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PubMedDate not supplied

Carotid and lower extremity arterial disease in elderly adults with isolated systolic hypertension.

The prevalence of carotid and lower extremity arterial disease was assessed in a healthy population of 56 elderly adults with isolated systolic hypertension. Duplex scans were performed to determine the extent of carotid disease, and postexercise ratios of ankle to arm systolic blood pressure were measured to assess lower extremity arterial disease. Internal carotid stenosis was found in 38% (21 of 56) of subjects and lower extremity arterial disease in 42% (23 of 55). The strongest predictor of internal carotid stenosis was lower extremity arterial disease. Independent risk factors for lower extremity arterial disease were smoking, internal carotid stenosis, and age. A measure of extent of carotid plaque was found to correlate with age, carotid stenosis, male sex, history of smoking, and total cholesterol. The high prevalence of peripheral vascular disease in this population may be related to their age and blood pressure. The high correlation between carotid stenosis and lower extremity arterial disease suggests that persons with peripheral vascular disease should be assessed and treated for atherosclerotic disease in general.

Aged↗

PubMed1980

Comments on the functional asymmetries of the lower extremities.

Several tasks have been used to establish laterality in the lower extremities, but most of them are not satisfactory. The lower extremities are involved in various posturomotor, locomotor and operant activities, and several kinds of differentiated bilateralizations of the lower limbs can be identified. A distinction between leggedness and footedness seems warranted. The complexity of the functional asymmetries of the lower extremities requires new methods in both research and clinical testing, with elecctrophysiological procedures as a promising approach. Available evidence indicates that the functional asymmetries of the axial neuromotor mechanisms have to be considered in the study and the assessment of those of the lower extremities.

Conditioning, Operant↗

PubMed2004

The use of free anterolateral thigh flap for reconstructing soft tissue defects of the lower extremities.

The goal of soft tissue reconstruction in the lower extremities is to provide a functional and cosmetically acceptable limb. The anterolateral thigh flap has become one of the most popular options for soft tissue defect reconstruction recently because of the large amount of skin available and the reliable and versatile nature of this material. The purpose of this article is to present our experiences with the free anterolateral thigh flap for the reconstruction of soft tissue defects of the lower extremity. From April 2002 to October 2003, 31 consecutive free anterolateral thigh flaps were used. There were 24 male and 7 female patients, and their ages were between 3 and 78 years. The size of the flaps ranged from 11 to 34 cm long and 6 to 16 cm wide. In 9 patients, the flaps were harvested in a flow-through manner to both reconstruct soft tissue defects and protect and maintain the vascular status of the lower extremities. In these patients, the pedicle was interposed between vascular gaps, either present or created, in the extremity. The patency of distal anastomosis with the course of the distal vessel was confirmed by using conventional Doppler flow monitoring in flow-through flaps. In 4 cases, thinning of the flap was performed. In 3 patients, flaps were used in a neurosensorial fashion. Four flaps required reoperation due to vascular compromises. While 3 of these were salvaged, 1 flap was lost due to recipient arterial problems. Sixteen cases underwent split-thickness skin grafting of the donor site. No infection or hematomas were observed. We conclude that the anterolateral thigh flap is an ideal and versatile material, especially for lower extremity reconstructions, with its functional and cosmetic advantages, and it can be considered a suitable alternative to the most commonly used conventional soft tissue flaps.

Adolescent↗

PubMed2005

Effects of vehicle bumper height and impact velocity on type of lower extremity injury in vehicle-pedestrian accidents.

In nonfatal passenger vehicle-pedestrian accidents, the lower extremities are the most commonly injured body parts. The European Enhanced Vehicle-safety Committee Working Group 17 (EEVC/WG17) pedestrian subsystem test method using a legform impactor has been developed mainly for evaluation of aggressiveness of the front bumper of passenger vehicles. However, in recent years the number of sports utility vehicles (SUV) with a high bumper has been rapidly increasing. Since the bumper height is different between a passenger vehicle and an SUV, the type of lower extremity injury may be different. The type of lower extremity injury caused by this different bumper height should be clarified, because the test method and vehicle safety countermeasure must take into account a certain type of injury. Furthermore, the effect of vehicle impact velocity on the type of lower extremity injury in vehicle-pedestrian accidents has not been investigated so far. Therefore, the objective of this study is to clarify the effect of vehicle bumper height and vehicle impact velocity on the type of lower extremity injury in vehicle-pedestrian accidents. The Pedestrian Crash Data Study (PCDS), an in-depth accident database in the USA, was used for the current analyses. The results indicate that the type of injury, i.e., to the tibia and knee ligament, could become an injury to the femur with an increase in bumper height. Furthermore, the main injury at an impact velocity of around 20-30km/h is to the knee ligament. On the other hand, the main injury at an impact velocity of around 40km/h is a fracture of the lower extremities.

Accidents, Traffic↗

PubMed1993

Significance of pre-existent conditions in basal cell carcinoma on the lower extremities.

BACKGROUND: Basal cell carcinoma (BCC) rarely appears on the lower extremities; over 85% appear on the head and neck. CASE REPORTS: Five patients had BCC on the lower extremity. Histologically, this was of the superficial type. One patient developed a lesion of actinic keratosis. RESULTS: The presence of pre-existent cutaneous changes of BCC arising on the lower extremities was studied. Among 40 tumors reported in Japan, 10 cases (25%) had pre-existent cutaneous changes. This value is significantly higher than those of BCC over the whole body in both Japanese and Caucasian. CONCLUSIONS: Pre-existent cutaneous changes, thus, are thought to be a possible etiologic factor in the pathogenesis of BCC on the lower extremities.

Adult↗

PubMed1990

Real-time ultrasound in the diagnosis of acute deep venous thrombosis of the lower extremity.

One hundred twenty-six patients with clinically suspected acute deep venous thrombosis of the lower extremity (DVT) were examined comparatively with ultrasound and venography. In total, 174 lower extremity venograms were obtained. Ultrasonic examinations were performed on patients in the supine position. The venous segments were evaluated almost exclusively with transversal scanning. In the thigh, the only criterion for DVT was the reduced or absent compressibility of the venous lumen when gently compressed with the transducer. In the calf, normal unobstructed veins can usually not be viewed in the supine patient, whereas thrombotic veins appear as sonolucent, incompressible channels. Eight-three of the 174 lower extremity venograms were positive for DVT. In the majority of cases (53 of 83) the thrombotic process had involved two or more segments in combination. The sites of involvement of the different venous segments were distributed as follows: 24 occlusions of the common femoral vein, 52 of the superficial femoral vein, 56 of the popliteal vein, and 71 of the calf veins. Ultrasound had a sensitivity of 100% for thrombosis of the common femoral vein, 96% for the superficial femoral veins, 98% for the popliteal vein, and 93% for the calf veins. For the entire lower extremity, in regard to the diagnosis of thrombosis, the overall sensitivity was 95%. In 90% the extension of the occlusion was foreseen correctly. In no cases were false-positive results reported. Thus the overall specificity was 100%. The authors conclude that real-time ultrasound is a highly accurate method for the diagnosis of DVT of the lower extremity. It is the only indirect method capable of evaluating the venous system of the thigh, as well as that of the calf, with high accuracy. It should be the first choice of diagnostic imaging method in the diagnosis of deep venous thrombosis of the lower extremity.

Adolescent↗

PubMed1983