The ground state of three flavor quark matter at asymptotically large density is believed to be the color-flavor-locked (CFL) phase. At nonasymptotic density the effect of the nonzero strange quark mass cannot be neglected. If the strange quark mass exceeds m(s) approximately m(u)(1/3)delta(2/3), the CFL state becomes unstable toward the formation of a neutral kaon condensate. Recently, several authors discovered that for m(s) approximately (2deltap(F))(1/2) the CFL state contains gapless fermions, and that the gapless modes lead to an instability in current-current correlation functions. Using an effective theory of the CFL state, we demonstrate that this instability can be resolved by the formation of a meson supercurrent, analogous to Migdal's p-wave pion condensate. This state has a nonzero meson current that is canceled by a backflow of gapless fermions.

BACKGROUND

Wnt5A is released by activated macrophages and elevated levels have been detected in sepsis patients with severe systemic inflammation. However, the signalling and functional effects of Wnt5A in the vascular endothelial cells (VEC) remained unclear. Recently, we showed that Wnt5A affects barrier function in human VEC through Ryk interaction. Wnt5A/Ryk signalling activates LIMK to inactivate the actin depolymerisation factor CFL by phosphorylation, promotes actin polymerisation and disrupts endothelial adherens junctions.

RESULTS

Here, we investigate the antagonistic effect of the Ryk specific secreted Wnt antagonist Wnt inhibitory factor (WIF)-1 on Wnt5A-mediated activation/inactivation of LIMK/CFL, and adherens junction disruption in human VEC. In human coronary artery endothelial cells (HCAEC), treatment with Wnt5A enhanced the phosphorylation of LIMK and CFL that was significantly prevented by WIF1. The presence of WIF1 suppressed Wnt5A-mediated disruption of β-catenin and VE-cadherin adherens junctions in HCAEC, thereby preventing barrier dysfunction caused by Wnt5A.

CONCLUSIONS

We conclude that WIF1 or molecules with similar properties could be potent tools for the prevention of vascular leakage due to Wnt5A-mediated actin cytoskeleton remodeling in diseases associated with systemic inflammation.

To obtain a better understanding of the beneficial effect of high plasma viscosity observed in hemodilution and resuscitation experiments, we conducted a computational study to investigate the suspending viscosity effect on red blood cell (RBC) dynamics and blood flow behaviors in microvessels. For single RBCs in simple shear or channel flows, RBCs appear more flexible as indicated by the tank-treading motion in shear flows and the strong transverse migration in channel flows. For the multiple RBC flows in straight channels, our results indicate no significant change with the suspending viscosity in stable flow structure and hemorheologic behaviors, under both constant flow and forcing conditions. However, due to the increase in apparent cell deformability in a more viscous medium, the cell-free layer (CFL) can be established in a shorter distance along the channel. Considering the multilevel bifurcated structure of the microvascular network, this change in CFL development distance may affect the phase skimming and RBC separation processes at the downstream bifurcation, and therefore the microcirculation performance in the tissue. This may suggest a possible mechanism for the high functional capillary density associated with a high suspending viscosity observed in experiments.

Heterogeneous distribution of red blood cells (RBCs) in downstream vessels of arteriolar bifurcations can be promoted by an asymmetric formation of cell-free layer (CFL) in upstream vessels. Consequently, the CFL widths in subsequent downstream vessels become an important determinant for tissue oxygenation (O2) and vascular tone change by varying nitric oxide (NO) availability. To extend our previous understanding on the formation of CFL in arteriolar bifurcations, this study investigated the formation of CFL widths from 2 to 6 vessel-diameter (2D-6D) downstream of arteriolar bifurcations in the rat cremaster muscle (D = 51.5 ± 1.3 μm). As the CFL widths are highly influenced by RBC aggregation, the degree of aggregation was adjusted to simulate levels seen during physiological and pathological states. Our in vivo experimental results showed that the asymmetry of CFL widths persists along downstream vessels up to 6D from the bifurcating point. Moreover, elevated levels of RBC aggregation appeared to retard the recovery of CFL width symmetry. The required length of complete symmetry recovery was estimated to be greater than 11D under reduced flow conditions, which is relatively longer than interbifurcation distances of arterioles for vessel diameter of ∼50 μm. In addition, our numerical prediction showed that the persistent asymmetry of CFL widths could potentially result in a heterogeneous vasoactivity over the entire arteriolar network in such abnormal flow conditions.

This study examined the effects of red blood cell (RBC) aggregation at pathological levels on NO/O2 transport in small arterioles. Transient gas diffusion simulations were performed with in vivo cell-free layer (CFL) widths data obtained from arteriolar flows in the rat cremaster muscle. The CFL data were measured at physiological and pathological levels of aggregation under reduced flow conditions (pseudoshear rate = 31.4 ± 10.5 s-1). Our results showed that the mean peak NO concentration significantly decreased with increasing the aggregation level from non-aggregating to normal-aggregating (P < 0.05) and to hyper-aggregating (P < 0.01) conditions. In contrast, the partial O2 pressure (PO2) in pathological aggregating conditions significantly increased from those under non-aggregating (P < 0.001) and normal-aggregating (P < 0.05) conditions. Although the NO scavenging by RBCs could be impaired with a thicker CFL at higher levels of aggregation, the overall decrease in NO production due to reduction of wall shear stress with the thicker CFL dominantly limited the NO availability in tissue. On the other hand, the O2 availability in tissue increased due to the relatively high core hematocrit in the blood lumen with the thicker CFL.

26 practically healthy youths of 16-18 years old not adapted to the mountains earlier were investigated under the conditions of a plain (Kiev) and at the height of 2100 m and 3000 m above sea-level (Chegem). A stay under the conditions of moderate altitude for one month was found to favour amelioration of the characteristics of the functional lability (CFL) of the nervous system, information processing velocity, attention concentration and distribution, short-term memory volume, general subjective feeling as well as shortening the latent periods of visually-motor reactions. Large adaptive shifts of the CFL and more stable positive effect of mountain adaptation after returning to the plain were found in persons with initially high functional lability level in comparison to those with mean or lower values of CFL. Positive connection between the CFL and the degree of adaptive changes of external respiration was observed under the conditions of moderate altitude. Statistically significant connection of the CFL with the respiratory center sensitivity to hypercapnia was found rather than their correlation with the value of ventilatory response to acute hypoxia during gas mixtures respiration.

UNASSIGNED

What is the central question of this study? The aim was to evaluate the effect of perfusion pressure on blood flow in small arterioles. The hypothesis was that blood flow regulates the thickness of the red-cell-free layer and, therefore, blood flow determines blood apparent viscosity and local vascular resistance in vascular networks with limited myogenic or metabolic regulation of blood flow. What is the main finding and its importance? Reduced perfusion pressures lowered volumetric flow rates and increased local vascular resistance, due to increased blood apparent viscosity. Thus, the local vascular resistance of small arterioles with limited myogenic or metabolic regulation of blood flow, appeared to be determined by changes in blood rheology rather than blood vessel diameter. The study of blood flow regulation is important to understand and resolve pathological conditions. As blood is a complex non-Newtonian multiphase system, the foundations of blood rheological properties have been obtained mostly in viscometers. However, blood rheological behaviour in vivo depends on the concentration of red blood cells (RBCs), their mechanical properties and the RBC hydrodynamics, including RBC migration away from the vessel wall in shear flow. This migration promotes the formation of a RBC-depleted zone, or cell-free layer (CFL), which reduces the apparent viscosity of blood. We hypothesize that perfusion pressure determines blood apparent viscosity in microvessels, as shear rate affects axial migration of RBCs by influencing the CFL thickness. In this study, we analysed the effects of perfusion pressure on blood flow in individual arterioles within the rat cremaster muscle preparation. Perfusion pressures to this microvascular bed were controlled by occlusions of the iliac artery using a pressure cuff. Blood flow measurements were obtained from direct measurements of blood flow velocity profile, as well as determination of CFL thickness using intravital microscopy. Our results indicate that perfusion pressure determines shear rates and the CFL thickness and its variations. In addition, blood flow reduction increased local vascular resistance by augmenting blood apparent viscosity rather than vascular hindrance. In conclusion, blood rheology could act as an intrinsic mechanism to further limit blood flow to tissue with limited myogenic and metabolic responses at low perfusion pressures.

Human leukocyte antigen (HLA)-DR-positive synovial fibroblasts are frequently observed in rheumatoid arthritis (RA) and may be implicated in the autoimmune reaction because RA is associated with certain HLA-DRB1* alleles. The question of whether components of the class II antigen presentation pathway and specific DRB alleles are efficiently expressed by synovial fibroblasts is germane to this hypothesis. To address this, cultured fibroblast-like synoviocytes (cFLS) were analyzed for constitutive and interferon (IFN)-gamma-induced expression of specific DRB alleles and class II-associated cochaperones. IFN-gamma induction of invariant chain, DM, and DR molecules was observed in all cFLS, but expression of specific DR allotypes was variable. Interestingly, DM-modulated epitopes on RA-associated DR molecules were either absent or delayed, despite strong DM expression and a paucity of major histocompatibility complex/class II-associated invariant chain peptide complexes. Altered expression of specific peptide-dependent epitopes on RA-associated HLA-DR molecules suggests differences in antigen presentation by cFLS, which may have implications for the immunopathogenesis of RA.

BACKGROUND

Nonanatomic tenodesis reconstruction procedures have been used for lateral ankle ligament reconstruction. However, there has been no comparison of Watson-Jones, Evans, and Chrisman-Snook procedures with respect to biomechanical characteristics such as kinematics, ligaments and grafts stresses using finite element analysis.

METHODS

A three-dimensional finite element model of the ankle including seven bony structures, cartilage and nine principal ligaments surrounding the ankle joint complex was developed and validated. In addition to the intact model, combined anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) deficient, Watson-Jones reconstruction, Evans reconstruction and Chrisman-Snook reconstruction models were simulated. Then, the forces in the ligaments and grafts and the kinematics of the talus and calcaneus were predicted for an inversion or internal torque of 1.7 Nom and an anterior drawer stress of 150 N through the range of ankle motion.

RESULTS

All three operations were able to improve the stability of the ankle, but the effectiveness of each procedure was dependent on the direction of the stress applied and the position of the ankle in dorsiflexion-plantarflexion.

CONCLUSIONS

This study showed that the Watson-Jones procedure has advantages with regard to anterior and rotational stabilities as well as ligaments and grafts stresses in comparison with other nonanatomic tenodesis reconstruction methods.

CONCLUSIONS

The knowledge of stress inside the ligaments and reconstructed grafts could help to better understand the biomechanical behavior of the reconstructed joint.

The development of scientifically sound instrumentation, methods, and procedures for the electromagnetic exposure assessment of compact fluorescent lamps (CFLs) is investigated. The incident and induced fields from 11 CFLs have been measured in the 10 kHz-1 MHz range, and they are compared with the levels for incandescent and light emitting diode (LED) bulbs. Commercially available equipment was used to measure the incident fields, while a novel sensor was built to assess the induced fields in humans. Incident electric field levels significantly exceed the International Commission on Non-Ionizing Radiation Protection (ICNIRP) reference levels at close distances for some sources, while the induced fields are within the ICNIRP basic restrictions. This demonstrates the importance of assessing the induced fields rather than the incident fields for these sources. Maximum current densities for CFLs are comparable to the limits (in the range of 9% to 56%), demonstrating the need for measurements to establish compliance. For the frequency range investigated, the induced fields were found to be considerably higher for CFLs than for incandescent light bulbs, while the exposure from the two LED bulbs was low. The proposed instrumentation and methods offer several advantages over an existing measurement standard, and the measurement uncertainty is significantly better than the assessment of electric and magnetic fields at close distances.

Because of the often observed undesired effects in patients transfused with leukocytes collected by continuous filtration leukapheresis (CFL), we have investigated the morphology of these cells in the hope that such studies may help evaluate their in vivo functions. Aliquots of CFL samples, procured by the Fenwal Leukopak and taken before and after tapping the filters, were examined. Leukocytes prepared by dextran sedimentation served as controls and were used to demonstrate the vulnerability of these cells to mechanical injury. The morphology of leukocytes harvested by filtration leukapheresis was markedly altered, ranging from formation of cytoplasmic projections and vacuoles to disintegration of entire cells. The severe changes were only observed in samples collected after the filters were tapped. The number of cells involved varied from donor to donor. In some cases more than half of the examined leukocytes showed signs of damage. Dextran sedimentation leukocytes retained their normal ultrastructure. However, substantial injuries were inflicted on dextran sedimentation collected leukocytes following brief periods of vortexing. Our results indicate that leukocytes are quite vulnerable to mechanical injury, and the major cause of damage found in Leukopak-isolated leukocytes is the tapping of the filters. The toxic reactions in some recipients transfused with Leukopak-collected leukocyte preparations may result from materials released from disrupted leukocytes. We believe that the employment of the continuous filtration to procure leukocytes with the present procedure should be reviewed.

The lateral talocalcaneal ligament (LTCL) connects the talus and calcaneus on the lateral side of the hindfoot. Although its function remains has not yet been clearly elucidated, the LTCL is thought to be important for the stabilization of the subtalar joint. Ankle sprains often include not only the talocrural joint but also the subtalar joint; therefore, LTCL injuries occur at a certain rate. Moreover, surgeons often encounter and reluctantly dissect the LTCL during arthroscopic anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) reconstruction because the LTCL connects to the ATFL at the talus in 42% of people and connects to the CFL at the calcaneus in 18% of people. As a result, LTCL reconstruction might be necessary for those patients. We describe the arthroscopic reconstruction technique of the ATFL, LTCL, and CFL using a triangle-shaped tendon graft (ALC-triangle). This technique provides a possible advantage of an anatomical and stable talocrural joint and subtalar joint.

The human reception of light includes image-forming and non-image-forming effects which are triggered by spectral distribution and intensity of light. Ideal lighting is similar to daylight, which could be evaluated by spectral or chromaticity match. LED-based and CFL-based lighting were analyzed here, proposed according to spectral and chromaticity match, respectively. The photobiological effects were expressed by effectiveness for blue light hazard, cirtopic activity, and photopic vision. Good spectral match provides light with more similar effects to those obtained by the chromaticity match. The new parameters are useful for better evaluation of complex human responses caused by lighting.

Legislation in many countries has banned inefficient household lighting. Consequently, classic incandescent lamps have to be replaced by more efficient alternatives such as halogen and compact fluorescent lamps (CFL). Alternatives differ in their spectral power distributions, implying colour-rendering differences. Participants performed a colour discrimination task - the Farnsworth-Munsell 100 Hue Test--and a proofreading task under CFL or halogen lighting of comparable correlated colour temperatures at low (70 lx) or high (800 lx) illuminance. Illuminance positively affected colour discrimination and proofreading performance, whereas the light source was only relevant for colour discrimination. Discrimination was impaired with CFL lighting. There were no differences between light sources in terms of self-reported physical discomfort and mood state, but the majority of the participants correctly judged halogen lighting to be more appropriate for discriminating colours. The findings hint at the colour-rendering deficiencies associated with energy-efficient CFLs.

UNASSIGNED

In order to compare performance under energy-efficient alternatives of classic incandescent lighting, colour discrimination and proofreading performance was compared under CFL and halogen lighting. Colour discrimination was impaired under CFLs, which hints at the practical drawbacks associated with the reduced colour-rendering properties of energy-efficient CFLs.

Despite the significant roles of the cell-free layer (CFL) in balancing nitric oxide (NO) and oxygen (O2) bioavailability in arteriolar tissue, many previous numerical approaches have relied on a one-dimensional (1-D) steady-state model for simplicity. However, these models are unable to demonstrate the influence of spatiotemporal variations in the CFL on the NO/O2 transport under dynamic flow conditions. Therefore, the present study proposes a new two-dimensional (2-D) transient model capable of predicting NO/O2 transport modulated by the spatiotemporal variations in the CFL width. Our model predicted that NO bioavailability was inversely related to the CFL width as expected. The enhancement of NO production by greater wall shear stress with a thinner CFL could dominate the diffusion barrier role of the CFL. In addition, NO/O2 availability along the vascular wall was inhomogeneous and highly regulated by dynamic changes of local CFL width variation. The spatial variations of CFL widths on opposite sides of the arteriole exhibited a significant inverse relation. This asymmetric formation of CFL resulted in a significantly imbalanced NO/O2 bioavailability on opposite sides of the arteriole. The novel integrative methodology presented here substantially highlighted the significance of spatiotemporal variations of the CFL in regulating the bioavailability of NO/O2, and provided further insight about the opposing effects of the CFL on arteriolar NO production.

The influence of the neonatal frontal lesion in unilateral cerebral hemisphere for the organization of intact forelimb motor cortex in the rat was investigated by intracortical microstimulation (ICMS). The relative size of the rostral forelimb area (RFL) compared to the caudal forelimb area (CFL) in the ipsilateral motor field of lesioned rat was significantly greater than those of contralateral in normal and lesioned rats. The optimal sites of the stimulation for ipsilateral responses in lesioned rats were located in the RFL, while the optimal sites for contralateral were located caudolaterally, as for those of normal rats. At the ipsilateral optimal sites within the RFL in the lesioned animals, the threshold for the ipsilateral responses was lower than that for the contralateral responses. That is, the intact hemisphere of the animal preferentially developed the RFL rather than the CFL, for the ipsilateral forelimb. This may suggest a critical role for the RFL in individual forelimb motor control within the normal hemisphere.

In this study, the 1D blood flow equations are solved using a newly proposed enhanced trapezoidal rule method (ETM), which is an extension to the simplified trapezoidal rule method. At vessel junctions, the conservation of mass and conservation of total pressure are held as system constraints using Lagrange multipliers that can be physically interpreted as external flow rates. The ETM scheme is compared with published arterial network benchmark problems and a dam break problem. Strengths of the ETM scheme include being simple to implement, intuitive connection to lumped parameter models, and no restrictive stability criteria such as the Courant-Friedrichs-Lewy (CFL) number. The ETM scheme does not require the use of characteristics at vessel junctions, or for inlet and outlet boundary conditions. The ETM forms an implicit system of equations, which requires only one global solve per time step for pressure, followed by flow rate update on the elemental system of equations; thus, no iterations are required per time step. Consistent results are found for all benchmark cases, and for a 56-vessel arterial network problem, it gives very satisfactory solutions at a spatial and time discretization that results in a maximum CFL of 3, taking 4.44 seconds per cardiac cycle. By increasing the time step and element size to produce a maximum CFL number of 15, the method takes only 0.39 second per cardiac cycle with only a small compromise on accuracy.

BACKGROUND

The purpose of the study therefore was to determine radiographic landmarks that support the identification of the insertion site of the distal calcaneofibular ligament (CFL) in anatomic ankle ligament reconstructions.

METHODS

In 10 lower limb cadaver specimens the midpoint of the distal CFL insertion was dissected and marked with a nail inserted orthogonally. On a standardized lateral radiograph in neutral ankle position a horizontal tangent was aligned to the deepest visible concavity of the tarsal sinus and one vertical tangent to the farthest posterior convexity of the talus. Additionally, a line was drawn from the radiographically marked distal CFL to the fibular insertion of the CFL to determine the CFL-fibular angle.

RESULTS

In relation to the radiographic tangents intersection the mean deviation of the depicted CFL nails was 2.2mm [SD ± 1.1 mm] leading to an angular, circular to slightly oval 6 mm insertion. The scatter-plot of the marked positions convened along a line from the supposed fibular CFL insertion to the intersection in all cases. The mean CFL-fibular angle was 131.7° [SD ± 3.16°].

CONCLUSIONS

Determining a virtual intersection between a horizontal tangent aligned to the deepest visible concavity of the tarsal sinus and one vertical tangent aligned to the farthest posterior convexity of the talus on a standardized lateral radiograph in neutral ankle position supports an anatomic insertion of the distal calcaneofibular ligament most probably.

Contact inhibition of locomotion (CIL), the repulsive response of cells upon cell-cell contact, has been the predominant paradigm for contact-mediated responses. However, it is difficult for CIL alone to account for the complex behavior of cells within a multicellular environment, where cells often migrate in cohorts such as sheets, clusters, and streams. Although cell-cell adhesion and mechanical interactions play a role, how individual cells coordinate their migration within a multicellular environment remains unclear. Using micropatterned substrates to guide cell migration and manipulate cell-cell contact, we show that contacts between different regions of cells elicit different responses. Repulsive responses were limited to interaction with the head of a migrating cell, while contact with the tail of a neighboring cell promoted migration toward the tail. The latter behavior, termed contact following of locomotion (CFL), required the Wnt signaling pathway. Inhibition of the Wnt pathway disrupted not only CFL but also collective migration of epithelial cells, without affecting the migration of individual cells. In contrast, inhibition of myosin II with blebbistatin disrupted the migration of both individual epithelial cells and collectives. We propose that CFL, in conjunction with CIL, plays a major role in guiding and coordinating cell migration within a multicellular environment.

OBJECTIVE

Reconstruction of the anterior talofibular (ATFL) and calcaneofibular (CFL) ligament in patients with chronic lateral ankle instability.

METHODS

Symptomatic chronic lateral ankle instability.

METHODS

Bony malalignment, advanced arthritic changes of the ankle joint, diabetic foot syndrome.

METHODS

Reconstruction of the ATFL and CFL with a free gracilisor or semitendinosus tendon graft through a V-shaped tunnel at the insertion site of the ATFL on the talar neck as well as a transfibular tunnel directed anterior to posterior through the fibula tip to a blind ending tunnel in the calcaneus at the insertion site of the CFL. Insertion of the graft through the talar tunnel, passing both graft ends through the fibular tunnel to the calcaneus. Fixation with a bioabsorbable screw.

METHODS

Short leg cast for 10-14 days and partial weight-bearing. Afterwards ankle brace for 6 weeks and functional physical therapy.

RESULTS

From December 2003 to August 2005, reconstruction of the ATFL and CFL with a hamstring tendon autograft was performed in 20 patients with chronic lateral instability of the ankle joint. All patients were evaluated after a mean follow-up time of 1.8 years (15-36 months). Clinical evaluation referred to the AOFAS score. Stress radiography was performed for objective assessment of lateral ankle stability. Postoperatively 19 of 20 patients reported good subjective stability with no further ankle sprains. The mean postoperative AOFAS score was 92 of 100 points (72-100). Stress radiography showed a significant reduction of both lateral ankle instability and talar tilt.

OBJECTIVE

To explore the effect and mechanism of acupoint sticking of Chuanfuling (CFL) in dog-days (the hottest periods of the year) in preventing and treating children asthma in remission stage.

METHODS

Ninety patients were divided into three groups, 30 in each. Patients in the CFL group were treated with CFL sticking, in the Western medicine (WM) group treated with Pulmicort inhalation, and in the control group was untreated. The clinical effect and indexes of humoral immunity (IgE, IgA, IgG) and cellular immunity (Eos, IL-4, IFN-gamma) before and after treatment were observed.

RESULTS

After treatment in the CFL group all the immune parameters were significantly improved (P<0.05 or P<0.01), all were better than those in the control group (P<0.05 or P<0.01), and the effect on IgA and IgG was better than that in the WM group. In the WM group after treatment, improvement was shown on the IgE and cellular immune parameters with signifian difference (P<0.05 or P<0.01), better than those in the control group (P<0.05 or P<0.01). Besides, significant difference was shown in comparing IL-4 level between the WM group and the CFL group (P<0.05).

CONCLUSIONS

CFL sticking in dog-days could significantly improve the immune function in children with asthma to alleviate and control the attack.

Atlantic Bluefin Tuna Thunnus thynnus (ABFT) is considered one of the most important socio-economic species but there is a lack of information on the physiological and molecular processes regulating its growth and metabolism. In the present study, we focused on key molecules involved in growth process. The aim of the present study was to associate molecular markers related to growth with canonical procedures like morphological measurements such as curved fork length (CFL) and round weight (RWT). The ABFT specimens (n = 41) were organized into three different groups A, B and C according to their age. The molecular analysis of liver samples revealed that igf1, igf1r and mTOR genes, involved in growth process, were differentially expressed in relation to the age of the fish. In addition, during the analyzed period, faster growth was evident from 5 to 8 years of age, after that, the growth rate decreased in terms of length yet increased in terms of adipose tissue storage, as supported by the higher fat content in the liver. These results are useful in expanding basic knowledge about the metabolic system of ABFT and provide new knowledge for the aquaculture industry.

50 male patients, diagnosed to have chronic folliculitis of legs (CFL), were included in a clinico epidemiological study. CFL affected predominantly young adults of the age group of 16 - 25 years. Severe pruritus was associated in 86% of patients with CFL, and this symptom preceded the onset of new lesions. Follicular papules were seen more often than pustules in 58% of patients. Staphylococcus aureus was isolated in 72.5%. The lesions were confined to both legs in 50%, extending upto thigh in 28% and in legs, thighs and forearms in 10% of individuals studied.