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Sample records for newly developed limb

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

    Directory of Open Access Journals (Sweden)

    Luciano Marcon

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

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

    Science.gov (United States)

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

    2010-01-01

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

  3. Limb development: a paradigm of gene regulation.

    Science.gov (United States)

    Petit, Florence; Sears, Karen E; Ahituv, Nadav

    2017-04-01

    The limb is a commonly used model system for developmental biology. Given the need for precise control of complex signalling pathways to achieve proper patterning, the limb is also becoming a model system for gene regulation studies. Recent developments in genomic technologies have enabled the genome-wide identification of regulatory elements that control limb development, yielding insights into the determination of limb morphology and forelimb versus hindlimb identity. The modulation of regulatory interactions - for example, through the modification of regulatory sequences or chromatin architecture - can lead to morphological evolution, acquired regeneration capacity or limb malformations in diverse species, including humans.

  4. Compact and Light-Weight Solar Spaceflight Instrument Designs Utilizing Newly Developed Miniature Free-Standing Zone Plates: EUV Radiometer and Limb-Scanning Monochromator

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    Seely, J. F.; McMullin, D. R.; Bremer, J.; Chang, C.; Sakdinawat, A.; Jones, A. R.; Vest, R.

    2014-12-01

    Two solar instrument designs are presented that utilize newly developed miniature free-standing zone plates having interconnected Au opaque bars and no support membrane resulting in excellent long-term stability in space. Both instruments are based on a zone plate having 4 mm outer diameter and 1 to 2 degree field of view. The zone plate collects EUV radiation and focuses a narrow bandpass through a pinhole aperture and onto a silicon photodiode detector. As a miniature radiometer, EUV irradiance is accurately determined from the zone plate efficiency and the photodiode responsivity that are calibrated at the NIST SURF synchrotron facility. The EUV radiometer is pointed to the Sun and measures the absolute solar EUV irradiance in high time cadence suitable for solar physics and space weather applications. As a limb-scanning instrument in low earth orbit, a miniature zone-plate monochromator measures the extinction of solar EUV radiation by scattering through the upper atmosphere which is a measure of the variability of the ionosphere. Both instruments are compact and light-weight and are attractive for CubeSats and other missions where resources are extremely limited.

  5. Development and the evolvability of human limbs.

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    Young, Nathan M; Wagner, Günter P; Hallgrímsson, Benedikt

    2010-02-23

    The long legs and short arms of humans are distinctive for a primate, the result of selection acting in opposite directions on each limb at different points in our evolutionary history. This mosaic pattern challenges our understanding of the relationship of development and evolvability because limbs are serially homologous and genetic correlations should act as a significant constraint on their independent evolution. Here we test a developmental model of limb covariation in anthropoid primates and demonstrate that both humans and apes exhibit significantly reduced integration between limbs when compared to quadrupedal monkeys. This result indicates that fossil hominins likely escaped constraints on independent limb variation via reductions to genetic pleiotropy in an ape-like last common ancestor (LCA). This critical change in integration among hominoids, which is reflected in macroevolutionary differences in the disparity between limb lengths, facilitated selection for modern human limb proportions and demonstrates how development helps shape evolutionary change.

  6. Duplex ultrasound: Indications and findings in a newly created ...

    African Journals Online (AJOL)

    Duplex ultrasound: Indications and findings in a newly created facility at the University of Calabar Teaching Hospital, Calabar. ... It is recommended that timely referrals be made, and mobile Doppler units be acquired to save more lives and limbs in the developing world. Keywords: Calabar, deep venous thrombosis, duplex ...

  7. Sall4-Gli3 system in early limb progenitors is essential for the development of limb skeletal elements

    OpenAIRE

    Akiyama, Ryutaro; Kawakami, Hiroko; Wong, Julia; Oishi, Isao; Nishinakamura, Ryuichi; Kawakami, Yasuhiko

    2015-01-01

    The limb skeletal elements that have unique morphology and distinct locations are developed from limb progenitors, derived from the lateral plate mesoderm. These skeletal elements arise during limb development. In this study, we show genetic evidence that function of Sall4 is essential prior to limb outgrowth for development of the anterior-proximal skeletal elements. Furthermore, genetic interaction between Sall4 and Gli3 is upstream of establishing Shh (Sonic hedgehog) expression, and there...

  8. Development and the evolvability of human limbs

    OpenAIRE

    Young, Nathan M.; Wagner, Günter P.; Hallgrímsson, Benedikt

    2010-01-01

    The long legs and short arms of humans are distinctive for a primate, the result of selection acting in opposite directions on each limb at different points in our evolutionary history. This mosaic pattern challenges our understanding of the relationship of development and evolvability because limbs are serially homologous and genetic correlations should act as a significant constraint on their independent evolution. Here we test a developmental model of limb covariation in anthropoid primate...

  9. Impairment of complex upper limb motor function in de novo parkinson's disease.

    NARCIS (Netherlands)

    Ponsen, M.M.; Daffertshofer, A.; Wolters, E.C.M.J.; Beek, P.J.; Berendse, H.W.

    2008-01-01

    The aim of the present study was to evaluate complex upper limb motor function in newly diagnosed, untreated Parkinson's disease (PD) patients. Four different unimanual upper limb motor tasks were applied to 13 newly diagnosed, untreated PD patients and 13 age- and sex-matched controls. In a

  10. Genetic Regulation of Embryological Limb Development with Relation to Congenital Limb Deformity in Humans

    OpenAIRE

    Barham, Guy; Clarke, Nicholas M. P.

    2008-01-01

    Over the last 15 years, great improvements in genetic engineering and genetic manipulation strategies have led to significant advances in the understanding of the genetics governing embryological limb development. This field of science continues to develop, and the complex genetic interactions and signalling pathways are still not fully understood. In this review we will discuss the roles of the principle genes involved in the three-dimensional patterning of the developing limb and will discu...

  11. A newly recognized autosomal dominant limb girdle muscular dystrophy with cardiac involvement

    NARCIS (Netherlands)

    van der Kooi, A. J.; Ledderhof, T. M.; de Voogt, W. G.; Res, C. J.; Bouwsma, G.; Troost, D.; Busch, H. F.; Becker, A. E.; de Visser, M.

    1996-01-01

    Sixty-five members of three families with limb girdle muscular dystrophy (LGMD) underwent neurological, cardiological, and ancillary investigations. Thirty-five individuals were diagnosed as having slowly progressive autosomal dominant LGMD. Symmetrical weakness started in the proximal lower limb

  12. Learning about Vertebrate Limb Development

    Science.gov (United States)

    Liang, Jennifer O.; Noll, Matthew; Olsen, Shayna

    2014-01-01

    We have developed an upper-level undergraduate laboratory exercise that enables students to replicate a key experiment in developmental biology. In this exercise, students have the opportunity to observe live chick embryos and stain the apical ectodermal ridge, a key tissue required for development of the vertebrate limb. Impressively, every…

  13. Mechanobiology of embryonic limb development.

    Science.gov (United States)

    Nowlan, Niamh C; Murphy, Paula; Prendergast, Patrick J

    2007-04-01

    Considerable evidence exists to support the hypothesis that mechanical forces have an essential role in healthy embryonic skeletal development. Clinical observations and experimental data indicate the importance of muscle contractions for limb development. However, the influence of these forces is seldom referred to in biological descriptions of bone development, and perhaps this is due to the fact that the hypothesis that mechanical forces are essential for normal embryonic skeletal development is difficult to test and elaborate experimentally in vivo, particularly in humans. Computational modeling has the potential to address this issue by simulating embryonic growth under a range of loading conditions but the potential of such models has yet to be fully exploited. In this article, we review the literature on mechanobiology of limb development in three main sections: (a) experimental alteration of the mechanical environment, (b) mechanical properties of embryonic tissues, and (c) the use of computational models. Then we analyze the main issues, and suggest how experimental and computational fields could work closer together to enhance our understanding of mechanobiology of the embryonic skeleton.

  14. Cell to cell signalling during vertebrate limb bud development

    NARCIS (Netherlands)

    Panman, Lia

    2004-01-01

    Communication between cells is essential during embryonic development. The vertebrate limb bud provides us a model to study signalling interactions between cells during patterning of embryonic tissues and organogenesis. In chapter 1 I give an introduction about limb bud development that is focussed

  15. Expression of Msx genes in regenerating and developing limbs of axolotl.

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    Koshiba, K; Kuroiwa, A; Yamamoto, H; Tamura, K; Ide, H

    1998-12-15

    Msx genes, homeobox-containing genes, have been isolated as homologues of the Drosophila msh gene and are thought to play important roles in the development of chick or mouse limb buds. We isolated two Msx genes, Msx1 and Msx2, from regenerating blastemas of axolotl limbs and examined their expression patterns using Northern blot and whole mount in situ hybridization during regeneration and development. Northern blot analysis revealed that the expression level of both Msx genes increased during limb regeneration. The Msx2 expression level increased in the blastema at the early bud stage, and Msx1 expression level increased at the late bud stage. Whole mount in situ hybridization revealed that Msx2 was expressed in the distal mesenchyme and Msx1 in the entire mesenchyme of the blastema at the late bud stage. In the developing limb bud, Msx1 was expressed in the entire mesenchyme, while Msx2 was expressed in the distal and peripheral mesenchyme. The expression patterns of Msx genes in the blastemas and limb buds of the axolotl were different from those reported for chick or mouse limb buds. These expression patterns of axolotl Msx genes are discussed in relation to the blastema or limb bud morphology and their possible roles in limb patterning.

  16. Deep-time evolution of regeneration and preaxial polarity in tetrapod limb development.

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    Fröbisch, Nadia B; Bickelmann, Constanze; Olori, Jennifer C; Witzmann, Florian

    2015-11-12

    Among extant tetrapods, salamanders are unique in showing a reversed preaxial polarity in patterning of the skeletal elements of the limbs, and in displaying the highest capacity for regeneration, including full limb and tail regeneration. These features are particularly striking as tetrapod limb development has otherwise been shown to be a highly conserved process. It remains elusive whether the capacity to regenerate limbs in salamanders is mechanistically and evolutionarily linked to the aberrant pattern of limb development; both are features classically regarded as unique to urodeles. New molecular data suggest that salamander-specific orphan genes play a central role in limb regeneration and may also be involved in the preaxial patterning during limb development. Here we show that preaxial polarity in limb development was present in various groups of temnospondyl amphibians of the Carboniferous and Permian periods, including the dissorophoids Apateon and Micromelerpeton, as well as the stereospondylomorph Sclerocephalus. Limb regeneration has also been reported in Micromelerpeton, demonstrating that both features were already present together in antecedents of modern salamanders 290 million years ago. Furthermore, data from lepospondyl 'microsaurs' on the amniote stem indicate that these taxa may have shown some capacity for limb regeneration and were capable of tail regeneration, including re-patterning of the caudal vertebral column that is otherwise only seen in salamander tail regeneration. The data from fossils suggest that salamander-like regeneration is an ancient feature of tetrapods that was subsequently lost at least once in the lineage leading to amniotes. Salamanders are the only modern tetrapods that retained regenerative capacities as well as preaxial polarity in limb development.

  17. Different regulation of limb development by p63 transcript variants.

    Directory of Open Access Journals (Sweden)

    Manabu Kawata

    Full Text Available The apical ectodermal ridge (AER, located at the distal end of each limb bud, is a key signaling center which controls outgrowth and patterning of the proximal-distal axis of the limb through secretion of various molecules. Fibroblast growth factors (FGFs, particularly Fgf8 and Fgf4, are representative molecules produced by AER cells, and essential to maintain the AER and cell proliferation in the underlying mesenchyme, meanwhile Jag2-Notch pathway negatively regulates the AER and limb development. p63, a transcription factor of the p53 family, is expressed in the AER and indispensable for limb formation. However, the underlying mechanisms and specific roles of p63 variants are unknown. Here, we quantified the expression of p63 variants in mouse limbs from embryonic day (E 10.5 to E12.5, and found that ΔNp63γ was strongly expressed in limbs at all stages, while TAp63γ expression was rapidly increased in the later stages. Fluorescence-activated cell sorting analysis of limb bud cells from reporter mouse embryos at E11.5 revealed that all variants were abundantly expressed in AER cells, and their expression was very low in mesenchymal cells. We then generated AER-specific p63 knockout mice by mating mice with a null and a flox allele of p63, and Msx2-Cre mice (Msx2-Cre;p63Δ/fl. Msx2-Cre;p63Δ/fl neonates showed limb malformation that was more obvious in distal elements. Expression of various AER-related genes was decreased in Msx2-Cre;p63Δ/fl limb buds and embryoid bodies formed by p63-knockdown induced pluripotent stem cells. Promoter analyses and chromatin immunoprecipitation assays demonstrated Fgf8 and Fgf4 as transcriptional targets of ΔNp63γ, and Jag2 as that of TAp63γ. Furthermore, TAp63γ overexpression exacerbated the phenotype of Msx2-Cre;p63Δ/fl mice. These data indicate that ΔNp63 and TAp63 control limb development through transcriptional regulation of different target molecules with different roles in the AER. Our findings

  18. Sall4-Gli3 system in early limb progenitors is essential for the development of limb skeletal elements.

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    Akiyama, Ryutaro; Kawakami, Hiroko; Wong, Julia; Oishi, Isao; Nishinakamura, Ryuichi; Kawakami, Yasuhiko

    2015-04-21

    Limb skeletal elements originate from the limb progenitor cells, which undergo expansion and patterning to develop each skeletal element. Posterior-distal skeletal elements, such as the ulna/fibula and posterior digits develop in a Sonic hedgehog (Shh)-dependent manner. However, it is poorly understood how anterior-proximal elements, such as the humerus/femur, the radius/tibia and the anterior digits, are developed. Here we show that the zinc finger factors Sall4 and Gli3 cooperate for proper development of the anterior-proximal skeletal elements and also function upstream of Shh-dependent posterior skeletal element development. Conditional inactivation of Sall4 in the mesoderm before limb outgrowth caused severe defects in the anterior-proximal skeletal elements in the hindlimb. We found that Gli3 expression is reduced in Sall4 mutant hindlimbs, but not in forelimbs. This reduction caused posteriorization of nascent hindlimb buds, which is correlated with a loss of anterior digits. In proximal development, Sall4 integrates Gli3 and the Plzf-Hox system, in addition to proliferative expansion of cells in the mesenchymal core of nascent hindlimb buds. Whereas forelimbs developed normally in Sall4 mutants, further genetic analysis identified that the Sall4-Gli3 system is a common regulator of the early limb progenitor cells in both forelimbs and hindlimbs. The Sall4-Gli3 system also functions upstream of the Shh-expressing ZPA and the Fgf8-expressing AER in fore- and hindlimbs. Therefore, our study identified a critical role of the Sall4-Gli3 system at the early steps of limb development for proper development of the appendicular skeletal elements.

  19. Development of Phantom Limb Pain after Femoral Nerve Block

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    Sadiah Siddiqui

    2014-01-01

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

  20. Prevalence and clinical characteristics of lower limb atherosclerotic lesions in newly diagnosed patients with ketosis-onset diabetes: a cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background The clinical features of atherosclerotic lesions in ketosis-onset diabetes are largely absent. We aimed to compare the characteristics of lower limb atherosclerotic lesions among type 1, ketosis-onset and non-ketotic type 2 diabetes. Methods A cross-sectional study was performed in newly diagnosed Chinese patients with diabetes, including 53 type 1 diabetics with positive islet-associated autoantibodies, 208 ketosis-onset diabetics without islet-associated autoantibodies, and 215 non-ketotic type 2 diabetics. Sixty-two subjects without diabetes were used as control. Femoral intima-media thickness (FIMT), lower limb atherosclerotic plaque and stenosis were evaluated and compared among the four groups based on ultrasonography. The risk factors associated with lower limb atherosclerotic plaque were evaluated via binary logistic regression in patients with diabetes. Results After adjusting for age and sex, the prevalence of lower limb plaque in the patients with ketosis-onset diabetes (47.6%) was significantly higher than in the control subjects (25.8%, p = 0.013), and showed a higher trend compared with the patients with type 1 diabetes (39.6%, p = 0.072), but no difference was observed in comparison to the patients with non-ketotic type 2 diabetes (62.3%, p = 0.859). The mean FIMT in the ketosis-onset diabetics (0.73 ± 0.17 mm) was markedly greater than that in the control subjects (0.69 ± 0.13 mm, p = 0.045) after controlling for age and sex, but no significant differences were found between the ketosis-onset diabetics and the type 1 diabetics (0.71 ± 0.16 mm, p = 0.373), and the non-ketotic type 2 diabetics (0.80 ± 0.22 mm, p = 0.280), respectively. Age and FIMT were independent risk factors for the presence of lower limb plaque in both the ketosis-onset and non-ketotic type 2 diabetic patients, while sex and age in the type 1 diabetic patients. Conclusions The prevalence and risk of lower limb

  1. Expression of Msx-2 during development, regeneration, and wound healing in axolotl limbs.

    Science.gov (United States)

    Carlson, M R; Bryant, S V; Gardiner, D M

    1998-12-15

    Msx genes are transcription factors that are expressed during embryogenesis of developing appendages in regions of epithelial-mesenchymal interactions. Various lines of evidence indicate that these genes function to maintain embryonic tissues in an undifferentiated, proliferative state. We have identified the axolotl homolog of Msx-2, and investigated its expression during limb development, limb regeneration, and wound healing. As in limb buds of higher vertebrates, axolotl Msx-2 is expressed in the apical epidermis and mesenchyme; however, its expression domain is more extensive, reflecting the broader region of the apical epidermal cap in amphibians. Msx-2 expression is downregulated at late stages of limb development, but is reexpressed within one hour after limb amputation. Msx-2 is also reexpressed during wound healing, and may be essential in the early stages of initiation of the limb regeneration cascade.

  2. Watch-ing out for chick limb development.

    Science.gov (United States)

    Pascoal, Susana; Palmeirim, Isabel

    2007-09-01

    Time control is a crucial issue during embryonic development. Nevertheless, little is known about how embryonic cells measure time. Until recently, the only molecular clock known to operate during vertebrate embryonic development was the somitogenesis clock, exclusively functioning in coordinating the precise timing of each new pair of somites formed from the presomitic mesoderm. We have recently evidenced that a similar molecular clock also underlies the timing at which autopod chondrogenic precursors are laid down to form a skeletal limb element. In addition, we herein suggest that the molecular clock is not the only parallelism that can be established between somitogenesis and limb-bud development. In an evolutionary perspective, we support the previously proposed idea that the molecular mechanisms involved in the segmentation of the body axis may have been partially reused in the mesoderm of the lateral plate, thereby allowing the emergence of paired appendages.

  3. The Roles of T-Box Genes in Vertebrate Limb Development.

    Science.gov (United States)

    Sheeba, C J; Logan, M P O

    2017-01-01

    Members of the T-box gene family have diverse roles during embryogenesis and many play critical roles in the developing limb. This is exemplified by the fact that, in humans, mutations in T-box genes are associated with several congenital syndromes that include limb defects as part of their characteristic spectrum of abnormalities. T-box genes encode for evolutionary conserved transcription factors that include both transcriptional activators and repressors. The hallmark of T-box gene members is the presence of the eponymous DNA-binding T-box domain. There are 17 mammalian T-box genes, which based on the sequence homology of the T-box domain, are grouped into five subfamilies, namely, T, Tbx1, Tbx2, Tbx6, and Tbr1. At least nine T-box genes are expressed during limb development with distinct and dynamic expression patterns. All four members of Tbx2 subfamily (Tbx2, Tbx3, Tbx4, Tbx5) and three members of Tbx1 (Tbx1, Tbx15, Tbx18), Brachyury (T) and Eomes (Tbr2) are expressed in the developing limb. © 2017 Elsevier Inc. All rights reserved.

  4. Cross-limb Interference during motor learning

    DEFF Research Database (Denmark)

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

    2013-01-01

    It is well known that following skill learning, improvements in motor performance may transfer to the untrained contralateral limb. It is also well known that retention of a newly learned task A can be degraded when learning a competing task B that takes place directly after learning A. Here we...

  5. Effect of acute irradiation on the development of limbs in sheep

    Energy Technology Data Exchange (ETDEWEB)

    Rajtova, V [Institut fuer Normale Anatomie der Hochschule fuer Veterinaermedizin, Kosice, Czechoslovakia; Horak, J

    1976-01-01

    The effect of acute irradiation on the limb development in sheep was studied. The pelvic area of a pregnant sheep was irradiated locally on the 28th, 29th and 30th days after fertilization. The fetus was removed on the 15th day after irradiation and treated histologically. A single exposure with 250 R (higher exposures killed the fetus) was found to cease the limb development on the 28th day after irradiation (the critical period of the sheep limb development), to induce persistence of the intermedial ray on the 29th and 30th days, an early disappearance of the side finger rays, an early disappearance, fusion or deformation of some carpal and tarsal elements on the 29th and the 30th days after irradiation.

  6. Cross-limb interference during motor learning.

    Directory of Open Access Journals (Sweden)

    Benedikt Lauber

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

  7. A review of supernumerary and absent limbs and digits of the upper limb.

    Science.gov (United States)

    Klaassen, Zachary; Choi, Monica; Musselman, Ruth; Eapen, Deborah; Tubbs, R Shane; Loukas, Marios

    2012-03-01

    For years people have been enamored by anomalies of the human limbs, particularly supernumerary and absent limbs and digits. Historically, there are a number of examples of such anomalies, including royal families of ancient Chaldea, tribes from Arabia, and examples from across nineteenth century Europe. The development of the upper limbs in a growing embryo is still being elucidated with the recent advent of homeobox genes, but researchers agree that upper limbs develop between stages 12-23 through a complex embryological process. Maternal thalidomide intake during limb development is known to cause limb reduction and subsequent amelia or phocomelia. Additionally, a number of clinical reports have illustrated different limb anomaly cases, with each situation unique in phenotype and developmental abnormality. Supernumerary and absent limbs and digits are not unique to humans, and a number of animal cases have also been reported. This review of the literature illustrates the historical, anatomical, and clinical aspects of supernumerary and absent limbs and digits for the upper limb.

  8. A telephone questionnaire in order to assess functional outcome after post-traumatic limb salvage surgery: Development and preliminary validation.

    Science.gov (United States)

    Wulterkens, Leonie; Aurégan, Jean-Charles; Letellier, Thomas; Mebtouche, Nasser; Levante, Stéphane; Cottin, Philippe; Bégué, Thierry

    2015-12-01

    outcomes after posttraumatic limb salvage surgery of the lower extremity. Further research on a large number of patients will be necessary to validate this newly developed questionnaire. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Limb anomalies

    DEFF Research Database (Denmark)

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

    2002-01-01

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

  10. Radiographic analysis of the development of the pelvic limb of captive-reared cranes (Grus spp.)

    International Nuclear Information System (INIS)

    Curro, T.G.; Langenberg, J.A.; Deakin, L.

    1996-01-01

    For captive-reared cranes, pelvic limb abnormalities in chicks have been identified as significant morbidity/mortality factors. An important component of the diagnosis of limb abnormalities is the understanding of the normal limb. This study was undertaken to describe the normal, radiographic development of the femur, tibiotarsus, tarsometatarsus, and fibula of the whooping crane (Grus americana), Florida sandhill crane (Grus canadensis pratensis), and Siberian crane (Grus leucogeranus). Crane chicks were anesthetized and their pelvic limb bone development evaluated radiographically on a weekly to bimonthly basis from one to fourteen weeks of age. Body weight, bone length, diaphyseal width, and physeal development and closure were evaluated. Based on the radiographic analysis, the gross development of the long bones of the pelvic limb of whooping, Florida sandhill, and Siberian cranes was found to be similar among the three species, and not dissimilar from other avian species which have been studied. Repeated handling, anesthesia, and radiographic exposure did not produce any behavioral, developmental, or physical abnormalities in the studied cranes when compared to cranes of the same species raised using the same methods. This is the first work to describe pelvic limb bone development in these species

  11. The effect of acute irradiation on the development of limbs in sheep

    International Nuclear Information System (INIS)

    Rajtova, V.; Horak, J.

    1976-01-01

    The effect of acute irradiation on the limb development in sheep was studied. The pelvic area of a pregnant sheep was irradiated locally on the 28th, 29th and 30th days after fertilization. The fetus was removed on the 15th day after irradiation and treated histologically. A single exposure with 250 R (higher exposures killed the fetus) was found to cease the limb development on the 28th day after irradiation (the critical period of the sheep limb development), to induce persistence of the intermedial ray on the 29th and 30th days, an early disappearance of the side finger rays, an early disappearance, fusion or deformation of some carpal and tarsal elements on the 29th and the 30th days after irradiation. (author)

  12. Ectopic Fgf signaling induces the intercalary response in developing chicken limb buds.

    Science.gov (United States)

    Makanae, Aki; Satoh, Akira

    2018-01-01

    Intercalary pattern formation is an important regulatory step in amphibian limb regeneration. Amphibian limb regeneration is composed of multiple steps, including wounding, blastema formation, and intercalary pattern formation. Attempts have been made to transfer insights from regeneration-competent animals to regeneration-incompetent animalsat each step in the regeneration process. In the present study, we focused on the intercalary mechanism in chick limb buds. In amphibian limb regeneration, a proximodistal axis is organized as soon as a regenerating blastema is induced. Intermediate structures are subsequently induced (intercalated) between the established proximal and distal identities. Intercalary tissues are derived from proximal tissues. Fgf signaling mediates the intercalary response in amphibian limb regeneration. We attempted to transfer insights into intercalary regeneration from amphibian models to the chick limb bud. The zeugopodial part was dissected out, and the distal and proximal parts were conjunct at st. 24. Delivering ectopic Fgf2 + Fgf8 between the distal and proximal parts resulted in induction of zeugopodial elements. Examination of HoxA11 expression, apoptosis, and cell proliferation provides insights to compare with those in the intercalary mechanism of amphibian limb regeneration. Furthermore, the cellular contribution was investigated in both the chicken intercalary response and that of axolotl limb regeneration. We developed new insights into cellular contribution in amphibian intercalary regeneration, and found consistency between axolotl and chicken intercalary responses. Our findings demonstrate that the same principal of limb regeneration functions between regeneration-competent and -incompetent animals. In this context, we propose the feasibility of the induction of the regeneration response in amniotes.

  13. The many lives of SHH in limb development and evolution.

    Science.gov (United States)

    Lopez-Rios, Javier

    2016-01-01

    The SHH signaling pathway is essential for proper formation of the limb skeleton, as is required for the survival and expansion of distal chondrogenic progenitor cells. At the same time, SHH is important to specify digit identities along the anterior-posterior axis. Upon gain or loss of activity of the SHH pathway, bones are gained, lost or malformed, and such deregulation underlies the aetiology of various human congenital limb defects. Likewise, accumulating evidence suggests that evolutionary tampering with SHH signaling underlies the morphological diversification of the tetrapod appendicular skeleton. This review summarizes the roles of the SHH pathway in the context of limb development and evolution and incorporates recent evidence into a mechanistic view of how the positioning of digit condensations is integrated with the specification of distinct bone morphologies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Nipbl and mediator cooperatively regulate gene expression to control limb development.

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    Akihiko Muto

    2014-09-01

    Full Text Available Haploinsufficiency for Nipbl, a cohesin loading protein, causes Cornelia de Lange Syndrome (CdLS, the most common "cohesinopathy". It has been proposed that the effects of Nipbl-haploinsufficiency result from disruption of long-range communication between DNA elements. Here we use zebrafish and mouse models of CdLS to examine how transcriptional changes caused by Nipbl deficiency give rise to limb defects, a common condition in individuals with CdLS. In the zebrafish pectoral fin (forelimb, knockdown of Nipbl expression led to size reductions and patterning defects that were preceded by dysregulated expression of key early limb development genes, including fgfs, shha, hand2 and multiple hox genes. In limb buds of Nipbl-haploinsufficient mice, transcriptome analysis revealed many similar gene expression changes, as well as altered expression of additional classes of genes that play roles in limb development. In both species, the pattern of dysregulation of hox-gene expression depended on genomic location within the Hox clusters. In view of studies suggesting that Nipbl colocalizes with the mediator complex, which facilitates enhancer-promoter communication, we also examined zebrafish deficient for the Med12 Mediator subunit, and found they resembled Nipbl-deficient fish in both morphology and gene expression. Moreover, combined partial reduction of both Nipbl and Med12 had a strongly synergistic effect, consistent with both molecules acting in a common pathway. In addition, three-dimensional fluorescent in situ hybridization revealed that Nipbl and Med12 are required to bring regions containing long-range enhancers into close proximity with the zebrafish hoxda cluster. These data demonstrate a crucial role for Nipbl in limb development, and support the view that its actions on multiple gene pathways result from its influence, together with Mediator, on regulation of long-range chromosomal interactions.

  15. Wnts and wing: Wnt signaling in vertebrate limb development and musculoskeletal morphogenesis.

    Science.gov (United States)

    Yang, Yingzi

    2003-11-01

    In the past twenty years, secreted signaling molecules of the Wnt family have been found to play a central role in controlling embryonic development from hydra to human. In the developing vertebrate limb, Wnt signaling is required for limb bud initiation, early limb patterning (which is governed by several well-characterized signaling centers), and, finally, late limb morphogenesis events. Wnt ligands are unique, in that they can activate several different receptor-mediated signal transduction pathways. The most extensively studied Wnt pathway is the canonical Wnt pathway, which controls gene expression by stabilizing beta-catenin in regulating a diverse array of biological processes. Recently, more attention has been given to the noncanonical Wnt pathway, which is beta-catenin-independent. The noncanonical Wnt pathway signals through activating Ca(2+) flux, JNK activation, and both small and heterotrimeric G proteins, to induce changes in gene expression, cell adhesion, migration, and polarity. Abnormal Wnt signaling leads to developmental defects and human diseases affecting either tissue development or homeostasis. Further understanding of the biological function and signaling mechanism of Wnt signaling is essential for the development of novel preventive and therapeutic approaches of human diseases. This review provides a critical perspective on how Wnt signaling regulates different developmental processes. As Wnt signaling in tumor formation has been reviewed extensively elsewhere, this part is not included in the review of the clinical significance of Wnt signaling.

  16. Evaluation of Genes Involved in Limb Development, Angiogenesis, and Coagulation as Risk Factors for Congenital Limb Deficiencies

    Science.gov (United States)

    Browne, Marilyn L.; Carter, Tonia C.; Kay, Denise M.; Kuehn, Devon; Brody, Lawrence C.; Romitti, Paul A.; Liu, Aiyi; Caggana, Michele; Druschel, Charlotte M.; Mills, James L.

    2012-01-01

    We conducted a population-based case-control study of single nucleotide polymorphisms (SNPs) in selected genes to find common variants that play a role in the etiology of limb deficiencies (LD)s. Included in the study were 389 infants with LDs of unknown cause and 980 unaffected controls selected from all births in New York State (NYS) for the years 1998 to 2005. We used cases identified from the NYS Department of Health (DOH) Congenital Malformations Registry. Genotypes were obtained for 132 SNPs in genes involved in limb development (SHH, WNT7A, FGF4, FGF8, FGF10, TBX3, TBX5, SALL4, GREM1, GDF5, CTNNB1, EN1, CYP26A1, CYP26B1), angiogenesis (VEGFA, HIF1A, NOS3), and coagulation (F2, F5, MTHFR). Genotype call rates were >97% and SNPs were tested for departure from Hardy-Weinberg expectations by race/ethnic subgroups. For each SNP, odds ratios (OR)s and confidence intervals (CI)s were estimated and corrected for multiple comparisons for all LDs combined and for LD subtypes. Among non-Hispanic white infants, associations between FGF10 SNPs rs10805683 and rs13170645 and all LDs combined were statistically significant following correction for multiple testing (OR=1.99; 95% CI=1.43-2.77; uncorrected p=0.000043 for rs10805683 heterozygous genotype, and OR=2.37; 95% CI=1.48-3.78; uncorrected p=0.00032 for rs13170645 homozygous minor genotype). We also observed suggestive evidence for associations with SNPs in other genes including CYP26B1 and WNT7A. Animal studies have shown that FGF10 induces formation of the apical ectodermal ridge and is necessary for limb development. Our data suggest that common variants in FGF10 increase the risk for a wide range of non-syndromic limb deficiencies. PMID:22965740

  17. SMOC1 is essential for ocular and limb development in humans and mice.

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    Okada, Ippei; Hamanoue, Haruka; Terada, Koji; Tohma, Takaya; Megarbane, Andre; Chouery, Eliane; Abou-Ghoch, Joelle; Jalkh, Nadine; Cogulu, Ozgur; Ozkinay, Ferda; Horie, Kyoji; Takeda, Junji; Furuichi, Tatsuya; Ikegawa, Shiro; Nishiyama, Kiyomi; Miyatake, Satoko; Nishimura, Akira; Mizuguchi, Takeshi; Niikawa, Norio; Hirahara, Fumiki; Kaname, Tadashi; Yoshiura, Koh-Ichiro; Tsurusaki, Yoshinori; Doi, Hiroshi; Miyake, Noriko; Furukawa, Takahisa; Matsumoto, Naomichi; Saitsu, Hirotomo

    2011-01-07

    Microphthalmia with limb anomalies (MLA) is a rare autosomal-recessive disorder, presenting with anophthalmia or microphthalmia and hand and/or foot malformation. We mapped the MLA locus to 14q24 and successfully identified three homozygous (one nonsense and two splice site) mutations in the SPARC (secreted protein acidic and rich in cysteine)-related modular calcium binding 1 (SMOC1) in three families. Smoc1 is expressed in the developing optic stalk, ventral optic cup, and limbs of mouse embryos. Smoc1 null mice recapitulated MLA phenotypes, including aplasia or hypoplasia of optic nerves, hypoplastic fibula and bowed tibia, and syndactyly in limbs. A thinned and irregular ganglion cell layer and atrophy of the anteroventral part of the retina were also observed. Soft tissue syndactyly, resulting from inhibited apoptosis, was related to disturbed expression of genes involved in BMP signaling in the interdigital mesenchyme. Our findings indicate that SMOC1/Smoc1 is essential for ocular and limb development in both humans and mice.

  18. An Evaluation of Significance of Herbal Acupuncture on Treating Limb Impediment Among the Children with Development Disabilities

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    Huh Young-Jin

    2004-02-01

    Full Text Available Objectives : This study was conducted to establish a standard and classify suitability in the treatment of limb impediment among the children with development disabilities using bee venom and eight principles herbal acupuncture. Methods : 10 patients with pediatric development disabilities with limb impediment as the main symptoms were chosen in this study. Bee venom herbal acupuncture and eight principles herbal acupuncture treatments were rendered and evaluated responses as well as pursuing most proper treatment methods. Results : 1. Bee venom herbal acupuncture showed a significant effects when used as supplement treatment technique for the children with partial movement, but insignificant for the children whom were unable to move. 2. Bee venom was effective for severe limb impediment and limb asthenia, whileas eight principles herbal acupuncture effective for mild limb impediment and spasticity. 3. Bee venom herbal acupuncture used in conjunction with eight principles herbal acupuncture for treating limb impediment among the children with development disabilities showed general improvement by intensifying muscular strength.

  19. Spatiotemporal distribution of proliferation, proapoptotic and antiapoptotic factors in the early human limb development.

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    Bečić, Tina; Bilan, Kanito; Mardešić, Snježana; Vukojević, Katarina; Saraga-Babić, Mirna

    2016-06-01

    Involvement of proliferation and apoptosis in the human limb development was analyzed electronmicroscopically and immunohistochemically in histological sections of 8 human embryos, 4(th) -10(th) week old, using apoptotic (caspase-3, AIF, BAX), anti-apoptotic (Bcl-2) and proliferation (Ki-67) markers, and TUNEL method. The data were analyzed by Mann-Whitney test, Kruskal-Wallis and Dunn's post hoc test. Initially, developing human limbs consisted of mesenchymal core and surface ectoderm with apical ectodermal ridge (AER). During progression of development, strong proliferation activity gradually decreased in the mesenchyme (from 78% to 68%) and in the epithelium (from 62% to 42%), while in the differentiating finger cartilages proliferation was constantly low (26-7%). Apoptotic caspase-3 and AIF-positive cells characterized mesenchyme and AER at earliest stages, while during digit separation they appeared in interdigital mesenchyme as well. Strong Bcl-2 expression was observed in AER, subridge mesenchyme and phalanges, while BAX expression charaterized limb areas undergoing apoptosis. Ultrastructurally, proliferating cells showed mitotic figures, while apoptotic cells were characterized by nuclear fragmentation. Macrophages were observed around the apoptotic cells. We suggest that intense proliferation enables growth and elongation of human limb primordia, and differential growth of digits. Both caspase-3 and AIF-dependant pathways of cell death control the extent of AER and numer of cells in the subridge mesenchyme at earliest developmental stages, as well as process of digit separation at later stages of limb development. Spatio-temporal co-expresson of Bcl-2 and BAX indicates their role in suppression of apoptosis and selective stimulation of growth during human limb morphogenesis. Copyright © 2016 Elsevier GmbH. All rights reserved.

  20. Revised upper limb module for spinal muscular atrophy: Development of a new module.

    Science.gov (United States)

    Mazzone, Elena S; Mayhew, Anna; Montes, Jacqueline; Ramsey, Danielle; Fanelli, Lavinia; Young, Sally Dunaway; Salazar, Rachel; De Sanctis, Roberto; Pasternak, Amy; Glanzman, Allan; Coratti, Giorgia; Civitello, Matthew; Forcina, Nicola; Gee, Richard; Duong, Tina; Pane, Marika; Scoto, Mariacristina; Pera, Maria Carmela; Messina, Sonia; Tennekoon, Gihan; Day, John W; Darras, Basil T; De Vivo, Darryl C; Finkel, Richard; Muntoni, Francesco; Mercuri, Eugenio

    2017-06-01

    There is a growing need for a robust clinical measure to assess upper limb motor function in spinal muscular atrophy (SMA), as the available scales lack sensitivity at the extremes of the clinical spectrum. We report the development of the Revised Upper Limb Module (RULM), an assessment specifically designed for upper limb function in SMA patients. An international panel with specific neuromuscular expertise performed a thorough review of scales currently available to assess upper limb function in SMA. This review facilitated a revision of the existing upper limb function scales to make a more robust clinical scale. Multiple revisions of the scale included statistical analysis and captured clinically relevant changes to fulfill requirements by regulators and advocacy groups. The resulting RULM scale shows good reliability and validity, making it a suitable tool to assess upper extremity function in the SMA population for multi-center clinical research. Muscle Nerve 55: 869-874, 2017. © 2016 Wiley Periodicals, Inc.

  1. LHX2 Mediates the FGF-to-SHH Regulatory Loop during Limb Development

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    Billy A. Watson

    2018-06-01

    Full Text Available During limb development, fibroblast growth factors (Fgfs govern proximal–distal outgrowth and patterning. FGFs also synchronize developmental patterning between the proximal–distal and anterior–posterior axes by maintaining Sonic hedgehog (Shh expression in cells of the zone of polarizing activity (ZPA in the distal posterior mesoderm. Shh, in turn, maintains Fgfs in the apical ectodermal ridge (AER that caps the distal tip of the limb bud. Crosstalk between Fgf and Shh signaling is critical for patterned limb development, but the mechanisms underlying this feedback loop are not well-characterized. Implantation of Fgf beads in the proximal posterior limb bud can maintain SHH expression in the former ZPA domain (evident 3 h after application, while prolonged exposure (24 h can induce SHH outside of this domain. Although temporally and spatially disparate, comparative analysis of transcriptome data from these different populations accentuated genes involved in SHH regulation. Comparative analysis identified 25 candidates common to both treatments, with eight linked to SHH expression or function. Furthermore, we demonstrated that LHX2, a LIM Homeodomain transcription factor, is an intermediate in the FGF-mediated regulation of SHH. Our data suggest that LHX2 acts as a competency factor maintaining distal posterior SHH expression subjacent to the AER.

  2. Standardized Approach to Quantitatively Measure Residual Limb Skin Health in Individuals with Lower Limb Amputation.

    Science.gov (United States)

    Rink, Cameron L; Wernke, Matthew M; Powell, Heather M; Tornero, Mark; Gnyawali, Surya C; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Albury, Alexander W; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

    2017-07-01

    Objective: (1) Develop a standardized approach to quantitatively measure residual limb skin health. (2) Report reference residual limb skin health values in people with transtibial and transfemoral amputation. Approach: Residual limb health outcomes in individuals with transtibial ( n  = 5) and transfemoral ( n  = 5) amputation were compared to able-limb controls ( n  = 4) using noninvasive imaging (hyperspectral imaging and laser speckle flowmetry) and probe-based approaches (laser doppler flowmetry, transcutaneous oxygen, transepidermal water loss, surface electrical capacitance). Results: A standardized methodology that employs noninvasive imaging and probe-based approaches to measure residual limb skin health are described. Compared to able-limb controls, individuals with transtibial and transfemoral amputation have significantly lower transcutaneous oxygen tension, higher transepidermal water loss, and higher surface electrical capacitance in the residual limb. Innovation: Residual limb health as a critical component of prosthesis rehabilitation for individuals with lower limb amputation is understudied in part due to a lack of clinical measures. Here, we present a standardized approach to measure residual limb health in people with transtibial and transfemoral amputation. Conclusion: Technology advances in noninvasive imaging and probe-based measures are leveraged to develop a standardized approach to quantitatively measure residual limb health in individuals with lower limb loss. Compared to able-limb controls, resting residual limb physiology in people that have had transfemoral or transtibial amputation is characterized by lower transcutaneous oxygen tension and poorer skin barrier function.

  3. Role of Hoxc genes in the development of the limb integumentary organ (nail, claw, or hoof).

    Science.gov (United States)

    Lasierra, Maria Angeles Ros; Fernández-Guerrero, Marc; Delisle, Lucille; Yakushiji-Kaminatsui, Nayuta; Darbellay, Fabrice; Pérez-Gómez, Rocío; Duboule, Denis

    2018-04-01

    The developing vertebrate limb has long proved as an excellent system for studying the mechanisms involved in pattern formation and morphogenesis and more recently in transcriptional regulation and morphological evolution. To elucidate the stage-specific expression profiles of the components of the developing limb, we have generated the temporal transcriptome of the limb progenitors and of the overlying ectoderm separately. Our study has uncovered a collinear activation of Hoxc genes in the limb ectoderm that we have validated by in situ hybridization. However, while members of the HoxA and HoxD clusters show complex and dynamic patterns of expression during limb development that correlate with the morphology of the different limb segments, no specific function for the HoxC or HoxB clusters has been identified ( 1 - 3 ). To investigate the function of Hoxc genes in the limb ectoderm, we have reexamined the HoxC cluster null mice. Remarkably, and despite exhibiting normal terminal phalanges, these mice didn't form claws (anonychia). Morphological and immunohistochemical analysis identified a failure in the differentiation of the main components of the nail/claw organ. To unravel the transcriptional regulation of Hoxc genes in the limb ectoderm, we used the ATACseq technique. Using this approach, we identified two putative regulatory regions which activity was tested in mouse transgenic enhancer assays. It is currently considered that Hox genes have played a key role in the evolution of morphological traits, probably associated with changes in their regulatory landscapes ( 4 ). Given that the form and size of the distal limb integumentary organ (nail, claw or hoof) correlates with that of the distal phalanx and that the development of hooves was a major innovation in the evolution of a cursorial lifestyle, we are also exploring the possible implication of Hoxc genes in the nail/claw/hoof transition. This abstract is from the Experimental Biology 2018 Meeting. There

  4. Genetic interactions between Shox2 and Hox genes during the regional growth and development of the mouse limb.

    Science.gov (United States)

    Neufeld, Stanley J; Wang, Fan; Cobb, John

    2014-11-01

    The growth and development of the vertebrate limb relies on homeobox genes of the Hox and Shox families, with their independent mutation often giving dose-dependent effects. Here we investigate whether Shox2 and Hox genes function together during mouse limb development by modulating their relative dosage and examining the limb for nonadditive effects on growth. Using double mRNA fluorescence in situ hybridization (FISH) in single embryos, we first show that Shox2 and Hox genes have associated spatial expression dynamics, with Shox2 expression restricted to the proximal limb along with Hoxd9 and Hoxa11 expression, juxtaposing the distal expression of Hoxa13 and Hoxd13. By generating mice with all possible dosage combinations of mutant Shox2 alleles and HoxA/D cluster deletions, we then show that their coordinated proximal limb expression is critical to generate normally proportioned limb segments. These epistatic interactions tune limb length, where Shox2 underexpression enhances, and Shox2 overexpression suppresses, Hox-mutant phenotypes. Disruption of either Shox2 or Hox genes leads to a similar reduction in Runx2 expression in the developing humerus, suggesting their concerted action drives cartilage maturation during normal development. While we furthermore provide evidence that Hox gene function influences Shox2 expression, this regulation is limited in extent and is unlikely on its own to be a major explanation for their genetic interaction. Given the similar effect of human SHOX mutations on regional limb growth, Shox and Hox genes may generally function as genetic interaction partners during the growth and development of the proximal vertebrate limb. Copyright © 2014 by the Genetics Society of America.

  5. Sizing Performance of the Newly Developed Eddy Current System

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    Cho, Chan Hee; Lee, Hee Jong; Yoo, Hyun Ju; Moon, Gyoon Young; Lee, Tae Hoon [Korea Hydro and Nuclear Power Co., Ltd., Daejeon (Korea, Republic of)

    2013-10-15

    This paper describes the comparison results of sizing performance for two systems. The KHNP developed a new eddy current testing system for the inspection of steam generator tubing in domestic nuclear power plants. The equivalency assessment of the newly developed system with the EPRI-qualified system was already carried out. In this paper, the comparisons of depth-sizing performance for the artificial flaws between two systems were performed. The results show that the newly developed system is in good agreement with the qualified system. Therefore, it is expected that the newly developed eddy current system can be used for the inspection of steam generator tubing in nuclear power plants. There are some non-destructive examination (NDE) methods for the inspection of components in nuclear power plants, such as ultrasonic, radiographic, eddy current testing, etc. The eddy current testing is widely used for the inspection of steam generator (SG) tubing because it offers a relatively low cost approach for high speed, large scale testing of metallic materials in high pressure and temperature engineering systems. The Korea Hydro and Nuclear Power Co., Ltd. (KHNP) developed an eddy current testing system for the inspection of steam generator tubing in nuclear power plants. This system includes not only hardware but software such as the frequency generator and data acquisition-analysis program. The foreign eddy current system developed by ZETEC is currently used for the inspection of steam generator tubing in domestic nuclear power plants. The equivalency assessment between two systems was already carried out in accordance with the EPRI steam generator examination guidelines.

  6. Lower limb alignment characteristics are not associated with running injuries in runners: Prospective cohort study.

    Science.gov (United States)

    Hespanhol Junior, Luiz Carlos; de Carvalho, Aline Carla Araújo; Costa, Leonardo Oliveira Pena; Lopes, Alexandre Dias

    2016-11-01

    There is conflicting evidence on the association between lower limb alignment characteristics and the incidence of running-related injury (RRI). Therefore, the primary aim of this study was to investigate the association between lower limb alignment characteristics and the incidence proportion of RRI in a convenience sample of recreational runners. A total of 89 recreational runners were included in this prospective cohort study. These participants had been running for at least six months and were injury-free at baseline. Lower limb alignment measurements were conducted in order to calculate lower limb discrepancy, Q-angle, subtalar angle and plantar index. All participants also answered a baseline and biweekly online surveys about their running routine, history of RRI and newly developed RRI over a period of 12 weeks. The prevalence of previous RRI and the 12-week incidence proportion of new RRI were calculated. Logistic regression analysis was performed to estimate the association between lower limb length discrepancy, Q-angle, subtalar angle and plantar ach index with the incidence proportion of RRI. The prevalence of previous RRI was 55.1% (n = 49). The 12-week incidence proportion of new RRI was 27.0% (n = 24). Muscle injuries and tendinopathies were the main types of RRI identified. The lower leg and the knee were the main anatomical regions affected. We did not find significant associations between lower limb length discrepancy, Q-angle, subtalar angle and plantar arch index and injury occurrence.

  7. A newly developed snack effective for enhancing bone volume

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    Hayashi Hidetaka

    2009-07-01

    Full Text Available Abstract Background The incidence of primary osteoporosis is higher in Japan than in USA and European countries. Recently, the importance of preventive medicine has been gradually recognized in the field of orthopaedic surgery with a concept that peak bone mass should be increased in childhood as much as possible for the prevention of osteoporosis. Under such background, we have developed a new bean snack with an aim to improve bone volume loss. In this study, we examined the effects of a newly developed snack on bone volume and density in osteoporosis model mice. Methods Orchiectomy (ORX and ovariectomy (OVX were performed for C57BL/6J mice of twelve-week-old (Jackson Laboratory, Bar Harbar, ME, USA were used in this experiment. We prepared and given three types of powder diet e.g.: normal calcium diet (NCD, Ca: 0.9%, Clea Japan Co., Tokyo, Japan, low calcium diet (LCD, Ca: 0.63%, Clea Japan Co., and special diet (SCD, Ca: 0.9%. Eighteen weeks after surgery, all the animals were sacrified and prepared for histomorphometric analysis to quantify bone density and bone mineral content. Results As a result of histomorphometric examination, SCD was revealed to enhance bone volume irrespective of age and sex. The bone density was increased significantly in osteoporosis model mice fed the newly developmental snack as compared with the control mice. The bone mineral content was also enhanced significantly. These phenomena were revealed in both sexes. Conclusion It is shown that the newly developed bean snack is highly effective for the improvement of bone volume loss irrespective of sex. We demonstrated that newly developmental snack supplements may be a useful preventive measure for Japanese whose bone mineral density values are less than the ideal condition.

  8. Assessing upper limb function in nonambulant SMA patients: development of a new module.

    Science.gov (United States)

    Mazzone, Elena; Bianco, Flaviana; Martinelli, Diego; Glanzman, Allan M; Messina, Sonia; De Sanctis, Roberto; Main, Marion; Eagle, Michelle; Florence, Julaine; Krosschell, Kristin; Vasco, Gessica; Pelliccioni, Marco; Lombardo, Marilena; Pane, Marika; Finkel, Richard; Muntoni, Francesco; Bertini, Enrico; Mercuri, Eugenio

    2011-06-01

    We report the development of a module specifically designed for assessing upper limb function in nonambulant SMA patients, including young children and those with severe contractures. The application of the module to a preschool cohort of 40 children (age 30-48 months) showed that all the items could be completed by 30 months. The module was also used in 45 nonambulant SMA patients (age 30 months to 27 years). Their scores were more variable than in the preschool cohort, ranging from 0 to 18. The magnitude of scores was not related to age (r=-0.19). The upper limb scores had a good correlation with the Hammersmith Functional Motor Scale, r=0.75, but the upper limb function did not always strictly follow the overall gross motor function. These findings suggest that even some of the very weak nonambulant children possess upper limb skills that can be measured. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. [The function of transcription factor P63 and its signaling pathway during limb development].

    Science.gov (United States)

    Ma, Wei; Tian, Wen

    2014-08-01

    The development of human limb is controlled by several transcription factors and signaling pathways, which are organized in precise time- and space-restricted manners. Recent studies showed that P63 and its signaling pathway play important roles in this process. Transcription factor P63, one member of the P53 family, is characterized by a similar amino acid domain, plays a crucial role in the development of limb and ectoderm differentiation, especially with its DNA binding domain, and sterile alpha motif domains. Mutated P63 gene may produce abnormal transcription factor P63 which can affect the signaling pathway. Furthermore, defective signaling protein in structure and/or quantity is synthesized though the pathway. Eventually, members of the signaling protein family are involved in the regulation of differentiation and development of stem cell, which causes deformity of limbs. In brief, three signaling pathways are related to the digit formation along three axes, including SHH-ZPA, FGFs-AER and Lmx1B-Wnt7a-En1. Each contains numerous signaling molecules which are integrated in self-regulatory modules that assure the acquisition or the correct digit complements. These finding has brought new clues for deciphering the etiology of congenital limb malformation and may provide alternatives for both prevention and treatment.

  10. Supernumerary and absent limbs and digits of the lower limb: a review of the literature.

    Science.gov (United States)

    Klaassen, Zachary; Shoja, Mohammadali M; Tubbs, R Shane; Loukas, Marios

    2011-07-01

    Anatomical history over centuries includes description of a wide variety of malformations involving the lower limbs. This article offers an organized review of these diverse abnormalities, including new understanding of mechanisms through recent discoveries in genetics and molecular biology. In 19th century Europe, a number of unique anomalies were reported, as well as evidence of foot amputations occurring in ancient Peruvian culture. Embryologically, the limbs develop early, with the lower limb being recognizable for the first time at stage 13 of development. By stage 23, the toes are clearly defined and by birth, although the legs appear bowed, the tibia and fibula are straight. Removal of the apical ectodermal ridge results in cessation of limb development, conversely, a second apical ectodermal ridge results in duplication of distal structures. Supernumerary limbs have been documented to occur as part of a teratoma with unique morphology and accompanying blood supply. Additionally, many examples of polydactyly occur in the foot postulating that deletion of chromosome 22q11 is involved in postaxial polydactyly. Such deletions occur near the middle of the chromosome at a location designated q11.2 (i.e., on the long arm of one of the pair of chromosomes 22) and this syndrome is also referred to as DiGeorge syndrome, which has a prevalence estimated at 1:4,000. Absence of the lower limbs has also been noted, with hypoplasia of the fibula being the most common manifestation of congenital bone absences in the lower limb. In addition to fibular aplasia, cases of tibial aplasia have been reported. This article is important for surgeons attempting correctional repair of lower limb anomalies, as well as providing analysis of the historical, anatomical and clinical aspects of supernumerary and absent limbs and digits for the lower limb. Copyright © 2011 Wiley-Liss, Inc.

  11. Limb patterning genes and heterochronic development of the emu wing bud

    Directory of Open Access Journals (Sweden)

    Craig A. Smith

    2016-12-01

    Full Text Available Abstract Background The forelimb of the flightless emu is a vestigial structure, with greatly reduced wing elements and digit loss. To explore the molecular and cellular mechanisms associated with the evolution of vestigial wings and loss of flight in the emu, key limb patterning genes were examined in developing embryos. Methods Limb development was compared in emu versus chicken embryos. Immunostaining for cell proliferation markers was used to analyze growth of the emu forelimb and hindlimb buds. Expression patterns of limb patterning genes were studied, using whole-mount in situ hybridization (for mRNA localization and RNA-seq (for mRNA expression levels. Results The forelimb of the emu embryo showed heterochronic development compared to that in the chicken, with the forelimb bud being retarded in its development. Early outgrowth of the emu forelimb bud is characterized by a lower level of cell proliferation compared the hindlimb bud, as assessed by PH3 immunostaining. In contrast, there were no obvious differences in apoptosis in forelimb versus hindlimb buds (cleaved caspase 3 staining. Most key patterning genes were expressed in emu forelimb buds similarly to that observed in the chicken, but with smaller expression domains. However, expression of Sonic Hedgehog (Shh mRNA, which is central to anterior–posterior axis development, was delayed in the emu forelimb bud relative to other patterning genes. Regulators of Shh expression, Gli3 and HoxD13, also showed altered expression levels in the emu forelimb bud. Conclusions These data reveal heterochronic but otherwise normal expression of most patterning genes in the emu vestigial forelimb. Delayed Shh expression may be related to the small and vestigial structure of the emu forelimb bud. However, the genetic mechanism driving retarded emu wing development is likely to rest within the forelimb field of the lateral plate mesoderm, predating the expression of patterning genes.

  12. Early regulation of axolotl limb regeneration.

    Science.gov (United States)

    Makanae, Aki; Satoh, Akira

    2012-10-01

    Amphibian limb regeneration has been studied for a long time. In amphibian limb regeneration, an undifferentiated blastema is formed around the region damaged by amputation. The induction process of blastema formation has remained largely unknown because it is difficult to study the induction of limb regeneration. The recently developed accessory limb model (ALM) allows the investigation of limb induction and reveals early events of amphibian limb regeneration. The interaction between nerves and wound epidermis/epithelium is an important aspect of limb regeneration. During early limb regeneration, neurotrophic factors act on wound epithelium, leading to development of a functional epidermis/epithelium called the apical epithelial cap (AEC). AEC and nerves create a specific environment that inhibits wound healing and induces regeneration through blastema formation. It is suggested that FGF-signaling and MMP activities participate in creating a regenerative environment. To understand why urodele amphibians can create such a regenerative environment and humans cannot, it is necessary to identify the similarities and differences between regenerative and nonregenerative animals. Here we focus on ALM to consider limb regeneration from a new perspective and we also reported that focal adhesion kinase (FAK)-Src signaling controlled fibroblasts migration in axolotl limb regeneration. Copyright © 2012 Wiley Periodicals, Inc.

  13. Developmental origin of limb size variation in lizards.

    Science.gov (United States)

    Andrews, Robin M; Skewes, Sable A

    2017-05-01

    In many respects, reptile hatchlings are fully functional, albeit miniature, adults. This means that the adult morphology must emerge during embryonic development. This insight emphasizes the connection between the mechanisms that generate phenotypic variation during embryonic development and the action of selection on post-hatching individuals. To determine when species-specific differences in limb and tail lengths emerge during embryonic development, we compared allometric patterns of early limb growth of four distantly related species of lizards. The major questions addressed were whether early embryonic limb and tail growth is characterized by the gradual (continuous allometry) or by the abrupt emergence (transpositional allometry) of size differences among species. Our observations supported transpositional allometry of both limbs and tails. Species-specific differences in limb and tail length were exhibited when limb and tail buds first protruded from the body wall. Genes known to be associated with early limb development of tetrapods are obvious targets for studies on the genetic mechanisms that determine interspecific differences in relative limb length. Broadly comparative studies of gene regulation would facilitate understanding of the mechanisms underlying adaptive variation in limb size, including limb reduction and loss, of squamate reptiles. © 2017 Wiley Periodicals, Inc.

  14. Gdf11 is a negative regulator of chondrogenesis and myogenesis in the developing chick limb.

    Science.gov (United States)

    Gamer, L W; Cox, K A; Small, C; Rosen, V

    2001-01-15

    GDF11, a new member of the TGF-beta gene superfamily, regulates anterior/posterior patterning in the axial skeleton during mouse embryogenesis. Gdf11 null mice display skeletal abnormalities that appear to represent anterior homeotic transformations of vertebrae consistent with high levels of Gdf11 expression in the primitive streak, presomitic mesoderm, and tail bud. However, despite strong Gdf11 expression in the limb throughout development, this structure does not appear to be affected in the knockout mice. In order to understand this dichotomy of Gdf11 expression versus Gdf11 function, we identified the chicken Gdf11 gene and studied its role during limb formation. In the early limb bud, Gdf11 transcripts are detected in the subectodermal mesoderm at the distal tip, in a region overlapping the progress zone. At these stages, Gdf11 is excluded from the central core mesenchyme where precartilaginous condensations will form. Later in development, Gdf11 continues to be expressed in the distal most mesenchyme and can also be detected more proximally, in between the forming skeletal elements. When beads incubated in GDF11 protein were implanted into the early wing bud, GDF11 caused severe truncations of the limb that affected both the cartilage elements and the muscle. Limb shortening appeared to be the result of an inhibition of chondrogenesis and myogenesis and using an in vitro micromass assay, we confirmed the negative effects of GDF11 on both myogenic and chondrogenic cell differentiation. Analysis of molecular markers of skeletal patterning revealed that GDF11 induced ectopic expression of Hoxd-11 and Hoxd-13, but not of Hoxa-11, Hoxa-13, or the Msx genes. These data suggest that GDF11 may be involved in controlling the late distal expression of the Hoxd genes during limb development and that misregulation of these Hox genes by excess GDF11 may cause some of the observed alterations in skeletal element shape. In addition, GDF11 induced the expression of its own

  15. Enhancer elements upstream of the SHOX gene are active in the developing limb.

    Science.gov (United States)

    Durand, Claudia; Bangs, Fiona; Signolet, Jason; Decker, Eva; Tickle, Cheryll; Rappold, Gudrun

    2010-05-01

    Léri-Weill Dyschondrosteosis (LWD) is a dominant skeletal disorder characterized by short stature and distinct bone anomalies. SHOX gene mutations and deletions of regulatory elements downstream of SHOX resulting in haploinsufficiency have been found in patients with LWD. SHOX encodes a homeodomain transcription factor and is known to be expressed in the developing limb. We have now analyzed the regulatory significance of the region upstream of the SHOX gene. By comparative genomic analyses, we identified several conserved non-coding elements, which subsequently were tested in an in ovo enhancer assay in both chicken limb bud and cornea, where SHOX is also expressed. In this assay, we found three enhancers to be active in the developing chicken limb, but none were functional in the developing cornea. A screening of 60 LWD patients with an intact SHOX coding and downstream region did not yield any deletion of the upstream enhancer region. Thus, we speculate that SHOX upstream deletions occur at a lower frequency because of the structural organization of this genomic region and/or that SHOX upstream deletions may cause a phenotype that differs from the one observed in LWD.

  16. SMOC1 Is Essential for Ocular and Limb Development in Humans and Mice

    OpenAIRE

    Okada, Ippei; Hamanoue, Haruka; Terada, Koji; Tohma, Takaya; Megarbane, Andre; Chouery, Eliane; Abou-Ghoch, Joelle; Jalkh, Nadine; Cogulu, Ozgur; Ozkinay, Ferda; Horie, Kyoji; Takeda, Junji; Furuichi, Tatsuya; Ikegawa, Shiro; Nishiyama, Kiyomi

    2011-01-01

    Microphthalmia with limb anomalies (MLA) is a rare autosomal-recessive disorder, presenting with anophthalmia or microphthalmia and hand and/or foot malformation. We mapped the MLA locus to 14q24 and successfully identified three homozygous (one nonsense and two splice site) mutations in the SPARC (secreted protein acidic and rich in cysteine)-related modular calcium binding 1 (SMOC1) in three families. Smoc1 is expressed in the developing optic stalk, ventral optic cup, and limbs of mouse em...

  17. Development of chain limbing and small-drum barking equipment; Ketjukarsinta- ja pienrumpukuorintaan perustuvan laitteiston kehittaeminen tuotantovalmiiksi

    Energy Technology Data Exchange (ETDEWEB)

    Rieppo, K [Metsaeteho Oy, Helsinki (Finland); Hakkila, P; Kalaja, H [Finnish Forest Research Inst., Vantaa (Finland)

    1997-12-01

    Three test series were carried out in 1996 at the chain limbing- drum barking station developed by Pertti Szepaniak Oy. The test equipment was developed during the test series. During the first experiment in February the wood used was frozen. In this test series the whipping efficiency was insignificant and consequently, the bark contents remained too large. In the second test in September the whipping efficiency was too high and was not easy to adjust, and as a consequence the wood loss was unreasonable. In the third test in November, when the wood was not yet frozen, the whipping efficiency was correct and promising results were obtained both with regard to the bark content and wood loss. Limbed pine pulpwood was used as raw material. The bark contents of the chips ranged from 0.2 to 0.4 % and the wood loss in barking from 2.8 to 3.6 %. The productivity also improved clearly during the tests. The experiments indicated that a separate station based on a combination of chain limbing- barking and drum-barking is able to produce high-grade pulp chips both from limbed and non-limbed first-thinning pine wood. (orig.)

  18. Motorcycle limb injuries in a developing Country | Oluwadiya | West ...

    African Journals Online (AJOL)

    42.2% were due to collision with automobiles, 22% pedestrian while 8.7% were collisions between motorcycles. The use of protective/safety devices was practically non-existent. Seventy-six (66.1%) patients had lower limbs injuries, 25 (21.7%) patients had upper limb injuries while the remaining 14 (12.2%) injured both ...

  19. Effect of WNT5a on chondrogenesis and limb development

    Czech Academy of Sciences Publication Activity Database

    Killinger, Michael; Veselá, Iva; Buchtová, Marcela

    2015-01-01

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

  20. Internal models of limb dynamics and the encoding of limb state

    Science.gov (United States)

    Hwang, Eun Jung; Shadmehr, Reza

    2005-09-01

    Studies of reaching suggest that humans adapt to novel arm dynamics by building internal models that transform planned sensory states of the limb, e.g., desired limb position and its derivatives, into motor commands, e.g., joint torques. Earlier work modeled this computation via a population of basis elements and used system identification techniques to estimate the tuning properties of the bases from the patterns of generalization. Here we hypothesized that the neural representation of planned sensory states in the internal model might resemble the signals from the peripheral sensors. These sensors normally encode the limb's actual sensory state in which movement errors occurred. We developed a set of equations based on properties of muscle spindles that estimated spindle discharge as a function of the limb's state during reaching and drawing of circles. We then implemented a simulation of a two-link arm that learned to move in various force fields using these spindle-like bases. The system produced a pattern of adaptation and generalization that accounted for a wide range of previously reported behavioral results. In particular, the bases showed gain-field interactions between encoding of limb position and velocity, very similar to the gain fields inferred from behavioral studies. The poor sensitivity of the bases to limb acceleration predicted behavioral results that were confirmed by experiment. We suggest that the internal model of limb dynamics is computed by the brain with neurons that encode the state of the limb in a manner similar to that expected of muscle spindle afferents.

  1. Genomic features of human limb specific enhancers.

    Science.gov (United States)

    Ali, Shahid; Amina, Bibi; Anwar, Saneela; Minhas, Rashid; Parveen, Nazia; Nawaz, Uzma; Azam, Syed Sikandar; Abbasi, Amir Ali

    2016-10-01

    To elucidate important cellular and molecular interactions that regulate patterning and skeletal development, vertebrate limbs served as a model organ. A growing body of evidence from detailed studies on a subset of limb regulators like the HOXD cluster or SHH, reveals the importance of enhancers in limb related developmental and disease processes. Exploiting the recent genome-wide availability of functionally confirmed enhancer dataset, this study establishes regulatory interactions for dozens of human limb developmental genes. From these data, it appears that the long-range regulatory interactions are fairly common during limb development. This observation highlights the significance of chromosomal breaks/translocations in human limb deformities. Transcriptional factor (TF) analysis predicts that the differentiation of early nascent limb-bud into future territories entail distinct TF interaction networks. Conclusively, an important motivation for annotating the human limb specific regulatory networks is to pave way for the systematic exploration of their role in disease and evolution. Copyright © 2016. Published by Elsevier Inc.

  2. Health Promotion Outcomes of a Newly Developed Elastic Band Exercise Program for Older Adults in the Community: A Pilot Test.

    Science.gov (United States)

    Chan, Shu-Ya; Kuo, Chang-Chih; Chen, Kuei-Min; Tseng, Wei-Shyuan; Huang, Hsin-Ting; Li, Chun-Huw

    2016-06-01

    Studies indicate that the incidence of disease, the mortality rate, and medical costs are significantly higher in people aged 65 years and over who do not engage in physical activities than in their peers who do engage in these activities. Therefore, promoting appropriate physical activity among older adults in the community is essential to delaying the health implications of aging. This pilot test was developed to assess the effectiveness of a newly developed Senior Elastic Band (SEB) exercise program on the health of older adults in community care stations. A quasiexperimental design was used. A convenience sample of 20 participants from a community care station was recruited. The SEB intervention included three phases (warm-up, aerobic motion, and static stretching) and was conducted three times per week, 40 minutes per session for 1 month. Twelve health indicators in three categories (functional fitness, self-perceived health status, and sleep quality) were examined before and immediately after 1 month of SEB exercises. Participants showed improved performance at the end of the 1-month study for the following indicators: lung capacity, cardiopulmonary fitness, upper and lower body flexibilities, upper limb muscle power, lower limb muscle endurance, and self-perceived physical health status (all ps exercise program shows preliminary and promising effects on improving the health of older adults in a community care station. Healthcare professionals who work with older adults living in the community may consider the SEB exercise program as a health promotion modality to recommend and implement with this population. However, we recommend further testing the long-term effects of this program on a larger population.

  3. Sp6 and Sp8 Transcription Factors Control AER Formation and Dorsal-Ventral Patterning in Limb Development

    Science.gov (United States)

    Haro, Endika; Delgado, Irene; Junco, Marisa; Yamada, Yoshihiko; Mansouri, Ahmed; Oberg, Kerby C.; Ros, Marian A.

    2014-01-01

    The formation and maintenance of the apical ectodermal ridge (AER) is critical for the outgrowth and patterning of the vertebrate limb. The induction of the AER is a complex process that relies on integrated interactions among the Fgf, Wnt, and Bmp signaling pathways that operate within the ectoderm and between the ectoderm and the mesoderm of the early limb bud. The transcription factors Sp6 and Sp8 are expressed in the limb ectoderm and AER during limb development. Sp6 mutant mice display a mild syndactyly phenotype while Sp8 mutants exhibit severe limb truncations. Both mutants show defects in AER maturation and in dorsal-ventral patterning. To gain further insights into the role Sp6 and Sp8 play in limb development, we have produced mice lacking both Sp6 and Sp8 activity in the limb ectoderm. Remarkably, the elimination or significant reduction in Sp6;Sp8 gene dosage leads to tetra-amelia; initial budding occurs, but neither Fgf8 nor En1 are activated. Mutants bearing a single functional allele of Sp8 (Sp6−/−;Sp8+/−) exhibit a split-hand/foot malformation phenotype with double dorsal digit tips probably due to an irregular and immature AER that is not maintained in the center of the bud and on the abnormal expansion of Wnt7a expression to the ventral ectoderm. Our data are compatible with Sp6 and Sp8 working together and in a dose-dependent manner as indispensable mediators of Wnt/βcatenin and Bmp signaling in the limb ectoderm. We suggest that the function of these factors links proximal-distal and dorsal-ventral patterning. PMID:25166858

  4. Mapping subsurface in proximity to newly-developed sinkhole along roadway.

    Science.gov (United States)

    2013-02-01

    MS&T acquired electrical resistivity tomography profiles in immediate proximity to a newly-developed sinkhole in Nixa Missouri : The sinkhole has closed a well-traveled municipal roadway and threatens proximal infrastructure. The intent of this inves...

  5. Development of a hybrid strength training technique for paretic lower-limb muscles

    NARCIS (Netherlands)

    Bennett, T. L.; Glaser, R. M.; Janssen, T. W J; Couch, W. P.; Herr, C. J.; Almeyda, J. W.; Petrofsky, S. H.; Akuthota, P.

    1996-01-01

    A hybrid resistance exercise technique for strength training of patients with lower-limb paresis was developed. It consists of electrical stimulation-induced contractions (ESIC) superimposed on voluntary contractions to increase recruitment of motor units and the functional load capability of

  6. BMP-Mediated Functional Cooperation between Dlx5;Dlx6 and Msx1;Msx2 during Mammalian Limb Development

    Science.gov (United States)

    Vieux-Rochas, Maxence; Bouhali, Kamal; Mantero, Stefano; Garaffo, Giulia; Provero, Paolo; Astigiano, Simonetta; Barbieri, Ottavia; Caratozzolo, Mariano F.; Tullo, Apollonia; Guerrini, Luisa; Lallemand, Yvan; Robert, Benoît

    2013-01-01

    The Dlx and Msx homeodomain transcription factors play important roles in the control of limb development. The combined disruption of Msx1 and Msx2, as well as that of Dlx5 and Dlx6, lead to limb patterning defects with anomalies in digit number and shape. Msx1;Msx2 double mutants are characterized by the loss of derivatives of the anterior limb mesoderm which is not observed in either of the simple mutants. Dlx5;Dlx6 double mutants exhibit hindlimb ectrodactyly. While the morphogenetic action of Msx genes seems to involve the BMP molecules, the mode of action of Dlx genes still remains elusive. Here, examining the limb phenotypes of combined Dlx and Msx mutants we reveal a new Dlx-Msx regulatory loop directly involving BMPs. In Msx1;Dlx5;Dlx6 triple mutant mice (TKO), beside the expected ectrodactyly, we also observe the hallmark morphological anomalies of Msx1;Msx2 double mutants suggesting an epistatic role of Dlx5 and Dlx6 over Msx2. In Msx2;Dlx5;Dlx6 TKO mice we only observe an aggravation of the ectrodactyly defect without changes in the number of the individual components of the limb. Using a combination of qPCR, ChIP and bioinformatic analyses, we identify two Dlx/Msx regulatory pathways: 1) in the anterior limb mesoderm a non-cell autonomous Msx-Dlx regulatory loop involves BMP molecules through the AER and 2) in AER cells and, at later stages, in the limb mesoderm the regulation of Msx2 by Dlx5 and Dlx6 occurs also cell autonomously. These data bring new elements to decipher the complex AER-mesoderm dialogue that takes place during limb development and provide clues to understanding the etiology of congenital limb malformations. PMID:23382810

  7. BMP-mediated functional cooperation between Dlx5;Dlx6 and Msx1;Msx2 during mammalian limb development.

    Directory of Open Access Journals (Sweden)

    Maxence Vieux-Rochas

    Full Text Available The Dlx and Msx homeodomain transcription factors play important roles in the control of limb development. The combined disruption of Msx1 and Msx2, as well as that of Dlx5 and Dlx6, lead to limb patterning defects with anomalies in digit number and shape. Msx1;Msx2 double mutants are characterized by the loss of derivatives of the anterior limb mesoderm which is not observed in either of the simple mutants. Dlx5;Dlx6 double mutants exhibit hindlimb ectrodactyly. While the morphogenetic action of Msx genes seems to involve the BMP molecules, the mode of action of Dlx genes still remains elusive. Here, examining the limb phenotypes of combined Dlx and Msx mutants we reveal a new Dlx-Msx regulatory loop directly involving BMPs. In Msx1;Dlx5;Dlx6 triple mutant mice (TKO, beside the expected ectrodactyly, we also observe the hallmark morphological anomalies of Msx1;Msx2 double mutants suggesting an epistatic role of Dlx5 and Dlx6 over Msx2. In Msx2;Dlx5;Dlx6 TKO mice we only observe an aggravation of the ectrodactyly defect without changes in the number of the individual components of the limb. Using a combination of qPCR, ChIP and bioinformatic analyses, we identify two Dlx/Msx regulatory pathways: 1 in the anterior limb mesoderm a non-cell autonomous Msx-Dlx regulatory loop involves BMP molecules through the AER and 2 in AER cells and, at later stages, in the limb mesoderm the regulation of Msx2 by Dlx5 and Dlx6 occurs also cell autonomously. These data bring new elements to decipher the complex AER-mesoderm dialogue that takes place during limb development and provide clues to understanding the etiology of congenital limb malformations.

  8. BMP-mediated functional cooperation between Dlx5;Dlx6 and Msx1;Msx2 during mammalian limb development.

    Science.gov (United States)

    Vieux-Rochas, Maxence; Bouhali, Kamal; Mantero, Stefano; Garaffo, Giulia; Provero, Paolo; Astigiano, Simonetta; Barbieri, Ottavia; Caratozzolo, Mariano F; Tullo, Apollonia; Guerrini, Luisa; Lallemand, Yvan; Robert, Benoît; Levi, Giovanni; Merlo, Giorgio R

    2013-01-01

    The Dlx and Msx homeodomain transcription factors play important roles in the control of limb development. The combined disruption of Msx1 and Msx2, as well as that of Dlx5 and Dlx6, lead to limb patterning defects with anomalies in digit number and shape. Msx1;Msx2 double mutants are characterized by the loss of derivatives of the anterior limb mesoderm which is not observed in either of the simple mutants. Dlx5;Dlx6 double mutants exhibit hindlimb ectrodactyly. While the morphogenetic action of Msx genes seems to involve the BMP molecules, the mode of action of Dlx genes still remains elusive. Here, examining the limb phenotypes of combined Dlx and Msx mutants we reveal a new Dlx-Msx regulatory loop directly involving BMPs. In Msx1;Dlx5;Dlx6 triple mutant mice (TKO), beside the expected ectrodactyly, we also observe the hallmark morphological anomalies of Msx1;Msx2 double mutants suggesting an epistatic role of Dlx5 and Dlx6 over Msx2. In Msx2;Dlx5;Dlx6 TKO mice we only observe an aggravation of the ectrodactyly defect without changes in the number of the individual components of the limb. Using a combination of qPCR, ChIP and bioinformatic analyses, we identify two Dlx/Msx regulatory pathways: 1) in the anterior limb mesoderm a non-cell autonomous Msx-Dlx regulatory loop involves BMP molecules through the AER and 2) in AER cells and, at later stages, in the limb mesoderm the regulation of Msx2 by Dlx5 and Dlx6 occurs also cell autonomously. These data bring new elements to decipher the complex AER-mesoderm dialogue that takes place during limb development and provide clues to understanding the etiology of congenital limb malformations.

  9. Working conditions at hospital food service and the development of venous disease of lower limbs.

    Science.gov (United States)

    da Luz, Clarissa Medeiros; da Costa Proença, Rossana Pacheco; de Salazar, Begoña Rodriguez Ortiz; do Nascimento Galego, Gilberto

    2013-12-01

    The present study assesses some factors that may influence the development of lower limb venous disease in workers of a hospital food service unit. An Ergonomic analysis of work was carried out at a hospital located in the south of Brazil. As for data collection, the following were used: interviews and body mass index assessment; specific clinical examination to diagnose venous disease, water displacement volumetry of the lower limbs. The activities performed at the workplace were followed by direct observation with image registration, use of pedometers, stopwatches, decibel meter, and digital thermo-hygrometer. It was observed different degrees of venous disease in 78% of the cases investigated. The volumetric variation of the lower limbs was 5.13%, showing the presence of edema. Working in hospital food service is associated with circulatory disorders of lower limbs, such as edema and venous disease. The following risk factors were identified: standing activities at work during a long period of time, high temperature, and humidity and carrying heavy weights.

  10. Development of an Upper Limb Motorized Assistive-Rehabilitative Robot

    Science.gov (United States)

    Amiri, Masoud; Casolo, Federico

    While the number of people requiring help for the activities of daily living are increasing, several studies have been shown the effectiveness of robot training for upper limb functionality recovery. The robotic system described in this paper is an active end-effector based robot which can be used for assisting and rehabilitating of human upper limb. The robot is able to take into account desire of the patient for the support that patient needs to complete the task.

  11. Transcriptomic insights into the genetic basis of mammalian limb diversity.

    Science.gov (United States)

    Maier, Jennifer A; Rivas-Astroza, Marcelo; Deng, Jenny; Dowling, Anna; Oboikovitz, Paige; Cao, Xiaoyi; Behringer, Richard R; Cretekos, Chris J; Rasweiler, John J; Zhong, Sheng; Sears, Karen E

    2017-03-23

    From bat wings to whale flippers, limb diversification has been crucial to the evolutionary success of mammals. We performed the first transcriptome-wide study of limb development in multiple species to explore the hypothesis that mammalian limb diversification has proceeded through the differential expression of conserved shared genes, rather than by major changes to limb patterning. Specifically, we investigated the manner in which the expression of shared genes has evolved within and among mammalian species. We assembled and compared transcriptomes of bat, mouse, opossum, and pig fore- and hind limbs at the ridge, bud, and paddle stages of development. Results suggest that gene expression patterns exhibit larger variation among species during later than earlier stages of limb development, while within species results are more mixed. Consistent with the former, results also suggest that genes expressed at later developmental stages tend to have a younger evolutionary age than genes expressed at earlier stages. A suite of key limb-patterning genes was identified as being differentially expressed among the homologous limbs of all species. However, only a small subset of shared genes is differentially expressed in the fore- and hind limbs of all examined species. Similarly, a small subset of shared genes is differentially expressed within the fore- and hind limb of a single species and among the forelimbs of different species. Taken together, results of this study do not support the existence of a phylotypic period of limb development ending at chondrogenesis, but do support the hypothesis that the hierarchical nature of development translates into increasing variation among species as development progresses.

  12. Fingernails Yield Clues to Limb Regeneration

    Science.gov (United States)

    ... it is involved in limb formation in mammalian embryonic development, as well as limb regeneration in amphibians. ... of the nail stem cells and the underlying layer of cells called the nail epithelium are left ...

  13. Development and evolution of the mammalian limb: adaptive diversification of nails, hooves, and claws.

    Science.gov (United States)

    Hamrick, M W

    2001-01-01

    Paleontological evidence indicates that the evolutionary diversification of mammals early in the Cenozoic era was characterized by an adaptive radiation of distal limb structures. Likewise, neontological data show that morphological variation in distal limb integumentary appendages (e.g., nails, hooves, and claws) can be observed not only among distantly related mammalian taxa but also among closely related species within the same clade. Comparative analysis of nail, claw, and hoof morphogenesis reveals relatively subtle differences in mesenchymal and epithelial patterning underlying these adult differences in distal limb appendage morphology. Furthermore, studies of regulatory gene expression during vertebrate claw development demonstrate that many of the signaling molecules involved in patterning ectodermal derivatives such as teeth, hair, and feathers are also involved in organizing mammalian distal limb appendages. For example, Bmp4 signaling plays an important role during the recruitment of mesenchymal cells into the condensations forming the terminal phalanges, whereas Msx2 affects the length of nails and claws by suppressing proliferation of germinal epidermal cells. Evolutionary changes in the form of distal integumentary appendages may therefore result from changes in gene expression during formation of mesenchymal condensations (Bmp4, posterior Hox genes), induction of the claw fold and germinal matrix (shh), and/or proliferation of epidermal cells in the claw matrix (Msx1, Msx2). The prevalence of convergences and parallelisms in nail and claw structure among mammals underscores the existence of multiple morphogenetic pathways for evolutionary change in distal limb appendages.

  14. The two domain hypothesis of limb prepattern and its relevance to congenital limb anomalies.

    Science.gov (United States)

    Tao, Hirotaka; Kawakami, Yasuhiko; Hui, Chi-Chung; Hopyan, Sevan

    2017-07-01

    Functional annotation of mutations that cause human limb anomalies is enabled by basic developmental studies. In this study, we focus on the prepatterning stage of limb development and discuss a recent model that proposes anterior and posterior domains of the early limb bud generate two halves of the future skeleton. By comparing phenotypes in humans with those in model organisms, we evaluate whether this prepatterning concept helps to annotate human disease alleles. WIREs Dev Biol 2017, 6:e270. doi: 10.1002/wdev.270 For further resources related to this article, please visit the WIREs website. © 2017 Wiley Periodicals, Inc.

  15. Clustering of Tissue-Specific Sub-TADs Accompanies the Regulation of HoxA Genes in Developing Limbs

    Science.gov (United States)

    Berlivet, Soizik; Paquette, Denis; Dumouchel, Annie; Langlais, David; Dostie, Josée; Kmita, Marie

    2013-01-01

    HoxA genes exhibit central roles during development and causal mutations have been found in several human syndromes including limb malformation. Despite their importance, information on how these genes are regulated is lacking. Here, we report on the first identification of bona fide transcriptional enhancers controlling HoxA genes in developing limbs and show that these enhancers are grouped into distinct topological domains at the sub-megabase scale (sub-TADs). We provide evidence that target genes and regulatory elements physically interact with each other through contacts between sub-TADs rather than by the formation of discreet “DNA loops”. Interestingly, there is no obvious relationship between the functional domains of the enhancers within the limb and how they are partitioned among the topological domains, suggesting that sub-TAD formation does not rely on enhancer activity. Moreover, we show that suppressing the transcriptional activity of enhancers does not abrogate their contacts with HoxA genes. Based on these data, we propose a model whereby chromatin architecture defines the functional landscapes of enhancers. From an evolutionary standpoint, our data points to the convergent evolution of HoxA and HoxD regulation in the fin-to-limb transition, one of the major morphological innovations in vertebrates. PMID:24385922

  16. Clustering of tissue-specific sub-TADs accompanies the regulation of HoxA genes in developing limbs.

    Directory of Open Access Journals (Sweden)

    Soizik Berlivet

    Full Text Available HoxA genes exhibit central roles during development and causal mutations have been found in several human syndromes including limb malformation. Despite their importance, information on how these genes are regulated is lacking. Here, we report on the first identification of bona fide transcriptional enhancers controlling HoxA genes in developing limbs and show that these enhancers are grouped into distinct topological domains at the sub-megabase scale (sub-TADs. We provide evidence that target genes and regulatory elements physically interact with each other through contacts between sub-TADs rather than by the formation of discreet "DNA loops". Interestingly, there is no obvious relationship between the functional domains of the enhancers within the limb and how they are partitioned among the topological domains, suggesting that sub-TAD formation does not rely on enhancer activity. Moreover, we show that suppressing the transcriptional activity of enhancers does not abrogate their contacts with HoxA genes. Based on these data, we propose a model whereby chromatin architecture defines the functional landscapes of enhancers. From an evolutionary standpoint, our data points to the convergent evolution of HoxA and HoxD regulation in the fin-to-limb transition, one of the major morphological innovations in vertebrates.

  17. Analysis of Msx1; Msx2 double mutants reveals multiple roles for Msx genes in limb development.

    Science.gov (United States)

    Lallemand, Yvan; Nicola, Marie-Anne; Ramos, Casto; Bach, Antoine; Cloment, Cécile Saint; Robert, Benoît

    2005-07-01

    The homeobox-containing genes Msx1 and Msx2 are highly expressed in the limb field from the earliest stages of limb formation and, subsequently, in both the apical ectodermal ridge and underlying mesenchyme. However, mice homozygous for a null mutation in either Msx1 or Msx2 do not display abnormalities in limb development. By contrast, Msx1; Msx2 double mutants exhibit a severe limb phenotype. Our analysis indicates that these genes play a role in crucial processes during limb morphogenesis along all three axes. Double mutant limbs are shorter and lack anterior skeletal elements (radius/tibia, thumb/hallux). Gene expression analysis confirms that there is no formation of regions with anterior identity. This correlates with the absence of dorsoventral boundary specification in the anterior ectoderm, which precludes apical ectodermal ridge formation anteriorly. As a result, anterior mesenchyme is not maintained, leading to oligodactyly. Paradoxically, polydactyly is also frequent and appears to be associated with extended Fgf activity in the apical ectodermal ridge, which is maintained up to 14.5 dpc. This results in a major outgrowth of the mesenchyme anteriorly, which nevertheless maintains a posterior identity, and leads to formation of extra digits. These defects are interpreted in the context of an impairment of Bmp signalling.

  18. High acceptability of a newly developed urological practical skills training program.

    NARCIS (Netherlands)

    Vries, A.H. de; Luijk, S.J. van; Scherpbier, A.J.J.A.; Hendrikx, A.J.M.; Koldewijn, E.L.; Wagner, C.; Schout, B.M.A.

    2015-01-01

    Background: Benefits of simulation training are widely recognized, but its structural implementation into urological curricula remains challenging. This study aims to gain insight into current and ideal urological practical skills training and presents the outline of a newly developed skills

  19. High acceptability of a newly developed urological practical skills training program

    NARCIS (Netherlands)

    de Vries, A.H.; van Luijk, S.J.; Scherpbier, A.J.J.A.; Hendrikx, A.J.M.; Koldewijn, E.L.; Wagner, C.; Schout, B.M.A.

    2015-01-01

    Background: Benefits of simulation training are widely recognized, but its structural implementation into urological curricula remains challenging. This study aims to gain insight into current and ideal urological practical skills training and presents the outline of a newly developed skills

  20. Case-control study of risk factors for the development of laminitis in the contralateral limb in Equidae with unilateral lameness

    International Nuclear Information System (INIS)

    Peloso, J.G.; Cohen, N.D.; Walker, M.A.; Watkins, J.P.; Gayle, J.M.; Moyer, W.

    1996-01-01

    To identify risk factors associated with development of laminitis of the supporting limb in Equidae with unilateral laminitis and to determine the radiographic appearance of this type of laminitis. Retrospective analysis of medical records. 20 Equidae with unilateral lameness that developed laminitis of the contralateral limb. Case animals were compared with matched and unmatched populations of control animals that did not develop contralateral limb laminitis. Lateromedial radiographic projections of affected feet were evaluated for evidence of laminitis. Body weight of case animals was not significantly different from that of control animals, but number of days that control animals were lame prior to recovery was significantly less than number of days that case animals were lame prior to the onset of laminitis. Lateromedial radiographic projections of the foot of the support limb were available for 16 of the 20 case animals. For all 16, thickness of the soft tissue dorsal to the distal phalanx was > 29% of the palmar cortical length of the distal phalanx, but only 1 had evidence of rotation of the distal phalanx. The proportion of case animals that were euthanatized was significantly greater than the proportion of control animals that were euthanatized. Duration of lameness, but not body weight, was a risk factor for development of laminitis in the contralateral limb in Equidae with unilateral lameness, and animals that developed this complication were more likely to be euthanatized than were animals that did not

  1. Radiographic anatomy of developing canine pectoral limb

    International Nuclear Information System (INIS)

    Charjan, R.Y.; Bhamburkar, V.R.; Dalvi, R.S.; Banubakode, S.B.

    2006-01-01

    Age period for the appearance of the ossification centre that appear after birth in the limb bones of the dog were determined by radiography, at set intervals in 3 German Shepherd, Pomeranian and Non-descript. The ossification centres appeared in the same chronological order, but the ages at which they appear, showed variation

  2. Robotics in Lower-Limb Rehabilitation after Stroke.

    Science.gov (United States)

    Zhang, Xue; Yue, Zan; Wang, Jing

    2017-01-01

    With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots.

  3. Lymphoedema of the lower limbs: management problems in a developing country.

    Science.gov (United States)

    Adigun, A I; Ogundipe, O K

    2008-01-01

    Lymphoedema is a clinical condition involving the extremities that is characterized by accumulation of protein rich fluid within the intercellular space of the skin and the subcutaneous tissue. It most frequently occurs in the extremities. Developing countries are mostly faced with cases of secondary lymphoedema where patients present lately. In addition to swollen limbs, there are lot of skin changes on the affected limb, these create a lot of problems to the managing clinician. We hereby present five cases out of several patients managed to highlight the challenges. We review the case notes of three patients managed by our unit and present the summary of each patient. Majority of our patients present late to the hospital, mainly because of the socio-cultural and spiritual beliefs concerning the aetiology of the condition. Most of them have visited the spiritualist, herbalist and the clergymen for solution. Clinicians in the developing countries are seriously handicapped by lack of modern equipment for both diagnostic and therapeutic management of these clinical conditions. Chronic lymphoedema is a major cause of permanent disability. Excisional surgery such as Charles procedure even though old is still very much relevant in our environment. Patients need to be enlightened on the need for early presentation, adequate post-operative care and prolonged follow-up.

  4. From fins to limbs to fins: limb evolution in fossil marine reptiles.

    Science.gov (United States)

    Caldwell, Michael W

    2002-10-15

    Limb osteology and ontogenetic patterns of limb ossification are reviewed for extinct lineages of aquatically adapted diapsid reptiles. Phylogenies including these fossil taxa show that paddle-like limbs were independently derived, and that the varied limb morphologies were produced by evolutionary modifications to different aspects of the limb skeleton. Ancient marine reptiles modify the limb by reducing the relative size of the epipodials, modifying the perichondral and periosteal surface of elements distal to the propodials, and evolving extremes of hyperphalangy and hyperdactyly. Developmental genetic models illuminate gene systems that may have controlled limb evolution in these animals. Copyright 2002 Wiley-Liss, Inc.

  5. Gait and Lower Limb Observation of Paediatrics (GALLOP): development of a consensus based paediatric podiatry and physiotherapy standardised recording proforma.

    Science.gov (United States)

    Cranage, Simone; Banwell, Helen; Williams, Cylie M

    2016-01-01

    Paediatric gait and lower limb assessments are frequently undertaken in podiatry and physiotherapy clinical practice and this is a growing area of expertise within Australia. No concise paediatric standardised recording proforma exists to assist clinicians in clinical practice. The aim of this study was to develop a gait and lower limb standardised recording proforma guided by the literature and consensus, for assessment of the paediatric foot and lower limb in children aged 0-18 years. Expert Australian podiatrists and physiotherapists were invited to participate in a three round Delphi survey panel using the online Qualtrics(©) survey platform. The first round of the survey consisted of open-ended questions on paediatric gait and lower limb assessment developed from existing templates and a literature search of standardised lower limb assessment methods. Rounds two and three consisted of statements developed from the first round responses. Questions and statements were included in the final proforma if 70 % or more of the participants indicated consensus or agreement with the assessment method and if there was support within the literature for paediatric age-specific normative data with acceptable reliability of outcome measures. There were 17 of the 21 (81 %) participants who completed three rounds of the survey. Consensus was achieved for 41 statements in Round one, 54 statements achieved agreement in two subsequent rounds. Participants agreed on 95 statements relating to birth history, developmental history, hip measurement, rotation of the lower limb, ankle range of motion, foot posture, balance and gait. Assessments with acceptable validity and reliability were included within the final Gait and Lower Limb Observation of Paediatrics (GALLOP) proforma. The GALLOP proforma is a consensus based, systematic and standardised way to collect information and outcome measures in paediatric lower limb assessment. This standardised recording proforma will assist

  6. Functional Capacity Evaluation in Upper Limb Reduction Deficiency and Amputation : Development and Pilot Testing

    NARCIS (Netherlands)

    Postema, S G; Bongers, R M; Reneman, M F; van der Sluis, C K

    Purpose To develop and pilot test a functional capacity evaluation (FCE) for individuals with upper limb absence (ULA) due to reduction deficiency or amputation, and to examine the relationship between FCE results and presence of musculoskeletal complaints (MSC). Method Five tests (overhead lifting,

  7. Advanced upper limb prosthetic devices: implications for upper limb prosthetic rehabilitation.

    Science.gov (United States)

    Resnik, Linda; Meucci, Marissa R; Lieberman-Klinger, Shana; Fantini, Christopher; Kelty, Debra L; Disla, Roxanne; Sasson, Nicole

    2012-04-01

    The number of catastrophic injuries caused by improvised explosive devices in the Afghanistan and Iraq Wars has increased public, legislative, and research attention to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize the function of an advanced prosthetic arm system that will enable greater independence and function. In this special communication, we examine current practices in prosthetic rehabilitation including trends in adoption and use of prosthetic devices, financial considerations, and the role of rehabilitation team members in light of our experiences with a prototype advanced upper limb prosthesis during a VA study to optimize the device. We discuss key challenges in the adoption of advanced prosthetic technology and make recommendations for service provision and use of advanced upper limb prosthetics. Rates of prosthetic rejection are high among upper limb amputees. However, these rates may be reduced with sufficient training by a highly specialized, multidisciplinary team of clinicians, and a focus on patient education and empowerment throughout the rehabilitation process. There are significant challenges emerging that are unique to implementing the use of advanced upper limb prosthetic technology, and a lack of evidence to establish clinical guidelines regarding prosthetic prescription and treatment. Finally, we make recommendations for future research to aid in the identification of best practices and development of policy decisions regarding insurance coverage of prosthetic rehabilitation. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Acetylcholinesterase Regulates Skeletal In Ovo Development of Chicken Limbs by ACh-Dependent and -Independent Mechanisms.

    Directory of Open Access Journals (Sweden)

    Janine Spieker

    Full Text Available Formation of the vertebrate limb presents an excellent model to analyze a non-neuronal cholinergic system (NNCS. Here, we first analyzed the expression of acetylcholinesterase (AChE by IHC and of choline acetyltransferase (ChAT by ISH in developing embryonic chicken limbs (stages HH17-37. AChE outlined formation of bones, being strongest at their distal tips, and later also marked areas of cell death. At onset, AChE and ChAT were elevated in two organizing centers of the limb anlage, the apical ectodermal ridge (AER and zone of polarizing activity (ZPA, respectively. Thereby ChAT was expressed shortly after AChE, thus strongly supporting a leading role of AChE in limb formation. Then, we conducted loss-of-function studies via unilateral implantation of beads into chicken limb anlagen, which were soaked in cholinergic components. After varying periods, the formation of cartilage matrix and of mineralizing bones was followed by Alcian blue (AB and Alizarin red (AR stainings, respectively. Both acetylcholine (ACh- and ChAT-soaked beads accelerated bone formation in ovo. Notably, inhibition of AChE by BW284c51, or by the monoclonal antibody MAB304 delayed cartilage formation. Since bead inhibition of BChE was mostly ineffective, an ACh-independent action during BW284c51 and MAB304 inhibition was indicated, which possibly could be due to an enzymatic side activity of AChE. In conclusion, skeletogenesis in chick is regulated by an ACh-dependent cholinergic system, but to some extent also by an ACh-independent aspect of the AChE protein.

  9. Radiography of syndactylous limbs of cattle

    International Nuclear Information System (INIS)

    Taura, Y.; Takeuchi, A.; Uchino, T.

    1985-01-01

    Fore and hind limbs of 4-month-old Holstein-Friesian cattle ♀ (No.I) and those of 1-month-old Holstein-Friesian×Japanese Black cattle ♀ (No.II) suffering from syndactyly were dissected by means of radiographic examinations. The details were reported as follows. 1. The phalanges of both fore and left hind limbs of No.II cattle were completely fused. But, all the phalanges of left fore limb and proximal phalanges of right fore limb in No.I and the distal phalanges of right hind limb in No.II were normal, the others being of partial synostosis. 2. The distal parforating canal was absent in the metacarpus and the right metatarsus in No.II cattle. Also, in No.II on the distal part of the metacarpal or metatarsal, bone vestiges were noted, not only of the fifth and second metacarpus or metatarsus, but also the mutually jointed phalanges. 3. In No.I cattle, the left fore limb and 4 proximal sesamoid bones and 2 distal sesamoid bones, but the right limb had 4 sesamoid bones and 0 distal one. In No.II cattle, the fore limbs had 2 proximal and 0 distal sesamoid bones, left hind limb had 3 proximal and 0 distal ones, right hind limb had 3 proximal and 1 distal ones. 4. The arteries accommodated the syndactylous deformities. The median and radial arteries were fixed to be descended on to the palmar side of the metacarpus and mutually anastomosed to form a deep palmar arch. arising from the deep palmar arch, two branches (palmar proper digital aa. III and IV) were terminated by the lateral and medial palmar surfaces of the digit, where some anastomosing arches were formed by them. The arteries of the hind limbs were also similar to those of the fore limbs. 5. In radiographic examinations of syndactyly (in No.II) after 7-month feeding, hoof and digital bones were noted to have been developed, but distal phalanges were destructed and left in suspicion of bad prognosis

  10. Focal skin defect, limb anomalies and microphthalmia.

    NARCIS (Netherlands)

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

    2004-01-01

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

  11. Capturing the Perceived Phantom Limb through Virtual Reality

    Directory of Open Access Journals (Sweden)

    Christian Rogers

    2016-01-01

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

  12. The origin of vertebrate limbs.

    Science.gov (United States)

    Coates, M I

    1994-01-01

    The earliest tetrapod limbs are polydactylous, morphologically varied and do not conform to an archetypal pattern. These discoveries, combined with the unravelling of limb developmental morphogenetic and regulatory mechanisms, have prompted a re-examination of vertebrate limb evolution. The rich fossil record of vertebrate fins/limbs, although restricted to skeletal tissues, exceeds the morphological diversity of the extant biota, and a systematic approach to limb evolution produces an informative picture of evolutionary change. A composite framework of several phylogenetic hypotheses is presented incorporating living and fossil taxa, including the first report of an acanthodian metapterygium and a new reconstruction of the axial skeleton and caudal fin of Acanthostega gunnari. Although significant nodes in vertebrate phylogeny remain poorly resolved, clear patterns of morphogenetic evolution emerge: median fin origination and elaboration initially precedes that of paired fins; pectoral fins initially precede pelvic fin development; evolving patterns of fin distribution, skeletal tissue diversity and structural complexity become decoupled with increased taxonomic divergence. Transformational sequences apparent from the fish-tetrapod transition are reiterated among extant lungfishes, indicating further directions for comparative experimental research. The evolutionary diversification of vertebrate fin and limb patterns challenges a simple linkage between Hox gene conservation, expression and morphology. A phylogenetic framework is necessary in order to distinguish shared from derived characters in experimental model regulatory systems. Hox and related genomic evolution may include convergent patterns underlying functional and morphological diversification. Brachydanio is suggested as an example where tail-drive patterning demands may have converged with the regulation of highly differentiated limbs in tetrapods.

  13. Analysis of the expression and function of Wnt-5a and Wnt-5b in developing and regenerating axolotl (Ambystoma mexicanum) limbs.

    Science.gov (United States)

    Ghosh, Sukla; Roy, Stéphane; Séguin, Carl; Bryant, Susan V; Gardiner, David M

    2008-05-01

    Urodele amphibians are unique adult vertebrates because they are able to regenerate body parts after amputation. Studies of urodele limb regeneration, the key model system for vertebrate regeneration, have led to an understanding of the origin of blastema cells and the importance of positional interactions between blastema cells in the control of growth and pattern formation. Progress is now being made in the identification of the signaling pathways that regulate dedifferentiation, blastema morphogenesis, growth and pattern formation. Members of the Wnt family of secreted proteins are expressed in developing and regenerating limbs, and have the potential to control growth, pattern formation and differentiation. We have studied the expression of two non-canonical Wnt genes, Wnt-5a and Wnt-5b. We report that they are expressed in equivalent patterns during limb development and limb regeneration in the axolotl (Ambystoma mexicanum), and during limb development in other tetrapods, implying conservation of function. Our analysis of the effects of ectopic Wnt-5a expression is consistent with the hypothesis that canonical Wnt signaling functions during the early stages of regeneration to control the dedifferentiation of stump cells giving rise to the regeneration-competent cells of the blastema.

  14. Dact gene expression profiles suggest a role for this gene family in integrating Wnt and TGF-β signaling pathways during chicken limb development.

    Science.gov (United States)

    Sensiate, Lucimara Aparecida; Sobreira, Débora R; Da Veiga, Fernanda Cristina; Peterlini, Denner Jefferson; Pedrosa, Angelica Vasconcelos; Rirsch, Thaís; Joazeiro, Paulo Pinto; Schubert, Frank R; Collares-Buzato, Carla Beatriz; Xavier-Neto, José; Dietrich, Susanne; Alvares, Lúcia Elvira

    2014-03-01

    Dact gene family encodes multifunctional proteins that are important modulators of Wnt and TGF-β signaling pathways. Given that these pathways coordinate multiple steps of limb development, we investigated the expression pattern of the two chicken Dact genes (Dact1 and Dact2) from early limb bud up to stages when several tissues are differentiating. During early limb development (HH24-HH30) Dact1 and Dact2 were mainly expressed in the cartilaginous rudiments of the appendicular skeleton and perichondrium, presenting expression profiles related, but distinct. At later stages of development (HH31-HH35), the main sites of Dact1 and Dact2 expression were the developing synovial joints. In this context, Dact1 expression was shown to co-localize with regions enriched in the nuclear β-catenin protein, such as developing joint capsule and interzone. In contrast, Dact2 expression was restricted to the interzone surrounding the domains of bmpR-1b expression, a TGF-β receptor with crucial roles during digit morphogenesis. Additional sites of Dact expression were the developing tendons and digit blastemas. Our data indicate that Dact genes are good candidates to modulate and, possibly, integrate Wnt and TGF-β signaling during limb development, bringing new and interesting perspectives about the roles of Dact molecules in limb birth defects and human diseases. Copyright © 2013 Wiley Periodicals, Inc.

  15. Detection of genes regulated by Lmx1b during limb dorsalization.

    Science.gov (United States)

    Feenstra, Jennifer M; Kanaya, Kohei; Pira, Charmaine U; Hoffman, Sarah E; Eppey, Richard J; Oberg, Kerby C

    2012-05-01

    Lmx1b is a homeodomain transcription factor that regulates dorsal identity during limb development. Lmx1b knockout (KO) mice develop distal ventral-ventral limbs. Although induction of Lmx1b is linked to Wnt7a expression in the dorsal limb ectoderm, the downstream targets of Lmx1b that accomplish limb dorsalization are unknown. To identify genes targeted by Lmx1b, we compared gene arrays from Lmx1b KO and wild type mouse limbs during limb dorsalization, i.e., 11.5, 12.5, and 13.5 days post coitum. We identified 54 target genes that were differentially expressed in all three stages. Several skeletal targets, including Emx2, Matrilin1 and Matrilin4, demonstrated a loss of scapular expression in the Lmx1b KO mice, supporting a role for Lmx1b in scapula development. Furthermore, the relative abundance of extracellular matrix-related soft tissue targets regulated by Lmx1b, such as collagens and proteoglycans, suggests a mechanism that includes changes in the extracellular matrix composition to accomplish limb dorsalization. Our study provides the most comprehensive characterization of genes regulated by Lmx1b during limb development to-date and provides targets for further investigation. © 2012 The Authors. Development, Growth & Differentiation © 2012 Japanese Society of Developmental Biologists.

  16. Artificial limb representation in amputees

    OpenAIRE

    van den Heiligenberg, FMZ; Orlov, T; Macdonald, SN; Duff, EP; Henderson Slater, JDE; Beckmann, CF; Johansen-Berg, H; Culham, JC; Makin, TR

    2018-01-01

    The human brain contains multiple hand-selective areas, in both the sensorimotor and visual systems. Could our brain repurpose neural resources, originally developed for supporting hand function, to represent and control artificial limbs? We studied individuals with congenital or acquired hand-loss (hereafter one-handers) using functional MRI. We show that the more one-handers use an artificial limb (prosthesis) in their everyday life, the stronger visual hand-selective areas in the lateral o...

  17. Development and reliability of the rating of compensatory movements in upper limb prosthesis wearers during work-related tasks.

    Science.gov (United States)

    van der Laan, Tallie M J; Postema, Sietke G; Reneman, Michiel F; Bongers, Raoul M; van der Sluis, Corry K

    2018-02-10

    Reliability study. Quantifying compensatory movements during work-related tasks may help to prevent musculoskeletal complaints in individuals with upper limb absence. (1) To develop a qualitative scoring system for rating compensatory shoulder and trunk movements in upper limb prosthesis wearers during the performance of functional capacity evaluation tests adjusted for use by 1-handed individuals (functional capacity evaluation-one handed [FCE-OH]); (2) to examine the interrater and intrarater reliability of the scoring system; and (3) to assess its feasibility. Movement patterns of 12 videotaped upper limb prosthesis wearers and 20 controls were analyzed. Compensatory movements were defined for each FCE-OH test, and a scoring system was developed, pilot tested, and adjusted. During reliability testing, 18 raters (12 FCE experts and 6 physiotherapists/gait analysts) scored videotapes of upper limb prosthesis wearers performing 4 FCE-OH tests 2 times (2 weeks apart). Agreement was expressed in % and kappa value. Feasibility (focus area's "acceptability", "demand," and "implementation") was determined by using a questionnaire. After 2 rounds of pilot testing and adjusting, reliability of a third version was tested. The interrater reliability for the first and second rating sessions were к = 0.54 (confidence interval [CI]: 0.52-0.57) and к = 0.64 (CI: 0.61-0.66), respectively. The intrarater reliability was к = 0.77 (CI: 0.72-0.82). The feasibility was good but could be improved by a training program. It seems possible to identify compensatory movements in upper limb prosthesis wearers during the performance of FCE-OH tests reliably by observation using the developed observational scoring system. Interrater reliability was satisfactory in most instances; intrarater reliability was good. Feasibility was established. Copyright © 2018 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  18. Vertebrate limb development: moving from classical morphogen gradients to an integrated 4-dimensional patterning system.

    Science.gov (United States)

    Bénazet, Jean-Denis; Zeller, Rolf

    2009-10-01

    A wealth of classical embryological manipulation experiments taking mainly advantage of the chicken limb buds identified the apical ectodermal ridge (AER) and the zone of polarizing activity (ZPA) as the respective ectodermal and mesenchymal key signaling centers coordinating proximodistal (PD) and anteroposterior (AP) limb axis development. These experiments inspired Wolpert's French flag model, which is a classic among morphogen gradient models. Subsequent molecular and genetic analysis in the mouse identified retinoic acid as proximal signal, and fibroblast growth factors (FGFs) and sonic hedgehog (SHH) as the essential instructive signals produced by AER and ZPA, respectively. Recent studies provide good evidence that progenitors are specified early with respect to their PD and AP fates and that morpho-regulatory signaling is also required for subsequent proliferative expansion of the specified progenitor pools. The determination of particular fates seems to occur rather late and depends on additional signals such as bone morphogenetic proteins (BMPs), which indicates that cells integrate signaling inputs over time and space. The coordinate regulation of PD and AP axis patterning is controlled by an epithelial-mesenchymal feedback signaling system, in which transcriptional regulation of the BMP antagonist Gremlin1 integrates inputs from the BMP, SHH, and FGF pathways. Vertebrate limb-bud development is controlled by a 4-dimensional (4D) patterning system integrating positive and negative regulatory feedback loops, rather than thresholds set by morphogen gradients.

  19. Adjustments to amputation and an artificial limb in lower limb amputees

    NARCIS (Netherlands)

    Sinha, Richa; van den Heuvel, Wim J. A.; Arokiasamy, Perianayagam

    Background: Positive adjustments to amputation and an artificial limb play important roles in the rehabilitation process. Objectives: To study the different facets of adjustments to amputation and an artificial limb in lower limb amputees and to assess the possible role of different background and

  20. The axolotl limb blastema: cellular and molecular mechanisms driving blastema formation and limb regeneration in tetrapods

    Science.gov (United States)

    McCusker, Catherine; Bryant, Susan V.

    2015-01-01

    Abstract The axolotl is one of the few tetrapods that are capable of regenerating complicated biological structures, such as complete limbs, throughout adulthood. Upon injury the axolotl generates a population of regeneration‐competent limb progenitor cells known as the blastema, which will grow, establish pattern, and differentiate into the missing limb structures. In this review we focus on the crucial early events that occur during wound healing, the neural−epithelial interactions that drive the formation of the early blastema, and how these mechanisms differ from those of other species that have restricted regenerative potential, such as humans. We also discuss how the presence of cells from the different axes of the limb is required for the continued growth and establishment of pattern in the blastema as described in the polar coordinate model, and how this positional information is reprogrammed in blastema cells during regeneration. Multiple cell types from the mature limb stump contribute to the blastema at different stages of regeneration, and we discuss the contribution of these types to the regenerate with reference to whether they are “pattern‐forming” or “pattern‐following” cells. Lastly, we explain how an engineering approach will help resolve unanswered questions in limb regeneration, with the goal of translating these concepts to developing better human regenerative therapies. PMID:27499868

  1. Development of subliminal persuasion system to improve the upper limb posture in laparoscopic training: a preliminary study.

    Science.gov (United States)

    Zhang, Di; Sessa, Salvatore; Kong, Weisheng; Cosentino, Sarah; Magistro, Daniele; Ishii, Hiroyuki; Zecca, Massimiliano; Takanishi, Atsuo

    2015-11-01

    Current training for laparoscopy focuses only on the enhancement of manual skill and does not give advice on improving trainees' posture. However, a poor posture can result in increased static muscle loading, faster fatigue, and impaired psychomotor task performance. In this paper, the authors propose a method, named subliminal persuasion, which gives the trainee real-time advice for correcting the upper limb posture during laparoscopic training like the expert but leads to a lower increment in the workload. A 9-axis inertial measurement unit was used to compute the upper limb posture, and a Detection Reaction Time device was developed and used to measure the workload. A monitor displayed not only images from laparoscope, but also a visual stimulus, a transparent red cross superimposed to the laparoscopic images, when the trainee had incorrect upper limb posture. One group was exposed, when their posture was not correct during training, to a short (about 33 ms) subliminal visual stimulus. The control group instead was exposed to longer (about 660 ms) supraliminal visual stimuli. We found that subliminal visual stimulation is a valid method to improve trainees' upper limb posture during laparoscopic training. Moreover, the additional workload required for subconscious processing of subliminal visual stimuli is less than the one required for supraliminal visual stimuli, which is processed instead at the conscious level. We propose subliminal persuasion as a method to give subconscious real-time stimuli to improve upper limb posture during laparoscopic training. Its effectiveness and efficiency were confirmed against supraliminal stimuli transmitted at the conscious level: Subliminal persuasion improved upper limb posture of trainees, with a smaller increase on the overall workload.

  2. Functional analysis of limb transcriptional enhancers in the mouse.

    Science.gov (United States)

    Nolte, Mark J; Wang, Ying; Deng, Jian Min; Swinton, Paul G; Wei, Caimiao; Guindani, Michele; Schwartz, Robert J; Behringer, Richard R

    2014-01-01

    Transcriptional enhancers are genomic sequences bound by transcription factors that act together with basal transcriptional machinery to regulate gene transcription. Several high-throughput methods have generated large datasets of tissue-specific enhancer sequences with putative roles in developmental processes. However, few enhancers have been deleted from the genome to determine their roles in development. To understand the roles of two enhancers active in the mouse embryonic limb bud we deleted them from the genome. Although the genes regulated by these enhancers are unknown, they were selected because they were identified in a screen for putative limb bud-specific enhancers associated with p300, an acetyltransferase that participates in protein complexes that promote active transcription, and because the orthologous human enhancers (H1442 and H280) drive distinct lacZ expression patterns in limb buds of embryonic day (E) 11.5 transgenic mice. We show that the orthologous mouse sequences, M1442 and M280, regulate dynamic expression in the developing limb. Although significant transcriptional differences in enhancer-proximal genes in embryonic limb buds accompany the deletion of M1442 and M280 no gross limb malformations during embryonic development were observed, demonstrating that M1442 and M280 are not required for mouse limb development. However, M280 is required for the development and/or maintenance of body size; M280 mice are significantly smaller than controls. M280 also harbors an "ultraconserved" sequence that is identical between human, rat, and mouse. This is the first report of a phenotype resulting from the deletion of an ultraconserved element. These studies highlight the importance of determining enhancer regulatory function by experiments that manipulate them in situ and suggest that some of an enhancer's regulatory capacities may be developmentally tolerated rather than developmentally required. © 2014 Wiley Periodicals, Inc.

  3. Limb anomaly and associated conditions: our clinical experience

    Directory of Open Access Journals (Sweden)

    Ragavan M

    2011-03-01

    Full Text Available Munisamy Ragavan1, Uppalu Haripriya1, Janarthanam Sarvavinothini2, Nagaraja Rao3, Ramamoorthy Gokulkrishnan31Department of Pediatric Surgery, 2Department of Anesthesia, 3Department of Pediatrics, Narayana Medical College and Superspeciality Hospital, Nellore, Andhra Pradesh, IndiaAbstract: Limb anomalies are a common clinical problem with a various spectrum of involvement. There are many conditions associated with these anomalies. There is a variable extent of involvement in the form of agenesis, overgrowth, and duplication, and there is no standard classification to describe all these lesions. Studying limb anomalies provides insights into limb development which may be useful for etiologic studies and public health monitoring. We pooled our data for 12 limb anomaly cases presenting from January 2008 to May 2009 and investigated their associated conditions. A descriptive system for the nomenclature and classification of congenital limb malformations suitable for clinical, epidemiological, and experimental use is discussed.Keywords: limb anomaly, phocomelia, amelia 

  4. Ectopic expression of Msx-2 in posterior limb bud mesoderm impairs limb morphogenesis while inducing BMP-4 expression, inhibiting cell proliferation, and promoting apoptosis.

    Science.gov (United States)

    Ferrari, D; Lichtler, A C; Pan, Z Z; Dealy, C N; Upholt, W B; Kosher, R A

    1998-05-01

    During early stages of chick limb development, the homeobox-containing gene Msx-2 is expressed in the mesoderm at the anterior margin of the limb bud and in a discrete group of mesodermal cells at the midproximal posterior margin. These domains of Msx-2 expression roughly demarcate the anterior and posterior boundaries of the progress zone, the highly proliferating posterior mesodermal cells underneath the apical ectodermal ridge (AER) that give rise to the skeletal elements of the limb and associated structures. Later in development as the AER loses its activity, Msx-2 expression expands into the distal mesoderm and subsequently into the interdigital mesenchyme which demarcates the developing digits. The domains of Msx-2 expression exhibit considerably less proliferation than the cells of the progress zone and also encompass several regions of programmed cell death including the anterior and posterior necrotic zones and interdigital mesenchyme. We have thus suggested that Msx-2 may be in a regulatory network that delimits the progress zone by suppressing the morphogenesis of the regions of the limb mesoderm in which it is highly expressed. In the present study we show that ectopic expression of Msx-2 via a retroviral expression vector in the posterior mesoderm of the progress zone from the time of initial formation of the limb bud severely impairs limb morphogenesis. Msx-2-infected limbs are typically very narrow along the anteroposterior axis, are occasionally truncated, and exhibit alterations in the pattern of formation of skeletal elements, indicating that as a consequence of ectopic Msx-2 expression the morphogenesis of large portions of the posterior mesoderm has been suppressed. We further show that Msx-2 impairs limb morphogenesis by reducing cell proliferation and promoting apoptosis in the regions of the posterior mesoderm in which it is ectopically expressed. The domains of ectopic Msx-2 expression in the posterior mesoderm also exhibit ectopic

  5. Development and operation of an off-limb solar AO system

    Science.gov (United States)

    Taylor, Gregory Edward

    2014-01-01

    An Adaptive Optics system capable of locking-on to off-limb prominence structure has been proven successful. It has been shown to allow for diffraction limited spectroscopy and polarimetry of prominence structure. Spectroscopic data obtained using the Off-Limb AO system have been shown to contain a trove of information regarding the nature of solar prominences. In particular a Rayleigh-Taylor instability was seen in part of this data set. Such instabilities, and the rising plumes that result from them, are thought to be critical clues to the longterm persistence of quiescent solar prominences. This adaptive optics system will allow scientists to come one step closer to understanding the true nature of solar prominences.

  6. Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ross H. Miller

    2017-02-01

    Full Text Available Background Individuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss. Methods Cross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW. Results Peak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s vs. controls (157% BW, 1,985% BW/s, with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters. Discussion Assuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted.

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Phantom Limbs, Neuroprosthetics, and the Developmental Origins of Embodiment.

    Science.gov (United States)

    Blumberg, Mark S; Dooley, James C

    2017-10-01

    Amputees who wish to rid themselves of a phantom limb must weaken the neural representation of the absent limb. Conversely, amputees who wish to replace a lost limb must assimilate a neuroprosthetic with the existing neural representation. Whether we wish to remove a phantom limb or assimilate a synthetic one, we will benefit from knowing more about the developmental process that enables embodiment. A potentially critical contributor to that process is the spontaneous activity - in the form of limb twitches - that occurs exclusively and abundantly during active (REM) sleep, a particularly prominent state in early development. The sensorimotor circuits activated by twitching limbs, and the developmental context in which activation occurs, could provide a roadmap for creating neuroprosthetics that feel as if they are part of the body. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Improving a newly developed patient-reported outcome for thyroid patients, using cognitive interviewing

    DEFF Research Database (Denmark)

    Watt, Torquil; Rasmussen, Ase Krogh; Groenvold, Mogens

    2008-01-01

    Objective To improve a newly developed patient-reported outcome measure for thyroid patients using cognitive interviewing. Methods Thirty-one interviews using immediate retrospective and expansive probing were conducted among patients with non-toxic goiter (n = 4), nodular toxic goiter (n = 5) Gr...

  10. Newly Developed Ceramic Membranes for Dehydration and Separation of Organic Mixtures by Pervaporation

    NARCIS (Netherlands)

    Gemert, van R.W.; Cuperus, F.P.

    1995-01-01

    Polymeric pervaporation membranes sometimes show great variety in performance when they are alternately used for different solvent mixtures. In addition, membrane stability in time is a problem in case of some solvents. Therefore, newly developed ceramic silica membranes with a 'dense' top layer

  11. Soft Tissue Coverage of the Lower Limb following Oncological Surgery.

    Science.gov (United States)

    Radtke, Christine; Panzica, Martin; Dastagir, Khaled; Krettek, Christian; Vogt, Peter M

    2015-01-01

    The treatment of lower limb tumors has been shifted by advancements in adjuvant treatment protocols and microsurgical reconstruction from limb amputation to limb salvage. Standard approaches include oncological surgery by a multidisciplinary team in terms of limb sparing followed by soft tissue reconstruction and adjuvant therapy when indicated. For the development of a comprehensive surgical plan, the identity of the tumor should first be determined by histology after biopsy. Then the surgical goal and comprehensive treatment concept should be developed by a multidisciplinary tumor board and combined with soft tissue reconstruction. In this article, plastic surgical reconstruction options for soft coverage of the lower extremity following oncological surgery will be described along with the five clinical cases.

  12. Soft tissue coverage of the lower limb following oncological surgery

    Directory of Open Access Journals (Sweden)

    Christine eRadtke

    2016-01-01

    Full Text Available The treatment of lower limb tumours has been shifted by advancements in adjuvant treatment protocols and microsurgical reconstruction from limb amputation to limb salvage. Standard approaches include oncological surgery by a multidisciplinary team in terms of limb sparing followed by soft tissue reconstruction and adjuvant therapy when indicated. For development of a comprehensive surgical plan, the identity of the tumour should first be determined by histology after biopsy. Then the surgical goal and comprehensive treatment concept should be developed by a multidisciplinary tumour board and combined with soft tissue reconstruction. In this article, plastic surgical reconstruction options for soft coverage of the lower extremity following oncologic surgery will be described along with five clinical cases.

  13. Brain machine interface and limb reanimation technologies: restoring function after spinal cord injury through development of a bypass system.

    Science.gov (United States)

    Lobel, Darlene A; Lee, Kendall H

    2014-05-01

    Functional restoration of limb movement after traumatic spinal cord injury (SCI) remains the ultimate goal in SCI treatment and directs the focus of current research strategies. To date, most investigations in the treatment of SCI focus on repairing the injury site. Although offering some promise, these efforts have met with significant roadblocks because treatment measures that are successful in animal trials do not yield similar results in human trials. In contrast to biologic therapies, there are now emerging neural interface technologies, such as brain machine interface (BMI) and limb reanimation through electrical stimulators, to create a bypass around the site of the SCI. The BMI systems analyze brain signals to allow control of devices that are used to assist SCI patients. Such devices may include a computer, robotic arm, or exoskeleton. Limb reanimation technologies, which include functional electrical stimulation, epidural stimulation, and intraspinal microstimulation systems, activate neuronal pathways below the level of the SCI. We present a concise review of recent advances in the BMI and limb reanimation technologies that provides the foundation for the development of a bypass system to improve functional outcome after traumatic SCI. We also discuss challenges to the practical implementation of such a bypass system in both these developing fields. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  14. Anatomical Network Comparison of Human Upper and Lower, Newborn and Adult, and Normal and Abnormal Limbs, with Notes on Development, Pathology and Limb Serial Homology vs. Homoplasy.

    Science.gov (United States)

    Diogo, Rui; Esteve-Altava, Borja; Smith, Christopher; Boughner, Julia C; Rasskin-Gutman, Diego

    2015-01-01

    How do the various anatomical parts (modules) of the animal body evolve into very different integrated forms (integration) yet still function properly without decreasing the individual's survival? This long-standing question remains unanswered for multiple reasons, including lack of consensus about conceptual definitions and approaches, as well as a reasonable bias toward the study of hard tissues over soft tissues. A major difficulty concerns the non-trivial technical hurdles of addressing this problem, specifically the lack of quantitative tools to quantify and compare variation across multiple disparate anatomical parts and tissue types. In this paper we apply for the first time a powerful new quantitative tool, Anatomical Network Analysis (AnNA), to examine and compare in detail the musculoskeletal modularity and integration of normal and abnormal human upper and lower limbs. In contrast to other morphological methods, the strength of AnNA is that it allows efficient and direct empirical comparisons among body parts with even vastly different architectures (e.g. upper and lower limbs) and diverse or complex tissue composition (e.g. bones, cartilages and muscles), by quantifying the spatial organization of these parts-their topological patterns relative to each other-using tools borrowed from network theory. Our results reveal similarities between the skeletal networks of the normal newborn/adult upper limb vs. lower limb, with exception to the shoulder vs. pelvis. However, when muscles are included, the overall musculoskeletal network organization of the upper limb is strikingly different from that of the lower limb, particularly that of the more proximal structures of each limb. Importantly, the obtained data provide further evidence to be added to the vast amount of paleontological, gross anatomical, developmental, molecular and embryological data recently obtained that contradicts the long-standing dogma that the upper and lower limbs are serial homologues

  15. The Development Needs of Newly Appointed Senior School Leaders in the Western Cape South Africa: A Case Study

    Directory of Open Access Journals (Sweden)

    Nelius Jansen van Vuuren

    2017-12-01

    Full Text Available The essential role that senior school leaders play in school leadership teams to ensure effective strategic leadership in schools has been the subject of intense discussion for many years. Crucial to this debate is the establishment of professional learning and leadership approaches for newly appointed senior school leaders. Recommendations for policy and practice highlight the importance of appropriate, multifaceted, developmental support initiatives for newly appointed school leaders. In many countries, including South Africa, a teaching qualification and, in most cases, extensive teaching experience is the only requirement for being appointed as a senior school leader in a school. This tends to suggest that no further professional development is required for newly appointed school leaders, the problem addressed in this paper. This paper reports on the main findings of the perceived development needs of newly appointed senior school leaders in the Western Cape, South Africa, and suggests that school leaders occupy a unique and specialist role in education, which requires relevant and specific preparation to support effective leadership. The respondents of this study report a lack of contextualised training and support before and after their appointment in their new roles creating unique development needs. This paper, therefore, employs a mixed-method approach to gather data to understand the perceived needs of twenty newly appointed senior school leaders in the Western Cape, South Africa.

  16. Development of nylon-based artificial muscles for the usage in robotic prosthetic limb

    Science.gov (United States)

    Atikah, Nurul Anis; Weng, Leong Yeng; Anuar, Adzly; Fat, Chau Chien; Abidin, Izham Zainal; Sahari, Khairul Salleh Mohamed

    2017-09-01

    This paper describes the development of nylon-based artificial muscles that is intended to be used in prosthetic limb for young amputees. Prosthetic limbs are very expensive and this situation is further compounded for young amputees who are very quickly out-grow their prosthesis. The proposed artificial muscles are made of nylon fishing strings from various size such as 0.45mm, 0.55mm, 0.65mm and 1.00mm. These fishing strings were twisted into coils to create Super Coiled Polymers (SCP) and tested using hot air blower. These artificial muscles react counterintuitively, where when it is exposed to heat, contracts, and when cooled, expands. Peltier devices, when switched-on acts as heat pump, where one side is hot and the other is cold. This phenomenon, when affixed in between 2 SCP's, creates tandem motion similar to triceps and biceps. As initial study, the hot side of the Peltier module was tested using these artificial muscles. The string was measured for both its force production, length contraction, the initial results were promising.

  17. Cartilage and bone cells do not participate in skeletal regeneration in Ambystoma mexicanum limbs.

    Science.gov (United States)

    McCusker, Catherine D; Diaz-Castillo, Carlos; Sosnik, Julian; Q Phan, Anne; Gardiner, David M

    2016-08-01

    The Mexican Axolotl is one of the few tetrapod species that is capable of regenerating complete skeletal elements in injured adult limbs. Whether the skeleton (bone and cartilage) plays a role in the patterning and contribution to the skeletal regenerate is currently unresolved. We tested the induction of pattern formation, the effect on cell proliferation, and contributions of skeletal tissues (cartilage, bone, and periosteum) to the regenerating axolotl limb. We found that bone tissue grafts from transgenic donors expressing GFP fail to induce pattern formation and do not contribute to the newly regenerated skeleton. Periosteum tissue grafts, on the other hand, have both of these activities. These observations reveal that skeletal tissue does not contribute to the regeneration of skeletal elements; rather, these structures are patterned by and derived from cells of non-skeletal connective tissue origin. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Design Optimization and Development of Tubular Isogrid Composites Tubes for Lower Limb Prosthesis

    Science.gov (United States)

    Junqueira, Diego Morais; Gomes, Guilherme Ferreira; Silveira, Márcio Eduardo; Ancelotti, Antonio Carlos

    2018-04-01

    From the beginnings of humanity, natural or unnatural misfortunes such as illnesses, wars, automobile accidents cause loss of body limbs like teeth, arms, legs, etc. The solution found for the replacement of these missing limbs is in the use of prostheses. Lower limbs tubes or pylons are prosthetics components that are claimed to support loads during walking and other daily tasks activities. Commonly, prosthetic tubes are manufactured using metal materials such as stainless steel, aluminum and titanium. The mass of these tubes is generally high compared to tubes made of carbon fiber reinforced polymer matrix (CFRP) composite. Therefore, this work has the objective of design, manufacturing and analyzing the feasibility of a new tube concept, made of composite material, which makes use of lattice structure and inner layer. Until the present moment, lower limb prosthesis tubes using lattice structure and ineer layer have never been studied and/or tested to date. It can be stated that the tube of rigid ribs with inner layer and angle of 40° is more efficient than those of 26° and 30°. The proposed design allows a structural weight reduction in high performance prostheses from 120 g to 40 g.

  19. Achievement report for fiscal 1999 on research and development of technologies for medical welfare equipment. Rehabilitation system for upper limbs and lower limbs; 1999 nendo iryo fukushi kiki gijutsu kenkyu kaihatsu seika hokokusho. Shintai kino rihabiri shien system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-05-01

    This project aims to develop physical function measuring and training systems equipped with a variety of feedback utilities and widely applicable to the prevention of the elderly from physical function degradation, to the preservation of physical functions, and to their recovery from mild physical difficulties, thereby helping the elderly enjoy independence and participation in social activities. Possibilities will be studied of providing them with engineering support in the field of exercise therapy through the analysis of the characteristics of old people's movement, and the findings will be applied to the designing and assessment of welfare and nursing equipment and also fed back to their development environment. In the gait training system, the suspension force is adjusted according to data from the force plate and various position sensors, and the system produces an effect similar to that of walking in the water. The lower limb rehabilitation system facilitates the treatment of the aged or handicapped people, and patients suffering from cerebral disorders, at any of their physical positions from lying to standing. The upper limb training support system is to provide motivation for the aged or handicapped people suffering from mild difficulties in their upper limbs. In this fiscal year, basic designs have been prepared for the gait training system and the lower limb rehabilitation system, and a preparatory survey is conducted for the upper limb training support system. (NEDO)

  20. Globalisation reaches gene regulation: the case for vertebrate limb development.

    Science.gov (United States)

    Zuniga, Aimée

    2005-08-01

    Analysis of key regulators of vertebrate limb development has revealed that the cis-regulatory regions controlling their expression are often located several hundred kilobases upstream of the transcription units. These far up- or down-stream cis-regulatory regions tend to reside within rather large, functionally and structurally unrelated genes. Molecular analysis is beginning to reveal the complexity of these large genomic landscapes, which control the co-expression of clusters of diverse genes by this novel type of long-range and globally acting cis-regulatory region. An increasing number of spontaneous mutations in vertebrates, including humans, are being discovered inactivating or altering such global control regions. Thereby, the functions of a seemingly distant but essential gene are disrupted rather than the closest.

  1. A short overview of upper limb rehabilitation devices

    Science.gov (United States)

    Macovei, S.; Doroftei, I.

    2016-08-01

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

  2. Arterial mapping of lower limbs

    International Nuclear Information System (INIS)

    Acuna Allen, Rafael

    2011-01-01

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

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

    Science.gov (United States)

    Lee, Jangwoo; Gardiner, David M

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jangwoo Lee

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

  5. THE INFLUENCE OF LOWER LIMB MOVEMENT ON UPPER LIMB MOVEMENT SYMMETRY WHILE SWIMMING THE BREASTSTROKE

    OpenAIRE

    M. Jaszczak

    2011-01-01

    This study 1) examined the influence of lower limb movement on upper limb movement symmetry, 2) determined the part of the propulsion phase displaying the greatest hand movement asymmetry, 3) diagnosed the range of upper limb propulsion phase which is the most prone to the influence of the lower limbs while swimming the breaststroke. Twenty-four participants took part in two tests. Half of them performed an asymmetrical leg movement. The propulsion in the first test was generated by four limb...

  6. Validating self-reported mobile phone use in adults using a newly developed smartphone application

    NARCIS (Netherlands)

    Goedhart, Geertje; Kromhout, Hans; Wiart, Joe; Vermeulen, Roel

    2015-01-01

    OBJECTIVE: Interpretation of epidemiological studies on health effects from mobile phone use is hindered by uncertainties in the exposure assessment. We used a newly developed smartphone application (app) to validate self-reported mobile phone use and behaviour among adults. METHODS: 107

  7. Differentiation of cartilaginous anlagen in entire embryonic mouse limbs cultured in a rotating bioreactor

    Science.gov (United States)

    Montufar-Solis, D.; Oakley, C. R.; Jefferson, Y.; Duke, P. J.

    2003-10-01

    Mechanisms involved in development of the embryonic limb have remained the same throughout eons of genetic and environmental evolution under Earth gravity (lg). During the spaceflight era it has been of interest to explore the ancient theory that form of the skeleton develops in response to gravity, and that changes in gravitational forces can change the developmental pattern of the limb. This has been shown in vivo and in vitro, allowing the hypergravity of centrifugation and microgravity of space to be used as tools to increase our knowledge of limb development. In recapitulations of spaceflight experiments, premetatarsals were cultured in suspension in a bioreactor, and found to be shorter and less differentiated than those cultured in standard culture dishes. This study only measured length of the metatarsals, and did not account for possible changes due to the skeletal elements having a more in vivo 3D shape while in suspension vs. flattened tissues compressed by their own weight. A culture system with an outcome closer to in vivo and that supports growth of younger limb buds than traditional systems will allow studies of early Hox gene expression, and contribute to the understanding of very early stages of development. The purpose of the current experiment was to determine if entire limb buds could be cultured in the bioreactor, and to compare the growth and differentiation with that of culturing in a culture dish system. Fore and hind limbs from E11-E13 ICR mouse embryos were cultured for six days, either in the bioreactor or in center-well organ culture dishes, fixed, and embedded for histology. E13 specimens grown in culture dishes were flat, while bioreactor culture specimens had a more in vivo-like 3D limb shape. Sections showed excellent cartilage differentiation in both culture systems, with more cell maturation, and hypertrophy in the specimens cultured in the bioreactor. Younger limb buds fused together during culture, so an additional set of El 1

  8. Micro-computed tomography newly developed for in vivo small animal imaging

    International Nuclear Information System (INIS)

    Arai, Yoshinori; Ninomiya, Tadashi; Kato, Takafumi; Masuda, Yuji

    2005-01-01

    The aim of this paper is to report a newly developed micro-computed tomography system for in vivo use. The system was composed of a micro-focus X-ray tube and an image intensifier (I.I.), both of which rotated around the object stage. A guinea pig and a rat were examined. The anesthetized animal was set on the secure object stage. Images of the head of the guinea pig and the tibia knee joint of the rat were taken. In addition, an image of the rat's tail was taken. The reconstruction and the image viewing were carried out using I-View software. The voxel matrix was 512 x 512 x 384. The voxel sizes ranged from 10 x 10 x 10 μm to 100 x 100 x 100 μm. The exposure time was 17 s, and the reconstruction time was 150 s. The head of the guinea pig and the tibia/knee joint of the rat were observed clearly under 100-μm and 30μm voxels, respectively. The trabecular bone of the tail was also observed clearly under a 10 μm voxel. The newly developed micro-computed tomography system makes it possible to obtain images of anesthetized animals set on a secure object stage. Clear bone images of the small animals could be obtained within a short time. (author)

  9. THE INFLUENCE OF LOWER LIMB MOVEMENT ON UPPER LIMB MOVEMENT SYMMETRY WHILE SWIMMING THE BREASTSTROKE

    Directory of Open Access Journals (Sweden)

    M. Jaszczak

    2011-09-01

    Full Text Available This study 1 examined the influence of lower limb movement on upper limb movement symmetry, 2 determined the part of the propulsion phase displaying the greatest hand movement asymmetry, 3 diagnosed the range of upper limb propulsion phase which is the most prone to the influence of the lower limbs while swimming the breaststroke. Twenty-four participants took part in two tests. Half of them performed an asymmetrical leg movement. The propulsion in the first test was generated by four limbs while in the second one only by the upper limbs. The pressure differentials exerted by the water on the back and on the palm of the right and left hand were measured. Then, the asymmetry coefficient of the hand movement was determined. No changes in the level of the asymmetry index in participants performing correct (symmetrical lower limb movement were observed. Incorrect (asymmetrical leg motion resulted in an increase of hand asymmetry. It could be concluded that lower limb faults neutralize upper limb performance when swimming on a rectilinear path. However, most asymmetrical arm performance should be identified with the conversion of propulsion into recovery. Nevertheless, its proneness to influence improper leg performance might be expected at the beginning of arm propulsion.

  10. Lmx1b-targeted cis-regulatory modules involved in limb dorsalization.

    Science.gov (United States)

    Haro, Endika; Watson, Billy A; Feenstra, Jennifer M; Tegeler, Luke; Pira, Charmaine U; Mohan, Subburaman; Oberg, Kerby C

    2017-06-01

    Lmx1b is a homeodomain transcription factor responsible for limb dorsalization. Despite striking double-ventral (loss-of-function) and double-dorsal (gain-of-function) limb phenotypes, no direct gene targets in the limb have been confirmed. To determine direct targets, we performed a chromatin immunoprecipitation against Lmx1b in mouse limbs at embryonic day 12.5 followed by next-generation sequencing (ChIP-seq). Nearly 84% ( n =617) of the Lmx1b-bound genomic intervals (LBIs) identified overlap with chromatin regulatory marks indicative of potential cis -regulatory modules (PCRMs). In addition, 73 LBIs mapped to CRMs that are known to be active during limb development. We compared Lmx1b-bound PCRMs with genes regulated by Lmx1b and found 292 PCRMs within 1 Mb of 254 Lmx1b-regulated genes. Gene ontological analysis suggests that Lmx1b targets extracellular matrix production, bone/joint formation, axonal guidance, vascular development, cell proliferation and cell movement. We validated the functional activity of a PCRM associated with joint-related Gdf5 that provides a mechanism for Lmx1b-mediated joint modification and a PCRM associated with Lmx1b that suggests a role in autoregulation. This is the first report to describe genome-wide Lmx1b binding during limb development, directly linking Lmx1b to targets that accomplish limb dorsalization. © 2017. Published by The Company of Biologists Ltd.

  11. Hyperinnervation improves Xenopus laevis limb regeneration.

    Science.gov (United States)

    Mitogawa, Kazumasa; Makanae, Aki; Satoh, Akira

    2018-01-15

    Xenopus laevis (an anuran amphibian) shows limb regeneration ability between that of urodele amphibians and that of amniotes. Xenopus frogs can initiate limb regeneration but fail to form patterned limbs. Regenerated limbs mainly consist of cone-shaped cartilage without any joints or branches. These pattern defects are thought to be caused by loss of proper expressions of patterning-related genes. This study shows that hyperinnervation surgery resulted in the induction of a branching regenerate. The hyperinnervated blastema allows the identification and functional analysis of the molecules controlling this patterning of limb regeneration. This paper focuses on the nerve affects to improve Xenopus limb patterning ability during regeneration. The nerve molecules, which regulate limb patterning, were also investigated. Blastemas grown in a hyperinnervated forelimb upregulate limb patterning-related genes (shh, lmx1b, and hoxa13). Nerves projecting their axons to limbs express some growth factors (bmp7, fgf2, fgf8, and shh). Inputs of these factors to a blastema upregulated some limb patterning-related genes and resulted in changes in the cartilage patterns in the regenerates. These results indicate that additional nerve factors enhance Xenopus limb patterning-related gene expressions and limb regeneration ability, and that bmp, fgf, and shh are candidate nerve substitute factors. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Assessing College Students' Perceptions of a Case Teacher's Pedagogical Content Knowledge Using a Newly Developed Instrument

    Science.gov (United States)

    Jang, Syh-Jong

    2011-01-01

    Ongoing professional development for college teachers has been much emphasized. However, previous research on learning environments has seldom addressed college students' perceptions of teachers' PCK. This study aimed to evaluate college students' perceptions of a physics teacher's PCK development using a newly developed instrument and workshop…

  13. Wearable Vibrotactile Biofeedback Device Allowing Identification of Different Floor Conditions for Lower-Limb Amputees.

    Science.gov (United States)

    Wan, Anson H; Wong, Duo W; Ma, Christina Z; Zhang, Ming; Lee, Winson C

    2016-07-01

    To evaluate a newly developed biofeedback device enabling lower-limb amputees to identify various floor conditions. Self-control with repeated measures (with and without the biofeedback device) within the amputee group, and group control comparing between amputee and nonamputee groups. University locomotion laboratory. Five lower-limb amputees and 8 nonamputees (N=13). A wearable biofeedback device, which identified different floor conditions by analyzing the force patterns under the prosthetic feet and provided vibration cues in response to different floor conditions, was provided to the amputees. The subjects stepped on a foam platform concealing a small object or no object at 1 of the 4 locations of the foot sole. Subjects were asked whether there was a small object under their feet and the location of the object if it existed. The test was repeated with 4 different object types and 4 object locations. The success rate of floor identification was evaluated. Without the biofeedback device, nonamputee subjects (76.56%) identified floor conditions better than amputees (22.5%) significantly (Pdevice, the amputees significantly improved (Pdevice, amputees significantly improved their abilities in identifying different floor conditions. Future attempts could configure the device to allow it to provide warning signals in response to fall-inducing conditions. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Development of a Novel Tissue Engineering Strategy Towards Whole Limb Regeneration

    National Research Council Canada - National Science Library

    Laurencin, Cato T

    2008-01-01

    .... In contrast to the bottom up approach of limb regeneration that relies on blastema formation outgrowth and cell dedifferentiation as seen in amphibians and lower vertebrates tissue engineering...

  15. Applicability of newly developed 610MPa class heavy thickness high strength steel to boiler pressure vessel

    Energy Technology Data Exchange (ETDEWEB)

    Katayama, Norihiko; Kaihara, Shoichiro; Ishii, Jun [Ishikawajima-Harima Heavy Industries Corp., Yokohama (Japan); Kajigaya, Ichiro [Ishikawajima-Harima Heavy Industries Corp., Tokyo (Japan); Totsuka, Takehiro; Miyazaki, Takashi [Ishikawajima-Harima Heavy Industries Corp., Aioi (Japan)

    1995-11-01

    Construction of a 350 MW Class PFBC (Pressurized Fluidized Bed Combustion) boiler plant is under planning in Japan. Design temperature and pressure of the vessel are maximum 350 C and 1.69 MPa, respectively. As the plate thickness of the vessel exceeds over 100 mm, high strength steel plate of good weldability and less susceptible to reheat cracking was required and developed. The steel was aimed to satisfy the tensile strength over 610 MPa at 350 C after postweld heat treatment (PWHT), with good notch toughness. The authors investigated the welding performances of the newly developed steel by using 150 mm-thick plate welded by pulsed-MAG and SAW methods. It was confirmed that the newly developed steel and its welds possess sufficient strength and toughness after PWHT, and applicable to the actual pressure vessel.

  16. Limb salvage surgery.

    Science.gov (United States)

    Kadam, Dinesh

    2013-05-01

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

  17. Fundamental Characteristics of the Newly Developed ATA™ Membrane Dialyzer.

    Science.gov (United States)

    Sunohara, Takashi; Masuda, Toshiaki

    2017-01-01

    Dialysis membranes are often made from synthetic polymers, such as polysulfone. However, membranes made from cellulose triacetate have superior biocompatibility and have been used since the 1980s. On-line hemodiafiltration treatment accompanied by massive fluid replacement is increasingly being used in Europe and Japan, but cellulose triacetate is not suitable for this treatment. Our newly developed asymmetric triacetate membrane, the ATA™ membrane, substantially improved the filtration properties and blood compatibility because of the asymmetric structure and smooth surface of this cellulose acetate membrane. Key Message: The ATA membrane maintains its high permeability even after massive filtration and shows less temporal variation in its permeation performance, lower protein adsorption, and superior biocompatibility compared with conventional membranes. © 2017 S. Karger AG, Basel.

  18. 100 top-cited scientific papers in limb prosthetics.

    Science.gov (United States)

    Eshraghi, Arezoo; Osman, Noor Azuan Abu; Gholizadeh, Hossein; Ali, Sadeeq; Shadgan, Babak

    2013-11-17

    Research has tremendously contributed to the developments in both practical and fundamental aspects of limb prosthetics. These advancements are reflected in scientific articles, particularly in the most cited papers. This article aimed to identify the 100 top-cited articles in the field of limb prosthetics and to investigate their main characteristics. Articles related to the field of limb prosthetics and published in the Web of Knowledge database of the Institute for Scientific Information (ISI) from the period of 1980 to 2012. The 100 most cited articles in limb prosthetics were selected based on the citation index report. All types of articles except for proceedings and letters were included in the study. The study design and level of evidence were determined using Sackett's initial rules of evidence. The level of evidence was categorized either as a systematic review or meta-analysis, randomized controlled trial, cohort study, case-control study, case series, expert opinion, or design and development. The top cited articles in prosthetics were published from 1980 to 2012 with a citation range of 11 to 90 times since publication. The mean citation rate was 24.43 (SD 16.7) times. Eighty-four percent of the articles were original publications and were most commonly prospective (76%) and case series studies (67%) that used human subjects (96%) providing level 4 evidence. Among the various fields, rehabilitation (47%), orthopedics (29%), and sport sciences (28%) were the most common fields of study. The study established that studies conducted in North America and were written in English had the highest citations. Top cited articles primarily dealt with lower limb prosthetics, specifically, on transtibial and transradial prosthetic limbs. Majority of the articles were experimental studies.

  19. Management of the multiple limb amputee.

    Science.gov (United States)

    Davidson, J H; Jones, L E; Cornet, J; Cittarelli, T

    2002-09-10

    Multiple limb amputations involving at least one upper extremity are very uncommon. The amputation of both an upper and lower limb is even more uncommon. Due to the rarity of these amputations therapists are uncertain regarding the most appropriate treatment methods. While the majority of the protocols used for single limb amputations are appropriate for these multiple limb amputees, there are differences. Loss of multiple limbs creates a problem of overheating for the individual. Loss of an arm and leg results in difficulty donning the prostheses and difficulty using crutches and parallel bars during mobilization. A review is given of 16 multiple limb amputees seen in our rehabilitation centre in the last 15 years. Return to work was seen in one third and was not related to the number of the amputations. A higher proportion of these multiple limb amputations occur through alcoholism or attempted suicide behaviour than occurs with either single upper limb amputations or lower limb amputations. This existing behaviour can create a management problem for the rehabilitation team during rehabilitation. Guidelines as to appropriate prosthetic and preprosthetic care are provided to assist the practitioner who has the acute and long term care of these patients. All multiple limb amputees should be referred to a specialized rehabilitation centre to discuss prosthetic options and long term rehabilitation requirements. This paper does not discuss bilateral lower limb amputations when not combined with an upper limb amputation.

  20. How accurate is anatomic limb alignment in predicting mechanical limb alignment after total knee arthroplasty?

    Science.gov (United States)

    Lee, Seung Ah; Choi, Sang-Hee; Chang, Moon Jong

    2015-10-27

    Anatomic limb alignment often differs from mechanical limb alignment after total knee arthroplasty (TKA). We sought to assess the accuracy, specificity, and sensitivity for each of three commonly used ranges for anatomic limb alignment (3-9°, 5-10° and 2-10°) in predicting an acceptable range (neutral ± 3°) for mechanical limb alignment after TKA. We also assessed whether the accuracy of anatomic limb alignment was affected by anatomic variation. This retrospective study included 314 primary TKAs. The alignment of the limb was measured with both anatomic and mechanical methods of measurement. We also measured anatomic variation, including the femoral bowing angle, tibial bowing angle, and neck-shaft angle of the femur. All angles were measured on the same full-length standing anteroposterior radiographs. The accuracy, specificity, and sensitivity for each range of anatomic limb alignment were calculated and compared using mechanical limb alignment as the reference standard. The associations between the accuracy of anatomic limb alignment and anatomic variation were also determined. The range of 2-10° for anatomic limb alignment showed the highest accuracy, but it was only 73 % (3-9°, 65 %; 5-10°, 67 %). The specificity of the 2-10° range was 81 %, which was higher than that of the other ranges (3-9°, 69 %; 5-10°, 67 %). However, the sensitivity of the 2-10° range to predict varus malalignment was only 16 % (3-9°, 35 %; 5-10°, 68 %). In addition, the sensitivity of the 2-10° range to predict valgus malalignment was only 43 % (3-9°, 71 %; 5-10°, 43 %). The accuracy of anatomical limb alignment was lower for knees with greater femoral (odds ratio = 1.2) and tibial (odds ratio = 1.2) bowing. Anatomic limb alignment did not accurately predict mechanical limb alignment after TKA, and its accuracy was affected by anatomic variation. Thus, alignment after TKA should be assessed by measuring mechanical alignment rather than anatomic

  1. A heart-hand syndrome gene: Tfap2b plays a critical role in the development and remodeling of mouse ductus arteriosus and limb patterning.

    Directory of Open Access Journals (Sweden)

    Feng Zhao

    Full Text Available BACKGROUND: Patent ductus arteriosus (PDA is one of the most common forms of congenital heart disease. Mutations in transcription factor TFAP2B cause Char syndrome, a human disorder characterized by PDA, facial dysmorphysm and hand anomalies. Animal research data are needed to understand the mechanisms. The aim of our study was to elucidate the pathogenesis of Char syndrome at the molecular level. METHODOLOGY/PRINCIPAL FINDINGS: Gene expression of Tfap2b during mouse development was studied, and newborns of Tfap2b-deficient mice were examined to identify phenotypes. Gel shift assays had been carried out to search for Tfap2 downstream genes. Promoters of candidate genes were cloned into a reporter construct and used to demonstrate their regulation by Tfap2b in cell transfection. In situ hybridizations showed that the murine transcription factor Tfap2b was expressed during the entire development of mouse ductus arteriosus. Histological examination of ductus arteriosus from Tfap2b knockout mice 6 hours after birth revealed that they were not closed. Consequently, the lungs of Tfap2b(-/- mice demonstrated progressive congestion of the pulmonary capillaries, which was postulated to result secondarily from PDA. In addition, Tfap2b was expressed in the limb buds, particularly in the posterior limb field during development. Lack of Tfap2b resulted in bilateral postaxial accessory digits. Further study indicated that expressions of bone morphogenetic protein (Bmp genes, which are reported to be involved in the limb patterning and ductal development, were altered in limb buds of Tfap2b-deficient embryos, due to direct control of Bmp2 and Bmp4 promoter activity by Tfap2b. CONCLUSIONS/SIGNIFICANCE: Tfap2b plays important roles in the development of mouse ductus arteriosus and limb patterning. Loss of Tfap2b results in altered Bmp expression that may cause the heart-limb defects observed in Tfap2b mouse mutants and Char syndrome patients. The Tfap2b knockout

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

    Science.gov (United States)

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

    2016-09-01

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

  3. Treatment of limb apraxia: moving forward to improved action.

    Science.gov (United States)

    Buxbaum, Laurel J; Haaland, Kathleen Y; Hallett, Mark; Wheaton, Lewis; Heilman, Kenneth M; Rodriguez, Amy; Gonzalez Rothi, Leslie J

    2008-02-01

    Limb apraxia is a common disorder of skilled, purposive movement that is frequently associated with stroke and degenerative diseases such as Alzheimer disease. Despite evidence that several types of limb apraxia significantly impact functional abilities, surprisingly few studies have focused on development of treatment paradigms. Additionally, although the most disabling types of apraxia reflect damage to gesture and/or object memory systems, existing treatments have not fully taken advantage of principles of experience known to affect learning and neural plasticity. We review the current state of the art in the rehabilitation of limb apraxia, indicate possible points of contact with the learning literature, and generate suggestions for how translational principles might be applied to the development of future research on treatment of this disabling disorder.

  4. Exploring the fine structure at the limb in coronal holes

    Science.gov (United States)

    Karovska, Magarita; Blundell, Solon F.; Habbal, Shadia Rifai

    1994-01-01

    The fine structure of the solar limb in coronal holes is explored at temperatures ranging from 10(exp 4) to 10(exp 6) K. An image enhancement algorithm orignally developed for solar eclipse observations is applied to a number of simultaneous multiwavelength observations made with the Harvard Extreme Ultraviolet Spectrometer experiment on Skylab. The enhanced images reveal the presence of filamentary structures above the limb with a characteristic separation of approximately 10 to 15 sec . Some of the structures extend from the solar limb into the corona to at least 4 min above the solar limb. The brightness of these structures changes as a function of height above the limb. The brightest emission is associated with spiculelike structures in the proximity of the limb. The emission characteristic of high-temperature plasma is not cospatial with the emission at lower temperatures, indicating the presence of different temperature plasmas in the field of view.

  5. Delayed amputation following trauma increases residual lower limb infection.

    Science.gov (United States)

    Jain, Abhilash; Glass, Graeme E; Ahmadi, Hootan; Mackey, Simon; Simmons, Jon; Hettiaratchy, Shehan; Pearse, Michael; Nanchahal, Jagdeep

    2013-04-01

    Residual limb infection following amputation is a devastating complication, resulting in delayed rehabilitation, repeat surgery, prolonged hospitalisation and poor functional outcome. The aim of this study was to identify variables predicting residual limb infection following non-salvageable lower limb trauma. All cases of non-salvageable lower limb trauma presenting to a specialist centre over 5 years were evaluated from a prospective database and clinical and management variables correlated with the development of deep infection. Forty patients requiring 42 amputations were identified with a mean age of 49 years (±19.9, 1SD). Amputations were performed for 21 Gustilo IIIB injuries, 12 multi-planar degloving injuries, seven IIIC injuries and one open Schatzker 6 fracture. One limb was traumatically amputated at the scene and surgically revised. Amputation level was transtibial in 32, through-knee in one and transfemoral in nine. Median time from injury to amputation was 4 days (range 0-30 days). Amputation following only one debridement and within 5 days resulted in significantly fewer stump infections (p = 0.026 and p = 0.03, respectively, Fisher's exact test). The cumulative probability of infection-free residual limb closure declined steadily from day 5. Multivariate analyses revealed that neither the nature of the injury nor pre-injury patient morbidity independently influenced residual limb infection. Avoiding residual limb infection is critically dependent on prompt amputation of non-salvageable limbs. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Motor control and learning with lower-limb myoelectric control in amputees.

    Science.gov (United States)

    Alcaide-Aguirre, Ramses E; Morgenroth, David C; Ferris, Daniel P

    2013-01-01

    Advances in robotic technology have recently enabled the development of powered lower-limb prosthetic limbs. A major hurdle in developing commercially successful powered prostheses is the control interface. Myoelectric signals are one way for prosthetic users to provide feedforward volitional control of prosthesis mechanics. The goal of this study was to assess motor learning in people with lower-limb amputation using proportional myoelectric control from residual-limb muscles. We examined individuals with transtibial amputation and nondisabled controls performing tracking tasks of a virtual object. We assessed how quickly the individuals with amputation improved their performance and whether years since amputation correlated with performance. At the beginning of training, subjects with amputation performed much worse than control subjects. By the end of a short training period, tracking error did not significantly differ between subjects with amputation and nondisabled subjects. Initial but not final performance correlated significantly with time since amputation. This study demonstrates that although subjects with amputation may initially have poor volitional control of their residual lower-limb muscles, training can substantially improve their volitional control. These findings are encouraging for the future use of proportional myoelectric control of powered lower-limb prostheses.

  7. Feasibility and safety of early lower limb robot-assisted training in sub-acute stroke patients: a pilot study.

    Science.gov (United States)

    Gandolfi, Marialuisa; Geroin, Christian; Tomelleri, Christopher; Maddalena, Isacco; Kirilova Dimitrova, Eleonora; Picelli, Alessandro; Smania, Nicola; Waldner, Andreas

    2017-12-01

    So far, the development of robotic devices for the early lower limb mobilization in the sub-acute phase after stroke has received limited attention. To explore the feasibility of a newly robotic-stationary gait training in sub-acute stroke patients. To report the training effects on lower limb function and muscle activation. A pilot study. Rehabilitation ward. Two sub-acute stroke inpatients and ten age-matched healthy controls were enrolled. Healthy controls served as normative data. Patients underwent 10 robot-assisted training sessions (20 minutes, 5 days/week) in alternating stepping movements (500 repetitions/session) on a hospital bed in addition to conventional rehabilitation. Feasibility outcome measures were compliance, physiotherapist time, and responses to self-report questionnaires. Efficacy outcomes were bilateral lower limb muscle activation pattern as measured by surface electromyography (sEMG), Motricity Index (MI), Medical Research Council (MRC) grade, and Ashworth Scale (AS) scores before and after training. No adverse events occurred. No significant differences in sEMG activity between patients and healthy controls were observed. Post-training improvement in MI and MRC scores, but no significant changes in AS scores, were recorded. Post-treatment sEMG analysis of muscle activation patterns showed a significant delay in rectus femoris offset (P=0.02) and prolonged duration of biceps femoris (P=0.04) compared to pretreatment. The robot-assisted training with our device was feasible and safe. It induced physiological muscle activations pattern in both stroke patients and healthy controls. Full-scale studies are needed to explore its potential role in post-stroke recovery. This robotic device may enrich early rehabilitation in subacute stroke patients by inducing physiological muscle activation patterns. Future studies are warranted to evaluate its effects on promoting restorative mechanisms involved in lower limb recovery after stroke.

  8. Prenatal exposure to environmental factors and congenital limb defects.

    Science.gov (United States)

    Alexander, Peter G; Clark, Karen L; Tuan, Rocky S

    2016-09-01

    Limb congenital defects afflict approximately 0.6:1000 live births. In addition to genetic factors, prenatal exposure to drugs and environmental toxicants, represents a major contributing factor to limb defects. Examples of well-recognized limb teratogenic agents include thalidomide, warfarin, valproic acid, misoprostol, and phenytoin. While the mechanism by which these agents cause dymorphogenesis is increasingly clear, prediction of the limb teratogenicity of many thousands of as yet uncharacterized environmental factors (pollutants) remains inexact. This is limited by the insufficiencies of currently available models. Specifically, in vivo approaches using guideline animal models have inherently deficient predictive power due to genomic and anatomic differences that complicate mechanistic comparisons. On the other hand, in vitro two-dimensional (2D) cell cultures, while accessible for cellular and molecular experimentation, do not reflect the three-dimensional (3D) morphogenetic events in vivo nor systemic influences. More robust and accessible models based on human cells that accurately replicate specific processes of embryonic limb development are needed to enhance limb teratogenesis prediction and to permit mechanistic analysis of the adverse outcome pathways. Recent advances in elucidating mechanisms of normal development will aid in the development of process-specific 3D cell cultures within specialized bioreactors to support multicellular microtissues or organoid constructs that will lead to increased understanding of cell functions, cell-to-cell signaling, pathway networks, and mechanisms of toxicity. The promise is prompting researchers to look to such 3D microphysiological systems to help sort out complex and often subtle interactions relevant to developmental malformations that would not be evident by standard 2D cell culture testing. Birth Defects Research (Part C) 108:243-273, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

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

    Science.gov (United States)

    Satoh, Akira; Hirata, Ayako; Makanae, Aki

    2012-03-01

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

  10. Limb salvage surgery

    Directory of Open Access Journals (Sweden)

    Dinesh Kadam

    2013-01-01

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

  11. Is Atherectomy the Best First-Line Therapy for Limb Salvage in Patients With Critical Limb Ischemia?

    Science.gov (United States)

    Loor, Gabriel; Skelly, Christopher L.; Wahlgren, Carl-Magnus; Bassiouny, Hisham S.; Piano, Giancarlo; Shaalan, Wael

    2010-01-01

    Objective To determine the efficacy of atherectomy for limb salvage compared with open bypass in patients with critical limb ischemia. Methods Ninety-nine consecutive bypass and atherectomy procedures performed for critical limb ischemia between January 2003 and October 2006 were reviewed. Results A total of 99 cases involving TASC C (n = 43, 44%) and D (n = 56, 56%) lesions were treated with surgical bypass in 59 patients and atherectomy in 33 patients. Bypass and atherectomy achieved similar 1-year primary patency (64% vs 63%; P = .2). However, the 1-year limb salvage rate was greater in the bypass group (87% vs 69%; P = .004). In the tissue loss subgroup, there was a greater limb salvage rate for bypass patients versus atherectomy (79% vs 60%; P = .04). Conclusions Patients with critical limb ischemia may do better with open bypass compared with atherectomy as first-line therapy for limb salvage. PMID:19640919

  12. Phosphorylation of Lbx1 controls lateral myoblast migration into the limb.

    Science.gov (United States)

    Masselink, Wouter; Masaki, Megumi; Sieiro, Daniel; Marcelle, Christophe; Currie, Peter D

    2017-10-15

    The migration of limb myogenic precursors from limb level somites to their ultimate site of differentiation in the limb is a paradigmatic example of a set of dynamic and orchestrated migratory cell behaviours. The homeobox containing transcription factor ladybird homeobox 1 (Lbx1) is a central regulator of limb myoblast migration, null mutations of Lbx1 result in severe disruptions to limb muscle formation, particularly in the distal region of the limb in mice (Gross et al., 2000). As such Lbx1 has been hypothesized to control lateral migration of myoblasts into the distal limb anlage. It acts as a core regulator of the limb myoblast migration machinery, controlled by Pax3. A secondary role for Lbx1 in the differentiation and commitment of limb musculature has also been proposed (Brohmann et al., 2000; Uchiyama et al., 2000). Here we show that lateral migration, but not differentiation or commitment of limb myoblasts, is controlled by the phosphorylation of three adjacent serine residues of LBX1. Electroporation of limb level somites in the chick embryo with a dephosphomimetic form of Lbx1 results in a specific defect in the lateral migration of limb myoblasts. Although the initial delamination and migration of myoblasts is unaffected, migration into the distal limb bud is severely disrupted. Interestingly, myoblasts undergo normal differentiation independent of their migratory status, suggesting that the differentiation potential of hypaxial muscle is not regulated by the phosphorylation state of LBX1. Furthermore, we show that FGF8 and ERK mediated signal transduction, both critical regulators of the developing limb bud, have the capacity to induce the phosphorylation of LBX1 at these residues. Overall, this suggests a mechanism whereby the phosphorylation of LBX1, potentially through FGF8 and ERK signalling, controls the lateral migration of myoblasts into the distal limb bud. Copyright © 2017. Published by Elsevier Inc.

  13. Structure design of lower limb exoskeletons for gait training

    Science.gov (United States)

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

    2015-09-01

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

  14. Single cell analysis of caspase-3 in apoptotic and non-apoptotic cells during mouse limb development

    Czech Academy of Sciences Publication Activity Database

    Adamová, Eva; Klepárník, Karel; Matalová, E.

    2014-01-01

    Roč. 3, - (2014), PP58 ISSN 2052-1219. [European Calcified Tissue Society Congress /41./. 17.05.2014-20.05.2014, Praha] R&D Projects: GA ČR GAP206/11/2377; GA ČR(CZ) GA14-28254S Institutional support: RVO:68081715 Keywords : single cell analysis * caspase-3 * mouse limb development Subject RIV: CB - Analytical Chemistry, Separation

  15. Reasonable classical concepts in human lower limb anatomy from the viewpoint of the primitive persistent sciatic artery and twisting human lower limb.

    Science.gov (United States)

    Kawashima, Tomokazu; Sasaki, Hiroshi

    2010-11-01

    The main aim of this review is (1) to introduce the two previous studies we published human lower limb anatomy based on the conventional macroscopic anatomical [corrected] criteria with hazardous recognition of this description, (2) to activate the discussion whether the limb homology exists, and (3) to contribute to future study filling the gap between the gross anatomy and embryology. One of the topics we discussed was the human persistent sciatic artery. To date, numerous human cases of persistent sciatic artery have been reported in which the anomalous artery was present in the posterior compartment of the thigh alongside the sciatic nerve. As one of the important criteria for assessing the human primitive sciatic artery, its ventral arterial position with respect to the sciatic nerve is reasonable based on the initial positional relationship between ventral arterial and dorsal nervous systems and comparative anatomical findings. We also discuss ways of considering the topography of muscles of the lower limb and their innervations compared to those of the upper limb. We propose a schema of the complex anatomical characteristics of the lower limb based on the vertebrate body plan. According to this reasonable schema, the twisted anatomy of the lower limb can be understood more easily. These two main ideas discussed in this paper will be useful for further understanding of the anatomy of the lower limb and as a first step for future. We hope that the future study in lower limb will be further developed by both viewpoints of the classical gross anatomy and recent embryology.

  16. Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

    Directory of Open Access Journals (Sweden)

    Baoguo Xu

    2011-09-01

    Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot-assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three-dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot-assisted upper limb rehabilitation system, the patient's EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patient's motivation and attention and directly facilitate upper limb post-stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot-assisted training with motor imagery-based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

  17. Limb immobilization and corticobasal syndrome.

    Science.gov (United States)

    Graff-Radford, Jonathan; Boeve, Bradley F; Drubach, Daniel A; Knopman, David S; Ahlskog, J Eric; Golden, Erin C; Drubach, Dina I; Petersen, Ronald C; Josephs, Keith A

    2012-12-01

    Recently, we evaluated two patients with corticobasal syndrome (CBS) who reported symptom onset after limb immobilization. Our objective was to investigate the association between trauma, immobilization and CBS. The charts of forty-four consecutive CBS patients seen in the Mayo Clinic Alzheimer Disease Research Center were reviewed with attention to trauma and limb immobilization. 10 CBS patients (23%) had immobilization or trauma on the most affected limb preceding the onset or acceleration of symptoms. The median age at onset was 61. Six patients manifested their first symptoms after immobilization from surgery or fracture with one after leg trauma. Four patients had pre-existing symptoms of limb dysfunction but significantly worsened after immobilization or surgery. 23 percent of patients had immobilization or trauma of the affected limb. This might have implications for management of CBS, for avoiding injury, limiting immobilization and increasing movement in the affected limb. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Vascular access in critical limb ischemia.

    Science.gov (United States)

    Kang, Won Yu; Campia, Umberto; Ota, Hideaki; Didier, Romain J; Negi, Smita I; Kiramijyan, Sarkis; Koifman, Edward; Baker, Nevin C; Magalhaes, Marco A; Lipinski, Michael J; Escarcega, Ricardo O; Torguson, Rebecca; Waksman, Ron; Bernardo, Nelson L

    2016-01-01

    Currently, percutaneous endovascular intervention is considered a first line of therapy for treating patients with critical limb ischemia. As the result of remarkable development of techniques and technologies, percutaneous endovascular intervention has led to rates of limb salvage comparable to those achieved with bypass surgery, with fewer complications, even in the presence of lower rates of long-term patency. Currently, interventionalists have a multiplicity of access routes including smaller arteries, with both antegrade and retrograde approaches. Therefore, the choice of the optimal access site has become an integral part of the success of the percutaneous intervention. By understanding the technical aspects, as well as the advantages and limitations of each approach, the interventionalists can improve clinical outcomes in patients with severe peripheral arterial disease. This article reviews the access routes in critical limb ischemia, their advantages and disadvantages, and the clinical outcomes of each. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. PHL10/460: Cancerfacts.com - Vertical Portal with Newly Developed Health Profiler

    OpenAIRE

    Lenz, C; Brucksch, M

    1999-01-01

    Introduction Unlike general health portals such as WebMD and Drkoop.com that cover everything from the flu to heart disease, Silicon Valley-based cancerfacts.com is a so-called vertical portal. It covers only one small vertical niche of health care: cancer, and in particular, prostate cancer. As a value-added proprietary technology, the company offers its newly developed profile engine to health information retrievers. Methods Users are enabled to insert their specific medical information - r...

  20. Comparative transcriptional profiling of the axolotl limb identifies a tripartite regeneration-specific gene program.

    Directory of Open Access Journals (Sweden)

    Dunja Knapp

    Full Text Available Understanding how the limb blastema is established after the initial wound healing response is an important aspect of regeneration research. Here we performed parallel expression profile time courses of healing lateral wounds versus amputated limbs in axolotl. This comparison between wound healing and regeneration allowed us to identify amputation-specific genes. By clustering the expression profiles of these samples, we could detect three distinguishable phases of gene expression - early wound healing followed by a transition-phase leading to establishment of the limb development program, which correspond to the three phases of limb regeneration that had been defined by morphological criteria. By focusing on the transition-phase, we identified 93 strictly amputation-associated genes many of which are implicated in oxidative-stress response, chromatin modification, epithelial development or limb development. We further classified the genes based on whether they were or were not significantly expressed in the developing limb bud. The specific localization of 53 selected candidates within the blastema was investigated by in situ hybridization. In summary, we identified a set of genes that are expressed specifically during regeneration and are therefore, likely candidates for the regulation of blastema formation.

  1. Limb Darkening and Planetary Transits: Testing Center-to-limb Intensity Variations and Limb-darkening Directly from Model Stellar Atmospheres

    Energy Technology Data Exchange (ETDEWEB)

    Neilson, Hilding R.; Lester, John B. [Department of Astronomy and Astrophysics, University of Toronto, 50 St. George Street, Toronto, ON M5S 3H4 (Canada); McNeil, Joseph T.; Ignace, Richard, E-mail: neilson@astro.utoronto.ca [Department of Physics and Astronomy, East Tennessee State University, Box 70652, Johnson City, TN 37614 (United States)

    2017-08-10

    The transit method, employed by Microvariability and Oscillation of Stars ( MOST ), Kepler , and various ground-based surveys has enabled the characterization of extrasolar planets to unprecedented precision. These results are precise enough to begin to measure planet atmosphere composition, planetary oblateness, starspots, and other phenomena at the level of a few hundred parts per million. However, these results depend on our understanding of stellar limb darkening, that is, the intensity distribution across the stellar disk that is sequentially blocked as the planet transits. Typically, stellar limb darkening is assumed to be a simple parameterization with two coefficients that are derived from stellar atmosphere models or fit directly. In this work, we revisit this assumption and compute synthetic planetary-transit light curves directly from model stellar atmosphere center-to-limb intensity variations (CLIVs) using the plane-parallel Atlas and spherically symmetric SAtlas codes. We compare these light curves to those constructed using best-fit limb-darkening parameterizations. We find that adopting parametric stellar limb-darkening laws leads to systematic differences from the more geometrically realistic model stellar atmosphere CLIV of about 50–100 ppm at the transit center and up to 300 ppm at ingress/egress. While these errors are small, they are systematic, and they appear to limit the precision necessary to measure secondary effects. Our results may also have a significant impact on transit spectra.

  2. Physiotherapy after amputation of the limb

    OpenAIRE

    Pospíšil, Daniel

    2010-01-01

    In this bachelor thesis the author considers physiotherapy after amputation of the lower limb. The theoretical section describes the anatomy of the lower limb, a procedure for amputation of the lower limb, occupational theraoy and prosthesis. The author then goes on to discuss physiotherapy in relation to two case studies of patients who have had their lower limbs removed.

  3. Gene expression patterns specific to the regenerating limb of the Mexican axolotl

    Directory of Open Access Journals (Sweden)

    James R. Monaghan

    2012-07-01

    Salamander limb regeneration is dependent upon tissue interactions that are local to the amputation site. Communication among limb epidermis, peripheral nerves, and mesenchyme coordinate cell migration, cell proliferation, and tissue patterning to generate a blastema, which will form missing limb structures. An outstanding question is how cross-talk between these tissues gives rise to the regeneration blastema. To identify genes associated with epidermis-nerve-mesenchymal interactions during limb regeneration, we examined histological and transcriptional changes during the first week following injury in the wound epidermis and subjacent cells between three injury types; 1 a flank wound on the side of the animal that will not regenerate a limb, 2 a denervated limb that will not regenerate a limb, and 3 an innervated limb that will regenerate a limb. Early, histological and transcriptional changes were similar between the injury types, presumably because a common wound-healing program is employed across anatomical locations. However, some transcripts were enriched in limbs compared to the flank and are associated with vertebrate limb development. Many of these genes were activated before blastema outgrowth and expressed in specific tissue types including the epidermis, peripheral nerve, and mesenchyme. We also identified a relatively small group of transcripts that were more highly expressed in innervated limbs versus denervated limbs. These transcripts encode for proteins involved in myelination of peripheral nerves, epidermal cell function, and proliferation of mesenchymal cells. Overall, our study identifies limb-specific and nerve-dependent genes that are upstream of regenerative growth, and thus promising candidates for the regulation of blastema formation.

  4. The effect of limb amputation on standing weight distribution in the remaining three limbs in dogs.

    Science.gov (United States)

    Cole, Grayson Lee; Millis, Darryl

    2017-01-16

    Despite the fact that limb amputation is a commonly performed procedure in veterinary medicine, quantitative data regarding outcomes are lacking. The intention of this study was to evaluate the effect of limb amputation on weight distribution to the remaining three limbs at a stance in dogs. Ten dogs with a prior forelimb amputation and ten dogs with a prior hindlimb amputation; all of which had no history of orthopaedic or neural disease in the remaining three limbs were included in the study. Standing weight bearing was evaluated with a commercial stance analyzer in all dogs. Five valid trials were obtained and a mean percentage of weight bearing was calculated for each remaining limb. The dogs with a previous forelimb amputation, and also those with a previous hindlimb amputation, had the largest mean increase in weight bearing in the contralateral forelimb. In conclusion, proactive monitoring of orthopaedic disease in the contralateral forelimb may be advisable in dogs with a previous limb amputation. In addition, when determining candidacy for a limb amputation, disease of the contralateral forelimb should be thoroughly evaluated.

  5. Transparent biocompatible sensor patches for touch sensitive prosthetic limbs

    KAUST Repository

    Nag, Anindya

    2016-12-26

    The paper presents the fabrication of transparent, flexible sensor patches developed using a casting technique with polydimethylsiloxane (PDMS) as substrate and a nanocomposite of carbon nanotubes (CNTs) and PDMS as interdigital electrodes. The electrodes act as strain sensitive capacitor. The prototypes were used as touch sensitive sensors attached to the limbs. Experiments results show the sensitivity of the patches towards tactile sensing. The results are very promising and can play a key role in the development of a cost efficient sensing system attached to prosthetic limbs.

  6. Transparent biocompatible sensor patches for touch sensitive prosthetic limbs

    KAUST Repository

    Nag, Anindya; Mukhopadhyay, Subhas; Kosel, Jü rgen

    2016-01-01

    The paper presents the fabrication of transparent, flexible sensor patches developed using a casting technique with polydimethylsiloxane (PDMS) as substrate and a nanocomposite of carbon nanotubes (CNTs) and PDMS as interdigital electrodes. The electrodes act as strain sensitive capacitor. The prototypes were used as touch sensitive sensors attached to the limbs. Experiments results show the sensitivity of the patches towards tactile sensing. The results are very promising and can play a key role in the development of a cost efficient sensing system attached to prosthetic limbs.

  7. Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

    Directory of Open Access Journals (Sweden)

    Baoguo Xu

    2011-09-01

    Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot‐assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three‐dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot‐assisted upper limb rehabilitation system, the patientʹs EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patientʹs motivation and attention and directly facilitate upper limb post‐stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot‐assisted training with motor imagery‐ based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

  8. Intensity-modulated radiation therapy to bilateral lower limb extremities concurrently: a planning case study

    Energy Technology Data Exchange (ETDEWEB)

    Fitzgerald, Emma, E-mail: emmafitz1390@gmail.com; Miles, Wesley; Fenton, Paul; Frantzis, Jim [Radiation Oncology, Epworth HealthCare, Victoria (Australia)

    2014-09-15

    Non-melanomatous skin cancers represent 80% of all newly diagnosed cancers in Australia with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) being the most common. A previously healthy 71-year-old woman presented with widespread and tender superficial skin cancers on the lower bilateral limbs. External beam radiation therapy through the use of intensity-modulated radiation therapy (IMRT) was employed as the treatment modality of choice as this technique provides conformal dose distribution to a three-dimensional treatment volume while reducing toxicity to surrounding tissues. The patient was prescribed a dose of 60 Gy to the planning target volume (PTV) with 1.0 cm bolus over the ventral surface of each limb. The beam arrangement consisted of six treatment fields that avoided entry and exit through the contralateral limb. The treatment plans met the International Commission on Radiation Units and Measurements (ICRU) guidelines and produced highly conformal dosimetric results. Skin toxicity was measured against the National Cancer Institute: Common Terminology Criteria for Adverse Events (NCI: CTCAE) version 3. A well-tolerated treatment was delivered with excellent results given the initial extent of the disease. This case study has demonstrated the feasibility and effectiveness of IMRT for skin cancers as an alternative to surgery and traditional superficial radiation therapy, utilising a complex PTV of the extremities for patients with similar presentations.

  9. Lineage tracing of genome-edited alleles reveals high fidelity axolotl limb regeneration.

    Science.gov (United States)

    Flowers, Grant Parker; Sanor, Lucas D; Crews, Craig M

    2017-09-16

    Salamanders are unparalleled among tetrapods in their ability to regenerate many structures, including entire limbs, and the study of this ability may provide insights into human regenerative therapies. The complex structure of the limb poses challenges to the investigation of the cellular and molecular basis of its regeneration. Using CRISPR/Cas, we genetically labelled unique cell lineages within the developing axolotl embryo and tracked the frequency of each lineage within amputated and fully regenerated limbs. This allowed us, for the first time, to assess the contributions of multiple low frequency cell lineages to the regenerating limb at once. Our comparisons reveal that regenerated limbs are high fidelity replicas of the originals even after repeated amputations.

  10. Running With an Elastic Lower Limb Exoskeleton.

    Science.gov (United States)

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

    2016-06-01

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

  11. Evaluation of Limb-Girdle Muscular Dystrophy

    Science.gov (United States)

    2014-03-06

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

  12. The benefit of limb cloud imaging for infrared limb sounding of tropospheric trace gases

    Directory of Open Access Journals (Sweden)

    G. Heinemann

    2009-06-01

    Full Text Available Advances in detector technology enable a new generation of infrared limb sounders to measure 2-D images of the atmosphere. A proposed limb cloud imager (LCI mode will detect clouds with a spatial resolution unprecedented for limb sounding. For the inference of temperature and trace gas distributions, detector pixels of the LCI have to be combined into super-pixels which provide the required signal-to-noise and information content for the retrievals. This study examines the extent to which tropospheric coverage can be improved in comparison to limb sounding using a fixed field of view with the size of the super-pixels, as in conventional limb sounders. The study is based on cloud topographies derived from (a IR brightness temperatures (BT of geostationary weather satellites in conjunction with ECMWF temperature profiles and (b ice and liquid water content data of the Consortium for Small-scale Modeling-Europe (COSMO-EU of the German Weather Service. Limb cloud images are simulated by matching the cloud topography with the limb sounding line of sight (LOS. The analysis of the BT data shows that the reduction of the spatial sampling along the track has hardly any effect on the gain in information. The comparison between BT and COSMO-EU data identifies the strength of both data sets, which are the representation of the horizontal cloud extent for the BT data and the reproduction of the cloud amount for the COSMO-EU data. The results of the analysis of both data sets show the great advantage of the cloud imager. However, because both cloud data sets do not present the complete fine structure of the real cloud fields in the atmosphere it is assumed that the results tend to underestimate the increase in information. In conclusion, real measurements by such an instrument may result in an even higher benefit for tropospheric limb retrievals.

  13. Sensory cortical re-mapping following upper-limb amputation and subsequent targeted reinnervation: A case report

    Directory of Open Access Journals (Sweden)

    Jun Yao

    2015-01-01

    Full Text Available This case study demonstrates the change of sensory cortical representations of the residual parts of the arm in an individual who underwent a trans-humeral amputation and subsequent targeted reinnervation (TR. As a relatively new surgical technique, TR restores a direct neural connection from amputated sensorimotor nerves to specific target muscles. This method has been successfully applied to upper-limb and lower-limb amputees, and has shown effectiveness in regaining control signals via the newly re-innervated muscles. Correspondingly, recent study results have shown that motor representations for the missing limb move closer to their original locations following TR. Besides regaining motor control signals, TR also restores the sensation in the re-innervated skin areas. We therefore hypothesize that TR causes analogous cortical sensory remapping that may return closer to their original locations. In order to test this hypothesis, cortical activity in response to sensory-level electrical stimulation in different parts of the arm was studied longitudinally in one amputated individual before and up to 2 years after TR. Our results showed that 1 before TR, the cortical response to sensory electrical stimulation in the residual limb showed a diffuse bilateral pattern without a clear focus in either the time or spatial domain; and 2 2 years after TR, the sensory map of the reinnervated median nerve reorganized, showing predominant activity over the contralateral S1 hand area as well as moderate activity over the ipsilateral S1. Therefore, this work provides new evidence for long-term sensory cortical plasticity in the human brain after TR.

  14. Sensory cortical re-mapping following upper-limb amputation and subsequent targeted reinnervation: A case report.

    Science.gov (United States)

    Yao, Jun; Chen, Albert; Kuiken, Todd; Carmona, Carolina; Dewald, Julius

    2015-01-01

    This case study demonstrates the change of sensory cortical representations of the residual parts of the arm in an individual who underwent a trans-humeral amputation and subsequent targeted reinnervation (TR). As a relatively new surgical technique, TR restores a direct neural connection from amputated sensorimotor nerves to specific target muscles. This method has been successfully applied to upper-limb and lower-limb amputees, and has shown effectiveness in regaining control signals via the newly re-innervated muscles. Correspondingly, recent study results have shown that motor representations for the missing limb move closer to their original locations following TR. Besides regaining motor control signals, TR also restores the sensation in the re-innervated skin areas. We therefore hypothesize that TR causes analogous cortical sensory remapping that may return closer to their original locations. In order to test this hypothesis, cortical activity in response to sensory-level electrical stimulation in different parts of the arm was studied longitudinally in one amputated individual before and up to 2 years after TR. Our results showed that 1) before TR, the cortical response to sensory electrical stimulation in the residual limb showed a diffuse bilateral pattern without a clear focus in either the time or spatial domain; and 2) 2 years after TR, the sensory map of the reinnervated median nerve reorganized, showing predominant activity over the contralateral S1 hand area as well as moderate activity over the ipsilateral S1. Therefore, this work provides new evidence for long-term sensory cortical plasticity in the human brain after TR.

  15. Probability of Regenerating a Normal Limb After Bite Injury in the Mexican Axolotl (Ambystoma mexicanum).

    Science.gov (United States)

    Thompson, Sierra; Muzinic, Laura; Muzinic, Christopher; Niemiller, Matthew L; Voss, S Randal

    2014-06-01

    Multiple factors are thought to cause limb abnormalities in amphibian populations by altering processes of limb development and regeneration. We examined adult and juvenile axolotls ( Ambystoma mexicanum ) in the Ambystoma Genetic Stock Center (AGSC) for limb and digit abnormalities to investigate the probability of normal regeneration after bite injury. We observed that 80% of larval salamanders show evidence of bite injury at the time of transition from group housing to solitary housing. Among 717 adult axolotls that were surveyed, which included solitary-housed males and group-housed females, approximately half presented abnormalities, including examples of extra or missing digits and limbs, fused digits, and digits growing from atypical anatomical positions. Bite injury likely explains these limb defects, and not abnormal development, because limbs with normal anatomy regenerated after performing rostral amputations. We infer that only 43% of AGSC larvae will present four anatomically normal looking adult limbs after incurring a bite injury. Our results show regeneration of normal limb anatomy to be less than perfect after bite injury.

  16. Prevalence of upper limb disorders among female librarians.

    Science.gov (United States)

    Pandy, R

    2013-09-01

    Work as a librarian involves exposure to potential risk factors for developing upper limb disorders. The prevalence of upper limb symptoms has, however, not previously been assessed in this occupational group. To estimate the 7-day and annual prevalence of self-reported neck and upper limb symptoms in librarians and to examine associations with specific tasks and ergonomic risk factors. A cross-sectional study using components of the standardized Nordic questionnaire. The study population consisted of librarians employed by a large local authority, and data collection was by means of a self-administered questionnaire. from studies on keyboard workers and on the general population were used as comparators. The 7-day prevalence of self-reported neck and upper limb pain in female librarians was 42% (95% confidence interval (CI) 33.7-50.5) and the annual prevalence was 65% (95% CI 56.6-72.8). The prevalence of reported wrist and hand pain increased with increased working involving a wide thumb-index span (P librarians was high, but there was insufficient evidence to confirm whether the prevalence was higher than in the general population or among keyboard workers. Working with a wide thumb-index span was associated with reporting upper limb symptoms.

  17. How the embryo makes a limb: determination, polarity and identity.

    Science.gov (United States)

    Tickle, Cheryll

    2015-10-01

    The vertebrate limb with its complex anatomy develops from a small bud of undifferentiated mesoderm cells encased in ectoderm. The bud has its own intrinsic polarity and can develop autonomously into a limb without reference to the rest of the embryo. In this review, recent advances are integrated with classical embryology, carried out mainly in chick embryos, to present an overview of how the embryo makes a limb bud. We will focus on how mesoderm cells in precise locations in the embryo become determined to form a limb and express the key transcription factors Tbx4 (leg/hindlimb) or Tbx5 (wing/forelimb). These Tbx transcription factors have equivalent functions in the control of bud formation by initiating a signalling cascade involving Wnts and fibroblast growth factors (FGFs) and by regulating recruitment of mesenchymal cells from the coelomic epithelium into the bud. The mesoderm that will form limb buds and the polarity of the buds is determined with respect to both antero-posterior and dorso-ventral axes of the body. The position in which a bud develops along the antero-posterior axis of the body will also determine its identity - wing/forelimb or leg/hindlimb. Hox gene activity, under the influence of retinoic acid signalling, is directly linked with the initiation of Tbx5 gene expression in the region along the antero-posterior axis of the body that will form wings/forelimbs and determines antero-posterior polarity of the buds. In contrast, Tbx4 expression in the regions that will form legs/hindlimbs is regulated by the homeoprotein Pitx1 and there is no evidence that Hox genes determine antero-posterior polarity of the buds. Bone morphogenetic protein (BMP) signalling determines the region along the dorso-ventral axis of the body in which both wings/forelimbs and legs/hindlimbs develop and dorso-ventral polarity of the buds. The polarity of the buds leads to the establishment of signalling regions - the dorsal and ventral ectoderm, producing Wnts and BMPs

  18. Newly developed semi-empirical formulas for (p, α) at 17.9 MeV and ...

    Indian Academy of Sciences (India)

    Home; Journals; Pramana – Journal of Physics; Volume 74; Issue 6. Newly developed semi-empirical formulas for (, ) at 17.9 MeV and (, ) at 22.3 MeV reaction cross-sections. Eyyup Tel Abdullah Aydin E Gamze Aydin Abdullah Kaplan Ömer Yavaş İskender A Reyhancan. Research Articles Volume 74 Issue 6 June ...

  19. Clinical practice guidelines for the management of acute limb compartment syndrome following trauma.

    Science.gov (United States)

    Wall, Christopher J; Lynch, Joan; Harris, Ian A; Richardson, Martin D; Brand, Caroline; Lowe, Adrian J; Sugrue, Michael

    2010-03-01

    Acute compartment syndrome is a serious and not uncommon complication of limb trauma. The condition is a surgical emergency, and is associated with significant morbidity if not managed appropriately. There is variation in management of acute limb compartment syndrome in Australia. Clinical practice guidelines for the management of acute limb compartment syndrome following trauma were developed in accordance with Australian National Health and Medical Research Council recommendations. The guidelines were based on critically appraised literature evidence and the consensus opinion of a multidisciplinary team involved in trauma management who met in a nominal panel process. Recommendations were developed for key decision nodes in the patient care pathway, including methods of diagnosis in alert and unconscious patients, appropriate assessment of compartment pressure, timing and technique of fasciotomy, fasciotomy wound management, and prevention of compartment syndrome in patients with limb injuries. The recommendations were largely consensus based in the absence of well-designed clinical trial evidence. Clinical practice guidelines for the management of acute limb compartment syndrome following trauma have been developed that will support consistency in management and optimize patient health outcomes.

  20. Growth factors FGF8 and FGF2 and their receptor FGFR1, transcriptional factors Msx-1 and MSX-2, and apoptotic factors p19 and RIP5 participate in the early human limb development.

    Science.gov (United States)

    Becic, Tina; Kero, Darko; Vukojevic, Katarina; Mardesic, Snjezana; Saraga-Babic, Mirna

    2018-04-01

    The expression pattern of fibroblast growth factors FGF8 and FGF2 and their receptor FGFR1, transcription factors MSX-1 and MSX-2, as well as cell proliferation (Ki-67) and cell death associated caspase-3, p19 and RIP5 factors were analyzed in histological sections of eight 4th-9th-weeks developing human limbs by immunohistochemistry and semi-thin sectioning. Increasing expression of all analyzed factors (except FGF8) characterized both the multilayered human apical ectodermal ridge (AER), sub-ridge mesenchyme (progress zone) and chondrocytes in developing human limbs. While cytoplasmic co-expression of MSX-1 and MSX-2 was observed in both limb epithelium and mesenchyme, p19 displayed strong cytoplasmic expression in non-proliferating cells. Nuclear expression of Ki-67 proliferating cells, and partly of MSX-1 and MSX-2 was detected in the whole limb primordium. Strong expression of factors p19 and RIP5, both in the AER and mesenchyme of human developing limbs indicates their possible involvement in control of cell senescence and cell death. In contrast to animal studies, expression of FGFR1 in the surface ectoderm and p19 in the whole limb primordium might reflect interspecies differences in limb morphology. Expression of FGF2 and downstream RIP5 gene, and transcription factors Msx-1 and MSX-2 did not show human-specific changes in expression pattern. Based on their spatio-temporal expression during human limb development, our study indicates role of FGFs and Msx genes in stimulation of cell proliferation, limb outgrowth, digit elongation and separation, and additionally MSX-2 in control of vasculogenesis. The cascade of orchestrated gene expressions, including the analyzed developmental factors, jointly contribute to the complex human limb development. Copyright © 2018 Elsevier GmbH. All rights reserved.

  1. Features of surgical tactics in traumatic amputations of limbs

    Directory of Open Access Journals (Sweden)

    E. V. Ponomarenko

    2016-12-01

    Full Text Available The frequency of traumatic amputations is constantly growing, which is associated with the development of transport and modern technology, military conflicts. Aim: To improve the results of treatment of patients with wound and functional defects after injury by developing a comprehensive program of surgical treatment to restore the shape and function of the trunk and limbs. Materials and methods. From 2010 to 2016 52 patients were observed in the clinic. Traumatic amputations at the hip level were observed in 14 patients, at the level of the upper third of the tibia – in 7 patients, at the level of the lower third of the tibia – 3, foot – 6. Simultaneous amputation of two lower limbs was observed in 2 patients. Amputation of upper limbs at shoulder level was observed in 3 patients, hand – 2, fingers – 15 patients. Among the reasons of limb amputations road traffic injuries occupied the leading position – 77.8 %. Combined injury (mechanical and thermal was observed in 1 case – there was a burn of amputated limb. In 31 cases (59.6 % there was complete amputation of a limb, incomplete – in 21 cases (40.4 %. Results. As a result of these tactics, only in 3 cases we had to do limb reamputation due to the inconsistency of the stump. In 22 patients for the conservation of sufficient length and the optimum shape of the stump the imposition of primary sutures was not made. At the stage of recovery of tissue covering the stump in 16 cases the closure of wound defects with simple split skin graft was fulfilled, 3 – with plastic by local tissues, 4 – islet flap on the peripheral stalk, 1 – plastic flat bridging flap, 20 operations were performed with tubular migratory classic flap. There were no complications in the postoperative period. Conclusions. The main principles in establishing the indications for reconstruction of large limb segments should be both critical attitude to the operation and strict individual approach to each

  2. Development and acceptability testing of decision trees for self-management of prosthetic socket fit in adults with lower limb amputation.

    Science.gov (United States)

    Lee, Daniel Joseph; Veneri, Diana A

    2018-05-01

    The most common complaint lower limb prosthesis users report is inadequacy of a proper socket fit. Adjustments to the residual limb-socket interface can be made by the prosthesis user without consultation of a clinician in many scenarios through skilled self-management. Decision trees guide prosthesis wearers through the self-management process, empowering them to rectify fit issues, or referring them to a clinician when necessary. This study examines the development and acceptability testing of patient-centered decision trees for lower limb prosthesis users. Decision trees underwent a four-stage process: literature review and expert consultation, designing, two-rounds of expert panel review and revisions, and target audience testing. Fifteen lower limb prosthesis users (average age 61 years) reviewed the decision trees and completed an acceptability questionnaire. Participants reported agreement of 80% or above in five of the eight questions related to acceptability of the decision trees. Disagreement was related to the level of experience of the respondent. Decision trees were found to be easy to use, illustrate correct solutions to common issues, and have terminology consistent with that of a new prosthesis user. Some users with greater than 1.5 years of experience would not use the decision trees based on their own self-management skills. Implications for Rehabilitation Discomfort of the residual limb-prosthetic socket interface is the most common reason for clinician visits. Prosthesis users can use decision trees to guide them through the process of obtaining a proper socket fit independently. Newer users may benefit from using the decision trees more than experienced users.

  3. The newly developed Toyota plug-in hybrid system

    Energy Technology Data Exchange (ETDEWEB)

    Takaoka, Toshifumi; Ichinose, Hiroki [Toyota Motor Corporation (Japan)

    2010-07-01

    Toyota has been introducing several hybrid vehicles (HV) as a countermeasure to the automobile's concerns, like CO2 reduction, energy security, and emission reduction in urban areas. A next step towards an even more effective solution for these concerns is a plug-in hybrid vehicle (PHV). This vehicle combines the advantages of electric vehicles (EV), which use clean electric energy, and HV, with it's high environmental potential and user- friendliness comparable to conventional vehicles, such as a long cruising range. This paper describes a newly developed plug-in hybrid system and its vehicle performance. This system uses a Li-ion battery with high energy density and has an affordable EV range without sacrificing cabin space. The vehicle achieves a CO2 emission of 59g/km and meets the most stringent emission regulations in the world. The new PHV is a forerunner of the large-scale mass production PHV two years later. PHVs have the potential to become popular as a realistic solution towards sustainable mobility by renewable electricity usage in the future. (orig.)

  4. Radiologic analysis of congenital limb anomalies

    International Nuclear Information System (INIS)

    Chung, Hong Jun; Kim, Ok Hwa; Shinn, Kyung Sub; Kim, Nam Ae

    1994-01-01

    Congenital limb anomalies are manifested in various degree of severity and complexity bearing conclusion for description and nomenclature of each anomaly. We retrospectively analyzed the roentgenograms of congenital limb anomalies for the purpose of further understanding of the radiologic manifestations based on the embryonal defect and also to find the incidence of each anomaly. Total number of the patients was 89 with 137 anomalies. Recently the uniform system of classification for congenital anomalies of the upper limb was adopted by International Federation of Societies for Surgery of the Hand (IFSSH), which were categorized as 7 classifications. We used the IFSSH classification with some modification as 5 classifications; failure of formation of parts, failure of differentiation of parts, duplications, overgrowth and undergrowth. The patients with upper limb anomalies were 65 out of 89(73%), lower limb were 21(24%), and both upper and lower limb anomalies were 3(4%). Failure of formation was seen in 18%, failure of differentiation 39%, duplications 39%, overgrowth 8%, and undergrowth in 12%. Thirty-five patients had more than one anomaly, and 14 patients had intergroup anomalies. The upper limb anomalies were more common than lower limb. Among the anomalies, failure of differentiation and duplications were the most common types of congenital limb anomalies. Patients with failure of formation, failure of differentiation, and undergrowth had intergroup association of anomalies, but duplication and overgrowth tended to be isolated anomalies

  5. Splenogonadal fusion with limb deficiency and micrognathia.

    Science.gov (United States)

    Moore, P J; Hawkins, E P; Galliani, C A; Guerry-Force, M L

    1997-11-01

    Splenogonadal fusion (SGF) is a rare abnormality with two known types. In the continuous type, the spleen is connected to the gonad, and there are often limb defects, micrognathia, or other congenital malformations such as ventricular septal defect, anal atresia, microgastria, spina bifida, craniosynostosis, thoracopagus, diaphragmatic hernia, hypoplastic lung and abnormal lung fissures, polymicrogyria, deficient coccyx, and bifid spine C6-T3. The discontinuous type is usually not associated with congenital defects, and the gonad that fused with an accessory spleen has no connection with the native spleen. The etiology of SGF is not known. Conceivably, a teratogenic insult occurring between 5 weeks' and 8 weeks' gestation could interfere with the normal development of the spleen, gonads, and limb buds. We describe a case of splenogonadal fusion in a stillborn black boy with associated micrognathia and limb deformities. Also, we review the possible teratogenic etiologies and embryonic basis of SGF.

  6. How Schools Can Promote Healthy Development for Newly Arrived Immigrant and Refugee Adolescents: Research Priorities

    Science.gov (United States)

    McNeely, Clea A.; Morland, Lyn; Doty, S. Benjamin; Meschke, Laurie L.; Awad, Summer; Husain, Altaf; Nashwan, Ayat

    2017-01-01

    Background: The US education system must find creative and effective ways to foster the healthy development of the approximately 2 million newly arrived immigrant and refugee adolescents, many of whom contend with language barriers, limited prior education, trauma, and discrimination. We identify research priorities for promoting the school…

  7. Research Priorities in Limb and Task-Specific Dystonias

    Science.gov (United States)

    Pirio Richardson, Sarah; Altenmüller, Eckart; Alter, Katharine; Alterman, Ron L.; Chen, Robert; Frucht, Steven; Furuya, Shinichi; Jankovic, Joseph; Jinnah, H. A.; Kimberley, Teresa J.; Lungu, Codrin; Perlmutter, Joel S.; Prudente, Cecília N.; Hallett, Mark

    2017-01-01

    Dystonia, which causes intermittent or sustained abnormal postures and movements, can present in a focal or a generalized manner. In the limbs, focal dystonia can occur in either the upper or lower limbs and may be task-specific causing abnormal motor performance for only a specific task, such as in writer’s cramp, runner’s dystonia, or musician’s dystonia. Focal limb dystonia can be non-task-specific and may, in some circumstances, be associated with parkinsonian disorders. The true prevalence of focal limb dystonia is not known and is likely currently underestimated, leaving a knowledge gap and an opportunity for future research. The pathophysiology of focal limb dystonia shares some commonalities with other dystonias with a loss of inhibition in the central nervous system and a loss of the normal regulation of plasticity, called homeostatic plasticity. Functional imaging studies revealed abnormalities in several anatomical networks that involve the cortex, basal ganglia, and cerebellum. Further studies should focus on distinguishing cause from effect in both physiology and imaging studies to permit focus on most relevant biological correlates of dystonia. There is no specific therapy for the treatment of limb dystonia given the variability in presentation, but off-label botulinum toxin therapy is often applied to focal limb and task-specific dystonia. Various rehabilitation techniques have been applied and rehabilitation interventions may improve outcomes, but small sample size and lack of direct comparisons between methods to evaluate comparative efficacy limit conclusions. Finally, non-invasive and invasive therapeutic modalities have been explored in small studies with design limitations that do not yet clearly provide direction for larger clinical trials that could support new clinical therapies. Given these gaps in our clinical, pathophysiologic, and therapeutic knowledge, we have identified priorities for future research including: the development of

  8. Research Priorities in Limb and Task-Specific Dystonias

    Directory of Open Access Journals (Sweden)

    Sarah Pirio Richardson

    2017-05-01

    : the development of diagnostic criteria for limb dystonia, more precise phenotypic characterization and innovative clinical trial design that considers clinical heterogeneity, and limited available number of participants.

  9. A computer literacy scale for newly enrolled nursing college students: development and validation.

    Science.gov (United States)

    Lin, Tung-Cheng

    2011-12-01

    Increasing application and use of information systems and mobile technologies in the healthcare industry require increasing nurse competency in computer use. Computer literacy is defined as basic computer skills, whereas computer competency is defined as the computer skills necessary to accomplish job tasks. Inadequate attention has been paid to computer literacy and computer competency scale validity. This study developed a computer literacy scale with good reliability and validity and investigated the current computer literacy of newly enrolled students to develop computer courses appropriate to students' skill levels and needs. This study referenced Hinkin's process to develop a computer literacy scale. Participants were newly enrolled first-year undergraduate students, with nursing or nursing-related backgrounds, currently attending a course entitled Information Literacy and Internet Applications. Researchers examined reliability and validity using confirmatory factor analysis. The final version of the developed computer literacy scale included six constructs (software, hardware, multimedia, networks, information ethics, and information security) and 22 measurement items. Confirmatory factor analysis showed that the scale possessed good content validity, reliability, convergent validity, and discriminant validity. This study also found that participants earned the highest scores for the network domain and the lowest score for the hardware domain. With increasing use of information technology applications, courses related to hardware topic should be increased to improve nurse problem-solving abilities. This study recommends that emphases on word processing and network-related topics may be reduced in favor of an increased emphasis on database, statistical software, hospital information systems, and information ethics.

  10. Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial.

    Science.gov (United States)

    Rink, Cameron; Wernke, Matthew M; Powell, Heather M; Gynawali, Surya; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

    2016-01-01

    A growing number of clinical trials and case reports support qualitative claims that use of an elevated vacuum suspension (EVS) prosthesis improves residual-limb health on the basis of self-reported questionnaires, clinical outcomes scales, and wound closure studies. Here, we report first efforts to quantitatively assess residual-limb circulation in response to EVS. Residual-limb skin health and perfusion of people with lower-limb amputation (N = 10) were assessed during a randomized crossover study comparing EVS with nonelevated vacuum suspension (control) over a 32 wk period using noninvasive probes (transepidermal water loss, laser speckle imaging, transcutaneous oxygen measurement) and functional hyperspectral imaging approaches. Regardless of the suspension system, prosthesis donning decreased perfusion in the residual limb under resting conditions. After 16 wk of use, EVS improved residual-limb oxygenation during treadmill walking. Likewise, prosthesis-induced reactive hyperemia was attenuated with EVS following 16 wk of use. Skin barrier function was preserved with EVS but disrupted after control socket use. Taken together, outcomes suggest chronic EVS use improves perfusion and preserves skin barrier function in people with lower-limb amputation. ClinicalTrials.gov; "Evaluation of limb health associated with a prosthetic vacuum socket system": NCT01839123; https://clinicaltrials.gov/ct2/show/NCT01839123?term=NCT01839123&rank=1.

  11. Newly developed chitosan-silver hybrid nanoparticles: biosafety and apoptosis induction in HepG2 cells

    International Nuclear Information System (INIS)

    El-Sherbiny, Ibrahim M.; Salih, Ehab; Yassin, Abdelrahman M.; Hafez, Elsayed E.

    2016-01-01

    The present study reports the biosafety assessment, the exact molecular effects, and apoptosis induction of newly developed chitosan-silver hybrid nanoparticles (Cs–Ag NPs) in HepG2 cells. The investigated hybrid NPs were green synthesized using Cs/grape leaves aqueous extract (Cs/GLE) or Cs/GLE NPs as reducing and stabilizing agents. The successful formation of Cs/GLE NPs and Cs–Ag hybrid NPs has been confirmed by UV–Vis spectrophotometry, FTIR spectroscopy, XRD, and HRTEM. From the TEM analysis, the prepared Cs/GLE NPs are uniform and spherical with an average size of 150 nm, and the AgNPs (5–10 nm) were formed mainly on their surface. The UV–Vis spectra of Cs–Ag NPs showed a surface plasmon resonance (SPR) peak at about 450 nm confirming their formation. The synthesized Cs–Ag NPs were found to be crystalline as shown by XRD patterns with fcc phase oriented along the (111), (200), (220), and (311) planes. The cytotoxicity patterns, the antiproliferative activities, and the possible mechanisms of anticancer activity at molecular level of the newly developed Cs–Ag hybrid NPs were investigated. Cytotoxicity patterns of all the preparations demonstrated that the nontoxic treatment concentrations are ranged from 0.39 to 50 %, and many of the newly prepared Cs–Ag hybrid NPs showed high anticancer activities against HpG2 cells, and induced cellular apoptosis by downregulating BCL2 gene and upregulating P53.Graphical Abstract

  12. Newly developed chitosan-silver hybrid nanoparticles: biosafety and apoptosis induction in HepG2 cells

    Energy Technology Data Exchange (ETDEWEB)

    El-Sherbiny, Ibrahim M., E-mail: ielsherbiny@Zewailcity.edu.eg; Salih, Ehab [Zewail City of Science and Technology, Center for Materials Science (Egypt); Yassin, Abdelrahman M. [Genetic Engineering and Biotechnology Research Institute, City of Scientific Research and Technology Applications, Biopharmaceutical Product Research Department (Egypt); Hafez, Elsayed E. [City of Scientific Research and Technology Applications, Plant Protection and Biomolecular Diagnosis Department (Egypt)

    2016-07-15

    The present study reports the biosafety assessment, the exact molecular effects, and apoptosis induction of newly developed chitosan-silver hybrid nanoparticles (Cs–Ag NPs) in HepG2 cells. The investigated hybrid NPs were green synthesized using Cs/grape leaves aqueous extract (Cs/GLE) or Cs/GLE NPs as reducing and stabilizing agents. The successful formation of Cs/GLE NPs and Cs–Ag hybrid NPs has been confirmed by UV–Vis spectrophotometry, FTIR spectroscopy, XRD, and HRTEM. From the TEM analysis, the prepared Cs/GLE NPs are uniform and spherical with an average size of 150 nm, and the AgNPs (5–10 nm) were formed mainly on their surface. The UV–Vis spectra of Cs–Ag NPs showed a surface plasmon resonance (SPR) peak at about 450 nm confirming their formation. The synthesized Cs–Ag NPs were found to be crystalline as shown by XRD patterns with fcc phase oriented along the (111), (200), (220), and (311) planes. The cytotoxicity patterns, the antiproliferative activities, and the possible mechanisms of anticancer activity at molecular level of the newly developed Cs–Ag hybrid NPs were investigated. Cytotoxicity patterns of all the preparations demonstrated that the nontoxic treatment concentrations are ranged from 0.39 to 50 %, and many of the newly prepared Cs–Ag hybrid NPs showed high anticancer activities against HpG2 cells, and induced cellular apoptosis by downregulating BCL2 gene and upregulating P53.Graphical Abstract.

  13. A Newly Designed Tennis Elbow Orthosis With a Traditional Tennis Elbow Strap in Patients With Lateral Epicondylitis

    Science.gov (United States)

    Saremi, Hossein; Chamani, Vahid; Vahab-Kashani, Reza

    2016-01-01

    Background Lateral epicondylitis is a common cause of pain and upper limb dysfunction. The use of counterforce straps for treatment of lateral epicondylitis is widespread. This kind of orthosis can be modified to have a greater effect on relieving pain by reducing tension on the origin of the extensor pronator muscles. Objectives To determine the immediate effects of a newly designed orthosis on pain and grip strength in patients with lateral epicondylitis. Materials and Methods Twelve participants (six men and six women) were recruited (mean age = 41 ± 6.7 years) and evaluated for pain and grip strength in three sessions. A 48-hour break was taken between each session. The first session was without any orthosis, the second session was with the new modified tennis elbow orthosis, and the third session was with a conventional tennis elbow strap. Results Both counterforce straps were effective. However, significantly more improvement was observed in pain and grip strength after using the newly modified orthosis (P < 0.05). Conclusions The newly designed strap reduces pain more effectively and improves grip strength by causing greater localized pressure on two regions with different force applications (two component vectors versus one). PMID:28180116

  14. A Newly Designed Tennis Elbow Orthosis With a Traditional Tennis Elbow Strap in Patients With Lateral Epicondylitis.

    Science.gov (United States)

    Saremi, Hossein; Chamani, Vahid; Vahab-Kashani, Reza

    2016-07-01

    Lateral epicondylitis is a common cause of pain and upper limb dysfunction. The use of counterforce straps for treatment of lateral epicondylitis is widespread. This kind of orthosis can be modified to have a greater effect on relieving pain by reducing tension on the origin of the extensor pronator muscles. To determine the immediate effects of a newly designed orthosis on pain and grip strength in patients with lateral epicondylitis. Twelve participants (six men and six women) were recruited (mean age = 41 ± 6.7 years) and evaluated for pain and grip strength in three sessions. A 48-hour break was taken between each session. The first session was without any orthosis, the second session was with the new modified tennis elbow orthosis, and the third session was with a conventional tennis elbow strap. Both counterforce straps were effective. However, significantly more improvement was observed in pain and grip strength after using the newly modified orthosis (P < 0.05). The newly designed strap reduces pain more effectively and improves grip strength by causing greater localized pressure on two regions with different force applications (two component vectors versus one).

  15. Limb myokymia

    International Nuclear Information System (INIS)

    Albers, J.W.; Allen, A.A.; Bastron, J.A.; Daube, J.R.

    1981-01-01

    Thirty-eight patients with myokymic discharges localized to limb muscles on needle electromyography had various neurologic lesions, both acute and chronic. Of the 38 patients, 27 had had previous radiation therapy and the clinical diagnosis of radiation-induced plexopathy, myelopathy, or both. For the remaining 11 patients, the diagnoses included multiple sclerosis, inflammatory polyradiculoneuropathy, ischemic neuropathy, inflammatory myopathy, and chronic disorders of the spinal cord and peripheral nerves. The clinical presentations and results of local ischemia, peripheral nerve block, and percutaneous stimulation suggest that most limb myokymic discharges arise focally at the site of a chronic peripheral nerve lesion

  16. Msx genes are important apoptosis effectors downstream of the Shh/Gli3 pathway in the limb.

    Science.gov (United States)

    Lallemand, Yvan; Bensoussan, Vardina; Cloment, Cécile Saint; Robert, Benoît

    2009-07-15

    In tetrapods, the anteroposterior (AP) patterning of the limb is under the control of the antagonistic activities of the secreted factor Sonic hedgehog (Shh) and Gli3R, the truncated repressor form of the transcription factor Gli3. In this report, we show that Msx1 and Msx2 are targets and downstream effectors of Gli3R. Consequently, in Shh null mutants, Msx genes are overexpressed and, furthermore, partially responsible for the limb phenotype. This is exemplified by the fact that reducing Msx activity in Shh mutants partially restores a normal limb development. Finally, we show that the main action of the Msx genes, in both normal and Shh(-/-) limb development, is to control cell death in the mesenchyme. We propose that, in the limb, Msx genes act downstream of the Shh/Gli3 pathway by transducing BMP signaling and that, in the absence of Shh signaling, their deregulation contributes to the extensive apoptosis that impairs limb development.

  17. The benefit of limb cloud imaging for infrared limb sounding of tropospheric trace gases

    OpenAIRE

    G. Heinemann; P. Preusse; R. Spang; S. Adams

    2009-01-01

    Advances in detector technology enable a new generation of infrared limb sounders to measure 2-D images of the atmosphere. A proposed limb cloud imager (LCI) mode will detect clouds with a spatial resolution unprecedented for limb sounding. For the inference of temperature and trace gas distributions, detector pixels of the LCI have to be combined into super-pixels which provide the required signal-to-noise and information content for the retrievals. This study examines the extent to which tr...

  18. Moving a generalised limb : a simulation with consequences for theories on limb control

    NARCIS (Netherlands)

    Otten, E

    The movement control of articulated limbs in vertebrates has been explained in terms of equilibrium points and moving equilibrium points or virtual trajectories. These hypotheses state that the nervous system makes the control Of multi-segment limbs easier by simply planning in terms of these

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

    Directory of Open Access Journals (Sweden)

    Li S

    2015-04-01

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

  20. Limb Amputations in Fixed Dystonia: A Form of Body Integrity Identity Disorder?

    OpenAIRE

    Edwards, Mark J; Alonso-Canovas, Araceli; Schrag, Arnette; Bloem, Bastiaan R; Thompson, Philip D; Bhatia, Kailash

    2011-01-01

    Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought amputation of the affected limb. We place these cases in the context of previous reports of patients with healthy limbs and patients with chronic regional pain syndrome who have sought amputation. Our cases...

  1. A newly development RIA for thyroid hormone autoantibodies (THAAb)

    International Nuclear Information System (INIS)

    Li Fengying; Gu Liqiong; Chen Xiayin; Jin Yan; Chen Shuxian; Zhang Qun; Qiu Hongxia; Yang Jingren; Zhao Yongju; Chen Mingdao

    2004-01-01

    Objective: To report a newly developed RIA for THAAb from this laboratory. Methods: The tested serum samples were cultured with labelled thyroid hormone analogous ( 125 I T 3 , 125 I T 4 ) for 16 hours. Antigen-antibody complex was precipitated with anti-human IgG (immune precipitation method) and radio-activity determined. Results: The mean positive rate of THAAb in healthy euthyroid controls (n=186) was only 1.07%. The mean positive rate in patients with thyroid disorders was 14.4% (mean rate 13.5% in hyperthyroid subjects, n=118 and mean rate 15.2% in hypothyroid subjects, n=72). The serum THAAb titer could be markedly lowered after adding non-labelled thyroid hormones (P 3 and FT 4 would be significantly lowered (P 3 , FT 4 levels. In patients with positive THAAb (about 14.4% in patients with all thyroid disorders), the FT 3 , FT 4 levels were best determined after PEG precipitation. (authors)

  2. Muscle Attenuation Is Associated With Newly Developed Hypertension in Men of African Ancestry.

    Science.gov (United States)

    Zhao, Qian; Zmuda, Joseph M; Kuipers, Allison L; Bunker, Clareann H; Patrick, Alan L; Youk, Ada O; Miljkovic, Iva

    2017-05-01

    Increased ectopic adipose tissue infiltration in skeletal muscle is associated with insulin resistance and diabetes mellitus. We evaluated whether change in skeletal muscle adiposity predicts subsequent development of hypertension in men of African ancestry, a population sample understudied in previous studies. In the Tobago Health Study, a prospective longitudinal study among men of African ancestry (age range 40-91 years), calf intermuscular adipose tissue, and skeletal muscle attenuation were measured with computed tomography. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, or a diastolic blood pressure ≥90 mm Hg, or receiving antihypertensive medications. Logistic regression was performed with adjustment for age, insulin resistance, baseline and 6-year change in body mass index, baseline and 6-year change in waist circumference, and other potential confounding factors. Among 746 normotensive men at baseline, 321 (43%) developed hypertension during the mean 6.2 years of follow-up. Decreased skeletal muscle attenuation was associated with newly developed hypertension after adjustment for baseline and 6-year change of body mass index (odds ratio [95% confidence interval] per SD, 1.3 [1.0-1.6]) or baseline and 6-year change of waist circumference (odds ratio [95% confidence interval] per SD, 1.3 [1.0-1.6]). No association was observed between increased intermuscular adipose tissue and hypertension. Our novel findings show that decreased muscle attenuation is associated with newly developed hypertension among men of African ancestry, independent of general and central adiposity and insulin resistance. Further studies are needed to adjust for inflammation, visceral and other ectopic adipose tissue depots, and to confirm our findings in other population samples. © 2017 American Heart Association, Inc.

  3. A Brief History of Limb Lengthening.

    Science.gov (United States)

    Birch, John G

    2017-09-01

    In the last 35 years, orthopaedic surgeons have witnessed 3 major advances in the technique of limb lengthening: "distraction osteogenesis" facilitated by Gavriil Ilizarov method and infinitely-adaptable circular fixator with fine-wire bone fragment fixation; the introduction of the "6-strut" computer program-assisted circular fixators to effect complex deformity correction simultaneously; and the development of motorized intramedullary lengthening nails. However, the principles and associated complications of these techniques are on the basis of observations by Codivilla, Putti, and Abbott from as much as 110 years ago. This review notes the contribution of these pioneers in limb lengthening, and the contribution of Thor Heyerdahl principles of tolerance and diversity to the dissemination of Ilizarov principles to the Western world.

  4. Determinants of limb preference for initiating compensatory stepping poststroke.

    Science.gov (United States)

    Mansfield, Avril; Inness, Elizabeth L; Lakhani, Bimal; McIlroy, William E

    2012-07-01

    To investigate the determinants of limb preference for initiating compensatory stepping poststroke. Retrospective chart review. Inpatient rehabilitation. Convenience sample of individuals admitted to inpatient rehabilitation with poststroke hemiparesis. Not applicable. Compensatory stepping responses were evoked using a lean-and-release postural perturbation. The limb used to initiate compensatory stepping was determined. The relationships between stepping with the paretic limb and premorbid limb dominance, weight bearing on the paretic limb in quiet standing, ability to bear weight on the paretic limb, preperturbation weight bearing on the paretic limb, and lower-limb motor recovery scores were determined. The majority (59.1%) of responses were steps initiated with the nonparetic limb. Increased lower-limb motor recovery scores and preperturbation weight bearing on the nonparetic limb were significantly related to increased frequency of stepping with the paretic limb. When the preferred limb was physically blocked, an inappropriate response was initiated in 21% of trials (ie, nonstep responses or an attempt to step with the blocked limb). This study reveals the challenges that individuals with poststroke hemiparesis face when executing compensatory stepping responses to prevent a fall after a postural perturbation. The inability or challenges to executing a compensatory step with the paretic limb may increase the risk for falls poststroke. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. A new take on an old story: chick limb organ culture for skeletal niche development and regenerative medicine evaluation

    Directory of Open Access Journals (Sweden)

    EL Smith

    2013-09-01

    Full Text Available Scientific research and progress, particularly in the drug discovery and regenerative medicine fields, is typically dependent on suitable animal models to develop new and improved clinical therapies for injuries and diseases. In vivo model systems are frequently utilised, but these models are expensive, highly complex and pose a number of ethical considerations leading to the development and use of a number of alternative ex vivo model systems. The ex vivo embryonic chick long bone and limb bud models have been utilised in the scientific research field as a model to understand skeletal development for over eighty years. The rapid development of avian skeletal tissues, coupled with the ease of experimental manipulation, availability of genome sequence and the presence of multiple cell and tissue types has seen such model systems gain significant research interest in the last few years in the tissue engineering field. The models have been explored both as systems for understanding the developmental bone niche and as potential testing tools for tissue engineering strategies for bone repair and regeneration. This review details the evolution of the chick limb organ culture system and presents recent innovative developments and emerging techniques and technologies applied to these models that are aiding our understanding of skeletal developmental and regenerative medicine research and application.

  6. Limb Regeneration in Axolotl: Is It Superhealing?

    Directory of Open Access Journals (Sweden)

    Stéphane Roy

    2006-01-01

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

  7. Golf and upper limb injuries: a summary and review of the literature

    Directory of Open Access Journals (Sweden)

    Pollard Henry P

    2005-05-01

    Full Text Available Abstract Background Golf is a popular past time that provides exercise with social interaction. However, as with all sports and activities, injury may occur. Many golf-related injuries occur in the upper limb, yet little research on the potential mechanisms of these injuries has been conducted. Objective To review the current literature on golf-related upper limb injuries and report on potential causes of injury as it relates to the golf swing. Discussion An overview of the golf swing is described in terms of its potential to cause the frequently noted injuries. Most injuries occur at impact when the golf club hits the ball. This paper concludes that more research into golf-related upper limb injuries is required to develop a thorough understanding of how injuries occur. Types of research include epidemiology studies, kinematic swing analysis and electromyographic studies of the upper limb during golf. By conducting such research, preventative measures maybe developed to reduce golf related injury.

  8. Understanding positional cues in salamander limb regeneration: implications for optimizing cell-based regenerative therapies

    Directory of Open Access Journals (Sweden)

    Catherine D. McCusker

    2014-06-01

    Full Text Available Regenerative medicine has reached the point where we are performing clinical trials with stem-cell-derived cell populations in an effort to treat numerous human pathologies. However, many of these efforts have been challenged by the inability of the engrafted populations to properly integrate into the host environment to make a functional biological unit. It is apparent that we must understand the basic biology of tissue integration in order to apply these principles to the development of regenerative therapies in humans. Studying tissue integration in model organisms, where the process of integration between the newly regenerated tissues and the ‘old’ existing structures can be observed and manipulated, can provide valuable insights. Embryonic and adult cells have a memory of their original position, and this positional information can modify surrounding tissues and drive the formation of new structures. In this Review, we discuss the positional interactions that control the ability of grafted cells to integrate into existing tissues during the process of salamander limb regeneration, and discuss how these insights could explain the integration defects observed in current cell-based regenerative therapies. Additionally, we describe potential molecular tools that can be used to manipulate the positional information in grafted cell populations, and to promote the communication of positional cues in the host environment to facilitate the integration of engrafted cells. Lastly, we explain how studying positional information in current cell-based therapies and in regenerating limbs could provide key insights to improve the integration of cell-based regenerative therapies in the future.

  9. Lower limb muscle volume estimation from maximum cross-sectional area and muscle length in cerebral palsy and typically developing individuals.

    Science.gov (United States)

    Vanmechelen, Inti M; Shortland, Adam P; Noble, Jonathan J

    2018-01-01

    Deficits in muscle volume may be a significant contributor to physical disability in young people with cerebral palsy. However, 3D measurements of muscle volume using MRI or 3D ultrasound may be difficult to make routinely in the clinic. We wished to establish whether accurate estimates of muscle volume could be made from a combination of anatomical cross-sectional area and length measurements in samples of typically developing young people and young people with bilateral cerebral palsy. Lower limb MRI scans were obtained from the lower limbs of 21 individuals with cerebral palsy (14.7±3years, 17 male) and 23 typically developing individuals (16.8±3.3years, 16 male). The volume, length and anatomical cross-sectional area were estimated from six muscles of the left lower limb. Analysis of Covariance demonstrated that the relationship between the length*cross-sectional area and volume was not significantly different depending on the subject group. Linear regression analysis demonstrated that the product of anatomical cross-sectional area and length bore a strong and significant relationship to the measured muscle volume (R 2 values between 0.955 and 0.988) with low standard error of the estimates of 4.8 to 8.9%. This study demonstrates that muscle volume may be estimated accurately in typically developing individuals and individuals with cerebral palsy by a combination of anatomical cross-sectional area and muscle length. 2D ultrasound may be a convenient method of making these measurements routinely in the clinic. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Differential expression of Meis2, Mab21l2 and Tbx3 during limb development associated with diversification of limb morphology in mammals.

    Science.gov (United States)

    Dai, Mengyao; Wang, Yao; Fang, Lu; Irwin, David M; Zhu, Tengteng; Zhang, Junpeng; Zhang, Shuyi; Wang, Zhe

    2014-01-01

    Bats are the only mammals capable of self-powered flight using wings. Differing from mouse or human limbs, four elongated digits within a broad wing membrane support the bat wing, and the foot of the bat has evolved a long calcar that spread the interfemoral membrane. Our recent mRNA sequencing (mRNA-Seq) study found unique expression patterns for genes at the 5' end of the Hoxd gene cluster and for Tbx3 that are associated with digit elongation and wing membrane growth in bats. In this study, we focused on two additional genes, Meis2 and Mab21l2, identified from the mRNA-Seq data. Using whole-mount in situ hybridization (WISH) we validated the mRNA-Seq results for differences in the expression patterns of Meis2 and Mab21l2 between bat and mouse limbs, and further characterize the timing and location of the expression of these two genes. These analyses suggest that Meis2 may function in wing membrane growth and Mab21l2 may have a role in AP and DV axial patterning. In addition, we found that Tbx3 is uniquely expressed in the unique calcar structure found in the bat hindlimb, suggesting a role for this gene in calcar growth and elongation. Moreover, analysis of the coding sequences for Meis2, Mab21l2 and Tbx3 showed that Meis2 and Mab21l2 have high sequence identity, consistent with the functions of genes being conserved, but that Tbx3 showed accelerated evolution in bats. However, evidence for positive selection in Tbx3 was not found, which would suggest that the function of this gene has not been changed. Together, our findings support the hypothesis that the modulation of the spatiotemporal expression patterns of multiple functional conserved genes control limb morphology and drive morphological change in the diversification of mammalian limbs.

  11. Diffusion tensor tractography reveals muscle reconnection during axolotl limb regeneration.

    Directory of Open Access Journals (Sweden)

    Cheng-Han Wu

    Full Text Available Axolotls have amazing ability to regenerate their lost limbs. Our previous works showed that after amputation the remnant muscle ends remained at their original location whilst sending satellite cells into the regenerating parts to develop into early muscle fibers in the late differentiation stage. The parental and the newly formed muscle fibers were not connected until very late stage. The present study used non-invasive diffusion tensor imaging (DTI to monitor weekly axolotl upper arm muscles after amputation of their upper arms. DTI tractography showed that the regenerating muscle fibers became visible at 9-wpa (weeks post amputation, but a gap was observed between the regenerating and parental muscles. The gap was filled at 10-wpa, indicating reconnection of the fibers of both muscles. This was confirmed by histology. The DTI results indicate that 23% of the muscle fibers were reconnected at 10-wpa. In conclusion, DTI can be used to visualize axolotls' skeletal muscles and the results of muscle reconnection were in accordance with our previous findings. This non-invasive technique will allow researchers to identify the timeframe in which muscle fiber reconnection takes place and thus enable the study of the mechanisms underlying this reconnection.

  12. Development of Device to Evoke Stretch Reflexes by Use of Electromagnetic Force for the Rehabilitation of the Hemiplegic Upper Limb after Stroke

    Science.gov (United States)

    Hayashi, Ryota; Ishimine, Tomoyasu; Kawahira, Kazumi; Yu, Yong; Tsujio, Showzow

    In this research, we focus on the method of rehabilitation with stretch reflexes for the hemiplegic upper limb in stroke patients. We propose a new device which utilizes electromagnetic force to evoke stretch reflexes. The device can exert an assisting force safely, because the electromagnetic force is non contact force. In this paper, we develop a support system applying the proposed device for the functional recovery training of the hemiplegic upper limb. The results obtained from several clinical tests with and without our support system are compared. Then we discuss the validity of our support system.

  13. Movement patterns of limb coordination in infant rolling.

    Science.gov (United States)

    Kobayashi, Yoshio; Watanabe, Hama; Taga, Gentaro

    2016-12-01

    Infants must perform dynamic whole-body movements to initiate rolling, a key motor skill. However, little is known regarding limb coordination and postural control in infant rolling. To address this lack of knowledge, we examined movement patterns and limb coordination during rolling in younger infants (aged 5-7 months) that had just begun to roll and in older infants (aged 8-10 months) with greater rolling experience. Due to anticipated difficulty in obtaining measurements over the second half of the rolling sequence, we limited our analysis to the first half. Ipsilateral and contralateral limbs were identified on the basis of rolling direction and were classified as either a stationary limb used for postural stability or a moving limb used for controlled movement. We classified the observed movement patterns by identifying the number of stationary limbs and the serial order of combinational limb movement patterns. Notably, older infants performed more movement patterns that involved a lower number of stationary limbs than younger infants. Despite the wide range of possible movement patterns, a small group of basic patterns dominated in both age groups. Our results suggest that the fundamental structure of limb coordination during rolling in the early acquisition stages remains unchanged until at least 8-10 months of age. However, compared to younger infants, older infants exhibited a greater ability to select an effective rotational movement by positioning themselves with fewer stationary limbs and performing faster limb movements.

  14. Development of Quasi-3DOF upper limb rehabilitation system using ER brake: PLEMO-P1

    International Nuclear Information System (INIS)

    Kikuchi, T; Fukushima, K; Furusho, J; Ozawa, T

    2009-01-01

    In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. However, almost all the devices are active-type (motor-driven) haptic devices and they basically require high-cost safety system compared to passive-type (brake-based) devices. In this study, we developed a new practical haptic device 'PLEMO-P1'; this system adopted ER brakes as its force generators. In this paper, the mechanism of PLEMO-P1 and its software for a reaching rehabilitation are described.

  15. Development of Quasi-3DOF upper limb rehabilitation system using ER brake: PLEMO-P1

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, T; Fukushima, K; Furusho, J; Ozawa, T [Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: kikuchi@mech.eng.osaka-u.ac.jp

    2009-02-01

    In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. However, almost all the devices are active-type (motor-driven) haptic devices and they basically require high-cost safety system compared to passive-type (brake-based) devices. In this study, we developed a new practical haptic device 'PLEMO-P1'; this system adopted ER brakes as its force generators. In this paper, the mechanism of PLEMO-P1 and its software for a reaching rehabilitation are described.

  16. Thalidomide Induces Limb Anomalies by PTEN Stabilization, Akt Suppression, and Stimulation of Caspase-Dependent Cell Death▿

    OpenAIRE

    Knobloch, Jürgen; Schmitz, Ingo; Götz, Katrin; Schulze-Osthoff, Klaus; Rüther, Ulrich

    2007-01-01

    Thalidomide, a drug used for the treatment of multiple myeloma and inflammatory diseases, is also a teratogen that causes birth defects, such as limb truncations and microphthalmia, in humans. Thalidomide-induced limb truncations result from increased cell death during embryonic limb development and consequential disturbance of limb outgrowth. Here we demonstrate in primary human embryonic cells and in the chicken embryo that thalidomide-induced signaling through bone morphogenetic proteins (...

  17. The OMPS Limb Profiler Instrument: Two-Dimensional Retrieval Algorithm

    Science.gov (United States)

    Rault, Didier F.

    2010-01-01

    The upcoming Ozone Mapper and Profiler Suite (OMPS), which will be launched on the NPOESS Preparatory Project (NPP) platform in early 2011, will continue monitoring the global distribution of the Earth's middle atmosphere ozone and aerosol. OMPS is composed of three instruments, namely the Total Column Mapper (heritage: TOMS, OMI), the Nadir Profiler (heritage: SBUV) and the Limb Profiler (heritage: SOLSE/LORE, OSIRIS, SCIAMACHY, SAGE III). The ultimate goal of the mission is to better understand and quantify the rate of stratospheric ozone recovery. The focus of the paper will be on the Limb Profiler (LP) instrument. The LP instrument will measure the Earth's limb radiance (which is due to the scattering of solar photons by air molecules, aerosol and Earth surface) in the ultra-violet (UV), visible and near infrared, from 285 to 1000 nm. The LP simultaneously images the whole vertical extent of the Earth's limb through three vertical slits, each covering a vertical tangent height range of 100 km and each horizontally spaced by 250 km in the cross-track direction. Measurements are made every 19 seconds along the orbit track, which corresponds to a distance of about 150km. Several data analysis tools are presently being constructed and tested to retrieve ozone and aerosol vertical distribution from limb radiance measurements. The primary NASA algorithm is based on earlier algorithms developed for the SOLSE/LORE and SAGE III limb scatter missions. All the existing retrieval algorithms rely on a spherical symmetry assumption for the atmosphere structure. While this assumption is reasonable in most of the stratosphere, it is no longer valid in regions of prime scientific interest, such as polar vortex and UTLS regions. The paper will describe a two-dimensional retrieval algorithm whereby the ozone distribution is simultaneously retrieved vertically and horizontally for a whole orbit. The retrieval code relies on (1) a forward 2D Radiative Transfer code (to model limb

  18. Limb sparing approach: Adjuvant radiation therapy in adults with intermediate or high-grade limb soft tissue sarcoma

    International Nuclear Information System (INIS)

    Merimsky, Ofer; Soyfer, Vjacheslav; Kovner, Felix; Bickels, Jacob; Issakov, Josephine; Flusser, Gideon; Meller, Isaac; Ofer, Oded; Kollender, Yehuda

    2005-01-01

    Background: Limb soft tissue sarcomas (STS) are currently treated with limb sparing surgery (LSS) followed by radiation therapy (RT). Patients and methods: Between October 1994 and October 2002, 133 adult patients with intermediate or high-grade limb STS were approached by LSS+RT. Results: RT related toxicity was manageable, with a low rate of severe effects. At 4-year median follow-up, there were 48 recurrences of any type, 23 of isolated local failure, and 35 of systemic spread w/o local failure. DFS and OS were influenced by disease stage II vs I, primary site in the upper limb vs lower limb, MPNST vs other types, induction therapy vs no induction, adequate resection vs marginal resection or involved margins, and good response to induction therapy vs bad response. DFS and OS were Patient's age and sex, tumor depth, acute or late toxicity of RT, or the interval of time between the date of definitive surgery and the start of RT did not affect DFS and or OS. Conclusions: The RT protocol is applicable in the era of complicated, expensive and time-consuming 3D therapy. Our results of LSS+RT in adults with limb HG STS are satisfactory

  19. [A Case of Middle Cerebral Artery Stenosis Presented with Limb-Shaking TIA].

    Science.gov (United States)

    Uno, Junji; Mineta, Haruyuki; Ren, Nice; Takagishi, Sou; Nagaoka, Shintarou; Kameda, Katsuharu; Maeda, Kazushi; Ikai, Yoshiaki; Gi, Hidefuku

    2016-07-01

    Involuntary movement is a rare clinical manifestation of transient ischemic attack (TIA). However, limb-shaking TIA is well described presentation of carotid occlusive disease. We present the case of a patient who developed limb-shaking TIA associated with high-grade stenosis of middle cerebral artery (M1), which was treated with percutaneous transluminal angioplasty (PTA). The procedure was performed successfully without complication and the symptom disappeared immediately after the procedure. The patient remained free of symptoms at the 38-month follow-up. There was no tendency of restenosis of M1. In this case, PTA was technically feasible and beneficial for limb-shaking TIA with M1 stenosis. Limb-shaking TIA can be a symptom of high-grade stenosis of M1.

  20. Predictive score for the development or progression of Graves' orbitopathy in patients with newly diagnosed Graves' hyperthyroidism

    DEFF Research Database (Denmark)

    Wiersinga, Wilmar; Žarković, Miloš; Bartalena, Luigi

    2018-01-01

    OBJECTIVE: To construct a predictive score for the development or progression of Graves' orbitopathy (GO) in Graves' hyperthyroidism (GH). DESIGN: Prospective observational study in patients with newly diagnosed GH, treated with antithyroid drugs (ATD) for 18 months at ten participating centers f...

  1. Roux limb volvulus in laparoscopic Roux-en-Y gastric bypass due to Roux limb stabilization suture: case series.

    Science.gov (United States)

    Marr, Brendan; Yenumula, Panduranga

    2012-01-01

    Complications after laparoscopic Roux-en-Y gastric bypass surgery may be related to the type of surgical technique employed. One technique, the placement of a Roux limb stabilization suture, presumably prevents kink at the gastrojejunal anastomosis. However, it can have an adverse effect and we studied a series of cases presenting with intestinal obstruction secondary to this stitch. A retrospective review of a prospectively collected database of laparoscopic Roux-en-Y gastric bypass cases who had reoperations for Roux limb volvulus was performed at a single bariatric center by a single surgeon. Out of 199 patients who underwent laparoscopic Roux en Y gastric bypass with placement of Roux limb stabilization suture, 4 patients (2.01%) presented with Roux limb volvulus postoperatively. BMI was 45.35 ± 2.95. The postoperative time to presentation was 11 ± 10.6 months. All four patients required surgical exploration to reduce the volvulus. In all cases, the Roux limb volvulus was directly attributable to the presence of the stabilization suture. In subsequent 250 cases where this suture was eliminated, there was no volvulus of Roux limb seen. The use of a stabilization suture can result in volvulus of the Roux limb causing intestinal obstruction and this complication can be prevented by avoiding this suture.

  2. Pressure drop performance evaluation for test assemblies with the newly developed top and bottom nozzles

    International Nuclear Information System (INIS)

    Lee, S. K.; Park, N. K.; Su, J. M.; Kim, H. K.; Lee, J. N.; Kim, K. T.

    2003-01-01

    To perform the hydraulic test for the newly developed top and bottom nozzles, two kinds of test assemblies were manufactured i. e. one is the test assembly which has the newly developed top and bottom nozzles and the other is Guardian test assembly which is commercially in mass production now. The test results show that the test assembly with one top nozzle and two bottom nozzles has a greater pressure loss coefficient than Guardian test assembly by 60.9% and 90.4% at the bottom nozzle location. This cause is due to the debris filtering plate for bottom nozzle to improve a filtering efficiency aginst foreign material. In the region of mid grid and top nozzle, there is no difference in pressure loss coefficient between the test assemblies since the componet features in these regions are very similar or same each other. The loss coefficients are 14.2% and 21.9% for model A and B respectively in the scale of test assembly, and the value would be within the 10% in the scale of real fuel assembly. As a result of hydraulic performance evaluation, model A is superior to model B

  3. Expression and function of the SDF-1 chemokine receptors CXCR4 and CXCR7 during mouse limb muscle development and regeneration.

    Science.gov (United States)

    Hunger, Conny; Ödemis, Veysel; Engele, Jürgen

    2012-10-15

    The chemokine, SDF-1/CXCL12, and its receptor, CXCR4, have been implied to play major roles during limb myogenesis. This concept was recently challenged by the identification of CXCR7 as an alternative SDF-1 receptor, which can either act as a scavenger receptor, a modulator of CXCR4, or an active chemokine receptor. We have now re-examined this issue by determining whether SDF-1 would signal to C2C12 myoblasts and subsequently influence their differentiation via CXCR4 and/or CXCR7. In addition, we have analyzed CXCR7, CXCR4, and SDF-1 expression in developing and injured mouse limb muscles. We demonstrate that in undifferentiated C2C12 cells, SDF-1-dependent cell signaling and resulting inhibitory effects on myogenic differentiation are entirely mediated by CXCR4. We further demonstrate that CXCR7 expression increases in differentiating C2C12 cells, which in turn abrogates CXCR4 signaling. Moreover, consistent with the view that CXCR4 and CXCR7 control limb myogenesis in vivo by similar mechanisms, we found that CXCR4 expression is the highest in late embryonic hindlimb muscles and drops shortly after birth when secondary muscle growth terminates. Vice versa, CXCR7 expression increased perinatally and persisted into adult life. Finally, underscoring the role of the SDF-1 system in muscle regeneration, we observed that SDF-1 is continuously expressed by endomysial cells of postnatal and adult muscle fibers. Analysis of dystrophin-deficient mdx mice additionally revealed that muscle regeneration is associated with muscular re-expression of CXCR4. The apparent tight control of limb muscle development and regeneration by CXCR4 and CXCR7 points to these chemokine receptors as promising therapeutic targets for certain muscle disorders. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. The effects of gait training using powered lower limb exoskeleton robot on individuals with complete spinal cord injury.

    Science.gov (United States)

    Wu, Cheng-Hua; Mao, Hui-Fen; Hu, Jwu-Sheng; Wang, Ting-Yun; Tsai, Yi-Jeng; Hsu, Wei-Li

    2018-03-05

    Powered exoskeleton can improve the mobility for people with movement deficits by providing mechanical support and facilitate the gait training. This pilot study evaluated the effect of gait training using a newly developed powered lower limb exoskeleton robot for individuals with complete spinal cord injury (SCI). Two participants with a complete SCI were recruited for this clinical study. The powered exoskeleton gait training was 8 weeks, 1 h per session, and 2 sessions per week. The evaluation was performed before and after the training for (1) the time taken by the user to don and doff the powered exoskeleton independently, (2) the level of exertion perceived by participants while using the powered exoskeleton, and (3) the mobility performance included the timed up-and-go test, 10-m walk test, and 6-min walk test with the powered exoskeleton. The safety of the powered exoskeleton was evaluated on the basis of injury reports and the incidence of falls or imbalance while using the device. The results indicated that the participants were donning and doffing the powered lower limb exoskeleton robot independently with a lower level of exertion and walked faster and farther without any injury or fall incidence when using the powered exoskeleton than when using a knee-ankle-foot orthosis. Bone mineral densities was also increased after the gait training. No adverse effects, such as skin abrasions, or discomfort were reported while using the powered exoskeleton. The findings demonstrated that individuals with complete SCI used the powered lower limb exoskeleton robot independently without any assistance after 8 weeks of powered exoskeleton gait training. Trial registration: National Taiwan University Hospital. 201210051RIB . Name of registry: Hui-Fen Mao. URL of registry: Not available. Date of registration: December 12th, 2012. Date of enrolment of the first participant to the trial: January 3rd, 2013.

  5. Self Managing the Consequences of Major Limb Trauma

    National Research Council Canada - National Science Library

    MacKenzie, Ellen J

    2008-01-01

    .... The intervention will build on widely accepted self-management programs developed for persons with arthritis as well as components of a face-to-face self-management program for civilians with long-standing limb loss...

  6. BMP-2 functions independently of SHH signaling and triggers cell condensation and apoptosis in regenerating axolotl limbs

    Directory of Open Access Journals (Sweden)

    Finnson Kenneth

    2010-02-01

    Full Text Available Abstract Background Axolotls have the unique ability, among vertebrates, to perfectly regenerate complex body parts, such as limbs, after amputation. In addition, axolotls pattern developing and regenerating autopods from the anterior to posterior axis instead of posterior to anterior like all tetrapods studied to date. Sonic hedgehog is important in establishing this anterior-posterior axis of limbs in all tetrapods including axolotls. Interestingly, its expression is conserved (to the posterior side of limb buds and blastemas in axolotl limbs as in other tetrapods. It has been suggested that BMP-2 may be the secondary mediator of sonic hedgehog, although there is mounting evidence to the contrary in mice. Since BMP-2 expression is on the anterior portion of developing and regenerating limbs prior to digit patterning, opposite to the expression of sonic hedgehog, we examined whether BMP-2 expression was dependent on sonic hedgehog signaling and whether it affects patterning of the autopod during regeneration. Results The expression of BMP-2 and SOX-9 in developing and regenerating axolotl limbs corresponded to the first digits forming in the anterior portion of the autopods. The inhibition of sonic hedgehog signaling with cyclopamine caused hypomorphic limbs (during development and regeneration but did not affect the expression of BMP-2 and SOX-9. Overexpression of BMP-2 in regenerating limbs caused a loss of digits. Overexpression of Noggin (BMP inhibitor in regenerating limbs also resulted in a loss of digits. Histological analysis indicated that the loss due to BMP-2 overexpression was the result of increased cell condensation and apoptosis while the loss caused by Noggin was due to a decrease in cell division. Conclusion The expression of BMP-2 and its target SOX-9 was independent of sonic hedgehog signaling in developing and regenerating limbs. Their expression correlated with chondrogenesis and the appearance of skeletal elements has

  7. How Schools Can Promote Healthy Development for Newly Arrived Immigrant and Refugee Adolescents: Research Priorities.

    Science.gov (United States)

    McNeely, Clea A; Morland, Lyn; Doty, S Benjamin; Meschke, Laurie L; Awad, Summer; Husain, Altaf; Nashwan, Ayat

    2017-02-01

    The US education system must find creative and effective ways to foster the healthy development of the approximately 2 million newly arrived immigrant and refugee adolescents, many of whom contend with language barriers, limited prior education, trauma, and discrimination. We identify research priorities for promoting the school success of these youth. The study used the 4-phase priority-setting method of the Child Health and Nutrition Research Initiative. In the final stage, 132 researchers, service providers, educators, and policymakers based in the United States were asked to rate the importance of 36 research options. The highest priority research options (range 1 to 5) were: evaluating newcomer programs (mean = 4.44, SD = 0.55), identifying how family and community stressors affect newly arrived immigrant and refugee adolescents' functioning in school (mean = 4.40, SD = 0.56), identifying teachers' major stressors in working with this population (mean = 4.36, SD = 0.72), and identifying how to engage immigrant and refugee families in their children's education (mean = 4.35, SD = 0.62). These research priorities emphasize the generation of practical knowledge that could translate to immediate, tangible benefits for schools. Funders, schools, and researchers can use these research priorities to guide research for the highest benefit of schools and the newly arrived immigrant and refugee adolescents they serve. © 2017, American School Health Association.

  8. A multi-method approach to curriculum development for in-service training in China's newly established health emergency response offices.

    Directory of Open Access Journals (Sweden)

    Yadong Wang

    Full Text Available To describe an innovative approach for developing and implementing an in-service curriculum in China for staff of the newly established health emergency response offices (HEROs, and that is generalisable to other settings.The multi-method training needs assessment included reviews of the competency domains needed to implement the International Health Regulations (2005 as well as China's policies and emergency regulations. The review, iterative interviews and workshops with experts in government, academia, the military, and with HERO staff were reviewed critically by an expert technical advisory panel.Over 1600 participants contributed to curriculum development. Of the 18 competency domains identified as essential for HERO staff, nine were developed into priority in-service training modules to be conducted over 2.5 weeks. Experts from academia and experienced practitioners prepared and delivered each module through lectures followed by interactive problem-solving exercises and desktop simulations to help trainees apply, experiment with, and consolidate newly acquired knowledge and skills.This study adds to the emerging literature on China's enduring efforts to strengthen its emergency response capabilities since the outbreak of SARS in 2003. The multi-method approach to curriculum development in partnership with senior policy-makers, researchers, and experienced practitioners can be applied in other settings to ensure training is responsive and customized to local needs, resources and priorities. Ongoing curriculum development should reflect international standards and be coupled with the development of appropriate performance support systems at the workplace for motivating staff to apply their newly acquired knowledge and skills effectively and creatively.

  9. A multi-method approach to curriculum development for in-service training in China's newly established health emergency response offices.

    Science.gov (United States)

    Wang, Yadong; Li, Xiangrui; Yuan, Yiwen; Patel, Mahomed S

    2014-01-01

    To describe an innovative approach for developing and implementing an in-service curriculum in China for staff of the newly established health emergency response offices (HEROs), and that is generalisable to other settings. The multi-method training needs assessment included reviews of the competency domains needed to implement the International Health Regulations (2005) as well as China's policies and emergency regulations. The review, iterative interviews and workshops with experts in government, academia, the military, and with HERO staff were reviewed critically by an expert technical advisory panel. Over 1600 participants contributed to curriculum development. Of the 18 competency domains identified as essential for HERO staff, nine were developed into priority in-service training modules to be conducted over 2.5 weeks. Experts from academia and experienced practitioners prepared and delivered each module through lectures followed by interactive problem-solving exercises and desktop simulations to help trainees apply, experiment with, and consolidate newly acquired knowledge and skills. This study adds to the emerging literature on China's enduring efforts to strengthen its emergency response capabilities since the outbreak of SARS in 2003. The multi-method approach to curriculum development in partnership with senior policy-makers, researchers, and experienced practitioners can be applied in other settings to ensure training is responsive and customized to local needs, resources and priorities. Ongoing curriculum development should reflect international standards and be coupled with the development of appropriate performance support systems at the workplace for motivating staff to apply their newly acquired knowledge and skills effectively and creatively.

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

    Directory of Open Access Journals (Sweden)

    Emma Pomeroy

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

  11. Diagnosis and treatment of upper limb apraxia.

    Science.gov (United States)

    Dovern, A; Fink, G R; Weiss, P H

    2012-07-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients' everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients' prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed and ill-treated entity. Based on a systematic literature search, this review summarizes the current tools of diagnosis and treatment strategies for upper limb apraxia. It furthermore provides clinicians with graded recommendations. In particular, a short screening test for apraxia, and a more comprehensive diagnostic apraxia test for clinical use are recommended. Although currently only a few randomized controlled studies investigate the efficacy of different apraxia treatments, the gesture training suggested by Smania and colleagues can be recommended for the therapy of apraxia, the effects of which were shown to extend to activities of daily living and to persist for at least 2 months after completion of the training. This review aims at directing the reader's attention to the ecological relevance of apraxia. Moreover, it provides clinicians with appropriate tools for the reliable diagnosis and effective treatment of apraxia. Nevertheless, this review also highlights the need for further research into how to improve diagnosis of apraxia based on neuropsychological models and to develop new therapeutic strategies.

  12. Isolated primary lymphedema tarda of the upper limb.

    Science.gov (United States)

    Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

    2013-03-01

    Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

  13. Premier's imaging IR limb sounder

    Science.gov (United States)

    Kraft, Stefan; Bézy, Jean-Loup; Meynart, Roland; Langen, Jörg; Carnicero Dominguez, Bernardo; Bensi, Paolo; Silvestrin, Pierluigi

    2017-11-01

    The Imaging IR Limb Sounder (IRLS) is one of the two instruments planned on board of the candidate Earth Explorer Core Mission PREMIER. PREMIER stands for PRocess Exploration through Measurements of Infrared and Millimetre-wave Emitted Radiation. PREMIER went recently through the process of a feasibility study (Phase A) within the Earth Observation Envelope Program. Emerging from recent advanced instrument technologies IRLS shall, next to a millimetre-wave limb sounder (called STEAMR), explore the benefits of three-dimensional limb sounding with embedded cloud imaging capability. Such 3D imaging technology is expected to open a new era of limb sounding that will allow detailed studies of the link between atmospheric composition and climate, since it will map simultaneously fields of temperature and many trace gases in the mid/upper troposphere and stratosphere across a large vertical and horizontal field of view and with high vertical and horizontal resolution. PREMIER shall fly in a tandem formation looking backwards to METOP's swath and thereby improve meteorological and environmental analyses.

  14. Upper limb position control in fibromyalgia

    Directory of Open Access Journals (Sweden)

    Bardal Ellen

    2012-09-01

    Full Text Available Abstract Background Motor problems are reported by patients with fibromyalgia (FM. However, the mechanisms leading to alterations in motor performance are not well understood. In this study, upper limb position control during sustained isometric contractions was investigated in patients with FM and in healthy controls (HCs. Methods Fifteen female FM patients and 13 HCs were asked to keep a constant upper limb position during sustained elbow flexion and shoulder abduction, respectively. Subjects received real-time visual feedback on limb position and both tasks were performed unloaded and while supporting loads (1, 2, and 3 kg. Accelerations of the dominant upper limb were recorded, with variance (SD of mean position and power spectrum analysis used to characterize limb position control. Normalized power of the acceleration signal was extracted for three frequency bands: 1–3 Hz, 4–7 Hz, and 8–12 Hz. Results Variance increased with load in both tasks (P 0.001 but did not differ significantly between patients and HCs (P > 0.17. Power spectrum analysis showed that the FM patients had a higher proportion of normalized power in the 1–3 Hz band, and a lower proportion of normalized power in the 8–12 Hz band compared to HCs (P 0.05. The results were consistent for all load conditions and for both elbow flexion and shoulder abduction. Conclusion FM patients exhibit an altered neuromuscular strategy for upper limb position control compared to HCs. The predominance of low-frequency limb oscillations among FM patients may indicate a sensory deficit.

  15. Lower Limb Injuries Arising From Motorcycle Crashes | Kortor ...

    African Journals Online (AJOL)

    Background: Motorcycle accidents are the second most common cause of road traffic accidents in both developing and developed countries. In this study we aim to look at the pattern and characteristics of lower limb injuries arising from motorcycle accidents and evaluate early outcome of treatment. Methods: All the patients ...

  16. Activation of germline-specific genes is required for limb regeneration in the Mexican axolotl

    Science.gov (United States)

    Zhu, Wei; Pao, Gerald M; Satoh, Akira; Cummings, Gillian; Monaghan, James R; Harkins, Timothy T; Bryant, Susan V; Voss, S Randal; Gardiner, David M; Hunter, Tony

    2013-01-01

    The capacity for tissue and organ regeneration in humans is dwarfed by comparison to that of salamanders. Emerging evidence suggests that mechanisms learned from the early phase of salamander limb regeneration – wound healing, cellular dedifferentiation and blastemal formation – will reveal therapeutic approaches for tissue regeneration in humans. Here we describe a unique transcriptional fingerprint of regenerating limb tissue in the Mexican axolotl (Ambystoma mexicanum) that is indicative of cellular reprogramming of differentiated cells to a germline-like state. Two genes that are required for self-renewal of germ cells in mice and flies, Piwi-like 1 (PL1) and Piwi-like 2 (PL2), are expressed in limb blastemal cells, the basal layer keratinocytes and the thickened apical epithelial cap in the wound epidermis in the regenerating limb. Depletion of PL1 and PL2 by morpholino oligonucleotides decreased cell proliferation and increased cell death in the blastema leading to a significant retardation of regeneration. Examination of key molecules that are known to be required for limb development or regeneration further revealed that FGF8 is transcriptionally downregulated in the presence of the morpholino oligos, indicating PL1 and PL2 might participate in FGF signaling during limb regeneration. Given the requirement for FGF signaling in limb development and regeneration, the results suggest that PL1 and PL2 function to establish a unique germline-like state that is associated with successful regeneration. PMID:22841627

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

    DEFF Research Database (Denmark)

    Raffin, Estelle; Richard, Nathalie; Giraux, Pascal

    2016-01-01

    A substantial body of evidence documents massive reorganization of primary sensory and motor cortices following hand amputation, the extent of which is correlated with phantom limb pain. Many therapies for phantom limb pain are based upon the idea that plastic changes after amputation...... for the maladaptative plasticity model, we demonstrate for the first time that motor capacities of the phantom limb correlate with post-amputation reorganization, and that this reorganization is not limited to the face and hand representations but also includes the proximal upper-limb....

  18. Study on development of active-passive rehabilitation system for upper limbs: Hybrid-PLEMO

    International Nuclear Information System (INIS)

    Kikuchi, T; Jin, Y; Fukushima, K; Akai, H; Furusho, J

    2009-01-01

    In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. Active-type (motor-driven) haptic devices can realize a lot of varieties of haptics. But they basically require high-cost safety system. On the other hand, passive-type (brake-based) haptic devices have inherent safety. However, the passive robot system has strong limitation on varieties of haptics. There are not sufficient evidences to clarify how the passive/active haptics effect to the rehabilitation of motor skills. In this paper, we developed an active-passive-switchable rehabilitation system with ER clutch/brake device named 'Hybrid-PLEMO' in order to address these problems. In this paper, basic structures and haptic control methods of the Hybrid-PLEMO are described.

  19. Study on development of active-passive rehabilitation system for upper limbs: Hybrid-PLEMO

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, T; Jin, Y; Fukushima, K; Akai, H; Furusho, J [Department of Mechanical Engineering, Graduate School of Engineering, Osaka University, Osaka (Japan)], E-mail: kikuchi@mech.eng.osaka-u.ac.jp

    2009-02-01

    In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. Active-type (motor-driven) haptic devices can realize a lot of varieties of haptics. But they basically require high-cost safety system. On the other hand, passive-type (brake-based) haptic devices have inherent safety. However, the passive robot system has strong limitation on varieties of haptics. There are not sufficient evidences to clarify how the passive/active haptics effect to the rehabilitation of motor skills. In this paper, we developed an active-passive-switchable rehabilitation system with ER clutch/brake device named 'Hybrid-PLEMO' in order to address these problems. In this paper, basic structures and haptic control methods of the Hybrid-PLEMO are described.

  20. Lower-Limb Wearable Exoskeleton

    OpenAIRE

    Pons, J.L.; Moreno, J.C.; Brunetti, F.J.; Rocon, E.

    2007-01-01

    The differences found in the patients' kinematic gait patterns during the application of functional compensation on the lower limb showed significant differences regarding the subjects' usual gait. In both patients rapid adaptations were observed and new motor commands were learnt necessary for managing the exoskeleton with the constraints imposed on the limb. The benefits of the correct release of the knee in both instances is clear evidence of approximating their gait patterns to the normal...

  1. A Statistical Perspective on Running with Prosthetic Lower-Limbs: An Advantage or Disadvantage?

    Directory of Open Access Journals (Sweden)

    Hossein Hassani

    2014-11-01

    Full Text Available Technological developments have led to the increased use of carbon fiber and prosthetic lower-limbs in running events at the Paralympic Games. This study aims to exploit a series of statistical techniques in order to prepare a response to the vital question of whether utilizing prosthetic feet can affect an athletes ability when running competitively at the Paralympics Games by comparing both within and between different classifications. The study also considers the differences between running on biological limbs and prosthetic lower-limbs from a mechanical point of view. The results from the male 100 m, 200 m and 400 m at the 2012 London Paralympic Games have been the source of this investigation. The investigation provides statistical evidence to propose that the number of prosthetic limbs used and the structure of such limbs have a significant impact on the outcome of track events at the Paralympic Games.

  2. Emulating Upper Limb Disorder for Therapy Education

    Directory of Open Access Journals (Sweden)

    Noor Ayuni binti Che Zakaria

    2014-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Kazumasa Mitogawa

    Full Text Available Axolotls (Ambystoma mexicanum can completely regenerate lost limbs, whereas Xenopus laevis frogs cannot. During limb regeneration, a blastema is first formed at the amputation plane. It is thought that this regeneration blastema forms a limb by mechanisms similar to those of a developing embryonic limb bud. Furthermore, Xenopus laevis frogs can form a blastema after amputation; however, the blastema results in a terminal cone-shaped cartilaginous structure called a "spike." The causes of this patterning defect in Xenopus frog limb regeneration were explored. We hypothesized that differences in chondrogenesis may underlie the patterning defect. Thus, we focused on chondrogenesis. Chondrogenesis marker genes, type I and type II collagen, were compared in regenerative and nonregenerative environments. There were marked differences between axolotls and Xenopus in the expression pattern of these chondrogenesis-associated genes. The relative deficit in the chondrogenic capacity of Xenopus blastema cells may account for the absence of total limb regenerative capacity.

  4. Developmental Mechanism of Limb Field Specification along the Anterior–Posterior Axis during Vertebrate Evolution

    Directory of Open Access Journals (Sweden)

    Mikiko Tanaka

    2016-05-01

    Full Text Available In gnathostomes, limb buds arise from the lateral plate mesoderm at discrete positions along the body axis. Specification of these limb-forming fields can be subdivided into several steps. The lateral plate mesoderm is regionalized into the anterior lateral plate mesoderm (ALPM; cardiac mesoderm and the posterior lateral plate mesoderm (PLPM. Subsequently, Hox genes appear in a nested fashion in the PLPM and provide positional information along the body axis. The lateral plate mesoderm then splits into the somatic and splanchnic layers. In the somatic layer of the PLPM, the expression of limb initiation genes appears in the limb-forming region, leading to limb bud initiation. Furthermore, past and current work in limbless amphioxus and lampreys suggests that evolutionary changes in developmental programs occurred during the acquisition of paired fins during vertebrate evolution. This review presents these recent advances and discusses the mechanisms of limb field specification during development and evolution, with a focus on the role of Hox genes in this process.

  5. TNFa-based isolated limb perfusion in the rat : development of a model and analysis of efficacy determining factors

    NARCIS (Netherlands)

    E.R. Manusama (Eric)

    1998-01-01

    textabstractIsolated limb perfusion (lLP) with high dose TNFa in combination with IFNr and melphalan in patients with melanoma in transit metastases confined to the limb has recently been reported to result in much higher complete tumor response rates than after the standard therapy of ILP with

  6. Contribution of limb momentum to power transfer in athletic wheelchair pushing.

    Science.gov (United States)

    Masson, G; Bégin, M-A; Lopez Poncelas, M; Pelletier, S-K; Lessard, J-L; Laroche, J; Berrigan, F; Langelier, E; Smeesters, C; Rancourt, D

    2016-09-06

    Pushing capacity is a key parameter in athletic racing wheelchair performance. This study estimated the potential contribution of upper limb momentum to pushing. The question is relevant since it may affect the training strategy adopted by an athlete. A muscle-free Lagrangian dynamic model of the upper limb segments was developed and theoretical predictions of power transfer to the wheelchair were computed during the push phase. Results show that limb momentum capacity for pushing can be in the order of 40J per push cycle at 10m/s, but it varies with the specific pushing range chosen by the athlete. Although use of momentum could certainly help an athlete improve performance, quantifying the actual contribution of limb momentum to pushing is not trivial. A preliminary experimental investigation on an ergometer, along with a simplified model of the upper limb, suggests that momentum is not the sole contributor to power transfer to a wheelchair. Muscles substantially contribute to pushing, even at high speeds. Moreover, an optimal pushing range is challenging to find since it most likely differs if an athlete chooses a limb momentum pushing strategy versus a muscular exertion pushing strategy, or both at the same time. The study emphasizes the importance of controlling pushing range, although one should optimize it while also taking the dynamics of the recovery period into account. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. A Study of Correlations within the Dimensions of Lower Limb Parts for Personal Identification in a Sudanese Population

    Directory of Open Access Journals (Sweden)

    Altayeb Abdalla Ahmed

    2014-01-01

    Full Text Available The presence of an isolated limb or limb parts from different individuals presents a major challenge for medicolegal investigators in establishing identification in cases of wars, mass disasters, and criminal assaults because different populations have different sizes and proportions. The measurement of lower limb dimensions showed a high success rate in establishing individual identity in terms of sex and stature in various populations. However, there is a paucity of data concerning the correlation within the lower limb parts. This study aims to assess the existence of relationships within lower limb parts and to develop regression formulae to reconstruct limb parts from one another. The tibial length, bimalleolar breadth, foot length, and foot breadth of 376 right-handed Sudanese adults were measured. The results showed that all variables were significantly larger in males than in females. A significant positive correlation (P<0.001 was found within the lower limb parts. Sex-specific linear equations and multiple regression equations were developed to reconstruct the lower limb parts in the presence of single dimension or multiple dimensions from the same limb. The use of multiple regression equations provided a better reconstruction than simple regression equations. These results are significant in forensics and orthopedic reconstructive surgery.

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

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2012-05-01

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

  9. Reactivation of larval keratin gene (krt62.L) in blastema epithelium during Xenopus froglet limb regeneration.

    Science.gov (United States)

    Satoh, Akira; Mitogawa, Kazumasa; Saito, Nanami; Suzuki, Miyuki; Suzuki, Ken-Ichi T; Ochi, Haruki; Makanae, Aki

    2017-12-15

    Limb regeneration is considered a form of limb redevelopment because of the molecular and morphological similarities. Forming a regeneration blastema is, in essence, creating a developing limb bud in an adult body. This reactivation of a developmental process in a mature body is worth studying. Xenopus laevis has a biphasic life cycle that involves distinct larval and adult stages. These distinct developmental stages are useful for investigating the reactivation of developmental processes in post-metamorphic frogs (froglets). In this study, we focused on the re-expression of a larval gene (krt62.L) during Xenopus froglet limb regeneration. Recently renamed krt62.L, this gene was known as the larval keratin (xlk) gene, which is specific to larval-tadpole stages. During limb regeneration in a froglet, krt62.L was re-expressed in a basal layer of blastema epithelium, where adult-specific keratin (Krt12.6.S) expression was also observable. Nerves produce important regulatory factors for amphibian limb regeneration, and also play a role in blastema formation and maintenance. The effect of nerve function on krt62.L expression could be seen in the maintenance of krt62.L expression, but not in its induction. When an epidermis-stripped limb bud was grafted in a froglet blastema, the grafted limb bud could reach the digit-forming stage. This suggests that krt62.L-positive froglet blastema epithelium is able to support the limb development process. These findings imply that the developmental process is locally reactivated in an postmetamorphic body during limb regeneration. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Multidisciplinary ''limb salvage'' treatment of soft tissue and skeletal sarcomas

    International Nuclear Information System (INIS)

    Weisenburger, T.H.; Eilber, F.R.; Grant, T.T.; Morton, D.L.; Mirra, J.J.; Steinberg, M.; Rickles, D.

    1984-01-01

    The goal of treating primary bone and soft tissue tumors, as with most other malignancies, is to control the disease locally and systematically while preserving as much function as possible. For soft tissue sarcomas the results following radical excision and post-operative radiation therapy with preservation of the limb have equaled the control rates of amputation. However, local recurrence rates of approximately 25-30% are reported for high-grade lesions of the proximal lower extremity. Amputations provides excellent local control for osteosarcoma but the functional results may be less than optimal. In an attempt to achieve limb salvage for these tumors, a multidisciplinary protocol was developed using intra-arterial doxorubicin, pre-operative radiation therapy and limb-sparing radical wide excision followed by post-operative chemotherapy for presumed micro-metastatic disease

  11. Discharge destination following lower limb fracture: development of a prediction model to assist with decision making.

    Science.gov (United States)

    Kimmel, Lara A; Holland, Anne E; Edwards, Elton R; Cameron, Peter A; De Steiger, Richard; Page, Richard S; Gabbe, Belinda

    2012-06-01

    Accurate prediction of the likelihood of discharge to inpatient rehabilitation following lower limb fracture made on admission to hospital may assist patient discharge planning and decrease the burden on the hospital system caused by delays in decision making. To develop a prognostic model for discharge to inpatient rehabilitation. Isolated lower extremity fracture cases (excluding fractured neck of femur), captured by the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR), were extracted for analysis. A training data set was created for model development and validation data set for evaluation. A multivariable logistic regression model was developed based on patient and injury characteristics. Models were assessed using measures of discrimination (C-statistic) and calibration (Hosmer-Lemeshow (H-L) statistic). A total of 1429 patients met the inclusion criteria and were randomly split into training and test data sets. Increasing age, more proximal fracture type, compensation or private fund source for the admission, metropolitan location of residence, not working prior to injury and having a self-reported pre-injury disability were included in the final prediction model. The C-statistic for the model was 0.92 (95% confidence interval (CI) 0.88, 0.95) with an H-L statistic of χ(2)=11.62, p=0.17. For the test data set, the C-statistic was 0.86 (95% CI 0.83, 0.90) with an H-L statistic of χ(2)=37.98, plower limb fracture was developed with excellent discrimination although the calibration was reduced in the test data set. This model requires prospective testing but could form an integral part of decision making in regards to discharge disposition to facilitate timely and accurate referral to rehabilitation and optimise resource allocation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Neurotrophic regulation of epidermal dedifferentiation during wound healing and limb regeneration in the axolotl (Ambystoma mexicanum).

    Science.gov (United States)

    Satoh, A; Graham, G M C; Bryant, S V; Gardiner, D M

    2008-07-15

    Adult urodeles (salamanders) are unique in their ability to regenerate complex organs perfectly. The recently developed Accessory Limb Model (ALM) in the axolotl provides an opportunity to identify and characterize the essential signaling events that control the early steps in limb regeneration. The ALM demonstrates that limb regeneration progresses in a stepwise fashion that is dependent on signals from the wound epidermis, nerves and dermal fibroblasts from opposite sides of the limb. When all the signals are present, a limb is formed de novo. The ALM thus provides an opportunity to identify and characterize the signaling pathways that control blastema morphogenesis and limb regeneration. In the present study, we have utilized the ALM to identity the buttonhead-like zinc-finger transcription factor, Sp9, as being involved in the formation of the regeneration epithelium. Sp9 expression is induced in basal keratinocytes of the apical blastema epithelium in a pattern that is comparable to its expression in developing limb buds, and it thus is an important marker for dedifferentiation of the epidermis. Induction of Sp9 expression is nerve-dependent, and we have identified KGF as an endogenous nerve factor that induces expression of Sp9 in the regeneration epithelium.

  13. Reflexology treatment for patients with lower limb amputations and phantom limb pain--an exploratory pilot study.

    Science.gov (United States)

    Brown, Christine Ann; Lido, Catherine

    2008-05-01

    The objectives of the study were to evaluate the possibility of reflexology being used as a non-invasive form of phantom limb pain relief and of empowering patients to maintain any positive results with self-treatment. Prosthetic Services Centre, Herbert Street, Wolverhampton, West Midlands, England. A same-subject, experimental pilot study, recording the intensity of phantom limb pain in weekly pain diaries over a 30-week period, which was divided into five phases: phase 1 gave a baseline of pain, whilst phase 3 was a resting phase. Phases 2, 4 and 5 provided the reflexology interventions. Ten participants with unilateral lower limb amputations and phantom limb pain were selected from the database at the Prosthetic Centre. REFLEXOLOGY INTERVENTIONS: In phase 2, six weekly reflexology treatments were given, which consisted of: full foot reflexology to the remaining foot and full hand reflexology to the hand of the amputated side of the body. In phase 4, six weekly hand reflexology teaching sessions were carried out; patients copied on their own hands what the therapist did on hers. A hand reflexology booklet gave the sequence of the treatment and was used as a reference. In phase 5, the patients self-treated for 6 weeks at home, using the reference material. Over the 30-week period, there was an improvement in the perception of the presence and the intensity of the phantom limb pain, with a corresponding improvement in the duration of the pain and the affect on the person's lifestyle. The improvement was maintained when the clients self-treated. FOLLOW-UP QUESTIONNAIRE: A follow-up questionnaire was carried out in 2007--12 months after the project had ended--to elicit whether the patients had suffered from phantom pain over the previous 12 months, whether they still had relief from phantom limb pain and whether they still self-treated. The project indicated that reflexology treatment, teaching and self-treatment were effective in eradicating or reducing the

  14. Association Between Manual Loading and Newly Developed Carpal Tunnel Syndrome in Subjects With Physical Disabilities: A Follow-Up Study.

    Science.gov (United States)

    Lin, Yen-Nung; Chiu, Chun-Chieh; Huang, Shih-Wei; Hsu, Wen-Yen; Liou, Tsan-Hon; Chen, Yi-Wen; Chang, Kwang-Hwa

    2017-10-01

    To identify the association between body composition and newly developed carpal tunnel syndrome (CTS) and to search for the best probabilistic cutoff value of associated factors to predict subjects with physical disabilities developing new CTS. Longitudinal. University-affiliated medical center. Subjects with physical disabilities (N=47; mean age ± SD, 42.1±7.7y). Not applicable. Median and ulnar sensory nerve conduction velocity (SNCV) were measured at the initial and follow-up tests (interval >2y). Total and regional body composition were measured with dual-energy x-ray absorptiometry at the initial test. Leg lean tissue percentage was calculated to delineate each participant's manual loading degree during locomotion. Leg lean tissue percentage is the lean tissue mass of both legs divided by body weight. Based on median SNCV changes, we divided all participants into 3 groups: subjects with bilateral CTS (median SNCV value normative ulnar SNCV value >37.8m/s) in the initial test (n=10), subjects with newly developed CTS in the follow-up test (n=8), and subjects without additional CTS in the follow-up test (n=27). Eight of 35 subjects not having bilateral CTS initially developed new CTS (8.8% per year; mean follow-up period, 2.6y). Leg lean tissue percentage was associated with the probability of newly developed CTS (adjusted odds ratio, .64; P12% were less likely to have developed new CTS at the follow-up test (sensitivity, .75; specificity, .85; area under the curve, .88; Pphysical disabilities. Therefore, a preventive program for those subjects at risk can start early. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Adolescent Neuroblastoma of Lower Limb

    Directory of Open Access Journals (Sweden)

    Rajeshwari K

    2013-04-01

    Full Text Available Neuroblastoma is an embryonic tumour of neural crest origin, commonly seen in children with upper abdomen involvement. Rarely neuroblastomas present in adolescents and adults involving lower limb. Histopathologically neuroblastoma of lower limb can be confused with other small round cell tumour especially with Ewing's sarcoma and rhabdomyosarcoma. A 16 year old male presented with 15x11cm swelling, pain and multiple discharging sinuses of right leg since 4 months. Routine haematological and biochemical analysis were within normal limits. Radiology of right leg showed large soft tissue swelling encompassing the pathological fracture of tibia and bowing of fibula. Fine needle aspiration of the swelling revealed malignant small round cell tumour. Histopathology revealed poorly differentiated neuroblastoma of lower limb. The immunohistochemistry of Synaptophysin and Chromogranin were positive and CD 99 was negative. Neuroblastoma diagnosed at unusual site with uncommon age has poor prognosis. Hence, one must keep in mind the differential diagnosis of neuroblastoma as one of the differential diagnosis in evaluating the soft tissue tumours of lower limb.

  16. Knockdown of connexin43-mediated regulation of the zone of polarizing activity in the developing chick limb leads to digit truncation.

    Science.gov (United States)

    Law, Lee Yong; Lin, Jun Sheng; Becker, David L; Green, Colin R

    2002-12-01

    In the developing chick wing, the use of antisense oligodeoxynucleotides to transiently knock down the expression of the gap junction protein, connexin43 (Cx43), results in limb patterning defects, including deletion of the anterior digits. To understand more about how such defects arise, the effects of transient Cx43 knockdown on the expression patterns of several genes known to play pivotal roles in limb formation were examined. Sonic hedgehog (Shh), which is normally expressed in the zone of polarizing activity (ZPA) and is required to maintain both the ZPA and the apical ectodermal ridge (AER), was found to be downregulated in treated limbs within 30 h. Bone morphogenetic protein-2 (Bmp-2), a gene downstream of Shh, was similarly downregulated. Fibroblast growth factor-8 expression, however, was unaltered 30 h after treatment but was greatly reduced at 48 h post-treatment, when the AER begins to regress. Expressions of Bmp-4 and Muscle segment homeobox-like gene (Msx-1) were not affected at any of the time points examined. Cx43 expression is therefore involved in some, but not all patterning cascades, and appears to play a role in the regulation of ZPA activity.

  17. Multiple cranial neuropathies without limb involvements: guillain-barre syndrome variant?

    Science.gov (United States)

    Yu, Ju Young; Jung, Han Young; Kim, Chang Hwan; Kim, Hyo Sang; Kim, Myeong Ok

    2013-10-01

    Acute multiple cranial neuropathies are considered as variant of Guillain-Barre syndrome, which are immune-mediated diseases triggered by various cases. It is a rare disease which is related to infectious, inflammatory or systemic diseases. According to previous case reports, those affected can exhibit almost bilateral facial nerve palsy, then followed by bulbar dysfunctions (cranial nerves IX and X) accompanied by limb weakness and walking difficulties due to motor and/or sensory dysfunctions. Furthermore, reported cases of the acute multiple cranial neuropathies show electrophysiological abnormalities compatible with the typical Guillain-Barre syndromes (GBS). We recently experienced a patient with a benign infectious disease who subsequently developed symptoms of variant GBS. Here, we describe the case of a 48-year-old male patient who developed multiple symptoms of cranial neuropathy without limb weakness. His laboratory findings showed a positive result for anti-GQ1b IgG antibody. As compared with previously described variants of GBS, the patient exhibited widespread cranial neuropathy, which included neuropathies of cranial nerves III-XII, without limb involvement or ataxia.

  18. Slower lower limb blood pooling in young women with orthostatic intolerance.

    Science.gov (United States)

    Lindenberger, Marcus; Länne, Toste

    2015-01-01

    What is the central question of this study? Orthostatic stress is mostly caused by venous blood pooling in the lower limbs. Venous distension elicits sympathetic responses, and increased distension speed enhances the cardiovascular response. We examine whether lower limb blood pooling rate during lower body negative pressure is linked to orthostatic intolerance. What is the main finding and its importance? A similar amount of blood was pooled in the lower limb, but at a slower rate in women who developed signs of orthostatic intolerance. The difference in blood pooling rate increased with orthostatic stress and was most prominent at a presyncope-inducing level of lower body negative pressure. The findings have implications for the pathophysiology as well as treatment of orthostatic intolerance. Vasovagal syncope is common in young women, but its aetiology remains elusive. Orthostatic stress-induced lower limb blood pooling is linked with central hypovolaemia and baroreceptor unloading. Venous distension in the arm elicits a sympathetic response, which is enhanced with more rapid distension. Our aim was to study both the amount and the speed of lower limb pooling during orthostatic stress and its effects on compensatory mechanisms to maintain cardiovascular homeostasis in women with orthostatic intolerance. Twenty-seven healthy women, aged 20-27 years, were subjected to a lower body negative pressure (LBNP) of 11-44 mmHg. Five women developed symptoms of vasovagal syncope (orthostatic intolerant) and were compared with the remaining women, who tolerated LBNP well (orthostatic tolerant). Lower limb blood pooling, blood flow and compensatory mobilization of venous capacitance blood were measured. Lower body negative pressure induced equal lower limb blood pooling in both groups, but at a slower rate in orthostatic intolerant women (e.g. time to 50% of total blood pooling, orthostatic intolerant 44 ± 7 s and orthostatic tolerant 26 ± 2 s; P intolerant women (P = 0

  19. [Psychotherapies for the Treatment of Phantom Limb Pain].

    Science.gov (United States)

    Cárdenas, Katherine; Aranda, Mariana

    The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42 to 90% of amputees. Regular drug treatment of phantom limb pain is almost never effective. A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items. After reviewing the abstracts, 25 articles were excluded for not being related to the objective of the research. Additionally cross references of included articles and literature were reviewed. To describe the psychotherapies used in the management of phantom limb pain, their effectiveness and clinical application reported in the literature. The mechanisms underlying phantom limb pain were initially explained, as were the published studies on the usefulness of some psychotherapies such as mirror visual feedback and immersive virtual reality, visual imagery, desensitization and reprocessing eye movements and hypnosis. The phantom limb pain is a complex syndrome that requires pharmacological and psychotherapeutic intervention. The psychotherapies that have been used the most as adjuvants in the treatment of phantom limb pain are mirror visual feedback, desensitization and reprocessing eye movements, imagery and hypnosis. Studies with more representative samples, specifically randomized trials are required. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  20. Duplex ultrasound: Indications and findings in a newly created ...

    African Journals Online (AJOL)

    2015-09-21

    Sep 21, 2015 ... save more lives and limbs in the developing world. Key words: Calabar ... managed with only clinical assessment of their blood vessels and X‑rays. With the .... are supposed to be bread winners and, therefore, more fearful.

  1. Agency over Phantom Limb Enhanced by Short-Term Mirror Therapy.

    Science.gov (United States)

    Imaizumi, Shu; Asai, Tomohisa; Koyama, Shinichi

    2017-01-01

    Most amputees experience phantom limb, whereby they feel that the amputated limb is still present. In some cases, these experiences include pain that can be alleviated by "mirror therapy." Mirror therapy consists of superimposing a mirrored image of the moving intact limb onto the phantom limb. This therapy provides a closed loop between the motor command to the amputated limb and its predicted visual feedback. This loop is also involved in the sense of agency, a feeling of controlling one's own body. However, it is unclear how mirror therapy is related to the sense of agency over a phantom limb. Using mirror therapy, we investigated phantom limb pain and the senses of agency and ownership (i.e., a feeling of having one's own body) of the phantom limb. Nine upper-limb amputees, five of whom reported recent phantom limb pain, underwent a single 15-min trial of mirror therapy. Before and after the trial, the participants completed a questionnaire regarding agency, ownership, and pain related to their phantom limb. They reported that the sense of agency over the phantom limb increased following the mirror therapy trial, while the ownership slightly increased but not as much as did the agency. The reported pain did not change; that is, it was comparably mild before and after the trial. These results suggest that short-term mirror therapy can, at least transiently, selectively enhance the sense of agency over a phantom limb, but may not alleviate phantom limb pain.

  2. Development of an occupational advice intervention for patients undergoing lower limb arthroplasty (the OPAL study).

    Science.gov (United States)

    Baker, Paul; Coole, Carol; Drummond, Avril; McDaid, Catriona; Khan, Sayeed; Thomson, Louise; Hewitt, Catherine; McNamara, Iain; McDonald, David; Fitch, Judith; Rangan, Amar

    2018-06-28

    There are an increasing number of patients of working age undergoing hip and knee replacements. Currently there is variation in the advice and support given about sickness absence, recovery to usual activities and return to work after these procedures. Earlier, sustainable, return to work improves the health of patients and benefits their employers and society. An intervention that encourages and supports early recovery to usual activities, including work, has the potential to reduce the health and socioeconomic burden of hip and knee replacements. A two-phase research programme delivered over 27 months will be used to develop and subsequently test the feasibility of an occupational advice intervention to facilitate return to work and usual activities in patients undergoing lower limb arthroplasty. The 2 phases will incorporate a six-stage intervention mapping process: Phase 1: Intervention mapping stages 1-3: 1 Needs assessment (including rapid evidence synthesis, prospective cohort analysis and structured stakeholder interviews) 2 Identification of intended outcomes and performance objectives 3 Selection of theory-based methods and practical strategies Phase 2: Intervention mapping stages 4-6: 4 Development of components and materials for the occupational advice intervention using a modified Delphi process 5 Adoption and implementation of the intervention 6 Evaluation and feasibility testing The study will be undertaken in four National Health Service (NHS) hospitals in the United Kingdom and two Higher Education Institutions. OPAL (Occupational advice for Patients undergoing Arthroplasty of the Lower limb) aims to develop an occupational advice intervention to support early recovery to usual activities including work, which is tailored to the requirements of patients undergoing hip and knee replacements. The developed intervention will then be assessed with a specific focus on evaluating its feasibility as a potential trial intervention to improve speed of

  3. Limb Loss

    Science.gov (United States)

    ... in amputation. Injuries, including from traffic accidents and military combat Cancer Birth defects Some amputees have phantom pain, which is the feeling of pain in the missing limb. Other physical problems include surgical complications and skin problems, if you ...

  4. Spasticity and contractures at the wrist after stroke: time course of development and their association with functional recovery of the upper limb

    NARCIS (Netherlands)

    Malhotra, S.; Malhotra, S.; Pandyan, A.D.; Rosewilliam, S.; Roffe, C.; Hermens, Hermanus J.

    Objective: To investigate the time course of development of spasticity and contractures at the wrist after stroke and to explore if these are associated with upper limb functional recovery. - Design: Longitudinal observational study using secondary data from the control group of a randomized

  5. 3D optical imagery for motion compensation in a limb ultrasound system

    Science.gov (United States)

    Ranger, Bryan J.; Feigin, Micha; Zhang, Xiang; Mireault, Al; Raskar, Ramesh; Herr, Hugh M.; Anthony, Brian W.

    2016-04-01

    Conventional processes for prosthetic socket fabrication are heavily subjective, often resulting in an interface to the human body that is neither comfortable nor completely functional. With nearly 100% of amputees reporting that they experience discomfort with the wearing of their prosthetic limb, designing an effective interface to the body can significantly affect quality of life and future health outcomes. Active research in medical imaging and biomechanical tissue modeling of residual limbs has led to significant advances in computer aided prosthetic socket design, demonstrating an interest in moving toward more quantifiable processes that are still patient-specific. In our work, medical ultrasonography is being pursued to acquire data that may quantify and improve the design process and fabrication of prosthetic sockets while greatly reducing cost compared to an MRI-based framework. This paper presents a prototype limb imaging system that uses a medical ultrasound probe, mounted to a mechanical positioning system and submerged in a water bath. The limb imaging is combined with three-dimensional optical imaging for motion compensation. Images are collected circumferentially around the limb and combined into cross-sectional axial image slices, resulting in a compound image that shows tissue distributions and anatomical boundaries similar to magnetic resonance imaging. In this paper we provide a progress update on our system development, along with preliminary results as we move toward full volumetric imaging of residual limbs for prosthetic socket design. This demonstrates a novel multi-modal approach to residual limb imaging.

  6. A Cognitive Overview of Limb Apraxia.

    Science.gov (United States)

    Bartolo, Angela; Ham, Heidi Stieglitz

    2016-08-01

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

  7. Customizable Rehabilitation Lower Limb Exoskeleton System

    Directory of Open Access Journals (Sweden)

    Riaan Stopforth

    2012-10-01

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

  8. Balneotherapy in treatment of spastic upper limb after stroke.

    Science.gov (United States)

    Erceg-Rukavina, Tatjana; Stefanovski, Mihajlo

    2015-02-01

    After stroke, spasticity is often the main problem that prevents functional recovery. Pain occurs in up to 70% of patients during the first year post-stroke. A total of 70 patients (30 female and 45 male) mean age (65.67) participated in prospective, controlled study. ischaemic stroke, developed spasticity of upper limb, post-stroke interval balneotherapy and inability to follow commands. Experimental group (Ex) (n=35) was treated with sulphurous baths (31°-33°C) and controlled group (Co) with taped water baths, during 21 days. All patients were additionally treated with kinesitherapy and cryotherapy. The outcome was evaluated using Modified Ashworth scale for spasticity and VAS scale for pain. The significance value was sat at pbalneotherapy with sulphurous bath on spasticity and pain in affected upper limb. Reduction in tone of affected upper limb muscles was significant in Ex group (pbalneotherapy with sulphurous water reduces spasticity and pain significantly and can help in treatment of post-stroke patients.

  9. Chicken homeobox gene Msx-1: structure, expression in limb buds and effect of retinoic acid.

    Science.gov (United States)

    Yokouchi, Y; Ohsugi, K; Sasaki, H; Kuroiwa, A

    1991-10-01

    A chicken gene carrying a homeobox highly homologous to the Drosophila muscle segment homeobox (msh) gene was isolated and designated as Msx-1. Conceptual translation from the longest ORF gave a protein of 259 amino acids lacking the conserved hexapeptide. Northern analysis detected a single 2.6 kb transcript. As early as day 2 of incubation, the transcript was detected but was not found in adult tissue. In situ hybridization analysis revealed that Msx-1 expression is closely related to a particular mesenchymal cell lineage during limb bud formation. In early stage embryos, Msx-1 was expressed in the somatopleure. When primordial mesenchyme cells for limb bud were generated from the Wolffian ridge of the somatopleure, Msx-1 expression began to diminish in the posterior half of the limb bud then in the presumptive cartilage-forming mesenchyme. In developing limb buds, remarkable expression was seen in the apical ectodermal ridge (AER), which is responsible for the sustained outgrowth and development of the limb. The Msx-1 transcripts were found in the limb mesenchymal cells in the region covering the necrotic zone and ectodermal cells overlying such mesenchymal cells. Both ectodermal and mesenchymal expression in limb bud were rapidly suppressed by local treatment of retinoic acid which can generate mirror-image duplication of digits. This indicates that retinoic acid alters the marginal presumptive non-cartilage forming mesenchyme cell lineage through suppression of Msx-1 expression.

  10. Development of a subset of forelimb muscles and their attachment sites requires the ulnar-mammary syndrome gene Tbx3

    Directory of Open Access Journals (Sweden)

    Mary P. Colasanto

    2016-11-01

    Full Text Available In the vertebrate limb over 40 muscles are arranged in a precise pattern of attachment via muscle connective tissue and tendon to bone and provide an extensive range of motion. How the development of somite-derived muscle is coordinated with the development of lateral plate-derived muscle connective tissue, tendon and bone to assemble a functional limb musculoskeletal system is a long-standing question. Mutations in the T-box transcription factor, TBX3, have previously been identified as the genetic cause of ulnar-mammary syndrome (UMS, characterized by distinctive defects in posterior forelimb bones. Using conditional mutagenesis in mice, we now show that TBX3 has a broader role in limb musculoskeletal development. TBX3 is not only required for development of posterior forelimb bones (ulna and digits 4 and 5, but also for a subset of posterior muscles (lateral triceps and brachialis and their bone eminence attachment sites. TBX3 specification of origin and insertion sites appears to be tightly linked with whether these particular muscles develop and may represent a newly discovered mechanism for specification of anatomical muscles. Re-examination of an individual with UMS reveals similar previously unrecognized muscle and bone eminence defects and indicates a conserved role for TBX3 in regulating musculoskeletal development.

  11. Development of a Biofeedback Therapeutic Exercise Supporting Manipulator for Lower Limbs

    Science.gov (United States)

    Hashimoto, Yosuke; Hisada, Takashi; Komada, Satoshi; Hirai, Junji

    Although equipments that support physical therapy have been developed, there are few types of equipment to improve quality of physical therapy. This paper proposes a new concept of robotic biofeedback exercise equipment that displays human muscle force during training. The concept tries to have therapeutic value through grasping of condition for trainee during exercise and giving an incentive to perform training. The equipment is not only for convalescent patients but also for athletes and healthy persons with a physical trouble. The manipulator is designed to support lower limb rehabilitation of knee and hip joints in sagittal plane, where a 3-degrees-of-freedom manipulator is adopted in order to realize low height equipment. Since the manipulator has redundant degree of freedom, collision avoidance is performed by a controller based on acceleration control by disturbance observer. Moreover, simultaneous isokinetic movement for knee and hip joints that has an adjustment capability of maximum speed and time constant is realized in order to perform safe training by isokinetic muscular contraction. Desired motion is realized experimentally by the proposed manipulator.

  12. Adaptive behaviour and motor skills in children with upper limb deficiency.

    Science.gov (United States)

    Mano, Hiroshi; Fujiwara, Sayaka; Haga, Nobuhiko

    2018-04-01

    The dysfunction of individuals with upper limb deficiencies affects their daily lives and social participation. To clarify the adaptive behaviours and motor skills of children with upper limb deficiencies. Cross-sectional survey. The subjects were 10 children ranging from 1 to 6 years of age with unilateral upper limb deficiencies at the level distal to the elbow who were using only cosmetic or passive prostheses or none at all. To measure their adaptive behaviour and motor skills, the Vineland Adaptive Behavior Scales, Second Edition was used. They were evaluated on the domains of communication, daily living skills, socialization and motor skills. We also examined the relationship of the scores with age. There were no statistically significant scores for domains or subdomains. The domain standard score of motor skills was significantly lower than the median scores of the domains and was negatively correlated with age. Children with upper limb deficiencies have individual weaknesses in motor skill behaviours, and these weaknesses increase with age. It may be helpful in considering approaches to rehabilitation and the prescription of prostheses to consider the characteristics and course of children's motor skill behaviours. Clinical relevance Even if children with unilateral upper limb deficiencies seem to compensate well for their affected limb function, they have or will experience individual weaknesses in motor skills. We should take this into consideration to develop better strategies for rehabilitation and prostheses prescriptions.

  13. LIMB-DARKENING COEFFICIENTS FOR ECLIPSING WHITE DWARFS

    Energy Technology Data Exchange (ETDEWEB)

    Gianninas, A.; Strickland, B. D.; Kilic, Mukremin [Homer L. Dodge Department of Physics and Astronomy, University of Oklahoma, 440 W. Brooks St., Norman, OK 73019 (United States); Bergeron, P., E-mail: alexg@nhn.ou.edu, E-mail: benstrickland@ou.edu, E-mail: kilic@ou.edu, E-mail: bergeron@astro.umontreal.ca [Departement de Physique, Universite de Montreal, C.P. 6128, Succ. Centre-Ville, Montreal, Quebec H3C 3J7 (Canada)

    2013-03-20

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

  14. LIMB-DARKENING COEFFICIENTS FOR ECLIPSING WHITE DWARFS

    International Nuclear Information System (INIS)

    Gianninas, A.; Strickland, B. D.; Kilic, Mukremin; Bergeron, P.

    2013-01-01

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

  15. Importance of upper-limb inertia in calculating concentric bench press force.

    Science.gov (United States)

    Rambaud, Olivier; Rahmani, Abderrahmane; Moyen, Bernard; Bourdin, Muriel

    2008-03-01

    The purpose of this study was to investigate the influence of upper-limb inertia on the force-velocity relationship and maximal power during concentric bench press exercise. Reference peak force values (Fpeakp) measured with a force plate positioned below the bench were compared to those measured simultaneously with a kinematic device fixed on the barbell by taking (Fpeakt) or not taking (Fpeakb) upper-limb inertia into account. Thirteen men (27.8 +/- 4.1 years, 184.6 +/- 5.5 cm, 99.5 +/- 18.6 kg) performed all-out concentric bench press exercise against 8 loads ranging between 7 and 74 kg. The results showed that for each load, Fpeakb was significantly less than Fpeakp (P force (F0), maximal velocity (V0), optimal velocity (Vopt), and maximal power (Pmax), extrapolated from the force- and power-velocity relationships determined with the kinematic device, were significantly underestimated when upper-limb inertia was ignored. The results underline the importance of taking account of the total inertia of the moving system to ensure precise evaluation of upper-limb muscular characteristics in all-out concentric bench press exercise with a kinematic device. A major application of this study would be to develop precise upper-limb muscular characteristic evaluation in laboratory and field conditions by using a simple and cheap kinematic device.

  16. Bilateral Persistent Sciatic Arteries Complicated with Acute Left Lower Limb Ischemia

    OpenAIRE

    Hsuan-Yin Wu; Yu-Jen Yang; Chao-Han Lai; Jun-Neng Roan; Chwan-Yau Luo; Chung-Dann Kan

    2007-01-01

    Persistent sciatic artery (PSA) is a rare congenital malformation. In the early embryonic stage, the sciatic artery is the major blood supply for the lower limb bulb and is later replaced by the iliofemoral artery as the limb develops. Its failure to regress, sometimes associated with femoral arterial hypoplasia, and therefore becoming the dominant inflow to the lower extremity is called PSA. This anomaly is often associated with a higher rate of aneurysm formation or thromboembolic complicat...

  17. Origin of directionally tuned responses in lower limb muscles to unpredictable upper limb disturbances.

    Directory of Open Access Journals (Sweden)

    Ali Forghani

    Full Text Available Unpredictable forces which perturb balance are frequently applied to the body through interaction between the upper limb and the environment. Lower limb muscles respond rapidly to these postural disturbances in a highly specific manner. We have shown that the muscle activation patterns of lower limb muscles are organized in a direction specific manner which changes with lower limb stability. Ankle muscles change their activity within 80 ms of the onset of a force perturbation applied to the hand which is earlier than the onset of changes in ground reaction force, ankle angle or head motion. The latency of the response is sensitive to the perturbation direction. However, neither the latency nor the magnitude of the response is affected by stiffening the arm even though this alters the magnitude and timing of motion of the body segments. Based on the short latency, insensitivity of the change in ankle muscle activation to motion of the body segments but sensitivity to perturbation direction we reason that changes in ankle muscle activation are most likely triggered by sensory signals originating from cutaneous receptors in the hand. Furthermore, evidence that the latency of changes in ankle muscle activation depends on the number of perturbation directions suggests that the neural pathway is not confined to the spinal cord.

  18. The risk of newly developed visual impairment in treated normal-tension glaucoma: 10-year follow-up.

    Science.gov (United States)

    Choi, Yun Jeong; Kim, Martha; Park, Ki Ho; Kim, Dong Myung; Kim, Seok Hwan

    2014-12-01

    To investigate the risk and risk factors for newly developed visual impairment in treated patients with normal-tension glaucoma (NTG) followed up on for 10 years. Patients with NTG, who did not have visual impairment at the initial diagnosis and had undergone intraocular pressure (IOP)-lowering treatment for more than 7 years, were included on the basis of a retrospective chart review. Visual impairment was defined as either low vision (0.05 [20/400] ≤ visual acuity (VA) visual field (VF) visual impairment, Kaplan-Meier survival analysis and generalized linear mixed effects models were utilized. During the 10.8 years mean follow-up period, 20 eyes of 16 patients were diagnosed as visual impairment (12 eyes as low vision, 8 as blindness) among 623 eyes of 411 patients. The cumulative risk of visual impairment in at least one eye was 2.8% at 10 years and 8.7% at 15 years. The risk factors for visual impairment from treated NTG were worse VF mean deviation (MD) at diagnosis and longer follow-up period. The risk of newly developed visual impairment in the treated patients with NTG was relatively low. Worse VF MD at diagnosis and longer follow-up period were associated with development of visual impairment. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. The Influence of Basketball on the Asymmetry in the Use of Limbs

    Directory of Open Access Journals (Sweden)

    Aleksandar Čvorović

    2012-09-01

    Full Text Available The purpose of this study was to determine how basketball affects the uneven use of the limbs in relation to non-basketball population. Participants were compared by multiple motoric and situational tests, and for each participant tested the relationship between all limbs, both upper and lower. Before the motoric and situational tests participants completed a questionnaire on preference in limb use in everyday life and during sports activities. Participants belong to two groups, one group of young players with the rank of at least four years experience in basketball training, while the second group consists of members of the healthy school population, but with no experience in the continuous training of basketball. The study tested the explosive power of the lower and upper limbs, and the reaction time and agility in the lower limbs. Statistical analysis of results showed significant differences in certain tests between groups and within groups, both among the upper and lower extremities. It can be concluded that basketball as a specific sporting activity has positive influence on the development of the tested variables, while the level of asymmetry at basketball player is less than in the non-basketball population.

  20. Diagnosis and treatment of upper limb apraxia

    OpenAIRE

    Dovern, A.; Fink, G. R.; Weiss, P. H.

    2012-01-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients’ everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients’ prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed...

  1. Prenatal MRI evaluation of limb-body wall complex

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-11-15

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

  2. Value of a newly sequenced bacterial genome

    DEFF Research Database (Denmark)

    Barbosa, Eudes; Aburjaile, Flavia F; Ramos, Rommel Tj

    2014-01-01

    and annotation will not be undertaken. It is important to know what is lost when we settle for a draft genome and to determine the "scientific value" of a newly sequenced genome. This review addresses the expected impact of newly sequenced genomes on antibacterial discovery and vaccinology. Also, it discusses...... heightened expectations that NGS would boost antibacterial discovery and vaccine development. Although many possible drug and vaccine targets have been discovered, the success rate of genome-based analysis has remained below expectations. Furthermore, NGS has had consequences for genome quality, resulting...

  3. HST observations of the limb polarization of Titan

    Science.gov (United States)

    Bazzon, A.; Schmid, H. M.; Buenzli, E.

    2014-12-01

    Context. Titan is an excellent test case for detailed studies of the scattering polarization from thick hazy atmospheres. Accurate scattering and polarization parameters have been provided by the in situ measurements of the Cassini-Huygens landing probe. For Earth-bound observations Titan can only be observed at a backscattering situation, where the disk-integrated polarization is close to zero. However, with resolved imaging polarimetry a second order polarization signal along the entire limb of Titan can be measured. Aims: We present the first limb polarization measurements of Titan, which are compared as a test to our limb polarization models. Methods: Previously unpublished imaging polarimetry from the HST archive is presented, which resolves the disk of Titan. We determine flux-weighted averages of the limb polarization and radial limb polarization profiles, and investigate the degradation and cancelation effects in the polarization signal due to the limited spatial resolution of our observations. Taking this into account we derive corrected values for the limb polarization in Titan. The results are compared with limb polarization models, using atmosphere and haze scattering parameters from the literature. Results: In the wavelength bands between 250 nm and 2 μm a strong limb polarization of about 2 - 7% is detected with a position angle perpendicular to the limb. The fractional polarization is highest around 1 μm. As a first approximation, the polarization seems to be equally strong along the entire limb. The comparison of our data with model calculations and the literature shows that the detected polarization is compatible with expectations from previous polarimetric observations taken with Voyager 2, Pioneer 11, and the Huygens probe. Conclusions: Our results indicate that ground-based monitoring measurements of the limb-polarization of Titan could be useful for investigating local haze properties and the impact of short-term and seasonal variations of

  4. Limb-segment selection in drawing behaviour

    NARCIS (Netherlands)

    Meulenbroek, R G; Rosenbaum, D A; Thomassen, A.J.W.M.; Schomaker, L R

    How do we select combinations of limb segments to carry out physical tasks? Three possible determinants of limb-segment selection are hypothesized here: (1) optimal amplitudes and frequencies of motion for the effectors; (2) preferred movement axes for the effectors; and (3) a tendency to continue

  5. LIMB-SEGMENT SELECTION IN DRAWING BEHAVIOR

    NARCIS (Netherlands)

    MEULENBROEK, RGJ; ROSENBAUM, DA; THOMASSEN, AJWM; SCHOMAKER, LRB; Schomaker, Lambertus

    How do we select combinations of limb segments to carry out physical tasks? Three possible determinants of limb-segment selection are hypothesized here: (1) optimal amplitudes and frequencies of motion for the effectors; (2) preferred movement axes for the effectors; and (3) a tendency to continue

  6. Infantile lipofibromatosis of the upper limb

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-12-01

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

  7. The normal radiological anteroposterior alignment of the lower limb in children

    Energy Technology Data Exchange (ETDEWEB)

    Popkov, Dmitry; Popkov, Arnold [Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics, Kurgan (Russian Federation); Lascombes, Pierre [University of Geneva, Division of Pediatric Orthopaedics, Geneva (Switzerland); Berte, Nicolas; Hetzel, Laurent; Baptista, Bruno Ribeiro; Journeau, Pierre [Children' s Hospital of Nancy, Department of Pediatric Orthopaedics, Nancy (France)

    2014-07-05

    The development of reconstructive surgery of the lower limbs aimed at multilevel correction demands a precise knowledge of the physiological variations in general radiological parameters of the lower limbs in children of various age groups. It is crucial in systemic skeletal diseases, when deformities affect limbs and the surgeon does not have an intact limb as a reference. The aim of this retrospective study was to establish the normal radiological values of lower limb parameters used in the surgical correction of deformities in children of various age groups. Teleradiographs of the lower limbs taken in children with unilateral congenital or posttraumatic deformity were retrospectively reviewed. Weight-bearing full-length anteroposterior radiographs of the entire lower extremities were taken in a standing position. The study involved 215 extremities of 208 children (93 girls and 115 boys); the ages ranged from 2 years 1 month to 15 years 11 months old. Key variables included the anatomic medial proximal femoral angle (aMPFA), anatomic lateral distal femoral angle (aLDFA), anatomic medial proximal tibial angle (aMPTA), anatomic lateral distal tibial angle (aLDTA), mechanical axis deviation (MAD), the angle formed by the femoral anatomical axis and the mechanical axis of the lower limb. The means and dynamics of variations, standard deviations (SD) and 95 % confidence intervals of each parameter were calculated for each age and gender group. Simple regression analysis was performed to determine the relationship between the patient's age and the magnitude of aMPFA, aLDFA, aMPTA and aLDTA. Simple regression analysis showed a significant inverse correlation between patient age and the magnitude of aMPFA: the correlation coefficient was -0.77. A statistically significant inverse correlation between the MAD and the angle between the anatomic femoral axis and mechanical limb axis was found: the correlation coefficient was -0.53. In general, the received values were

  8. Underground trials on a newly developed EDW 150-2 L unit

    Energy Technology Data Exchange (ETDEWEB)

    Wille, G.; Klimek, K.H.

    1982-01-01

    Coal-getting from medium thick coalbeds (> 1.7 m) requires high-performance shearer-loaders. Machine length and adjustability have to be such as to permit smooth cutting through geological faults. Furthermore they should be suitable to cut out niches for the AFC drives so that gateroads can be driven along with the face line. The newly developed EDW 150-2 L shearer-loader meets these expectations after various mechanical and electrical improvements. The unit proved its usefulness from the beginning and in the most difficult geological conditions where other shearer-loaders normally available for the range of coalbed thickness would mostly have failed. The multiple requirements and disturbances have led to a number of separate improvements and disturbances have led to a number of separate improvements which together contribute to a basic improvement of the machine concept as far as applications, operational flexibility and safety are concerned.

  9. Two-dimensional characterization of atmospheric profile retrievals from limb sounding observations

    International Nuclear Information System (INIS)

    Worden, J.R.; Bowman, K.W.; Jones, D.B.

    2004-01-01

    Limb sounders measure atmospheric radiation that is dependent on atmospheric temperature and constituents that have a radial and angular distribution in Earth-centered coordinates. In order to evaluate the sensitivity of a limb retrieval to radial and angular distributions of trace gas concentrations, we perform and characterize one-dimensional (vertical) and two-dimensional (radial and angular) atmospheric profile retrievals. Our simulated atmosphere for these retrievals is a distribution of carbon monoxide (CO), which represents a plume off the coast of south-east Asia. Both the one-dimensional (1D) and two-dimensional (2D) limb retrievals are characterized by evaluating their averaging kernels and error covariances on a radial and angular grid that spans the plume. We apply this 2D characterization of a limb retrieval to a comparison of the 2D retrieval with the 1D (vertical) retrieval. By characterizing a limb retrieval in two dimensions the location of the air mass where the retrievals are most sensitive can be determined. For this test case the retrievals are most sensitive to the CO concentrations about 2 deg.latitude in front of the tangent point locations. We find the information content for the 2D retrieval is an order of magnitude larger and the degrees of freedom is about a factor of two larger than that of the 1D retrieval primarily because the 2D retrieval can estimate angular distributions of CO concentrations. This 2D characterization allows the radial and angular resolution as well as the degrees of freedom and information content to be computed for these limb retrievals. We also use the 2D averaging kernel to develop a strategy for validation of a limb retrieval with an in situ measurement

  10. Myokymia of lower limbs for over one year

    Directory of Open Access Journals (Sweden)

    Jing ZHAO

    2015-09-01

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

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

    International Nuclear Information System (INIS)

    Orero, A.; Muxi, A.; Rubi, S.; Duch, J.; Vidal-Sicart, S.; Pons, F.; Roe, N.; Rull, R.; Pavon, N.; Pavia, J.

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-01

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

  13. A Newly Improved Modified Method Development and Validation of Bromofenac Sodium Sesquihydrate in Bulk Drug Manufacturing

    OpenAIRE

    Sunil Kumar Yelamanchi V; Useni Reddy Mallu; I. V Kasi Viswanath; D. Balasubramanyam; G. Narshima Murthy

    2016-01-01

    The main objective of this study was to develop a simple, efficient, specific, precise and accurate newly improved modified Reverse Phase High Performance Liquid Chromatographic Purity (or) Related substance method for bromofenac sodium sesquihydrate active pharmaceuticals ingredient dosage form. Validation of analytical method is the confirmation by examination and the provision of objective evidence that the particular requirements for a specific intended use are fulfilled as per ICH, USP...

  14. A Dynamic Model for Limb Selection

    NARCIS (Netherlands)

    Cox, R.F.A; Smitsman, A.W.

    2008-01-01

    Two experiments and a model on limb selection are reported. In Experiment 1 left-handed and right-handed participants (N = 36) repeatedly used one hand for grasping a small cube. After a clear switch in the cube’s location, perseverative limb selection was revealed in both handedness groups. In

  15. Microwave solar limb brightening

    Energy Technology Data Exchange (ETDEWEB)

    Ahmad, I A; Kundu, M R [Maryland Univ., College Park (USA)

    1981-02-01

    Previous models of microwave limb brightening have omitted the alignment of spicules along supergranule boundaries, have neglected the high temperature sheath around spicules, and have assumed an interspicular medium which was averaged over chromospheric network and non-network regions. We present a model which includes these factors. By constraining the model to conform to results from earlier UV and optical studies we are effectively left with two free parameters: the temperature at the core of the spicules, Tsub(c)sub(o)sub(r)sub(e), and (at solar minimum), the interspicular chromospheric network density model of the lower transition zone. The absence of limb brightening at the short millimeter wavelengths implies Tsub(c)sub(o)sub(r)sub(e) approx. < 6000 k. Differences between the model and certain deconvolved observations near 9 mm are expected as a consequence of an extension of emission beyond the optical limb, predicted by the model, which affects the accuracy of the deconvolution technique. Unlike models which assume homogeous spicules in a random distribution, ours does not require an abnormally high spicule area.

  16. Limb amputations in fixed dystonia: a form of body integrity identity disorder?

    Science.gov (United States)

    Edwards, Mark J; Alonso-Canovas, Araceli; Schrag, Arnette; Bloem, Bastiaan R; Thompson, Philip D; Bhatia, Kailash

    2011-07-01

    Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought amputation of the affected limb. We place these cases in the context of previous reports of patients with healthy limbs and patients with chronic regional pain syndrome who have sought amputation. Our cases, combined with recent data regarding disorders of mental rotation in patients with fixed dystonia, as well as previous data regarding body integrity identity disorder and amputations sought by patients with chronic regional pain syndrome, raise the possibility that patients with fixed dystonia might have a deficit in body schema that predisposes them to developing fixed dystonia and drives some to seek amputation. The outcome of amputation in fixed dystonia is invariably unfavorable. Copyright © 2011 Movement Disorder Society.

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

    Science.gov (United States)

    Pathak, Yagna; Johnson, Michelle

    2012-01-01

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

  18. 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.

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

    International Nuclear Information System (INIS)

    Palena, Luis Mariano; Brocco, Enrico; Manzi, Marco

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-05-09

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

  1. Quasi-static modeling of human limb for intra-body communications with experiments.

    Science.gov (United States)

    Pun, Sio Hang; Gao, Yue Ming; Mak, PengUn; Vai, Mang I; Du, Min

    2011-11-01

    In recent years, the increasing number of wearable devices on human has been witnessed as a trend. These devices can serve for many purposes: personal entertainment, communication, emergency mission, health care supervision, delivery, etc. Sharing information among the devices scattered across the human body requires a body area network (BAN) and body sensor network (BSN). However, implementation of the BAN/BSN with the conventional wireless technologies cannot give optimal result. It is mainly because the high requirements of light weight, miniature, energy efficiency, security, and less electromagnetic interference greatly limit the resources available for the communication modules. The newly developed intra-body communication (IBC) can alleviate most of the mentioned problems. This technique, which employs the human body as a communication channel, could be an innovative networking method for sensors and devices on the human body. In order to encourage the research and development of the IBC, the authors are favorable to lay a better and more formal theoretical foundation on IBC. They propose a multilayer mathematical model using volume conductor theory for galvanic coupling IBC on a human limb with consideration on the inhomogeneous properties of human tissue. By introducing and checking with quasi-static approximation criteria, Maxwell's equations are decoupled and capacitance effect is included to the governing equation for further improvement. Finally, the accuracy and potential of the model are examined from both in vitro and in vivo experimental results.

  2. Upper Limb Rehabilitation Robot Powered by PAMs Cooperates with FES Arrays to Realize Reach-to-Grasp Trainings

    Science.gov (United States)

    Su, Chen; Jiang, Xiaobo

    2017-01-01

    The reach-to-grasp activities play an important role in our daily lives. The developed RUPERT for stroke patients with high stiffness in arm flexor muscles is a low-cost lightweight portable exoskeleton rehabilitation robot whose joints are unidirectionally actuated by pneumatic artificial muscles (PAMs). In order to expand the useful range of RUPERT especially for patients with flaccid paralysis, functional electrical stimulation (FES) is taken to activate paralyzed arm muscles. As both the exoskeleton robot driven by PAMs and the neuromuscular skeletal system under FES possess the highly nonlinear and time-varying characteristics, iterative learning control (ILC) is studied and is taken to control this newly designed hybrid rehabilitation system for reaching trainings. Hand function rehabilitation refers to grasping. Because of tiny finger muscles, grasping and releasing are realized by FES array electrodes and matrix scan method. By using the surface electromyography (EMG) technique, the subject's active intent is identified. The upper limb rehabilitation robot powered by PAMs cooperates with FES arrays to realize active reach-to-grasp trainings, which was verified through experiments. PMID:29065566

  3. Upper Limb Rehabilitation Robot Powered by PAMs Cooperates with FES Arrays to Realize Reach-to-Grasp Trainings

    Directory of Open Access Journals (Sweden)

    Xikai Tu

    2017-01-01

    Full Text Available The reach-to-grasp activities play an important role in our daily lives. The developed RUPERT for stroke patients with high stiffness in arm flexor muscles is a low-cost lightweight portable exoskeleton rehabilitation robot whose joints are unidirectionally actuated by pneumatic artificial muscles (PAMs. In order to expand the useful range of RUPERT especially for patients with flaccid paralysis, functional electrical stimulation (FES is taken to activate paralyzed arm muscles. As both the exoskeleton robot driven by PAMs and the neuromuscular skeletal system under FES possess the highly nonlinear and time-varying characteristics, iterative learning control (ILC is studied and is taken to control this newly designed hybrid rehabilitation system for reaching trainings. Hand function rehabilitation refers to grasping. Because of tiny finger muscles, grasping and releasing are realized by FES array electrodes and matrix scan method. By using the surface electromyography (EMG technique, the subject’s active intent is identified. The upper limb rehabilitation robot powered by PAMs cooperates with FES arrays to realize active reach-to-grasp trainings, which was verified through experiments.

  4. A Newly Developed Nested PCR Assay for the Detection of Helicobacter pylori in the Oral Cavity.

    Science.gov (United States)

    Ismail, Hawazen; Morgan, Claire; Griffiths, Paul; Williams, John; Jenkins, Gareth

    2016-01-01

    To develop a new nested polymerase chain reaction (PCR) assay for identifying Helicobacter pylori DNA from dental plaque. H. pylori is one of the most common chronic bacterial pathogens in humans. The accurate detection of this organism is essential for proper patient management and for the eradication of the bacteria following treatment. Forty-nine patients (24 males and 25 females; mean age: 51; range, 19 to 94 y) were investigated for the presence of H. pylori in dental plaque by single-step PCR and nested PCR and in the stomach by single-step PCR, nested PCR, and histologic examination. The newly developed nested PCR assay identified H. pylori DNA in gastric biopsies of 18 patients who were histologically classified as H. pylori-positive and 2 additional biopsies of patients who were H. pylori-negative by histologic examination (20/49; 40.8%). Dental plaque samples collected before and after endoscopy from the 49 patients revealed that single-step PCR did not detect H. pylori but nested PCR was able to detect H. pylori DNA in 40.8% (20/49) patients. Nested PCR gave a higher detection rate (40.8%, 20/49) than that of histology (36.7%, 18/49) and single-step PCR. When nested PCR results were compared with histology results there was no significant difference between the 2 methods. Our newly developed nested PCR assay is at least as sensitive as histology and may be useful for H. pylori detection in patients unfit for endoscopic examination.

  5. Characteristics of bread prepared from wheat flours blended with various kinds of newly developed rice flours.

    Science.gov (United States)

    Nakamura, S; Suzuki, K; Ohtsubo, K

    2009-04-01

    Characteristics of the bread prepared from wheat flour blended with the flour of various kinds of newly developed rice cultivars were investigated. Qualities of the bread made from wheat flour blended with rice flour have been reported to be inferior to those from 100% wheat flour bread. To improve its qualities, we searched for the new-characteristic rice flours among the various kinds of newly developed rice cultivars to blend with the wheat flour for the bread preparation. The most suitable new characteristic rices are combination of purple waxy rice, high-amylose rice, and sugary rice. Specific volume of the bread from the combination of wheat and these 3 kinds of rice flours showed higher specific volume (3.93) compared with the traditional wheat/rice bread (3.58). We adopted the novel method, continuous progressive compression test, to measure the physical properties of the dough and the bread in addition to the sensory evaluation. As a result of the selection of the most suitable rice cultivars and blending ratio with the wheat flour, we could develop the novel wheat/rice bread, of which loaf volume, physical properties, and tastes are acceptable and resistant to firming on even 4 d after the bread preparation. To increase the ratio of rice to wheat, we tried to add a part of rice as cooked rice grains. The specific volume and qualities of the bread were maintained well although the rice content of total flour increased from 30% to 40%.

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

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2008-01-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  8. Effects of Strength Training Combined with Specific Plyometric exercises on body composition, vertical jump height and lower limb strength development in elite male handball players: a case study

    Directory of Open Access Journals (Sweden)

    Carvalho Alberto

    2014-07-01

    Full Text Available The purpose of the present study was to identify the effects of a strength training program combined with specific plyometric exercises on body composition, vertical jump (VJ height and strength development of lower limbs in elite male handball players. A 12-week program with combined strength and specific plyometric exercises was carried out for 7 weeks. Twelve elite male handball players (age: 21.6 ± 1.73 competing in the Portuguese Major League participated in the study. Besides the anthropometric measurements, several standardized jump tests were applied to assess VJ performance together with the strength development of the lower limbs in an isokinetic setting. No significant changes were found in body circumferences and diameters. Body fat content and fat mass decreased by 16.4 and 15.7% respectively, while lean body mass increased by 2.1%. Despite small significance, there was in fact an increase in squat jump (SJ, counter movement jump (CMJ and 40 consecutive jumps after the training period (6.1, 3.8 and 6.8%, respectively. After the applied protocol, peak torque increased in lower limb extension and flexion in the majority of the movements assessed at 90°s-1. Consequently, it is possible to conclude that combining general strength-training with plyometric exercises can not only increase lower limb strength and improve VJ performance but also reduce body fat content.

  9. Effects of Strength Training Combined with Specific Plyometric exercises on body composition, vertical jump height and lower limb strength development in elite male handball players: a case study.

    Science.gov (United States)

    Carvalho, Alberto; Mourão, Paulo; Abade, Eduardo

    2014-06-28

    The purpose of the present study was to identify the effects of a strength training program combined with specific plyometric exercises on body composition, vertical jump (VJ) height and strength development of lower limbs in elite male handball players. A 12-week program with combined strength and specific plyometric exercises was carried out for 7 weeks. Twelve elite male handball players (age: 21.6 ± 1.73) competing in the Portuguese Major League participated in the study. Besides the anthropometric measurements, several standardized jump tests were applied to assess VJ performance together with the strength development of the lower limbs in an isokinetic setting. No significant changes were found in body circumferences and diameters. Body fat content and fat mass decreased by 16.4 and 15.7% respectively, while lean body mass increased by 2.1%. Despite small significance, there was in fact an increase in squat jump (SJ), counter movement jump (CMJ) and 40 consecutive jumps after the training period (6.1, 3.8 and 6.8%, respectively). After the applied protocol, peak torque increased in lower limb extension and flexion in the majority of the movements assessed at 90ºs-1. Consequently, it is possible to conclude that combining general strength-training with plyometric exercises can not only increase lower limb strength and improve VJ performance but also reduce body fat content.

  10. Establishment probability in newly founded populations

    Directory of Open Access Journals (Sweden)

    Gusset Markus

    2012-06-01

    Full Text Available Abstract Background Establishment success in newly founded populations relies on reaching the established phase, which is defined by characteristic fluctuations of the population’s state variables. Stochastic population models can be used to quantify the establishment probability of newly founded populations; however, so far no simple but robust method for doing so existed. To determine a critical initial number of individuals that need to be released to reach the established phase, we used a novel application of the “Wissel plot”, where –ln(1 – P0(t is plotted against time t. This plot is based on the equation P0t=1–c1e–ω1t, which relates the probability of extinction by time t, P0(t, to two constants: c1 describes the probability of a newly founded population to reach the established phase, whereas ω1 describes the population’s probability of extinction per short time interval once established. Results For illustration, we applied the method to a previously developed stochastic population model of the endangered African wild dog (Lycaon pictus. A newly founded population reaches the established phase if the intercept of the (extrapolated linear parts of the “Wissel plot” with the y-axis, which is –ln(c1, is negative. For wild dogs in our model, this is the case if a critical initial number of four packs, consisting of eight individuals each, are released. Conclusions The method we present to quantify the establishment probability of newly founded populations is generic and inferences thus are transferable to other systems across the field of conservation biology. In contrast to other methods, our approach disaggregates the components of a population’s viability by distinguishing establishment from persistence.

  11. Bone transplantation in limb saving surgeries: Philippine experience

    International Nuclear Information System (INIS)

    Wang, Edward H.M.

    1998-01-01

    Until the turn of the decade, Filipino patients afflicted with malignant and aggressive extremity tumors were almost uniformly treated with mutilating amputations. Limb saving surgery only recently became an option locally - this resulting not only from a better comprehension of surgical oncologic principles but also from the development and refinement of reconstructive procedures following such surgeries. Foremost among the latter is the use of long bone transplants, otherwise known as large segment bone allografts. Large segment allografts are available from the Tissue and Bone Bank of the University of the Philippines- the only bank of its kind in the country. All allografts are harvested from appropriate donors (both cadaveric and live), processed at the bank, radiation-sterilized at the Philippine Nuclear Research Institute (PNRI), and finally brought back to and stored in a -80 degrees centigrade deep freezer at the Bank. This paper presents our 4-year experience with large-segment allografts for extensive defects of limbs salvage surgery in musculoskeletal tumors. All patients included in this presentation had : (1) malignant or aggressive extremity tumors; (2) surgery performed by the University of the Philippines-Musculoskeletal Tumor Unit (UP-MuST Unit); (3) follow-up at least one year or until death; and (4) available pre-and post-operative radiographs for review. Over a period of 4 years (January 1993-January 1997), 63 patients with malignant or aggressive extremity tumors (who formerly would have been amputated) underwent limb salvage surgery by the UP-MuST Unit. Twenty (20) of these patients had reconstructions utilizing irradiated large-segment allografts and fulfilled the above criteria for inclusion in this review. Limb saving surgery for Filipino patients with musculoskeletal tumors continues to be a challenge because of both tumor size and the size of the defect requiring reconstruction. Large-segment allografts from the UP-Tissue and Bone Bank

  12. Activity-related energy expenditure during lower limb cast immobilization in children.

    Science.gov (United States)

    Maggio, Albane B; Martin, Xavier E; Ceroni, Dimitri

    2017-05-01

    Physical inactivity, which may result from immobilization, is recognized as a risk factor for the development of obesity. We aimed to quantify the decrease in activity-related energy expenditure (AEE) because of lower limb cast immobilization. We carried out a longitudinal matched case-control study: 34 adolescents with a first episode of lower limb fracture and 34 healthy cases. Physical activity was assessed during cast immobilization by an accelerometer from which we calculated the decrease in AEE. AEE in adolescents with lower limb fractures was estimated to be 16.0% lower than healthy controls. When converted into kcal per mean participants' weight, the difference in AEE amounted to 125 kcal/day, which corresponds to 5.2 h of slow walking. A significant reduction of AEE in adolescents with lower limb fractures may lead to a significantly positive energy balance as there is usually no compensatory reduction of energy intake. An increase of walking seems unrealistic in this situation and patients should be advised at the emergency unit to reduce their energy intake during the immobilization period. Level III, prospective case-control study.

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

    International Nuclear Information System (INIS)

    Shionoya, S.; Hirai, M.; Kawai, S.; Ohta, T.; Seko, T.

    1981-01-01

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

  14. An approach to the painful upper limb

    African Journals Online (AJOL)

    Pain in the upper limb is a common presenting complaint in the primary health care setting and the ... disruptions or pathological fracture, as opposed to ... and a neurological assessment of the lower limbs. This is in addition to a thorough.

  15. A novel upper limb rehabilitation system with self-driven virtual arm illusion.

    Science.gov (United States)

    Aung, Yee Mon; Al-Jumaily, Adel; Anam, Khairul

    2014-01-01

    This paper proposes a novel upper extremity rehabilitation system with virtual arm illusion. It aims for fast recovery from lost functions of the upper limb as a result of stroke to provide a novel rehabilitation system for paralyzed patients. The system is integrated with a number of technologies that include Augmented Reality (AR) technology to develop game like exercise, computer vision technology to create the illusion scene, 3D modeling and model simulation, and signal processing to detect user intention via EMG signal. The effectiveness of the developed system has evaluated via usability study and questionnaires which is represented by graphical and analytical methods. The evaluation provides with positive results and this indicates the developed system has potential as an effective rehabilitation system for upper limb impairment.

  16. Reliability of an instrument to determine lower limb comfort in professional football

    Directory of Open Access Journals (Sweden)

    Michael Kinchington

    2010-06-01

    Full Text Available Michael Kinchington1, Kevin Ball1, Geraldine Naughton21School of Human Movement, Recreation and Performance, Victoria University, Melbourne, Australia; 2The Centre of Physical Activity Across the Lifespan (COPAAL, Australian Catholic University, Victoria, AustraliaAims and Objectives: This study extends previous work in the field of injury awareness using a novel lower limb comfort index (LLCI, which was developed to assess comfort in professional football. Participants rated comfort for designated anatomical segments of the lower limb utilizing a seven point Likert scale. The aims of the study were (i to assess the reliability of the LLCI in a competitive football environment (Australian Rules and Rugby League, and (ii to assess whether LLCI measurements were responsive to changes in lower limb comfort over time.Methods and Results: The reliability of the LLCI was observed in two professional football environments: Training Week (mean difference 0.1 point, intra-class correlation coefficient, ICC 0.99 for n = 41 participants; and Match Day (mean difference 0.2 points, ICC 0.97 for n = 22 players. Measurements of lower limb comfort were responsive to changes in comfort over time. Within-player differences were not significant for periods 0–8 hrs (P > 0.05 but, generally, significant for time periods 0–24 hrs (P < 0.05, and significant between 24–96 hrs (P < 0.01. The results indicate that the LLCI was reliable when tested for repeated measures and indicated how the index measures lower limb comfort changes over time.Conclusion: This study shows that the use of a lower limb comfort index, when used in a competitive football environment, is both reliable and responsive to change during both a training week and under match day conditions.Keywords: lower limb comfort, musculoskeletal, football, injury

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

    Directory of Open Access Journals (Sweden)

    John R. Hutchinson

    2015-06-01

    Full Text Available We developed a three-dimensional, biomechanical computer model of the 36 major pelvic limb muscle groups in an ostrich (Struthio camelus to investigate muscle function in this, the largest of extant birds and model organism for many studies of locomotor mechanics, body size, anatomy and evolution. Combined with experimental data, we use this model to test two main hypotheses. We first query whether ostriches use limb orientations (joint angles that optimize the moment-generating capacities of their muscles during walking or running. Next, we test whether ostriches use limb orientations at mid-stance that keep their extensor muscles near maximal, and flexor muscles near minimal, moment arms. Our two hypotheses relate to the control priorities that a large bipedal animal might evolve under biomechanical constraints to achieve more effective static weight support. We find that ostriches do not use limb orientations to optimize the moment-generating capacities or moment arms of their muscles. We infer that dynamic properties of muscles or tendons might be better candidates for locomotor optimization. Regardless, general principles explaining why species choose particular joint orientations during locomotion are lacking, raising the question of whether such general principles exist or if clades evolve different patterns (e.g., weighting of muscle force–length or force–velocity properties in selecting postures. This leaves theoretical studies of muscle moment arms estimated for extinct animals at an impasse until studies of extant taxa answer these questions. Finally, we compare our model’s results against those of two prior studies of ostrich limb muscle moment arms, finding general agreement for many muscles. Some flexor and extensor muscles exhibit self-stabilization patterns (posture-dependent switches between flexor/extensor action that ostriches may use to coordinate their locomotion. However, some conspicuous areas of disagreement in our

  18. Amniotic fluid deficiency and congenital abnormalities both influence fluctuating asymmetry in developing limbs of human deceased fetuses.

    Directory of Open Access Journals (Sweden)

    Clara Mariquita Antoinette ten Broek

    Full Text Available Fluctuating asymmetry (FA, as an indirect measure of developmental instability (DI, has been intensively studied for associations with stress and fitness. Patterns, however, appear heterogeneous and the underlying causes remain largely unknown. One aspect that has received relatively little attention in the literature is the consequence of direct mechanical effects on asymmetries. The crucial prerequisite for FA to reflect DI is that environmental conditions on both sides should be identical. This condition may be violated during early human development if amniotic fluid volume is deficient, as the resulting mechanical pressures may increase asymmetries. Indeed, we showed that limb bones of deceased human fetuses exhibited increased asymmetry, when there was not sufficient amniotic fluid (and, thus, space in the uterine cavity. As amniotic fluid deficiency is known to cause substantial asymmetries and abnormal limb development, these subtle asymmetries are probably at least in part caused by the mechanical pressures. On the other hand, deficiencies in amniotic fluid volume are known to be associated with other congenital abnormalities that may disturb DI. More specifically, urogenital abnormalities can directly affect/reduce amniotic fluid volume. We disentangled the direct mechanical effects on FA from the indirect effects of urogenital abnormalities, the latter presumably representing DI. We discovered that both factors contributed significantly to the increase in FA. However, the direct mechanical effect of uterine pressure, albeit statistically significant, appeared less important than the effects of urogenital abnormalities, with an effect size only two-third as large. We, thus, conclude that correcting for the relevant direct factors allowed for a representative test of the association between DI and stress, and confirmed that fetuses form a suitable model system to increase our understanding in patterns of FA and symmetry development.

  19. Upper limb fractures in rugby in Huddersfield 1986-1990.

    OpenAIRE

    Eyres, K S; Abdel-Salam, A; Cleary, J

    1991-01-01

    Most injuries sustained by rugby players affect the soft tissues, and fracture is relatively uncommon. Whereas the lower limb is most affected in footballers, the upper limb tends to be injured in rugby players. Thirty consecutive fractures and ten dislocations affecting the upper limb, sustained by 35 rugby players, are reported.

  20. Tharsis Limb Cloud

    Science.gov (United States)

    2005-01-01

    [figure removed for brevity, see original site] Annotated image of Tharsis Limb Cloud 7 September 2005 This composite of red and blue Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) daily global images acquired on 6 July 2005 shows an isolated water ice cloud extending more than 30 kilometers (more than 18 miles) above the martian surface. Clouds such as this are common in late spring over the terrain located southwest of the Arsia Mons volcano. Arsia Mons is the dark, oval feature near the limb, just to the left of the 'T' in the 'Tharsis Montes' label. The dark, nearly circular feature above the 'S' in 'Tharsis' is the volcano, Pavonis Mons, and the other dark circular feature, above and to the right of 's' in 'Montes,' is Ascraeus Mons. Illumination is from the left/lower left. Season: Northern Autumn/Southern Spring

  1. Regeneration and repair of human digits and limbs: fact and fiction.

    Science.gov (United States)

    Shieh, Shyh-Jou; Cheng, Tsun-Chih

    2015-08-01

    A variety of digit and limb repair and reconstruction methods have been used in different clinical settings, but regeneration remains an item on every plastic surgeon's "wish list." Although surgical salvage techniques are continually being improved, unreplantable digits and limbs are still abundant. We comprehensively review the structural and functional salvage methods in clinical practice, from the peeling injuries of small distal fingertips to multisegmented amputated limbs, and the developmental and tissue engineering approaches for regenerating human digits and limbs in the laboratory. Although surgical techniques have forged ahead, there are still situations in which digits and limbs are unreplantable. Advances in the field are delineated, and the regeneration processes of salamander limbs, lizard tails, and mouse digits and each component of tissue engineering approaches for digit- and limb-building are discussed. Although the current technology is promising, there are many challenges in human digit and limb regeneration. We hope this review inspires research on the critical gap between clinical and basic science, and leads to more sophisticated digit and limb loss rescue and regeneration innovations.

  2. The Evolution of Devices and Systems Supporting Rehabilitation of Lower Limbs

    Science.gov (United States)

    Olinski, M.; Lewandowski, B.; Gronowicz, A.

    2015-02-01

    This paper presents the process of development, as well as examples of devices and systems supporting rehabilitation of the human lower extremities, developed independently over the years in many parts of the world. Particular emphasis was placed on indicating, which major groups of devices supporting kinesitherapy of the lower limbs can be distinguished, what are the important advantages and disadvantages of particular types of solutions, as well as what directions currently dominating in development of rehabilitation systems may be specified. A deeper analysis and comparison of several selected systems was also conducted, resulting in gathering the outcomes in two tables. They focused on a few features of mechanical design, especially the devices' kinematic structures, and devices' additional functions associated with, among others, interaction, as well as diagnosis of the limb's state and the progress of rehabilitation.

  3. The effectiveness of newly developed written asthma action plan in improvement of asthma outcome in children.

    Science.gov (United States)

    Lakupoch, Kingthong; Manuyakorn, Wiparat; Preutthipan, Aroonwan; Kamalaporn, Harutai

    2017-09-17

    Providing asthma education about controller medication use and appropriate management of asthma exacerbation are the keys to improving the disease outcome. Many asthma guidelines recommend that physicians provide written asthma action plan (WAAP) to all of their asthmatic patients. However, the benefit of WAAP is unclear. Thus, we have created a new WAAP which is simplified in Thai and more user friendly. To determine the effectiveness of the newly developed asthma action plan in management of children with asthma. Asthmatic children who meet inclusion criteria all received the WAAP and they were followed up for 6 months with measurement of outcome variables, such as asthma exacerbation that required emergency room visit, unscheduled OPD visit, admission and school absence in order to compare with the past 6 months before receiving the WAAP. The analyzed outcomes of forty-nine children show significantly reduced emergency room visit (P-value 0.005), unscheduled OPD visit (P-value 0.046), admission days (P-value 0.026) and school absence days (P-value 0.022). Well controlled group and mild severity group were not the factors that contribute to decreased emergency room visit but step up therapy may be the co-factor to decreased ER visit. The results of this study suggest that the provision of newly developed WAAP is useful for improving self-care of asthma patients and reducing asthma exacerbation.

  4. Risk factors in limb reduction defects.

    Science.gov (United States)

    Stoll, C; Alembik, Y; Dott, B; Roth, M P

    1992-07-01

    Risk factors were studied in 123 children with limb reduction defects (LRD) from 118,265 consecutive births of known outcome during the period from 1979 to 1987 in the area which is covered by our registry of congenital malformations. For each case a control was studied. The LRD was localised and classified according to the EUROCAT guide for the description and classification of limb defects. The prevalence of LRD was 1.04 per thousand: 82.9% of the babies were liveborn, 13.0% were late spontaneous abortion or stillborn and termination was performed in 4.0% of the cases. The proportion of males was 0.55. The most common malformations in the 51.2% of children who had at least one other anomaly than LRD were associated cardiac, digestive and renal anomalies. The pregnancy with limb anomalies was more often complicated by oligohydramnios, polyhydramnios and threatened abortion but there were no differences in parental characteristics. However, 9.7% of marriages were consanguineous (P less than 0.01) and the incidence of LRD in first-degree relatives of the children with LRD was high. First-degree relatives also had more non-limb malformations than did those of controls.

  5. Computational evaluation of some lower limbs protective systems under explosive loading

    Directory of Open Access Journals (Sweden)

    Casas J.P.

    2012-08-01

    Full Text Available Different types of protective equipment for human lower limb, such as boots and gaiters, have been developed in order to reduce the injury caused by blast antipersonnel-mines. Damage is mainly studied by the energy transmitted to the extremity that has stepped on the mine; nonetheless, side effects that may affect adjacent limbs cannot be left aside. This study is divided into three stages due to the complexity in modeling the different phenomena related to the problem. The first stage is the study of the energy transmitted when a mine is activated. Different results are gathered according to the variation of parameters such as: deep of burial, standoff between ground and protective equipment, explosive mass, energy absorbing material placed between the ground and the protected limb, and computational issues like the distance of the boundary conditions and the discretization level. The second stage is the base and first approximation to the modeling and evaluation of lower limb behavior. It includes the interaction of the detonation products and a lower limb that is placed in a mechanical measuring device. The energy transferred to the mechanical device is correlated to the damage caused by the explosion products in an attempt to validate previously experimental data. Finally, in the third stage, the side effect on the lower contiguous leg is assessed: pressure and temperature measures are taken at different distances according to the human pace in order to evaluate the worst-case scenario. The first and third stages propose different material arrangements or configurations to reduce the energy transmitted to the mechanical device and to mitigate damage caused to the contiguous limb respectively. All the three stages are simulated using two-dimensional (2D hydrocode Ansys AUTODYN ® and material previously reported in literature.

  6. Computational evaluation of some lower limbs protective systems under explosive loading

    Science.gov (United States)

    Calle, J. C.; Coronado, R.; Rodriguez, J.; Casas, J. P.

    2012-08-01

    Different types of protective equipment for human lower limb, such as boots and gaiters, have been developed in order to reduce the injury caused by blast antipersonnel-mines. Damage is mainly studied by the energy transmitted to the extremity that has stepped on the mine; nonetheless, side effects that may affect adjacent limbs cannot be left aside. This study is divided into three stages due to the complexity in modeling the different phenomena related to the problem. The first stage is the study of the energy transmitted when a mine is activated. Different results are gathered according to the variation of parameters such as: deep of burial, standoff between ground and protective equipment, explosive mass, energy absorbing material placed between the ground and the protected limb, and computational issues like the distance of the boundary conditions and the discretization level. The second stage is the base and first approximation to the modeling and evaluation of lower limb behavior. It includes the interaction of the detonation products and a lower limb that is placed in a mechanical measuring device. The energy transferred to the mechanical device is correlated to the damage caused by the explosion products in an attempt to validate previously experimental data. Finally, in the third stage, the side effect on the lower contiguous leg is assessed: pressure and temperature measures are taken at different distances according to the human pace in order to evaluate the worst-case scenario. The first and third stages propose different material arrangements or configurations to reduce the energy transmitted to the mechanical device and to mitigate damage caused to the contiguous limb respectively. All the three stages are simulated using two-dimensional (2D) hydrocode Ansys AUTODYN ® and material previously reported in literature.

  7. Gait Phase Recognition for Lower-Limb Exoskeleton with Only Joint Angular Sensors

    Directory of Open Access Journals (Sweden)

    Du-Xin Liu

    2016-09-01

    Full Text Available Gait phase is widely used for gait trajectory generation, gait control and gait evaluation on lower-limb exoskeletons. So far, a variety of methods have been developed to identify the gait phase for lower-limb exoskeletons. Angular sensors on lower-limb exoskeletons are essential for joint closed-loop controlling; however, other types of sensors, such as plantar pressure, attitude or inertial measurement unit, are not indispensable.Therefore, to make full use of existing sensors, we propose a novel gait phase recognition method for lower-limb exoskeletons using only joint angular sensors. The method consists of two procedures. Firstly, the gait deviation distances during walking are calculated and classified by Fisher’s linear discriminant method, and one gait cycle is divided into eight gait phases. The validity of the classification results is also verified based on large gait samples. Secondly, we build a gait phase recognition model based on multilayer perceptron and train it with the phase-labeled gait data. The experimental result of cross-validation shows that the model has a 94.45% average correct rate of set (CRS and an 87.22% average correct rate of phase (CRP on the testing set, and it can predict the gait phase accurately. The novel method avoids installing additional sensors on the exoskeleton or human body and simplifies the sensory system of the lower-limb exoskeleton.

  8. Gait Phase Recognition for Lower-Limb Exoskeleton with Only Joint Angular Sensors

    Science.gov (United States)

    Liu, Du-Xin; Wu, Xinyu; Du, Wenbin; Wang, Can; Xu, Tiantian

    2016-01-01

    Gait phase is widely used for gait trajectory generation, gait control and gait evaluation on lower-limb exoskeletons. So far, a variety of methods have been developed to identify the gait phase for lower-limb exoskeletons. Angular sensors on lower-limb exoskeletons are essential for joint closed-loop controlling; however, other types of sensors, such as plantar pressure, attitude or inertial measurement unit, are not indispensable.Therefore, to make full use of existing sensors, we propose a novel gait phase recognition method for lower-limb exoskeletons using only joint angular sensors. The method consists of two procedures. Firstly, the gait deviation distances during walking are calculated and classified by Fisher’s linear discriminant method, and one gait cycle is divided into eight gait phases. The validity of the classification results is also verified based on large gait samples. Secondly, we build a gait phase recognition model based on multilayer perceptron and train it with the phase-labeled gait data. The experimental result of cross-validation shows that the model has a 94.45% average correct rate of set (CRS) and an 87.22% average correct rate of phase (CRP) on the testing set, and it can predict the gait phase accurately. The novel method avoids installing additional sensors on the exoskeleton or human body and simplifies the sensory system of the lower-limb exoskeleton. PMID:27690023

  9. The effect of different skin-ankle brace application pressures on quiet single-limb balance and electromyographic activation onset of lower limb muscles

    Directory of Open Access Journals (Sweden)

    Papadakis Stamatios A

    2007-09-01

    Full Text Available Abstract Background Several studies have been carried out in order to investigate the effect of ankle bracing on ankle joint function and performance. However, no study so far has examined the role of skin-brace interface pressure in neuromuscular control. The aim of this study was to investigate the effect of different skin-ankle brace interface pressures on quiet single limb balance and the electromyographic (EMG activation sequence of four lower limb muscles. Methods Thirty three male physical education students who volunteered to take part in the study were measured under three ankle brace conditions: i without brace, ii with brace and 30 kPa application pressure and iii with brace and 60 kPa application pressure. Single limb balance (anteroposterior and mediolateral parameter was assessed on the dominant lower limb, with open and closed eyes, on a force platform, simultaneously with the EMG recording of four lower lower limb muscles' (gastrocnemius, peroneus longus, rectus femoris and biceps femoris activation onset. Results The results showed that overall balance (total stability parameter was not significantly affected in any of the three ankle brace conditions. However, the anteroposterior centre of pressure excursion and centre of pressure excursion velocity were significantly increased with the application of ankle brace, both with 30 and 60 kPa application pressures. Furthermore, it was found that single limb balance was significantly worse with closed eyes compared to open eyes. EMG measurements showed that the sequence of lower limb activation onset was not affected in any of the three ankle brace application conditions. The results of this study showed that the application of an ankle brace with two different skin-brace interface pressures had no effect on overall single limb balance and the sequence of lower limb muscle activation. Conclusion These findings suggest that peripheral joint receptors are either not adequately

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

    Directory of Open Access Journals (Sweden)

    Valdmanová L.

    2013-06-01

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

  11. [Partial replantation following proximal limb injury].

    Science.gov (United States)

    Dubert, T; Malikov, S A; Dinh, A; Kupatadze, D D; Oberlin, C; Alnot, J Y; Nabokov, B B

    2000-11-01

    Proximal replantation is a technically feasible but life-threatening procedure. Indications must be restricted to patients in good condition with a good functional prognosis. The goal of replantation must be focused not only on reimplanting the amputated limb but also on achieving a good functional outcome. For the lower limb, simple terminalization remains the best choice in many cases. When a proximal amputation is not suitable for replantation, the main aim of the surgical procedure must be to reconstruct a stump long enough to permit fitting a prosthesis preserving the function of the adjacent joint. If the proximal stump beyond the last joint is very short, it may be possible to restore some length by partial replantation of spared tissues from the amputated part. We present here the results we obtained following this policy. This series included 16 cases of partial replantations, 14 involving the lower limb and 2 the upper limb. All were osteocutaneous microsurgical transfers. For the lower limb, all transfers recovered protective sensitivity following tibial nerve repair. The functional calcaeoplantar unit was used in 13 cases. The transfer of this specialized weight bearing tissue provided a stable distal surface making higher support unnecessary. In one case, we raised a 13-cm vascularized tibial segment covered with foot skin for additional length. For the upper limb, the osteocutaneous transfer, based on the radial artery, was not reinnervated, but this lack of sensitivity did not impair prosthesis fitting. One vascular failure was finally amputated. This was the only unsuccessful result. For all other patients, the surgical procedure facilitated prosthesis fitting and preserved the proximal joint function despite an initially very proximal amputation. The advantages of partial replantation are obvious compared with simple terminalization or secondary reconstruction. There is no secondary donor site and, because there is no major muscle mass in the

  12. Lower limb control and mobility following exercise training

    Directory of Open Access Journals (Sweden)

    Kim Sukwon

    2012-02-01

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

  13. Effects of postural changes of the upper limb on reflex transmission in the lower limb. Cervicolumbar reflex interactions in man.

    Science.gov (United States)

    Delwaide, P J; Figiel, C; Richelle, C

    1977-06-01

    The influence of passive changes in upper limb position on the excitability of three myotatic arc reflexes (soleus, quadriceps, and biceps femoris) of the lower limb has been explored on 42 volunteers. The results indicate that the excitability of the three myotatic arcs can be influenced at a distance by postural modifications of the upper limb. When the ipsilateral upper limb is forwards or the contralateral backwards, a facilitation of both soleus and quadriceps tendon reflexes is observed while the biceps femoris reflexes are reduced. This pattern of facilitation and inhibition is reversed when the ipsilateral upper limb is backwards or the contralateral forwards. The facilitations as well as inhibitions of proximal myotatic arc reflexes are quantitatively more marked than that of the soleus reflex. Facilitation and inhibition are not linearly related to the angle of the arm with the trunk. Effects begin at a considerable angle, become maximal at 45 degrees, and progressively disappear for greater values. It is suggested that the distinct pattern of facilitation and inhibition which is exerted in reciprocal fashion on extensor and flexor motor nuclei might depend on the long propriospinal neurones connecting cervical and lumbar enlargements.

  14. Morphological Variation in Anuran Limbs: Constraints and Novelties.

    Science.gov (United States)

    Fabrezi, Marissa; Goldberg, Javier; Chuliver Pereyra, Mariana

    2017-09-01

    Anurans have three primary types of locomotion: walking, jumping, and swimming. Additionally, they may dig, climb, grasp, etc. All adult anurans have four limbs, with four fingers on the hands and five toes on the feet. We summarized and updated knowledge on the interspecific variation within anuran limbs, then discuss how developmental constraints (e.g., in size) and novelties may have influenced anuran diversification through the locomotion. We analyze morphological variation from limb bud stages up to the final limb form resulting from certain skeletal organization and growth. We find limited morphometric variations in the skeleton of different developmental modules (i.e., skull, trunk, urostyle, limbs) indicate that the anuran body shape is largely constrained. We identify specializations of the stylopodium, zeugopodium, and proximal carpals/tarsals that have evolved to facilitiate saltatorial locomotion. We show that the anuran prepollex and prehallux are not vestigial digits and that they have come to serve specialized function. Medial rotation of the manus in anurans appears to have evolved to help distribute the force of impact upon landing at the end of a jump. Additional skeletal elements in anuran limbs are intercalary elements and sesamoids. The intercalary elements appear within neobatrachians and are integrated with digital pads in lineages capable of locomotion on smooth vertical surfaces. They have allowed arboreal anurans to occupy a wide range of arboreal habitats. © 2017 Wiley Periodicals, Inc.

  15. [Variants of anatomical structure of lower-limb veins as a possible cause of the development of primary varicosity].

    Science.gov (United States)

    Vakhitov, M Kh; Bol'shakov, O P

    2011-01-01

    In order to reveal anatomical prerequisites for the development of primary varicose veins we investigated the structure of the venous system on a total of 53 adult human cadaveric lower extremities. Congenital morphological grounds providing the phlebohaemodynemics of the lower limbs are ambiguous in different individual forms. We revealed a total of 18 variants of the structure of deep veins, reflecting various stages of the embryonic development. In 34.1% of cases we saw the forms characteristic of incomplete reduction and unfinished transformation, with 30.2% of cases showing the utmost degree of reduction and transformation. An inadequate outflow along the deep veins conditioned by their anatomical structure is a prerequisite for the development of valvular insufficiency and venous reflux to the superficial veins followed by varicose transformation thereof

  16. Conventional and improved cytotoxicity test methods of newly developed biodegradable magnesium alloys

    Science.gov (United States)

    Han, Hyung-Seop; Kim, Hee-Kyoung; Kim, Yu-Chan; Seok, Hyun-Kwang; Kim, Young-Yul

    2015-11-01

    Unique biodegradable property of magnesium has spawned countless studies to develop ideal biodegradable orthopedic implant materials in the last decade. However, due to the rapid pH change and extensive amount of hydrogen gas generated during biocorrosion, it is extremely difficult to determine the accurate cytotoxicity of newly developed magnesium alloys using the existing methods. Herein, we report a new method to accurately determine the cytotoxicity of magnesium alloys with varying corrosion rate while taking in-vivo condition into the consideration. For conventional method, extract quantities of each metal ion were determined using ICP-MS and the result showed that the cytotoxicity due to pH change caused by corrosion affected the cell viability rather than the intrinsic cytotoxicity of magnesium alloy. In physiological environment, pH is regulated and adjusted within normal pH (˜7.4) range by homeostasis. Two new methods using pH buffered extracts were proposed and performed to show that environmental buffering effect of pH, dilution of the extract, and the regulation of eluate surface area must be taken into consideration for accurate cytotoxicity measurement of biodegradable magnesium alloys.

  17. Progressive Loss of Function in a Limb Enhancer during Snake Evolution

    Energy Technology Data Exchange (ETDEWEB)

    Kvon, Evgeny Z.; Kamneva, Olga K.; Melo, Uirá S.; Barozzi, Iros; Osterwalder, Marco; Mannion, Brandon J.; Tissières, Virginie; Pickle, Catherine S.; Plajzer-Frick, Ingrid; Lee, Elizabeth A.; Kato, Momoe; Garvin, Tyler H.; Akiyama, Jennifer A.; Afzal, Veena; Lopez-Rios, Javier; Rubin, Edward M.; Dickel, Diane E.; Pennacchio, Len A.; Visel, Axel

    2016-10-20

    The evolution of body shape is thought to be tightly coupled to changes in regulatory sequences, but specific molecular events associated with major morphological transitions in vertebrates have remained elusive. In this paper, we identified snake-specific sequence changes within an otherwise highly conserved long-range limb enhancer of Sonic hedgehog (Shh). Transgenic mouse reporter assays revealed that the in vivo activity pattern of the enhancer is conserved across a wide range of vertebrates, including fish, but not in snakes. Genomic substitution of the mouse enhancer with its human or fish ortholog results in normal limb development. In contrast, replacement with snake orthologs caused severe limb reduction. Synthetic restoration of a single transcription factor binding site lost in the snake lineage reinstated full in vivo function to the snake enhancer. Our results demonstrate changes in a regulatory sequence associated with a major body plan transition and highlight the role of enhancers in morphological evolution.

  18. A prosthesis-specific multi-link segment model of lower-limb amputee sprinting.

    Science.gov (United States)

    Rigney, Stacey M; Simmons, Anne; Kark, Lauren

    2016-10-03

    Lower-limb amputees commonly utilize non-articulating energy storage and return (ESAR) prostheses for high impact activities such as sprinting. Despite these prostheses lacking an articulating ankle joint, amputee gait analysis conventionally features a two-link segment model of the prosthetic foot. This paper investigated the effects of the selected link segment model׳s marker-set and geometry on a unilateral amputee sprinter׳s calculated lower-limb kinematics, kinetics and energetics. A total of five lower-limb models of the Ottobock ® 1E90 Sprinter were developed, including two conventional shank-foot models that each used a different version of the Plug-in-Gait (PiG) marker-set to test the effect of prosthesis ankle marker location. Two Hybrid prosthesis-specific models were then developed, also using the PiG marker-sets, with the anatomical shank and foot replaced by prosthesis-specific geometry separated into two segments. Finally, a Multi-link segment (MLS) model was developed, consisting of six segments for the prosthesis as defined by a custom marker-set. All full-body musculoskeletal models were tested using four trials of experimental marker trajectories within OpenSim 3.2 (Stanford, California, USA) to find the affected and unaffected hip, knee and ankle kinematics, kinetics and energetics. The geometry of the selected lower-limb prosthesis model was found to significantly affect all variables on the affected leg (p prosthesis-specific spatial, inertial and elastic properties from full-body models significantly affects the calculated amputee gait characteristics, and we therefore recommend the implementation of a MLS model. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Scale effects between body size and limb design in quadrupedal mammals.

    Science.gov (United States)

    Kilbourne, Brandon M; Hoffman, Louwrens C

    2013-01-01

    Recently the metabolic cost of swinging the limbs has been found to be much greater than previously thought, raising the possibility that limb rotational inertia influences the energetics of locomotion. Larger mammals have a lower mass-specific cost of transport than smaller mammals. The scaling of the mass-specific cost of transport is partly explained by decreasing stride frequency with increasing body size; however, it is unknown if limb rotational inertia also influences the mass-specific cost of transport. Limb length and inertial properties--limb mass, center of mass (COM) position, moment of inertia, radius of gyration, and natural frequency--were measured in 44 species of terrestrial mammals, spanning eight taxonomic orders. Limb length increases disproportionately with body mass via positive allometry (length ∝ body mass(0.40)); the positive allometry of limb length may help explain the scaling of the metabolic cost of transport. When scaled against body mass, forelimb inertial properties, apart from mass, scale with positive allometry. Fore- and hindlimb mass scale according to geometric similarity (limb mass ∝ body mass(1.0)), as do the remaining hindlimb inertial properties. The positive allometry of limb length is largely the result of absolute differences in limb inertial properties between mammalian subgroups. Though likely detrimental to locomotor costs in large mammals, scale effects in limb inertial properties appear to be concomitant with scale effects in sensorimotor control and locomotor ability in terrestrial mammals. Across mammals, the forelimb's potential for angular acceleration scales according to geometric similarity, whereas the hindlimb's potential for angular acceleration scales with positive allometry.

  20. A Neuromotor Device for Reducing Phantom Limb Pain in Individuals with Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Cui Lei

    2016-01-01

    Full Text Available Phantom Limb Pain is a disorder that can be experienced by individuals after amputation or spinal cord injury. In spinal cord injury the paralysis or paresis is often bilateral, thus limiting the application of apparent movement as a therapeutic model for phantom limb pain. This project aimed to develop a robotic rehabilitation device that replicated apparent movement to apply the same therapeutic principles with individuals with lower limb phantom pain that have bilateral paralysis of paresis. The proposed device achieved lower limb planar motion of the knee by a six-bar linkage of a single degree of freedom (DOF. It is driven by a linear actuator while the ankle motion is achieved by a gear motor, reaching an effective 70° range of motion for both joints. The system features closed loop control using feedback from surface electromyography sensors, limit switches and position sensors with an Arduino microcontroller as the control unit. This device will be used to further our understanding of the disorder and create opportunities for robot aided treatment for individuals with phantom limb pain as a result of spinal cord injury.

  1. Replacement of irradiated epidermis by migration of non-irradiated epidermis in the newt limb: the necessity of healthy epidermis for regeneration

    Energy Technology Data Exchange (ETDEWEB)

    Lheureux, E. (Universite des Sciences et Techniques, Lille (France). Lab. de Morphogenese Animale)

    1983-08-01

    An X-irradiated newt limb is able to regenerate if non-irradiated skin as well as non-irradiated muscle is transplanted to the stump. In order to know whether limb regeneration required healthy epidermis or not, a triploid skin cuff was set at the most proximal level of an irradiated limb and muscle was transplanted to the level of the midforearm. The forearm was then amputated through the muscle graft. The result was a complete replacement of diploid irradiated epidermis by triploid epidermis, during the six weeks necessary for regeneration. Another investigation consisted of detecting a possible migration of non-irradiated triploid epidermis along an irradiated limb which had not been amputated. Healthy epidermis was found to migrate distally and replace irradiated epidermis in three weeks. Transplantation of a non-irradiated skin cuff or muscle to an irradiated limb stump was carried out on animals entirely irradiated to prevent any extra healthy epidermis cells from contaminating the regenerating limb epidermis. A regenerate developed from the skin graft but not from muscle graft. It is concluded that healthy epidermis must be present on the limb stump to permit the blastema to develop.

  2. Replacement of irradiated epidermis by migration of non-irradiated epidermis in the newt limb: the necessity of healthy epidermis for regeneration

    International Nuclear Information System (INIS)

    Lheureux, E.

    1983-01-01

    An X-irradiated newt limb is able to regenerate if non-irradiated skin as well as non-irradiated muscle is transplanted to the stump. In order to know whether limb regeneration required healthy epidermis or not, a triploid skin cuff was set at the most proximal level of an irradiated limb and muscle was transplanted to the level of the midforearm. The forearm was then amputated through the muscle graft. The result was a complete replacement of diploid irradiated epidermis by triploid epidermis, during the six weeks necessary for regeneration. Another investigation consisted of detecting a possible migration of non-irradiated triploid epidermis along an irradiated limb which had not been amputated. Healthy epidermis was found to migrate distally and replace irradiated epidermis in three weeks. Transplantation of a non-irradiated skin cuff or muscle to an irradiated limb stump was carried out on animals entirely irradiated to prevent any extra healthy epidermis cells from contaminating the regenerating limb epidermis. A regenerate developed from the skin graft but not from muscle graft. It is concluded that healthy epidermis must be present on the limb stump to permit the blastema to develop. (author)

  3. Regeneration and repair of human digits and limbs: fact and fiction

    Science.gov (United States)

    Cheng, Tsun‐Chih

    2015-01-01

    Abstract A variety of digit and limb repair and reconstruction methods have been used in different clinical settings, but regeneration remains an item on every plastic surgeon's “wish list.” Although surgical salvage techniques are continually being improved, unreplantable digits and limbs are still abundant. We comprehensively review the structural and functional salvage methods in clinical practice, from the peeling injuries of small distal fingertips to multisegmented amputated limbs, and the developmental and tissue engineering approaches for regenerating human digits and limbs in the laboratory. Although surgical techniques have forged ahead, there are still situations in which digits and limbs are unreplantable. Advances in the field are delineated, and the regeneration processes of salamander limbs, lizard tails, and mouse digits and each component of tissue engineering approaches for digit‐ and limb‐building are discussed. Although the current technology is promising, there are many challenges in human digit and limb regeneration. We hope this review inspires research on the critical gap between clinical and basic science, and leads to more sophisticated digit and limb loss rescue and regeneration innovations. PMID:27499873

  4. Evaluation of Shielding Performance for Newly Developed Composite Materials

    Science.gov (United States)

    Evans, Beren Richard

    This work details an investigation into the contributing factors behind the success of newly developed composite neutron shield materials. Monte Carlo simulation methods were utilized to assess the neutron shielding capabilities and secondary radiation production characteristics of aluminum boron carbide, tungsten boron carbide, bismuth borosilicate glass, and Metathene within various neutron energy spectra. Shielding performance and secondary radiation data suggested that tungsten boron carbide was the most effective composite material. An analysis of the macroscopic cross-section contributions from constituent materials and interaction mechanisms was then performed in an attempt to determine the reasons for tungsten boron carbide's success over the other investigated materials. This analysis determined that there was a positive correlation between a non-elastic interaction contribution towards a material's total cross-section and shielding performance within the thermal and epi-thermal energy regimes. This finding was assumed to be a result of the boron-10 absorption reaction. The analysis also determined that within the faster energy regions, materials featuring higher non-elastic interaction contributions were comparable to those exhibiting primarily elastic scattering via low Z elements. This allowed for the conclusion that composite shield success within higher energy neutron spectra does not necessitate the use elastic scattering via low Z elements. These findings suggest that the inclusion of materials featuring high thermal absorption properties is more critical to composite neutron shield performance than the presence of constituent materials more inclined to maximize elastic scattering energy loss.

  5. Upper limb injury in rugby union football: results of a cohort study.

    Science.gov (United States)

    Usman, Juliana; McIntosh, Andrew Stuart

    2013-04-01

    There have been few in-depth studies of upper limb injury epidemiology in rugby union football, despite reports that they accounted for between 14% and 28% of all rugby injuries. To report on upper limb injury incidence, injury severity and to identify the risk factors associated with upper limb injuries, for example, level of play, season (years) and playing position. Prospective cohort study across five rugby seasons from 2004 to 2008. Formal rugby competitions-suburban, provincial and international. 1475 adult male rugby players in Colts, Grade and Elite competitions. An upper limb injury resulting in a missed game and its characteristics. A total of 61 598 athletic exposures (AE) and 606 upper limb injuries were recorded. About 66% of the injuries were to the shoulder. The overall upper limb injury incidence rate (IIR) was 9.84 injuries/1000 AE (95% CI 9.06 to 10.62). Statistically significant associations were found between upper limb injuries and level of play; and between shoulder injuries and playing position (p<0.05). No association was found between upper limb and shoulder injuries and study year. The overall upper limb IIR decreased as the level of play increased; 10.74 upper limb injuries/1000 AE (95% CI 9.93 to 11.56) in Colts to 6.07 upper limb injuries/1000 AE (95% CI 5.46 to 6.69) in Elite. The upper limb IIR decreased as the level of play increased indicating that age, level of skill and playing experience may be risk factors for upper limb injury.

  6. Exoskeleton-Based Robotic Platform Applied in Biomechanical Modelling of the Human Upper Limb

    Directory of Open Access Journals (Sweden)

    Andres F. Ruiz

    2009-01-01

    Full Text Available One of the approaches to study the human motor system, and specifically the motor strategies implied during postural tasks of the upper limbs, is to manipulate the mechanical conditions of each joint of the upper limbs independently. At the same time, it is essential to pick up biomechanical signals and bio-potentials generated while the human motor system adapts to the new condition. The aim of this paper is two-fold: first, to describe the design, development and validation of an experimental platform designed to modify or perturb the mechanics of human movement, and simultaneously acquire, process, display and quantify bioelectric and biomechanical signals; second, to characterise the dynamics of the elbow joint during postural control. A main goal of the study was to determine the feasibility of estimating human elbow joint dynamics using EMG-data during maintained posture. In particular, the experimental robotic platform provides data to correlate electromyographic (EMG activity, kinetics and kinematics information from the upper limb motion. The platform aims consists of an upper limb powered exoskeleton, an EMG acquisition module, a control unit and a software system. Important concerns of the platform such as dependability and safety were addressed in the development. The platform was evaluated with 4 subjects to identify, using system identification methods, the human joint dynamics, i.e. visco-elasticity. Results obtained in simulations and experimental phase are introduced.

  7. Gangrene of the limb complicating Salmonella typhi Septicaemia in ...

    African Journals Online (AJOL)

    We report an unusual case of lower limb gangrene in a pubertal boy following a typical clinical presentation of septicaemia due to Salmonella typhi. After an initial response to presumed appropriate antibiotic and supportive therapy, the patient developed tissue ischaemia in both feet. There were no clinical or laboratory ...

  8. Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation

    Science.gov (United States)

    Cortés, Camilo; Ardanza, Aitor; Molina-Rueda, F.; Cuesta-Gómez, A.; Ruiz, Oscar E.

    2014-01-01

    New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation. PMID:25110698

  9. Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation

    Directory of Open Access Journals (Sweden)

    Camilo Cortés

    2014-01-01

    Full Text Available New motor rehabilitation therapies include virtual reality (VR and robotic technologies. In limb rehabilitation, limb posture is required to (1 provide a limb realistic representation in VR games and (2 assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a the mathematical formulation and solution to the problem, (b the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c its integration into a rehabilitation VR game platform, and (d the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i animate avatars that represent the patient in VR games and (ii obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation.

  10. Automatic limb identification and sleeping parameters assessment for pressure ulcer prevention.

    Science.gov (United States)

    Baran Pouyan, Maziyar; Birjandtalab, Javad; Nourani, Mehrdad; Matthew Pompeo, M D

    2016-08-01

    Pressure ulcers (PUs) are common among vulnerable patients such as elderly, bedridden and diabetic. PUs are very painful for patients and costly for hospitals and nursing homes. Assessment of sleeping parameters on at-risk limbs is critical for ulcer prevention. An effective assessment depends on automatic identification and tracking of at-risk limbs. An accurate limb identification can be used to analyze the pressure distribution and assess risk for each limb. In this paper, we propose a graph-based clustering approach to extract the body limbs from the pressure data collected by a commercial pressure map system. A robust signature-based technique is employed to automatically label each limb. Finally, an assessment technique is applied to evaluate the experienced stress by each limb over time. The experimental results indicate high performance and more than 94% average accuracy of the proposed approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Microarray Analysis of microRNA Expression during Axolotl Limb Regeneration

    Science.gov (United States)

    Holman, Edna C.; Campbell, Leah J.; Hines, John; Crews, Craig M.

    2012-01-01

    Among vertebrates, salamanders stand out for their remarkable capacity to quickly regrow a myriad of tissues and organs after injury or amputation. The limb regeneration process in axolotls (Ambystoma mexicanum) has been well studied for decades at the cell-tissue level. While several developmental genes are known to be reactivated during this epimorphic process, less is known about the role of microRNAs in urodele amphibian limb regeneration. Given the compelling evidence that many microRNAs tightly regulate cell fate and morphogenetic processes through development and adulthood by modulating the expression (or re-expression) of developmental genes, we investigated the possibility that microRNA levels change during limb regeneration. Using two different microarray platforms to compare the axolotl microRNA expression between mid-bud limb regenerating blastemas and non-regenerating stump tissues, we found that miR-21 was overexpressed in mid-bud blastemas compared to stump tissue. Mature A. mexicanum (“Amex”) miR-21 was detected in axolotl RNA by Northern blot and differential expression of Amex-miR-21 in blastema versus stump was confirmed by quantitative RT-PCR. We identified the Amex Jagged1 as a putative target gene for miR-21 during salamander limb regeneration. We cloned the full length 3′UTR of Amex-Jag1, and our in vitro assays demonstrated that its single miR-21 target recognition site is functional and essential for the response of the Jagged1 gene to miR-21 levels. Our findings pave the road for advanced in vivo functional assays aimed to clarify how microRNAs such as miR-21, often linked to pathogenic cell growth, might be modulating the redeployment of developmental genes such as Jagged1 during regenerative processes. PMID:23028429

  12. Microarray analysis of microRNA expression during axolotl limb regeneration.

    Directory of Open Access Journals (Sweden)

    Edna C Holman

    Full Text Available Among vertebrates, salamanders stand out for their remarkable capacity to quickly regrow a myriad of tissues and organs after injury or amputation. The limb regeneration process in axolotls (Ambystoma mexicanum has been well studied for decades at the cell-tissue level. While several developmental genes are known to be reactivated during this epimorphic process, less is known about the role of microRNAs in urodele amphibian limb regeneration. Given the compelling evidence that many microRNAs tightly regulate cell fate and morphogenetic processes through development and adulthood by modulating the expression (or re-expression of developmental genes, we investigated the possibility that microRNA levels change during limb regeneration. Using two different microarray platforms to compare the axolotl microRNA expression between mid-bud limb regenerating blastemas and non-regenerating stump tissues, we found that miR-21 was overexpressed in mid-bud blastemas compared to stump tissue. Mature A. mexicanum ("Amex" miR-21 was detected in axolotl RNA by Northern blot and differential expression of Amex-miR-21 in blastema versus stump was confirmed by quantitative RT-PCR. We identified the Amex Jagged1 as a putative target gene for miR-21 during salamander limb regeneration. We cloned the full length 3'UTR of Amex-Jag1, and our in vitro assays demonstrated that its single miR-21 target recognition site is functional and essential for the response of the Jagged1 gene to miR-21 levels. Our findings pave the road for advanced in vivo functional assays aimed to clarify how microRNAs such as miR-21, often linked to pathogenic cell growth, might be modulating the redeployment of developmental genes such as Jagged1 during regenerative processes.

  13. Consumer design priorities for upper limb prosthetics.

    Science.gov (United States)

    Biddiss, Elaine; Beaton, Dorcas; Chau, Tom

    2007-11-01

    To measure consumer satisfaction with upper limb prosthetics and provide an enumerated list of design priorities for future developments. A self-administered, anonymous survey collected information on participant demographics, history of and goals for prosthesis use, satisfaction, and design priorities. The questionnaire was available online and in paper format and was distributed through healthcare providers, community support groups, and one prosthesis manufacturer; 242 participants of all ages and levels of upper limb absence completed the survey. Rates of rejection for myoelectric hands, passive hands, and body-powered hooks were 39%, 53%, and 50%, respectively. Prosthesis wearers were generally satisfied with their devices while prosthesis rejecters were dissatisfied. Reduced prosthesis weight emerged as the highest priority design concern of consumers. Lower cost ranked within the top five design priorities for adult wearers of all device types. Life-like appearance is a priority for passive/cosmetic prostheses, while improved harness comfort, wrist movement, grip control and strength are required for body-powered devices. Glove durability, lack of sensory feedback, and poor dexterity were also identified as design priorities for electric devices. Design priorities reflect consumer goals for prosthesis use and vary depending on the type of prosthesis used and age. Future design efforts should focus on the development of more light-weight, comfortable prostheses.

  14. Factors impacting participation in sports for children with limb absence: a qualitative study.

    Science.gov (United States)

    Sayed Ahmed, Batoul; Lamy, Marena; Cameron, Debra; Artero, Lisa; Ramdial, Sandra; Leineweber, Matthew; Andrysek, Jan

    2018-06-01

    Individuals with limb absence benefit from participating in sports. While barriers and facilitators affecting sport participation are well documented for adults, they have not been explored for children with limb absence. To identify the perceived factors impacting participation in sports according to children with limb absence and their parents. This study uses a descriptive qualitative study design. Nineteen participants, consisting of children and their parents, were recruited from an outpatient hospital clinic for semi-structured interviews. The 11 interviews were audio recorded and transcribed. Transcripts were then coded and analyzed using the DEPICT model. The thematic analysis was guided by the International Classification of Functioning, Disability, and Health framework. Analysis of our participant interviews identified six themes as having an influence on sport participation: "functionality of prosthesis", "plan in advance", "know what I can do" (understanding capabilities), "it's like every stroke, 2 million questions" (stigma and the social environment), "love for the game" (love for sport), and "these things are an investment" (the investment involved). The findings have the potential to inform the development and implementation of strategies to increase levels of participation in sports among children with limb absence. Information from this study may help to deepen the rehabilitation team's understanding of factors that impact engagement in sports among children with limb absence. Implications for Rehabilitation Children with limb absence present with unique barriers and facilitators to participating in sports, thus, what may be a facilitator or barrier for one child may not for another. Strategies to increase a child's participation in sports should consider both person and environmental factors. Rehabilitation professionals can play a crucial role in educating both families and the community on living and coping with a limb difference, services and

  15. Quality of life among lower limb prosthesis users attending Artificial Limb Center of Fauji Foundation Hospital Rawalpindi

    International Nuclear Information System (INIS)

    Kalsoom, U.; Bairam, S.

    2018-01-01

    To assess quality of life and the influencing factors as perceived by lower limb prosthesis users. Study Design: Cross sectional study. Place and Duration of Study: Artificial Limb Centre, Fauji Foundation Hospital Rawalpindi, 11 months (Jan to Nov 2014). Material and Methods: A sample of 50 patients with lower limb amputations and using lower limb prosthesis were recruited by applying inclusion criteria. Responses were recorded on demographic variables, reasons for amputation, time of provision of prosthesis, employment status etc. by the investigator on a structured pretested questionnaire after their consent. A p-value of <0.05 was taken as significant. Quality of life was interpreted on 5 point Likert scale. Data was analyzed in SPSS version 21. Result: Majority of respondents i.e. 17 (34%) were in 51-60 years age group with mean age 46 +- 14 years while 33 (66%) were males and 27 (54%) illiterate, 33 (66%) could afford a prosthesis. Trauma 28 (56%) was the most prevalent cause of lower limb amputation and among them 15 (53%) had road accident injuries. Various factors influenced quality of life as perceived by the respondents and in 10 (20%), 16 (32%), 25 (50%) social, family life and emotional status was affected respectively, while 14 (28%) of the prosthesis user were unemployed. Prosthesis were provided after 2 years in 18 (36%) and in 37 (74%) prosthesis were provided by the health care facility. Good quality of life was perceived in 40 (80%) respondents. Conclusion: Perceived Quality of life was good in majority of the prosthesis users but others can't be ignored. It can be improved by early provision of prosthesis which can help in better employment opportunities. (author)

  16. Core stability training on lower limb balance strength.

    Science.gov (United States)

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

    2016-01-01

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

  17. Limb-body wall complex: Prenatal sonographic findings versus autopsy findings

    International Nuclear Information System (INIS)

    Song, Mi Jin; Cho, Jeong Yeon; Lee, Young Ho

    2001-01-01

    To evaluate prenatal ultrasonographic findings of limb-body wall complex and to correlate them with autopsy findings. From October 1995 to June 2000, a retrospectively review of prenatal ultrasonography (US) of 11 patients with pathologically proven limb-body wall complex was done. US findings were then compared with autopsy findings. Prenatal ultrasonography revealed thoraco-abdominoschists (n=7.64%), kyphoscoliosis (n=7.64%), cranial defect (n=5.45%), limb defect (n=4.36%), facial defect (n=1.10%), amniotic band (n=5.45%), and umbilical cord anomaly (n=3.27%). Meanwhile, autopsy findings showed thoraco-abdominoschisis (n=8.72%), limb defect (n=7.64%), facial defect (n=7.64%), kyphoscoliosis (n=5.45%), cranial defect (n=5.45%), amniotic band (n=5.45%) and umbilical cord anomaly (n=4.36%). The most common ultrasonography features of limb-body wall complex were thoraco-abdominoschisis and kyphoscoliosis while the thoraco-abdominoschisis and limb defects were the most frequent findings at autopsy.

  18. A cytochemical study of histones in the muscular cells of Triturus cristatus limbs in normal regeneration of limbs irradiated by X-rays, of irradiated limbs in which the regenerative power is restored by cartilage implants

    International Nuclear Information System (INIS)

    Desselle, J.-C.

    1976-01-01

    The muscular cells of regenerating limbs and of limbs in which regenerative power is restored, show an important decrease in the amount of cytophotometrically detected histones. This decrease is owing to the arginine rich fraction and to the lysine rich fraction. The muscular cells of irradiated limbs show a decrease in the amount of histones. This decrease is owing only to the arginine rich fraction and continues after the thirtieth day of irradiation and amputation [fr

  19. 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.

  20. Energetic benefits and adaptations in mammalian limbs: Scale effects and selective pressures.

    Science.gov (United States)

    Kilbourne, Brandon M; Hoffman, Louwrens C

    2015-06-01

    Differences in limb size and shape are fundamental to mammalian morphological diversity; however, their relevance to locomotor costs has long been subject to debate. In particular, it remains unknown if scale effects in whole limb morphology could partially underlie decreasing mass-specific locomotor costs with increasing limb length. Whole fore- and hindlimb inertial properties reflecting limb size and shape-moment of inertia (MOI), mass, mass distribution, and natural frequency-were regressed against limb length for 44 species of quadrupedal mammals. Limb mass, MOI, and center of mass position are negatively allometric, having a strong potential for lowering mass-specific locomotor costs in large terrestrial mammals. Negative allometry of limb MOI results in a 40% reduction in MOI relative to isometry's prediction for our largest sampled taxa. However, fitting regression residuals to adaptive diversification models reveals that codiversification of limb mass, limb length, and body mass likely results from selection for differing locomotor modes of running, climbing, digging, and swimming. The observed allometric scaling does not result from selection for energetically beneficial whole limb morphology with increasing size. Instead, our data suggest that it is a consequence of differing morphological adaptations and body size distributions among quadrupedal mammals, highlighting the role of differing limb functions in mammalian evolution. © 2015 The Author(s). Evolution © 2015 The Society for the Study of Evolution.

  1. Upper Limb-Hand 3D Display System for Biomimetic Myoelectric Hand Simulator

    National Research Council Canada - National Science Library

    Jimenez, Gonzalo

    2001-01-01

    A graphics system displaying both upper limb posture and opening-closing of a prosthetic hand was developed for realtime operation of our biomimetic myoelectric hand simulator, Posture of the upper...

  2. Psychological adjustment to amputation: variations on the bases of sex, age and cause of limb loss

    International Nuclear Information System (INIS)

    Ali, S.; Haider, S.K.F.

    2017-01-01

    Amputation is the removal of a limb or part of a limb by a surgical procedure in order to save the life of a person. The underlying reasons behind the occurrence of this tragic incidence may be varied. However, irrespective of its cause limb loss is associated with wide range of life challenges. The study was done to investigate the psychological sequel of an individual after losing a limb and to know the level of strain and pressure they experience after this traumatic event. It also attempts to examine the moderating role of some demographic traits such as age, sex and cause of limb loss in psychosocial adjustment to amputation. Methods: The study includes 100 adult amputees of both genders and the data was collected from major government and private hospitals of Peshawar district. Demographic data sheet was constructed in order to know the demographics traits of amputees and a standardize Psychological Adjustment Scale developed by Sabir (1999) was used to find out the level of psychological adjustment after limb loss. Results: Nearly all the amputees' exhibit signs of psychological maladjustment at varying degrees. Males showed much greater signs of maladjustment than women and young adults were much psychologically shattered and disturbed as a result of limb loss. Amputation caused by planned medical reasons leads to less adjustment issues as compared to unplanned accidental amputation in which patient were not mentally prepare to accept this loss. Conclusion: Psychological aspect of amputation is an important aspect of limb loss which needs to be addressed properly in order to rehabilitate these patients and helps them to adjust successfully to their limb loss. (author)

  3. Review: Biological and Molecular Differences between Tail Regeneration and Limb Scarring in Lizard: An Inspiring Model Addressing Limb Regeneration in Amniotes.

    Science.gov (United States)

    Alibardi, Lorenzo

    2017-09-01

    Tissue regeneration in lizards represents a unique model of regeneration and scarring in amniotes. The tail and limb contain putative stem cells but also dedifferentiating cells contribute to regeneration. Following tail amputation, inflammation is low and cell proliferation high, leading to regeneration while the intense inflammation in the limb leads to low proliferation and scarring. FGFs stimulate tail and limb regeneration and are present in the wound epidermis and blastema while they disappear in the limb wound epidermis 2-3 weeks postamputation in the scarring outgrowth. FGFs localize in the tail blastema and the apical epidermal peg (AEP), an epidermal microregion that allows tail growth but is absent in the limb. Inflammatory cells invade the limb blastema and wound epidermis, impeding the formation of an AEP. An embryonic program of growth is activated in the tail, dominated by Wnt-positive and -negative regulators of cell proliferation and noncoding RNAs, that represent the key regenerative genes. The balanced actions of these regulators likely impede the formation of a tumor in the tail tip. Genes for FACIT and fibrillar collagens, protease inhibitors, and embryonic keratins are upregulated in the regenerating tail blastema. A strong downregulation of genes for both B and T-lymphocyte activation suggests the regenerating tail blastema is a temporal immune-tolerated organ, whereas a scarring program is activated in the limb. Wnt inhibitors, pro-inflammatory genes, negative regulators of cell proliferation, downregulation of myogenic genes, proteases, and oxidases favoring scarring are upregulated. The evolution of an efficient immune system may be the main limiting barrier for organ regeneration in amniotes, and the poor regeneration of mammals and birds is associated with the efficiency of their mature immune system. This does not tolerate embryonic antigens formed in reprogrammed embryonic cells (as for neoplastic cells) that are consequently

  4. Positional information in axolotl and mouse limb extracellular matrix is mediated via heparan sulfate and fibroblast growth factor during limb regeneration in the axolotl (Ambystoma mexicanum).

    Science.gov (United States)

    Phan, Anne Q; Lee, Jangwoo; Oei, Michelle; Flath, Craig; Hwe, Caitlyn; Mariano, Rachele; Vu, Tiffany; Shu, Cynthia; Dinh, Andrew; Simkin, Jennifer; Muneoka, Ken; Bryant, Susan V; Gardiner, David M

    2015-08-01

    Urodele amphibians are unique among adult vertebrates in their ability to regenerate complex body structures after traumatic injury. In salamander regeneration, the cells maintain a memory of their original position and use this positional information to recreate the missing pattern. We used an in vivo gain-of-function assay to determine whether components of the extracellular matrix (ECM) have positional information required to induce formation of new limb pattern during regeneration. We discovered that salamander limb ECM has a position-specific ability to either inhibit regeneration or induce de novo limb structure, and that this difference is dependent on heparan sulfates that are associated with differential expression of heparan sulfate sulfotransferases. We also discovered that an artificial ECM containing only heparan sulfate was sufficient to induce de novo limb pattern in salamander limb regeneration. Finally, ECM from mouse limbs is capable of inducing limb pattern in axolotl blastemas in a position-specific, developmental-stage-specific, and heparan sulfate-dependent manner. This study demonstrates a mechanism for positional information in regeneration and establishes a crucial functional link between salamander regeneration and mammals.

  5. [Domestic external fixator application in the treatment of limb deformities: 7 289 cases application report].

    Science.gov (United States)

    Qin, S H; Guo, B F; Zheng, X J; Jiao, S F; Xia, H T; Peng, A M; Pan, Q; Zang, J C; Wang, Z J

    2017-09-01

    Objective: To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs. Methods: A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator. The Ilizarov, hybrid and monobrachial external fixator were used in 67, 65 and 0 patients on the upper limbs and in 2 665, 4 616 and 57 patients on the lower limbs. There were 3 028 patients operated on the left limbs, 3 260 patients operated on the right limbs and 1 001 patients operated on the bilateral limbs. The top three types of diseases were sequelae of poliomyelitis, cerebral palsy and post-traumatic stress disorder peromely. Deformity types inclued talipes equinovarus, knee flexion deformity, cavus foot and so on. Results: All the patients were followed up for a period of 2.5 months to 22.4 years, with an average follow-up time of 5.4 years. All of the external fixators were used for single once, and there was no substitute for external fixator quality problem. All the patients were completed surgery goal until removing external fixation except 1 patient gave up treatment and 1 removed the fixator because of metal allergy. The common complications included wire or pin infection and joint movement limitation and so on. Conclusions: The domestic external fixator developed and produced based on the characteristics of Chinese limb deformity disability. The domestic external fixator can be used to treat kinds of limb deformities with the advantages of practical

  6. Limb salvage with microvascular free fibula following primary bone sarcoma resection

    Directory of Open Access Journals (Sweden)

    Sahasrabudhe Parag

    2016-01-01

    Full Text Available Background: Extremity sarcomas are challenging to manage. Total eradication of tumour has to be balanced with restoration of limb function to prevent mortality and morbidity. Disease-free survival with maximum limb function is the ultimate goal in these patients. Materials and Methods: We present a series of ten cases of extremity malignancies, where limb salvage was attempted with microvascular free fibula for limb reconstruction from the period of 2008 to 2015. Results: Of the ten cases in the study, there were two females and eight males. There were nine patients with lower limb malignancies and one patient with upper limb malignancy. There were four patients with Ewing's sarcoma of femur, five patients with osteosarcoma of femur and one patient with chondrosarcoma of the humerus. The follow-up period ranged from 1.2 to 6.2 years with mean follow-up of 3.1 years. There were two deaths during follow-up, both were due to distant metastasis. The assessment of the function was done on the basis of Musculoskeletal Tumour Society functional score. Maximum score was 30 and minimum score was 24, the average score being 26. Of the eight surviving patients, three patients had full weightbearing, four patients had partial weightbearing at end of 2 years and one patient of upper limb reconstruction had complete upper limb function. None of the patients had to undergo limb amputation. Conclusion: Limb salvage with vascularised fibula graft offers good functional outcome along with good disease-free survival rates.

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

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2015-09-01

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

  8. Combustion, performance and emissions characteristics of a newly ...

    Indian Academy of Sciences (India)

    of a newly developed CRDI single cylinder diesel engine. AVINASH ... In case of unit injector and unit pump systems, fuel injection pressure depends on ... nozzle hole diameters were effective in reducing smoke and PM emissions. However ...

  9. Evaluation of bone microstructure in CRPS-affected upper limbs by HR-pQCT.

    Science.gov (United States)

    Mussawy, Haider; Schmidt, Tobias; Rolvien, Tim; Rüther, Wolfgang; Amling, Michael

    2017-01-01

    Complex regional pain syndrome (CRPS) is a major complication after trauma, surgery, and/or immobilization of an extremity. The disease often starts with clinical signs of local inflammation and develops into a prolonged phase that is characterized by trophic changes and local osteoporosis and sometimes results in functional impairment of the affected limb. While the pathophysiology of CRPS remains poorly understood, increased local bone resorption plays an undisputed pivotal role. The aim of this retrospective clinical study was to assess the bone microstructure in patients with CRPS. Patients with CRPS type I of the upper limb whose affected and unaffected distal radii were analyzed by high-resolution peripheral quantitative computed tomography (HR-pQCT) were identified retrospectively. The osteology laboratory data and dual-energy X-ray absorptiometry (DXA) images of the left femoral neck and lumbar spine, which were obtained on the same day as HR-pQCT, were extracted from the medical records. Five patients were identified. The CRPS-affected upper limbs had significantly lower trabecular numbers and higher trabecular thicknesses than the unaffected upper limbs. However, the trabecular bone volume to total bone volume and cortical thickness values of the affected and unaffected sides were similar. Trabecular thickness tended to increase with time since disease diagnosis. CRPS associated with significant alterations in the bone microstructure of the affected upper limb that may amplify as the duration of disease increases.

  10. The use of newly developed real-time PCR for the rapid identification of bacteria in culture-negative osteomyelitis.

    Science.gov (United States)

    Kobayashi, Naomi; Bauer, Thomas W; Sakai, Hiroshige; Togawa, Daisuke; Lieberman, Isador H; Fujishiro, Takaaki; Procop, Gary W

    2006-12-01

    We report a case of a culture-negative osteomyelitis in which our newly developed real-time polymerase chain reaction (PCR) could differentiate Staphylococcus aureus from Staphylococcus epidermidis. This is the first report that described the application of this novel assay to an orthopedics clinical sample. This assay may be useful for other clinical culture-negative cases in a combination with a broad-spectrum assay as a rapid microorganism identification method.

  11. Characteristics of the muscle activities of the elderly for various pressures in the pneumatic actuator of lower limb orthosis

    Science.gov (United States)

    Kim, Kyong; Yu, Chang-Ho; Kwon, Tae-Kyu; Hong, Chul-Un; Kim, Nam-Gyun

    2005-12-01

    There developed a lower limb orthosis with a pneumatic rubber actuator, which can assist and improve the muscular activities in the lower limb of the elderly. For this purpose, the characteristics of the lower limbs muscle activities for various pressures in the pneumatic actuator for the lower limb orthosis was investigated. To find out the characteristics of the muscle activities for various pneumatic pressures, it analyzed the flexing and extending movement of the knees, and measured the lower limbs muscular power. The subjects wearing the lower limbs orthosis were instructed to perform flexing and extending movement of the knees. The variation in the air pressure of the pneumatic actuator was varies from one kgf/cm2 to four kgf/cm2. The muscular power was measured by monitoring electromyogram using MP100 (BIOPAC Systems, Inc.) and detailed three-dimensional motions of the lower limbs were collected by APAS 3D Motion Analysis system. Through this study, it expected to find the most suitable air pressure for the improvement of the muscular power of the aged.

  12. Cut your losses: self-amputation of injured limbs increases survival.

    Science.gov (United States)

    Emberts, Zachary; Miller, Christine W; Kiehl, Daniel; St Mary, Colette M

    2017-01-01

    Autotomy, self-induced limb loss, is an extreme trait observed throughout the animal kingdom; lizards drop their tails, crickets release their legs, and crabs drop their claws. These repeated evolutionary origins suggest that autotomy is adaptive. Yet, we do not have a firm understanding of the selective pressures that promote and maintain this extreme trait. Although multiple adaptive hypotheses exist, research has generally focused on autotomy's adaptive value as a form of predator escape. However, autotomy could also be selected to reduce the cost of an injured limb, which we investigate here. Previously, this alternative hypothesis has been challenging to directly test because when an injury occurs on an autotomizable limb, that limb is almost always dropped (i.e., autotomy is behaviorally fixed within populations). Recently, however, we have identified a species, Narnia femorata (Insecta: Hemiptera: Coreidae), where some individuals autotomize limbs in response to injury, but some do not. This natural variation allowed us to investigate both the survival costs of retaining an injured limb and the benefits of autotomizing it. In this study, we find a positive association between autotomizing injured limbs and survival, thereby quantifying a new and likely widespread benefit of autotomy-reducing the cost of injury.

  13. Perceptions of the clinical competence of newly registered nurses in the North West province

    Directory of Open Access Journals (Sweden)

    M.R. Moeti

    2004-09-01

    Full Text Available The clinical competence of newly registered nurses relating to the care of individual Clients, depends on their ability to correlate theoretical knowledge learned in the classroom with practice and the development of clinical skills. Its foundation lies in the ability to identify and solve problems that emanate from critical thinking, analytical reasoning and reflective practice. It is clear that the quality of clinical exposure plays a leading role in the development of nursing professionals. Nursing skills alone cannot ensure quality care of clients without the application of theory. Facilitation of this theory to practice therefore remains an essential component of nursing education. This study was aimed at identifying areas of incompetence of newly registered nurses (1998- 2001 in the clinical area by determining the newly registered nurses1 and professional nurses1 perceptions of the competence of the newly registered nurses. A quantitative, non-experimental, descriptive survey was used to collect the data regarding the clinical competence of newly registered nurses (1998-2001.

  14. Atmospheric limb sounding with imaging FTS

    Science.gov (United States)

    Friedl-Vallon, Felix; Riese, Martin; Preusse, Peter; Oelhaf, Hermann; Fischer, Herbert

    Imaging Fourier transform spectrometers in the thermal infrared are a promising new class of sensors for atmospheric science. The availability of fast and sensitive large focal plane arrays with appropriate spectral coverage in the infrared region allows the conception and construction of innovative sensors for Nadir and Limb geometry. Instruments in Nadir geometry have already reached prototype status (e.g. Geostationary Imaging Fourier Transform Spectrometer / U. Wisconsin and NASA) or are in Phase A study (infrared sounding mission on Meteosat third generation / ESA and EUMETSAT). The first application of the new technical possibilities to atmospheric limb sounding from space, the Imaging Michelson Interferometer for Passive Atmospheric Sounding (IMIPAS), is currently studied by industry in the context of preparatory work for the next set of ESA earth explorers. The scientific focus of the instrument is on the processes controlling the composition of the mid/upper troposphere and lower stratosphere. The instrument concept of IMIPAS has been conceived at the research centres Karlsruhe and J¨lich. The development of a precursor instrument (GLORIA-AB) at these research institutions u started already in 2005. The instrument will be able to fly on board of various airborne platforms. First scientific missions are planned for the second half of the year 2009 on board the new German research aircraft HALO. This airborne sensor serves its own scientific purpose, but it also provides a test bed to learn about this new instrument class and its peculiarities and to learn to exploit and interpret the wealth of information provided by a limb imaging IR Fourier transform spectrometer. The presentation will discuss design considerations and challenges for GLORIA-AB and put them in the context of the planned satellite application. It will describe the solutions found, present first laboratory figures of merit for the prototype instrument and outline the new scientific

  15. In vivo locomotor strain in the hindlimb bones of alligator mississippiensis and iguana iguana: implications for the evolution of limb bone safety factor and non-sprawling limb posture

    Science.gov (United States)

    Blob; Biewener

    1999-05-01

    Limb postures of terrestrial tetrapods span a continuum from sprawling to fully upright; however, most experimental investigations of locomotor mechanics have focused on mammals and ground-dwelling birds that employ parasagittal limb kinematics, leaving much of the diversity of tetrapod locomotor mechanics unexplored. This study reports measurements of in vivo locomotor strain from the limb bones of lizard (Iguana iguana) and crocodilian (Alligator mississippiensis) species, animals from previously unsampled phylogenetic lineages with non-parasagittal limb posture and kinematics. Principal strain orientations and shear strain magnitudes indicate that the limb bones of these species experience considerable torsion during locomotion. This contrasts with patterns commonly observed in mammals, but matches predictions from kinematic observations of axial rotation in lizard and crocodilian limbs. Comparisons of locomotor load magnitudes with the mechanical properties of limb bones in Alligator and Iguana indicate that limb bone safety factors in bending for these species range from 5.5 to 10.8, as much as twice as high as safety factors previously calculated for mammals and birds. Limb bone safety factors in shear (3.9-5.4) for Alligator and Iguana are also moderately higher than safety factors to yield in bending for birds and mammals. Finally, correlations between limb posture and strain magnitudes in Alligator show that at some recording locations limb bone strains can increase during upright locomotion, in contrast to expectations based on size-correlated changes in posture among mammals that limb bone strains should decrease with the use of an upright posture. These data suggest that, in some lineages, strain magnitudes may not have been maintained at constant levels through the evolution of a non-sprawling posture unless the postural change was accompanied by a shift to parasagittal kinematics or by an evolutionary decrease in body size.

  16. Mutations in WNT7A cause a range of limb malformations, including Fuhrmann syndrome and Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome.

    Science.gov (United States)

    Woods, C G; Stricker, S; Seemann, P; Stern, R; Cox, J; Sherridan, E; Roberts, E; Springell, K; Scott, S; Karbani, G; Sharif, S M; Toomes, C; Bond, J; Kumar, D; Al-Gazali, L; Mundlos, S

    2006-08-01

    Fuhrmann syndrome and the Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome are considered to be distinct limb-malformation disorders characterized by various degrees of limb aplasia/hypoplasia and joint dysplasia in humans. In families with these syndromes, we found homozygous missense mutations in the dorsoventral-patterning gene WNT7A and confirmed their functional significance in retroviral-mediated transfection of chicken mesenchyme cell cultures and developing limbs. The results suggest that a partial loss of WNT7A function causes Fuhrmann syndrome (and a phenotype similar to mouse Wnt7a knockout), whereas the more-severe limb truncation phenotypes observed in Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome result from null mutations (and cause a phenotype similar to mouse Shh knockout). These findings illustrate the specific and conserved importance of WNT7A in multiple aspects of vertebrate limb development.

  17. Growth characteristics of fibroblasts isolated from the trunk and distal aspect of the limb of horses and ponies.

    Science.gov (United States)

    Miller, C B; Wilson, D A; Keegan, K G; Kreeger, J M; Adelstein, E H; Ganjam, V K

    2000-01-01

    To determine if there is a difference in in vitro growth of fibroblasts isolated from the trunk and distal aspect of the limb of horses and ponies. To determine the effects of a corticosteroid and monokine on in vitro growth of fibroblasts isolated from the trunk and distal aspect of the limb of horses and ponies. Growth of fibroblasts from tissues harvested from the trunk and limb were compared from horse and pony samples grown in control media and control media with triamcinolone or monokine added. Dermal and subcutaneous tissue from 22 horses and 17 ponies of various ages and breeds. Fibroblast growth was assessed by tritiated thymidine uptake using standard cell culture techniques. The effect of a monokine or triamcinolone plus control media were compared with control media for fibroblast growth. Fibroblast growth from tissues isolated from the horse limb was significantly less than growth from the horse trunk and the limb and trunk of ponies. Monokine was more effective than triamcinolone in suppressing fibroblast growth from tissues isolated from the trunk and limb in both horses and ponies. There are growth differences in fibroblasts isolated from the limb of horses compared with those isolated from the trunk and from the limb and trunk of ponies. The difference in fibroblast growth from tissues isolated from the trunk and limb of horses and ponies may provide evidence for the difference reported in the healing characteristics of limb wounds in horses and ponies. Influencing fibroblast growth may provide a key to controlling the development of exuberant granulation tissue in horses and ponies.

  18. [Epidemiological analysis of selected congenital limb malformations in Hengyang].

    Science.gov (United States)

    Li, Na-Na; Yuan, Yu-Mei; Liu, Yong; Dai, Li; Deng, Chang-Fei; Nie, Xing-Hui; Zheng, Xiang-Chi; Hu, Yan-Zhen; Liu, Yun-Rong

    2013-07-01

    To describe the epidemiological characteristics of selected congenital limb malformations (CLM) in newborns of Hengyang. During the period of 2008-2010, cluster sampling survey was adopted to investigate the congenital limb malformations of neonates born to women resident in Hengyang, including Nanyue District, Zhuhui District, Changning City and Hengshan County. Each newborn was examined for the screening of CLM after birth. Limb malformations were grouped into the isolated (ILM) and the syndromic (SLM) form, depending on associated malformations of the affected. Prevalence rates, CLM spectrum and clinical manifestations were analyzed. A total of 170 CLM cases were identified among 52,307 newborns during the study period, resulting overall rate of 32.50/10(4). The rates for isolated and syndromic CLM were 28.29 and 4.21 per 10 000 births respectively. The rates for polydactyly, congenital talipes equinovarus, syndactyly and limb reduction defects were 13.00/10(4), 9.56/10(4), 5.16/10(4) and 3.63/10(4), respectively. No significant difference in rates of overall CLM or specified CLM was observed across urban-rural, gender and maternal age groups. Of the cases affected by polydactyly, syndactyly and limb reduction defects, malformation involved upper limbs, lower limbs and the both accounted for 68.14%, 14.16% and 17.70%. Preterm birth, low birth-weight, still birth and neonatal death were observed more frequently in syndromic cases than in isolated patients. The high CLM prevalence rate and fatality rate in Hengyang suggest that effective measures should be taken to prevent malformations and to improve survival of the affected.

  19. [Limb lengthening in dwarfism].

    Science.gov (United States)

    Correll, J; Held, P

    2000-09-01

    Limb lengthening in dwarfism has become a standardised procedure with a good prognosis. In most cases external fixation is used. Gain of leg length up to 15 cm and more is possible in the lower leg and the femur and 8.5 cm in the humerus. Limb lengthening is useful in many cases of dwarfism due to skeletal dysplasia. There are a number of risks and possible complications involved and the procedure also requires considerable time. We report the results of 48 patients with dwarfism operated on in the Orthopädische Kinderklinik Aschau (Orthopaedic Hospital for Children). It must not be recommended as a normal tool in handling the problems of dwarfism, but it makes sense in some cases of dwarfism. We describe and discuss the prerequisites for the operative treatment.

  20. Thoracic limb morphology of the red panda (Ailurus fulgens evidenced by osteology and radiography

    Directory of Open Access Journals (Sweden)

    Modesta Makungu

    2015-07-01

    Full Text Available The red panda (Ailurus fulgens is distributed primarily in the Himalayas and southern China. It is classified as a vulnerable species by the International Union for Conservation of Nature. The aim of this study was to describe the normal osteology and radiographic anatomy of the thoracic limb of the red panda. Radiography of the right thoracic limb was performed in seven captive adult red pandas. Radiographic findings were correlated with bone specimens from three adult animals. The scapula was wide craniocaudally and presented with a large area for the origin of the teres major muscle. The square-shaped major tubercle did not extend proximal to the head of the humerus. The medial epicondyle was prominent. A supracondylar foramen was present. The radial tuberosity and sesamoid bone for the abductor digiti I longus were prominent. The accessory carpal bone was directed palmarolaterally. Metacarpal bones were widely spread. The thoracic limb morphology of the red panda evidenced by osteology and radiography indicated flexibility of the thoracic limb joints and well-developed flexor and supinator muscles, which are important in arboreal quadrupedal locomotion. Knowledge gained during this study may prove useful in identifying skeletal material or remains and diagnosing musculoskeletal diseases and injuries of the thoracic limb.

  1. Thoracic limb morphology of the red panda (Ailurus fulgens) evidenced by osteology and radiography.

    Science.gov (United States)

    Makungu, Modesta; Groenewald, Hermanus B; du Plessis, Wencke M; Barrows, Michelle; Koeppel, Katja N

    2015-07-15

    The red panda (Ailurus fulgens) is distributed primarily in the Himalayas and southern China. It is classified as a vulnerable species by the International Union for Conservation of Nature. The aim of this study was to describe the normal osteology and radiographic anatomy of the thoracic limb of the red panda. Radiography of the right thoracic limb was performed in seven captive adult red pandas. Radiographic findings were correlated with bone specimens from three adult animals. The scapula was wide craniocaudally and presented with a large area for the origin of the teres major muscle. The square-shaped major tubercle did not extend proximal to the head of the humerus. The medial epicondyle was prominent. A supracondylar foramen was present. The radial tuberosity and sesamoid bone for the abductor digiti I longus were prominent. The accessory carpal bone was directed palmarolaterally. Metacarpal bones were widely spread. The thoracic limb morphology of the red panda evidenced by osteology and radiography indicated flexibility of the thoracic limb joints and well-developed flexor and supinator muscles, which are important in arboreal quadrupedal locomotion. Knowledge gained during this study may prove useful in identifying skeletal material or remains and diagnosing musculoskeletal diseases and injuries of the thoracic limb.

  2. Measurement equivalence of the newly developed Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55).

    Science.gov (United States)

    Ferro, Mark A; Goodwin, Shane W; Sabaz, Mark; Speechley, Kathy N

    2016-03-01

    The aim of this study was to examine measurement equivalence of the newly developed Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) across age, sex, and time in a representative sample of children with newly diagnosed epilepsy. Data come from 373 children enrolled in the Health-related Quality of Life in Children with Epilepsy Study (HERQULES), a multisite prospective cohort study. Measurement equivalence was examined using a multiple-group confirmatory factor analysis framework, whereby increasingly stringent parameter constraints are imposed on the model. Comparison groups were stratified based on age (4-7 years vs. 8-12 years), sex (male vs. female), and time (measurement of health-related quality of life at diagnosis vs. 24 months later). The QOLCE-55 demonstrated measurement equivalence at the level of strict invariance for each model tested--age: χ(2) (3,123) = 4,097.3, p QOLCE-55 are perceived similarly among groups stratified by age, sex, and time and provide further evidence supporting the validity of the scale in children with epilepsy. Health professionals and researchers should be confident that group comparisons made using the QOLCE-55 are unbiased and that any group differences detected are meaningful; that is, not related to differences in the interpretation of items by informants. Future research replicating these findings is encouraged. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  3. Practicing on Newly Dead

    Directory of Open Access Journals (Sweden)

    Jewel Abraham

    2015-07-01

    Full Text Available A newly dead cadaver simulation is practiced on the physical remains of the dead before the onset of rigor mortis. This technique has potential benefits for providing real-life in-situ experience for novice providers in health care practices. Evolving ethical views in health care brings into question some of the ethical aspects associated with newly dead cadaver simulation in terms of justification for practice, autonomy, consent, and the need of disclosure. A clear statement of policies and procedures on newly dead cadaver simulation has yet to be implemented. Although there are benefits and disadvantages to an in-situ cadaver simulation, such practices should not be carried out in secrecy as there is no compelling evidence that suggests such training as imperative. Secrecy in these practices is a violation of honor code of nursing ethics. As health care providers, practitioners are obliged to be ethically honest and trustworthy to their patients. The author explores the ethical aspects of using newly dead cadaver simulation in training novice nursing providers to gain competency in various lifesaving skills, which otherwise cannot be practiced on a living individual. The author explores multiple views on cadaver simulation in relation to ethical theories and practices such as consent and disclosure to family.

  4. Development of an E-Health App for Lower Limb Postoperative Rehabilitation Based on Plantar Pressure Analysis

    Directory of Open Access Journals (Sweden)

    Xiao Cheng

    2018-05-01

    Full Text Available The traditional postoperative rehabilitation training mode of lower limbs is mostly confined to hospitals or nursing sites. With the increase of postoperative patients, the current shortage of medical resources is obviously not satisfactory, and the medical costs are high, thus it is difficult to apply widely. A new mobile phone application (app based on plantar pressure analysis is developed to fulfill the requirements of remote postoperative rehabilitation. It is designed, implemented, tested, and used for pilot experiment in conjunction with the system design methodology of the waterfall model. Preliminary testing and a pilot experiment showed that the app has realized basic functions and can achieve patient rehabilitation out of hospitals. The development of the app can shorten the hospitalization time of patients, reduce medical costs, and make up for the current shortage of medical resources. In the future, more experiments will be done to verify the effectiveness of the app.

  5. Newly qualified teachers´ possibilities to get foothold in a lifelong career course

    DEFF Research Database (Denmark)

    Krøjgaard, Frede; Frederiksen, Lisbeth Angela Lunde

    Keyword: Induction program, newly qualified teachers, NQT, retention, professional development In Contrary to many other countries in Europe Denmark does not have any kind of national program regarding teacher induction program (TIP) or support in general to newly qualified teachers what so ever...

  6. Hind limb malformations in free-living northern leopard frogs (Rana pipiens) from Maine, Minnesota, and Vermont suggest multiple etiologies

    Science.gov (United States)

    Meteyer, C.U.; Loeffler, I.K.; Fallon, J.F.; Converse, K.A.; Green, E.; Helgen, J.C.; Kersten, S.; Levey, R.; Eaton-Poole, L.; Burkhart, J.G.

    2000-01-01

    Background Reports of malformed frogs have increased throughout the North American continent in recent years. Most of the observed malformations have involved the hind limbs. The goal of this study was to accurately characterize the hind limb malformations in wild frogs as an important step toward understanding the possible etiologies. Methods During 1997 and 1998, 182 recently metamorphosed northern leopard frogs (Rana pipiens) were collected from Minnesota, Vermont, and Maine. Malformed hind limbs were present in 157 (86%) of these frogs, which underwent necropsy and radiographic evaluation at the National Wildlife Health Center. These malformations are described in detail and classified into four major categories: (1) no limb (amelia); (2) multiple limbs or limb elements (polymelia, polydactyly, polyphalangy); (3) reduced limb segments or elements (phocomelia, ectromelia, ectrodactyly, and brachydactyly; and (4) distally complete but malformed limb (bone rotations, bridging, skin webbing, and micromelia). Results Amelia and reduced segments and/or elements were the most common finding. Frogs with bilateral hind limb malformations were not common, and in only eight of these 22 frogs were the malformations symmetrical. Malformations of a given type tended to occur in frogs collected from the same site, but the types of malformations varied widely among all three states, and between study sites within Minnesota. Conclusions Clustering of malformation type suggests that developmental events may produce a variety of phenotypes depending on the timing, sequence, and severity of the environmental insult. Hind limb malformations in free-living frogs transcend current mechanistic explanations of tetrapod limb development.

  7. The practical skills of newly qualified nurses.

    Science.gov (United States)

    Danbjørg, Dorthe Boe; Birkelund, Regner

    2011-02-01

    This paper reports the findings from a study of newly qualified nurses and which subjects the nurses regarded as the most important in order to be able to live up to the requirements of clinical practice, and how they experience their potential for developing practical and moral skills, after the decrease in practical training. A qualitative approach guided the research process and the analysis of the data. The data was collected by participant observation and qualitative interviews with four nurses as informants. The conclusions made in this study are based on the statements and the observations of the newly qualified nurses. Our findings are discussed in relation to the Aristotelian concept and other relevant literature. The main message is that the newly qualified nurses did not feel equipped when they finished their training. This could be interpreted as a direct consequence of the decrease in practical training. Our study also underlines that the way nursing theory is perceived and taught is problematic. The interviews revealed that the nurses think that nursing theories should be applied directly in practice. This misunderstanding is probably also applicable to the teachers of the theories. Copyright © 2010 Elsevier Ltd. All rights reserved.

  8. Comparison of newly developed anti-bone morphogenetic protein 4 llama-derived antibodies with commercially available BMP4 inhibitors.

    Science.gov (United States)

    Calpe, Silvia; Correia, Ana C P; Sancho-Serra, Maria Del Carmen; Krishnadath, Kausilia K

    2016-01-01

    Due to improved understanding of the role of bone morphogenetic protein 4 (BMP4) in an increasing number of diseases, the development of selective inhibitors of BMP4 is an attractive therapeutic option. The currently available BMP4 inhibitors are not suitable as therapeutics because of their low specificity and low effectiveness. Here, we compared newly generated anti-BMP4 llama-derived antibodies (VHHs) with 3 different types of commercially available BMP4 inhibitors, natural antagonists, small molecule BMPR inhibitors and conventional anti-BMP4 monoclonal antibodies. We found that the anti-BMP4 VHHs were as effective as the natural antagonist or small molecule inhibitors, but had higher specificity. We also showed that commercial anti-BMP4 antibodies were inferior in terms of both specificity and effectiveness. These findings might result from the fact that the VHHs C4C4 and C8C8 target a small region within the BMPR1 epitope of BMP4, whereas the commercial antibodies target other areas of the BMP4 molecule. Our results show that the newly developed anti-BMP4 VHHs are promising antibodies with better specificity and effectivity for inhibition of BMP4, making them an attractive tool for research and for therapeutic applications.

  9. Defining the role of sensation, strength, and prehension for upper limb function in cervical spinal cord injury.

    Science.gov (United States)

    Kalsi-Ryan, Sukhvinder; Beaton, Dorcas; Curt, Armin; Duff, Susan; Jiang, Depeng; Popovic, Milos R; Rudhe, Claudia; Fehlings, Michael G; Verrier, Mary C

    2014-01-01

    Upper limb function plays a significant role in enhancing independence for individuals with tetraplegia. However, there is limited knowledge about the specific input of sensorimotor deficits on upper limb function. Thus the theoretical framework designed to develop the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) was used as a hypothetical model to analyze the impact of impairment on function. To define the association of impairment (sensation, strength, and prehension measured by the GRASSP) to upper limb function as defined by functional measures (Capabilities of Upper Extremity Questionnaire, Spinal Cord Independence Measure). A hypothetical model representing relationships by applying structural equation modeling was used to estimate the effect of the impairment domains in GRASSP on upper limb function. Data collected on 72 chronic individuals with tetraplegia was used to test the hypothetical model. Structural equation modeling confirmed strong associations between sensation, strength, and prehension with upper limb function, and determined 72% of the variance in "sensorimotor upper limb function" was explained by the model. Statistics of fit showed the data did fit the hypothesized model. Sensation and strength influence upper limb function directly and indirectly with prehension as the mediator. The GRASSP is a sensitive diagnostic tool in distinguishing the relative contribution of strength, sensation and prehension to function. Thus, the impact of interventions on specific domains of impairment and related contribution on clinical recovery of the upper limb can be detailed to optimize rehabilitation programs.

  10. A Lower Limb Rehabilitation Robot in Sitting Position with a Review of Training Activities.

    Science.gov (United States)

    Eiammanussakul, Trinnachoke; Sangveraphunsiri, Viboon

    2018-01-01

    Robots for stroke rehabilitation at the lower limbs in sitting/lying position have been developed extensively. Some of them have been applied in clinics and shown the potential of the recovery of poststroke patients who suffer from hemiparesis. These robots were developed to provide training at different joints of lower limbs with various activities and modalities. This article reviews the training activities that were realized by rehabilitation robots in literature, in order to offer insights for developing a novel robot suitable for stroke rehabilitation. The control system of the lower limb rehabilitation robot in sitting position that was introduced in the previous work is discussed in detail to demonstrate the behavior of the robot while training a subject. The nonlinear impedance control law, based on active assistive control strategy, is able to define the response of the robot with more specifications while the passivity property and the robustness of the system is verified. A preliminary experiment is conducted on a healthy subject to show that the robot is able to perform active assistive exercises with various training activities and assist the subject to complete the training with desired level of assistance.

  11. A Lower Limb Rehabilitation Robot in Sitting Position with a Review of Training Activities

    Directory of Open Access Journals (Sweden)

    Trinnachoke Eiammanussakul

    2018-01-01

    Full Text Available Robots for stroke rehabilitation at the lower limbs in sitting/lying position have been developed extensively. Some of them have been applied in clinics and shown the potential of the recovery of poststroke patients who suffer from hemiparesis. These robots were developed to provide training at different joints of lower limbs with various activities and modalities. This article reviews the training activities that were realized by rehabilitation robots in literature, in order to offer insights for developing a novel robot suitable for stroke rehabilitation. The control system of the lower limb rehabilitation robot in sitting position that was introduced in the previous work is discussed in detail to demonstrate the behavior of the robot while training a subject. The nonlinear impedance control law, based on active assistive control strategy, is able to define the response of the robot with more specifications while the passivity property and the robustness of the system is verified. A preliminary experiment is conducted on a healthy subject to show that the robot is able to perform active assistive exercises with various training activities and assist the subject to complete the training with desired level of assistance.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-02-01

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

  13. Multi-body simulation of a canine hind limb: model development, experimental validation and calculation of ground reaction forces

    Directory of Open Access Journals (Sweden)

    Wefstaedt Patrick

    2009-11-01

    Full Text Available Abstract Background Among other causes the long-term result of hip prostheses in dogs is determined by aseptic loosening. A prevention of prosthesis complications can be achieved by an optimization of the tribological system which finally results in improved implant duration. In this context a computerized model for the calculation of hip joint loadings during different motions would be of benefit. In a first step in the development of such an inverse dynamic multi-body simulation (MBS- model we here present the setup of a canine hind limb model applicable for the calculation of ground reaction forces. Methods The anatomical geometries of the MBS-model have been established using computer tomography- (CT- and magnetic resonance imaging- (MRI- data. The CT-data were collected from the pelvis, femora, tibiae and pads of a mixed-breed adult dog. Geometric information about 22 muscles of the pelvic extremity of 4 mixed-breed adult dogs was determined using MRI. Kinematic and kinetic data obtained by motion analysis of a clinically healthy dog during a gait cycle (1 m/s on an instrumented treadmill were used to drive the model in the multi-body simulation. Results and Discussion As a result the vertical ground reaction forces (z-direction calculated by the MBS-system show a maximum deviation of 1.75%BW for the left and 4.65%BW for the right hind limb from the treadmill measurements. The calculated peak ground reaction forces in z- and y-direction were found to be comparable to the treadmill measurements, whereas the curve characteristics of the forces in y-direction were not in complete alignment. Conclusion In conclusion, it could be demonstrated that the developed MBS-model is suitable for simulating ground reaction forces of dogs during walking. In forthcoming investigations the model will be developed further for the calculation of forces and moments acting on the hip joint during different movements, which can be of help in context with the in

  14. Modular control of limb movements during human locomotion

    NARCIS (Netherlands)

    Ivanenko, Yuri P; Cappellini, Germana; Dominici, Nadia; Poppele, Richard E; Lacquaniti, Francesco

    2007-01-01

    The idea that the CNS may control complex interactions by modular decomposition has received considerable attention. We explored this idea for human locomotion by examining limb kinematics. The coordination of limb segments during human locomotion has been shown to follow a planar law for walking at

  15. Development of a framework for identification of political environmental issues faced by multinational hotel chains in newly industrialized countries in Asia

    OpenAIRE

    Kim, Chol Yong

    1992-01-01

    The primary/objective of this study was to develop a framework for identification of political environmental issues faced by multinational hotel chains in newly industrialized countries in Asia. To accomplish the objective, key factors having an impact upon these hotel chains were identified using the Delphi Technique.

  16. In situ saphenous vein bypass for limb salvage.

    Science.gov (United States)

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

    1993-02-01

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

  17. Body image and self-esteem in lower-limb amputees.

    Science.gov (United States)

    Holzer, Lukas A; Sevelda, Florian; Fraberger, Georg; Bluder, Olivia; Kickinger, Wolfgang; Holzer, Gerold

    2014-01-01

    Limb amputation is often an inevitable procedure in the advanced condition of various diseases and poses a dramatic impact on a patient's life. The aim of the present study is to analyze the impact of lower-limb amputations on aesthetic factors such as body image and self-esteem as well as quality of life (QoL). 298 patients (149 uni- or bilateral lower-limb amputees and 149 controls) were included in this cross-sectional study in three centers. Demographic data was collected and patients received a 118-item questionnaire including the Multidimensional Body-Self Relations Questionnaire (MBSRQ), the Rosenberg Self-esteem (RSE) scale and the SF-36 Health Survey (QoL). ANOVA and student's t-test were used for statistical analysis. Unilateral lower-limb amputees showed a significant lower MBSRQ score of 3.07±0.54 compared with 3.41±0.34 in controls (pbody image and QoL. Self-esteem seems to be an independent aspect, which is not affected by lower-limb amputation. However, self-esteem is influenced significantly by phantom pain sensation.

  18. Effect of limb regeneration on size increase at molt of the shore crabs Hemigrapsus oregonensis and Pachygrapsus crassipes.

    Science.gov (United States)

    Kuris, A M; Mager, M

    1975-09-01

    Size increase at molt is reduced following multiple limb regeneration in the shore crabs, Hemigrapsus oregonensis and Pachygrapsus crassipes. Limb loss per se does not influence postmolt size. Effect of increasing number of regenerating limbs is additive. Postmolt size is programmed early in the premolt period of the preceding instar and is probably not readily influenced by water uptake mechanics at ecdysis. A simple model for growth, molting, and regeneration in heavily calcified Crustacea is developed from the viewpoint of adaptive strategies and energetic considerations.

  19. A new model for the determination of limb segment mass in children.

    Science.gov (United States)

    Kuemmerle-Deschner, J B; Hansmann, S; Rapp, H; Dannecker, G E

    2007-04-01

    The knowledge of limb segment masses is critical for the calculation of joint torques. Several methods for segment mass estimation have been described in the literature. They are either inaccurate or not applicable to the limb segments of children. Therefore, we developed a new cylinder brick model (CBM) to estimate segment mass in children. The aim of this study was to compare CBM and a model based on a polynomial regression equation (PRE) to volume measurement obtained by the water displacement method (WDM). We examined forearms, hands, lower legs, and feet of 121 children using CBM, PRE, and WDM. The differences between CBM and WDM or PRE and WDM were calculated and compared using a Bland-Altman plot of differences. Absolute limb segment mass measured by WDM ranged from 0.16+/-0.04 kg for hands in girls 5-6 years old, up to 2.72+/-1.03 kg for legs in girls 11-12 years old. The differences of normalised segment masses ranged from 0.0002+/-0.0021 to 0.0011+/-0.0036 for CBM-WDM and from 0.0023+/-0.0041 to 0.0127+/-0.036 for PRE-WDM (values are mean+/-2 S.D.). The CBM showed better agreement with WDM than PRE for all limb segments in girls and boys. CBM is accurate and superior to PRE for the estimation of individual limb segment mass of children. Therefore, CBM is a practical and useful tool for the analysis of kinetic parameters and the calculation of resulting forces to assess joint functionality in children.

  20. Differentiation of cartilaginous anlage in entire embryonic mouse limbs cultured in a rotating bioreactor.

    Science.gov (United States)

    Duke, P.; Oakley, C.; Montufar-Solis, D.

    The embryonic mammalian limb is sensitive both in vivo and in vitro to changes in gravitational force. Hypergravity of centrifugation and microgravity of space decreased size of elements due to precocious or delayed chondrogenesis respectively. In recapitulating spaceflight experiments, premetatarsals were cultured in suspension in a low stress, low sheer rotating bioreactor, and found to be shorter than those cultured in standard culture dishes, and cartilage development was delayed. This study only measured length of the metatarsals, and did not account for possible changes in width and/or in form of the skeletal elements. Shorter cartilage elements in limbbuds cultured in the bioreactor may be due to the ability of the system to reproduce a more in vivo 3D shape than traditional organ cultures. Tissues subjected to traditional organ cultures become flattened by their own weight, attachment to the filter, and restrictions imposed by nutrient diffusion. The purpose of the current experiment was to determine if entire limb buds could be successfully cultured in the bioreactor, and to compare the effects on 3D shape with that of culturing in a culture dish system. Fore and hind limbs from E11-E13 ICR mouse embryos were placed either in the bioreactor, in Trowell culture, or fixed as controls. Limbbuds were cultured for six days, fixed, and processed either as whole mounts or embedded for histology. Qualitative analysis revealed that the Trowell culture specimens were flattened, while bioreactor culture specimens had a more in vivo-like 3D limb shape. Sections of limbbuds from both types of cultures had excellent cartilage differentiation, with apparently more cell maturation, and hypertrophy in the specimens cultured in the bioreactor. Morphometric quantitation of the cartilaginous elements for comparisons of the two culture systems was complicated due to some limb buds fusing together during culture. This problem was especially noticeable in the younger limbs, and

  1. Body image and self-esteem in lower-limb amputees.

    Directory of Open Access Journals (Sweden)

    Lukas A Holzer

    Full Text Available BACKGROUND: Limb amputation is often an inevitable procedure in the advanced condition of various diseases and poses a dramatic impact on a patient's life. The aim of the present study is to analyze the impact of lower-limb amputations on aesthetic factors such as body image and self-esteem as well as quality of life (QoL. METHODS: 298 patients (149 uni- or bilateral lower-limb amputees and 149 controls were included in this cross-sectional study in three centers. Demographic data was collected and patients received a 118-item questionnaire including the Multidimensional Body-Self Relations Questionnaire (MBSRQ, the Rosenberg Self-esteem (RSE scale and the SF-36 Health Survey (QoL. ANOVA and student's t-test were used for statistical analysis. RESULTS: Unilateral lower-limb amputees showed a significant lower MBSRQ score of 3.07±0.54 compared with 3.41±0.34 in controls (p<0.001 and a lower score in the RSE compared to controls (21.63±4.72 vs. 21.46±5.86. However, differences were not statistically significant (p = 0.36. Patients with phantom pain sensation had a significantly reduced RSE (p = 0.01. The SF-36 health survey was significantly lower in patients with lower-limb amputation compared to controls (42.17±14.47 vs. 64.05±12.39 (p<0.001. CONCLUSION: This study showed that lower-limb amputations significantly influence patients' body image and QoL. Self-esteem seems to be an independent aspect, which is not affected by lower-limb amputation. However, self-esteem is influenced significantly by phantom pain sensation.

  2. UPPER LIMB FUNCTIONAL ASSESSMENT USING HAPTIC INTERFACE

    Directory of Open Access Journals (Sweden)

    Aleš Bardorfer

    2004-12-01

    Full Text Available A new method for the assessment of the upper limb (UL functional state, using a haptic interface is presented. A haptic interface is used as a measuring device, capable of providing objective, repeatable and quantitative data of the UL motion. A patient is presented with a virtual environment, both graphically via a computer screen and haptically via the Phantom Premium 1.5 haptic interface. The setup allows the patient to explore and feel the virtual environment with three of his/her senses; sight, hearing, and most important, touch. Specially designed virtual environments are used to assess the patient’s UL movement capabilities. The tests range from tracking tasks – to assess the accuracy of movement – tracking tasks with added disturbances in a form of random forces – to assess the patient’s control abilities, a labyrinth test – to assess both speed and accuracy, to the last test for measuring the maximal force capacity of the UL.A new method for the assessment of the upper limb (UL functional state, using a haptic interface is presented. A haptic interface is used as a measuring device, capable of providing objective, repeatable and quantitative data of the UL motion. A patient is presented with a virtual environment, both graphically via a computer screen and haptically via the Phantom Premium 1.5 haptic interface. The setup allows the patient to explore and feel the virtual environment with three of his/her senses; sight, hearing, and most important, touch. Specially designed virtual environments are used to assess the patient’s UL movement capabilities. The tests range from tracking tasks–to assess the accuracy of movement-tracking tasks with added disturbances in a form of random forces-to assess the patient’s control abilities, a labyrinth test-to assess both speed and accuracy, to the last test for measuring the maximal force capacity of the UL.A comprehensive study, using the developed measurement setup within the

  3. Network based transcription factor analysis of regenerating axolotl limbs

    Directory of Open Access Journals (Sweden)

    Cameron Jo Ann

    2011-03-01

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

  4. Work-related upper limb “overuse” syndromes

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis

    2016-01-01

    A previous review of historical descriptions and theories about the character and pathogenesis of writer’s cramp and other comparable chronic upper limb “overuse” work-related pain syndromes has indicated that somatic dysfunctions explain symptoms and findings. The first case studies and case...... series suggested that these conditions were caused by pathology affecting the peripheral nerves. The general perception gradually changed, however, with symptoms becoming attributed to central nervous system dysfunction and ultimately to represent a psychiatric condition. Work-related upper limb...... disorders remain diagnostically challenging to clinicians and there is still a tendency to see many patients’ pain as a psychiatric problem when a standard physical examination does not explain the condition. This article describes reports of writer’s cramp and comparable occupational upper limb “overuse...

  5. Upper limb treatment technigues for stroke survivors

    Directory of Open Access Journals (Sweden)

    Martyna Kornet

    2017-03-01

    It was considered that the most important elements of the treatment used in the rehabilitation of the paretic upper limb are: exercise matching the anti-spasm pattern, maintaining appropriate position for exercise that provide an approximation of the shoulder joint and the use of cross-facilitation. The study indicates that the treatment of a post stroke upper limb should be based on the: physiotherapy, kinesiotherapy and specific positioning - all of them corresponding to a given stage of the disease. The work also presents the most frequently used methods, especially highlighting: the Prorioceptive Neuromuscular Facilitation (PNF, Bobath, Brunnstrom, CIMT and OIT. It was also shown that in order to enhance the effects of a post-stroke upper limb rehabilitation, it should be extended by modern methods such as Mirror Therapy, Virtual Reality or Robot-assisted Therapy.

  6. Retinoic acid-independent expression of Meis2 during autopod patterning in the developing bat and mouse limb.

    Science.gov (United States)

    Mason, Mandy K; Hockman, Dorit; Curry, Lyle; Cunningham, Thomas J; Duester, Gregg; Logan, Malcolm; Jacobs, David S; Illing, Nicola

    2015-01-01

    The bat has strikingly divergent forelimbs (long digits supporting wing membranes) and hindlimbs (short, typically free digits) due to the distinct requirements of both aerial and terrestrial locomotion. During embryonic development, the morphology of the bat forelimb deviates dramatically from the mouse and chick, offering an alternative paradigm for identifying genes that play an important role in limb patterning. Using transcriptome analysis of developing Natal long-fingered bat (Miniopterus natalensis) fore- and hindlimbs, we demonstrate that the transcription factor Meis2 has a significantly higher expression in bat forelimb autopods compared to hindlimbs. Validation by reverse transcriptase and quantitative polymerase chain reaction (RT-qPCR) and whole mount in situ hybridisation shows that Meis2, conventionally known as a marker of the early proximal limb bud, is upregulated in the bat forelimb autopod from CS16. Meis2 expression is localised to the expanding interdigital webbing and the membranes linking the wing to the hindlimb and tail. In mice, Meis2 is also expressed in the interdigital region prior to tissue regression. This interdigital Meis2 expression is not activated by retinoic acid (RA) signalling as it is present in the retained interdigital tissue of Rdh10 (trex/trex) mice, which lack RA. Additionally, genes encoding RA-synthesising enzymes, Rdh10 and Aldh1a2, and the RA nuclear receptor Rarβ are robustly expressed in bat fore- and hindlimb interdigital tissues indicating that the mechanism that retains interdigital tissue in bats also occurs independently of RA signalling. Mammalian interdigital Meis2 expression, and upregulation in the interdigital webbing of bat wings, suggests an important role for Meis2 in autopod development. Interdigital Meis2 expression is RA-independent, and retention of interdigital webbing in bat wings is not due to the suppression of RA-induced cell death. Rather, RA signalling may play a role in the thinning

  7. A Force-Feedback Exoskeleton for Upper-Limb Rehabilitation in Virtual Reality

    Directory of Open Access Journals (Sweden)

    Antonio Frisoli

    2009-01-01

    Full Text Available This paper presents the design and the clinical validation of an upper-limb force-feedback exoskeleton, the L-EXOS, for robotic-assisted rehabilitation in virtual reality (VR. The L-EXOS is a five degrees of freedom exoskeleton with a wearable structure and anthropomorphic workspace that can cover the full range of motion of human arm. A specific VR application focused on the reaching task was developed and evaluated on a group of eight post-stroke patients, to assess the efficacy of the system for the rehabilitation of upper limb. The evaluation showed a significant reduction of the performance error in the reaching task (paired t-test, p < 0.02

  8. Limb anomalies in DiGeorge and CHARGE syndromes

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-01-20

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

  9. Rethinking Functional Outcome Measures: The Development of a Novel Upper Limb Token Transfer Test to Assess Basal Ganglia Dysfunction

    Directory of Open Access Journals (Sweden)

    Susanne P. Clinch

    2018-05-01

    Full Text Available The basal ganglia are implicated in a wide range of motor, cognitive and behavioral activities required for normal function. This region is predominantly affected in Huntington's disease (HD, meaning that functional ability progressively worsens. However, functional outcome measures for HD, particularly those for the upper limb, are limited meaning there is an imperative for well-defined, quantitative measures. Here we describe the development and evaluation of the Moneybox test (MBT. This novel, functional upper limb assessment was developed in accordance with translational neuroscience and physiological principles for people with a broad disease manifestation, such as HD. Participants with HD (n = 64 and healthy controls (n = 21 performed the MBT, which required subjects to transfer tokens into a container in order of size (Baseline Transfer, value (Complex Transfer with and without reciting the alphabet (Dual Transfer. Disease specific measures of motor, cognition, behavior, and function were collected. HD patients were grouped into disease stage, from which, discriminative and convergent validity was assessed using Analysis of Variance and Pearson's correlation respectively. Manifest HD participants were slower than pre-manifest and control participants, and achieved significantly lower MBT total scores. Performance in the Complex Transfer and Dual Transfer tasks were significantly different between pre-manifest and stage 1 HD. All MBT performance variables significantly correlated with routinely used measures of motor, cognition, behavior, and function. The MBT provides a valid, sensitive, and affordable functional outcome measure. Unlike current assessments, MBT performance significantly distinguished the subtle differences between the earliest disease stages of HD, which are the populations typically targeted in clinical trials.

  10. A reevaluation of X-irradiation-induced phocomelia and proximodistal limb patterning.

    Science.gov (United States)

    Galloway, Jenna L; Delgado, Irene; Ros, Maria A; Tabin, Clifford J

    2009-07-16

    Phocomelia is a devastating, rare congenital limb malformation in which the long bones are shorter than normal, with the upper portion of the limb being most severely affected. In extreme cases, the hands or fingers are attached directly to the shoulder and the most proximal elements (those closest to the shoulder) are entirely missing. This disorder, previously known in both autosomal recessive and sporadic forms, showed a marked increase in incidence in the early 1960s due to the tragic toxicological effects of the drug thalidomide, which had been prescribed as a mild sedative. This human birth defect is mimicked in developing chick limb buds exposed to X-irradiation. Both X-irradiation and thalidomide-induced phocomelia have been interpreted as patterning defects in the context of the progress zone model, which states that a cell's proximodistal identity is determined by the length of time spent in a distal limb region termed the 'progress zone'. Indeed, studies of X-irradiation-induced phocomelia have served as one of the two major experimental lines of evidence supporting the validity of the progress zone model. Here, using a combination of molecular analysis and lineage tracing in chick, we show that X-irradiation-induced phocomelia is fundamentally not a patterning defect, but rather results from a time-dependent loss of skeletal progenitors. Because skeletal condensation proceeds from the shoulder to fingers (in a proximal to distal direction), the proximal elements are differentially affected in limb buds exposed to radiation at early stages. This conclusion changes the framework for considering the effect of thalidomide and other forms of phocomelia, suggesting the possibility that the aetiology lies not in a defect in the patterning process, but rather in progenitor cell survival and differentiation. Moreover, molecular evidence that proximodistal patterning is unaffected after X-irradiation does not support the predictions of the progress zone model.

  11. Outcomes of lower extremity bypass performed for acute limb ischemia.

    Science.gov (United States)

    Baril, Donald T; Patel, Virendra I; Judelson, Dejah R; Goodney, Philip P; McPhee, James T; Hevelone, Nathanael D; Cronenwett, Jack L; Schanzer, Andres

    2013-10-01

    Acute limb ischemia remains one of the most challenging emergencies in vascular surgery. Historically, outcomes following interventions for acute limb ischemia have been associated with high rates of morbidity and mortality. The purpose of this study was to determine contemporary outcomes following lower extremity bypass performed for acute limb ischemia. All patients undergoing infrainguinal lower extremity bypass between 2003 and 2011 within hospitals comprising the Vascular Study Group of New England were identified. Patients were stratified according to whether or not the indication for lower extremity bypass was acute limb ischemia. Primary end points included bypass graft occlusion, major amputation, and mortality at 1 year postoperatively as determined by Kaplan-Meier life table analysis. Multivariable Cox proportional hazards models were constructed to evaluate independent predictors of mortality and major amputation at 1 year. Of 5712 lower extremity bypass procedures, 323 (5.7%) were performed for acute limb ischemia. Patients undergoing lower extremity bypass for acute limb ischemia were similar in age (66 vs 67; P = .084) and sex (68% male vs 69% male; P = .617) compared with chronic ischemia patients, but were less likely to be on aspirin (63% vs 75%; P < .0001) or a statin (55% vs 68%; P < .0001). Patients with acute limb ischemia were more likely to be current smokers (49% vs 39%; P < .0001), to have had a prior ipsilateral bypass (33% vs 24%; P = .004) or a prior ipsilateral percutaneous intervention (41% vs 29%; P = .001). Bypasses performed for acute limb ischemia were longer in duration (270 vs 244 minutes; P = .007), had greater blood loss (363 vs 272 mL; P < .0001), and more commonly utilized prosthetic conduits (41% vs 33%; P = .003). Acute limb ischemia patients experienced increased in-hospital major adverse events (20% vs 12%; P < .0001) including myocardial infarction, congestive heart failure exacerbation, deterioration in renal function

  12. Goniometry and Limb Girth in Miniature Dachshunds

    OpenAIRE

    Thomovsky, Stephanie A.; Chen, Annie V.; Kiszonas, Alecia M.; Lutskas, Lori A.

    2016-01-01

    Purpose. To report the mean and median pelvic limb joint angles and girth measurements in miniature Dachshunds presenting with varying degrees of pelvic limb weakness secondary to thoracolumbar intervertebral disc extrusion. Methods. 15 miniature Dachshunds who presented to WSU-VTH for thoracolumbar disc extrusion. Dachshunds varied in neurologic status from ambulatory paraparetic to paraplegic at the time of measurements. Results. There were no significant differences in joint angles or girt...

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

    NARCIS (Netherlands)

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

    2000-01-01

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

  14. Newly graduated nurses' use of knowledge sources

    DEFF Research Database (Denmark)

    Voldbjerg, Siri Lygum; Grønkjaer, Mette; Sørensen, Erik Elgaard

    2016-01-01

    AIM: To advance evidence on newly graduated nurses' use of knowledge sources. BACKGROUND: Clinical decisions need to be evidence-based and understanding the knowledge sources that newly graduated nurses use will inform both education and practice. Qualitative studies on newly graduated nurses' use...... underscoring progression in knowledge use and perception of competence and confidence among newly graduated nurses. CONCLUSION: The transition phase, feeling of confidence and ability to use critical thinking and reflection, has a great impact on knowledge sources incorporated in clinical decisions....... The synthesis accentuates that for use of newly graduated nurses' qualifications and skills in evidence-based practice, clinical practice needs to provide a supportive environment which nurtures critical thinking and questions and articulates use of multiple knowledge sources....

  15. Being a team leader: newly registered nurses relate their experiences.

    Science.gov (United States)

    Ekström, Louise; Idvall, Ewa

    2015-01-01

    This paper presents a study that explores how newly qualified registered nurses experience their leadership role in the ward-based nursing care team. A nurse's clinical leadership affects the quality of care provided. Newly qualified nurses experience difficulties during the transition period from student to qualified professional and find it challenging to lead nursing care. Twelve nurses were interviewed and the transcribed texts analysed using qualitative content analysis to assess both manifest and latent content. Five themes were identified: feeling stranded; forming well-functioning teams; learning to lead; having the courage, strength, and desire to lead; and ensuring appropriate care. The findings indicate that many factors limit nurses' leadership but some circumstances are supportive. The leadership prerequisites for newly registered nurses need to improve, emphasizing different ways to create a supportive atmosphere that promotes professional development and job satisfaction. To increase nurse retention and promote quality of care, nurse managers need to clarify expectations and guide and support newly qualified nurses in a planned way. © 2013 John Wiley & Sons Ltd.

  16. Determinants of midterm functional outcomes, wound healing, and resources used in a hospital-based limb preservation program.

    Science.gov (United States)

    Ramanan, Bala; Ahmed, Ayman; Wu, Bian; Causey, Marlin W; Gasper, Warren J; Vartanian, Shant M; Reyzelman, Alexander M; Hiramoto, Jade S; Conte, Michael S

    2017-12-01

    The objective of this study was to assess midterm functional status, wound healing, and in-hospital resource use among a prospective cohort of patients treated in a tertiary hospital, multidisciplinary Center for Limb Preservation. Data were prospectively gathered on all consecutive admissions to the Center for Limb Preservation from July 2013 to October 2014 with follow-up data collection through January 2016. Limbs were staged using the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) threatened limb classification scheme at the time of hospital admission. Patients with nonatherosclerotic vascular disorders, acute limb ischemia, and trauma were excluded. The cohort included 128 patients with 157 threatened limbs; 8 limbs with unstageable disease were excluded. Mean age (±standard deviation [SD]) was 66 (±13) years, and median follow-up duration (interquartile range) was 395 (80-635) days. Fifty percent (n = 64/128) of patients were readmitted at least once, with a readmission rate of 20% within 30 days of the index admission. Mean total number of admissions per patient (±SD) was 1.9 ± 1.2, with mean (±SD) cumulative length of stay (cLOS) of 17.1 (±17.9) days. During follow-up, 25% of limbs required a vascular reintervention, and 45% developed recurrent wounds. There was no difference in the rate of readmission, vascular reintervention, or wound recurrence by initial WIfI stage (P > .05). At the end of the study period, 23 (26%) were alive and nonambulatory; in 20%, functional status was missing. On both univariate and multivariate analysis, end-stage renal disease and prior functional status predicted ability to ambulate independently (P wound healing. Direct hospital (inpatient) cost per limb saved was significantly higher in stage 4 patients (P wound healing, or wound recurrence. Patients presenting with limb-threatening conditions require significant inpatient care, have a high frequency of repeated hospitalizations, and are at

  17. The Incidence and Risk Factors for Lower Limb Skin Graft Failure

    Directory of Open Access Journals (Sweden)

    Sumeet Reddy

    2014-01-01

    Full Text Available Lower limb skin grafts are thought to have higher failure rates than skin grafts in other sites of the body. Currently, there is a paucity of literature on specific factors associated with lower limb skin graft failure. We present a series of 70 lower limb skin grafts in 50 patients with outcomes at 6 weeks. One-third of lower limb skin grafts went on to fail with increased BMI, peripheral vascular disease, and immunosuppressant medication use identified as significant risk factors.

  18. Health-related profiles of people with lower limb loss.

    Science.gov (United States)

    Amtmann, Dagmar; Morgan, Sara J; Kim, Jiseon; Hafner, Brian J

    2015-08-01

    To construct profiles of self-reported health indicators to examine differences and similarities between people with lower limb loss and a normative sample (hereafter called the norm) and to compare health indicators between subgroups based on level and etiology of limb loss. Survey. General community. Adults with unilateral lower limb loss (N=1091) participated in this study. Eligibility criteria included lower limb loss due to trauma or dysvascular complications and regular use of a prosthesis. Not applicable. The Patient-Reported Outcomes Measurement Information System 29-item Health Profile version 1.0 measures physical function, pain interference, fatigue, sleep disturbance, anxiety, depression, and satisfaction with participation in social roles. The norm includes 5239 individuals representative of the U.S. general population in sex, age, race, ethnicity, and education. People with lower limb loss reported statistically significantly worse physical function, pain interference, and satisfaction with participation in social roles and significantly less fatigue than did the norm. People with transfemoral (ie, above-knee) amputation significantly differed in physical function from people with transtibial (ie, below-knee) amputation. Similarly, people with amputation due to trauma and dysvascular etiology significantly differed in physical function and satisfaction with social roles after adjusting for relevant clinical characteristics. People with lower limb loss generally report worse physical function, pain interference, and satisfaction with social roles than do the norm. People with dysvascular amputation reported worse physical function and satisfaction with social roles than did people with traumatic amputation. Health indicator profiles are an efficient way of providing clinically meaningful information about numerous aspects of self-reported health in people with lower limb loss. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by

  19. Postural control strategies during single limb stance following acute lateral ankle sprain.

    Science.gov (United States)

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

    2014-06-01

    Single-limb stance is maintained via the integration of visual, vestibular and somatosensory afferents. Musculoskeletal injury challenges the somatosensory system to reweight distorted sensory afferents. This investigation supplements kinetic analysis of eyes-open and eyes-closed single-limb stance tasks with a kinematic profile of lower limb postural orientation in an acute lateral ankle sprain group to assess the adaptive capacity of the sensorimotor system to injury. Sixty-six participants with first-time acute lateral ankle sprain completed a 20-second eyes-open single-limb stance task on their injured and non-injured limbs (task 1). Twenty-three of these participants successfully completed the same 20-second single-limb stance task with their eyes closed (task 2). A non-injured control group of 19 participants completed task 1, with 16 completing task 2. 3-dimensional kinematics of the hip, knee and ankle joints, as well as associated fractal dimension of the center-of-pressure path were determined for each limb during these tasks. Between trial analyses revealed significant differences in stance limb kinematics and fractal dimension of the center-of-pressure path for task 2 only. The control group bilaterally assumed a position of greater hip flexion compared to injured participants on their side-matched "involved"(7.41 [6.1°] vs 1.44 [4.8]°; η(2)=.34) and "uninvolved" (9.59 [8.5°] vs 2.16 [5.6°]; η(2)=.31) limbs, with a greater fractal dimension of the center-of-pressure path (involved limb=1.39 [0.16°] vs 1.25 [0.14°]; uninvolved limb=1.37 [0.21°] vs 1.23 [0.14°]). Bilateral impairment in postural control strategies present following a first time acute lateral ankle sprain. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. DLX5, FGF8 and the Pin1 isomerase control ΔNp63α protein stability during limb development: a regulatory loop at the basis of the SHFM and EEC congenital malformations

    Science.gov (United States)

    Restelli, Michela; Lopardo, Teresa; Lo Iacono, Nadia; Garaffo, Giulia; Conte, Daniele; Rustighi, Alessandra; Napoli, Marco; Del Sal, Giannino; Perez-Morga, David; Costanzo, Antonio; Merlo, Giorgio Roberto; Guerrini, Luisa

    2014-01-01

    Ectrodactyly, or Split-Hand/Foot Malformation (SHFM), is a congenital condition characterized by the loss of central rays of hands and feet. The p63 and the DLX5;DLX6 transcription factors, expressed in the embryonic limb buds and ectoderm, are disease genes for these conditions. Mutations of p63 also cause the ectodermal dysplasia–ectrodactyly–cleft lip/palate (EEC) syndrome, comprising SHFM. Ectrodactyly is linked to defects of the apical ectodermal ridge (AER) of the developing limb buds. FGF8 is the key signaling molecule in this process, able to direct proximo-distal growth and patterning of the skeletal primordial of the limbs. In the limb buds of both p63 and Dlx5;Dlx6 murine models of SHFM, the AER is poorly stratified and FGF8 expression is severely reduced. We show here that the FGF8 locus is a downstream target of DLX5 and that FGF8 counteracts Pin1–ΔNp63α interaction. In vivo, lack of Pin1 leads to accumulation of the p63 protein in the embryonic limbs and ectoderm. We show also that ΔNp63α protein stability is negatively regulated by the interaction with the prolyl-isomerase Pin1, via proteasome-mediated degradation; p63 mutant proteins associated with SHFM or EEC syndromes are resistant to Pin1 action. Thus, DLX5, p63, Pin1 and FGF8 participate to the same time- and location-restricted regulatory loop essential for AER stratification, hence for normal patterning and skeletal morphogenesis of the limb buds. These results shed new light on the molecular mechanisms at the basis of the SHFM and EEC limb malformations. PMID:24569166

  1. DLX5, FGF8 and the Pin1 isomerase control ΔNp63α protein stability during limb development: a regulatory loop at the basis of the SHFM and EEC congenital malformations.

    Science.gov (United States)

    Restelli, Michela; Lopardo, Teresa; Lo Iacono, Nadia; Garaffo, Giulia; Conte, Daniele; Rustighi, Alessandra; Napoli, Marco; Del Sal, Giannino; Perez-Morga, David; Costanzo, Antonio; Merlo, Giorgio Roberto; Guerrini, Luisa

    2014-07-15

    Ectrodactyly, or Split-Hand/Foot Malformation (SHFM), is a congenital condition characterized by the loss of central rays of hands and feet. The p63 and the DLX5;DLX6 transcription factors, expressed in the embryonic limb buds and ectoderm, are disease genes for these conditions. Mutations of p63 also cause the ectodermal dysplasia-ectrodactyly-cleft lip/palate (EEC) syndrome, comprising SHFM. Ectrodactyly is linked to defects of the apical ectodermal ridge (AER) of the developing limb buds. FGF8 is the key signaling molecule in this process, able to direct proximo-distal growth and patterning of the skeletal primordial of the limbs. In the limb buds of both p63 and Dlx5;Dlx6 murine models of SHFM, the AER is poorly stratified and FGF8 expression is severely reduced. We show here that the FGF8 locus is a downstream target of DLX5 and that FGF8 counteracts Pin1-ΔNp63α interaction. In vivo, lack of Pin1 leads to accumulation of the p63 protein in the embryonic limbs and ectoderm. We show also that ΔNp63α protein stability is negatively regulated by the interaction with the prolyl-isomerase Pin1, via proteasome-mediated degradation; p63 mutant proteins associated with SHFM or EEC syndromes are resistant to Pin1 action. Thus, DLX5, p63, Pin1 and FGF8 participate to the same time- and location-restricted regulatory loop essential for AER stratification, hence for normal patterning and skeletal morphogenesis of the limb buds. These results shed new light on the molecular mechanisms at the basis of the SHFM and EEC limb malformations. © The Author 2014. Published by Oxford University Press.

  2. Development and testing of new upper-limb prosthetic devices: research designs for usability testing.

    Science.gov (United States)

    Resnik, Linda

    2011-01-01

    The purposes of this article are to describe usability testing and introduce designs and methods of usability testing research as it relates to upper-limb prosthetics. This article defines usability, describes usability research, discusses research approaches to and designs for usability testing, and highlights a variety of methodological considerations, including sampling, sample size requirements, and usability metrics. Usability testing is compared with other types of study designs used in prosthetic research.

  3. Influence of limb temperature on cutaneous silent periods.

    Science.gov (United States)

    Kofler, Markus; Valls-Solé, Josep; Vasko, Peter; Boček, Václav; Štetkárová, Ivana

    2014-09-01

    The cutaneous silent period (CSP) is a spinal inhibitory reflex mediated by small-diameter afferents (A-delta fibers) and large-diameter efferents (alpha motoneurons). The effect of limb temperature on CSPs has so far not been assessed. In 27 healthy volunteers (11 males; age 22-58 years) we recorded median nerve motor and sensory action potentials, median nerve F-wave and CSPs induced by noxious digit II stimulation in thenar muscles in a baseline condition at room temperature, and after randomly submersing the forearm in 42 °C warm or 15 °C cold water for 20 min each. In cold limbs, distal and proximal motor and sensory latencies as well as F-wave latencies were prolonged. Motor and sensory nerve conduction velocities were reduced. Compound motor and sensory nerve action potential amplitudes did not differ significantly from baseline. CSP onset and end latencies were more delayed than distal and proximal median nerve motor and sensory latencies, whereas CSP duration was not affected. In warm limbs, opposite but smaller changes were seen in nerve conduction studies and CSPs. The observed CSP shift "en bloc" towards longer latencies without affecting CSP duration during limb cooling concurs with slower conduction velocity in both afferent and efferent fibers. Disparate conduction slowing in afferents and efferents, however, suggests that nociceptive EMG suppression is mediated by fibers of different size in the afferent than in the efferent arm, indirectly supporting the contribution of A-delta fibers as the main afferent input. Limb temperature should be taken into account when testing CSPs in the clinical setting, as different limb temperatures affect CSP latencies more than large-diameter fiber conduction function. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  4. The Dependence of Solar Flare Limb Darkening on Emission Peak Formation Temperature

    Science.gov (United States)

    Thiemann, Edward; Epp, Luke; Eparvier, Francis; Chamberlin, Phillip C.

    2017-08-01

    Solar limb effects are local brightening or darkening of an emission that depend on where in the Sun's atmosphere it forms. Near the solar limb, optically thick (thin) emissions will darken (brighten) as the column of absorbers (emitters) along the line-of-sight increases. Note that in limb brightening, emission sources are re-arranged whereas in limb darkening they are obscured. Thus, only limb darkening is expected to occur in disk integrated observations. Limb darkening also results in center-to-limb variations of disk-integrated solar flare spectra, with important consequences for how planetary atmospheres are affected by flares. Flares are typically characterized by their flux in the optically thin 0.1-0.8 nm band measured by the X-ray Sensor (XRS) on board the Geostationary Operational Environmental Satellite (GOES). On the other hand, Extreme Ultraviolet (EUV) line emissions can limb darken because they are sensitive to resonant scattering, resulting in a flare's location on the solar disk controlling the amount of ionizing radiation that reaches a planet. For example, an X-class flare originating from disk center may significantly heat a planet's thermosphere, whereas the same flare originating near the limb may have no effect because much of the effective emissions are scattered in the solar corona.To advance the relatively poor understanding of flare limb darkening, we use over 300 M-class or larger flares observed by the EUV Variability Experiment (EVE) onboard the Solar Dynamics Observatory (SDO) to characterize limb darkening as a function of emission peak formation temperature, Tf. For hot coronal emissions (Tf>2 MK), these results show a linear relationship between the degree of limb darkening and Tf where lines with Tf=2 MK darken approximately 7 times more than lines with Tf=16 MK. Because the extent of limb darkening is dependent on the height of the source plasma, we use simple Beer-Lambert radiative transfer analysis to interpret these results

  5. Early and effective use of ketamine for treatment of phantom limb pain

    Directory of Open Access Journals (Sweden)

    Harsha Shanthanna

    2010-01-01

    Full Text Available Treatment for phantom limb pain is difficult and challenging. There is often suboptimum treatment with fewer than 10% receiving lasting relief. Treatments based broadly on other neuropathic pains may not be appropriate for a clinical success. We report a case of phantom limb pain, which proved resistant to multiple analgesics, including opioids and continuous epidural blockade. Treatment with intravenous (IV ketamine as an alternate day infusion, gave complete remission of phantom limb pain. This demonstrates an early and effective use of a potent NMDA antagonist for treatment of phantom limb pain. Mechanisms underlying phantom limb pain are briefly discussed.

  6. Interventional treatment of diabetic ischemic diseases of lower limb:a therapeutic observation

    International Nuclear Information System (INIS)

    Wang Zhaoyang; Liu Xiang

    2010-01-01

    Objective: To assess the clinical effects of endovascular interventional treatment for diabetic ischemic diseases of lower limb. Methods: Endovascular interventional management was performed in 47 patients with diabetic ischemic diseases of lower limb. The ankle-to-brachial index and the diameter of lower limb vessel were estimated both before the treatment and 3, 30 days after the treatment. The results were compared and analyzed. Results: Obvious improvement in ankle-to-brachial index and the diameter of lower limb vessel were observed after the treatment. Conclusion: Endovascular interventional treatment is very effective and reliable for diabetic ischemic diseases of lower limb. (authors)

  7. Neuromuscular asymmetries in the lower limbs of elite female youth basketball players and the application of the skillful limb model of comparison.

    Science.gov (United States)

    Fort-Vanmeerhaeghe, Azahara; Montalvo, Alicia M; Sitjà-Rabert, Mercè; Kiefer, Adam W; Myer, Gregory D

    2015-11-01

    Compare the ability of commonly used comparison models to detect neuromuscular asymmetries. A secondary purpose was to determine which neuromuscular task(s) has the greatest sensitivity to identify asymmetries based on the ASI (asymmetry index) calculation. Elite female youth basketball players (N = 29, age = 15.7 ± 1.34 y) performed the single leg countermovement jump in vertical, horizontal, and lateral directions, the star excursion balance test in the anterior, posteromedial, and posterolateral directions, and the sprint test with change of direction. Paired t-tests compared right and left limbs, the dominant (DL) and non-dominant (NDL) limbs, and the more/less skillful limbs. The coincident identification between the more skillful leg and the leg subjectively described as the DL was low for all of the tasks performed (35%-52%). There were significant differences between the more and less skillful legs for all tasks, while performances between the right and left limbs and DL and NDL differed significantly for only one task each. The largest ASI detected in this study was found in the vertical single leg countermovement jump (14.11%). The skillful limb model of comparison may be more useful than other models to detect neuromuscular asymmetries. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Recent Trends in Lower-Limb Robotic Rehabilitation Orthosis: Control Scheme and Strategy for Pneumatic Muscle Actuated Gait Trainers

    Directory of Open Access Journals (Sweden)

    Mohd Azuwan Mat Dzahir

    2014-04-01

    Full Text Available It is a general assumption that pneumatic muscle-type actuators will play an important role in the development of an assistive rehabilitation robotics system. In the last decade, the development of a pneumatic muscle actuated lower-limb leg orthosis has been rather slow compared to other types of actuated leg orthoses that use AC motors, DC motors, pneumatic cylinders, linear actuators, series elastic actuators (SEA and brushless servomotors. However, recent years have shown that the interest in this field has grown exponentially, mainly due to the demand for a more compliant and interactive human-robotics system. This paper presents a survey of existing lower-limb leg orthoses for rehabilitation, which implement pneumatic muscle-type actuators, such as McKibben artificial muscles, rubbertuators, air muscles, pneumatic artificial muscles (PAM or pneumatic muscle actuators (PMA. It reviews all the currently existing lower-limb rehabilitation orthosis systems in terms of comparison and evaluation of the design, as well as the control scheme and strategy, with the aim of clarifying the current and on-going research in the lower-limb robotic rehabilitation field.

  9. Identification of a spatially specific enhancer element in the chicken Msx-2 gene that regulates its expression in the apical ectodermal ridge of the developing limb buds of transgenic mice.

    Science.gov (United States)

    Sumoy, L; Wang, C K; Lichtler, A C; Pierro, L J; Kosher, R A; Upholt, W B

    1995-07-01

    Msx-2 is a member of the Msx family of homeobox-containing genes expressed in a variety of embryonic tissues involved in epithelial-mesenchymal interactions and pattern formation. In the developing chick limb bud, Msx-2 is expressed in the apical ectodermal ridge, which plays a crucial role in directing the growth and patterning of limb mesoderm. In addition, Msx-2 is expressed in the anterior nonskeletal-forming mesoderm of the limb bud, in the posterior necrotic zone, and in the interdigital mesenchyme. Studies of the altered expression patterns of Msx-2 in amelic and polydactylous mutant chick limbs have suggested that the apical ectodermal ridge and mesodermal domains of Msx-2 expression are independently regulated and that there might be separate cis-regulatory elements in the Msx-2 gene controlling its spatially distinct domains of expression. To test this hypothesis, we have isolated the chicken Msx-2 gene and have tested the ability of various regions of the gene to target expression of LacZ reporter gene to specific regions of the limbs of transgenic mice. A variety of these constructs are consistently expressed only in the apical ectodermal ridge and the ectoderm of the genital tubercle and are not expressed in the mesoderm of the limb bud or in other regions of the embryo where the endogenous Msx-2 gene is expressed. These results suggest the presence of spatially specific cis-regulatory elements in the Msx-2 gene. We identified a 348-bp region in the 5' flanking region of the Msx-2 gene which can act as an apical ectodermal ridge enhancer element when placed in reverse orientation in front of the reporter gene with transcription initiation directed by the minimal hsp68 promoter.

  10. Development of ODL in a Newly Industrialized Country according to Face-to-Face Contact, ICT, and E-Readiness

    Directory of Open Access Journals (Sweden)

    J. Marinda van Zyl

    2013-03-01

    Full Text Available A large number of unqualified and under-qualified in-service teachers are holding back socio-economical development in South Africa, a newly industrialized country. Open and distance learning (ODL provides an innovative strategy and praxis for developing and newly industrialized countries to reach their educational and socio-economical objectives through professional development and training. In order to examine factors which affect the success of ODL offered by the North-West University in South Africa, a qualitative and quantitative research approach is used. Factors examined include face-to-face classroom contact, the implementation and use of ICTs, and e-readiness. The relationships between these factors are also discussed. A questionnaire was administered to 87 teacher-students in four Advanced Certificate in Education (ACE programs to collect quantitative data regarding aspects of their classes and the e-readiness of students. This data was qualitatively elaborated upon by three semi-structured, open-ended focus-group interviews. Besides descriptive statistics, Spearman’s rank-order correlations (r were determined between variables pertaining to negative feelings towards face-to-face classroom contact, ODL as students’ choice of delivery mode, and students’ positive attitude towards information and communication technology (ICT. Combined quantitative and qualitative findings were used to evaluate the effectiveness of contact classes as well as the e-readiness of students towards the attainment of ODL development Phase D. This phase refers to UNESCO’s description of ICT implementation, integration, and use. Relationships (Spearman’s rank-order correlations between ODL, as teacher-students’ choice of educational delivery mode, and aspects of their e-readiness suggest that the e-readiness of teacher-students is implicit to their choice of ODL as educational delivery mode for professional development.

  11. Isolated limb perfusion.

    Science.gov (United States)

    Gillespie, Rosalyn; Chantier, Nariane

    1994-12-08

    Growing concern over the rising incidence of malignant melanoma has brought about a need for information on this disorder and the treatment available. Isolated limb perfusion is a relatively new technique used in only a few hospitals. An increased knowledge base will lead to a better understanding of the nursing care required and to a more in-depth care plan.

  12. Exoskeleton robots for upper-limb rehabilitation: state of the art and future prospects.

    Science.gov (United States)

    Lo, Ho Shing; Xie, Sheng Quan

    2012-04-01

    Current health services are struggling to provide optimal rehabilitation therapy to victims of stroke. This has motivated researchers to explore the use of robotic devices to provide rehabilitation therapy for strokepatients. This paper reviews the recent progress of upper limb exoskeleton robots for rehabilitation treatment of patients with neuromuscular disorders. Firstly, a brief introduction to rehabilitation robots will be given along with examples of existing commercial devices. The advancements in upper limb exoskeleton technology and the fundamental challenges in developing these devices are described. Potential areas for future research are discussed. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

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

    NARCIS (Netherlands)

    Weel, Vincent van

    2008-01-01

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

  14. Quantifying the human-robot interaction forces between a lower limb exoskeleton and healthy users.

    Science.gov (United States)

    Rathore, Ashish; Wilcox, Matthew; Ramirez, Dafne Zuleima Morgado; Loureiro, Rui; Carlson, Tom

    2016-08-01

    To counter the many disadvantages of prolonged wheelchair use, patients with spinal cord injuries (SCI) are beginning to turn towards robotic exoskeletons. However, we are currently unaware of the magnitude and distribution of forces acting between the user and the exoskeleton. This is a critical issue, as SCI patients have an increased susceptibility to skin lesions and pressure ulcer development. Therefore, we developed a real-time force measuring apparatus, which was placed at the physical human-robot interface (pHRI) of a lower limb robotic exoskeleton. Experiments captured the dynamics of these interaction forces whilst the participants performed a range of typical stepping actions. Our results indicate that peak forces occurred at the anterior aspect of both the left and right legs, areas that are particularly prone to pressure ulcer development. A significant difference was also found between the average force experienced at the anterior and posterior sensors of the right thigh during the swing phase for different movement primitives. These results call for the integration of instrumented straps as standard in lower limb exoskeletons. They also highlight the potential of such straps to be used as an alternative/complementary interface for the high-level control of lower limb exoskeletons in some patient groups.

  15. Postnatal ontogeny of limb proportions and functional indices in the subterranean rodent Ctenomys talarum (Rodentia: Ctenomyidae).

    Science.gov (United States)

    Echeverría, Alejandra Isabel; Becerra, Federico; Vassallo, Aldo Iván

    2014-08-01

    Burrow construction in the subterranean Ctenomys talarum (Rodentia: Ctenomyidae) primarily occurs by scratch-digging. In this study, we compared the limbs of an ontogenetic series of C. talarum to identify variation in bony elements related to fossorial habits using a morphometrical and biomechanical approach. Diameters and functional lengths of long bones were measured and 10 functional indices were constructed. We found that limb proportions of C. talarum undergo significant changes throughout postnatal ontogeny, and no significant differences between sexes were observed. Five of six forelimb indices and two of four hindlimb indices showed differences between ages. According to discriminant analysis, the indices that contributed most to discrimination among age groups were robustness of the humerus and ulna, relative epicondylar width, crural and brachial indices, and index of fossorial ability (IFA). Particularly, pups could be differentiated from juveniles and adults by more robust humeri and ulnae, wider epicondyles, longer middle limb elements, and a proportionally shorter olecranon. Greater robustness indicated a possible compensation for lower bone stiffness while wider epicondyles may be associated to improved effective forces in those muscles that originate onto them, compensating the lower muscular development. The gradual increase in the IFA suggested a gradual enhancement in the scratch-digging performance due to an improvement in the mechanical advantage of forearm extensors. Middle limb indices were higher in pups than in juveniles-adults, reflecting relatively more gracile limbs in their middle segments, which is in accordance with their incipient fossorial ability. In sum, our results show that in C. talarum some scratch-digging adaptations are already present during early postnatal ontogeny, which suggests that they are prenatally shaped, and other traits develop progressively. The role of early digging behavior as a factor influencing on

  16. Limb defects associated with major congenital anomalies : Clinical and epidemiological study from the international clearinghouse for birth defects monitoring systems

    NARCIS (Netherlands)

    Rosano, A; Botto, LD; Olney, RS; Khoury, MJ; Ritvanen, A; Goujard, J; Stoll, C; Cocchi, G; Merlob, P; Mutchinick, O; Cornel, MC; Castilla, EE; Martinez-Frias, ML; Zampino, G; Erickson, JD; Mastroiacovo, P

    2000-01-01

    Although limb defects associated with other congenital anomalies are rarely studied, they may provide insights into limb development that may be useful for etiologic studies and public health monitoring, me pooled data from II birth defect registries that are part of the International Clearinghouse

  17. Erosion of newly developed CFCs and Be under disruption heat loads

    Science.gov (United States)

    Nakamura, K.; Akiba, M.; Araki, M.; Dairaku, M.; Sato, K.; Suzuki, S.; Yokoyama, K.; Linke, J.; Duwe, R.; Bolt, H.; Roedig, M.

    1996-10-01

    An evaluation of the erosion under disruption heat loads is very important to the lifetime prediction of divertor armour tiles of next fusion devices such as ITER. In particular, erosion data on CFCs (carbon fiber reinforced composites) and beryllium (Be) as the armour materials is urgently required in the ITER design. For CFCs, high heat flux experiments on the newly developed CFCs with high thermal conductivity have been performed under the heat flux of around 800-2000 MW/m 2 and the pulse length of 2-5 ms in JAERI electron beam irradiation systems (JEBIS). As a result, the weight losses of B 4C doped CFCs after heating were almost same to those of the non doped CFC up to 5 wt% boron content. For Be, we have carried out our first disruption experiments on S65/C grade Be specimens in the Juelich divertor test facility in hot cells (JUDITH) facility as a frame work of the J—EU collaboration. The heating conditions were heat loads of 1250-5000 MW/m 2 for 2-8 ms, and the heated area was 3 × 3 mm 2. As a result, the protuberances of the heated area of Be were observed under the lower heat flux.

  18. Erosion of newly developed CFCs and Be under disruption heat loads

    International Nuclear Information System (INIS)

    Nakamura, K.; Duwe, R.; Bolt, H.; Roedig, M.

    1996-01-01

    An evaluation of the erosion under disruption heat loads is very important to the lifetime prediction of divertor armour tiles of next fusion devices such as ITER. In particular, erosion data on CFCs (carbon fiber reinforced composites) and beryllium (Be) as the armour materials is urgently required in the ITER design. For CFCs, high heat flux experiments on the newly developed CFCs with high thermal conductivity have been performed under the heat flux of around 800-2000 MW/m 2 and the pulse length of 2-5 ms in JAERI electron beam irradiation systems (JEBIS). As a result, the weight losses of B 4 C doped CFCs after heating were almost same to those of the non doped CFC up to 5 wt% boron content. For Be, we have carried out our first disruption experiments on S65/C grade Be specimens in the Juelich divertor test facility in hot cells (JUDITH) facility as a frame work of the J-EU collaboration. The heating conditions were heat loads of 1250-5000 MW/m 2 for 2-8 ms, and the heated area was 3 x 3 mm 2 . As a result, the protuberances of the heated area of Be were observed under the lower heat flux. (orig.)

  19. Weldability aspects of a newly developed duplex stainless steel LDX 2101

    Energy Technology Data Exchange (ETDEWEB)

    Westin, E.M. [Avesta Research Centre, Avesta (Sweden). Outokumpu Stainless; Brolund, B. [SSAB Tunnplat, Borlaenge (Sweden); Hertzman, S. [Outokumpu Stainless Research Foundation, Stockholm (Sweden)

    2008-06-15

    Duplex grades have, due to balanced chemical compositions of both filler and base metals, a weldability that allows for successful welding using a majority of the technically relevant techniques of today. In order to fulfil the performance requirements several aspects must be considered. In the heat affected zone (HAZ) the austenite reformation must be reasonably high and in the weld metal the microstructure must be stable so that e.g. high productivity welding and multi-pass welding are possible, without precipitation of detrimental phases in previous passes. This paper addresses the effect of alloying elements and thermal cycles on phase balance in the high temperature HAZ (HTHAZ) of the newly developed lean duplex grade LDX 2101 (EN 1.4162, UNS S32101). Bead-on-plate welds and simulated weld structures have been produced and investigated using metallography, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The results are analysed using the thermodynamic database Thermo-Calc and a model for phase transformation based on a paraequilibrium assumption for ferrite-austenite transformation. In the temperature region outside the paraequilibrium domain, growth controlled by diffusion of substitutional elements was considered. The analysis follows a model by Cahn regarding grain boundary nucleated growth and the Hillert-Engberg model on kinetics of spherical and planar growth. (orig.)

  20. Radionuclide venography of lower limbs by subcutaneous injection

    International Nuclear Information System (INIS)

    Wu, Chung-Chieng; Jong, Shiang-Bin

    1989-01-01

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

  1. NUMERICAL MODELLING OF THE SOIL BEHAVIOUR BY USING NEWLY DEVELOPED ADVANCED MATERIAL MODEL

    Directory of Open Access Journals (Sweden)

    Jan Veselý

    2017-02-01

    Full Text Available This paper describes a theoretical background, implementation and validation of the newly developed Jardine plastic hardening-softening model (JPHS model, which can be used for numerical modelling of the soils behaviour. Although the JPHS model is based on the elasto-plastic theory, like the Mohr-Coulomb model that is widely used in geotechnics, it contains some improvements, which removes the main disadvantages of the MC model. The presented model is coupled with an isotopically hardening and softening law, non-linear elastic stress-strain law, non-associated elasto-plastic material description and a cap yield surface. The validation of the model is done by comparing the numerical results with real measured data from the laboratory tests and by testing of the model on the real project of the tunnel excavation. The 3D numerical analysis is performed and the comparison between the JPHS, Mohr-Coulomb, Modified Cam-Clay, Hardening small strain model and monitoring in-situ data is done.

  2. Upper Limb Immobilisation: A Neural Plasticity Model with Relevance to Poststroke Motor Rehabilitation

    Directory of Open Access Journals (Sweden)

    Leonardo Furlan

    2016-01-01

    Full Text Available Advances in our understanding of the neural plasticity that occurs after hemiparetic stroke have contributed to the formulation of theories of poststroke motor recovery. These theories, in turn, have underpinned contemporary motor rehabilitation strategies for treating motor deficits after stroke, such as upper limb hemiparesis. However, a relative drawback has been that, in general, these strategies are most compatible with the recovery profiles of relatively high-functioning stroke survivors and therefore do not easily translate into benefit to those individuals sustaining low-functioning upper limb hemiparesis, who otherwise have poorer residual function. For these individuals, alternative motor rehabilitation strategies are currently needed. In this paper, we will review upper limb immobilisation studies that have been conducted with healthy adult humans and animals. Then, we will discuss how the findings from these studies could inspire the creation of a neural plasticity model that is likely to be of particular relevance to the context of motor rehabilitation after stroke. For instance, as will be elaborated, such model could contribute to the development of alternative motor rehabilitation strategies for treating poststroke upper limb hemiparesis. The implications of the findings from those immobilisation studies for contemporary motor rehabilitation strategies will also be discussed and perspectives for future research in this arena will be provided as well.

  3. Lower Limb Function in Elderly Korean Adults Is Related to Cognitive Function.

    Science.gov (United States)

    Kim, A-Sol; Ko, Hae-Jin

    2018-05-01

    Patients with cognitive impairment have decreased lower limb function. Therefore, we aimed to investigate the relationship between lower limb function and cognitive disorders to determine whether lower limb function can be screened to identify cognitive decline. Using Korean National Health Insurance Service-National Sample Cohort database data, we assessed the cognitive and lower limb functioning of 66-year-olds who underwent national health screening between 2010 and 2014. Cognitive function was assessed via a questionnaire. Timed Up-and-Go (TUG) and one-leg-standing (OLS) tests were performed to evaluate lower limb function. Associations between cognitive and lower limb functions were analyzed, and optimal cut-off points for these tests to screen for cognitive decline, were determined. Cognitive function was significantly correlated with TUG interval ( r = 0.414, p cognitive disorders were >11 s and ≤12 s for TUG interval and OLS duration, respectively. Among 66-year-olds who underwent national health screening, a significant correlation between lower limb and cognitive function was demonstrated. The TUG and OLS tests are useful screening tools for cognitive disorders in elderly patients. A large-scale prospective cohort study should be conducted to investigate the causal relationship between cognitive and lower limb function.

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

    Directory of Open Access Journals (Sweden)

    Michael Kinchington

    2010-12-01

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

  5. Update and validation of the Society for Vascular Surgery wound, ischemia, and foot infection threatened limb classification system.

    Science.gov (United States)

    Mills, Joseph L

    2014-03-01

    The diagnosis of critical limb ischemia, first defined in 1982, was intended to delineate a patient cohort with a threatened limb and at risk for amputation due to severe peripheral arterial disease. The influence of diabetes and its associated neuropathy on the pathogenesis-threatened limb was an excluded comorbidity, despite its known contribution to amputation risk. The Fontaine and Rutherford classifications of limb ischemia severity have also been used to predict amputation risk and the likelihood of tissue healing. The dramatic increase in the prevalence of diabetes mellitus and the expanding techniques of arterial revascularization has prompted modification of peripheral arterial disease classification schemes to improve outcomes analysis for patients with threatened limbs. The diabetic patient with foot ulceration and infection is at risk for limb loss, with abnormal arterial perfusion as only one determinant of outcome. The wound extent and severity of infection also impact the likelihood of limb loss. To better predict amputation risk, the Society for Vascular Surgery Lower Extremity Guidelines Committee developed a classification of the threatened lower extremity that reflects these important clinical considerations. Risk stratification is based on three major factors that impact amputation risk and clinical management: wound, ischemia, and foot infection. This classification scheme is relevant to the patient with critical limb ischemia because many are also diabetic. Implementation of the wound, ischemia, and foot infection classification system in critical limb ischemia patients is recommended and should assist the clinician in more meaningful analysis of outcomes for various forms of wound and arterial revascularizations procedures required in this challenging, patient population. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Finite element model to study temperature distribution in skin and deep tissues of human limbs.

    Science.gov (United States)

    Agrawal, Mamta; Pardasani, K R

    2016-12-01

    The temperature of body tissues is viewed as an indicator of tissue response in clinical applications since ancient times. The tissue temperature depends on various physical and physiological parameters like blood flow, metabolic heat generation, thermal conductivity of tissues, shape and size of organs etc. In this paper a finite element model has been proposed to study temperature distribution in skin and deep tissues of human limbs. The geometry of human limb is taken as elliptical tapered shape. It is assumed that outer surface of the limb is exposed to the environment. The appropriate boundary conditions have been framed based on physical conditions of the problem. The model has been developed for a three dimensional steady state case. Hexahedral circular sectoral elements are used to discretize the region. The results have been computed to obtain temperature profiles and study the relation of tissue temperature with the parameters like atmospheric temperature, rate of evaporation, thickness of tissues layers and shape of the limb. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Muscle-type Identity of Proprioceptors Specified by Spatially Restricted Signals from Limb Mesenchyme.

    Science.gov (United States)

    Poliak, Sebastian; Norovich, Amy L; Yamagata, Masahito; Sanes, Joshua R; Jessell, Thomas M

    2016-01-28

    The selectivity with which proprioceptive sensory neurons innervate their central and peripheral targets implies that they exhibit distinctions in muscle-type identity. The molecular correlates of proprioceptor identity and its origins remain largely unknown, however. In screens to define muscle-type proprioceptor character, we find all-or-none differences in gene expression for proprioceptors that control antagonistic muscles at a single hindlimb joint. Analysis of three of these genes, cadherin13 (cdh13), semaphorin5a (sema5a), and cartilage-acidic protein-1 (crtac1), reveals expression in proprioceptor subsets that supply muscle groups located at restricted dorsoventral and proximodistal domains of the limb. Genetically altering the dorsoventral character of the limb mesenchyme elicits a change in the profile of proprioceptor cdh13, sema5a, and crtac1 expression. These findings indicate that proprioceptors acquire aspects of their muscle-type identity in response to mesenchymal signals expressed in restricted proximodistal and dorsoventral domains of the developing limb. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Muscle-type identity of proprioceptors specified by spatially-restricted signals from limb mesenchyme

    Science.gov (United States)

    Poliak, Sebastian; Norovich, Amy L.; Yamagata, Masahito; Sanes, Joshua R.; Jessell, Thomas M.

    2016-01-01

    The selectivity with which proprioceptive sensory neurons innervate their central and peripheral targets implies that they exhibit distinctions in muscle-type identity. The molecular correlates of proprioceptor identity and its origins remain largely unknown, however. In screens to define muscle-type proprioceptor character we find all-or-none differences in gene expression for proprioceptors that control antagonistic muscles at a single hindlimb joint. Analysis of three of these genes, cadherin13 (cdh13), semaphorin5a (sema5a) and cartilage-acidic protein-1 (crtac1), reveals expression in proprioceptor subsets that supply muscle-groups located at restricted dorso-ventral and proximo-distal domains of the limb. Genetically altering the dorso-ventral character of the limb mesenchyme elicits a change in the profile of proprioceptor cdh13, sema5a and crtac1 expression. These findings indicate that proprioceptors acquire aspects of their muscle-type identity in response to mesenchymal signals expressed in restricted proximo-distal and dorso-ventral domains of the developing limb. PMID:26824659

  9. Parsing multiple processes of high temperature impacts on corn/soybean yield using a newly developed CLM-APSIM modeling framework

    Science.gov (United States)

    Peng, B.; Guan, K.; Chen, M.

    2016-12-01

    Future agricultural production faces a grand challenge of higher temperature under climate change. There are multiple physiological or metabolic processes of how high temperature affects crop yield. Specifically, we consider the following major processes: (1) direct temperature effects on photosynthesis and respiration; (2) speed-up growth rate and the shortening of growing season; (3) heat stress during reproductive stage (flowering and grain-filling); (4) high-temperature induced increase of atmospheric water demands. In this work, we use a newly developed modeling framework (CLM-APSIM) to simulate the corn and soybean growth and explicitly parse the above four processes. By combining the strength of CLM in modeling surface biophysical (e.g., hydrology and energy balance) and biogeochemical (e.g., photosynthesis and carbon-nitrogen interactions), as well as that of APSIM in modeling crop phenology and reproductive stress, the newly developed CLM-APSIM modeling framework enables us to diagnose the impacts of high temperature stress through different processes at various crop phenology stages. Ground measurements from the advanced SoyFACE facility at University of Illinois is used here to calibrate, validate, and improve the CLM-APSIM modeling framework at the site level. We finally use the CLM-APSIM modeling framework to project crop yield for the whole US Corn Belt under different climate scenarios.

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

    Lifescience Database Archive (English)

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

  11. Goniometry and Limb Girth in Miniature Dachshunds

    Directory of Open Access Journals (Sweden)

    Stephanie A. Thomovsky

    2016-01-01

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

  12. Goniometry and Limb Girth in Miniature Dachshunds.

    Science.gov (United States)

    Thomovsky, Stephanie A; Chen, Annie V; Kiszonas, Alecia M; Lutskas, Lori A

    2016-01-01

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

  13. Deep brain stimulation for phantom limb pain.

    Science.gov (United States)

    Bittar, Richard G; Otero, Sofia; Carter, Helen; Aziz, Tipu Z

    2005-05-01

    Phantom limb pain is an often severe and debilitating phenomenon that has been reported in up to 85% of amputees. Its pathophysiology is poorly understood. Peripheral and spinal mechanisms are thought to play a role in pain modulation in affected individuals; however central mechanisms are also likely to be of importance. The neuromatrix theory postulates a genetically determined representation of body image, which is modified by sensory input to create a neurosignature. Persistence of the neurosignature may be responsible for painless phantom limb sensations, whereas phantom limb pain may be due to abnormal reorganisation within the neuromatrix. This study assessed the clinical outcome of deep brain stimulation of the periventricular grey matter and somatosensory thalamus for the relief of chronic neuropathic pain associated with phantom limb in three patients. These patients were assessed preoperatively and at 3 month intervals postoperatively. Self-rated visual analogue scale pain scores assessed pain intensity, and the McGill Pain Questionnaire assessed the quality of the pain. Quality of life was assessed using the EUROQOL EQ-5D scale. Periventricular gray stimulation alone was optimal in two patients, whilst a combination of periventricular gray and thalamic stimulation produced the greatest degree of relief in one patient. At follow-up (mean 13.3 months) the intensity of pain was reduced by 62% (range 55-70%). In all three patients, the burning component of the pain was completely alleviated. Opiate intake was reduced in the two patients requiring morphine sulphate pre-operatively. Quality of life measures indicated a statistically significant improvement. This data supports the role for deep brain stimulation in patients with phantom limb pain. The medical literature relating to the epidemiology, pathogenesis, and treatment of this clinical entity is reviewed in detail.

  14. Generating Electricity during Walking with a Lower Limb-Driven Energy Harvester: Targeting a Minimum User Effort.

    Directory of Open Access Journals (Sweden)

    Michael Shepertycky

    Full Text Available Much research in the field of energy harvesting has sought to develop devices capable of generating electricity during daily activities with minimum user effort. No previous study has considered the metabolic cost of carrying the harvester when determining the energetic effects it has on the user. When considering device carrying costs, no energy harvester to date has demonstrated the ability to generate a substantial amount of electricity (> 5W while maintaining a user effort at the same level or lower than conventional power generation methods (e.g. hand crank generator.We developed a lower limb-driven energy harvester that is able to generate approximately 9W of electricity. To quantify the performance of the harvester, we introduced a new performance measure, total cost of harvesting (TCOH, which evaluates a harvester's overall efficiency in generating electricity including the device carrying cost. The new harvester captured the motion from both lower limbs and operated in the generative braking mode to assist the knee flexor muscles in slowing the lower limbs. From a testing on 10 participants under different walking conditions, the harvester achieved an average TCOH of 6.1, which is comparable to the estimated TCOH for a conventional power generation method of 6.2. When generating 5.2W of electricity, the TCOH of the lower limb-driven energy harvester (4.0 is lower than that of conventional power generation methods.These results demonstrated that the lower limb-driven energy harvester is an energetically effective option for generating electricity during daily activities.

  15. Generating Electricity during Walking with a Lower Limb-Driven Energy Harvester: Targeting a Minimum User Effort.

    Science.gov (United States)

    Shepertycky, Michael; Li, Qingguo

    2015-01-01

    Much research in the field of energy harvesting has sought to develop devices capable of generating electricity during daily activities with minimum user effort. No previous study has considered the metabolic cost of carrying the harvester when determining the energetic effects it has on the user. When considering device carrying costs, no energy harvester to date has demonstrated the ability to generate a substantial amount of electricity (> 5W) while maintaining a user effort at the same level or lower than conventional power generation methods (e.g. hand crank generator). We developed a lower limb-driven energy harvester that is able to generate approximately 9W of electricity. To quantify the performance of the harvester, we introduced a new performance measure, total cost of harvesting (TCOH), which evaluates a harvester's overall efficiency in generating electricity including the device carrying cost. The new harvester captured the motion from both lower limbs and operated in the generative braking mode to assist the knee flexor muscles in slowing the lower limbs. From a testing on 10 participants under different walking conditions, the harvester achieved an average TCOH of 6.1, which is comparable to the estimated TCOH for a conventional power generation method of 6.2. When generating 5.2W of electricity, the TCOH of the lower limb-driven energy harvester (4.0) is lower than that of conventional power generation methods. These results demonstrated that the lower limb-driven energy harvester is an energetically effective option for generating electricity during daily activities.

  16. Use of newly developed standardized form for interpretation of high-resolution CT in screening for pneumoconiosis

    International Nuclear Information System (INIS)

    Julien, P.J.; Sider, L.; Silverman, J.M.; Dahlgren, J.; Harber, P.; Bunn, W.

    1991-01-01

    This paper reports that although the International Labour Office (ILO) standard for interpretation of the posteroanterior chest radiograph has been available for 10 years, there has been no attempt to standardize the high-resolution CT (HRTC) readings for screening of pneumoconiosis. An integrated respirator surveillance program for 87 workers exposed to inorganic dust was conducted. This program consisted of a detailed occupational exposure history, physical symptoms and signs, spirometry, chest radiography, and HRCT. Two groups of workers with known exposure were studied with HRCT. Group 1 had normal spirometry results and chest radiographs, and group 2 had abnormalities at spirometry or on chest radiographs. The HRCT scans were read independently of the clinical findings and chest radiographs. The HRCT scans were interpreted by using an ILO-based standard form developed by the authors for this project. With the newly developed HRCT form, individual descriptive abnormality localized severity, and overall rating systems have been developed and compared for inter- and intraobserver consistency

  17. A new model for the immobilization of the rat hind limb

    Directory of Open Access Journals (Sweden)

    Coutinho E.L.

    2002-01-01

    Full Text Available An alternative device for the immobilization of the hind limb of the rat was developed to study the effects of chronic disuse on the soleus and tibialis anterior muscles, maintained for 3 weeks in the shortening and the stretching positions, respectively. The proposed device is made of steel mesh and cotton materials, and has some advantages when compared to cast or plaster cast: it is cheaper, lighter (12 g or 4% of the body weight of the rat and the same unit can be easily adjusted and used several times in the same animal or in animals of similar size. Immobilization is also useful to restrain the movements of the hip, knee, and ankle joints. Male rats (291 ± 35 g and aged 14 ± 2 weeks were used to develop and test the model. The soleus muscle of 18 rats was maintained in a shortened position for 21 consecutive days and lost 19 ± 7% of its length (P = 0.008 and 44 ± 6% of its weight (P = 0.002 compared to the contralateral intact muscle. No difference (P = 0.67 was found in the stretched tibialis anterior of the same hind limb when compared to the contralateral muscle. No ulcer, sore or foot swelling was observed in the animals. Immobilization was effective in producing chronic muscle disuse in the hind limbs of rats and is an acceptable alternative to the traditional methods of immobilization such as cast or plaster cast.

  18. Upper limb function in adults with Duchenne muscular dystrophy

    NARCIS (Netherlands)

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

    2011-01-01

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

  19. Management of limb fractures in a teaching hospital: comparison between Wenchuan and Yushu earthquakes.

    Science.gov (United States)

    Min, Li; Tu, Chong-qi; Liu, Lei; Zhang, Wen-li; Yi, Min; Song, Yue-ming; Huang, Fu-guo; Yang, Tian-fu; Pei, Fu-xing

    2013-01-01

    To comparatively analyze the medical records of patients with limb fractures as well as rescue strategy in Wenchuan and Yushu earthquakes so as to provide references for post-earthquake rescue. We retrospectively investigated 944 patients sustaining limb fractures, including 891 in Wenchuan earthquake and 53 in Yushu earthquake, who were admitted to West China Hospital (WCH) of Sichuan University. In Wenchuan earthquake, WCH met its three peaks of limb fracture patients influx, on post-earthquake day (PED) 2, 8 and 14 respectively. Between PED 3-14, 585 patients were transferred from WCH to other hospitals outside the Sichuan Province. In Yushu earthquake, the maximum influx of limb fracture patients happened on PED 3, and no one was shifted to other hospitals. Both in Wenchuan and Yushu earthquakes, most limb fractures were caused by blunt strike and crush/burying. In Wenchuan earthquake, there were 396 (396/942, 42.0%) open limb fractures, including 28 Gustilo I, 201 Gustilo II and 167 Gustilo III injuries. But in Yushu earthquake, the incidence of open limb fracture was much lower (6/61, 9.8%). The percent of patients with acute complications in Wenchuan earthquake (167/891, 18.7%) was much higher than that in Yushu earthquake (5/53, 3.8%). In Wenchuan earthquake rescue, 1 018 surgeries were done, composed of debridement in 376, internal fixation in 283, external fixation in 119, and vacuum sealing drainage in 117, etc. While among the 64 surgeries in Yushu earthquake rescue, the internal fixation for limb fracture was mostly adopted. All patients received proper treatment and survived except one who died due to multiple organs failure in Wenchuan earthquake. Provision of suitable and sufficient medical care in a catastrophe can only be achieved by construction of sophisticated national disaster medical system, prediction of the injury types and number of injuries, and confirmation of participating hospitals?exact role. Based on the valuable rescue experiences

  20. Pattern of Nerve Blocks for Upper Limb Surgery at the University of ...

    African Journals Online (AJOL)

    Background: Central and peripheral neural blockade techniques are popular for lower and upper limb surgeries respectively. Lower limb surgery is amenable to central neural blockade techniques, anatomical and physiological imperatives makes peripheral neural blockade more suited for upper limb surgeries. We looked ...

  1. Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury.

    Science.gov (United States)

    Wellsandt, Elizabeth; Failla, Mathew J; Snyder-Mackler, Lynn

    2017-05-01

    Study Design Prospective cohort. Background The high risk of second anterior cruciate ligament (ACL) injuries after return to sport highlights the importance of return-to-sport decision making. Objective return-to-sport criteria frequently use limb symmetry indexes (LSIs) to quantify quadriceps strength and hop scores. Whether using the uninvolved limb in LSIs is optimal is unknown. Objectives To evaluate the uninvolved limb as a reference standard for LSIs utilized in return-to-sport testing and its relationship with second ACL injury rates. Methods Seventy athletes completed quadriceps strength and 4 single-leg hop tests before anterior cruciate ligament reconstruction (ACLR) and 6 months after ACLR. Limb symmetry indexes for each test compared involved-limb measures at 6 months to uninvolved-limb measures at 6 months. Estimated preinjury capacity (EPIC) levels for each test compared involved-limb measures at 6 months to uninvolved-limb measures before ACLR. Second ACL injuries were tracked for a minimum follow-up of 2 years after ACLR. Results Forty (57.1%) patients achieved 90% LSIs for quadriceps strength and all hop tests. Only 20 (28.6%) patients met 90% EPIC levels (comparing the involved limb at 6 months after ACLR to the uninvolved limb before ACLR) for quadriceps strength and all hop tests. Twenty-four (34.3%) patients who achieved 90% LSIs for all measures 6 months after ACLR did not achieve 90% EPIC levels for all measures. Estimated preinjury capacity levels were more sensitive than LSIs in predicting second ACL injuries (LSIs, 0.273; 95% confidence interval [CI]: 0.010, 0.566 and EPIC, 0.818; 95% CI: 0.523, 0.949). Conclusion Limb symmetry indexes frequently overestimate knee function after ACLR and may be related to second ACL injury risk. These findings raise concern about whether the variable ACL return-to-sport criteria utilized in current clinical practice are stringent enough to achieve safe and successful return to sport. Level of Evidence

  2. Neural Basis of Limb Ownership in Individuals with Body Integrity Identity Disorder

    OpenAIRE

    van Dijk, Milenna T.; van Wingen, Guido A.; van Lammeren, Anouk; Blom, Rianne M.; de Kwaasteniet, Bart P.; Scholte, H. Steven; Denys, Damiaan

    2013-01-01

    Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID) lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis underlying the feeling of limb ownership, since these individuals have a feeling of disownership for a limb in the absence of apparent brain damage. Here we directly compared brain activation between limbs ...

  3. Malignant bone tumors and limb-salvage surgery in children

    International Nuclear Information System (INIS)

    Meyer, James S.; Mackenzie, William

    2004-01-01

    Limb-salvage surgery plays a major role in the management of children with malignant bone tumors. This article provides background on the clinical presentation and imaging evaluation of children with malignant bone tumors and describes various limb-salvage procedures used in the treatment of these children. (orig.)

  4. Congenital constriction ring syndrome of the limbs: A prospective ...

    African Journals Online (AJOL)

    In the upper limb malformations involved 42 digits; in the lower limb malformations involved 33 toes, one foot and fi ve legs. Four main types of lesions were found: constriction rings, intrauterine amputations, acrosyndactyly, and simple syndactyly. Conclusion: Congenital constriction ring syndrome is of uncertain aetiology ...

  5. Limb flexion-induced axial compression and bending in human femoropopliteal artery segments.

    Science.gov (United States)

    Poulson, William; Kamenskiy, Alexey; Seas, Andreas; Deegan, Paul; Lomneth, Carol; MacTaggart, Jason

    2018-02-01

    High failure rates of femoropopliteal artery (FPA) interventions are often attributed in part to severe mechanical deformations that occur with limb movement. Axial compression and bending of the FPA likely play significant roles in FPA disease development and reconstruction failure, but these deformations are poorly characterized. The goal of this study was to quantify axial compression and bending of human FPAs that are placed in positions commonly assumed during the normal course of daily activities. Retrievable nitinol markers were deployed using a custom-made catheter system into 28 in situ FPAs of 14 human cadavers. Contrast-enhanced, thin-section computed tomography images were acquired with each limb in the standing (180 degrees), walking (110 degrees), sitting (90 degrees), and gardening (60 degrees) postures. Image segmentation and analysis allowed relative comparison of spatial locations of each intra-arterial marker to determine axial compression and bending using the arterial centerlines. Axial compression in the popliteal artery (PA) was greater than in the proximal superficial femoral artery (SFA) or the adductor hiatus (AH) segments in all postures (P = .02). Average compression in the SFA, AH, and PA ranged from 9% to 15%, 11% to 19%, and 13% to 25%, respectively. The FPA experienced significantly more acute bending in the AH and PA segments compared with the proximal SFA (P < .05) in all postures. In the walking, sitting, and gardening postures, average sphere radii in the SFA, AH, and PA ranged from 21 to 27 mm, 10 to 18 mm, and 8 to 19 mm, whereas bending angles ranged from 150 to 157 degrees, 136 to 147 degrees, and 137 to 148 degrees, respectively. The FPA experiences significant axial compression and bending during limb flexion that occur at even modest limb angles. Moreover, different segments of the FPA appear to undergo significantly different degrees of deformation. Understanding the effects of limb flexion on axial compression and

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

    Directory of Open Access Journals (Sweden)

    Ibrahima F

    2014-05-01

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

  7. Coping and posttraumatic growth in women with limb amputations.

    Science.gov (United States)

    Stutts, Lauren A; Bills, Sarah E; Erwin, Savannah R; Good, Jessica J

    2015-01-01

    While ample research has examined the psychological experiences of men with limb amputations, minimal research has examined the psychological experiences of women with limb amputations. The present study utilizes a qualitative design to examine coping and posttraumatic growth in women with limb amputations. Thirty women completed the posttraumatic growth inventory (PTGI) and provided open-ended responses about coping, social support, discrimination, support groups, and acceptance. Interpretative phenomenological analysis was used to discern emergent and superordinate themes in qualitative responses. Superordinate themes included social support (friendships/family and community), self-beliefs, resources, physical complications, spirituality, specific strategies, and acceptance. Concerns related specifically to participants' gender identity included appearance and motherhood. Overall, women reported moderate-to-high PTGI scores. The current findings address a void in the literature by illuminating the unique perspective of women with amputations. Future research should use quantitative methodology to expand on our research findings, as well as assess interventions to assist women adjusting to limb loss.

  8. Limb amputations in fixed dystonia: A form of body integrity identity disorder?

    NARCIS (Netherlands)

    Edwards, M.J.; Alonso-Canovas, A.; Schrag, A.; Bloem, B.R.; Thompson, P.D.; Bhatia, K.

    2011-01-01

    Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought

  9. Comparing unilateral and bilateral upper limb training: the ULTRA-stroke program design

    NARCIS (Netherlands)

    van Delden, A.E.Q.; Peper, C.E.; Harlaar, J.; Daffertshofer, A.; Zijp, N.I.; Nienhuys, K.; Koppe, P.; Kwakkel, G.; Beek, P.J.

    2009-01-01

    Background: About 80% of all stroke survivors have an upper limb paresis immediately after stroke, only about a third of whom (30 to 40%) regain some dexterity within six months following conventional treatment programs. Of late, however, two recently developed interventions - constraint-induced

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

    Directory of Open Access Journals (Sweden)

    Zlatka Borisova Stoyneva

    2015-03-01

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

  11. Soft-plastic brace for lower limb fractures in patients with spinal cord injury.

    Science.gov (United States)

    Uehara, K; Akai, M; Kubo, T; Yamasaki, N; Okuma, Y; Tobimatsu, Y; Iwaya, T

    2013-04-01

    Retrospective study at a rehabilitation center. Patients with spinal cord injury, even if they are wheelchair users, sometimes suffer from fractures of the lower limb bones. As their bones are too weak to have surgery, and because a precise reduction is not required for restoration, such patients are often indicated for conservative treatment. This case series study investigated the use of a hinged, soft-plastic brace as a conservative approach to treating fractures of the lower extremities of patients with spinal cord injury. National Rehabilitation Center, Japan. Fifteen patients (male, n=10; female, n=5; average age, 52.7 years) with 19 fractures of the femur or the tibia who were treated with a newly-developed hinged, soft-plastic brace were studied. All of them used wheelchairs. We analyzed the time taken for fracture union and for wearing orthotics, degree of malalignment, femorotibial angle and side effects. The fractures in this series were caused by relatively low-energy impact. The average time taken for fracture union was 80.1 (37-189) days, and the average amount of time spent wearing orthotics was 77.9 (42-197) days. On final X-ray imaging, the average femorotibial angle was 176.9° (s.d. ±8.90), and 15° of misalignment in the sagittal plane occurred in one patient. A hinged, soft-plastic brace is a useful option as a conservative approach for treating fractures of the lower extremities in patients with spinal cord injury.

  12. Verification of gamma knife based fractionated radiosurgery with newly developed head-thorax phantom

    International Nuclear Information System (INIS)

    Bisht, Raj Kishor; Kale, Shashank Sharad; Natanasabapathi, Gopishankar; Singh, Manmohan Jit; Agarwal, Deepak; Garg, Ajay; Rath, Goura Kishore; Julka, Pramod Kumar; Kumar, Pratik; Thulkar, Sanjay; Sharma, Bhawani Shankar

    2016-01-01

    Objective: Purpose of the study is to verify the Gamma Knife Extend™ system (ES) based fractionated stereotactic radiosurgery with newly developed head-thorax phantom. Methods: Phantoms are extensively used to measure radiation dose and verify treatment plan in radiotherapy. A human upper body shaped phantom with thorax was designed to simulate fractionated stereotactic radiosurgery using Extend™ system of Gamma Knife. The central component of the phantom aids in performing radiological precision test, dosimetric evaluation and treatment verification. A hollow right circular cylindrical space of diameter 7.0 cm was created at the centre of this component to place various dosimetric devices using suitable adaptors. The phantom is made of poly methyl methacrylate (PMMA), a transparent thermoplastic material. Two sets of disk assemblies were designed to place dosimetric films in (1) horizontal (xy) and (2) vertical (xz) planes. Specific cylindrical adaptors were designed to place thimble ionization chamber inside phantom for point dose recording along xz axis. EBT3 Gafchromic films were used to analyze and map radiation field. The focal precision test was performed using 4 mm collimator shot in phantom to check radiological accuracy of treatment. The phantom head position within the Extend™ frame was estimated using encoded aperture measurement of repositioning check tool (RCT). For treatment verification, the phantom with inserts for film and ion chamber was scanned in reference treatment position using X-ray computed tomography (CT) machine and acquired stereotactic images were transferred into Leksell Gammaplan (LGP). A patient treatment plan with hypo-fractionated regimen was delivered and identical fractions were compared using EBT3 films and in-house MATLAB codes. Results: RCT measurement showed an overall positional accuracy of 0.265 mm (range 0.223 mm–0.343 mm). Gamma index analysis across fractions exhibited close agreement between LGP and film

  13. Long-term results after primary infrapopliteal angioplasty for limb ischemia

    International Nuclear Information System (INIS)

    Alfke, H.; Marburg Univ.; Vannucchi, A.; Froelich, J.J.; Klinikum Bad Hersfeld; El-Sheik, M.; Wagner, H.J.; Vivantes-Klinikum im Friedrichshain

    2007-01-01

    Purpose: To evaluate the technical success rate, procedure-related complications, and clinical long-term results for patients who underwent infrapopliteal angioplasty. Materials and Methods: We retrospectively evaluated all patients who underwent infrapopliteal angioplasty to treat critical chronic limb ischemia or severe claudication from 1/1997 to 12/1999. We excluded patients with acute (< 2 weeks) limb ischemia. Procedure-related data were prospectively documented in a database and analyzed with a focus on the technical success rate and procedure-related complications. In addition all clinical documents were analyzed, and a follow-up examination was performed or telephone interviews were conducted with patients, relatives and referring doctors for follow-up. The primary end points were the limb salvage rate and patient survival rate. The secondary end points included the complication rate, technical success rate, and walking distance. Results: 112 patients with a mean age of 72 years (41 women, 71 men) underwent crural angioplasty on 121 limbs. Four patients suffered from severe claudication (Rutherford category 3) and all others had critical chronic limb ischemia (category 4 to 6). The complication rate was 2.7 %. The technical success rate was 92 %. The ankle brachial index increased from 0.59 to 0.88. The mean walking distance increased significantly from 52 ± 66 to 284 ± 346 meters at the time of follow-up. The limb salvage rate was 83.6 % after one year and 81.1 % after three years. The mean survival rate according to Kaplan-Meier was 79.4 %, 69.2 %, and 54.2 % at 1, 2, and 3 years, respectively. Patients with at least one patent run-off vessel after angioplasty had a significantly better limb salvage rate. Diabetes was not a risk factor for limb salvage. Conclusion: Infrapopliteal angioplasty shows a high technical success rate with an acceptable complication rate. The clinical long-term success seems favorable if a least one open run-off vessel was

  14. Computer simulations of neural mechanisms explaining upper and lower limb excitatory neural coupling

    Directory of Open Access Journals (Sweden)

    Ferris Daniel P

    2010-12-01

    Full Text Available Abstract Background When humans perform rhythmic upper and lower limb locomotor-like movements, there is an excitatory effect of upper limb exertion on lower limb muscle recruitment. To investigate potential neural mechanisms for this behavioral observation, we developed computer simulations modeling interlimb neural pathways among central pattern generators. We hypothesized that enhancement of muscle recruitment from interlimb spinal mechanisms was not sufficient to explain muscle enhancement levels observed in experimental data. Methods We used Matsuoka oscillators for the central pattern generators (CPG and determined parameters that enhanced amplitudes of rhythmic steady state bursts. Potential mechanisms for output enhancement were excitatory and inhibitory sensory feedback gains, excitatory and inhibitory interlimb coupling gains, and coupling geometry. We first simulated the simplest case, a single CPG, and then expanded the model to have two CPGs and lastly four CPGs. In the two and four CPG models, the lower limb CPGs did not receive supraspinal input such that the only mechanisms available for enhancing output were interlimb coupling gains and sensory feedback gains. Results In a two-CPG model with inhibitory sensory feedback gains, only excitatory gains of ipsilateral flexor-extensor/extensor-flexor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 26%. In a two-CPG model with excitatory sensory feedback gains, excitatory gains of contralateral flexor-flexor/extensor-extensor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 100%. However, within a given excitatory sensory feedback gain, enhancement due to excitatory interlimb gains could only reach levels up to 20%. Interconnecting four CPGs to have ipsilateral flexor-extensor/extensor-flexor coupling, contralateral flexor-flexor/extensor-extensor coupling, and bilateral flexor-extensor/extensor-flexor coupling could enhance

  15. Data on chemical activation of Wnt/β-catenin during axolotl limb regeneration

    Directory of Open Access Journals (Sweden)

    Sabina Wischin

    2017-04-01

    Full Text Available Limb amputation in axolotls was performed to obtain data demonstrating that a chemical agonist of Wnt (int-related protein/β-catenin signalling can have a role in axolotl limb regeneration (Wischin et al., 2017 [1]. The data revealed that active β-catenin protein was present during limb regeneration in some Leydig cells in the epithelium; after the chemical treatment, it was observed in more Leydig cells. In addition, the chemical agonist of Wnt generated distinct limb malformation.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-03-01

    The purpose of this document is to present environmental monitoring data collected during the US Department of Energy Limestone Injection Multistage Burner (DOE LIMB) Demonstration Project Extension at the Ohio Edison Edgewater Generating Station in Lorain, Ohio. The DOE project is an extension of the US Environmental Protection Agency's (EPA's) original LIMB Demonstration. The program is operated nuclear DOE's Clean Coal Technology Program of emerging clean coal technologies'' under the categories of in boiler control of oxides of sulfur and nitrogen'' as well as post-combustion clean-up.'' The objective of the LIMB program is to demonstrate the sulfur dioxide (SO{sub 2}) and nitrogen oxide (NO{sub x}) emission reduction capabilities of the LIMB system. The LIMB system is a retrofit technology to be used for existing coal-fired boilers equipped with electrostatic precipitators (ESPs).

  17. Crossover replantation after bilateral traumatic lower limb amputations: a case report

    Directory of Open Access Journals (Sweden)

    Fang Jun

    2012-07-01

    Full Text Available Abstract Introduction Replantation of a limb to the contralateral stump after bilateral traumatic amputations is rare. To the best of our knowledge, there are only a few reports of crossover lower limb replantation in the literature. Case presentation We treated a 37-year-old Chinese woman with bilateral lower limb crush injuries sustained in a traffic accident. Her lower limb injuries were at different anatomic levels. We performed emergency bilateral amputations followed by crossover replantation. Five years later, the woman had recovered well, and had perfect movement and stability in her replanted leg. After reviewing the literature, we thought that presentation of our patient’s case might provide useful information for clinicians. Conclusions Crossover replantation should be considered when evaluating a patient with bilateral lower limb injuries, thus allowing the patient to touch the ground and stand using their own foot.

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

    Science.gov (United States)

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

    2013-03-01

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

  19. 3D-printed upper limb prostheses: a review.

    Science.gov (United States)

    Ten Kate, Jelle; Smit, Gerwin; Breedveld, Paul

    2017-04-01

    This paper aims to provide an overview with quantitative information of existing 3D-printed upper limb prostheses. We will identify the benefits and drawbacks of 3D-printed devices to enable improvement of current devices based on the demands of prostheses users. A review was performed using Scopus, Web of Science and websites related to 3D-printing. Quantitative information on the mechanical and kinematic specifications and 3D-printing technology used was extracted from the papers and websites. The overview (58 devices) provides the general specifications, the mechanical and kinematic specifications of the devices and information regarding the 3D-printing technology used for hands. The overview shows prostheses for all different upper limb amputation levels with different types of control and a maximum material cost of $500. A large range of various prostheses have been 3D-printed, of which the majority are used by children. Evidence with respect to the user acceptance, functionality and durability of the 3D-printed hands is lacking. Contrary to what is often claimed, 3D-printing is not necessarily cheap, e.g., injection moulding can be cheaper. Conversely, 3D-printing provides a promising possibility for individualiz