Disease relevance of Amputation

• Previous observations that halothane anesthesia plus hind-limb amputation increases the number of metastases were confirmed [1].
• Female C57BL/6 mice received a hindfoot amputation under anesthesia with Nembutal i.p. Twenty-four hr later, amputated and control groups were sacrificed, spleens were harvested, and cytotoxicity assays were performed using 51Cr-labeled Yac-1 lymphoma target cells [2].
• A patient who had undergone amputation and adjuvant chemotherapy with methotrexate doxorubicin hydrochloride for osteosarcoma of the femur later developed granulomatous hilar and paratracheal lymphadenopathy and multiple pulmonary nodules [3].
• Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy that has a high rate of morbidity (thrombosis and amputation) and mortality [4].
• CONCLUSIONS: Conservative treatment, including prolonged, culture-guided parenteral and oral antibiotics, is successful without amputation in a large proportion of diabetic patients admitted for a foot skin ulcer or suspected osteomyelitis [5].

Psychiatry related information on Amputation

• A case is reported in which a paraplegic patient with full sensory ablation below T11 experienced phantom limb pain only after actual amputation of one of his legs [6].
• Psychometric properties of the Activities-specific Balance Confidence Scale among individuals with a lower-limb amputation [7].

High impact information on Amputation

• Limbs generated at site of tail amputation in marbled balloon frog after vitamin A treatment [8].
• The accumulations of three beta-tubulin mRNAs (beta 1, beta 2, and beta 3) are temporally coordinated with ciliogenesis during blastula development and with the regeneration of cilia after their amputation [9].
• Multiple extremity amputations in hypotensive patients treated with dopamine [10].
• All patients recovered following amputation of the involved extremity, and treatment with high-dose penicillin in three cases, and erythromycin plus high-dose cephalothin in the fourth [11].
• Spontaneous bleeding or delayed rebleeding could not be documented in PAI-1-/- mice after partial amputation of the tail or of the caecum [12].

Chemical compound and disease context of Amputation

• The incidence of acute pulmonary embolism in 94 patients undergoing above the knee amputation was 25% in patients receiving heparin and 27% in patients receiving saline [13].
• In a homogeneous population of men who suffered traumatic bilateral above-the-knee amputation in the Vietnam War with subsequent development of obesity, it was shown that there was strong correlation between hypertension and hyperinsulinemia during oral glucose tolerance testing despite only mild glucose intolerance [14].
• Treatment with fluconazole led to mycologic cure and symptom improvement, although he subsequently underwent above-the-knee amputation due to continued joint instability [15].
• Veterans Administration Cooperative Study on antiplatelet agents in diabetic patients after amputation for gangrene: II. Effects of aspirin and dipyridamole on atherosclerotic vascular disease rates [16].
• Neither gender nor diabetes mellitus impacted survival; however, serum creatinine levels >2.0 mg/dL (5 years, 48.8% +/- 2.3% vs 23.9% +/- 4.2%, P < .0001) and the need for a major amputation < or =30 days (3 years, 60.8% +/- 2.1% vs 40.1% +/- 7.8%, P < .01) adversely affected survival [17].

Biological context of Amputation

• In both fetal and neonatal digits, we find that both Msx1 and Msx2 are expressed during regeneration, but not during wound healing associated with proximal amputations where no regenerative response is observed [18].
• This first cellular phenotype resulting from a gene knock-down in cnidarians suggests that the Kazal1 serine-protease-inhibitor activity is required to prevent excessive autophagy in intact hydra and to exert a cytoprotective function to survive the amputation stress [19].
• Thus, control of blood glucose and blood pressure should reduce risk for amputation [20].
• Hindlimb amputation resulted in significantly decreased superoxide anion synthesis (0.7 +/- 0.2 nm vs 1.7 +/- 0.3 nmol/l/10(6) cells in controls, P < 0.01) and phagocytosis and a significant increase in prostaglandin E2 synthesis [21].
• Propofol pharmacokinetics in a patient with bilateral leg amputation [22].

Anatomical context of Amputation

• METHODS: In a randomised, double-blind trial, 60 patients scheduled for lower-limb amputation were randomly assigned epidural bupivacaine (0.25% 4-7 mL/h) and morphine (0.16-0.28 mg/h) for 18 h before and during the operation (29 patients; blockade group) or epidural saline (4-7 mL/h) and oral or intramuscular morphine (31 patients; control group) [23].
• Forelimb amputation partially prevented the normal developmental increase of SP in the sixth cervical DRG destined to innervate that limb [24].
• Glucose, fructose, sorbitol and myoinositol concentrations were measured in biopsies of peripheral nerve obtained at above-knee or below-knee amputation [25].
• However, shank motoneurons did not innervate the thigh when motor nerve transection was combined with amputation of the hindlimb just above the presumptive knee.(ABSTRACT TRUNCATED AT 250 WORDS)[26]
• 6. The total area of 2DG uptake in the somatosensory cortex contralateral to a digit amputation conducted at 2 or 4 wk was not greater than that in the normal hemisphere, even though it was more widespread [27].

Associations of Amputation with chemical compounds

• Failure of metronidazole/penicillin oral prophylaxis to prevent amputation stump infection [28].
• Capsaicin for treatment of post-traumatic amputation stump pain [29].
• Amputations are done more frequently among black persons than among white persons (9.0 per 1000 compared with 6.3 per 1000), and Pima Indians have 3.7 times more amputations than do white persons [30].
• Dogs were treated with amputation or tumor excision and limb-sparing followed by chemotherapy with cisplatin [31].
• Control wrist and ankle, or elbow and knee blastemas treated with the retinoid solvent, dimethylsulphoxide, evoked intercalary regeneration as effectively as untreated blastemas, when grafted to the midstylopodial amputation surface of host limbs [32].

Gene context of Amputation

• Analysis of NvK8 and NvK18 transcripts confirms that K8 and K18 are expressed in the blastemal cells of regenerating newt limbs and that their expression is first observed 3-5 days after amputation, when the blastemal cells start to proliferate under the influence of the nerve, whose presence is essential for regeneration to proceed [33].
• RESULTS: At the amputation level, VEGF protein and VEGF and KDR mRNA levels in CLI limbs were similar to those in controls [34].
• Physiological combinations of NGF, NT-3 and GDNF, to mimic a 'surrogate target organ', may provide a novel 'homeostatic' approach to prevent the development and ameliorate intractable neuropathic pain (e.g., at painful amputation stumps) [35].
• METHODS: Rheumatoid synovial tissues were obtained from arthroplasty procedures on patients with late-stage rheumatoid arthritis; normal articular cartilage was obtained from lower limb amputations [36].
• Comparing the cDNA sequences of 2'-5'-OAS L1, L2, and L3 isoforms, between susceptible and resistant strains, we identified a STOP codon in exon 4 of the gene encoding the L1 isoform in susceptible strains that can lead to a truncated form with amputation of one domain, whereas all resistant mice tested so far have a normal copy of this gene [37].

Analytical, diagnostic and therapeutic context of Amputation

• No G-CSF-treated patient needed surgery, whereas two placebo recipients underwent to amputation and two had extensive debridement under anaesthesia [38].
• Treatment consisted of amputation (n = 2), one course of chemotherapy and amputation (n = 1), hyperthermic isolated limb perfusion (HILP; n = 1), intraarterial chemotherapy, radiotherapy, and endoprosthetic replacement (n = 1), and a combination of chemotherapy and radiation treatment (n = 1) [39].
• In a randomized, double-blind trial, 5,000 USP units of sodium heparin or saline were give subcutaneously at least two hours before surgery and at 12 hour intervals thereafter to patients requiring total hip replacement, surgical correction of hip fracture, or major lower extremity amputation for vascular insufficiency [13].
• From 1 January 1978 to 30 June 1981 100 patients suffering from inoperable occlusion of the arteries of the lower limbs and facing amputation were treated with intra-arterial PGE1 by prolonged perfusion over an average period of 34 days [40].
• One patient underwent major amputation 6.3 years after treatment of graft infection [41].

References