A cross-sectional study on the incidence of retinal changes and its correlation with variables like blood pressure, liver function tests, kidney function tests, proteinuria, and pedal edema in patients of pregnancy-induced hypertension in a rural setting

Purpose: Pregnancy?induced hypertension is a multisystem disorder that occurs after 20 weeks of pregnancy usually in primigravidas and is characterised by proteinuria, pedal edema, hypertension, and abnormal liver and kidney function tests. Since there exists a close relationship between retinal, cerebral, and renal vessels, fundoscopy gives the opportunity of observing the changes in the vascular tree. Methods: We conducted a study on 203 pregnant females over a period of 1.5 years in the rural population of North India. We recorded the baseline data from the patient files, including the biochemical investigations, and conducted a fundoscopic examination of all patients included in the study, and correlation of various variables was established. Results: Out of 203 patients (403 eyes), 60% were primigravidas of mean age 25.71 ± 4.46 years with the mean duration of pregnancy being 36 weeks. The mean systolic and diastolic blood pressure were160 and 101 mmHg, respectively. There was no significant correlation was seen of proteinuria with eclampsia and the fundus findings. But there was a significant correlation between proteinuria and pedal edema and between the fundus findings and deranged LFT and KFT values. Relationship between the variables was calculated by using Chi?square and Fisher’s exact test. A P value < 0.05 was taken as significant. Conclusion: Hypertension in pregnancy is the major concern of public health issue worldwide. With proper understanding of the correlating factors such as fundus changes which are directly correlated with whole bo dy vascular changes, which might affect the fetal growth, we can easily predict the outcome and can take appropriate actions as early as possible

Analysis of endovascular therapy for below-the-ankle arteriosclerosis occlusive disease / 中国医师杂志

Objective:To analyze the effect of endovascular therapy (including balloon dilation, debulking and anti-restenosis technique) for below-the-ankle atherosclerotic lesions in chronic limb threatening ischemic patients.Methods:A retrospective analysis was performed on the clinical data of 465 patients (570 limbs) with below-the-ankle atherosclerosis who were consecutively admitted to Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University from April 2018 to December 2021. All patients received balloon dilatation below the ankle artery as basic treatment, including 67 patients in debulking subgroup, 82 patients in anti-restenosis subgroup and 11 patients in the triple therapy subgroup. The reocclusion rate, target lesion reintervention rate at 1, 3, 6 and 12 months after surgery were compared; The wound healing rate at 3 months, limb salvage rate at 6 and 12 months and mortality at 12 months in the Global Limb Anatomic Staging System (GLASS) grading groups P0, P1 and P2 were compared.Results:The technical success rate of this group was 76.0%(433 limbs/570 limbs). The follow-up rates of 6 and 12 months after operation were 85.4%(370 limbs/433 limbs) and 75.3%(326 limbs/433 limbs), respectively. The length of treated lesions was (3.6±1.3)cm; The reocclusion rates were 5.5%(23 limbs/420 limbs), 8.2%(33 limbs/403 limbs), 14.9%(55 limbs/370 limbs) and 23.6%(77 limbs/326 limbs) at 1, 3, 6 and 12 months after operation; The reintervention rate of target lesions in 6, 12 months was 7.6%(28 limbs/370 limbs) and 12.0%(39 limbs/326 limbs) respectively; The wound healing rate in groups P0, P1 and P2 within 3 months was 87.3%(192 limbs), 70.5%(62 limbs) and 10.5%(2 limbs) respectively ( P<0.001), the limb salvage rate in 6 months was 96.2%(200 limbs), 84.7%(127 limbs) and 33.3%(4 limbs) respectively ( P<0.001), and the limb salvage rate in 12 months was 78.7%(170 limbs), 54.5%(55 limbs) and 22.2%(2 limbs) respectively ( P<0.001). The mortality was 6.9%(32/465) 12 months after operation. Conclusions:Endovascular therapy below-the-ankle is feasible and has high technical success rate. The constitute integrity of pedal-plantar loop in limb- threatening phase is related to 3-month wound healing rate and limb salvage rate.

A study of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsia

Background: Preeclampsia is defined as systolic blood pressure level of 140 mmHg or higher or a diastolic blood pressure level of 90 mmHg or higher that occurs after 20 weeks of gestation with proteinuria. Objective of this study was to study the role of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsiaMethods: This is a prospective observational study conducted in the department of obstetrics and gynaecology, BRD Medical College Gorakhpur, since October 2016 to September 2017 included 120 pregnant women with hypertension of gestational age more than 20 weeks. Ramdom urine sample of all the patient was taken before 12 noon after first voiding. For 24 hours urine sample patient was asked to collect all her urine she voids during 24 hours. The creatinine was estimated by the alkaline picrate method (Jaffe's Reaction) modified by the Bonsnes and Taussky, 1945. Creatinine in a protein free solution reacts with the alkaline picrate and produces red colour complex which is measured colorimeterically. Urinary protein was estimated in all the subjects by the Turbidimetric method. Urinary protein was precipitated by 3% sulphosalicylic acid and turbidity so produced was measured colorimetrically.Results: Protein: creatinine ratio in a random urine sample is better than random urine protein detection by dipstick method in cases of emergency when there is no time for detection of 24 hours urine protein.Conclusions: If cut-off level for urine protein: creatinine ratio in random urine sample is taken as 0.25 or more then sensitivity and specificity become same as 24 hours urine protein.

Impact of Pedal Arch Patency on Tissue Loss and Time to Healing in Diabetic Patients with Foot Wounds Undergoing Infrainguinal Endovascular Revascularization

OBJECTIVE: To retrospectively evaluate the impact of pedal arch quality on tissue loss and time to healing in diabetic patients with foot wounds undergoing infrainguinal endovascular revascularization. MATERIALS AND METHODS: Between January 2014 and June 2015, 137 consecutive diabetic patients with foot wounds underwent infrainguinal endovascular revascularization (femoro-popliteal or below-the-knee, arteries). Postprocedural angiography of the foot was used to divide the patients into the following three groups according to the pedal arch status: complete pedal arch (CPA), incomplete pedal arch (IPA), and absent pedal arch (APA). Time to healing and estimated 1-year outcomes in terms of freedom from minor amputation, limb salvage, and survival were evaluated and compared among the three groups. RESULTS: Postprocedural angiography showed the presence of a CPA in 42 patients (30.7%), IPA in 60 patients (43.8%), and APA in 35 patients (25.5%). Healing within 3 months from the procedure was achieved in 21 patients with CPA (50%), 17 patients with IPA (28.3%), and in 7 patients with APA (20%) (p = 0.01). There was a significant difference in terms of 1-year freedom from minor amputation among the three groups (CPA 84.1% vs. IPA 82.4% vs. APA 48.9%, p = 0.001). Estimated 1-year limb salvage was significantly better in patients with CPA (CPA 100% vs. IPA 93.8% vs. APA 70.1%, p < 0.001). Estimated 1-year survival was significantly better in patients with CPA (CPA 90% vs. IPA 80.8% vs. APA 62.7%, p = 0.004). CONCLUSION: Pedal arch status has a positive impact on time to healing, limb salvage, and survival in diabetic patients with foot wounds undergoing infrainguinal endovascular revascularization.

Applied anatomy of the first metatarsal proximal perforator-based neurocutaneous vascular flap / 中华显微外科杂志

Objective To explore the anatomical characteristics of mediate dorsal pedal cutaneous nerve and its nutritional vessels to provide anatomical basis of the perforator pedicle flap based on the medial dorsal pedal neurocutaneous vessels for repairing the forefoot soft-tissue defects.Methods From December,2016 to April,2017,the following contents were investigated in 30 adult feet specimens perfused with red latex:①The course,branches and distribution of the medial dorsal pedal cutaneous nerve.②The origin,course,branches and distribution of the nutrient vessels of the medial dorsal pedal neurocutaneous vessels.Mimic operation was performed on 1 fresh specimen.Results ①The mediate dorsal pedal cutaneous nerve mainly arose from the medial branch of the superficial peroneal nerve and processed forward for a distance of (2.5±0.4) cm under the surface of the inferior extensor retinaculum,and then divided into the mediate dorsal branch,the 1st and 2nd dorsal metatarsal branch over part of the dorsal pedal and digital skin.②The medial dorsal pedal neurocutaneous vessels were multiple segmental and polyphyletic,mainly include dorsalis pedis artery proximal perforator,the first metatarsal proximal perforator,the tibial proper plantar digital artery of the great toe and the perforater of the second toe web artery,of which the first metatarsal proximal perforator was most associated with operating methods.The first metatarsal proximal perforator perforate through the deep fascia to the subcutaneous area within the range of 1.0-2.0 cm near the proximal first plantar gap,the piercing point of which on deep fascia was constant,and the anatomical plane of the first metatarsal proximal perforator was higher than that of both the perforator of the toe web artery and the tibial proper plantar digital artery of the great toe.The first metatarsal proximal perforator divide into a large number of branches,which closely anastomose with adjacent perforators and other medial dorsal pedal neurocutaneous vessels.③Simulated surgery showed that the first metatarsal proximal perforation pedicle flap to meet the forefoot soft tissue defect repair.Conclusion The first metatarsal proximal perforator is constant in piercing point and reliable in blood supply,and it have a higher anatomical plane than that of both the perforator of the toe web artery and the tibial proper plantar digital artery of the great toe.The first metatarsal proximal perforator-based medial dorsal pedal neurocutaneous vascular flap can be transferred to repair the soft-tissue defects of forefoot.

Association between pulse pressure variation of radial artery and pulse pressure variation of dorsal pedal artery in neurosurgery operation / 临床麻醉学杂志

Objective To discuss the agreement between pulse pressure variation of radial artery and pulse pressure variation of dorsal pedalartery in neurosurgery.Methods Twenty-five patients undergoing selective craniotomy under general anesthesia were enrolled.The following data were monitored and recorded respectively after tracheal intubation general anesthesia under different time:radial artery pulse pressure variability (PPV1) and dorsalis pedis pulse pressure variation (PPV2).Tidal volume was set to 8 ml/kg.Bland-Altman plots were created to assess agreement between PPV1 and PPV2.Results The mean differences and the limits of agreement between PPV1 and PPV2 are 20 min after induction of anesthesia 0.5% (-1.9%-2.8%), boneless flap instantly-0.5% (-3.8%-2.9%), Cut the dura mater instantly-0.1% (-3.2%-3.0%), and bone flap 0.1% (-2.4%-2.6%).Conclusion Dorsal pedal artery pulse pressure variation in neurosurgery craniotomy has certain guiding significance to the monitoring and management.

Lower limb muscle mechanics during isokinetic pedaling / 中华物理医学与康复杂志

Objective To document and analyze thepeak force and work during isokinetic pedaling at different linear speeds and the flexion-extension peak force ratio.Methods Thirty healthy adults were tested using the Legpress system of the IsoMED 2000 apparatus.Peak force,work and the flexion-extension peak force ratio were recorded and analyzed during isokinetic pedalingat 5 and 50 cm/s.Results The peak force applied and work done by the lower limbs were both significantly lowerwhen pedaling at 50 cm/s than at 5 cm/s.There was no significant difference in peak force or work between the left and right legs at 50 cm/s.The peak force ratio at 50 cm/s was significantly higher than at 5 cm/s.Conclusion The mechanical characteristics of the leg muscles during isokinetic pedaling vary greatly.It is advisable to choose different linear speeds or training modes accordingly.

Pedal-plantar Loop Technique for Below-the-ankle Arterial Occlusion / 中国微创外科杂志

Objective To assess the feasibility and efficiency of pedal-plantar loop technique in the treatment of below-the-ankle arterial occlusion . Methods A retrospective analysis was undertaken on 12 cases ( 14 legs ) of below-the-ankle arterial occlusion.The pedal-plantar loop angioplasty was performed in all the cases .Balloon angioplasty was performed after traversing through the arterial obstruction sites using antegrade or retrograde technique .After 6 months of the surgery , the results of visual analogue scale , dorsal or plantar arterial pulse volume scores , ankle brachial index , TcPO2 , and healing of the ulcer were compared to preoperative measures. Results Technical success was achieved in 9 cases (11 legs).During follow-up, 1 patient died of cerebrovascular events 2 months after the therapy .The other 8 cases (10 legs) were followed up for 6 months and no one had recurrent ischemic symptoms . The results of visual analogue scale , ankle brachial index, and TcPO2 before the surgery were (5.68 ±1.09) points, 0.60 ±0.04, and (25.71 ±5.25) mm Hg, which were improved to (0.44 ±0.27) points, 0.87 ±0.05, and (35.90 ±5.28) mm Hg (P<0.05).Dorsal or plantar arterial pulse volume scores were also enhanced markedly (P=0.004).Complete ulcer healing was observed in 8 limbs.No related complication was observed in other patients after the surgery .One technical unsuccessful patient who suffered infection and severe rest pain was given leg amputation . Conclusion Pedal-plantar loop technique is an effective therapy for below-the-ankle arterial occlusion while long term follow-up data need to be collected .

Revisiting amlodipine induced pedal edema: a student’s perspective.

Amlodipine, a dihydropyridine, is used frequently used in the treatment of hypertension and angina pectoris. The drug acts by blocking the L-gated calcium channels which causes the blood vessels to relax. It's taken orally and excreted through the urine like many other drugs. Calcium channel blockers are usually well tolerated but as always exceptions always exist. Common side effects are constipation, dizziness, flushing, and pre-tibial edema. Pre-tibial edema has been a very common side effect that has lead the drug to be withdrawn in some patients therapy.

Interação de variáveis biomecânicas na composição de "feedback" visual aumentado para o ensino do ciclismo / Interaction of biomechanical variables in the composition of visual augmented feedback for learning cycling / Interacción de variables biomecánicas en la composición de feedback visual aumentado para el enseñanza del ciclismo

O objetivo deste estudo foi testar uma metodologia para o ensino da técnica da pedalada do ciclismo utilizando variáveis biomecánicas para desenvolver um sistema de "feedback" visual aumentado (FVA). Participaram do estudo 19 indivíduos, sem experiência no ciclismo , divididos em grupo experimental (n = 10) e controle (n = 9). Inicialmente foi realizado um pré-teste para determinar o consumo máximo de oxigênio (VO2máx) bem como a carga de trabalho utilizada nas sessões práticas que correspondeu a 60% do VO2máx. Em seguida foram realizadas sete sessões de prática. O grupo experimental foi submetido ao FVA e o grupo controle ao "feedback" aumentado (FA). O teste de retenção mostrou um aumento de 21 % na média do índice de efetividade (IE) do grupo experimental quando comparado ao grupo controle. Os resultados mostraram que variáveis biomecánicas são apropriadas para o desenvolvimento de FVA e podem contribuir no processo de ensino-aprendizagem da técnica da pedalada do ciclismo.

The aim of this study was to test a methodology to teach the pedaling technique of cycling using biomechanics variables to develop an augmented visual feedback system (AVF). Nineteen subjects divided in two groups (experimental = 10 and control = 9) without experience in cycling were used. A pre-test was conducted to determine the maximal oxygen uptake (VO2máx) , and to establishe the work load to be used during the learning sessions which was defined to be the load that was associated with the 60% of VO2máx . Seven practice sessions were held. The experimental group was submitted to AVF and the control group to augmented feedback (AF). After the practice sessions, the retention test showed a significant increase in the index of effectiveness (IE) for the experimental group of 21% compared to the control group. These results showed that the biomechanics variables were appropriated to the development the AVF system and can contribute in the process pedaling technique learning.

El objetivo de este estudio fue probar una metodología para enseñar la técnica de el ciclismo mediante la utilización de variables biomecánicas para desarrollar un sistema de feedback visual aumentado (FVA). Fue aplicado en 19 personas sin experiencia en el ciclismo, divididos en dos grupos (experimental = 10 y control = 9). Inicialmente se realizó un pre-test para determinar el consumo máximo de oxígeno (VO2max) y la carga de trabajo utilizada en las sesiones de práctica que correspondía al 60% del VO2máx. El grupo experimental fue sometido a la FVA y el control a la feedback aumentado (FA). El ensayo de retención mostró un aumento del 21% en la media del índice de eficacia (IE) en el grupo experimental en comparación con el grupo control. Los resultados mostraron que las variables biomecánicas son apropiadas para el desarrollo de la FVA y puede contribuir al proceso de enseñanza y aprendizaje del ciclismo.

Análise da técnica de pedalada durante o ciclismo até a exaustão / Analysis of pedaling technique during cycling until exhaustion

O objetivo deste estudo foi verificar a influência da fadiga na técnica de pedalada durante teste de ciclismo máximo até a exaustão. Oito ciclistas treinados realizaram um teste incremental máximo e um teste de carga constante até a exaustão com 48 horas de intervalo. As forças resultante (FR) e efetiva (FE) aplicadas no pedal foram calculadas para a determinação do índice de efetividade (IE). A FE apresentou aumento entre o início e fim do teste (de 125 ± 16 para 169 ± 52 N, p=0,03), enquanto o IE e a FR não apresentaram alterações (de 0,55 ± 0,10 para 0,59 ± 0,08, p=0,14; de 230 ± 33 para 284 ± 72 N, p=0,08, respectivamente). O tornozelo apresentou aumento na amplitude de movimento (de 19º ± 4,69 para 28 ± 7,29º, p<0,01). Os resultados sugerem que, durante teste de carga constante até a exaustão, ciclistas treinados mantêm a técnica de pedalada e que esta pode ser uma estratégia para manter a potência.

The aim of this study was to investigate the effects of fatigue on the pedaling technique during maximal cycling test until exhaustion. Eight well-trained cyclists completed an incremental test and a constant workload cycling test until exhaustion with 48 hours of rest. The resultant (FR) and effective (FE) forces were calculated to obtain the index of effectiveness (IE). FE increased from the start to the end of the test (from 125 ± 16 to 169 ± 52 N, p=0.03), whereas no differences were observed for IE and FR (from 0.55 ± 0.10 to 0.59 ± 0.08, p=0.14; from 230 ± 33 to 284 ± 72 N, p=0.08, respectively). Increases in ankle joint range of motion were observed (from 19º ± 4.69 to 28 ± 7.29º, p<0.01). Results suggest that during cycling until exhaustion well-trained cyclists are able to sustain the pedaling technique, which can be an important strategy in order to sustain the power output.

Pseudoaneurisma post traumático de la arteria pedia: caso clínico / Post traumatic pseudoaneurysm of the pedal artery: case report

Pseudoaneurysm of the pedal artery is an uncommon condition that is usually caused by a traumatic injury or an iatrogenic intervention. The patient usually complains of an enlarging painless, pulsatile mass. We report a previously healthy 49 years old male presenting with a pulsatile mass of his left foot and a history of a traumatic lesion in the zone three months ago. A Doppler ultrasound examination confirmed the presence of a pseudoaneurysm of the pedal artery of 2.6 x 1.5 cm diameter. The patient underwent surgical resection of the mass and suture ligation of the artery. The postoperative period was uneventful.

Los pseudoaneurismas de la arteria pedia son infrecuentes y habitualmente se generan secundariamente a un traumatismo o a una intervención iatrogénica. Presentamos el caso de un paciente sano de 49 años que presenta un aumento de volumen pulsátil 3 meses posterior al traumatismo contuso de su pie izquierdo. En el doppler color se evidencia la presencia de un pseudoaneurisma de la arteria pedia de 2,64 x 1,53 cm. El paciente fue intervenido con resección y ligadura de la arteria con buena evolución postoperatoria.

A Case of Familiar Painful Piezogenic Pedal Papules / 대한피부과학회지

We report a case of painful pizogenic pedal papules in a 10-year-old female patient who had developed tense, skin-colored papules with pain on both heels when weight was placed on the feet. Histopathologic findings showed subcutaneous fatty tissue protruding into the lower dermis and a basophilic degenerative change of part of the collagen in the dermis. Her father also had the same skin lesions on his both heels.

EFFECT OF PEDAL RATE AND TORQUE ON MUSCLE OXYGENATION AND ENERGY METABOLISM / 体力科学

The purpose of this study was to investigate the effect of constant endurance cycling exercise below Ventilatory Threshold (VT), under different pedal rate/torque regulations (PTR), on muscle oxygenation, as well as cardio-respiratory function and energy metabolism. Eight healthy male adults participated in the study for three tests. The first test was to examine the maximum oxygen uptake (VO₂max) using a ramp loading measurement of 60 rpm, 20 watt/min ; and an individual 80%VT load was obtained. The second and third tests (random) were to measure heart rate (HR), blood pressure (MAP), expired gas and NIRS data before, during and after 30 min 80%VT constant cycling exercise with low pedal rate/high torque (LPHT : 32 rpm, 23.3±6.0Nm) or high pedal rate/low torque (HPLT : 79rpm, 9.4±2.4Nm). As a result, HPLT showed higher values in HR (p<0.001), MAP (p<0.001), VO₂ (p<0.001), VCO₂ (p<0.001) and RER (p<0.05), than LPHT ; but LPHT showed a higher fat consumption rate than HPLT (p<0.05). Significant PTR effect were recognized for the parameters of the tissue hemoglobin index (THI) (p<0.001) and oxygenation hemoglobin (ΔO₂Hb) (p<0.01) ; and both indicated higher values for HPLT than LPHT ; but LPHT showed insignificantly (p=0.066) higher de-oxygenation hemoglobin (ΔHHb) than HPLT. Moreover, the significant time effects of THI and ΔO₂Hb were also recognized. In conclusion, this study indicated that during constant cycling exercise below VT, HPLT might result in greater muscle blood volume, higher muscle oxygenation concentration and higher HR and VO₂ compared with LPHT. These results suggest that, HPLT might be effective in alleviating the working load on lower limbs, as well as promoting muscle oxygenation, cardiorespiratory function (systemic oxygen supply) and energy metabolism. Therefore, HPLT constant cycling exercise below VT could be used in a rehabilitation program as a beneficial exercise for elderly people with decreasing muscle strength in their lower limbs.

Comparison of Electrodignostic Findings in Diabetic Neuropathy according to the Pedal Vascular Pulsation

OBJECTIVE: To evaluate the effect of vascular abnormality on diabetic neuropathy with the use of pedal vascular pulsation and electrodiagnostic study. METHOD: One hundred-eight non-insulin dependent diabetes mellitus patients were studied. All patients underwent nerve conduction studies. Evaluation of vascular status was done using pedal pulse palpation. Four groups were formed. Electrophysiologically normal group was subdivided into non-vascular abnormality group (A1) and vascular abnormality group (A2). Neuropathy group was subdivided into non-vascular abnormality group (B1) and vascular abnormality group (B2). The frequency of diabetic neuropathy among whole groups and the difference of amplitude, conduction velocity, and F-wave latency within A groups and B groups were investigated, respectively. RESULTS: Diabetic neuropathy was significantly correlated with vascular abnormality (p<0.05). There was no definite difference of electrophysiologic parameters between A1 and A2 groups. B1 group showed significantly reduced amplitude of SNAPs in sural and median sensory nerves compared with B2 group (p<0.05). CONCLUSION: The results of the study support the influence of vascular abnormality on diabetic neuropathy and suggest that vascular abnormality in patients with diabetic neuropathy results in axonal injury rather than demyelination injury.

A Case of Painful Piezogenic Pedal Papules / 대한피부과학회지

Piezogenic pedal papules are small, occasionally painful, fat herniation, which become apparent when weight is placed on the heel. We present a case of painful piezogenic pedal papules occurring on both heels of 30-year-old female patient without family history. Clinical and histopathological features confirmed diagnosis. Foot-ankle stocking was effective therapy for painful piezogenic pedal papules.

Clinical Experiences of Pedal Bypass

PURPOSE: Bypasses to the infra-inguinal arteries using autologous vein are now routinely used for limb salvage and as this technique has evolved, the distal limits of revascularization have been extended to near the ankle or in the foot. As the prevelances of chronic renal failure, diabetes and Buerger's disease increased, the more infrapopliteal arterial occlusions were detected. But the safety and effect of pedal bypass was not reported so much in our society. So we studied our cases of ankle bypass to find out its effect on preventing from primary amputation in infrapopliteal arterial occlusive diseases. METHOD: From July 2000 to December 2000, 12 cases of ankle bypasses were performed and followed most of them up to May 2001. The underlying diseases included 6 cases of atherosclerosis obliterance and 6 cases of Buerger's disease. Surgical indications were 9 minor toe gangrene, 2 major gangrene and 1 intractable resting pain. The surgical procedures were 3 popliteo-distal bypasses, 3 popliteo-distal bypasses after femoral thrombectomy, 2 above knee popliteo-below knee popliteo-distal sequential bypasses, 2 combined bypasses of femoro-above knee popliteal bypass and below knee popliteo-distal bypass, and 2 femoro-above knee popliteo-below knee popliteo-distal sequential bypasses. The distal bypass sites were 8 posterior tibial artery (PTA) near medial malleolous, 2 dorsalis pedis (DP) and 2 PTA-DP sequentially. RESULT: There were 2 cases of early occlusion from graft thrombosis and 1 case of late occlusion from inflow embolism. These 3 cases were revised and rebypassed. There was one case of amputation due to deep metatarsal infection. One patient with atherosclerosis died of acute myocardial infarction a month after bypass operation. One patient who underwent bilateral bypass was lost to follow up. The others showed patent graft unil may 2001. 3 patients underwent toe amputation but they didn't have any problem in bipedal ambulation. CONCLUSION: Ankle bypass is safe and promising procedure in infrainguinal arterial occlusive disease.

A Comparison between cyclists and noncyclists of joint torque of the lower extremities during pedaling / 体力科学

The purpose of this study was to compare the effect between cyclists and noncyclists of pedal rates on ankle, knee, and hip joint torque during pedaling exercises. Six male cyclists (CY) and seven male noncyclists (NC) pedaled at 40, 60, 90 and 120 rpm with a power output of 200 W. The lower limb was modeled as three rigid segment links constrained to plane motion. Based on the Newton-Euler method, the equation for each segment was constructed and solved on a computer using pedal force, pedal, crank, and lower limb position data to calculate torque at the ankle, knee, and hip joints. The average planter flexor torque decreased with increasing pedal rates in both groups. The average knee extensor torque for CY decreased up to 90 rpm, and then leveled off at 120 rpm. These results were similar to NC. The average knee flexor torque in both groups remained steady over all pedal rates. The average hip extensor torque for CY decreased significantly up to 90 rpm where it showed the lowest value, but increased at 120 rpm. For NC, the average hip extensor torque did not decrease at 90 rpm compared with 60 rpm, and was significantly higher than CY at 120 rpm (CY : 28.1 ± 9.0 Nm, NC : 38.6 ± 6.7 Nm, p<0.05) . The average hip flexsor torque for NC at 120 rpm increased significanly from 90 rpm, and was significantly higher than CY (CY : 11.6±2.9 Nm, NC : 22.6±11.8 Nm, p<0.05) . These results suggest that it would be better for cyclists to select a pedal rate of between 90 to 110 rpm to minimize joint torque, and, as a result, reduce peripheral muscle fatigue.

Work intensity during pedal-stepping exercise determined using a stair simulator based on vertical velocity / 体力科学

A study was conducted to ascertain the relationship between oxygen uptake (Vo<SUB>2</SUB>) and vertical velocity using a pedal-stepping stair simulator. Ten healthy volunteers performed fbur kinds of graded exercise using a stair simulator (SS), whose pitches were set at 80, 100, and 120 beat⋅min<SUP>-1</SUP>, and also an electrically braked bicycle ergometer (BE) . Work rate on the SS was detemined on the basis of the vertical pedal velocity, in accord with the climbingvelocity for stairs. The incremental rate was set at 0.34 W⋅kg<SUP>-1</SUP> every 3 min. Heart rate and Vo<SUB>2</SUB> were measured during the final minute of every stage. Both heart rate and Vo<SUB>2</SUB> during SS were significantly lower than those on BE at the same level of work intensity. Regression equations between Vo<SUB>2</SUB> (m<I>l</I>⋅kg<SUP>-1</SUP>⋅min<SUP>-1</SUP>) and velocity (<I>v</I>: m⋅s<SUP>-1</SUP>) were as follows;<BR>pitch 80: Vo<SUB>2</SUB>=1.00×<I>v</I>+0.06<BR>pitch 100: Vo<SUB>2</SUB>=0.88×<I>v</I>+1.58<BR>pitch 120: Vo<SUB>2</SUB>=0.84×<I>v</I>+2.13<BR>These equations give a lower value of Vo<SUB>2</SUB> than the previous equation based on stair-climbingvelocity reported by the American College of Sports Medicine. Although the individual relationship between Vo<SUB>2</SUB> and heart rate was closely linear, there was a significant effect ofexercise mode and stepping pitch. These results indicate that the work intensity of pedalstepping exercise with a stair simulator is overestimated if it is calculated based on theprevious equation for stair-climbing.

A Case of Piezogenic Pedal Papules with Family History / 대한피부과학회지

We present herein a case of painless piezogenic pedal papules occurring on the both heels of 25-year-old female patient, Histopathologic findings showed normal adipose tissue surrounded by loose fibrous tissue in the nid-dermis and thickening of venous wall. Hyalinized thick collagen bundles were distributed below the herniated adipose tissue in the nodular pattern. Her parents, one brother and sister had the sarne clinical features.