SEARCH · PubMed Health

Results for “THIGH”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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

At least 37 records · Page 2Linked to original sources

PubMed2005

The innervated anterolateral thigh flap: anatomical study and clinical implications.

During the past 20 years, the neural anatomy of many flaps has been investigated, although no extensive studies have been reported yet on the anterolateral thigh flap. The goal of this study was to describe the sensory territories of the nerves supplying the anterolateral thigh flap with dissections on fresh cadavers and with local anesthetic injections in living subjects. The sensate anterolateral thigh flap is typically described as innervated by the lateral cutaneous femoral nerve. Two other well-known nerves, the superior perforator nerve and the median perforator nerve, which enter the flap at its medial border, might have a role in anterolateral thigh flap innervation. Twenty-nine anterolateral thigh flaps were elevated in 15 cadavers, and the lateral cutaneous femoral nerve, the superior perforator nerve, and median perforator nerve were dissected. In the injection study, the lateral cutaneous femoral nerve, superior perforator nerve, and median perforator nerve in 16 thighs of eight subjects were sequentially blocked. The resulting sensory deficit from each injection was mapped on the skin and superimposed on the marked anterolateral thigh flap territory. The study shows that the sensate anterolateral thigh flap is basically innervated by all three nerves. The lateral cutaneous femoral nerve was present in 29 of 29 thighs, whereas the superior perforator nerve was present in 25 of 29 and the median perforator nerve in 24 of 29 thighs. Furthermore, in the proximal half of the flap, the lateral cutaneous femoral nerve lies deep, whereas the superior perforator nerve and median perforator nerve lie more superficially. Whereas the lateral cutaneous femoral nerve innervates the entire flap, the superior perforator nerve innervates 25 percent of the flap and the median perforator nerve innervates 60 percent of the flap. Clinically, a small anterolateral thigh flap (7 x 5 cm) can be raised sparing the lateral cutaneous femoral nerve and using only the selective areas innervated by the superior perforator and median perforator nerves. Alternatively, a large anterolateral thigh flap can be raised with this multiple innervation. This can be helpful if one wants to harvest the flap under local anesthesia. Sensate bilobed flaps can be harvested when dual innervated flaps are required.

Cadaver↗

PubMed2004

[Double anterior (anterolateral and anteromedial) thigh flaps for reconstruction of head and neck defects].

Although the anterolateral and anteromedial thigh flaps have such disadvantages as anatomical variations in the lateral circumflex femoral system and its cutaneous perforators, they have a sufficient number of cutaneous perforators on the anterior aspect of the thigh in many cases, meaning double anterior thigh flaps can be elevated from the ipsilateral thigh. We report 8 cases in which single-pedicle double anterior thigh flaps were transferred for reconstruction of head and neck defects following resection of head and neck tumors from January 1995 to March 2001 at Okayama Saiseikai General Hospital. Eight double anterior thigh flaps were classified into the following 3 types by perforator derivation: Type I flaps consisting of double anterolateral thigh flaps with a single vascular source were elevated in 4 cases. Type II flaps consisting of anterolateral thigh flap and anteromedial thigh flap supplied by separate branches from a single vascular source were elevated in 2 cases. Type III flaps, in which two anterior thigh flaps were harvested separately and constructed into a single flap with microvascular anastomosis, were elevated in 2 cases. Double anterior thigh flaps were combined with vascularized bone, and 2 flaps supplied by independent long vascular pedicles from a single vascular source could be 3-dimensionally arranged. All flaps completely survived in 7 cases and functionally and aesthetically acceptable results were obtained except in 1 case whose flap was lost to major necrosis after infection. We concluded that the single-pedicle double-flap technique using anterior thigh flaps is useful in 3-dimensional reconstruction of massive complex head and neck defects since sufficient tissue implant with preserved blood flow and free flap arrangement is made available.

Adult↗

PubMed1997

Thigh pain following tourniquet application in simultaneous bilateral total knee replacement arthroplasty.

Thigh pain following tourniquet application is a common patient complaint in the early postoperative period following total knee arthroplasty. Postoperative thigh pain was evaluated in 28 consecutive simultaneous bilateral total knee arthroplasty patients between April 1996 and October 1996. A prospective, double-blind, randomized clinical trial was performed. Tourniquet pressure of 350 mmHg was used on 1 thigh (thigh 1) and 100 mmHg plus systolic blood pressure on the other (thigh 2). A scale of pain (no pain, mild, moderate, or severe) was applied on the first, second, and third days, as well as 2 and 6 weeks after surgery. There were 16 men and 12 women with a mean age of 72 years (range, 55-85 years). The mean tourniquet time was similar in both groups (thigh 1 = 23 minutes, thigh 2 = 22 minutes). The mean tourniquet pressure in thigh 2 was 230 mmHg (range, 212-260 mmHg). There was a statistically significant difference in thigh pain on the first (P = .01), second (P = .01), and third (P = .001) postoperative days between both groups, with more thigh pain on the 350 mmHg side. At 6 weeks after surgery, the difference in thigh pain was gone. For total knee arthroplasty, using the tourniquet at a pressure of 100 mmHg above the systolic blood pressure is recommended. This is adequate to provide a bloodless field and will result in a less unpleasant postoperative period.

Aged↗

PubMed2005

Prediction of DXA-determined whole body fat from skinfolds: importance of including skinfolds from the thigh and calf in young, healthy men and women.

OBJECTIVE: To investigate the relationship of percent body fat (%fat), assessed by dual energy-X-ray absorptiometry (DXA) or a four-compartment model, with upper body and lower limb skinfolds. DESIGN: Cross-sectional design involving forward stepwise and hierarchical multiple regression analyses to assess the relationship of %fat with skinfolds and a combination of four commonly used upper body skinfolds (biceps, triceps, subscapular and iliac crest) with the calf and thigh skinfolds. SETTING: University research laboratory. SUBJECTS: In all, 31 females, mean age 20.9 (+/-2.0) y, and 21 males, mean age 22.3 (+/-5.5) y volunteered for this study, which was approved by the Ethics Committee of the School of Sport, Health and Exercise Sciences, University of Wales, Bangor. MEASUREMENTS: %fat from DXA in both groups, and %fat from a four-compartment (water, bone mineral mass, fat and residual) model (%fat4C) in females only. Skinfolds were measured at the abdomen, iliac crest, biceps, triceps, subscapular, calf and thigh. RESULTS: All skinfolds were positively associated with DXA estimates of %fat (P < 0.01). In males and females, the thigh skinfold had the highest correlation with %fat. This was also observed when %fat4C was used as the criterion in females. Stepwise multiple regression analysis using %fatDXA as the criterion selected the thigh (R(2) = 0.82), calf (R(2) change 0.04) and iliac crest (R(2) change = 0.03) for females, and the thigh (R(2) = 0.79), iliac crest (R(2) change = 0.11) and abdomen (R(2) change = 0.03) for males (all P < 0.01). When %fat4C was used as the criterion in the females, only the thigh was selected as a significant predictor (R(2) = 0.76). Independent prediction factors were created from the sum of biceps, triceps, subscapular and iliac crest (sigma4skf) and from the sum of the thigh and calf (sigmathigh + calf). These factors were then entered into a hierarchical multiple linear regression analysis to predict percent fat. Order of entry was varied to allow the assessment of unique variance accounted for by each predictor. The sum of the thigh and calf explained more variance in %fatDXA than that explained by the sigma4skf alone, irrespective of the order of entry in both males and females. This was also observed when %fat4C was used as the criterion in the females. CONCLUSIONS: The results of this study confirm that lower body skinfolds are highly related to percent body fat in fit and healthy young men and women, and uphold current recommendations by the British Olympic Association to include the thigh skinfold with sigma4skf. Conventional use of the sigma4skf to estimate percent body fat is significantly enhanced by the inclusion of the thigh and calf skinfolds, either independently or in combination. In this group of males and females, the sum of the thigh and calf skinfolds accounted for the most variance in percent fat.

Absorptiometry, Photon↗

PubMed2003

Comparison of arteriovenous grafts in the thigh and upper extremities in hemodialysis patients.

Placement of a thigh graft is an option in hemodialysis patients who have exhausted all upper extremity sites for permanent vascular access. The outcome of thigh grafts has been reported only in retrospective studies. The outcomes of 409 grafts placed at a single institution during a 3.5-yr period were evaluated prospectively, including 63 thigh grafts (15% of the total). Information was recorded on surgical complications, dates of radiologic and surgical interventions, and date of graft failure. The technical failure rate was approximately twice as high for thigh grafts, as compared with upper extremity grafts (12.7 versus 5.8%; P = 0.046). Intervention-free survival was similar for thigh and upper extremity grafts (median, 3.9 versus 3.5 mo; P = 0.55). Thrombosis-free survival was also comparable for thigh and upper extremity grafts (median, 5.7 versus 5.5 mo; P = 0.94). Cumulative survival (time to permanent failure) was similar for thigh and upper extremity grafts (median, 14.8 versus 20.8 mo; P = 0.62). When technical failures were excluded, the median cumulative survival was 27.6 mo for thigh grafts and 22.5 mo for upper extremity grafts (P = 0.72). The frequency of angioplasty (0.28 versus 0.57 per year), thrombectomy (1.58 versus 0.94 per year), surgical revision (0.28 versus 0.18 per year), and total intervention rate (2.15 versus 1.70 per year) was similar between thigh and upper extremity grafts. Access loss as a result of infection tended to be higher for thigh grafts than for upper extremity grafts (11.1 versus 5.2%; P = 0.07). In conclusion, placement of thigh grafts should be considered a viable option among hemodialysis patients who have exhausted all options for a permanent vascular access in both upper extremities.

Aged↗

PubMed1994

Pharmacokinetics and metabolic effects of growth hormone injected subcutaneously in growth hormone deficient patients: thigh versus abdomen.

OBJECTIVE: The absorption of insulin following subcutaneous (s.c.) injection is faster in the abdomen than the thigh. We therefore studied the effect of changing the site of injection on the absorption and metabolic effects of human growth hormone. DESIGN AND MEASUREMENTS: In a cross-over study human GH (Norditropin) was injected s.c. in the thigh or abdomen in random order. Ultrasonography of the thigh and abdomen was performed in order to evaluate the thickness of the s.c. tissue. After each treatment period (4 weeks), serum profiles of GH, IGF-I, IGF binding proteins 1 and 3 (IGFBP-1 and IGFBP-3), glucose, insulin, non-esterified fatty acids (NEFA), glycerol, 3-hydroxybutyrate, alanine, lactate and glucagon were measured for 37 hours after GH injection (3 IU/m2 at 1900 hour). PATIENTS: Nine GH deficient patients (five males, four females). RESULTS: The mean (+/- SEM) thickness of the s.c. tissue (mm) was higher on the abdominal site (9.35 +/- 1.38 (thigh), and 22.61 +/- 2.19 (abdomen), P < 0.001). Mean (+/- SEM) integrated levels (area under the curves (AUC) divided by time) of GH (mU/l) were identical: 5.54 +/- 0.70 (thigh) versus 5.48 +/- 0.64 (abdomen) (P = 0.91). AUC (mU/l) for the initial 6 hours were, however, significantly different (14.10 +/- 3.76 (thigh) and 19.02 +/- 3.18 (abdomen), P = 0.02). Maximal serum concentration (Cmax) (mU/l) 23.18 +/- 3.86 (thigh) and 29.66 +/- 4.78 (abdomen) (P = 0.19) was achieved faster (Tmax) following injection in the abdomen. Tmax (hours) was 5.89 +/- 0.41 (thigh) and 4.26 +/- 0.49 (abdomen) (P < 0.002). Mean IGF-I levels (microgram/l) were unaffected by GH injection sites (355 +/- 60 (thigh) and 365 +/- 63 (abdomen), P = 0.61). Mean IGFBP-3 levels (microgram/l) were significantly different (2100 +/- 143 (thigh), and 2350 +/- 176 (abdomen), P = 0.05). Mean levels of IGFBP-1, insulin, glucose, lipid intermediates, metabolites and glucagon were not significantly different. CONCLUSIONS: Human GH was absorbed faster when injected s.c. in the abdomen as compared with the thigh, despite the thicker s.c. tissue on the abdomen. Apart from higher IGFBP-3 levels after s.c. injections in the abdomen, similar metabolic effects of GH were obtained with the two injection sites.

Abdomen↗

PubMed2006

The mid-thigh loop arteriovenous graft: patient selection, technique, and results.

As patient longevity on hemodialysis has increased, surgeons are increasingly challenged to provide vascular access to patients who have exhausted options for access in the upper extremity. A common operation performed on these patients has been the loop thigh arteriovenous (AV) graft based off the common femoral vessels. However, there are several disadvantages of placing prosthetic grafts in proximity to the groin. Our group has modified the thigh loop AV graft procedure by moving the anastomoses to the mid-superficial femoral artery and vein. The advantage of this location is that it preserves the proximal femoral vessels for graft revision and avoids the node-bearing tissue and overhanging panniculus of the groin. The purpose of this study was to review our technique, patient selection, and experience with the mid-thigh loop AV graft procedure. Between 2001 and 2003, 46 mid-thigh loop AV grafts were placed in 38 patients. Patient hospital, office, and dialysis clinic records were reviewed. The primary and secondary patency for AV grafts in this study by life-table was 40 per cent and 68 per cent at 1 year and 18 per cent and 43 per cent at 2 years. There were 10 infections (21%) requiring graft removal. Four patients underwent subsequent placement of a proximal loop thigh AV graft after mid-thigh graft failure. Patient survival was 86 per cent at 1 year and 82 per cent at 2 years. There were no patient deaths related to thigh graft placement. Our results with the mid-thigh loop AV graft compare favorably with published results for thigh loop AV grafts. The procedure preserves the proximal vasculature, permitting graft revision or subsequent proximal graft placement, and may be associated with fewer infectious complications. The mid-thigh loop AV graft procedure should be considered before placement of a thigh loop AV graft based off the common femoral artery and vein.

Adult↗

PubMed1986

Computed axial tomographic scanning of the thigh: an alternative method of nutritional assessment in pediatrics.

In this study we compared the findings of computed axial tomographic (CT) scanning of the thigh with the findings of arm anthropometry and urinary creatinine determinations to assess nutrition in children with inflammatory bowel disease receiving total parenteral nutrition. All 14 children received our standard solution for total parenteral nutrition as well as prednisone and sulfasalazine (Azulfidine) therapy. All patients were assessed by arm anthropometry, 24-hour urine collections for creatinine clearance, and CT scanning of the thigh during total parenteral nutrition. Arm muscle and fat area were estimated by anthropometry, and those in the thigh were estimated by CT scanning. Our results show the total muscle area from the CT scan can predict muscle mass calculated from the urinary creatinine excretion rates. In addition, there is a close correlation between the thigh muscle area as measured by CT scanning and the muscle area calculated from urinary creatinine excretion rates. In addition, the comparison of thigh muscle area and thigh fat area to the midarm muscle area and midarm fat area, respectively, showed that the thigh is a better predictor of muscle than fat in the midarm. We conclude that the total thigh muscle area is a better predictor of muscle mass as compared to the midarm muscle area. In addition, the CT scan cut at the level of the thigh in children and adolescents with inflammatory bowel disease can provide valuable information about the thigh compartment and analyses of different cross-sectional areas of the thigh.

Adolescent↗

PubMed1989

Number and anatomical distribution of incompetent thigh perforating veins.

Although incompetent thigh perforating veins are considered to be a common cause of recurrence of varicose veins after high saphenous ligation, the number and distribution of such incompetent veins have not been reported. The aim of the study was to determine the number and anatomical distribution of incompetent thigh perforating veins. Sixty-five limbs in 48 patients with varicose veins who were found to have incompetent thigh perforating veins on ascending deep to superficial venography were studied. In 80 per cent of patients one incompetent thigh perforating vein was found and in 20 per cent more than one was found. Concomitant incompetent calf perforating veins were found in 92 per cent of the limbs studied. The incompetent thigh perforating veins were found to occur anywhere in the thigh, from the upper edge of the patella to a few centimetres below the saphenofemoral junction. The majority (71 per cent) were found in the middle third of the thigh. All incompetent thigh perforating veins were communicating with the long saphenous vein, including those in five patients with incomplete stripping. The surgeon should be aware of incompetent thigh perforating veins which may be multiple and occur at any site on the medial aspect of the thigh.

Adult↗

PubMed2006

Klippel-Trenaunay-Weber syndrome involving fetal thigh: prenatal presentations and outcomes.

OBJECTIVES: We analyzed the prenatal presentations and perinatal outcomes of Klippel-Trenaunay-Weber syndrome involving fetal thigh in order to provide relevant information for prenatal counseling. METHODS: We reviewed our own cases and searched for cases from Medline that met the criteria of Klippel-Trenaunay-Weber syndrome involving fetal thigh. Those with isolated hemangioma, hemangioendothelioma, and hemangiolymphangioma were excluded. RESULTS: The cases of Klippel-Trenaunay-Weber syndrome involving fetal thigh, totaling 21, were collected for analysis. These included 19 cases from Medline search and two cases from our institution. The cases with lesions involving right thigh, left thigh, and both thighs were 12:8:1. The gender of affected fetuses was 9 male, 9 female, and 3 unknown. Among the 21 cases, 6 fetuses (28.57%, 6/21) had isolated thigh lesions, and the other 15 cases (71.43%, 15/21) had extensive lesions involving pelvis, abdomen, retroperitoneum, or thorax. Prenatal presentations varied with hypoechoic cystic mass with limb asymmetry, 95.23% (20/21); polyhydramnios, 38.09% (8/21); cardiomegaly, 19.04% (4/21); thick placenta, 9.52% (2/21); nonimmune hydrops fetalis, 9.52% (2/21); and oligohydramnios, 4.76% (1/21). Ten cases (47.62%, 10/21) underwent termination of pregnancy. For those who continued with pregnancy, the rate of complications with Kasabach-Merritt syndrome was 36.36% (4/11) and the mortality rate in the neonatal period was 45.45% (5/11). The causes of neonatal mortality in these five cases included consumption coagulopathy (Kasabach-Merritt syndrome), cardiac failure, sepsis, and prematurity. CONCLUSIONS: Klippel-Trenaunay-Weber syndrome involving fetal thigh is rare. Our review showed that the location of involvement on the right thigh is more than on the left. Males and females were equally affected. Nearly three fourths of the cases had extensive involvement over other parts of the body. Prenatal ultrasound finding of a raised thigh mass of significant size and limb asymmetry were the most important features. The mortality rate was as high as 45.45% in the neonatal period.

Abortion, Eugenic↗

PubMed1998

Evaluation of the thigh muscles after knee exercise on a Cybex II.

We investigated the degree of local heat and swelling of the thigh muscles produced by exercise. Eleven university athletes aged from 19 to 23 years old performed isokinetic exercise of the right knee on a Cybex II. Then serial determination of thigh circumference and thigh temperature (up to 120 min after exercise) as well as serial magnetic resonance (MR) imaging (up to 60 min after exercise) was performed on both thighs. The circumference of the right thigh peaked at 5.6 +/- 2.1 min after exercise and returned to normal at 38.6 +/- 9.2 min. The temperature of the right thigh peaked at 14.2 +/- 5.7 min after exercise and was not normalized after 120 min except in two subjects. T2-weighted MR images showed a marked increase in the signal intensity of the right knee flexor and extensor muscles. The signal intensity peaked immediately after exercise and subsequently decreased gradually but did not return to normal after 60 min in some muscles. Changes in the thigh circumference were closely correlated with changes in the MR findings. The changes in the thigh muscles after knee exercise could be demonstrated using MR imaging, thigh circumference, and thigh temperature data. These parameters may provide indicators for managing muscle fatigue and recovery.

Adult↗

PubMed2004

Influence of the relative difference in chair seat height according to different lower thigh length on floor reaction force and lower-limb strength during sit-to-stand movement.

Chair-seat height affects the burden on the lower-limbs during sit-to-stand (STS) movement. Previous studies used the same height chair, attaching importance to practicability, but the difference in each subject's lower thigh length may relate to the burden on the lower-limbs. This study aimed to examine the influence of different lower thigh lengths on floor reaction force and lower-limb strength during an STS movement. Thirty young-adult male subjects participated in this study (age: 22.7+/-2.6 yr, height: 172.8+/-4.8 cm, body-mass: 66.3+/-5.2 kg). The subjects were divided into three groups (G1>42 cm, 42 cm > or =G2 > or =38 cm, 38 cm >G3) based on lower thigh length (G1: 44.1+/-2.5 cm, G2: 39.8+/-1.3 cm, G3: 34.3+/-2.1 cm). Namely, G1 was characterized by lower thigh length longer than 105% of 40 cm, G2 by 95-105% of lower thigh length and G3 by lower thigh length less than 95% of 40 cm, respectively. Subjects performed an STS movement twice from chairs at 40 cm-height and height adjusted by the lower thigh length of each subject. Vertical floor reaction force and electromyogram (EMG) on the rectus femoris and tibialis anterior muscles during an STS movement were measured to evaluate the force of knocking over and the burden on the lower-limbs. Fifteen parameters regarding floor reaction force (10) and EMG (5) were selected for analyses. Significant differences were found in floor reaction force at hip-syneresis (F1) and the impulse between hip-syneresis and appearance of the peak floor reaction force (F2). G1 was greater than G2 for the former, and G3 for the latter. Significant differences were found in active muscle mass of the tibialis anterior from the beginning of an STS movement to hip-syneresis (TE1) and peak active muscle level of the tibialis anterior (TE6). G1 was greater than G2 for the former, and G2 and G3 for the latter. It was suggested that when an STS movement is performed using a chair with the same height for each subject, the load imposed on the subject's leg at the time of an STS movement and the STS movement achievement strategy differed since chair seat height changes relatively by the difference in lower thigh length. Moreover, it is thought that the difference in these load conditions and movement strategies occurs when the chair seat height of a subject's lower thigh length is longer than 110%. When conducting the ability to achieve STS movement rating test, chair seat height considering each subject's lower thigh length may be needed.

Adult↗

PubMed2001

Sensory disturbance of the thigh after renal transplantation.

PURPOSE: Although sensory disturbance of the anterior and/or lateral thigh often develops after renal transplantation, this complication is overlooked because of the minor degree of disability. We evaluated the rate of sensory disturbance of the thigh after renal transplantation. MATERIALS AND METHODS: We examined neurological deficits of the thigh on the operated side in 61 patients who underwent renal transplantation, including 48 using the internal and 13 using the external iliac artery. RESULTS: We noted sensory disturbance in 23 of the 61 cases, including 20 of the 48 in which the internal iliac artery was used. One patient had complete femoral nerve palsy involving motor weakness. Sensory disturbance was in the anterior thigh in 15 patients, in the lateral thigh in 3, and on the anterior and lateral thigh in 2. Postoperatively there was sensory disturbance of the thigh in 3 of the 13 patients in whom the external iliac artery was used. Sensory disturbance persists in all 3 cases at the time of this report, including in the anterior thigh in 1, and in the anterior and lateral thigh in 2. CONCLUSIONS: The rate of sensory disturbance of the thigh after renal transplantation is high. Therefore, we should inform patients of the possibility of sensory disturbance before renal transplantation surgery is performed.

Femoral Nerve↗

PubMed2005

Low subcutaneous thigh fat is a risk factor for unfavourable glucose and lipid levels, independently of high abdominal fat. The Health ABC Study.

AIMS: We investigated whether low subcutaneous thigh fat is an independent risk factor for unfavourable glucose and lipid levels, and whether these associations differ between sexes, and between white and black adults. Our secondary aim was to investigate which body composition characteristics (lean tissue, fat tissue) are reflected by anthropometric measures (waist and thigh circumference). METHODS: Anthropometric measurements and computed tomography of the abdomen and of the thigh were performed for all participants of the Health, Aging and Body Composition Study, who were aged 70-79 years. Fasting glucose, triglycerides and HDL-cholesterol, and 2-h postload glucose were determined. RESULTS: After excluding those already diagnosed with diabetes or dyslipidaemia, we analysed data from 2,106 participants. After adjustment for abdominal subcutaneous and visceral fat, and intermuscular thigh fat, larger thigh subcutaneous fat area was statistically significantly associated with lower ln-transformed triglycerides [standardised beta (95% CI) -0.12 (-0.20 to -0.04) in men and -0.13 (-0.21 to -0.05) in women] and higher ln-HDL-cholesterol [0.10 (0.02 to 0.19) and 0.09 (0.01 to 0.18), respectively]. The associations with lower glucose levels were strong in men [-0.11 (-0.20 to -0.02) for fasting and -0.14 (-0.23 to -0.05) for postload glucose], but not statistically significant in women [-0.02 (-0.10 to 0.07) and -0.04 (-0.13 to 0.05), respectively]. There were no differences in the associations between white and black persons. Waist circumference was more strongly associated with abdominal subcutaneous fat, and this association became stronger with increasing BMI, whereas the association with visceral fat became weaker. Thigh circumference was equally dependent on thigh fat and thigh muscle in men, whereas in women the fat component was the main contributor. CONCLUSION: Larger subcutaneous thigh fat is independently associated with more favourable glucose (in men) and lipid levels (in both sexes) after accounting for abdominal fat depots, which are associated with unfavourable glucose and lipid levels. Anthropometric measures reflect different fat depots at different levels of BMI at the abdomen, and reflect both fat and lean tissue at the thigh. These results emphasise the importance of accurate measures of regional body composition when investigating potential health risks.

Abdomen↗

PubMed2002

Pharmacodynamics of the new fluoroquinolone gatifloxacin in murine thigh and lung infection models.

Gatifloxacin is a new 8-methoxy fluoroquinolone with enhanced activity against gram-positive cocci. We used the neutropenic murine thigh infection model to characterize the time course of antimicrobial activity of gatifloxacin and determine which pharmacokinetic (PK)-pharmacodynamic (PD) parameter best correlated with efficacy. The thighs of mice were infected with 10(6.5) to 10(7.4) CFU of strains of Staphylococcus aureus, Streptococcus pneumoniae, or Escherichia coli, and the mice were then treated for 24 h with 0.29 to 600 mg of gatifloxacin per kg of body weight per day, with the dose fractionated for dosing every 3, 6, 12, and 24 h. Levels in serum were measured by microbiologic assay. In vivo postantibiotic effects (PAEs) were calculated from serial values of the log(10) numbers of CFU per thigh 2 to 4 h after the administration of doses of 8 and 32 mg/kg. Nonlinear regression analysis was used to determine which PK-PD parameter best correlated with the numbers of CFU per thigh at 24 h. Pharmacokinetic studies revealed peak/dose values of 0.23 to 0.32, area under the concentration-time curve (AUC)/dose values of 0.47 to 0.62, and half-lives of 0.6 to 1.1 h. Gatifloxacin produced in vivo PAEs of 0.2 to 3.1 h for S. pneumoniae and 0.4 to 2.3 h for S. aureus. The 24-h AUC/MIC was the PK-PD parameter that best correlated with efficacy (R(2) = 90 to 94% for the three organisms, whereas R(2) = 70 to 81% for peak level/MIC and R(2) = 48 to 73% for the time that the concentration in serum was greater than the MIC). There was some reduced activity when dosing every 24 h was used due to the short half-life of gatifloxacin in mice. In subsequent studies we used the neutropenic and nonneutropenic murine thigh and lung infection models to determine if the magnitude of the AUC/MIC needed for the efficacy of gatifloxacin varied among pathogens (including resistant strains) and infection sites. The mice were infected with 10(6.5) to 10(7.4) CFU of four isolates of S. aureus (one methicillin resistant) per thigh, nine isolates of S. pneumoniae (two penicillin intermediate, four penicillin resistant, and two ciprofloxacin resistant) per thigh, four isolates of the family Enterobacteriaceae per thigh, a single isolate of Pseudomonas aeruginosa per thigh, and 10(8.3) CFU of Klebsiella pneumoniae per lung. The mice were then treated for 24 h with 0.29 to 600 mg of gatifloxacin per kg every 6 or 12 h. A sigmoid dose-response model was used to estimate the dose (in milligrams per kilogram per 24 h) required to achieve a net bacteriostatic effect over 24 h. MICs ranged from 0.015 to 8 microg/ml. The 24-h AUC/MICs for each static dose (1.7 to 592) varied from 16 to 72. Mean +/- standard deviation 24-h AUC/MICs for isolates of the family Enterobacteriaceae, S. pneumoniae, and S. aureus were 41 +/- 21, 52 +/- 20, and 36 +/- 9, respectively. Methicillin, penicillin, or ciprofloxacin resistance did not alter the magnitude of the AUC/MIC required for efficacy. The 24-h AUC/MICs required to achieve bacteriostatic effects against K. pneumoniae were quite similar in the thigh and lung (70 versus 56 in neutropenic mice and 32 versus 43 in nonneutropenic mice, respectively). The magnitude of the 24-h AUC/MIC of gatifloxacin required for efficacy against multiple pathogens varied only fourfold and was not significantly altered by drug resistance or site of infection.

Animals↗

PubMed1982

Influence of thigh blood flow upon the arterial pressure gradient over the collateral arteries in patients with occlusion of the superficial femoral artery.

The effect of circulatory arrest of the calf and foot and head-up tilt upon pressure gradient over the thigh and distribution of muscle blood flow in the thigh was studied in 14 patients with occlusion of the superficial femoral artery. In the supine position circulatory arrest just below the knee initially reduced the directly measured mean arterial pressure gradient over the thigh by about 30% indicating that a similar proportion of total leg blood flow supplied the calf and foot. Local muscle blood flow was measured by the local 133Xe washout technique proximally and distally in the thigh muscle. Total leg blood flow was measured by an indicator dilution technique. During 10 min of circulatory arrest of the calf and foot local muscle blood flow in the thigh increased by approximately 35% proximally and distally. Total leg blood flow remained unchanged and the pressure gradient was reduced by about 10% as compared with that before tourniquet. During head-up tilt local muscle blood flow in the thigh decreased by about 30% proximally and distally. Total leg blood flow also decreased by about 30%. Circulatory arrest below the knee did not alter this response. These findings indicate that blood flow change uniformly in the thigh during head-up tilt and during tourniquet on the calf. Furthermore blood flow to the calf appears only to account for 30% of the arterial pressure drop over the collateral arteries in the thigh, indicating that thigh blood flow is of major importance for the pressure gradient over the collateral arteries.

Aged↗

PubMed2000

Adaptations to a 7-day head-down bed rest with thigh cuffs.

PURPOSE: Thigh cuffs were two elastic strips fixed at the upper part of each thigh, which limits the shift of fluid from the legs into the cardio-thoracic region. The purpose of this study was to examine the effects of thigh cuffs on hormonal and plasma volume responses and orthostatic tolerance during a 7-day head-down bed rest (HDBR). METHODS: Orthostatic tolerance, plasma volume, total body water, blood volume-regulating hormones, and hydro-electrolyte responses were measured in eight healthy men (age range, 25-40 yr), using thigh cuffs 10 h daily during 7 d of -6 degrees HDBR. RESULTS: Thigh cuffs worn during HDBR attenuated the decrease in plasma volume observed after HDBR (thigh cuffs: -5.85 +/- 0.95% vs control: -9.09 +/- 0.82%, P < or = 0.05). During this experiment, there was no significant change in total body water. Thus, the hypovolemia did not result from a loss of water but from a fluid shift from the blood compartment into the interstitial and/or intracellular compartment. Hormonal responses during HDBR and stand test were not modified by the thigh cuffs. Thigh cuffs had no significant effect on the clinical symptoms of orthostatic intolerance after HDBR. CONCLUSIONS: Thigh cuffs worn during HDBR blunted the decrease in plasma volume but did not reduce orthostatic intolerance; thus, they are not a completely effective countermeasure. Furthermore, hypovolemia seems to be necessary but not sufficient to induce orthostatic intolerance after HDBR.

Adult↗

PubMed1991

Absorption of NPH (isophane) insulin in resting diabetic patients: evidence for subcutaneous injection in the thigh as the preferred site.

The absorption kinetics of NPH (isophane) insulin injected subcutaneously into the abdominal wall and subcutaneously (SC) and intramuscularly (IM) into the thigh was studied in 11 Type 1 diabetic patients. The thickness of the subcutaneous adipose tissue layer was measured by ultrasound. NPH (isophane) insulin injected IM into the thigh was absorbed faster than NPH insulin injected SC into the thigh (T50%, IM 8.0 +/- 0.6 h and SC 10.3 +/- 0.7 h, p less than 0.05). No difference in T50% values was found for injection into the abdominal wall (9.7 +/- 1.2h) compared with the thigh. The mean absorption rate from 1.5 to 13.5 h after injection was higher after injection IM into the thigh (6.4 +/- 0.3% of initial dose injected absorbed per h) than after SC injection into the thigh (5.2 +/- 0.3% h-1) and SC into the abdominal wall (5.1 +/- 0.3% h-1) (p less than 0.01). The most constant absorption rate was obtained after SC injection into the thigh (within-study day CV of the mean absorption rate 19.9 +/- 3.2% vs 34.4 +/- 3.2% after IM injection into the thigh and 27.1 +/- 4.9% after SC injection into the abdominal wall (p less than 0.02]. The study provides further evidence that the subcutaneous tissue of the thigh is the preferred injection site for NPH insulin.

Absorption↗