Water displacement leg volumetry in clinical studies - A discussion of error sources

<p>Abstract</p> <p>Background</p> <p>Water displacement leg volumetry is a highly reproducible method, allowing the confirmation of efficacy of vasoactive substances. Nevertheless errors of its execution and the selection of unsuitable patients are likely to negatively affect the outcome of clinical studies in chronic venous insufficiency (CVI).</p> <p>Discussion</p> <p>Placebo controlled double-blind drug studies in CVI were searched (Cochrane Review 2005, MedLine Search until December 2007) and assessed with regard to efficacy (volume reduction of the leg), patient characteristics, and potential methodological error sources. Almost every second study reported only small drug effects (≤ 30 mL volume reduction). As the most relevant error source the conduct of volumetry was identified. Because the practical use of available equipment varies, volume differences of more than 300 mL - which is a multifold of a potential treatment effect - have been reported between consecutive measurements. Other potential error sources were insufficient patient guidance or difficulties with the transition from the Widmer CVI classification to the CEAP (Clinical Etiological Anatomical Pathophysiological) grading.</p> <p>Summary</p> <p>Patients should be properly diagnosed with CVI and selected for stable oedema and further clinical symptoms relevant for the specific study. Centres require a thorough training on the use of the volumeter and on patient guidance. Volumetry should be performed under constant conditions. The reproducibility of short term repeat measurements has to be ensured.</p

Validity and reliability of a novel 3D scanner for assessment of the shape and volume of amputees’ residual limb models

Objective assessment methods to monitor residual limb volume following lower-limb amputation are required to enhance practitioner-led prosthetic fitting. Computer aided systems, including 3D scanners, present numerous advantages and the recent Artec Eva scanner, based on laser free technology, could potentially be an effective solution for monitoring residual limb volumes. The aim of this study was to assess the validity and reliability of the Artec Eva scanner (practical measurement) against a high precision laser 3D scanner (criterion measurement) for the determination of residual limb model shape and volume. Three observers completed three repeat assessments of ten residual limb models, using both the scanners. Validity of the Artec Eva scanner was assessed (mean percentage error <2%) and Bland-Altman statistics were adopted to assess the agreement between the two scanners. Intra and inter-rater reliability (repeatability coefficient <5%) of the Artec Eva scanner was calculated for measuring indices of residual limb model volume and shape (i.e. residual limb cross sectional areas and perimeters). Residual limb model volumes ranged from 885 to 4399 ml. Mean percentage error of the Artec Eva scanner (validity) was 1.4% of the criterion volumes. Correlation coefficients between the Artec Eva and the Romer determined variables were higher than 0.9. Volume intra-rater and inter-rater reliability coefficients were 0.5% and 0.7%, respectively. Shape percentage maximal error was 2% at the distal end of the residual limb, with intra-rater reliability coefficients presenting the lowest errors (0.2%), both for cross sectional areas and perimeters of the residual limb models. The Artec Eva scanner is a valid and reliable method for assessing residual limb model shapes and volumes. While the method needs to be tested on human residual limbs and the results compared with the current system used in clinical practice, it has the potential to quantify shape and volume fluctuations with greater resolution

How mohallas were formed: Typology of mohallas from the viewpoint of spatial formation and the urbanization process in Varanasi, India

The Japanese version of this paper was published in Volume 73, Number 623, pages 153‐160, https://doi.org/10.3130/aija.73.153 of the Journal of Architecture and Planning (Transactions of AIJ) . The authors have obtained permission for secondary publication of the English version in another journal from the editor of the Journal of Architecture and Planning (Transactions of AIJ) . This paper is based on the translation of the Japanese version, with some slight modifications. Correction following the first Japanese version publication: In order to clarify the argument, Figure 9 has been added and the section discussing block formation has been omitted.This paper focuses upon some mohallas in Varanasi's old urban area. The mohalla is a traditional neighborhood unit common in North Indian cities. Mohallas were elemental components of the city in the Mughal period as administrative tax units as well as autonomous organizations. Currently, however, they have lost their administrative meaning, and their geographical extent and boundaries are becoming unclear. Based on field surveys, this paper reveals features of the spatial formation of mohallas such as size, boundary form, distribution of facilities, and street pattern, and links them to the historical urbanization process of the city. Mohallas in Varanasi can be broadly classified into two types. One has a linear or tree shape along streets, and the other has a broad territorial shape. The spatial features of those two types are different in various aspects and reflect the degree of urbanization at the time when the mohallas were established

Trans-triquetral dorsal perilunate fracture dislocation

A rare case of trans-triquetral dorsal perilunate dislocation is described. It differs from the Mayfield and Johnson theory of progressive perilunar instability in greater arc injuries which states that the injury passes from the radial to the ulnar carpal bones and soft tissues in stages. This injury supports the concept of a reverse greater arc injury from ulnar to radial being possible with the radial carpal bones being spared in some cases. © 2007 The British Society for Surgery of the Hand.link_to_subscribed_fulltex

Kinesio Taping and the Circulation and Endurance Ratio of the Gastrocnemius Muscle

CONTEXT: Kinesio Tex tape is a therapeutic tape that is applied with the Kinesio-taping (KT) method and is theorized to increase circulation and subsequently improve muscle function. However, little research has been conducted to determine how KT affects performance. OBJECTIVE: To determine the effect of KT on muscular endurance ratio, blood flow, circumference, and volume of the gastrocnemius muscle. DESIGN: Randomized controlled clinical trial. SETTING: Research laboratory. PATIENTS OR OTHER PARTICIPANTS: Sixty-one healthy, active people (23 men, 38 women; age = 19.99 ± 8.01 years, height = 169.42 ± 23.62 cm, mass = 71.53 ± 36.77 kg) volunteered to participate. They were assigned randomly to 1 of 3 groups: treatment KT, sham KT, and control. INTERVENTION(S): Tape was applied based on group assignment. The treatment KT group received the ankle-tape technique as described in the KT manual. The sham KT group received 1 strip of Kinesio Tex tape around the circumference of the proximal gastrocnemius muscle. The control group did not receive tape application. MAIN OUTCOME MEASURE(S): The dependent variables were blood flow in blood perfusion units, volume of water displacement in milliliters, circumference of the gastrocnemius muscle in centimeters, and endurance ratio in joules measured before, 24 hours after, and 72 hours after the intervention. Separate repeated-measures analyses of variance were conducted for each dependent variable. RESULTS: We found no group-by-test day interaction for endurance ratios (F(4,116) = 1.99, P = .10). Blood flow, circumference, and volume measurements also yielded no differences among groups (F(2,58) range, 0.02–0.51; P > .05) or test days (F(2,116) range, 0.05–2.33; P > .05). CONCLUSIONS: We found KT does not enhance anaerobic muscle function measured by endurance ratio. The KT also did not affect circulation or volume of the gastrocnemius muscle in a healthy population