Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “THIGH”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed2005

The earlier clinic experience of the reverse-flow anterolateral thigh island flap.

Since Song first reported the anterolateral thigh flap in 1984, this flap has been applied widely in clinical practice. In 1997, we found that the proximal end of the vascular pedicle of the anterolateral thigh flap showed active bleeding. We therefore believed that this flap could form the reverse-flow flap, which can be used clinically. From 1997 to 2002, two patients who suffered from soft tissue defects in their lower extremities have been repaired successfully with the reversed flow anterolateral thigh island flaps. The reverse-flow anterolateral thigh island flap with reliable blood supply and long vascular pedicle can be designed to repair soft tissue defects around ipsilateral knee joint or contralateral distal rejoins of the leg, especially in the difficulty cases.

Accidents, Traffic↗
PubMed2005

Glycyrrhetinic acid, the active principle of licorice, can reduce the thickness of subcutaneous thigh fat through topical application.

Cortisol is involved in the distribution and deposition of fat, and its action is regulated by the activity of 11beta-hydroxysteroid dehydrogenase. Glycyrrhetinic acid, the active principle of licorice root, blocks 11beta-hydroxysteroid dehydrogenase type 1, thus reducing the availability of cortisol at the level of adipocytes. We evaluated the effect of topical application of a cream containing glycyrrhetinic acid in the thickness of fat at the level of the thigh. Eighteen healthy women (age range 20-33 years) with normal BMI were randomly allocated to treatment, at the level of the dominant thigh, with a cream containing 2.5% glycyrrhetinic acid (n=9) or with a placebo cream containing the excipients alone (n=9). Before and after 1 month of treatment both the circumference and the thickness of the superficial fat layer of the thighs (by ultrasound analysis) were measured. The circumference and the thickness of the superficial fat layer were significantly reduced in comparison to the controlateral untreated thigh and to control subjects treated with the placebo cream. No changes were observed in blood pressure, plasma renin activity, plasma aldosterone or cortisol. The effect of glycyrrhetinic acid on the thickness of subcutaneous fat was likely related to a block of 11beta-hydroxysteroid dehydrogenase type 1 at the level of fat cells; therefore, glycyrrhetinic acid could be effectively used in the reduction of unwanted local fat accumulation.

Adipose Tissue↗
PubMed1987

Fetal weight estimation formulas with head, abdominal, femur, and thigh circumference measurements.

Most current sonographic techniques for estimating fetal weight involve measurements of the head, abdomen, and femur length both alone and in combination. The value of the fetal thigh circumference measurement in addition to the head, abdominal, and femur length measurements has not been investigated previously. Eighty-nine patients were scanned within 72 hours of delivery, and the following ultrasonic fetal parameters were obtained in all fetuses: biparietal diameter, head circumference, abdominal circumference, femur length, and thigh circumference. With multiple stepwise regression analysis, the best-fit formulas were developed with one, two, three, four, and five parameters, respectively. The best results were obtained by combining measurements of all five parameters: biparietal diameter, head circumference, abdominal circumference, femur length, and thigh circumference. The mean error of this formula was 6%, the mean deviation 0.3%, and the SD 7.8%. These data suggest that the addition of thigh circumference to measurements of the head, abdomen, and femur length improves the accuracy of fetal weight estimates.

Abdomen↗
PubMed1993

Thigh injuries in athletes.

The thigh, which consists of the heavily muscled region around the femur, is vulnerable to many types of athletic injury. This review addresses the assessment, prevention, and rehabilitation of both the common thigh injuries associated with participation in sports, such as contusions and myositis ossificans traumatica, and a few relatively uncommon but diagnostically important entities that sports physicians must recognize when an athlete has pain or dysfunction attributable to the thigh. Dividing the thigh into anatomic compartments aids in both differential diagnosis and understanding of the pathomechanics that lead to injury. Rehabilitation is especially emphasized because improper selection of modalities or misuse of exercise can seriously impede or worsen recovery. Conversely, the use of appropriate rehabilitation principles and new concepts in exercise prescription can decrease morbidity and lead to rapid resumption of sports.

Athletic Injuries↗
PubMed2003

Comparative reactogenicity and parental acceptability of pertussis vaccines administered into the ventrogluteal area and anterolateral thigh in children aged 2, 4, 6 and 18 months.

The importance of site of injection of combined pertussis/diphtheria/tetanus vaccines was investigated in two single blind studies. In the pilot study, in which the research instrument was trialed, 283 children aged 2-18 months received whole cell pertussis vaccine (DTPw) by the intramuscular route either into the anterolateral thigh or the ventrogluteal site. In the larger randomised study, 566 children aged 2-18 months were similarly injected with acellular pertussis vaccine (DTPa). Adverse reactions monitored after 24h showed the same lower rates for both vaccines with ventrogluteal injection compared with anterolateral thigh injection for systemic reactions (irritability (P<0.0001), perceived fever (P<0.0001), persistent crying/screaming (P<0.0001) and local reactions (bruising (P<0.0001) and redness/swelling (P<0.0001)). The Haemophilus influenzae type b vaccine (HibTITER) given concurrently in the contralateral site to the pertussis vaccine showed the same lower rates in both studies for ventrogluteal injection compared with anterolateral thigh injection for local reactions (redness/swelling both studies (P<0.0001) and bruising DTPw study (P<0.0001) and DTPa study (P<0.0004)).Parental acceptability was greater (P<0.0001) in both studies for ventrogluteal injection compared with anterolateral thigh injection.

Diphtheria-Tetanus-Pertussis Vaccine↗
PubMed2002

Inhibition of lung metastasis of osteosarcoma cell line POS-1 transplanted into mice by thigh ligation.

Using a model with external ligation of the thigh, the effect of ischemia-reperfusion injury on tumor growth and the activity of lung metastasis was investigated in mice inoculated a spontaneous murine osteosarcoma cell line (POS-1) in vivo. POS-1 cell suspension was inoculated into the right hind footpad of 70 mice. Four weeks after inoculation, the ipsilateral thigh was ligated for 3 h in 15 mice and the contralateral thigh in 15 mice. Another ten mice were inoculated with POS-1 without ligating the thigh. The number of metastatic foci on the lung surface 6 weeks after inoculation was 2.29+/-0.98 (mean+/-SE) foci/lungs in mice with ipsilateral ligation and 6.25+/-2.41 in mice with contralateral ligation, which were significantly lower than control (13.40+/-1.42 in mice no ligation) (P<0.01). The number of metastatic foci on the lung surface in mice with intraperitoneal injection of superoxide dismutase (SOD) and catalase was 3.25+/-0.65 (mean+/-SE) foci/lungs in mice with ligation which was significantly greater than that in mice without SOD and catalase injection 1.29+/-0.97 (P=0.04). Cell viability was 9.12+/-4.07% with 100 microM H(2)O(2) in 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay. It revealed that at concentrations of 100 microM H(2)O(2) or higher was cytotoxic to POS-1. In cell invasion assay, the number of invading cells with 10 microM H(2)O(2) was 2.80+/-0.53 cells/field, which was significantly lower than control (5.93+/-0.18) (mean+/-SE), indicating that low-dose H(2)O(2) suppressed invasion of POS-1. These results suggested that reperfusion injury had selective cytotoxicity to POS-1 through producing reactive oxygen species. Activated oxygen was considered to inhibit the regional growth and the ability of lung metastasis of POS-1 cells.

Animals↗
PubMed2004

Prosthetic thigh arteriovenous access: outcome with SVS/AAVS reporting standards.

PURPOSE: Differences in the reporting methods of results for arteriovenous (AV) access can dramatically affect apparent outcome. To enable meaningful comparisons in the literature, the Society for Vascular Surgery and the American Association for Vascular Surgery (SVS/AAVS) recently published reporting standards for dialysis access. The purpose of the present study was to determine infection rates, patency rates, and possible predictive factors for prosthetic thigh AV access outcomes with the reporting standards of the SVS/AAVS. METHODS: A retrospective analysis was performed of all patients who underwent placement of thigh AV access by the Surgical Teaching Service at Greenville Memorial Hospital between 1989 and 2001. Outcomes were determined based on SVS/AAVS Standards for Reports Dealing with AV Accesses. The rate of revision per year of access patency was also determined; this end point more accurately reflects the true cost and morbidity associated with AV access than do patency or infection rates alone. RESULTS: One hundred twenty-five polytetrafluoroethylene thigh AV accesses were placed in 100 patients. Nine accesses were excluded from the study, six because there was no patient follow-up and 3 as a result of deaths unrelated to the access procedure and which occurred less than 30 days after access placement. There were six (4%) late access-related deaths. There were 18 (15%) early access failures, related to infection in 14 cases (12%), thrombosis in three cases (2%), and steal in one case (1%). Early failure was more common in patients with diabetes mellitus (P =.036). The primary and secondary functional patency rates were 19% and 54%, respectively, at 2 years. Infection occurred in 48 (41%) accesses. The patency and infection rates were not influenced by patient age, gender, body mass index, or diabetes mellitus. The median number of interventions per year of access patency was 1.68, and this outcome was positively correlated with body mass index (P <.001). CONCLUSIONS: Prosthetic AV access in the thigh is associated with higher morbidity compared with that reported for the upper extremity, and should be considered only if no upper extremity AV access option is available. Early access failure and the requirement for an increased number of interventions to reestablish and maintain access patency are more common in patients with diabetes mellitus and obesity. The number of interventions per year of access patency is a valuable end point when assessing the outcome of AV access procedures.

Blood Vessel Prosthesis Implantation↗
PubMed1997

Prevalence and clinical significance of posterolateral thigh perforator vein incompetence.

PURPOSE: Posterolateral thigh perforator (PLTP) veins are part of the lateral thigh venous system, which in most people remains undeveloped. This study was designed to determine the prevalence and clinical significance of these veins. METHODS: Over the past 6 years, 2820 lower limbs with signs and symptoms of chronic venous disease (CVD) were evaluated for venous reflux using color flow duplex imaging. Superficial, perforating, and deep veins were examined in the standing, sitting, and reversed Trendelenburg positions. PLTP veins were best identified in the standing position with the patient facing away from the examiner. RESULTS: Twenty-six incompetent PLTP veins were found in 24 limbs (0.85%) of 21 patients (mean age, 43 +/- 16 years; range, 22 to 77 years). All PLTP veins pierced the fascia lata 12 to 25 cm (mean, 16 +/- 3 cm) above the popliteal skin crease in the lateral aspect of the thigh. At this level, the PLTP veins dove posteriorly 3 to 8 cm to join primarily tributaries of the deep femoral vein, superficial femoral vein, or both. Eight PLTP veins were duplicated at 1 to 2 cm below the fascia. Seven PLTP veins gave rise to superficial tributaries that were extended to the lower lateral and posterior thigh, whereas the remaining 19 PLTP veins gave rise to tributaries alongside the lesser saphenous vein and the anterior arch of the greater saphenous vein. On nine occasions, reflux was found in the PLTP veins and their associated tributaries alone. In all of these cases, reflux was adequately controlled with a tourniquet placed distal to the fascial defect. In the remaining 17 PLTP veins, reflux was also seen in the greater saphenous vein, the lesser saphenous vein, or both. None of the limbs that had PLTP vein reflux alone exceeded CVD class 3. When PLTP vein reflux was combined with saphenous reflux, there were five limbs classified as CVD class 4 and one limb each as CVD classes 5 and 6. Twenty limbs underwent ligation and stripping of the varicosities. Three of the earlier patients in the series underwent incomplete operations, which resulted in immediate residual varicosities from the PLTP tributaries. All three patients underwent reoperation successfully within a year. CONCLUSIONS: The prevalence of PLTP vein reflux is quite low. Reflux in the PLTP veins alone is associated with mild to moderate clinical presentation. However, when it is combined with saphenous reflux skin damage can be present. Failure to recognize PLTP veins may result in an incomplete or unnecessary operation, leaving the patients with residual varicose veins.

Adult↗
PubMed1996

Incidence of thigh pain after uncemented total hip arthroplasty as a function of femoral stem size.

Two hundred seventy-one patients (297 primary total hip arthroplasties) were evaluated for thigh pain 2 years after surgery. All femoral components were identical in wedge-shaped geometry but differed in size. All components were radiographically stable. Regression analysis revealed the presence of thigh pain to be directly correlated to increasing stem size (P = .014, r = .857). An even more significant positive correlation to thigh pain was present for proximal and distal component moments of inertia for bending in the mediolateral plane. Femoral stem size has a significant effect on the incidence of thigh pain.

Aged↗
PubMed2002

Racial differences in insulin resistance and mid-thigh fat deposition in postmenopausal women.

OBJECTIVE: To determine whether racial differences in insulin resistance between African American (AA) and white women exist in postmenopausal women and whether they are related to physical fitness and/or obesity. RESEARCH METHODS AND PROCEDURES: We studied 35 obese AA (n = 9) and white (n = 26) women of comparable maximal oxygen consumption, obesity, and age. Total body fat was measured by DXA. Abdominal and mid-thigh low-density lean tissue (a marker of intramuscular fat) were determined with computed tomography. Glucose utilization (M) was measured during the last 30 minutes of a 3-hour hyperinsulinemic-euglycemic clamp. Insulin sensitivity was estimated from the relationship of M to the concentration of insulin during the last 30 minutes of the clamp. RESULTS: The percentage of fat and total body fat mass were similar between AA and white women, whereas fat-free mass was higher in African American women. Visceral adipose tissue was not different between groups, but subcutaneous abdominal fat was 17% higher in the AA than in the white women. AA women had an 18% greater mid-thigh muscle area (p < 0.01) and a 34% greater mid-thigh low-density lean tissue area than the white women. Fasting glucose concentrations were not different, but fasting insulin concentrations were 29% higher in AA women. Glucose utilization was 60% lower in the AA women because of a lower non-oxidative glucose disposal. Insulin sensitivity was 46% lower in the AA women. DISCUSSION: AA postmenopausal women have more mid-thigh intramuscular fat, lower glucose utilization, and are less insulin sensitive than white women despite comparable fitness and relative body fat levels.

Abdomen↗
PubMed2000

Effect of acute heat exposure on skin blood flow of the paralyzed thigh in persons with spinal cord injury.

OBJECTIVES: To investigate whether increased body temperature during heat exposure promotes skin blood flow of the thigh (SBFT) in individuals with spinal cord injury at rest. STUDY DESIGN: A prospective study with high lesion and with low lesion. SETTING: Hiroshima University, Higashi-Hiroshima, Japan. METHODS: Seven male paraplegics (T5-L2) and seven able-bodied subjects volunteered to participate in the experiment. First the subject rested for 1 h at an ambient temperature (Ta) of 25 degrees C and a relative humidity (Rh) of 50%. Thereafter, the subject moved to a climatic chamber heated to Ta of 33 degrees C an Rh of 50 - 55% and was exposed to this environment for 1 h. SBFT, stroke volume, heart rate, the skin temperature of the medial thigh (Tthigh) and the tympanic membrane temperature (Tty) were assessed during the experiment. RESULTS: The four subjects with high lesions between Th6 and Th10 (HL) showed no increase in SBFT, while the remaining three subjects with low lesion at Th11 or Th12 (LL) showed increased SBFT in the hot environment. Although Tty increased with exposure time in heat, correlation between Tty and SBFT was not significant in either paraplegic group. However, correlation between SBFT and Tthigh was highly significant in both groups. The increase in Tthigh in LL was due to increased skin blood flow in the thigh, while in HL it was considered attributable to heat transfer from the environment to the skin. CONCLUSION: These findings indicate that SBFT during heat exposure was largely dependent on the level of spinal cord injury. SBFT with low lesions increased during heat exposure when the sympathetic cutaneous vasomotor supply of the thigh was preserved.

Adult↗
PubMed2000

Histomorphology of rabbit thigh muscles: establishment of standard control values.

The thigh muscles of New Zealand White (NZW) rabbits are frequently used in experimental surgery, particularly for evaluation after reinnervation or ischaemia. Although histomorphometric analyses are regularly performed, morphological data for untreated thigh muscles in previously unoperated animals are not available. Specimens from the rectus femoris (RF), vastus medialis (VM) and adductor magnus (AM) muscles from both thighs were harvested in 7 untreated rabbits and were processed for histomorphometric evaluation. The right RF and VM were harvested in a further 5 rabbit hindlimbs after experimental denervation and reinnervation of the contralateral RF and subsequently processed for histomorphometric analysis. Muscle fibre type distribution, diameter and connective tissue content were evaluated on serial transverse cryosections reacted for ATPase and NADH tetrazolium reductase activity and statistical analysis was performed. In all untreated animals RF revealed the highest proportion of type I muscle fibres (right: 8.4+/-4%, left: 11.4+/-4.9%), whereas VM showed the highest percentage of IIa fibres (right: 31.9+/-5.5%, left: 28.3+/-7.8%) and AM the highest proportion of IIb/d fibres (right: 80.5+/-8.6%, left: 84.4+/-6.3%). Fibre type distribution and diameter in rabbits after contralateral experimental operations revealed a statistically significant difference from the data obtained in bilaterally untreated animals. Knowledge of the morphology of untreated muscles is fundamental to the understanding of changes induced by intervention to the ipsi and/or contralateral thigh muscles.

Analysis of Variance↗
PubMedDate not supplied

Effects of 3.3-MHz ultrasound on caudal thigh muscle temperature in dogs.

OBJECTIVE: To examine the tissue-temperature changes that occur at various depths during 3.3-MHz ultrasound (US) treatments of the caudal thigh muscles in dogs. STUDY DESIGN: A prospective, randomized, experimental study. ANIMALS: Ten mixed-breed research dogs. METHODS: Two US treatments, one at an intensity of 1.0 W/cm(2) and one at 1.5 W/cm2, were administered to the caudal thigh region of 10 adult male and female hound-type dogs weighing 20.5 to 25.0 kg. Needle thermistors were inserted in the caudal thigh muscles below the skin surface at depths of 1.0, 2.0, and 3.0 cm, directly under the US treatment area. Both intensities of US treatment were performed on each dog over a 10-cm2 area for 10 minutes using a sound head with an effective radiating area of 5 cm2. Treatments were administered in random order. Tissue temperature was measured before, during, and after US treatment until tissue temperature returned to baseline. RESULTS: At the completion of the 10-minute US treatment, the temperature rise at an intensity of 1.0 W/cm2 was 3.0 degrees C at the 1.0-cm depth, 2.3 degrees C at 2.0-cm depth, and 1.6 degrees C at 3.0-cm depth. At an intensity of 1.5 W/cm2, temperatures rose 4.6 degrees C at the 1.0-cm depth, 3.6 degrees C at 2.0-cm depth, and 2.4 degrees C at 3.0-cm depth. Tissue temperatures returned to baseline within 10 minutes or sooner after treatment in all dogs. CONCLUSIONS: This study demonstrates that significant heating occurs in the superficial thigh muscle of dogs during 3.3-MHz US. CLINICAL RELEVANCE: 3.3-MHz US can be used to increase superficial tissue temperature in dogs, although the amount of time that tissue temperature remains elevated is relatively short.

Animals↗
PubMed1999

De-epithelialised anterior (anterolateral and anteromedial) thigh flaps for dead space filling and contour correction in head and neck reconstruction.

Anterior (anterolateral and anteromedial) thigh flaps based on the descending branch of the lateral circumflex femoral vessels provide a long vascular pedicle and a large flap without sacrificing main vessels and muscles. Twenty-eight de-epithelialized anterior thigh flaps were transferred for reconstruction of head and neck defects following tumour ablation. Two flaps were lost in patients that had previously undergone high-dose radiotherapy following free tissue transfer. Vascularised fibula, vascularised iliac bone and other tissues were combined with anterior thigh flaps in 13 cases utilising the distal end or derivative branches of the vascular pedicle. Salivary fistula was seen in only one case, although there were many minor and major complications. In five cases, double skin flaps were harvested from the ipsilateral thigh. One of these flaps was used for coverage of intraoral defects, while the other was placed in the submandibular area to fill dead space. Compared with other methods, this multi-flap method is considered to be most suitable for dead space filling and contour correction.

Adult↗
PubMed2001

The short head of the biceps femoris as a monitor for the free lateral thigh flap in pharyngoesophageal reconstruction.

Free flaps are frequently used to reconstruct the defect following radical resection of pharyngoesophageal malignancy but postoperative monitoring of buried flaps is difficult. We have designed a monitoring-muscle flap using the short head of the biceps femoris muscle when using a free lateral thigh flap. The third and fourth perforators of the profunda femoris artery, the main vascular pedicle of the lateral thigh flap, pass through the short head of the biceps femoris. Partial excision of the short head of the biceps femoris muscle does not result in any functional disturbance of the leg, and the viability of the buried lateral thigh flap can be monitored by observing the exposed muscle through a small window in the neck. Between April and October 1998 five patients underwent pharyngoesophageal reconstruction by this method. The short head of the biceps femoris was used to monitor the main flap in three patients and to obliterate the dead space after neck dissection in two patients. There were no recipient-site complications such as fistula or infection and no disturbance of thigh function.

Aged↗
PubMed2002

Role of the anterolateral thigh flap in head and neck reconstruction: advantages of moderate skin and subcutaneous thickness.

Skin-flap thickness is an important consideration when choosing a free flap for head and neck reconstruction. The anterolateral thigh flap, the rectus abdominis flap, and the radial forearm flap, which included the epidermis, the dermal, and the subcutaneous layers, were measured using ultrasonography in 31 patients. The mean skin and subcutaneous thickness of the anterolateral thigh flap was 7.1 mm; the rectus abdominis flap was 13.7 mm; and the radial forearm flap was 2.1 mm. Further analysis revealed a statistically significant difference among the skin and subcutaneous thickness of the three flap groups. Of the 44 anterolateral thigh flap transfers done for head and neck reconstruction after cancer ablative surgery, 41 (93.2 percent) were transferred successfully. The anterolateral thigh flap creates a moderately thick skin flap, and is less variable in thickness across its area than is the rectus abdominis flap. The flap is adaptable for reconstruction of head and neck soft-tissue defects.

Adult↗
PubMed2003

Anterolateral thigh flap for breast reconstruction: review of the literature and case reports.

More women than ever before are undergoing mastectomies secondary to increased awareness and screening. This has also caused a corresponding increase in the number of breast reconstructions requested each year. The demand for improved results has fueled recent advances in new techniques. Aside from implant reconstruction, the methods now being employed are related to autogenous donations and reconstruction. Currently, the most commonly used techniques for autogenous breast reconstruction are the DIEP (deep inferior epigastric perforator) and TRAM (transverse rectus abdominis myocutaneous) flaps from the lower abdomen. The anterolateral thigh flap is a type of perforator flap usually described for use in head and neck reconstruction. The authors have discovered this flap's utility as an alternative in autogenous breast reconstruction when the abdomen is not available as a donor site. A review of the literature reveals a dearth of experience in using the anterolateral thigh flap for breast reconstruction. The article reviews the literature with regard to current uses of the anterolateral thigh flap, and then reports three case studies which highlight the thigh flap as an excellent alternative for breast reconstruction in selected patients.

Adult↗
PubMed2005

Recruitment of the thigh muscles during sprint cycling by muscle functional magnetic resonance imaging.

The purpose of the present study was to investigate recruitment patterns of the thigh muscles during maximal sprint cycling by muscle functional magnetic resonance imaging (mfMRI). Twelve healthy men participated in this study and performed 2, 5, and 10 sets of 6-s supramaximal cycling with a load of 7.5 % of their body weight with 0.5 min of rest between the sets. Before and immediately after the exercise, T2-weighted MR images, i.e. mfMRI, of the right-thigh were taken to calculate T2 of eleven thigh muscles. Vastus lateralis, semitendinosus, and sartorius were the highest activated, i. e. had the greatest T2 change, among the quadriceps, hamstring, and adductors, respectively, compared with other muscles. Total power output during 2, 5, and 10 sets of sprint cycling was correlated with percent change in T2 in the quadriceps correlated (r (2) = 0.507 to 0.696, p < 0.01), the hamstring (r (2) = 0.162 to 0.335, p < 0.05 approximately 0.001), and the adductor muscles (r (2) = 0.162 to 0.473, p < 0.05 approximately 0.0001). With use of stepwise regression analysis, total power output was significantly correlated with % change in T2 of the vastus medialis (VM) (p < 0.0001) and vastus intermedius (VI) (p < 0.05) (r (2) = 0.698, p < 0.0001). We concluded that eleven thigh muscles were activated non-uniformly, and that the VM and VI play a key role during maximal sprint cycling.

Adult↗