that animals use their legs to manage energy storage and dissipation, and that this management is important for gait stability. In this paper, we extend our previous analysis of control of the spring loaded inverted pendulum template via changes in the leg touch-down angle to include energy variations during the stance phase. Energy variations are incorporated through leg actuation that varies the force-free leg length during the stance phase, yet maintains qualitatively correct force and velocity profiles. In contrast to the partially asymptotically stable gaits identified in previous analyses, incorporating energy and leg angle variations in this manner produces complete asymptotic stability. Drop-step perturbation simulations reveal that the control strategy is rather robust, with gaits recovering from drops of up to 30% of the nominal hip height.

  16. Study on Mucin in Normal-Appearing Leg Skin.

    Science.gov (United States)

    Fernandez-Flores, Angel

    2017-03-01

    Dermal deposits of mucin in the legs have been described associated with venous insufficiency. However, some degree of stasis dermatitis is generally common in aged individuals. Therefore, some amount of mucin is expected a priori in the reticular dermis of aged patients, even in the absence of clinical lesions. To test this hypothesis, the authors investigated the mucin in the legs of aged individuals without any dermatologic disease. Cutaneous samples were taken from the legs of 15 autopsy cases. A sample of the skin of the legs (either from the left or the right leg without any distinction being made) was randomly taken (without selecting any specific area or attending to macroscopical features). The skin samples were fixed in formaldehyde, and sections obtained from all samples were stained with hematoxylin and eosin, iron, and Alcian blue. Iron deposits were graded as 0/4 in 7 cases, as 1/4 in 4 cases, as 2/4 in 2 cases, and as 4/4 in 2 cases. Cases with greater deposits of iron also had other signs of stasis, such as neovascularization. All the samples scored 0 for dermal mucin deposits in the reticular dermis. The authors conclude that mucin deposits in the legs are not inherent to aging. Therefore, any mucin deposit in the reticular dermis, as well as expansion of the periadnexal dermis by mucin deposits, should be considered abnormal.

  17. The effect of spinal manipulation on imbalances in leg strength.

    Science.gov (United States)

    Chilibeck, Philip D; Cornish, Stephen M; Schulte, Al; Jantz, Nathan; Magnus, Charlene R A; Schwanbeck, Shane; Juurlink, Bernhard H J

    2011-09-01

    We hypothesized that spinal manipulation (SM) would reduce strength imbalances between legs. Using an un-blinded randomized design, 28 males and 21 females (54 ± 19y) with at least a 15% difference in isometric strength between legs for hip flexion, extension, abduction, or knee flexion were randomized to treatment or placebo (mock spinal manipulation). Strength of the stronger and weaker legs for hip flexion, extension, abduction, and/or knee flexion was assessed before and after the intervention. SM reduced the relative strength difference between legs for knee flexion (mean ± SD 57 ± 53 to 5 ± 14%) and hip flexion (24 ± 12 to 11 ± 15%) compared to placebo (34 ± 29 to 24 ± 36%, and 20 ± 18 to 22 ± 26%, respectively) (p = 0.05). SM also improved strength in the weak leg for hip abduction (104 ± 43 to 116 ± 43 Nm) compared to placebo (84 ± 24 to 85 ± 31 Nm) (p = 0.03). This study suggests that spinal manipulation may reduce imbalances in strength between legs for knee and hip flexion.

  18. Force feedback reinforces muscle synergies in insect legs.

    Science.gov (United States)

    Zill, Sasha N; Chaudhry, Sumaiya; Büschges, Ansgar; Schmitz, Josef

    2015-11-01

    The nervous system solves complex biomechanical problems by activating muscles in modular, synergist groups. We have studied how force feedback in substrate grip is integrated with effects of sense organs that monitor support and propulsion in insects. Campaniform sensilla are mechanoreceptors that encode forces as cuticular strains. We tested the hypothesis that integration of force feedback from receptors of different leg segments during grip occurs through activation of specific muscle synergies. We characterized the effects of campaniform sensilla of the feet (tarsi) and proximal segments (trochanter and femur) on activities of leg muscles in stick insects and cockroaches. In both species, mechanical stimulation of tarsal sensilla activated the leg muscle that generates substrate grip (retractor unguis), as well as proximal leg muscles that produce inward pull (tibial flexor) and support/propulsion (trochanteral depressor). Stimulation of campaniform sensilla on proximal leg segments activated the same synergistic group of muscles. In stick insects, the effects of proximal receptors on distal leg muscles changed and were greatly enhanced when animals made active searching movements. In insects, the task-specific reinforcement of muscle synergies can ensure that substrate adhesion is rapidly established after substrate contact to provide a stable point for force generation.

  19. Criteria in diagnosing nocturnal leg cramps: a systematic review.

    Science.gov (United States)

    Hallegraeff, Joannes; de Greef, Mathieu; Krijnen, Wim; van der Schans, Cees

    2017-02-28

    Up to 33% of the general population over 50 years of age are affected by nocturnal leg cramps. Currently there are no generally accepted clinical characteristics, which identify nocturnal leg cramps. This study aims to identify these clinical characteristics and to differentiate between them and the characteristics of restless leg syndrome and periodic limb disorder. A systematic literature study was executed from December 2015 to May 2016. This study comprised of a systematic literature review of randomized clinical trials, observational studies on nocturnal and rest cramps of legs and other muscles, and other systematic and narrative reviews. Two researchers independently extracted literature data and analyzed this using a standardized reviewing protocol. Modified versions of the Cochrane Collaboration tools assessed the risk of bias. A Delphi study was conducted to assess agreement on the characteristics of nocturnal leg cramps. After systematic and manual searches, eight randomized trials and ten observational studies were included. On the basis of these we identified seven diagnostic characteristics of nocturnal leg cramps: intense pain, period of duration from seconds to maximum 10 minutes, location in calf or foot, location seldom in thigh or hamstrings, persistent subsequent pain, sleep disruption and distress. The seven above characteristics will enhance recognition of the condition, and help clinicians make a clear distinction between NLC and other sleep-related musculoskeletal disorder among older adults.

  20. Serum 25-hydroxyvitamin D levels in restless legs syndrome patients.

    Science.gov (United States)

    Balaban, Hatice; Yıldız, Özlem Kayım; Çil, Gülsüm; Şentürk, İlteriş Ahmet; Erselcan, Taner; Bolayır, Ertuğrul; Topaktaş, Suat

    2012-08-01

    Restless legs syndrome is characterised by discomfort during rest and an urge to move the limbs that is accompanied by abnormal sensations. Studies on disease pathophysiology have focused on dopaminergic dysfunction. Vitamin D may play an important role in dopamine function, but the role of vitamin D in restless legs syndrome has not been examined. We compared the serum vitamin D levels of RLS patients and matched controls and explored the correlation of plasma vitamin D levels with disease severity. We measured serum 25-hydroxyvitamin D levels in 36 patients with restless legs syndrome and compared them to 38 healthy control subjects. The mean serum 25-hydroxyvitamin D levels were 7.31±4.63 ng/mL in female patients with restless legs syndrome and 12.31±5.27 ng/mL in female control subjects (p=0.001). We found a significant inverse correlation between vitamin D levels and disease severity in females (p=0.01, r=-0.47). The mean serum vitamin D levels were lower in female patients with restless legs syndrome. Low vitamin D levels may cause dopaminergic dysfunction in restless legs syndrome patients. Further studies are required to confirm these results. Copyright © 2012 Elsevier B.V. All rights reserved.