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Mutational analysis of Stubble-stubbloid gene structure and function in Drosophila leg and bristle morphogenesis.

The Stubble-stubbloid (Sb-sbd) gene is required for ecdysone-regulated epithelial morphogenesis of imaginal tissues during Drosophila metamorphosis. Mutations in Sb-sbd are associated with defects in apical cell shape changes critical for the evagination of the leg imaginal disc and with defects in assembly and extension of parallel actin bundles in growing mechanosensory bristles. The Sb-sbd gene encodes a type II transmembrane serine protease (TTSP). Here we use a Sb-sbd transgenic construct to rescue both bristle and leg morphogenesis defects in Sb-sbd mutations. Molecular characterization of Sb-sbd mutations and rescue experiments with wild-type and modified Sb-sbd transgenic constructs show that the protease domain is required for both leg and bristle functions. Truncated proteins that express the noncatalytic domains without the protease have dominant effects in bristles but not in legs. Leg morphogenesis, but not bristle growth, is sensitive to Sb-sbd overexpression. Antibody localization of the Sb-sbd protein shows apical expression in elongating legs. Sb-sbd protein is found in the base and shaft in budding bristles and then concentrates at the growing tip when bristles are elongating rapidly. We propose a model whereby Sb-sbd helps coordinate proteolytic modification of extracellular matrix attachments with cytoskeletal changes in both legs and bristles.

Animals↗

Elevation of a patient's trunk and legs does not influence length of stay in the post-anesthesia care unit.

CONTEXT: Patient recovery time after anesthesia depends on problem-oriented monitoring and individual assessment. OBJECTIVE: To investigate the influence of patient positioning on post-anesthesia recovery time. TYPE OF STUDY: Retrospective. SETTING: Post-anesthesia care unit, Hospital das Clínicas, São Paulo. METHODS: Data were obtained from patients recovering from anesthesia in a supine horizontal position or with their trunk and legs elevated at 30 degrees. Data were recorded every 30 minutes. The start time was considered to be the admission to the unit, and the final measurement was taken with the patient reached an Aldrete-Kroulik index of 10. The length of time until discharge was recorded. RESULTS: 442 patients recovering after general (n = 274) or regional anesthesia (n = 168) were assigned to be kept in a supine position or with their trunk and legs elevated. There was no difference in the medians for non-parametric results, between supine position (75 min, n = 229) and trunk and legs elevated (70 min, n = 213); p = 0.729. Patients recovered faster from regional anesthesia with trunk and legs elevated (70 min) than in the supine position (84.5 min), although not significantly (p = 0.097). There was no difference between patients recovering from general anesthesia, no matter the positioning (70 min; p = 0.493). DISCUSSION: Elevated legs may supposedly improve venous return and cardiac output since spinal anesthesia blocks sympathetic system and considering leg-raising has been shown to improve cardiac output from hipovolemia. Our findings did not support this hypothesis. Some limitations included a retrospective collection of data that did not allow randomization for recovery position and the unregistered duration of the exposure to the anesthetic drugs. CONCLUSIONS: There was no difference in anesthesia recovery time in relation to positioning patients supinely or with trunk and legs elevated.

Adult↗

Genetic parameters for feet and leg traits evaluated in different environments.

The objective of this study was to test for genotype x environmental interaction (GXE) for feet and leg traits scored in different environments. Genetic correlations of seven feet and leg traits were estimated across different management systems: free versus tie stalls, slatted versus solid flooring, and intact versus trimmed hooves. Data were records from first-lactation Holstein cattle. Traits were claw uniformity, depth of heel, rear leg rear view, foot angle, bone quality, rear leg side view, and overall feet and legs. Different subsets of data were used for each comparison, resulting in 147,400; 53,550; and 145,160 records for housing, flooring, and hoof trimming management systems, respectively. Genetic parameters were estimated using REML and two-trait models in which for each animal a given trait was observed in one environment and missing in the other. Phenotypic scores were lower with tie stalls, slatted floors, and no trimming. Heritabilities tended to be greater in herds with tie stalls and slatted floors. Trimming had little effect on genetic parameters. The genetic correlations of feet and leg traits across pairs of management systems were > or = 0.85, except for rear legs, rear view. Therefore, effects of GXE were assumed to be of little importance and modification of genetic evaluation procedures on the basis of housing, flooring, and hoof conditions seems unnecessary.

Animal Husbandry↗

Relationship between udder and leg hygiene scores and subclinical mastitis.

The objective of this study was to determine the relationship between udder and leg hygiene scores of lactating dairy cattle and measures of subclinical mastitis. Study animals (n = 1250) consisted of lactating dairy cows from eight commercial dairy farms. Herds were enrolled during December 2000 and January 2001 and were visited bimonthly for a total of five visits per herd. Udder and leg hygiene scores were recorded by one person using a four-point scale ranging from one (very clean) to four (very dirty). Udder and leg hygiene scores were compared to bacteriological cultures of milk samples and monthly individual SCC values. Mean hygiene scores were 2.09 and 2.33 for udders and legs, respectively. Udder hygiene scores (UHS) were significantly associated with leg hygiene scores and varied among farms. Linear somatic cell scores increased as udder hygiene score increased. Significant differences in somatic cell scores were observed for all contrasts of udder hygiene score, except between scores of 1 and 2 and of 3 and 4. Linear somatic cell scores were associated with leg hygiene scores, but the only significant contrast was between leg hygiene scores of 2 and 4. There was a significant association between the prevalence of intramammary contagious pathogens and udder hygiene score. The prevalence of intramammary environmental pathogens was significantly associated with udder hygiene score and was 7.7, 10.0, 10.6, and 13.5% for UHS of 1, 2, 3, and 4, respectively. The prevalence of environmental pathogens was not associated with LHS. Cows with udder hygiene scores of 3 and 4 were 1.5 times more likely to have major pathogens isolated from milk samples compared with cows with hygiene scores of 1 and 2.

Animal Husbandry↗

Formation of heterocyclic amines in cooked chicken legs.

The effects of frying and microwave cooking on generation of heterocyclic amines (HAs) in chicken legs with skin and without skin were studied. Chicken legs were microwave-cooked at 2,450 MHz for 5, 10, and 15 min with an output power of 700 W. Frying of chicken legs was conducted at 100 and 150 degrees C for 15 min and at 200 degrees C for 5, 10, and 15 min. The various HAs were analyzed by HPLC with diode-array detection. Results showed that both the varieties and contents of HAs and the weight losses of chicken legs increased along with increasing cooking temperature and time. With skin both the amounts of HAs and weight losses of chicken legs were less than those without skin under the same heating conditions. The weight losses of microwave-cooked chicken legs were higher than those of fried chicken legs. The formation of the aminomethylimidazoquinoline type of HAs could be reduced by choosing microwave cooking in place of frying. Frying led to the formation of both the aminomethylimidazoquinoline and the carboline types of HAs.

Amines↗

Randomized, double-blind, placebo-controlled study of the safety and efficacy of vitamin B complex in the treatment of nocturnal leg cramps in elderly patients with hypertension.

Nocturnal leg cramps is a common and troublesome problem in elderly individuals, and their etiology is unknown. Treatment with quinine is a common practice, but the effectiveness of the drug is doubtful and adverse drug effects are common. This randomized, double-blind, placebo-controlled study was conducted to evaluate the safety and efficacy of vitamin B complex capsules (fursulthiamine 50 mg, hydroxocobalamin 250 micrograms, pyridoxal phosphate 30 mg, and riboflavin 5 mg) in 28 elderly patients with hypertension who had severe nocturnal leg cramps that disturbed their sleep. Self-reported ratings of leg cramp frequency, duration, and intensity were used to evaluate severity of nocturnal leg cramps. Both the patients taking vitamin B capsules (n = 14) and those taking placebo (n = 14) received medications three times daily, and were examined regularly at 2-week intervals for 3 months. After 3 months, 86% of the patients taking vitamin B had prominent remission of leg cramps, whereas those taking placebo had no significant difference from baseline. Treatment with vitamin B complex significantly reduced the frequency, intensity, and duration of nocturnal leg cramps. Because quinine is not without potential for side effects, and vitamin B complex is a relatively safe and effective alternative, clinicians should reconsider the treatment of choice for nocturnal leg cramps.

Aged↗

Treatment of the leg ulcers by skin grafting.

The ulcers, located below the knees and remaining for 6 weeks and more, are called trophic leg ulcers. The leg ulcers of different etiology disable 0.8-1% of total Earth population. It was found that blood vessel problems in legs account for more than 80% of ulcers; even 65% from these are caused by venous diseases. In Lithuania about 8000 patients suffer from venous trophic ulcers. Regardless of modern methods the treatment of leg ulcers remains an extremely expensive process. The treatment cost of trophic ulcers is the highest of all surgical wounds and also requires a lot of personal investments. In order to assess the efficiency of autodermoplastics in the treatment of large venous ulcers in legs a prospective study was carried out of 111 patients who were treated in the Department of Plastic Surgery and Burns of Kaunas University of Medicine Hospital from January 2001 to January 2004. The data was analyzed exceptionally of the operated 54 patients with venous origin ulcers open for more 6 months or exceeding 50 cm2. The above-mentioned patients were prepared for surgery by dressing the wounds with hydrocolloid Granuflex bandages and were operated by transplanting a 0.2-0.3 mm thick skin graft. The results were estimated by the surgeon during the dressings after the operation. The graft was taken in 35 (64.81%) cases; in 19 (35.19%) cases the graft was partially not taken and there were no cases when it was not taken at all. We came to the conclusions that skin graft transplantation is efficient in treatment of trophic venous leg ulcers larger than 50 cm2 and cures the trophic leg ulcers of vein origin completely in 2-3 weeks for 64.81% patients.

Adult↗

Physiologic responses to prolonged electrically stimulated leg-cycle exercise in the spinal cord injured.

This study determined the physiologic responses to prolonged functional neuromuscular stimulation (FNS) leg-cycle exercise in seven quadriplegic and seven paraplegic subjects. Each subject completed 30 minutes of continuous FNS leg cycling during which open-circuit spirometry, impedance cardiography, auscultation, and fingertip capillary blood sampling were used to assess metabolic and hemodynamic responses. Compared with resting values, oxygen uptake, carbon dioxide production, respiratory exchange ratio (RER), pulmonary ventilation, heart rate (HR), left ventricular stroke volume (SV), cardiac output (Qt), and blood lactate (La) concentration were significantly (p less than .05) elevated, whereas plasma volume, bicarbonate concentration, and pH were significantly decreased in both groups during prolonged FNS leg-cycle exercise. Mean arterial pressure remained unchanged in quadriplegic and paraplegic subjects during the prolonged FNS leg-cycle exercise bout. Persons with quadriplegia elicited significantly lower MAP and tended to have lower SV and Qt responses than persons with paraplegia, probably due to a higher degree of sympathetic dysfunction and circulatory hypokinesis during FNS leg-cycle exercise. All other physiologic variables responded similarly between groups. We speculate that the relative increases observed for HR (33% to 60%), SV (45% to 69%), and Qt (113% to 142%) during prolonged FNS leg-cycle exercise create a sufficient cardiac-volume load to promote central cardiovascular conditioning in persons with both quadriplegia and paraplegia. The La accumulation (4.7 to 5.2 mmol.L-1) in the spinal cord injured during prolonged FNS leg cycling is unusually high for the power output attained (5.2W and 6.1W for quadriplegia and paraplegia, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Chronic anterior-compartment syndrome of the leg. Results of treatment by fasciotomy.

Thirty legs in nineteen patients, eleven with bilateral and eight with unilateral chronic anterior-compartment syndrome, were treated by fasciotomy. In addition, five of these patients (six legs) had compression of the superficial peroneal nerve: two before and three after fasciotomy. One patient also had lateral compartment syndrome in one leg. The patients who had compression of the superficial peroneal nerve were relieved by partial fasciectomy and fasciotomy of the lateral compartment. In one of these patients, with bilateral nerve compression, both superficial peroneal nerves were anomalous. The patient who had lateral compartment syndrome was relieved by fasciotomy of this compartment. Two patients required a second fasciotomy due to recurrence of the chronic compartment syndrome. At an average length of follow-up of twenty-five months after fasciotomy for anterior compartment syndrome, functional capacity was unlimited or increased in eighteen patients (twenty-eight legs) and was unchanged in one patient (two legs) who had had compression of the superficial peroneal nerve. The intramuscular pressures in the anterior compartment were normal at rest as well as during and after exercise eight months after the original fasciotomy in twenty-eight legs and eight months after the second fasciotomy in two legs.

Adolescent↗

Enhanced incidence of leg abnormalities in reovirus WVU 2937-infected chickens fed various dietary levels of selected vitamins.

Five experiments were conducted to evaluate the incidence of leg abnormalities of 4-, 6-, and 8-week-old reovirus WVU 2937-infected and uninfected chickens fed diets containing 20%, 100%, or 200% of the 1977 National Research Council nutrient requirements (NRC-77) of poultry for manganese, biotin, niacin, choline, or folic acid. Reovirus infection significantly elevated the incidence of leg abnormalities in the biotin-, niacin-, and folic-acid-deficient chickens and decreased the incidence of leg abnormalities in choline-deficient chickens. Reovirus-infected male chickens had a significantly greater incidence of leg abnormalities than reovirus-infected female chickens in the biotin, niacin, and folic acid studies. No sex differences in the incidence of leg abnormalities were observed in uninfected chickens. The incidence of leg abnormalities decreased with increasing dietary levels of biotin, niacin, choline, or folic acid in all chickens except reovirus-infected male chickens in the biotin study. In the manganese study, neither reovirus infection nor dietary level had any effect on the incidence of leg abnormalities in male or female chickens.

Age Factors↗

The value of combined strain gauge plethysmography and radioactive iodine fibrinogen scan of the leg in the diagnosis of deep vein thrombosis.

The fallibility of the clinical diagnosis of deep venous thrombosis has led to a variety of noninvasive diagnostic methods, for example, Doppler ultrasound, plethysmography, 125I fibrinogen and radionuclide phlebography. This study was undertaken to analyze the value of combined strain gauge plethysmography and 125I fibrinogen scan of the leg in the diagnosis of deep venous thrombosis. The study was carried out upon 368 patients with suggestive findings of venous thrombosis. Four hundred and fifty strain gauge plethysmograms were reviewed. Venograms were done upon 106 limbs and 125I fibrinogen leg scans, on 136 limbs. Of the 64 limbs with normal strain gauge plethysmograms which had venograms, 58 were normal, five had incompetent perforators and one limb had deep venous thrombosis. Of the 42 legs with abnormal strain gauge plethysmograms which had venograms, 25 had deep venous thrombosis, 15 had incompetent perforators and two were normal. Twenty-three of 24 legs having both abnormal strain gauge plethysmograms and leg scans were confirmed to have deep venous thrombosis at venography. Fourteen of 18 legs with abnormal strain gauge plethysmograms but normal scans were found to have incompetent perforators. We conclude, that the strain gauge plethysmogram is a reliable test in excluding deep venous thrombosis and, when combined with the fibrinogen leg scan, is reliable in its diagnosis.

Adolescent↗

Low frequency analysis of opening sound for detection of single leg separation of Björk-Shiley Convexo-Concave heart valves.

The aim of the study was to evaluate the potential of low frequency analysis of valve opening sounds in order to detect the presence of single leg separation of the outlet strut of Björk-Shiley convexo-concave (BSCC) valves. Single leg separation is believed to precede outlet strut fracture. Phonocardiograms (PCG) of 28 patients with BSCC mitral valves were recorded and filtered to limit the frequency bandwidth between 90 and 1400 Hz (-20 dB). Twenty-four patients had BSCC valves that were presumably unimpaired and four patients had BSCC valves with single leg separation. Spectral analysis consisted of computing the power spectrum for 30 opening sounds for each patient using a fast Fourier transform (FFT) algorithm on an IBM-PC compatible computer. For each patient, the power spectra of the selected opening sounds were averaged and normalized in amplitude on a 0-100% linear scale. A ratio of the high to the low frequency area of the averaged power spectra was computed and evaluated as a diagnostic feature to identify the valves with single leg separation. Six cut-off frequencies serving to distinguish between high and low frequency areas of the spectra were tested: 400, 450, 500, 550, 600, and 650 Hz. The results showed that the high-to-low frequency area ratios tested were all able to identify valves with single leg separation. The correct classification performance was 96.4%. The sensitivity to detect valves with single leg separation was 75% and the specificity was 100%. The positive predictive value was 100% and the negative predictive value 96%. The study confirmed the potential of low frequency analysis of valve opening sounds to detect single leg separation of the outlet strut of BSCC valves implanted in humans.

Algorithms↗

A colour Doppler ultrasound study of venous reflux in patients with chronic leg ulcers.

OBJECTIVES: to evaluate the distribution of superficial and deep venous reflux in patients with chronic leg ulcers. MATERIALS: retrospective study of 186 patients with chronic leg ulcers (212 lower limbs). RESULTS: in 127 legs without arterial disease and a history of deep venous thrombosis (DVT), 62 (49%) had superficial, 45 (35%) had superficial and deep, and 14 (11%) had isolated deep venous reflux. In legs with a previous DVT, isolated deep venous reflux was more common (21/55, 38%) but superficial reflux, often in combination with deep reflux, still predominated (56%). CONCLUSIONS: a large part of the venous insufficiency causing venous leg ulcers is superficial and suitable for varicose vein surgery. In patients with chronic leg ulcers most reflux affects the superficial system and is potentially suitable for surgical correction.

Adult↗

Counteracting venous stasis during acute lower leg immobilization.

AIM: During lower limb immobilization, patients are at risk to develop deep venous thrombosis. Recently, a water-pad was developed that should counteract venous stasis. The water-pad, located under the plaster, mobilizes water from the foot to the calf during weight bearing and, thereby, imitates muscle pump function. The purpose of this study was to assess the effect of the water-pad on venous pump function in healthy individuals. METHODS: In 21 healthy subjects (10 men and 11 women) both legs were plastered. Venous pump function was assessed by plethysmography measuring lower leg venous ejection fraction and volume. Subjects were tilted from the supine position to upright standing to determine total venous volume. Hereafter, stepping was performed to measure venous ejection fraction and volume under different filling conditions of the water-pad (0, 50, 100, 150, 200, 250 and 300 mL). Different sizes of water-pads (small, medium and large) were applied to each plastered leg in order to test the effectiveness and to relate optimum size to anthropometrical data. RESULTS: The venous ejection fraction increased significantly from 30 +/- 17% to a maximum of 42 +/- 19% during stepping with increasing filling condition (RM anova; P = 0.009). Ejection volume also enhanced significantly during stepping with increasing filling condition from 1.3 +/- 0.7 to 1.9 +/- 0.9 mL (100 mL)(-1) (RM ANOVA; P = 0.006). The optimal filling condition of the water-pad depended on the water-pad size, while body height was the best predictive value for the water-pad size (Pearson's R = 0.72, P < 0.001). CONCLUSION: The filled water-pad markedly increased the venous ejection fraction and volume of the lower leg during stepping, hereby counteracting stasis of venous blood in the immobilized lower leg. Therefore, the water-pad seems to be a promising tool to prevent deep venous thrombosis during periods of lower leg immobilization.

Adult↗

How echographic image analysis of venous oedema reveals the benefits of leg elevation.

OBJECTIVE: Venous insufficiency, leading to venous oedema, is a key pathogenic factor for the non-healing of venous leg ulcers. This study aimed to evaluate the effects of leg elevation on venous oedema. METHOD: Ten patients aged 44-89 years (median: 61) with leg oedema had high-frequency B-mode ultrasound scanning and digital image analysis before and after three to four hours of leg elevation. The echographic image analysis system was used, where oedema is represented by the hypoechogenic part of the image--that is, the total number or density of low echogenic pixels (LEPs) in a particular area. RESULTS: Compared with pre-elevation, the volume of the lower leg decreased by 2.9% +/- 0.6 (138 cm3 +/- 39) after three to four hours' elevation (p < 0.05). After elevation, the LEPs in the upper, middle and lower sites of the limb decreased by 8.8%, 15.6% and 17.3% respectively, reaching statistical significance (p < 0.05) in the lower site. The ratio of LEPs in the upper and lower dermis in the upper, middle and lower sites decreased by 30.3%, 45.8% and 22.5% respectively. This was significant in both the middle and lower sites (p < 0.01). After elevation dermal thickness increased by 0.047 mm, 0.194 mm and 0.232 mm respectively. This change was statistically significant in the middle (p < 0.05) and lower sites of the limb (p < 0.01). CONCLUSION: LEPs are a sensitive marker of dermal oedema and its effects. Leg elevation is extremely effective in reducing oedema, even if only for three to four hours.

Adult↗

The peripheral resistance in arteries of legs is inversely proportional to the severity of chronic venous insufficiency.

There are conflicting reports in the literature about the existence of arteriovenous shunting in legs with chronic venous insufficiency. Using duplex scanning, we have earlier shown that there is lowered peripheral resistance in the arteries of legs with venous ulcer together with premature venous filling in angiography. In the present study we investigated the peripheral resistance in the arteries of 16 legs with chronic venous insufficiency without present ulcer. We compared the results with those obtained from 12 healthy legs and from 18 legs with venous ulcer. There was a highly significant inverse correlation between the severity of chronic venous insufficiency and the peripheral resistance in the popliteal, the dorsal pedal and the posterior tibial arteries (p < 0.001). These results suggest that there is arteriovenous shunting in legs with chronic venous insufficiency and that this phenomenon correlates with the degree of chronic venous insufficiency.

Arteries↗

Abnormal venous function in patients with homozygous sickle cell (SS) disease and chronic leg ulcers.

Chronic leg ulceration is a major cause of morbidity in homozygous sickle cell (SS) disease in Jamaica. These ulcers have features in common with venous ulcers in patients with a normal haemoglobin genotype (AA). Thus we sought to determine whether there is abnormal venous function in the legs of patients with SS disease who have ulcers. Experiments were performed on 15 SS patients with ulcers, and on 15 SS patients and 15 AA subjects with no history of leg ulcers. Changes in venous blood volume of the bottom one-third of the leg induced by venous occlusion and release were studied by air plethysmography, providing indices of segmental venous capacitance (SVC), maximal venous outflow (MVO) and venous emptying time (VET). The changes in volume (ambulatory volume change; AVC) induced by a period of leg exercise were also measured at the ankle (AVCa) and calf (AVCc); venous refilling times at these sites (RTa and RTc respectively) were also measured. Finally, cutaneous red blood cell flux recovery time (FRT) after ankle exercise was assessed by laser Doppler flowmetry. Measurements were also made of haematological variables. SVC, MVO and VET did not differ between the groups, indicating no deep venous obstruction in the SS patients with ulcers. AVCc, AVCa and RTc did not differ among the three subject groups. However, compared with AA subjects, SS patients with ulcers had reduced RTa and FRT. Moreover, RTa and FRT were further shortened in SS patients with ulcers relative to SS patients without ulcers. Since the levels of anaemia were similar in SS patients with and without ulcers, these differences cannot be attributed to differences in arterial flow secondary to anaemia. These results suggest abnormal venous function in SS patients with ulcers, relative to both AA subjects and SS patients without ulcers. We propose that there is incompetence of venous valves draining the ankle region of SS patients with ulcers: the consequent raised venous pressure contributes to the slow healing and, possibly, to the onset of leg ulceration in SS disease.

Adult↗

[Sonographic leg length measurement].

After brief presentation of the clinical and radiological methods to measure the leg length and the leg length difference the authors outline the new diagnostic method for measuring the leg length and the leg length difference by means of real time sonography. Postmortem tests and clinical examples show that ultrasound is ideal to determine exactly the length of femur and tibia. The joint gaps on the hip, knee and upper ankle joint can be demonstrated by means of a 5 MHz linear scanner. A 1 mm strong metal bar on the skin and under the scanner is placed at right angles to the longitudinal axis of the body so that the bar can be seen in the centre. A measuring device gives the distances of the joint gaps in cm so that the difference correspond to the real length of femur and tibia. This standardised measuring is done by a particularly developed bearing and measuring device. The results of the sonographical measurements on 20 corpses and checking after consecutive dissections showed in 75% of cases a 100% sonographic measuring accuracy of the total leg length. The separately considered results for femur (85%) and tibia (90) were even better. The maximum sonographic measuring fault was 1.0 cm for the femur (in one case) and 0.5 cm for the tibia, respectively. All sonographic measurements were performed with the Sonoline SL-1 of the Siemens Company (Erlangen, W-Germany). Thus, sonographical measuring of the leg length offers a reliable, non-invasive method that can be repeated as often as necessary and is simply executed.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗