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Sample records for subcutaneous counterpulsation device

  1. Acute Hemodynamic Efficacy of a 32-ml Subcutaneous Counterpulsation Device in a Calf Model of Diminished Cardiac Function

    PubMed Central

    Koenig, Steven C.; Litwak, Kenneth N.; Giridharan, Guruprasad A.; Pantalos, George M.; Dowling, Robert D.; Prabhu, Sumanth D.; Slaughter, Mark S.; Sobieski, Michael A.; Spence, Paul A.

    2010-01-01

    The acute hemodynamic efficacy of an implantable counter-pulsation device (CPD) was evaluated. The CPD is a valveless single port, 32-ml stroke volume blood chamber designed to be connected to the human axillary artery using a simple surface surgical procedure. Blood is drawn into the pump during systole and ejected during diastole. The acute hemodynamic effects of the 32-ml CPD were compared to a standard clinical 40-ml intra-aortic balloon pump (IABP) in calves (80 kg, n = 10). The calves were treated by a single oral dose of Monensin to produce a model of diminished cardiac function (DCF). The CPD and IABP produced similar increases in cardiac output (6% CPD vs. 5% IABP, p > 0.5) and reduction in left ventricular external work (14% CPD vs. 13% IABP, p > 0.5) compared to DCF (p < 0.05). However, the ratio of diastolic coronary artery flow to left ventricular external work increase from DCF baseline (p < 0.05) was greater with the CPD compared to the IABP (15% vs. 4%, p < 0.05). The CPD also produced a greater reduction in left ventricular myocardial oxygen consumption from DCF baseline (p < 0.05) compared to the IABP (13% vs. 9%, p < 0.05) despite each device providing similar improvements in cardiac output. There was no early indication of hemolysis, thrombus formation, or vascular injury. The CPD provides hemodynamic efficacy equivalent to an IABP and may become a therapeutic option for patients who may benefit from prolonged counterpulsation. PMID:19033769

  2. Acute hemodynamic efficacy of a 32-ml subcutaneous counterpulsation device in a calf model of diminished cardiac function.

    PubMed

    Koenig, Steven C; Litwak, Kenneth N; Giridharan, Guruprasad A; Pantalos, George M; Dowling, Robert D; Prabhu, Sumanth D; Slaughter, Mark S; Sobieski, Michael A; Spence, Paul A

    2008-01-01

    The acute hemodynamic efficacy of an implantable counterpulsation device (CPD) was evaluated. The CPD is a valveless single port, 32-ml stroke volume blood chamber designed to be connected to the human axillary artery using a simple surface surgical procedure. Blood is drawn into the pump during systole and ejected during diastole. The acute hemodynamic effects of the 32-ml CPD were compared to a standard clinical 40-ml intra-aortic balloon pump (IABP) in calves (80 kg, n = 10). The calves were treated by a single oral dose of Monensin to produce a model of diminished cardiac function (DCF). The CPD and IABP produced similar increases in cardiac output (6% CPD vs. 5% IABP, p > 0.5) and reduction in left ventricular external work (14% CPD vs. 13% IABP, p > 0.5) compared to DCF (p < 0.05). However, the ratio of diastolic coronary artery flow to left ventricular external work increase from DCF baseline (p < 0.05) was greater with the CPD compared to the IABP (15% vs. 4%, p < 0.05). The CPD also produced a greater reduction in left ventricular myocardial oxygen consumption from DCF baseline (p < 0.05) compared to the IABP (13% vs. 9%, p < 0.05) despite each device providing similar improvements in cardiac output. There was no early indication of hemolysis, thrombus formation, or vascular injury. The CPD provides hemodynamic efficacy equivalent to an IABP and may become a therapeutic option for patients who may benefit from prolonged counterpulsation. PMID:19033769

  3. Effect of counter-pulsation control of a pulsatile left ventricular assist device on working load variations of the native heart

    PubMed Central

    2014-01-01

    Background When using a pulsatile left ventricular assist device (LVAD), it is important to reduce the cardiac load variations of the native heart because severe cardiac load variations can induce ventricular arrhythmia. In this study, we investigated the effect of counter-pulsation control of the LVAD on the reduction of cardiac load variation. Methods A ventricular electrocardiogram-based counter-pulsation control algorithm for a LVAD was implemented, and the effects of counter-pulsation control of the LVAD on the reduction of the working load variations of the left ventricle were determined in three animal experiments. Results Deviations of the working load of the left ventricle were reduced by 51.3%, 67.9%, and 71.5% in each case, and the beat-to-beat variation rates in the working load were reduced by 84.8%, 82.7%, and 88.2% in each ease after counter-pulsation control. There were 3 to 12 premature ventricle contractions (PVCs) before counter-pulsation control, but no PVCs were observed during counter-pulsation control. Conclusions Counter-pulsation control of the pulsatile LVAD can reduce severe cardiac load variations, but the average working load is not markedly affected by application of counter-pulsation control because it is also influenced by temporary cardiac outflow variations. We believe that counter-pulsation control of the LVAD can improve the long-term safety of heart failure patients equipped with LVADs. PMID:24708625

  4. Controlling methods of a newly developed extra aortic counter-pulsation device using shape memory alloy fibers.

    PubMed

    Hashem, Mohamed O; Yamada, A; Tsuboko, Y; Muira, H; Homma, D; Shiraishi, Y; Yambe, T

    2013-01-01

    Diastolic counter-pulsation has been used to provide circulatory augmentation for short term cardiac support. The success of intra-aortic balloon pump (IABP) therapy has generated interest in long term counter-pulsation strategies to treat heart failure patients. The authors have been developing a totally implantable extra aortic pulsation device for the circulatory support of heart failure patients, using 150 µm Ni-Ti anisotropic shape memory alloy (SMA) fibers. These fibers contract by Joule heating with an electric current supply. The special features of our design are as follow: non blood contacting, extra aortic pulsation function synchronizing with the native heart, a wrapping mechanical structure for the aorta in order to achieve its assistance as the aortomyoplsty and the extra aortic balloon pump. The device consisted of rubber silicone wall plates, serially connected for radial contraction. We examined the contractile function of the device, as well as it controlling methods; the phase delay parameter and the pulse width modulation, in a systemic mock circulatory system, with a pneumatically driven silicone left ventricle model, arterial rubber tubing, a peripheral resistance unit, and a venous reservoir. The device was secured around the aortic tubing with a counter-pulsation mode of 1:4 against the heartbeat. Pressure and flow waveforms were measured at the aortic outflow, as well as its driving condition of the contraction phase width and the phase delay. The device achieved its variable phase control for co-pulsation or counter-pulsation modes by changing the phase delay of the SMA fibers. Peak diastolic pressure significantly augmented, mean flow increased (p<0.05) according to the pulse width modulation. Therefore the newly developed extra aortic counter-pulsation device using SMA fibers, through it controlling methods indicated its promising alternative extra aortic approach for non-blood contacting cardiovascular circulatory support. PMID

  5. 21 CFR 870.5225 - External counter-pulsating device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., prescription device used to assist the heart by applying positive or negative pressure to one or more of the body's limbs in synchrony with the heart cycle. (b) Classification. (1) Class II (special controls... angina pectoris; acute myocardial infarction; cardiogenic shock; congestive heart failure;...

  6. Cardiovascular devices; reclassification of external counter-pulsating devices for treatment of chronic stable angina; effective date of requirement for premarket approval for external counter-pulsating devices for other specified intended uses. Final order.

    PubMed

    2013-12-30

    The Food and Drug Administration (FDA) is issuing a final order to reclassify external counter-pulsating (ECP) devices for treatment of chronic stable angina that is refractory to optimal anti-anginal medical therapy and without options for revascularization, which is a preamendments class III device, into class II (special controls), and to require the filing of a premarket approval application (PMA) or a notice of completion of a product development protocol (PDP) for ECP devices for other intended uses specified in this proposed order. PMID:24383148

  7. Flow field of a novel implantable valveless counterpulsation heart assist device.

    PubMed

    Berthe, A; Gärtlein, S; Lederer, Ch; Kertzscher, U; Affeld, K; Goubergrits, L

    2012-09-01

    Flow fields are one of the key factors associated with the life threatening formation of thrombi in artificial organs. Therefore, knowledge of flow field is crucial for the design and optimization of a long-term blood pump performance. The blood chamber flow of a novel counterpulsation heart assist device (CPD) has been investigated using laser Doppler velocimetry (LDV), particle image velocimetry (PIV), and near-wall PIV (wall-PIV). The wall-PIV is an in-house developed technique assessing wall shear rates (WSR). These experimental techniques analyzed complex transient three-dimensional (3D) flow fields including major and secondary structures during the whole CPD cycle (ejection, filling, and hold time). PIV measurements in the central plane investigated an evolution (development and destruction) of the blood chamber fully filling vortex as the major CPD flow structure. The wall-PIV measurements identified areas of blood stagnation (vortex center and jet impingements) and quantified WSR at the front housing. Maximal mean WSR of 2,045 ± 605 s(-1) were found at the end of the filling. The LDV, which identified helical flow structure at the outer region of the pump, was used to complete 3D flow analysis and to combine PIV and wall-PIV results. The results suggest good washing behavior of the CPD regarding thrombus formation. PMID:22527012

  8. 78 FR 29672 - Cardiovascular Devices; Reclassification of External Counter-Pulsating Devices for Treatment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-21

    ... the 90-day period. Since these devices were classified in 1980, the 30-month period has expired (45 FR.... Regulatory History of the Device In the preamble to the proposed rule (44 FR 13426, March 9, 1979), the... devices into class III after receiving no comments on the proposed rule (45 FR 7966, February 5, 1980)....

  9. Assessing Consequences of Intraaortic Balloon Counterpulsation Versus Left Ventricular Assist Devices at the Time of Heart Transplantation.

    PubMed

    Castleberry, Anthony W; DeVore, Adam D; Southerland, Kevin W; Meza, James M; Irish, William D; Rogers, Joseph G; Milano, Carmelo A; Patel, Chetan B

    2016-01-01

    The proportion of heart transplant recipients bridged with durable, intracorporeal left ventricular assist devices (dLVADs) has dramatically increased; however, concern exists regarding obligate repeat sternotomy, increased bleeding risk because of anticoagulation and acquired von Willebrand disease, and increased rates of allosensitization. Whether dLVAD patients have impaired posttransplant outcomes compared with equivalent patients with less invasive intraaortic balloon pump counterpulsation (IABP) at the time of transplant is unknown. Therefore, we analyzed adult, first time, heart-only transplant procedures with dLVAD (n = 2,636) compared with IABP (n = 571) at the time of transplant based on data from the United Network for Organ Sharing (UNOS) July 2004 to December 2011. There was clear geographic variation in IABP and dLVAD at transplant. Multivariable analysis demonstrated equivalent cumulative risk of death (adjusted Cox proportional hazard ratio, 1.08; 95% confidence interval, 0.87-1.33; p = 0.51). There was no significant difference in adjusted comparison of perioperative morality, length of stay, postoperative renal failure requiring dialysis, or early acute rejection (p ≥ 0.14 for all). Therefore, data from UNOS suggest that the presence of dLVAD at the time of heart transplantation does not have a detrimental effect on postoperative outcomes compared with IABP, which must be considered in the context of pretransplant mortality and locoregional organ availability. PMID:26735554

  10. Method measuring oxygen tension and transport within subcutaneous devices

    PubMed Central

    Weidling, John; Sameni, Sara; Lakey, Jonathan R. T.; Botvinick, Elliot

    2014-01-01

    Abstract. Cellular therapies hold promise to replace the implantation of whole organs in the treatment of disease. For most cell types, in vivo viability depends on oxygen delivery to avoid the toxic effects of hypoxia. A promising approach is the in situ vascularization of implantable devices which can mediate hypoxia and improve both the lifetime and utility of implanted cells and tissues. Although mathematical models and bulk measurements of oxygenation in surrounding tissue have been used to estimate oxygenation within devices, such estimates are insufficient in determining if supplied oxygen is sufficient for the entire thickness of the implanted cells and tissues. We have developed a technique in which oxygen-sensitive microparticles (OSMs) are incorporated into the volume of subcutaneously implantable devices. Oxygen partial pressure within these devices can be measured directly in vivo by an optical probe placed on the skin surface. As validation, OSMs have been incorporated into alginate beads, commonly used as immunoisolation devices to encapsulate pancreatic islet cells. Alginate beads were implanted into the subcutaneous space of Sprague–Dawley rats. Oxygen transport through beads was characterized from dynamic OSM signals in response to changes in inhaled oxygen. Changes in oxygen dynamics over days demonstrate the utility of our technology. PMID:25162910

  11. Continuous internal counterpulsation as a bridge to recovery in acute and chronic heart failure

    PubMed Central

    Kontogiannis, Christos D; Malliaras, Konstantinos; Kapelios, Chris J; Mason, Jay W; Nanas, John N

    2016-01-01

    Cardiac recovery from cardiogenic shock (CS) and end-stage chronic heart failure (HF) remains an often insurmountable therapeutic challenge. The counterpulsation technique exerts numerous beneficial effects on systemic hemodynamics and left ventricular mechanoenergetics, rendering it attractive for promoting myocardial recovery in both acute and chronic HF. Although a recent clinical trial has questioned the clinical effectiveness of short-term hemodynamic support with intra-aortic balloon pump (IABP, the main representative of the counterpulsation technique) in CS complicating myocardial infarction, the issue remains open to further investigation. Moreover, preliminary data suggest that long-term IABP support in patients with end-stage HF is safe and may mediate recovery of left- or/and right-sided cardiac function, facilitating long-term weaning from mechanical support or enabling the application of other permanent, life-saving solutions. The potential of long-term counterpulsation could possibly be enhanced by implementation of novel, fully implantable counterpulsation devices. PMID:27011909

  12. Understanding Subcutaneous Tissue Pressure for Engineering Injection Devices for Large-Volume Protein Delivery.

    PubMed

    Doughty, Diane V; Clawson, Corbin Z; Lambert, William; Subramony, J Anand

    2016-07-01

    Subcutaneous injection allows for self-administration of monoclonal antibodies using prefilled syringes, autoinjectors, and on-body injector devices. However, subcutaneous injections are typically limited to 1 mL due to concerns of injection pain from volume, viscosity, and formulation characteristics. Back pressure can serve as an indicator for changes in subcutaneous mechanical properties leading to pain during injection. The purpose of this study was to investigate subcutaneous pressures and injection site reactions as a function of injection volume and flow rate. A pressure sensor in the fluid path recorded subcutaneous pressures in the abdomen of Yorkshire swine. The subcutaneous tissue accommodates large-volume injections and with little back pressure as long as low flow rates are used. A 1 mL injection in 10 seconds (360 mL/h flow rate) generated a pressure of 24.0 ± 3.4 kPa, whereas 10 mL delivered in 10 minutes (60 mL/h flow rate) generated a pressure of 7.4 ± 7.8 kPa. After the injection, the pressure decays to 0 over several seconds. The subcutaneous pressures and mechanical strain increased with increasing flow rate but not increasing dose volume. These data are useful for the design of injection devices to mitigate back pressure and pain during subcutaneous large-volume injection. PMID:27287520

  13. Counterpulse railgun energy recovery circuit

    SciTech Connect

    Honig, E.M.

    1986-02-25

    This patent describes a counterpulse railgun energy recovery circuit for propelling a projectile along a railgun the counterpulse railgun energy recovery circuit consists of: a railgun having an effective inductance; a source inductor initially charged to an initial current; current means for initially charging the source inductor to the initial current; first current-zero type switching means; second current-zero type switching; third current-zero type switching; muzzle current-zero type switching means; transfer capacitor, the transfer capacitor is for cooperating with the first, second, third, and muzzle current-zero type switching means for providing a resonant circuit for transferring current from the source inductor to the effective inductance of the railgun during the propelling of a projectile along the railgun and for returning current from the effective inductance of the railgun to the source inductance after the projectile has exited the railgun.

  14. Counterpulse railgun energy recovery circuit

    DOEpatents

    Honig, Emanuel M.

    1986-01-01

    In an electromagnetic launcher such as a railgun for propelling a projectile at high velocity, a counterpulse energy recovery circuit is employed to transfer stored inductive energy from a source inductor to the railgun inductance to propel the projectile down the railgun. Switching circuitry and an energy transfer capacitor are used to switch the energy back to the source inductor in readiness for a repetitive projectile propelling cycle.

  15. Intra-aortic balloon counterpulsation: potential for therapy in hemorrhagic shock with associated myocardial failure.

    PubMed Central

    Proctor, H J; Hsiao, H; Fry, J; Ebert, C

    1975-01-01

    After attaching appropriate monitoring devices enabling the measurement of the slope of the left ventricular function curve, left atrial pressure, mean aortic pressure, peak left ventricular pressure, and tension time index, three groups of ten dogs were subjected to varying periods of hemorrhagic shock until a slope of their ventricular function curve was reduced to either 75% (Group I), 50% (Group II), or 25% (Group III) of their baseline value. Resuscitation was attempted in all dogs by the intravenous infusion of shed blood plus additional balanced salt solution. This infusate was administered to maintain either the mean aortic pressure within 15 mm Hg of the baseline value or a left atrial pressure of 15 mm Hg, whichever occurred forst. One half of the dogs received, in addition, intra-aortic balloon counterpulsation. All dogs not receiving counterpulsation expired within two hours. There was no apparent effect of counterpulsation on Group I animals. Three of five animals (Group II) and four of five animals (Group III) receiving counterpulsation survived to the end of the experiment with significant (p smaller than .01) improvement in the parameters monitored. The utilization of counterpulsation as an adjunct to treatment in hemorrhagic shock is suggested. PMID:1119860

  16. Counterpulse railgun energy recovery circuit

    DOEpatents

    Honig, E.M.

    1984-09-28

    The invention presented relates to a high-power pulsing circuit and more particularly to a repetitive pulse inductive energy storage and transfer circuit for an electromagnetic launcher. In an electromagnetic launcher such as a railgun for propelling a projectile at high velocity, a counterpulse energy recovery circuit is employed to transfer stored inductive energy from a source inductor to the railgun inductance to propel the projectile down the railgun. Switching circuitry and an energy transfer capacitor are used to switch the energy back to the source inductor in readiness for a repetitive projectile propelling cycle.

  17. Series-counterpulse repetitive-pulse inductive storage circuit

    DOEpatents

    Honig, E.M.

    1984-06-05

    A high-power series-counterpulse repetitive-pulse inductive energy storage and transfer circuit includes an opening switch, a main energy storage coil, and a counterpulse capacitor. The local pulse is initiated simultaneously with the initiation of the counterpulse used to turn the opening switch off. There is no delay from command to output pulse. During the load pulse, the counterpulse capacitor is automatically charged with sufficient energy to accomplish the load counterpulse which terminates the load pulse and turns the load switch off. When the main opening switch is reclosed to terminate the load pulse, the counterpulse capacitor discharges through the load, causing a rapid, sharp cutoff of the load pulse as well as recovering any energy remaining in the load inductance. The counterpulse capacitor is recharged to its original condition by the main energy storage coil after the load pulse is over, not before it begins.

  18. Epidural catheter fixation. A comparison of subcutaneous tunneling versus device fixation technique

    PubMed Central

    Sharma, Ashima; Parasa, Sujay Kumar; Tejvath, Kiran; Ramachandran, Gopinath

    2016-01-01

    Background and Aims: The technique of securing the epidural catheter has a major bearing on the efficacy of epidural analgesia. Specific fixator devices, for e.g., Lockit epidural catheter clamp, which successfully prevents catheter migration, are available. The possibility of catheter snapping and surgical retrieval has been reported with tunneling of catheters. These techniques have not been compared for safety, efficacy and appropriateness of achieving secure epidural catheter fixation in the postoperative period. Material and Methods: A total of 200 patients who required postoperative epidural analgesia were included. They were randomized into two groups: Group I (n = 100) in whom epidural catheters were tunneled vertically in the paravertebral subcutaneous tissue and group II (n = 100) wherein a Lockit device was used to fix the catheter. Likert score was used to quantify patient's comfort during procedure. The techniques were compared for migration, catheter dislodgement, local trauma, catheter snapping and catheter obstruction. Results: 12% of tunneled catheters had migrated significantly outward. 22% of patients had erythema and 77% had significant procedural discomfort in group I. In group II, 3% catheters had kinked and 14% had erythema from device adhesive. Conclusion: Our results support the use of Lockit device as a safe and comfortable fixation device compared to subcutaneous tunneling of catheters. PMID:27006544

  19. 3D Printed Microfluidic Device with Integrated Biosensors for Online Analysis of Subcutaneous Human Microdialysate.

    PubMed

    Gowers, Sally A N; Curto, Vincenzo F; Seneci, Carlo A; Wang, Chu; Anastasova, Salzitsa; Vadgama, Pankaj; Yang, Guang-Zhong; Boutelle, Martyn G

    2015-08-01

    This work presents the design, fabrication, and characterization of a robust 3D printed microfluidic analysis system that integrates with FDA-approved clinical microdialysis probes for continuous monitoring of human tissue metabolite levels. The microfluidic device incorporates removable needle type integrated biosensors for glucose and lactate, which are optimized for high tissue concentrations, housed in novel 3D printed electrode holders. A soft compressible 3D printed elastomer at the base of the holder ensures a good seal with the microfluidic chip. Optimization of the channel size significantly improves the response time of the sensor. As a proof-of-concept study, our microfluidic device was coupled to lab-built wireless potentiostats and used to monitor real-time subcutaneous glucose and lactate levels in cyclists undergoing a training regime. PMID:26070023

  20. 3D Printed Microfluidic Device with Integrated Biosensors for Online Analysis of Subcutaneous Human Microdialysate

    PubMed Central

    2015-01-01

    This work presents the design, fabrication, and characterization of a robust 3D printed microfluidic analysis system that integrates with FDA-approved clinical microdialysis probes for continuous monitoring of human tissue metabolite levels. The microfluidic device incorporates removable needle type integrated biosensors for glucose and lactate, which are optimized for high tissue concentrations, housed in novel 3D printed electrode holders. A soft compressible 3D printed elastomer at the base of the holder ensures a good seal with the microfluidic chip. Optimization of the channel size significantly improves the response time of the sensor. As a proof-of-concept study, our microfluidic device was coupled to lab-built wireless potentiostats and used to monitor real-time subcutaneous glucose and lactate levels in cyclists undergoing a training regime. PMID:26070023

  1. Implantable Subcutaneous Venous Access Devices: Is Port Fixation Necessary? A Review of 534 Cases

    SciTech Connect

    McNulty, Nancy J. Perrich, Kiley D.; Silas, Anne M.; Linville, Robert M.; Forauer, Andrew R.

    2010-08-15

    Conventional surgical technique of subcutaneous venous port placement describes dissection of the port pocket to the pectoralis fascia and suture fixation of the port to the fascia to prevent inversion of the device within the pocket. This investigation addresses the necessity of that step. Between October 8, 2004 and October 19, 2007, 558 subcutaneous chest ports were placed at our institution; 24 cases were excluded from this study. We performed a retrospective review of the remaining 534 ports, which were placed using standard surgical technique with the exception that none were sutured into the pocket. Mean duration of port use, total number of port days, indications for removal, and complications were recorded and compared with the literature. Mean duration of port use was 341 days (182,235 total port days, range 1-1279). One port inversion/flip occurred, which resulted in malfunction and necessitated port revision (0.2%). Other complications necessitating port removal included infection 26 (5%), thrombosis n = 2 (<1%), catheter fracture/pinch n = 1 (<1%), pain n = 2 (<1%), and skin erosion n = 3 (1%). There were two arrhythmias at the time of placement; neither required port removal. The overall complication rate was 7%. The 0.2% incidence of port inversion we report is concordant with that previously published, although many previous reports do not specify if suture fixation of the port was performed. Suture fixation of the port, in our experience, is not routinely necessary and may negatively impact port removal.

  2. Measurement of subcutaneous adipose tissue development in children by the optical device LIPOMETER

    NASA Astrophysics Data System (ADS)

    Moeller, Reinhard; Horejsi, Renate; Sudi, Karl; Berg, Aloys; Reibnegger, Gilbert; Tafeit, Erwin

    2001-10-01

    The new optical device LIPOMETER enables the non-invasive, quick and save determination of the thickness of subcutantous adipose tissue (SAT) layers (in nm) at any site of the human body. The topographic specification of 15 evenly distributed body sites allows the precise measurement of subcutaneous body fat distribution, so called subcutaneous adipose tissue topopgraphy (SAT-Top). SAT-Top was determined in more than 1000 children aging from 7 to 21 yr. We describe the SAT-Top development of these subjects through different age groups and the differences between male and female SAT-Top development in each age group. SAT layer profiles (medians of the 15 body sites) for boys and girls in age group (7-9 yr) show a very similar pattern for both sexes, followed by decreasing SAT layer thicknesses in boys and increasing values in girls in the subsequent age groups. Between age group 3 (11-13 yr) and age group 7 (19- 21 yr) male and female SAT-Top is significantly different in (almost) all body sites. We present a precise description of SAT-Top development in boys and girls, providing a basis for further investigations in different fields such as obesity, sport sciences or metabolic disorders, and suggesting the LIPOMETER technique as an appropriate measurement tool.

  3. Reversing-counterpulse repetitive-pulse inductive storage circuit

    DOEpatents

    Honig, Emanuel M.

    1987-01-01

    A high-power reversing-counterpulse repetitive-pulse inductive storage and transfer circuit includes an opening switch, a main energy storage coil, a counterpulse capacitor and a small inductor. After counterpulsing the opening switch off, the counterpulse capacitor is recharged by the main energy storage coil before the load pulse is initiated. This gives the counterpulse capacitor sufficient energy for the next counterpulse operation, although the polarity of the capacitor's voltage must be reversed before that can occur. By using a current-zero switch as the counterpulse start switch, the capacitor is disconnected from the circuit (with a full charge) when the load pulse is initiated, preventing the capacitor from depleting its energy store by discharging through the load. After the load pulse is terminated by reclosing the main opening switch, the polarity of the counterpulse capacitor voltage is reversed by discharging the capacitor through a small inductor and interrupting the discharge current oscillation at zero current and peak reversed voltage. The circuit enables high-power, high-repetition-rate operation with reusable switches and features total control (pulse-to-pulse) over output pulse initiation, duration, repetition rate, and, to some extent, risetime.

  4. Reversing-counterpulse repetitive-pulse inductive storage circuit

    DOEpatents

    Honig, E.M.

    1987-02-10

    A high-power reversing-counterpulse repetitive-pulse inductive storage and transfer circuit includes an opening switch, a main energy storage coil, a counterpulse capacitor and a small inductor. After counterpulsing the opening switch off, the counterpulse capacitor is recharged by the main energy storage coil before the load pulse is initiated. This gives the counterpulse capacitor sufficient energy for the next counterpulse operation, although the polarity of the capacitor's voltage must be reversed before that can occur. By using a current-zero switch as the counterpulse start switch, the capacitor is disconnected from the circuit (with a full charge) when the load pulse is initiated, preventing the capacitor from depleting its energy store by discharging through the load. After the load pulse is terminated by reclosing the main opening switch, the polarity of the counterpulse capacitor voltage is reversed by discharging the capacitor through a small inductor and interrupting the discharge current oscillation at zero current and peak reversed voltage. The circuit enables high-power, high-repetition-rate operation with reusable switches and features total control (pulse-to-pulse) over output pulse initiation, duration, repetition rate, and, to some extent, risetime. 10 figs.

  5. Reversing-counterpulse repetitive-pulse inductive storage circuit

    DOEpatents

    Honig, E.M.

    1984-06-05

    A high power reversing-counterpulse repetitive-pulse inductive storage and transfer circuit includes an opening switch, a main energy storage coil, a counterpulse capacitor and a small inductor. After counterpulsing the opening switch off, the counterpulse capacitor is recharged by the main energy storage coil before the load pulse is initiated. This gives the counterpulse capacitor sufficient energy for the next counterpulse operation, although the polarity of the capacitor's voltage must be reversed before that can occur. By using a current-zero switch as the counterpulse start switch, the capacitor is disconnected from the circuit (with a full charge) when the load pulse is initiated, preventing the capacitor from depleting its energy store by discharging through the load. After the load pulse is terminated by reclosing the main opening switch, the polarity of the counterpulse capacitor voltage is reversed by discharging the capacitor through a small inductor and interrupting the discharge current oscillation at zero current and peak reversed voltage. The circuit enables high-power, high-repetition-rate operation with reusable switches and features total control (pulse-to-pulse) over output pulse initiation, duration, repetition rate, and, to some extent, risetime.

  6. Series-counterpulse repetitive-pulse inductive storage circuit

    DOEpatents

    Honig, Emanuel M.

    1986-01-01

    A high-power series-counterpulse repetitive-pulse inductive energy storage and transfer circuit includes an opening switch, a main energy storage coil, and a counterpulse capacitor. The load pulse is initiated simultaneously with the initiation of the counterpulse which is used to turn the opening switch off. There is no delay from command to output pulse. During the load pulse, the counterpulse capacitor is first discharged and then recharged in the opposite polarity with sufficient energy to accomplish the load counterpulse which terminates the load pulse and turns the load switch off. When the main opening switch is triggered closed again to terminate the load pulse, the counterpulse capacitor discharges in the reverse direction through the load switch and through the load, causing a rapid, sharp cutoff of the load pulse as well as recovering any energy remaining in the load inductance. The counterpulse capacitor is recharged to its original condition by the main energy storage coil after the load pulse is over, not before it begins.

  7. Subcutaneous Implantable Cardioverter-Defibrillator Implantation in a Patient with a Left Ventricular Assist Device Already in Place

    PubMed Central

    Subzposh, Faiz; Hankins, Shelley R.; Kutalek, Steven P.

    2015-01-01

    A 56-year-old man with ischemic cardiomyopathy, a biventricular implantable cardioverter-defibrillator (ICD), and a left ventricular assist device (LVAD) developed a pocket hematoma and infection after an ICD generator change. The biventricular ICD was extracted, and the patient was given a full course of antibiotics. Because he had no indications for bradycardia pacing or biventricular pacing, he was implanted with a subcutaneous ICD under full anticoagulation. There was no interference in sensing or shock delivery from the ICD. The LVAD readings were unchanged during and after the procedure. The patient had an uneventful postoperative course, and both devices were functioning normally. To our knowledge, this is the first reported case of the implantation of a subcutaneous ICD in the presence of an LVAD. This report illustrates that both devices can be implanted successfully in the same patient. In addition, the subcutaneous ICD minimizes the risk of bloodstream infections, which can be fatal in patients who have life-supporting devices such as an LVAD. PMID:25873825

  8. Diabetes Is Reversed in a Murine Model by Marginal Mass Syngeneic Islet Transplantation Using a Subcutaneous Cell Pouch Device

    PubMed Central

    Pepper, Andrew R.; Pawlick, Rena; Gala-Lopez, Boris; MacGillivary, Amanda; Mazzuca, Delfina M.; White, David J. G.; Toleikis, Philip M.; Shapiro, A. M. James

    2015-01-01

    Background Islet transplantation is a successful β-cell replacement therapy for selected patients with type 1 diabetes mellitus. Although high rates of early insulin independence are achieved routinely, long-term function wanes over time. Intraportal transplantation is associated with procedural risks, requires multiple donors, and does not afford routine biopsy. Stem cell technologies may require potential for retrievability, and graft removal by hepatectomy is impractical. There is a clear clinical need for an alternative, optimized transplantation site. The subcutaneous space is a potential substitute, but transplantation of islets into this site has routinely failed to reverse diabetes. However, an implanted device, which becomes prevascularized before transplantation, may alter this equation. Methods Syngeneic mouse islets were transplanted subcutaneously within Sernova Corp's Cell Pouch (CP). All recipients were preimplanted with CPs 4 weeks before diabetes induction and transplantation. After transplantation, recipients were monitored for glycemic control and glucose tolerance. Results Mouse islets transplanted into the CP routinely restored glycemic control with modest delay and responded well to glucose challenge, comparable to renal subcapsular islet grafts, despite a marginal islet dose, and normoglycemia was maintained until graft explantation. In contrast, islets transplanted subcutaneously alone failed to engraft. Islets within CPs stained positively for insulin, glucagon, and microvessels. Conclusions The CP is biocompatible, forms an environment suitable for islet engraftment, and offers a potential alternative to the intraportal site for islet and future stem cell therapies. PMID:26308506

  9. [Subcutaneous ureteral bypass devices as a treatment option for bilateral ureteral obstruction in a cat with ureterolithiasis].

    PubMed

    Heilmann, Romy M; Pashmakova, Medora; Lamb, Jodie H; Spaulding, Kathy A; Cook, Audrey K

    2016-06-16

    A 6-year-old female spayed Domestic Shorthair cat was presented with acute lethargy, dehydration, marked azotemia, metabolic acidosis, left-sided renomegaly, and bilateral hydronephrosis. Ureterolithiasis and ureteral obstruction were suspected based on further diagnostics including abdominal sonography. Medical treatment was not successful. Fluoroscopically guided antegrade pyelography confirmed the diagnosis of bilateral ureteral obstruction due to ureterolithiasis. Subcutaneous ureteral bypass (SUB) devices were placed bilaterally, followed by close patient monitoring. Frequent reassessment of patient parameters and blood work served to adjust the fluid needs of the patient and to ensure proper hydration, correction of azotemia at an appropriate rate, and cardiovascular stability. After significant improvement of all patient parameters within 5 days, the patient was discharged from the hospital. Treatment included a dietary change to reduce the risk of stone formation as well as a phosphorus binder. Clinical and clinicopathologic parameters were unchanged at the 1- and 4- and 7-month rechecks (consistent with IRIS CKD stage II-NP-AP0), and both SUB devices continued to provide unobstructed urine flow. Bilateral placement of subcutaneous ureteral bypass devices may be a safe and potentially effective treatment option for acute bilateral ureteral obstruction in cats with ureterolithiasis. Strict patient monitoring and patient-centered postoperative treatment decisions are crucial to successful treatment outcomes. PMID:26898228

  10. Mechanical testing of a device for subcutaneous internal anterior pelvic ring fixation versus external pelvic ring fixation

    PubMed Central

    2014-01-01

    Background Although useful in the emergency treatment of pelvic ring injuries, external fixation is associated with pin tract infections, the patient’s limited mobility and a restricted surgical accessibility to the lower abdomen. In this study, the mechanical stability of a subcutaneous internal anterior fixation (SIAF) system is investigated. Methods A standard external fixation and a SIAF system were tested on pairs of Polyoxymethylene testing cylinders using a universal testing machine. Each specimen was subjected to a total of 2000 consecutive cyclic loadings at 1 Hz with sinusoidal lateral compression/distraction (+/−50 N) and torque (+/− 0.5 Nm) loading alternating every 200 cycles. Translational and rotational stiffness were determined at 100, 300, 500, 700 and 900 cycles. Results There was no significant difference in translational stiffness between the SIAF and the standard external fixation when compared at 500 (p = .089), 700 (p = .081), and 900 (p = .266) cycles. Rotational stiffness observed for the SIAF was about 50 percent higher than the standard external fixation at 300 (p = .005), 500 (p = .020), and 900 (p = .005) cycles. No loosening or failure of the rod-pin/rod-screw interfaces was seen. Conclusions In comparison with the standard external fixation system, the tested device for subcutaneous internal anterior fixation (SIAF) in vitro has similar translational and superior rotational stiffness. PMID:24684828

  11. Dental management of a patient fitted with subcutaneous Implantable Cardioverter Defibrillator device and concomitant warfarin treatment

    PubMed Central

    Shah, Altaf Hussain; Khalil, Hesham Saleh; Kola, Mohammed Zaheer

    2015-01-01

    Automated Implantable Cardioverter Defibrillators (AICD), simply known as an Implantable Cardioverter Defibrillator (ICD), has been used in patients for more than 30 years. An Implantable Cardioverter Defibrillator (ICD) is a small battery-powered electrical impulse generator that is implanted in patients who are at a risk of sudden cardiac death due to ventricular fibrillation, ventricular tachycardia or any such related event. Typically, patients with these types of occurrences are on anticoagulant therapy. The desired International Normalized Ratio (INR) for these patients is in the range of 2–3 to prevent any subsequent cardiac event. These patients possess a challenge to the dentist in many ways, especially during oral surgical procedures, and these challenges include risk of sudden death, control of post-operative bleeding and pain. This article presents the dental management of a 60 year-old person with an ICD and concomitant anticoagulant therapy. The patient was on multiple medications and was treated for a grossly neglected mouth with multiple carious root stumps. This case report outlines the important issues in managing patients fitted with an ICD device and at a risk of sudden cardiac death. PMID:26236132

  12. Wave intensity analysis of para-aortic counterpulsation.

    PubMed

    Lu, Pong-Jeu; Yang, Chi-Fu Jeffrey; Wu, Meng-Yu; Hung, Chun-Hao; Chan, Ming-Yao; Hsu, Tzu-Cheng

    2012-04-01

    Wave intensity analysis (WIA) was used to delineate and maximize the efficacy of a newly developed para-aortic blood pump (PABP). The intra-aortic balloon pump (IABP) was employed as the comparison benchmark. Acute porcine experiments using eight pigs, randomly divided into IABP (n = 4) and PABP (n = 4) groups, were conducted to compare the characteristics of intra- and para-aortic counterpulsation. We measured pressure and velocity with probes installed in the left anterior descending coronary artery and aorta, during and without PABP assistance. Wave intensity for aortic and left coronary waves were derived from pressure and flow measurements with synchronization correction applied. To achieve maximized support efficacy, deflation timings ranging from 25 ms ahead of to 35 ms after the R-wave were tested. Similar to those associated with IABP counterpulsation, the PABP-generated backward-traveling waves predominantly drove aortic and coronary blood flows. However, in contrast with IABP counterpulsation, the nonocclusive nature of the PABP allowed systolic unloading to be delayed into early systole, which resulted in near elimination of coronary blood steal without diminution of systolic left ventricular ejection wave intensities. WIA can elucidate subtleties among different counterpulsatile support means with high sensitivity. Total accelerating wave intensity (TAWI), which was defined as the sum of the time integration of accelerated parts of the positive and negative wave intensities, was used to quantify counterpulsation efficacy. In general, the larger the TAWI gain, the better the counter-pulsatile support efficacy. However, when PABP deflation timings were delayed to after the R-wave, the TAWI was found to be inversely correlated with coronary perfusion. In this delayed deflation timing setting, greater wave cancellation occurred, which led to decreased TAWI but increased coronary perfusion attributed to blood regurgitation reduction. PMID:22227124

  13. A resonant series counterpulse technique for high current opening switches

    SciTech Connect

    Dijk, E. van; Gelder, P. van

    1995-01-01

    A counterpulse technique for the controlled interruption of very high currents in inductive storage pulsed power systems is described and analyzed, and some simulation results of its performance are presented. The accompanying circuit comprises a pre-charged capacitor bank, connected in series with the inductive load, which has to be provided with a current pulse. Upon actuation, a resonant counterpulse current is created in the opening switch, connected in parallel with the current source and the load. In this way, the opening switch is opened at low current. A separate closing switch prevents closing of the opening switch at high voltage. Operation of the opening switch, often a mechanical switch, at low current and low voltage prevents arc erosion of the contacts. The advantage of this circuit compared to other counterpulse circuits is that the capacitor bank does not experience a voltage reversal. Electrolytic capacitors, which have a high energy density, are applied. The remaining energy of the capacitor bank after opening the opening switch, is transferred to the load. The required initial voltage of the capacitor bank is only a few hundred volts, whereas it may be above a kilovolt in other circuits. Another advantage of the method described here is that the load does not experience a pre-current, causing unwanted preheating of the load, before the resonant current is activated. At the moment, work is being performed at the Pulse Physics Laboratory to develop the resonant series counterpulse circuit for use with rail accelerators, which must be supplied with current pulses in the millisecond range up to the mega-ampere level.

  14. Estimating percentage total body fat and determining subcutaneous adipose tissue distribution with a new noninvasive optical device LIPOMETER.

    PubMed

    Möller, Reinhard; Tafeit, Erwin; Smolle, Karl Heinz; Pieber, Thomas R.; Ipsiroglu, Osman; Duesse, Martina; Huemer, Christian; Sudi, Karl; Reibnegger, Gilbert

    2000-03-01

    A newly developed optical device was applied to measure the subcutaneous adipose tissue (SAT) thickness of 20 healthy women and 18 healthy men at specified body sites. These measurements were used to derive equations to estimate percentage total body fat (TBF%). Total body electrical conductivity (TOBEC) was employed as a reference method; caliper techniques and measurements of absorbances of infrared light in fat versus lean tissue were also compared. The LIPOMETER results show good agreement with TOBEC data (r = 0.96). The technique allows the precise determination of the distribution of SAT thickness at specified body sites. The method also permits the construction of profiles of SAT thicknesses, e.g., the profiles are significantly different between women and men. Based on the normal profiles of healthy subjects, patients with proven type-2 diabetes mellitus were also evaluated. The patients showed significantly different profiles. By linear discriminant analysis, classification functions were extracted with good predictive accuracy classification of subjects according to the presence or absence of type-2 diabetes mellitus. The data suggest that measurement of SAT thickness might aid in the diagnosis and/or classification of metabolic disorders. Am. J. Hum. Biol. 12:221-230, 2000. Copyright 2000 Wiley-Liss, Inc. PMID:11534019

  15. Subcutaneous emphysema

    MedlinePlus

    ... after certain infections, including gas gangrene , and after scuba diving. ... will determine the outcome. Subcutaneous emphysema associated with scuba diving is usually less worrisome or serious.

  16. Subcutaneous entomophthoromycoses

    PubMed Central

    Karuna, Tadepalli; Asati, Dinesh P.; Biswas, Debasis; Purwar, Shashank

    2015-01-01

    Subcutaneous entomophthoromycoses is a zygomycosis caused by Basidiobolus ranarum that is endemic in southern India. We report the case of a 63-year-old male from central India who presented with a nontender subcutaneous hyperpigmented plaque on his leg with mild discharge that yielded Basidiobolus ranarum. PMID:26753142

  17. 21 CFR 870.5225 - External counter-pulsating device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... used to assist the heart by applying positive or negative pressure to one or more of the body's limbs in synchrony with the heart cycle. (b) Classification. Class III (premarket approval). (c) Date...

  18. 21 CFR 870.5225 - External counter-pulsating device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... used to assist the heart by applying positive or negative pressure to one or more of the body's limbs in synchrony with the heart cycle. (b) Classification. Class III (premarket approval). (c) Date...

  19. 21 CFR 870.5225 - External counter-pulsating device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... used to assist the heart by applying positive or negative pressure to one or more of the body's limbs in synchrony with the heart cycle. (b) Classification. Class III (premarket approval). (c) Date...

  20. 21 CFR 870.5225 - External counter-pulsating device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... used to assist the heart by applying positive or negative pressure to one or more of the body's limbs in synchrony with the heart cycle. (b) Classification. Class III (premarket approval). (c) Date...

  1. Subcutaneous adipose tissue topography (SAT-Top) by means of the optical device lipometer highly correlated to plasma leptin levels in obese boys

    NASA Astrophysics Data System (ADS)

    Sudi, Karl; Moeller, Reinhard; Tafeit, Erwin; Reiterer, Elke; Borkenstein, Martin; Vrecko, Karoline; Horejsi, Renate; Reibnegger, Gilbert; Hofmann, Peter

    1998-05-01

    The product of the ob-gene named leptin is correlated with body fat mass in humans. Little evidence exists if the same holds true for body fat distribution. In this study we therefore investigated plasma leptin levels and the subcutaneous adipose tissue topography (SAT-Top) by means of the newly developed optical device Lipometer before and after a 3 week weight reduction camp. Thirty four obese boys (mean age 12a) took part in this study. Body fat distribution were assessed by means of Lipometer to measure the thickness of a subcutaneous fat layer at 15 standardized body sites (SAT- Top). Plasma leptin levels (LL) were measured by radioimmunoassay. All measurements were taken at the beginning and at the end of the camp. By dividing all boys according chronological age (group A: age less than 12a, n equals 17/group B: greater than 12a, n equals 17) we found correlations with the combination of measured body sites (MBS) before (A: MBS vs. LL, R2 equals 0.79; p less than 0.01/B: MBS vs. LL, R2 equals 0.35; n.s.) and after (A: MBS vs. LL, R2 equals 0.83; p less than 0.01/B: MBS vs. LL, R2 equals 0.70; p less than 0.01) the intervention. Our study confirms that the subcutaneous adipose tissue topography (SAT- Top) by means of the optical device Lipometer serves as a marker of plasma leptin levels in obese boys and highlights the use of this optical device in a predictive manner.

  2. Device-based local delivery of siRNA against mammalian target of rapamycin (mTOR) in a murine subcutaneous implant model to inhibit fibrous encapsulation

    PubMed Central

    Takahashi, Hironobu; Wang, Yuwei; Grainger, David W.

    2010-01-01

    Fibrous encapsulation of surgically implant devices is associated with elevated proliferation and activation of fibroblasts in tissues surrounding these implants, frequently causing foreign body complications. Here we test the hypothesis that inhibition of the expression of mammalian target of rapamycin (mTOR) in fibroblasts can mitigate the soft tissue implant foreign body response by suppressing fibrotic responses around implants. In this study, mTOR was knocked down using small interfering RNA conjugated with branched cationic polyethylenimine (bPEI) in fibroblastic lineage cells in serum-based cell culture as shown by both gene and protein analysis. This mTOR knockdown led to an inhibition in fibroblast proliferation by 70% and simultaneous down-regulation in the expression of type I collagen in fibroblasts in vitro. These siRNA/bPEI complexes were released from poly(ethylene glycol) (PEG)-based hydrogel coatings surrounding model polymer implants in a subcutaneous rodent model in vivo. No significant reduction in fibrous capsule thickness and mTOR expression in the foreign body capsules was observed. Observed siRNA inefficacy in this in vivo implant model was attributed to siRNA dosing limitations in the gel delivery system, and lack of targeting ability of the siRNA complex specifically to fibroblasts. While in vitro data supported mTOR knock-down in fibroblast cultures, in vivo siRNA delivery must be further improved to produce clinically relevant effects on fibrotic encapsulation around implants. PMID:20727922

  3. Challenges facing academic research in commercializing event-detector implantable devices for an in-vivo biomedical subcutaneous device for biomedical analysis

    NASA Astrophysics Data System (ADS)

    Juanola-Feliu, E.; Colomer-Farrarons, J.; Miribel-Català, P.; Samitier, J.; Valls-Pasola, J.

    2011-05-01

    It is widely recognized that the welfare of the most advanced economies is at risk, and that the only way to tackle this situation is by controlling the knowledge economies and dealing with. To achieve this ambitious goal, we need to improve the performance of each dimension in the "knowledge triangle": education, research and innovation. Indeed, recent findings point to the importance of strategies of adding-value and marketing during R+D processes so as to bridge the gap between the laboratory and the market and so ensure the successful commercialization of new technology-based products. Moreover, in a global economy in which conventional manufacturing is dominated by developing economies, the future of industry in the most advanced economies must rely on its ability to innovate in those high-tech activities that can offer a differential added-value, rather than on improving existing technologies and products. It seems quite clear, therefore, that the combination of health (medicine) and nanotechnology in a new biomedical device is very capable of meeting these requisites. This work propose a generic CMOS Front-End Self-Powered In-Vivo Implantable Biomedical Device, based on a threeelectrode amperometric biosensor approach, capable of detecting threshold values for targeted concentrations of pathogens, ions, oxygen concentration, etc. Given the speed with which diabetes can spread, as diabetes is the fastest growing disease in the world, the nano-enabled implantable device for in-vivo biomedical analysis needs to be introduced into the global diabetes care devices market. In the case of glucose monitoring, the detection of a threshold decrease in the glucose level it is mandatory to avoid critic situations like the hypoglycemia. Although the case study reported in this paper is complex because it involves multiple organizations and sources of data, it contributes to extend experience to the best practices and models on nanotechnology applications and

  4. [Evaluation of 2 years' experience with assisted circulation by diastolic counterpulsation].

    PubMed

    Vernant, P; Lellouche, D; Bouillot, M; Loisance, D; Nitenberg, A

    1975-01-01

    The authors report their two years' experience of circulatory assistance by diastolic counter-pulsation with an intra-aortic balloon. This technique was used in 23 patients: 9 cases of cardiogenic shock due to acute myocardial infarction, 9 septal ruptures, 1 rupture of the papillary muscle of the mitral valve, 1 acute ventricular aneurysm, 2 high risk coronary arteriographies and 1 case of early post-infarction recurrent ischemia. It confirms the gravity of cardiogenic shock as, in spite of the frequent improvement in hemodynamic parameters under counter-pulsation, there was only one survivor. The efficacy is greater in cases of septal rupture, where the author obtained 3 survivors out of 6 operated cases. The security of the method and its innocuity permit one to carry out high risk coronary arteriography and extend the indications for circulatory assistance, to certain cases of unstable angina or early recurrent anginal following acute infarction. PMID:1229961

  5. Successful use of intra-aortic balloon counterpulsation in the treatment of refractory intraoperative cardiogenic shock.

    PubMed

    Housman, L B; Kalush, S L; Li, W; Litchford, B; Wood, J A

    1975-09-01

    Intra-aortic balloon counterpulsation (IABC) has been used successfully in the treatment of shock following myocardial infarction. This report describes eight patients who developed medically refractory cardiogenic shock following cessation of cardiopulmonary bypass and who were treated with IABC. None of the eight became balloon dependent and seven of eight (87.5%) left the hospital doing well. The treatment of refractory intra-operative cardiogenic shock represents a new and additional indication for IABC. PMID:1166968

  6. Intraaortic Balloon Counterpulsation: An Eleven-Year Review and Analysis of Determinants of Survival

    PubMed Central

    Corral, Carlos H.; Vaughn, Cecil C.

    1986-01-01

    During an 11-year period ending January 1, 1985, 352 patients had insertions of an intraaortic balloon pump (IABP) as an adjunct to medical or surgical therapy. Group I, 175 patients, could not be weaned from cardiopulmonary bypass and required intraaortic balloon pump (IABP). Thirty-nine patients (22%) died in the operating room. Twenty-five patients (14%) died in the acute care unit. The remaining 111 patients (63.4%) survived and were discharged from the hospital. Group II, 104 patients, had the IABP inserted preoperatively. Indications were: postinfarction cardiogenic shock (34 patients), unstable angina (35), postinfarction angina (27), poor ventricular function (six), and prophylaxis (two). Of the 62 patients with unstable angina and postinfarction angina, 57 (92%) were successfully weaned. Of the 34 patients with postinfarction cardiogenic shock, 26 were weaned, but only 16 (47%) survived to leave the hospital. Group III, 34 patients, had the IABP inserted for postoperative hemodynamic deterioration in the acute care unit at variable times: 14 (41%) patients survived. Group IV, 39 patients, had IABP support for medical therapy. Of 24 patients with postinfarction cardiogenic shock, 12 survived. Twelve of 13 patients with unstable angina lived. Of the 352 patients, 228 (65%) were discharged from the hospital. The overall incidence of complications was 12.5%. Complications related to IABP were higher with percutaneous insertion than by femoral arteriotomy (15% vs 12%). Intraaortic balloon counterpulsation effectively unloads the failing left ventricle in weaning patients from cardiopulmonary bypass (Group I). Preoperative insertion (Group II) resulted in 92% survival in patients with both pre- and postinfarction angina. Delayed insertion (Group III) in postoperative patients gave the poorest survival (41%). In patients with postinfarction cardiogenic shock, IABP without corrective cardiac surgery was associated with a 50% survival: with corrective cardiac

  7. Subcutaneous granuloma annulare.

    PubMed

    Requena, Luis; Fernández-Figueras, María Teresa

    2007-06-01

    Subcutaneous granuloma annulare is a rare clinicopathologic variant of granuloma annulare, characterized by subcutaneous nodules that may appear alone or in association with intradermal lesions. The pathogenesis of this deep variant of granuloma annulare remains uncertain. Subcutaneous granuloma annulare appears more frequently in children and young adults, and the lesions consist of subcutaneous nodules with no inflammatory appearance at the skin surface, most commonly located on the anterior aspects of the lower legs, hands, head, and buttocks. Usually, subcutaneous granuloma annulare is an authentic and exclusive panniculitic process with no dermal participation, although in 25% of the patients lesions of subcutaneous granuloma annulare coexist with the classic findings of granuloma annulare in the dermis. Histopathologically, subcutaneous granuloma annulare consist of areas of basophilic degeneration of collagen bundles with peripheral palisading granulomas involving the connective tissue septa of the subcutis. Usually, the area of necrobiosis in subcutaneous granuloma annulare is larger than in the dermal counterpart. The central necrobiotic areas contain increased amounts of connective tissue mucin and nuclear dust from neutrophils between the degenerated collagen bundles. Eosinophils are more common in subcutaneous granuloma annulare than in the dermal counterpart. There are not descriptions of subcutaneous granuloma annulare showing a histopathologic pattern of the so-called incomplete or interstitial variant. Histopathologic differential diagnosis of subcutaneous granuloma annulare includes rheumatoid nodule, necrobiosis lipoidica and epithelioid sarcoma. PMID:17544961

  8. 78 FR 79304 - Cardiovascular Devices; Reclassification of External Counter-Pulsating Devices for Treatment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ... FR 7966; February 5, 1980). Therefore, section 501(f)(2)(B) of the FD&C Act requires that a PMA for... Federal Register of May 21, 2013 (78 FR 29672). FDA received and has considered one comment on this... controls for these uses. FDA published a proposed order in the Federal Register of May 21, 2013 (78...

  9. [Subcutaneous myxopapillary ependymoma].

    PubMed

    Bjørn, Niels; Søe, Morten; Detlefsen, Sönke

    2015-11-30

    Subcutaneous myxopapillary ependymoma is a very rare entity, and to our knowledge this is the first published case from Denmark. A previously healthy 32-year-old male presented with subcutaneous swelling and tenderness located at the top of the intergluteal cleft. The circular soft tumour, measuring 1.7 × 1.7 × 1.2 cm, was removed surgically. After histopathological examination with several immunohistochemical and special stainings, the diagnosis surprisingly was subcutaneous myxopapillary ependymoma. The tumour was removed with free margins and no metastases were found on follow-up CT- and MRI scans. PMID:26651556

  10. [Intra-aortic balloon pump (IABP) counterpulsation. Do we still need it and if so when?].

    PubMed

    Russ, M

    2015-09-01

    Intra-aortic balloon pump (IABP) counterpulsation was for a long time considered to be an indispensable standard for support of drug therapy for all forms of acute left-sided cardiac failure and especially in cardiogenic shock due to infarction. The advantages of the system seemed to be obvious; however, many of the postulated effects on the hemodynamics, microcirculation and coronary perfusion could not be confirmed later in prospective studies. It was found that IABP had no influence on microcirculation disorders in cardiogenic shock due to infarction. In a meta-analysis on the application for acute myocardial infarction without shock, no effect was found on mortality. The benefit as adjunct therapy for percutaneous coronary interventions (PCI) in cardiogenic shock due to infarction places a question mark over both IABP-SHOCK studies; however, in constellations without PCI the additional benefit of IABP cannot be excluded which is why the procedure could be an option in this situation. PMID:26340798

  11. Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry

    PubMed Central

    Bezerra, Cristiano Guedes; Adam, Eduardo Leal; Baptista, Mariana Lins; Ciambelli, Giuliano Serafino; Bernoche, Liliane Kopel, Claudia; Lopes, Leonardo Nicolau Geisler Daud; Macatrão-Costa, Milena Frota; Falcão, Breno de Alencar Araripe; Lage, Silvia Gelas

    2016-01-01

    Background The use of aortic counterpulsation therapy in advanced heart failure is controversial. Objectives To evaluate the hemodynamic and metabolic effects of intra-aortic balloon pump (IABP) and its impact on 30-day mortality in patients with heart failure. Methods Historical prospective, unicentric study to evaluate all patients treated with IABP betwen August/2008 and July/2013, included in an institutional registry named TBRIDGE (The Brazilian Registry of Intra-aortic balloon pump in Decompensated heart failure - Global Evaluation). We analyzed changes in oxygen central venous saturation (ScvO2), arterial lactate, and use of vasoactive drugs at 48 hours after IABP insertion. The 30-day mortality was estimated by the Kaplan-Meier method and diferences in subgroups were evaluated by the Log-rank test. Results A total of 223 patients (mean age 49 ± 14 years) were included. Mean left ventricle ejection fraction was 24 ± 10%, and 30% of patients had Chagas disease. Compared with pre-IABP insertion, we observed an increase in ScvO2 (50.5% vs. 65.5%, p < 0.001) and use of nitroprusside (33.6% vs. 47.5%, p < 0.001), and a decrease in lactate levels (31.4 vs. 16.7 mg/dL, p < 0.001) and use of vasopressors (36.3% vs. 25.6%, p = 0.003) after IABP insertion. Thirty-day survival was 69%, with lower mortality in Chagas disease patients compared without the disease (p = 0.008). Conclusion After 48 hours of use, IABP promoted changes in the use of vasoactive drugs, improved tissue perfusion. Chagas etiology was associated with lower 30-day mortality. Aortic counterpulsation therapy is an effective method of circulatory support for patients waiting for heart transplantation. PMID:26690691

  12. [Evaluation of the addition of counterpulsation to the partial left ventricular-femoral bypass for limitation of evolving myocardial infarction].

    PubMed

    Yamaguchi, A; Ide, H; Ino, T; Adachi, H; Mizuhara, A; Kawahito, K; Murata, S

    1994-08-01

    The effect of adding counterpulsation to a partial left ventricular bypass was evaluated in a canine model of acute myocardial ischemia by using a myocardial staining method. To establish a left ventricular bypass, a catheter consisting of bypass tube (90 cm in length and 15 Fr in inner diameter) and an accompanying intraaortic balloon as a single apparatus (Integrated Cardioassist Catheter; ICAC) was introduced into the left ventricle via the abdominal aorta. The left ventricular bypass was adjusted to 1 L/min. with or without counterpulsation with the aid of a centrifugal pump and IABP console. The use of the ICAC that provided pulsatile left ventricular bypass tended to raise the mean aortic pressure and cardiac output. Reduction of the tension time index was noted with the use of the ICAC in contrast to the control. And increment of the DPTI/TTI ratio was observed with the use of the ICAC in contrast to the control and partial left ventricular bypass alone. While the percentages of the region at risk were similar [17.3 +/- 9.5% (control), vs. 16.4 +/- 3.4% (partial left ventricular bypass alone) vs. 16.9 +/- 5.2% (ICAC)], the percentages of infarct sizes were reduced due to the use of counterpulsation. [61.9 +/- 12.2% (control), vs. 57.5 +/- 3.9% (partial left ventricular bypass alone) vs. 16.8 +/- 6.0% (ICAC)]. These results revealed that the addition of counterpulsation alleviates afterload reduction to the partial left ventricular bypass and was more beneficial to the reduction of the infarct size than partial left ventricular bypass alone. PMID:7963829

  13. Pneumoparotitis with subcutaneous emphysema.

    PubMed

    Balasubramanian, S; Srinivas, S; Aparna, K R

    2008-01-01

    We report an adolescent with recurrent bilateral parotitis with pneumoparotitis and subcutaneous emphysema due to self pneumoinsufflation by a Valsalva like maneuver. Investigations for recurrent parotitis did not yield any clue. His la belle indifference, prolonged school absence and the presence of sibling rivalry helped us identify the psychological cause. PMID:18250510

  14. Subcutaneous encapsulated fat necrosis.

    PubMed

    Aydin, Dogu; Berg, Jais O

    2016-04-01

    We have described subcutaneous encapsulated fat necrosis, which is benign, usually asymptomatic and underreported. Images have only been published on two earlier occasions, in which the necrotic nodules appear "pearly" than the cloudy yellow surface in present case. The presented image may help future surgeons to establish the diagnosis peroperatively. PMID:27099753

  15. The Subcutaneous Implantable Cardioverter Defibrillator.

    PubMed

    Mangels, Daniel; Frishman, William H

    2016-01-01

    The subcutaneous implantable cardioverter defibrillator (S-ICD) is a subcutaneous alternative to conventional transvenous ICD (TV-ICD) systems, which have previously been shown to treat life-threatening ventricular tachyarrhythmias in cardiac disease patients. A review of the literature reveals that S-ICDs have similar shock efficacy rates for both induced and spontaneous ventricular tachyarrhythmias when compared with TV-ICDs. Furthermore, S-ICDs seem to have a higher specificity for withholding therapy when supraventricular tachycardia is present compared with TV-ICDs. The advantages of the S-ICD system are numerous: fewer vascular complications including thrombosis and hemothorax, avoidance of fluoroscopy, and an easier means of lead replacement. These advantages make the S-ICD system most suitable for younger patients who may require replacements in later life, those with abnormal venous anatomy, and individuals prone to infection and/or central vein thrombosis. However, S-ICDs are not without their complications and are associated with a higher incidence of inappropriate shocks secondary to T wave oversensing. S-ICDs also lack antitachycardia pacing, making them a suboptimal device in patients with recurrent monomorphic ventricular tachycardia who would otherwise benefit from the antitachycardia pacing offered in TV-ICDs. Lastly, the limited number of long-term randomized, head-to-head studies involving direct comparison with TV-ICDs poses a challenge in the implementation of the S-ICD. PMID:26807549

  16. ExtaviJect® 30G device for subcutaneous self-injection of interferon beta-1b for multiple sclerosis: a prospective European study

    PubMed Central

    Boeru, Gabriel; Milanov, Ivan; De Robertis, Francesca; Kozubski, Wojciech; Lang, Michael; Rojas-Farreras, Sònia; Tomlinson, Mark

    2013-01-01

    Background The ExtaviJect® 30G autoinjector was developed to facilitate parenteral self-administration of interferon beta-1b (Extavia®), a first-line disease-modifying therapy in patients with multiple sclerosis. Our aim was to assess patient compliance with treatment when using the autoinjector, patients’ and nurses’ experiences of using the device, its tolerability, and patient satisfaction. Methods This was a 12-week, real-world, prospective, observational, noninterventional study conducted in nine European countries. Questionnaires were used to measure patient compliance and to assess patients’ and nurses’ experiences. All adverse events were recorded by severity, including injection site reactions or pain. Patient satisfaction and health-related quality of life were assessed using the Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9) and EuroQol-5 Dimension (EQ-5D) instruments, respectively. Results Of 582 patients enrolled, 568 (98%) received at least one injection and attended the first follow-up visit at 6 weeks, and 542 (93%) attended the second follow-up visit at 12 weeks. For the whole study, 548 of 568 (97%) patients were compliant with treatment. Among the various questions assessing whether the device was easy and quick to use accurately, without fear of the needle, 56%–98% of patients and 59%–98% of nurses were in agreement. There were nine serious adverse events (four disease-related) reported among the 227 (39%) patients reporting adverse events. Scores increased in the TSQM-9 convenience domain between weeks 6 and 12 (P=0.0009), and in the EQ-5D visual analog scale between baseline and week 12 (P<0.0001), indicating improvement in health-related quality of life. Conclusion ExtaviJect 30G was convenient to use and was associated with high levels of compliance. PMID:24255602

  17. 21 CFR 880.5965 - Subcutaneous, implanted, intravascular infusion port and catheter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Subcutaneous, implanted, intravascular infusion... Hospital and Personal Use Therapeutic Devices § 880.5965 Subcutaneous, implanted, intravascular infusion port and catheter. (a) Identification. A subcutaneous, implanted, intravascular infusion port...

  18. 21 CFR 880.5965 - Subcutaneous, implanted, intravascular infusion port and catheter.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Subcutaneous, implanted, intravascular infusion... Hospital and Personal Use Therapeutic Devices § 880.5965 Subcutaneous, implanted, intravascular infusion port and catheter. (a) Identification. A subcutaneous, implanted, intravascular infusion port...

  19. 21 CFR 880.5965 - Subcutaneous, implanted, intravascular infusion port and catheter.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Subcutaneous, implanted, intravascular infusion... Hospital and Personal Use Therapeutic Devices § 880.5965 Subcutaneous, implanted, intravascular infusion port and catheter. (a) Identification. A subcutaneous, implanted, intravascular infusion port...

  20. 21 CFR 880.5965 - Subcutaneous, implanted, intravascular infusion port and catheter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Subcutaneous, implanted, intravascular infusion... Hospital and Personal Use Therapeutic Devices § 880.5965 Subcutaneous, implanted, intravascular infusion port and catheter. (a) Identification. A subcutaneous, implanted, intravascular infusion port...

  1. 21 CFR 880.5965 - Subcutaneous, implanted, intravascular infusion port and catheter.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Subcutaneous, implanted, intravascular infusion... Hospital and Personal Use Therapeutic Devices § 880.5965 Subcutaneous, implanted, intravascular infusion port and catheter. (a) Identification. A subcutaneous, implanted, intravascular infusion port...

  2. [Study of sharing platform of web-based enhanced extracorporeal counterpulsation hemodynamic waveform data].

    PubMed

    Huang, Mingbo; Hu, Ding; Yu, Donglan; Zheng, Zhensheng; Wang, Kuijian

    2011-12-01

    Enhanced extracorporeal counterpulsation (EECP) information consists of both text and hemodynamic waveform data. At present EECP text information has been successfully managed through Web browser, while the management and sharing of hemodynamic waveform data through Internet has not been solved yet. In order to manage EECP information completely, based on the in-depth analysis of EECP hemodynamic waveform file of digital imaging and communications in medicine (DICOM) format and its disadvantages in Internet sharing, we proposed the use of the extensible markup language (XML), which is currently the Internet popular data exchange standard, as the storage specification for the sharing of EECP waveform data. Then we designed a web-based sharing system of EECP hemodynamic waveform data via ASP. NET 2.0 platform. Meanwhile, we specifically introduced the four main system function modules and their implement methods, including DICOM to XML conversion module, EECP waveform data management module, retrieval and display of EECP waveform module and the security mechanism of the system. PMID:22295686

  3. Recent developments in the subcutaneous ICD.

    PubMed

    Willcox, Mark E; Prutkin, Jordan M; Bardy, Gust H

    2016-08-01

    The subcutaneous implantable cardioverter-defibrillator (ICD) was developed as a simple device to reduce the morbidity of ICD therapy while providing a comparable reduction in sudden death from ventricular fibrillation. This review highlights the differences compared to the traditional ICD. It includes recent data on safety and efficacy, as well as best practices on screening and programming, and discusses expected future developments. PMID:27079889

  4. The potential synergism by combining external counterpulsation with intermittent theta burst stimulation in post-stroke motor function recovery.

    PubMed

    He, Weijia; Au-Yeung, Suk-Yin Stephanie; Mak, Margaret; Leung, Thomas Wai Hong; Leung, Howan; Wong, Lawrence Ka Sing

    2016-08-01

    Upper limb weakness and incoordination is a common disability following ischemic stroke. Previous studies have showed that the single application of external counterpulsation (ECP) and intermittent theta burst stimulation (iTBS) can effectively enhance the cortical motor excitability and facilitate recovery. However, it remains uncertain if sequential application of these therapies would further augment the recovery. We hypothesize a synergistic effect of ECP followed by iTBS to upper limb function may happen through improvements in both cerebral perfusion and neuron excitability. PMID:27372874

  5. Enhanced External Counterpulsation Is an Effective Treatment for Depression in Patients With Refractory Angina Pectoris

    PubMed Central

    Søgaard, Hans Jørgen

    2015-01-01

    Objective: To examine the effect of enhanced external counterpulsation (EECP) on depression in patients with refractory angina pectoris (Canadian Cardiovascular Society class 2–4). Method: The study was a prospective observational investigation with a 2-month control period preceding the EECP therapy (to minimize a possible effect of the regression-toward-the-mean phenomenon). The patients were examined 2 months before and just before EECP and just after, 3 months after, and 12 months after EECP. Depression was assessed using the Major Depression Inventory and the ICD-10. During EECP, 3 sets of cuffs were fastened around the lower extremities and were inflated sequentially to a pressure of 260 mm Hg in each diastole for 60 minutes 5 days a week for 7 weeks (35 sessions). The study was conducted at a regional hospital in Denmark from May 2006 to January 2011. Results: Fifty patients with angina pectoris and an abnormal coronary angiography, with no possibility for revascularization, were included (72% men, mean age of 63 years) between May 2006 and January 2011. The prevalence of depression before EECP was 18%, just after was 2%, 3 months after was 2%, and 12 months after was 4% (P = .013). The depressive state was more severe at a lower age (P = .016). No significant predictors of effect of EECP on depression were found (P > .05), and no association was detected between decline in depressive state and chest pain (P > .05). Conclusions: The study indicates that EECP is an effective treatment for depression in patients with refractory angina pectoris, that depression is more severe in younger patients, and that the effect of EECP on depression is not related to the effect on chest pain. Trial Registration: ClinicalTrials.gov identifier: NCT01112163 PMID:26693035

  6. Does Enhanced External Counterpulsation (EECP) Significantly Affect Myocardial Perfusion?: A Systematic Review & Meta-Analysis

    PubMed Central

    Qin, Xiaoxia; Deng, Yanye; Wu, Dandong; Yu, Lehua; Huang, Rongzhong

    2016-01-01

    Background Enhanced external counterpulsation (EECP) is currently applied for treating coronary artery disease (CAD) patients. However, the mechanism(s) by which EECP ameliorates angina pectoris and long-term left ventricular function remain largely unknown. The aim of this study will be to assess whether EECP significantly affects myocardial perfusion in CAD patients through a systematic review and meta-analysis of the available literature. Methods MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched for prospective studies on CAD patients that underwent EECP and reported myocardial perfusion data pre- and post-EECP. The impact of EECP was assessed based on the weighted mean difference (WMD) in myocardial perfusion from pre-EECP to post-EECP. Statistical heterogeneity was assessed by the I2 index. Publication bias was assessed through visual inspection of the funnel plot as well as Begg’s and Egger’s testing. Results Standard EECP therapy (i.e., 35–36 one-hour sessions within a seven-week period) significantly increased myocardial perfusion in CAD patients (pooled WMD: -0.19, 95% CI: -0.38 to 0.00, p = 0.049). A random effects analysis was applied on account of significant heterogeneity (I2 = 89.1%, p = 0.000). There was no evidence of significant publication bias (Begg’s p = 0.091; Egger’s p = 0.282). Conclusions Standard EECP therapy significantly increases myocardial perfusion in CAD patients. This study’s findings support the continued use of standard EECP therapy in CAD patients and provides one putative physiological mechanism to help explain the improvements in angina pectoris and long-term left ventricular function observed in CAD patients after EECP therapy. PMID:27045935

  7. Subcutaneous electrode structure

    NASA Technical Reports Server (NTRS)

    Lund, G. F. (Inventor)

    1980-01-01

    A subcutaneous electrode structure suitable for a chronic implant and for taking a low noise electrocardiogram of an active animal, comprises a thin inflexible, smooth disc of stainless steel having a diameter as of 5 to 30 mm, which is sutured in place to the animal being monitored. The disc electrode includes a radially directed slot extending in from the periphery of the disc for approximately 1/3 of the diameter. Electrical connection is made to the disc by means of a flexible lead wire that extends longitudinally of the slot and is woven through apertures in the disc and held at the terminal end by means of a spot welded tab. Within the slot, an electrically insulative sleeve, such as silicone rubber, is placed over the wire. The wire with the sleeve mounted thereon is captured in the plane of the disc and within the slot by means of crimping tabs extending laterally of the slot and over the insulative wire. The marginal lip of the slot area is apertured and an electrically insulative potting material such as silicone rubber, is potted in place overlaying the wire slot region and through the apertures.

  8. Cause or Effect of Arteriogenesis: Compositional Alterations of Microparticles from CAD Patients Undergoing External Counterpulsation Therapy

    PubMed Central

    Stutz, Monika; Buchs, Natasha; Heller, Manfred

    2012-01-01

    Recently, a clinical study on patients with stable coronary artery disease (CAD) showed that external counterpulsation therapy (ECP) at high (300 mmHg) but not at low inflation pressure (80 mmHg) promoted coronary collateral growth, most likely due to shear stress-induced arteriogenesis. The exact molecular mechanisms behind shear stress-induced arteriogenesis are still obscure. We therefore characterized plasma levels of circulating microparticles (MPs) from these CAD patients because of their ambivalent nature as a known cardiovascular risk factor and as a promoter of neovascularization in the case of platelet-derived MPs. MPs positive for Annexin V and CD31CD41 were increased, albeit statistically significant (P<0.05, vs. baseline) only in patients receiving high inflation pressure ECP as determined by flow cytometry. MPs positive for CD62E, CD146, and CD14 were unaffected. In high, but not in low, inflation pressure treatment, change of CD31CD41 was inversely correlated to the change in collateral flow index (CFI), a measure for collateral growth. MPs from the high inflation pressure group had a more sustained pro-angiogenic effect than the ones from the low inflation pressure group, with the exception of one patient showing also an increased CFI after treatment. A total of 1005 proteins were identified by a label-free proteomics approach from MPs of three patients of each group applying stringent acceptance criteria. Based on semi-quantitative protein abundance measurements, MPs after ECP therapy contained more cellular proteins and increased CD31, corroborating the increase in MPs. Furthermore, we show that MP-associated factors of the innate immune system were decreased, many membrane-associated signaling proteins, and the known arteriogenesis stimulating protein transforming growth factor beta-1 were increased after ECP therapy. In conclusion, our data show that ECP therapy increases platelet-derived MPs in patients with CAD and that the change in protein

  9. [Ultrasonography as an effective diagnostic method for human subcutaneous dirofilariasis].

    PubMed

    Kozlov, S S; Vecmadyan, O T; Mostovaya, O T; Alent'ev, S A; Turicin, V S

    2016-01-01

    The diagnosis of human dirofilariasis is difficult because of the absence of laboratory tests. Up-to-date ultrasound devices have a high resolution that can visualize this subcutaneous helminth. Ultrasonography can improve the timely diagnosis of this helminthism, as demonstrated by the given clinical example. PMID:27522705

  10. Penile subcutaneous fibrolipoma postaugmentative phalloplasty.

    PubMed

    Vicini, Patrizio; De Marco, Ferdinando; Letizia, Piero; Alei, Lavinia; Antonini, Gabriele; Alei, Giovanni; Gentile, Vincenzo

    2013-01-01

    Fibrolipomas are a rare subtype of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who three months earlier has been submitted to an augmentative phalloplasty due to aesthetic dysmorphophobia. After six months from the excision of the mass, the penile elongation and penile enlargement were stable, and the patient was satisfied with his sexual intercourse and sexual life. To our knowledge, this is the first reported penile subcutaneous fibrolipoma case in the literature. The diagnostics and surgical features of this case are discussed. PMID:24195003

  11. [Drainage for Subcutaneous Emphysema after Pulmonary Resection].

    PubMed

    Funakoshi, Yasunobu; Ohmori, Kenichi; Takeda, Shinichi

    2016-05-01

    Severe subcutaneous emphysema sometimes develops after pulmonary resection. We report our management of ten patients who were treated with subcutaneous Penrose drainage. Water seal test at chest closure showed no air leakage in 5, and a small amount in 5. Chest X-ray at the progression of massive subcutaneous emphysema showed no obvious pneumothorax in 2, and slight apical pneumothorax in 8. Subcutaneous emphysema developed after removal of chest tubes in 6, and before removal in 4. Subcutaneous drains were inserted at the midclavicular line or the side chest in 8, and both in 2. Subcutaneous emphysema improved immediately after subcutaneous Penrose drainage with active compressive massage. Subcutaneous penrose drainage is easy and useful for relieving massive subcutaneous emphysema. PMID:27220920

  12. [Subcutaneous abscess following epidural catheterization].

    PubMed

    Radif, Ahmed; Dalsgaard, Lars Bech

    2009-06-01

    A case of subcutaneous abscess and meningitis symptoms after insertion of epidural catheter is presented. The symptoms were pain at the site of insertion two days after insertion, later fever and neck rigidity. Treatment is surgical intervention after appropriate diagnostics by magnetic resonance imaging, and administration of appropriate antibiotics. PMID:19500519

  13. What are subcutaneous adipocytes really good for?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The development and potential function and physiological role of subcutaneous fat cells is reviewed in the context of several species including swine. The function or role subcutaneous fat cells is very dependent on species and location within subcutaneous tissues. Fat cells located around hair foll...

  14. Injectable agents affecting subcutaneous fats.

    PubMed

    Chen, David Lk; Cohen, Joel L; Green, Jeremy B

    2015-09-01

    Mesotherapy is an intradermal or subcutaneous injection of therapeutic agents to induce local effects, and was pioneered in Europe during the 1950s. For the past 2 decades, there has been significant interest in the use of mesotherapy for minimally invasive local fat contouring. Based on the theorized lipolytic effects of the agent phosphatidylcholine, initial attempts involved its injection into subcutaneous tissue. With further studies, however, it became apparent that the activity attributed to phosphatidylcholine mesotherapy was due to the adipolytic effects of deoxycholate, a detergent used to solubilize phosphatidylcholine. Since then, clinical trials have surfaced that demonstrate the efficacy of a proprietary formulation of deoxycholate for local fat contouring. Current trials on mesotherapy with salmeterol, a b-adrenergic agonist and lipolysis stimulator, are underway-with promising preliminary results as well. PMID:26566569

  15. Use of Intra-aortic- Balloon Pump Counterpulsation in Patients with Symptomatic Vasospasm Following Subarachnoid Hemorrhage and Neurogenic Stress Cardiomyopathy

    PubMed Central

    Al-Mufti, Fawaz; Morris, Nicholas; Lahiri, Shouri; Roth, William; Witsch, Jens; Machado, Iona; Agarwal, Sachin; Park, Soojin; Meyers, Philip M.; Connolly, E. Sander; Claassen, Jan

    2016-01-01

    Introduction Intra-aortic counterpulsation balloon pumps (IABPs) have been widely used to augment hemodynamics in critically ill patients with cardiogenic shock and have recently been proposed as a management strategy for subarachnoid hemorrhage (SAH) patients with neurogenic stress cardiomyopathy (NSC). Prior case series have described the use of IABP as a means to manage cardiogenic shock in this patient population; however, we sought to describe our experience with IABP as a means to wean vasopressor requirement while augmenting hemodynamics and maintaining pressures at goal. Methods Five patients were identified from a single center, prospective, observational cohort study that received an IABP for the management of ischemia related to cerebral vasospasm in the setting of NSC. We evaluated all cases for efficacy of IABP in reducing vasopressor requirement, and complications. Results Vasopressor requirements were reduced by a mean of 50% (range 25–65%) following IABPs placement within 24–48 h. There were no significant complications from IABPs. Out of the five patients, the outcome in three cases was favorable (mRS≤1). Two patients suffered delayed cerebral ischemia (DCI), one patient passed away due to severe sepsis, and one patient was left with severe disability. Only one patient required anticoagulation and that was for a preexisting deep venous thrombosis. Conclusion The use of IABPs may be beneficial as an adjunctive therapy in SAH patients with concomitant symptomatic vasospasm and NSC. PMID:27403221

  16. Broncho pleuro subcutaneous fistula with subcutaneous emphysema: A rare presentation of pulmonary tuberculosis

    PubMed Central

    Saxena, Mukul; Shameem, Mohammad; Bhargava, Rakesh; Baneen, Ummul; Alam, Mohd Mazhar; Fatima, Nazish

    2012-01-01

    Subcutaneous tissue emphysema is observed in a several clinical settings but spontaneous subcutaneous emphysema in the absence of pneumothorax with broncho pleuro subcutaneous fistula is rare. We report a case of spontaneous subcutaneous emphysema secondary to cavitary pulmonary tuberculosis in the absence of pneumothorax. PMID:26029604

  17. Subcutaneous blood flow in psoriasis

    SciTech Connect

    Klemp, P.

    1985-03-01

    The simultaneously recorded disappearance rates of /sup 133/xe from subcutaneous adipose tissue in the crus were studied in 10 patients with psoriasis vulgaris using atraumatic labeling of the tissue in lesional skin (LS) areas and symmetrical, nonlesional skin (NLS) areas. Control experiments were performed bilaterally in 10 younger, healthy subjects. The subcutaneous washout rate constant was significantly higher in LS, 0.79 +/- 0.05 min-1 x 10(2) compared to the washout rate constant of NLS, 0.56 +/- 0.07 min-1. 10(2), or the washout rate constant in the normal subjects, 0.46 +/- 0.17 min-1 x 10(2). The mean washout rate constant in NLS was 25% higher than the mean washout rate constant in the normal subjects. The difference was, however, not statistically significant. Differences in the washout rate constants might be due to abnormal subcutaneous tissue-to-blood partition (lambda) in the LS--and therefore not reflecting the real differences in the subcutaneous blood flow (SBF). The lambda for /sup 133/Xe was therefore measured--using a double isotope washout method (/sup 133/Xe and (/sup 131/I)antipyrine)--in symmetrical sites of the lateral crus in LS and NLS of 10 patients with psoriasis vulgaris and in 10 legs of normal subjects. In LS the lambda was 4.52 +/- 1.67 ml/g, which was not statistically different from that of NLS, 5.25 +/- 2.19 ml/g, nor from that of normal subcutaneous tissue, 4.98 +/- 1.04 ml/g. Calculations of the SBF using the obtained lambda values gave a significantly higher SBF in LS, 3.57 +/- 0.23 ml/100 g/min, compared to SBF in the NLS, 2.94 +/- 0.37 ml/100 g/min. There was no statistically significant difference between SBF in NLS and SBF in the normal subjects. The increased SBF in LS of psoriatics might be a secondary phenomenon to an increased heat loss in the lesional skin.

  18. [Subcutaneous emphysema after septoplasty: a case report].

    PubMed

    Balıkçı, Hasan Hüseyin; Bayram, Ali Alper; Özbay, İsa; Özkul, Murat Haluk

    2016-01-01

    Subcutaneous emphysema is characterized by the presence of air in the connective tissue within the fascial planes. The etiology of subcutaneous emphysema includes trauma, iatrogenic causes, or spontaneous development. Head and neck subcutaneous emphysema is a well-defined and life-threatening condition. In case of a large amount of air leaks into the fascial planes, the air can also extend into the retropharyngeal, mediastinal, pleural, and retroperitoneal spaces beyond the subcutaneous layers. Although numerous maxillofacial surgical procedures can cause subcutaneous emphysema, septoplasty has not been reported previously. In this unique case, subcutaneous emphysema developed after elective septoplasty and involved the maxillofacial, retropharyngeal, deep cervical, and orbital regions. The patient was treated conservatively with antibiotic prophylaxis and the condition completely resolved by day 10 spontaneously. Herein, we discuss the available literature data and optimal management strategies for unusual cases of head and neck subcutaneous emphysema. PMID:26794335

  19. A case of subcutaneous zygomycosis

    PubMed Central

    Anaparthy, Usha Rani; Deepika, G.

    2014-01-01

    Zygomycosis is an acute or chronic infection caused by several fungal agents belonging to the phylum Zygomycota. These are saprophytic fungi and are found ubiquitously in the environment. These are emerging highly opportunistic pathogenic organisms. Basidiobolus ranarum (B. haptosporus, B. meristoporus) is a fungus belonging to the order Entomophthorales under the family Zygomycota. Basidiobolomycosis is a predominantly subcutaneous infection involving the trunk and limbs in immunocompetent hosts. We hereby report a case of Basidiobolomycosis from the Department of Microbiology, Siddhartha Medical College, Vijayawada in a 6 month old child who presented to us with a painless swelling over her left knee following an insect bite. PMID:24616857

  20. [Intravenous and subcutaneous immunoglobulin therapy].

    PubMed

    Thon, Vojtěch

    2013-07-01

    Patients with agammaglobulinaemia and hypogammaglobulinaemia require immunoglobulin G (IgG) replacement therapy to prevent serious infections. Since the 1950s, therapy with human immune globulin products has been the standard of treatment. Currently, the most common routes of administration of IgG replacement therapy are intravenous (IVIG) or subcutaneous (SCIG). The home therapy may improve the quality of life in patients who require lifelong IgG replacement. The -anti-IgA antibody test identifies the patients with the risk of anaphylactoid reactions in IVIG replacement. The SCIG delivery may be used in patients with anti-IgA antibodies and previous systemic reactions to IVIG. PMID:23964967

  1. Foreign Body Reaction to Subcutaneous Implants.

    PubMed

    Kastellorizios, Michail; Tipnis, Namita; Burgess, Diane J

    2015-01-01

    Subcutaneously implanted materials trigger the host's innate immune system, resulting in the foreign body reaction. This reaction consists of protein adsorption on the implant surface, inflammatory cell infiltration, macrophage fusion into foreign body giant cells, fibroblast activation and ultimately fibrous encapsulation. This series of events may affect the function of subcutaneous implants, such as inhibition of drug diffusion from long-acting drug delivery depots and medical device failure. The foreign body reaction is a complex phenomenon and is not yet fully understood; ongoing research studies aim to elucidate the cellular and molecular dynamics involved. Recent studies have revealed information about the specific role of macrophages and their differential activation towards pro- and anti-inflammatory states, as well as species differences in the timing of collagen deposition and fibrosis. Understanding of the diverse processes involved in the foreign body reaction has led to multiple approaches towards its negation. Delivery of tissue response modifiers, such as corticosteroids, NSAIDs, antifibrotic agents, and siRNAs, has been used to prevent or minimize fibrosis. Of these, delivery of dexamethasone throughout the implantation period is the most common method to prevent inflammation and fibrosis. More recent approaches employ surface modifications to minimize protein adsorption to 'ultra-low' levels and reduce fibrosis. However, the diverse nature of the processes involved in the foreign body reaction favor the use of corticosteroids due to their wide spectrum action compared to other approaches. To date, combination approaches, such as hydrophilic coatings that reduce protein adsorption combined with delivery of dexamethasone are the most effective. PMID:26306445

  2. Subcutaneous immunoglobulin: opportunities and outlook

    PubMed Central

    Misbah, S; Sturzenegger, M H; Borte, M; Shapiro, R S; Wasserman, R L; Berger, M; Ochs, H D

    2009-01-01

    Immunoglobulin (Ig) administration via the subcutaneous (s.c.) route has become increasingly popular in recent years. The method does not require venous access, is associated with few systemic side effects and has been reported to improve patients' quality of life. One current limitation to its use is the large volumes which need to be administered. Due to the inability of tissue to accept such large volumes, frequent administration at multiple sites is necessary. Most studies conducted to date have investigated the use of subcutaneous immunoglobulin (SCIg) in patients treated previously with the intravenous (i.v.) formulation. New data now support the use of s.c. administration in previously untreated patients with primary immunodeficiencies. SCIg treatment may further be beneficial in the treatment of autoimmune neurological conditions, such as multi-focal motor neuropathy; however, controlled trials directly comparing the s.c. and i.v. routes are still to be performed for this indication. New developments may further improve and facilitate the s.c. administration route. For example, hyaluronidase-facilitated administration increases the bioavailability of SCIg, and may allow for the administration of larger volumes at a single site. Alternatively, more concentrated formulations may reduce the volume required for administration, and a rapid-push technique may allow for shorter administration times. As these developments translate into clinical practice, more physicians and patients may choose the s.c. administration route in the future. PMID:19883424

  3. Microwave non-contact imaging of subcutaneous human body tissues.

    PubMed

    Kletsov, Andrey; Chernokalov, Alexander; Khripkov, Alexander; Cho, Jaegeol; Druchinin, Sergey

    2015-10-01

    A small-size microwave sensor is developed for non-contact imaging of a human body structure in 2D, enabling fitness and health monitoring using mobile devices. A method for human body tissue structure imaging is developed and experimentally validated. Subcutaneous fat tissue reconstruction depth of up to 70 mm and maximum fat thickness measurement error below 2 mm are demonstrated by measurements with a human body phantom and human subjects. Electrically small antennas are developed for integration of the microwave sensor into a mobile device. Usability of the developed microwave sensor for fitness applications, healthcare, and body weight management is demonstrated. PMID:26609415

  4. Microwave non-contact imaging of subcutaneous human body tissues

    PubMed Central

    Chernokalov, Alexander; Khripkov, Alexander; Cho, Jaegeol; Druchinin, Sergey

    2015-01-01

    A small-size microwave sensor is developed for non-contact imaging of a human body structure in 2D, enabling fitness and health monitoring using mobile devices. A method for human body tissue structure imaging is developed and experimentally validated. Subcutaneous fat tissue reconstruction depth of up to 70 mm and maximum fat thickness measurement error below 2 mm are demonstrated by measurements with a human body phantom and human subjects. Electrically small antennas are developed for integration of the microwave sensor into a mobile device. Usability of the developed microwave sensor for fitness applications, healthcare, and body weight management is demonstrated. PMID:26609415

  5. Subcutaneous infusion in palliative care: a focus on the neria soft 90 infusion set.

    PubMed

    Gabriel, Janice

    2014-11-01

    Subcutaneous administration of medications and/or fluids can play a crucial part in supporting patients at home and thereby avoiding the need for hospitalisation. It is an area of patient care that has received little attention compared with other types of parenteral therapies. However, it is an effective and safe route for continuous administration for individuals requiring palliative care. Technological advancements have led to improved subcutaneous infusion devices, such as fine-gauge cannulae with integral sharps protection, as well as integral hypoallergenic dressings. These design features not only help to increase patient comfort but also minimise the potential for needlestick injuries, as well as providing the health professional with one sterile package containing all of the components needed to establish subcutaneous infusion. However, technological developments alone are insufficient to improve patient outcomes. Knowledge of the individual patient, together with their diagnosis and intended treatment, will influence the choice of subcutaneous infusion device, with the overall aim of minimising the potential for complications and improving comfort. This paper provides an overview of subcutaneous infusion, including the importance of patient assessment and the education and training needs of health professionals, and then focuses on one specific subcutaneous infusion device: the neria soft 90 infusion set. PMID:25426880

  6. Newly Shaped Intra-Aortic Balloons Improve the Performance of Counterpulsation at the Semirecumbent Position: An In Vitro Study.

    PubMed

    Kolyva, Christina; Pepper, John R; Khir, Ashraf W

    2016-08-01

    The major hemodynamic benefits of intra-aortic balloon pump (IABP) counterpulsation are augmentation in diastolic aortic pressure (Paug ) during inflation, and decrease in end-diastolic aortic pressure (ΔedP) during deflation. When the patient is nursed in the semirecumbent position these benefits are diminished. Attempts to change the shape of the IAB in order to limit or prevent this deterioration have been scarce. The aim of the present study was to investigate the hemodynamic performance of six new IAB shapes, and compare it to that of a traditional cylindrical IAB. A mock circulation system, featuring an artificial left ventricle and an aortic model with 11 branches and physiological resistance and compliance, was used to test one cylindrical and six newly shaped IABs at angles 0, 10, 20, 30, and 40°. Pressure was measured continuously at the aortic root during 1:1 and 1:4 IABP support. Shape 2 was found to consistently achieve, in terms of absolute magnitude, larger ΔedP at angles than the cylindrical IAB. Although ΔedP was gradually diminished with angle, it did so to a lesser degree than the cylindrical IAB; this diminishment was only 53% (with frequency 1:1) and 40% (with frequency 1:4) of that of the cylindrical IAB, when angle increased from 0 to 40°. During inflation Shape 1 displayed a more stable behavior with increasing angle compared to the cylindrical IAB; with an increase in angle from 0 to 40°, diastolic aortic pressure augmentation dropped only by 45% (with frequency 1:1) and by 33% (with frequency 1:4) of the drop reached with the cylindrical IAB. After compensating for differences in nominal IAB volume, Shape 1 generally achieved higher Paug over most angles. Newly shaped IABs could allow for IABP therapy to become more efficient for patients nursed at the semirecumbent position. The findings promote the idea of personalized rather than generalized patient therapy for the achievement of higher IABP therapeutic efficiency, with a choice

  7. Newly Shaped Intra‐Aortic Balloons Improve the Performance of Counterpulsation at the Semirecumbent Position: An In Vitro Study

    PubMed Central

    Kolyva, Christina; Pepper, John R.

    2016-01-01

    Abstract The major hemodynamic benefits of intra‐aortic balloon pump (IABP) counterpulsation are augmentation in diastolic aortic pressure (P aug) during inflation, and decrease in end‐diastolic aortic pressure (ΔedP) during deflation. When the patient is nursed in the semirecumbent position these benefits are diminished. Attempts to change the shape of the IAB in order to limit or prevent this deterioration have been scarce. The aim of the present study was to investigate the hemodynamic performance of six new IAB shapes, and compare it to that of a traditional cylindrical IAB. A mock circulation system, featuring an artificial left ventricle and an aortic model with 11 branches and physiological resistance and compliance, was used to test one cylindrical and six newly shaped IABs at angles 0, 10, 20, 30, and 40°. Pressure was measured continuously at the aortic root during 1:1 and 1:4 IABP support. Shape 2 was found to consistently achieve, in terms of absolute magnitude, larger ΔedP at angles than the cylindrical IAB. Although ΔedP was gradually diminished with angle, it did so to a lesser degree than the cylindrical IAB; this diminishment was only 53% (with frequency 1:1) and 40% (with frequency 1:4) of that of the cylindrical IAB, when angle increased from 0 to 40°. During inflation Shape 1 displayed a more stable behavior with increasing angle compared to the cylindrical IAB; with an increase in angle from 0 to 40°, diastolic aortic pressure augmentation dropped only by 45% (with frequency 1:1) and by 33% (with frequency 1:4) of the drop reached with the cylindrical IAB. After compensating for differences in nominal IAB volume, Shape 1 generally achieved higher P aug over most angles. Newly shaped IABs could allow for IABP therapy to become more efficient for patients nursed at the semirecumbent position. The findings promote the idea of personalized rather than generalized patient therapy for the achievement of higher IABP therapeutic efficiency

  8. Subcutaneous Implantable Cardioverter-Defibrillator

    MedlinePlus

    ... discriminator functions and lacks antitachycardia pacing. Expanded Programmability Programming that allows lower shock energies and the ability ... the original device and placed in a new one. Postprocedural hospitalization is occasionally needed. Replacement procedures can ...

  9. [The depressive disorders during the early rehabilitation period following preceding ischemic stroke: the possibilities for the application of the enhanced external counterpulsation method].

    PubMed

    Razumov, A N; Eneeva, M A; Kostenko, E V; Bobyreva, S N

    2016-01-01

    The authors present arguments in favour of the necessity to reveal and treat the co-morbid conditions with special reference to depressive disorders in the patients during the early rehabilitation period following preceding ischemic stroke. They demonstrate the importance of the application of non-medicamentous therapy in combination with the standard medicamental treatment. Special emphasis is placed on the analysis of the data obtained during evaluation of the effectiveness of combined therapy with the use of the enhanced external counterpulsation method in the early post-stroke period. It is concluded that the early diagnostics and timely correction of anxio-depressive conditions promotes the efficiency of rehabilitative measures and improves the quality of life of the patients with such disorders. PMID:27030561

  10. Subcutaneous Immunoglobulin in Refractory Juvenile Dermatomyositis.

    PubMed

    de Inocencio, Jaime; Enríquez-Merayo, Eugenia; Casado, Rocío; González-Granado, Luis Ignacio

    2016-04-01

    Juvenile dermatomyositis (JDM) is the most common form of juvenile idiopathic inflammatory myopathy. We report a child with steroid-dependent JDM refractory to hydroxychloroquine and subcutaneous methotrexate who experienced systemic reactions to intravenous immunoglobulin and was successfully treated with subcutaneous immunoglobulin. This form of therapy has been shown to be safe, has a very low rate of adverse effects, does not require hospital admission, reduces the number of missed school days, and decreases the costs associated with treatment. PMID:26966131

  11. The Influence of Different Operating Conditions on the Blood Damage of a Pulsatile Ventricular Assist Device.

    PubMed

    Xu, Zihao; Yang, Ming; Wang, Xianghui; Wang, Zhong

    2015-01-01

    Because of pulsatile blood flow's benefit for myocardial recovery, perfusion of coronary arteries and end organs, pulsatile ventricular assist devices (VADs) are still widely used as paracorporeal mechanical circulatory support devices in clinical applications, especially in pediatric heart failure patients. However, severe blood damage limits the VAD's service period. Besides optimizing the VAD geometry to reduce blood damage, the blood damage may also be decreased by changing the operating conditions. In this article, a pulsatile VAD was used to investigate the influence of operating conditions on its blood damage, including hemolysis, platelet activation, and platelet deposition. Three motion profiles of pusher plate (sine, cosine, and polynomial), three stroke volumes (ejection fractions) (56 ml [70%], 42 ml [52.5%], and 28 ml [35%]), three pulsatile rates (75, 100, and 150 bpm), and two assist modes (copulsation and counterpulsation) were implemented respectively in VAD fluid-structure interaction simulations to calculate blood damage. The blood damage indices indicate that cosine motion profile, higher ejection fraction, higher pulsatile rate, and counterpulsation can decrease platelet deposition whereas increase hemolysis and platelet activation, and vice versa. The results suggest that different operating conditions have different effects on pulsatile VAD's blood damage and may be beneficial to choose suitable operating condition to reduce blood damage in clinical applications. PMID:26164600

  12. Two Cases of Accidental Injection of Epinephrine into a Digit Treated with Subcutaneous Phentolamine Injections

    PubMed Central

    Bodkin, Ryan P.; Acquisto, Nicole M.; Wiegand, Timothy J.

    2013-01-01

    Accidental injection into the digit from an epinephrine autoinjection device can cause discoloration, pain, and paresthesias. Although loss of digit is rare, treatment in the emergency department is commonly aimed at vasodilation of the affected tissue. We report two cases of accidental injection of epinephrine into the digits that were successfully treated with subcutaneous phentolamine injection with no adverse events. PMID:24024046

  13. Subcutaneous immunoglobulin in treating inflammatory neuromuscular disorders

    PubMed Central

    Yoon, Min-Suk; Gold, Ralf

    2015-01-01

    Objective: Intravenous immunoglobulin administration has long been used in the treatment of autoimmune neuromuscular disorders. Immunoglobulins may be administered by intramuscular, intravenous or subcutaneous routes. Methods: This is a report on the long-term clinical follow up of six patients with inflammatory neuromuscular disorders, that is, three chronic inflammatory demyelinating polyneuropathy (CIDP), one multifocal motor neuropathy (MMN), one inclusion body myositis (IBM) and one myasthenia gravis (MG), treated with subcutaneous immunoglobulins for a mean of 3.25 years. Results: One MMN and two CIDP patients received a weekly dose of subcutaneous immunoglobulins equivalent to intravenous immunoglobulin. One CIDP patient received a 50% dose reduction, the IBM patient received a 30% reduction and the MG patient a 20% reduction. The lower dose chosen in the majority of patients was based not only on clinical effects, but also on studies of primary immunodeficiency syndromes. One patient with CIDP showed clinical fluctuation, which was successfully treated with an adaptation of the dose of subcutaneous immunoglobulins, while the remaining patients with neuromuscular disorders had a stable clinical course for 2 years. No serious side effects were observed. Conclusions: Our results suggest that subcutaneous immunoglobulins can be an attractive alternative therapy in autoimmune neuromuscular disorders. PMID:26136842

  14. Pneumomediastinum presenting as left periorbital subcutaneous emphysema.

    PubMed

    Orton, Jonathan; Collette, Emily

    2015-12-01

    Idiopathic spontaneous pneumomediastinum is rare but even rarer is associated unilateral periorbital subcutaneous emphysema. There is only 1 known case report noting both of these findings and was associated with endoscopic retrograde cholangiopancreatography complication. Isolated periorbital emphysema has been associated with dental procedures, facial trauma, and sneezing. It is has also been seen with pneumomediastinum caused by barotrauma, pneumothorax, endoscopic retrograde cholangiopancreatography, and esophageal perforation. A 52-year-old White male presents to the emergency department with complaint of left eye swelling that occurred overnight without known cause. He was found to have spontaneous idiopathic pneumomediastinum and unilateral periorbital subcutaneous emphysema. Although rare, it is important to rule out subcutaneous air tracking from pneumomediastinum when evaluating unilateral periorbital swelling in an otherwise asymptomatic patient. PMID:25986202

  15. Subcutaneous Phaeohyphomycosis Caused by Exophiala salmonis

    PubMed Central

    Yoon, Young Ahn; Park, Kyung Sun; Lee, Jang Ho; Sung, Ki-Sun; Ki, Chang-Seok

    2012-01-01

    We report a case of subcutaneous infection in a 55-yr-old Korean diabetic patient who presented with a cystic mass of the ankle. Black fungal colonies were observed after culturing on blood and Sabouraud dextrose agar. On microscopic observation, septated ellipsoidal or cylindrical conidia accumulating on an annellide were visualized after staining with lactophenol cotton blue. The organism was identified as Exophiala salmonis by sequencing of the ribosomal DNA internal transcribed spacer region. Phaeohyphomycosis is a heterogeneous group of mycotic infections caused by dematiaceous fungi and is commonly associated with immunocompromised patients. The most common clinical manifestations of subcutaneous lesions are abscesses or cystic masses. To the best of our knowledge, this is the first reported case in Korea of subcutaneous phaeohyphomycosis caused by E. salmonis that was confirmed by molecular analysis and identification of morphological characteristics. This case suggests that E. salmonis infections are no longer restricted to fish. PMID:23130345

  16. Preoperative intra-aortic counterpulsation in high-risk patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials†.

    PubMed

    Pilarczyk, Kevin; Boening, Andreas; Jakob, Heinz; Langebartels, Georg; Markewitz, Andreas; Haake, Nils; Heringlake, Matthias; Trummer, Georg

    2016-01-01

    In contrast to the results of previous studies, recent randomized controlled trials (RCTs) failed to show a benefit of prophylactic aortic counterpulsation in high-risk patients undergoing cardiac surgery. The present analysis aims to redefine the effects of this treatment modality in the light of this new evidence. MEDLINE, EMBASE, CENTRAL/CCTR, Google Scholar and reference lists of relevant articles were searched for full-text articles of RCTs in English or German. Assessments for eligibility, relevance, study validity and data extraction were performed by two reviewers independently using prespecified criteria. The primary outcome was hospital mortality. A total of nine eligible RCTs with 1171 patients were identified: 577 patients were treated preoperatively with intra-aortic balloon pump (IABP) and 594 patients served as controls. The pooled odds ratio (OR) for hospital mortality (22 hospital deaths in the intervention arm, 54 in the control group) was 0.381 (95% CI 0.230-0.629; P < 0.001). The pooled analyses of five RCTs including only patients undergoing isolated on-pump coronary artery bypass grafting (n[IABP] = 348, n[control] = 347) also showed a statistically significant improvement in mortality for preoperative IABP implantation (fixed-effects model: OR 0.267, 95% CI 0.129-0.552, P < 0.001). The pooled OR for hospital mortality from two randomized off-pump trials was 0.556 (fixed-effects model, 95% CI 0.207-1.493, P = 0.226). Preoperative aortic counterpulsation was associated with a significant reduction in low cardiac output syndrome (LCOS) in the total population (fixed-effects model: OR 0.330, 95% CI 0.214-0.508, P < 0.001) as well as in the subgroup of CAGB patients (fixed-effects model: OR 0.113, 95% CI 0.056-0.226, P < 0.001), whereas there was no benefit in the off-pump population (fixed-effects model: OR 0.555, 95% CI 0.209-1.474, P = 0.238). Preoperative IABP implantation was associated with a reduction of intensive care unit (ICU) stay in

  17. Combined subcutaneous, intrathoracic and abdominal splenosis.

    PubMed

    Javadrashid, Reza; Paak, Neda; Salehi, Ahad

    2010-09-01

    We report a case of combined subcutaneous, intrathoracic, and abdominal splenosis who presented with attacks of flushing, tachycardia and vague abdominal pain. The patient's past medical history included a splenectomy due to abdominal trauma and years later, a lung lobectomy due to recurrent pneumonia. An enhancing solid mass adjacent to the upper pole of the left kidney and nodular pleural based lesions in the left hemi-thorax along with nodular lesions in subcutaneous tissue of the left chest wall suggested possible adrenal malignancy with multiple metastases. Histopathologic examination demonstrated benign lesions of ectopic splenic tissue. PMID:20804314

  18. Subcutaneous and periorbital emphysema following dental procedure.

    PubMed

    Fleischman, David; Davis, Richard M; Lee, Lyndon B

    2014-01-01

    Subcutaneous emphysema following a dental procedure is a relatively uncommon phenomenon that may produce a dramatic clinical presentation. The advent of high-powered dental equipment that uses directed and highly pressurized air has increased the risk of this complication, but few cases have been described in the ophthalmic literature. The authors present a case of subcutaneous periorbital emphysema in a young woman following a dental procedure. Aside from a temporary ptosis, there were no other ophthalmic complications. An attempt to decompress the air produced minimal relief. The condition resolved spontaneously within 1 week. PMID:24614564

  19. Subcutaneous sacral ependymoma--a histopathological challenge.

    PubMed

    Helbig, Doris

    2016-01-01

    Subcutaneous myxopapillary or sacral ependymoma are rare tumors mostly developing in children or adolescents. The majority occurs in the sacrococcygeal region. There are numerous clinical and histopathological differential diagnoses. Owing to the fact that there have been rare reported cases that followed an aggressive course and in which the patient succumbed to metastatic disease, long term follow-up is necessary despite complete excision. We describe here a 25-year-old male patient with a histological unusual subcutaneous sacral ependymoma and discuss the differential diagnosis as well as treatment options. PMID:26289839

  20. Non-invasive subcutaneous fat reduction: a review.

    PubMed

    Kennedy, J; Verne, S; Griffith, R; Falto-Aizpurua, L; Nouri, K

    2015-09-01

    The risks, financial costs and lengthy downtime associated with surgical procedures for fat reduction have led to the development of a number of non-invasive techniques. Non-invasive body contouring now represents the fastest growing area of aesthetic medicine. There are currently four leading non-invasive techniques for reducing localized subcutaneous adipose tissue: low-level laser therapy (LLLT), cryolipolysis, radio frequency (RF) and high-intensity focused ultrasound (HIFU). To review and compare leading techniques and clinical outcomes of non-invasive subcutaneous fat reduction. The terms 'non-invasive', 'low-level laser', 'cryolipolysis', 'ultrasound' and 'radio frequency' were combined with 'lipolysis', 'fat reduction' or 'body contour' during separate searches in the PubMed database. We identified 31 studies (27 prospective clinical studies and four retrospective chart reviews) with a total of 2937 patients that had been treated with LLLT (n = 1114), cryolipolysis (n = 706), HIFU (n = 843) or RF (n = 116) or other techniques (n = 158) for fat reduction or body contouring. A majority of these patients experienced significant and satisfying results without any serious adverse effects. The studies investigating these devices have all varied in treatment regimen, body locations, follow-up times or outcome operationalization. Each technique differs in offered advantages and severity of adverse effects. However, multiple non-invasive devices are safe and effective for circumferential reduction in local fat tissue by 2 cm or more across the abdomen, hips and thighs. Results are consistent and reproducible for each device and none are associated with any serious or permanent adverse effects. PMID:25664493

  1. Subcutaneous immunoglobulin replacement therapy: ensuring success.

    PubMed

    Younger, M Elizabeth M; Blouin, William; Duff, Carla; Epland, Kristin Buehler; Murphy, Elyse; Sedlak, Debra

    2015-01-01

    Subcutaneous immunoglobulin (SCIg) infusions are an option for patients requiring immunoglobulin therapy. Nurses are uniquely positioned to advocate for patients and to teach them how to successfully manage their infusions. The purpose of this review is to describe SCIg therapy and to provide teaching instructions as well as creative tips to ensure treatment success. PMID:25545976

  2. Impressive Subcutaneous Calcifications in Systemic Lupus Erythematosus

    PubMed Central

    DIMA, Alina; BERZEA, Ioana; BAICUS, Cristian

    2015-01-01

    Dystrophic calcinosis cutis was commonly described in long-term dermatomyositis or systemic sclerosis, being rarely reported in other connective tissue diseases. We report the case of a 65-years old woman with an only 5-years history of systemic lupus erythematosus, who presents with multiple, impressive subcutaneous calcified masses and biological normal serum calcium and phosphate levels. PMID:26225152

  3. Subcutaneous emphysema and pneumolabyrinth plus pneumocephalus as complications of middle ear implant and cochlear implant surgery.

    PubMed

    McKinnon, Brian J; Watts, Tamara

    2013-07-01

    We conducted a retrospective case review at a tertiary academic medical center for the complications of pneumolabyrinth with pneumocephalus and subcutaneous emphysema after surgery for middle ear and cochlear implants. Charts of 76 cochlear implant and 2 middle ear implant patients from January 2001 through June 2009 were reviewed. We identified 1 cochlear implant recipient with pneumolabyrinth and pneumocephalus, and 1 middle ear implant recipient with subcutaneous emphysema. Surgical exploration was performed for the pneumolabyrinth with pneumocephalus; the subcutaneous emphysema was managed conservatively. The patient with the cochlear implant, who had had a ventriculoperitoneal shunt placed, experienced pneumolabyrinth with pneumocephalus 6 years after uneventful surgery. Middle ear exploration revealed no residual fibrous tissue seal at the cochleostomy. The middle ear and cochleostomy were obliterated with muscle, fat, and fibrin glue. The ventriculoperitoneal shunt was deactivated, with clinical and radiographic resolution. On postoperative day 5, the patient who had undergone the middle ear implant reported crepitance over the mastoid and implant device site after repeated Valsalva maneuvers. Computed tomography showed air surrounding the internal processor. A mastoid pressure dressing was applied and the subcutaneous emphysema resolved. These 2 cases support the importance of recognizing the clinical presentation of pneumolabyrinth with associated pneumocephalus, as well as subcutaneous emphysema. Securing the internal processor, adequately sealing the cochleostomy, and providing preoperative counseling regarding Valsalva maneuvers and the potential risk of cochlear implantation in the presence of a ventriculoperitoneal shunt may prevent adverse sequelae. PMID:23904304

  4. Orthogonal factor coefficient development of subcutaneous adipose tissue topography (SAT-Top) in girls and boys.

    PubMed

    Tafeit, E; Möller, R; Sudi, K; Horejsi, R; Berg, A; Reibnegger, G

    2001-05-01

    The new optical device Lipometer allows noninvasive, quick, and safe determination of the thickness of subcutaneous adipose tissue (SAT) layers (in mm) at any site of the human body. The specification of 15 evenly distributed body sites enables the precise measurement of subcutaneous body fat distribution, so-called subcutaneous adipose tissue topography (SAT-Top). SAT-Top was measured in 980 children aged 7-19 years. In this paper we describe the degree to which SAT-Top body sites are intercorrelated. We consider whether a meaningful reduction of data is possible using factor analysis, which factors can be extracted, and how SAT-Top data of children can be added to a factor value plot, depicting the essential results of age-dependent subcutaneous fat development. SAT layers situated on the same body area provide correlation coefficients up to +r = 0.91. Two factors are extracted: factor 1, containing all upper body sites (from neck to hip); and factor 2, consisting of all leg body sites. When all 980 children are divided into three age groups in a factor value plot, the first age group (7-11 years) shows almost equal SAT-Top development in boys and girls. Afterwards, for the consecutive age groups 2 (11-15 years) and 3 (15-19 years), the age-dependent subcutaneous fat development of boys and girls progresses into nearly orthogonal directions. PMID:11309750

  5. Effects of Additional Intra-aortic Balloon Counter-Pulsation Therapy to Cardiogenic Shock Patients Supported by Extra-corporeal Membranous Oxygenation

    PubMed Central

    Lin, Lian-Yu; Liao, Che-Wei; Wang, Chih-Hsien; Chi, Nai-Hsin; Yu, Hsi-Yu; Chou, Nai-Kuan; Hwang, Juey-Jen; Lin, Jiunn-Lee; Chiang, Fu-Tien; Chen, Yih-Sharng

    2016-01-01

    Extra-corporeal membranous oxygenation (ECMO) has been applied in patients with cardiopulmonary failure. One critical drawback of peripheral ECMO is an increase in left ventricular (LV) afterload which could be counterbalanced by the combination of intra-aortic balloon counter-pulsation (IABP) therapy. We hypothesized that an add-on therapy with IABP could improve outcomes in patients receiving ECMO support. We included patients (>18 years old) from 2002 to 2013 requiring ECMO support due to cardiogenic shock in a medical center. A total of 529 patients (227 ECMO alone and 302 combined IABP plus ECMO) were included. The mortality rates at 2 weeks (48.5 vs. 47.7%) after ECMO implantation were not different between the two groups (ECMO vs. combined group). After adjustment for propensity score and potential confounders, the odds ratios of outcomes within 14 days (combined group vs. ECMO) for poor LV systolic function, high preload, multi-organ failure and mortality were not different. The results remained similar for subgroup analysis. Compared with ECMO alone, combined IABP and ECMO treatment did not improve outcomes in patients with circulatory failure. PMID:27032984

  6. No Electromagnetic Interference Occurred in a Patient with a HeartMate II Left Ventricular Assist System and a Subcutaneous Implantable Cardioverter-Defibrillator.

    PubMed

    Raman, Ajay Sundara; Shabari, Farshad Raissi; Kar, Biswajit; Loyalka, Pranav; Hariharan, Ramesh

    2016-04-01

    The use of subcutaneous implantable cardioverter-defibrillators is a novel option for preventing arrhythmia-mediated cardiac death in patients who are at risk of endovascular-device infection or in whom venous access is difficult. However, the potential for electromagnetic interference between subcutaneous defibrillators and left ventricular assist devices is largely unknown. We report the case of a 24-year-old man in whom we observed no electromagnetic interference between a subcutaneous implanted cardioverter-defibrillator and a HeartMate II Left Ventricular Assist System, at 3 different pump speeds. To our knowledge, this is the first report of such findings in this circumstance. PMID:27127441

  7. No Electromagnetic Interference Occurred in a Patient with a HeartMate II Left Ventricular Assist System and a Subcutaneous Implantable Cardioverter-Defibrillator

    PubMed Central

    Raman, Ajay Sundara; Kar, Biswajit; Loyalka, Pranav; Hariharan, Ramesh

    2016-01-01

    The use of subcutaneous implantable cardioverter-defibrillators is a novel option for preventing arrhythmia-mediated cardiac death in patients who are at risk of endovascular-device infection or in whom venous access is difficult. However, the potential for electromagnetic interference between subcutaneous defibrillators and left ventricular assist devices is largely unknown. We report the case of a 24-year-old man in whom we observed no electromagnetic interference between a subcutaneous implanted cardioverter-defibrillator and a HeartMate II Left Ventricular Assist System, at 3 different pump speeds. To our knowledge, this is the first report of such findings in this circumstance. PMID:27127441

  8. Enhancing the contrast of subcutaneous veins

    NASA Astrophysics Data System (ADS)

    Zeman, Herbert D.; Lovhoiden, Gunnar

    1999-07-01

    A technique for enhancing the contrast of subcutaneous veins has been demonstrated. This technique uses a near infrared light source and one or more infrared sensitive CCD TV cameras to produce a contrast enhanced image of the subcutaneous veins. This video image of the veins is projected back onto the patient's skin using an LCD vein projector. The use of an infrared transmitting filter in front of the video cameras prevents any positive feedback from the visible light from the video projector from causing instabilities in the projected image. The demonstration contrast enhancing illuminator has been tested on adults, both Caucasian and African-American, and it enhances veins quite well in most cases. Preliminary studies on a 9 month old girl indicate promise for pediatric use.

  9. Optimization of subcutaneous vein contrast enhancement

    NASA Astrophysics Data System (ADS)

    Zeman, Herbert D.; Lovhoiden, Gunnar; Deshmukh, Harshal

    2000-05-01

    A technique for enhancing the contrast of subcutaneous veins has been demonstrated. This techniques uses a near IR light source and one or more IR sensitive CCD TV cameras to produce a contrast enhanced image of the subcutaneous veins. This video image of the veins is projected back onto the patient's skin using a n LCD video projector. The use of an IR transmitting filter in front of the video cameras prevents any positive feedback from the visible light from the video projector from causing instabilities in the projected image. The demonstration contrast enhancing illuminator has been tested on adults and children, both Caucasian and African-American, and it enhances veins quite well in all cases. The most difficult cases are those where significant deposits of subcutaneous fat are present which make the veins invisible under normal room illumination. Recent attempts to see through fat using different IR wavelength bands and both linearly and circularly polarized light were unsuccessful. The key to seeing through fat turns out to be a very diffuse source of RI light. Results on adult and pediatric subjects are shown with this new IR light source.

  10. Subcutaneous implantable cardioverter defibrillators in children, young adults and patients with congenital heart disease.

    PubMed

    Bordachar, Pierre; Marquié, Christelle; Pospiech, Thomas; Pasquié, Jean-Luc; Jalal, Zakaria; Haissaguerre, Michel; Thambo, Jean-Benoit

    2016-01-15

    The demonstration of severe complications in patients implanted with a transvenous implantable cardioverter defibrillator (ICD) has led to the development of devices equipped with a subcutaneous lead. This new technique offers numerous advantages but also certain disadvantages. Various studies or anecdotal clinical cases have specifically been conducted with this subcutaneous defibrillation system in children and/or patients with congenital heart disease. Results of these studies suggest: 1) a high feasibility despite being limited by a selection process that excludes patients requiring permanent pacing and patients declared ineligible during pre-screening; 2) good efficacy of electrical shocks in reducing induced or spontaneous ventricular arrhythmias; 3) in this specific subset of patients, 2 types of complications have been particularly described: a risk of device exteriorization and infection, and a large number of inappropriate therapies primarily related to T-wave oversensing. The subcutaneous ICD could therefore constitute the gold standard for patients with complex congenital heart disease with no venous access to the heart or with a persistent shunt increasing the risk of systemic emboli as well as in young patients with channelopathy or hypertrophic cardiomyopathy not requiring long-term pacing. Technological change (reduction in device size, better differentiation between R- and T-waves, possibility of pacing if device coupled with a leadless pacemaker) could reduce the limitations and complications and thereby increase the indications in this sub-group of patients. PMID:26519678

  11. Numerical simulation of the influence of a left ventricular assist device on the cardiovascular system.

    PubMed

    Verkerke, G J; Geertsema, A A; Mihaylov, D; Blanksma, P K; Rakhorst, G

    2000-11-01

    The PUCA (pulsatile catheter) pump is a left ventricular assist device (LVAD) capable of unloading the left ventricle (LV) and improving coronary flow by providing a counterpulsation effect. It consists of an extracorporeal located membrane pump, coupled to a transarterial catheter that enters the body via a superficial artery and ends in the LV. Blood is aspirated from the LV and pumped in the ascending aorta through the same catheter guided by a valve system. Timing and frequency of the PUCA pump influence its efficacy. To study the influence of several pump parameters a numerical model of the device and the circulatory system has been developed. Results of animal experiments were used to validate the model. Optimization studies resulted in a pump configuration with a stroke volume of 50 cc and pump:heart frequency mode of 1:2 that starts ejection at the beginning of diastole. PMID:11132021

  12. External Counterpulsation Reduces Beat-to-Beat Blood Pressure Variability When Augmenting Blood Pressure and Cerebral Blood Flow in Ischemic Stroke

    PubMed Central

    Tian, Ge; Xiong, Li; Lin, Wenhua; Han, Jinghao; Chen, Xiangyan; Leung, Thomas Wai Hong; Soo, Yannie Oi Yan

    2016-01-01

    Background and Purpose External counterpulsation (ECP) is a noninvasive method used to enhance cerebral perfusion by elevating the blood pressure in ischemic stroke. However, the response of the beat-to-beat blood pressure variability (BPV) in ischemic stroke patients during ECP remains unknown. Methods We enrolled recent ischemic stroke patients and healthy controls. Changes in the blood flow velocities in bilateral middle cerebral arteries and the continuous beat-to-beat blood pressure before, during, and after ECP were monitored. Power spectral analysis revealed that the BPV included oscillations at very low frequency (VLF; <0.04 Hz), low frequency (LF; 0.04–0.15 Hz), and high frequency (HF; 0.15–0.40 Hz), and the total power spectral density (TP; <0.40 Hz) and LF/HF ratio were calculated. Results We found that ECP significantly increased the systolic and diastolic blood pressures in both stroke patients and controls. ECP decreased markedly the systolic and diastolic BPVs at VLF and LF and the TP, and the diastolic BPV at HF when compared with baseline. The decreases in diastolic and systolic BPV reached 37.56% and 23.20%, respectively, at VLF, 21.15% and 12.19% at LF, 8.76% and 16.59% at HF, and 31.92% and 23.62% for the total TP in stroke patients, which did not differ from those in healthy controls. The change in flow velocity on the contralateral side was positively correlated with the total TP systolic BPV change induced by ECP (r=0.312, p=0.035). Conclusions ECP reduces the beat-to-beat BPV when increasing the blood pressure and cerebral blood flow velocity in ischemic stroke patients. ECP might be able to improve the clinical outcome by decreasing the beat-to-beat BPV in stroke patients, and this should be explored further in future studies. PMID:27095525

  13. Subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei.

    PubMed

    Chen, Yu-Chuan; Su, Yu-Chieh; Tsai, Chen-Chi; Lai, Ning-Sheng; Fan, Kou-Sheng; Liu, Keng-Chang

    2014-12-01

    Exophiala jeanselmei, a saprobe in the environment, is an opportunistic pathogen. We present a rare case of subcutaneous phaeohyphomycosis caused by E jeanselmei in a man aged 66 years with a 3-month history of a tender swelling on the dorsal area of the left middle finger. Purulent fluid was aspirated from the area, and the culture yielded black colonies composed of conidiophores, phialides, and yeast cells. After sequencing of the rDNA ITS1-5.8S-ITS2 gene, the pathogen was confirmed as E jeanselmei. The patient was cured by surgical excision without any antifungal agents. PMID:22841620

  14. Surgical management of subcutaneous Colletotrichum gloeosporioides.

    PubMed

    Allton, David R; Parvez, Najma; Ranganath, Sangeetha; Jinadatha, Chetan

    2015-01-01

    A 52-year-old male patient with a history of sarcoidosis and over 10 years of chronic low-dose glucocorticoid use, cirrhosis and type 2 diabetes mellitus presented with two painful, enlarging subcutaneous nodules ultimately identified as Colletotrichum gloeosporioides. Two attempts at needle aspiration of the larger nodule resulted in rapid reaccumulation. Complete surgical excision of both nodules resulted in complete resolution without the use of any concomitant antifungals. Patient had no recurrence at 2 years of follow-up. PMID:25737220

  15. Pulmonary carcinoid presenting as multiple subcutaneous nodules.

    PubMed

    Oleksowicz, L; Morris, J C; Phelps, R G; Bruckner, H W

    1990-02-28

    A 60-year-old female presented with a one-year history of multiple enlarging tender subcutaneous nodules. Initial biopsy demonstrated a poorly differentiated adenocarcinoma. Mammography showed multiple nodular breast lesions. After the patient failed to respond to tamoxifen, a second biopsy demonstrated a metastatic carcinoid tumor. Further search revealed a single small pulmonary nodule, which on aspiration biopsy proved to be a carcinoid tumor. The patient failed to respond to treatment with streptozotocin and 5'-fluorouracil. Therapy with leucovorin calcium and 5'-fluorouracil then produced a partial response. PMID:2321273

  16. Subcutaneous Direct-to-Implant Breast Reconstruction: Surgical, Functional, and Aesthetic Results after Long-Term Follow-Up

    PubMed Central

    Calabrese, Claudio; Cecconi, Lorenzo; Santi, Caterina; Gjondedaj, Ulpjana; Roselli, Jenny; Nori, Jacopo; Fausto, Alfonso; Orzalesi, Lorenzo; Casella, Donato

    2015-01-01

    Abstract Background: Direct-to-implant breast reconstruction can be achieved more easily by means of soft-tissue replacement devices such as dermal matrices and synthetic meshes. The feasibility of a subcutaneous approach has been recently investigated by some studies with different devices functioning as implant support. Aim of this study is to analyze the long-term results, both objective and subjective, of a previous nonrandomized trial comparing prepectoral (subcutaneous) and retropectoral breast reconstructions. Methods: Patients enrolled in a nonrandomized prospective trial, comparing the standard retropectoral reconstruction and the prepectoral subcutaneous approach, using a titanium-coated mesh in both techniques, were followed up and evaluated for long-term results. Cases were compared in terms of the causes and rate of reinterventions, of the postoperative BREAST-Q questionnaire results, and of an objective surgical evaluation. Results: The subcutaneous group had a rate of implant failure and removal of 5.1% when compared with 0% in the retropectoral group. Aesthetic outcome was significantly better for the subcutaneous group both at a subjective and at an objective evaluation. Capsular contracture rate was 0% in the subcutaneous group. Conclusions: A higher rate of implant failure and removal, although not significant, always because of skin flaps and wound problems, should be taken into account for a careful patients selection. The subcutaneous breast reconstruction shows good long-term results. A coherent subjective and objective cosmetic advantage of this approach emerges. Moreover, no capsular contracture is evident, albeit in a relatively limited number of cases. PMID:26893999

  17. Pharmacokinetics of subcutaneous fentanyl in Greyhounds.

    PubMed

    KuKanich, Butch

    2011-11-01

    The purpose of the study was to describe the pharmacokinetics of subcutaneous fentanyl (15μg/kg) in six healthy Greyhound dogs. Fentanyl plasma concentrations were determined by a liquid chromatography with mass spectrometry method. Non-compartmental pharmacokinetic analysis was used. Fentanyl was rapidly absorbed with a mean peak concentration (C(MAX)) of 3.56ng/mL at 0.24h. The mean terminal half-life, volume of distribution per bioavailability, and clearance per bioavailability were 2.97h, 7.09L/kg, 27.60mL/min/kg, respectively. Pain occurred on injection in all six dogs, but addition of 8.4% sodium bicarbonate (1mL per 20mL fentanyl) resulted in no pain on injection in 3/3 dogs but similar C(MAX) values. The subcutaneous route may be an alternative route of fentanyl administration if intravenous administration is not practical. PMID:21388844

  18. Subcutaneous rehydration: updating a traditional technique.

    PubMed

    Spandorfer, Philip R

    2011-03-01

    Subcutaneous (SC) rehydration therapy (SCRT), originally referred to as "hypodermoclysis," shows promise as an alternative to intravenous (IV) fluid administration for treatment of dehydration. A simple, safe, and effective technique, SCRT is indicated for treatment of mild-to-moderate dehydration. Augmentation of SCRT with administration of a recombinant human formulation of the hyaluronidase enzyme at the infusion site gives rise to SC fluid administration rates up to 5-fold faster than those achieved without the enzyme, making the technique more clinically practical. Unlike older, animal-derived forms of hyaluronidase, recombinant human hyaluronidase has a lower chance of allergic reactions with repeated dosing. Clinical trials have demonstrated that recombinant human hyaluronidase effectively and safely facilitates fluid delivery in adults and children and is well accepted by parents and clinicians. In the emergency department setting, SCRT may be an appropriate alternative to IV fluid administration in certain situations because it is less invasive and generally less painful, while still permitting administration of appropriate volumes of rehydration fluids. Subcutaneous rehydration therapy appears to be particularly useful in patients who present with mild-to-moderate dehydration and have had failed attempts at oral rehydration. The SC route also provides benefits in patients with small, collapsed, or difficult-to-visualize veins or in those who may be agitated or distressed by IV catheterization. Continued research will further clarify the role of recombinant human hyaluronidase-facilitated SCRT in the rehydration treatment algorithm. PMID:21378529

  19. Growth of subcutaneous chicken testicular transplants.

    PubMed

    Silversides, F G; Robertson, M C; Liu, J

    2013-07-01

    Avian genetic resources have declined dramatically over the past half century, partly because the poultry community has been slow to adopt cryoconservation of avian germplasm. Techniques for gonadal cryopreservation and functional recovery have recently been developed but only some have been optimized. Chicks were castrated at 2 or 6 d and testicles were autotransplanted subcutaneously in one piece after disruption of the tunica membranes to optimize transplantation procedures without the complication of tissue rejection or immunosuppression. At 22 wk of age, the roosters were euthanized and growth of the testicular tissue was evaluated. Mortality with castration at 2 d was high but was much reduced with castration at 6 d. Transplantation of whole testicles subcutaneously on the back of chicks, without complete removal of the tunica membranes, yielded good growth of tissue with transplantation at 2 or 6 d of age. These results will contribute to the use of testicular cryopreservation and transplantation as an effective conservation strategy for avian germplasm. Further definition of the age of treatment will improve the overall efficiency. PMID:23776280

  20. Subcutaneous compliance and gravitational adaptation in snakes.

    PubMed

    Lillywhite, H B

    1993-12-15

    Previous studies have implicated morphological adaptations as important counter-measures to gravitational stresses on the circulatory systems of arboreal or climbing snakes. Such features include tight skin and relatively non-compliant tissue compartments that oppose edema formation, but these traits have not been previously studied quantitatively. To provide information on this subject, interstitial fluid pressures were measured in eleven species of snakes using slit-end catheters positioned in subcutaneous tissue located at the base of the tail. Interstitial pressures in all species were typically 0 to +2 mm Hg in normally hydrated tissue, but varied widely when snakes were active or when the tail was curved at the site of measurement. Local compliance of the free fluid space was determined from measurements of pressure while saline was infused via the catheter tip. Such measurements varied from 0.18 microliters/mm Hg in Philodryas baroni, an arboreal species, to 2.3 microliters/mm Hg in Crotalus adamanteus, a ground-dwelling, terrestrial species. In general, compliance of the subcutaneous tissue space was greatest (P < 0.05) in non-climbing and aquatic species of snakes that do not face problems of gravitational edema in dependent tissues. Presumably, the compliance measurements reflect adaptive structural differences related to requirements for counteracting gravitational stresses in the various species. PMID:8277230

  1. Subcutaneous tumor growth complicating the positioning of Denver shunt and intrapleural port-à-cath in mesothelioma patients.

    PubMed

    van Ooijen, B; Eggermont, A M; Wiggers, T

    1992-12-01

    Patients with malignant ascites and malignant pleural fluid from abdominal or pleural mesothelioma underwent the positioning of Denver type peritoneovenous shunt or intrapleural catheter. They developed tumor growth in the subcutaneous tissue surrounding the devices throughout their courses. Neoplastic seeding is a potential complication of the positioning of shunts and catheters in cavities filled with fluid rich in tumor cells. PMID:1478300

  2. Prophylactic Subclavian Artery Intraaortic Balloon Counter-Pulsation is Safe in High-Risk Cardiac Surgery Patients.

    PubMed

    Russo, Mark J; Jeevanandam, Valluvan; Hur, Michael J; Johnson, Elizabeth M; Siffring, Travis; Shah, Atman P; Raman, Jaishankar

    2015-01-01

    The objective of this study was to determine the safety of prophylactic subclavian artery intraaortic balloon pumps (SCA-IABP) in high-risk cardiac surgery patients as a bridge to recovery (BTR). From November 2011 to January 2013, 11 consecutive patients at three institutions underwent prophylactic insertion of a SCA-IABP as a BTR. All patients (n = 11) had preoperative ejection fractions of 30% or less. Patients concurrently underwent one or a combination of the following procedures: coronary artery bypass grafting, mitral valve surgery, aortic valve replacement, left ventricular aneurysm resection, and ventricular/atrial septal defect closure. The primary outcome measure was a composite endpoint of device-related complications (including limb ischemia, stroke, device failure, bleeding requiring reoperation, brachial plexus injury, device-related infection, and vascular complications) and in-hospital mortality. Secondary outcome measures included interval to patient ambulation and postoperative length of stay. There were no device-related complications or in-hospital mortalities in this cohort of 11 consecutive patients. Mean time to ambulation, balloon pump support, and postoperative length of stay were 3.70 ± 2.50 days, 8.50 ± 7.00 days, and 15.9 ± 8.25 days, respectively. Prophylactic SCA-IABPs appear to be safe in high-risk cardiac surgery patients as a BTR. PMID:26313557

  3. Evaluation of Subcutaneous Phenobarbital Administration in Hospice Patients.

    PubMed

    Hosgood, Jessica Richards; Kimbrel, Jason M; McCrate Protus, Bridget; Grauer, Phyllis A

    2016-04-01

    Phenobarbital is used in hospice and palliative care to treat refractory symptoms. In end-of-life care, Food and Drug Administration approved routes of administration may be unreasonable based on patients' status. In these cases, phenobarbital may be administered subcutaneously for symptom management. However, according to the American Hospital Formulary Service, subcutaneous administration of commercially available injectable phenobarbital is cautioned due to possible skin reactions. This study evaluates the tolerability of phenobarbital administered subcutaneously. Of 69 patients and 774 distinct subcutaneous phenobarbital injections, 2 site reactions were recorded (2.9% of patients; 0.3% of injections). Both were mild, grade 1 reactions. Each patient continued to receive subcutaneous phenobarbital via newly placed ports with no additional reactions. Based on these findings, phenobarbital appears to be well tolerated when administered subcutaneously. PMID:25473092

  4. Panniculitis with crystals induced by etanercept subcutaneous injection.

    PubMed

    Llamas-Velasco, Mar; Requena, Luis

    2015-06-01

    Panniculitis with lipid crystallization within adipocytes may be seen in several disorders, including crystal-storing histiocytosis, gouty panniculitis, subcutaneous fat necrosis of the newborn, post-steroid panniculitis, sclerema neonatorum, oxalosis and subcutaneous fungal infections by mucormycosis, zygomycosis or aspergillosis. Panniculitis at the sites of subcutaneous injection of drugs are frequent, but to our knowledge no crystals have been described in the drug-induced panniculitis at the sites of subcutaneous injections. We report on a patient who developed a panniculitis with lipid crystallization at the site of etanercept injection. PMID:25727404

  5. Human dicrocoeliasis presenting as a subcutaneous mass

    PubMed Central

    Samaila, Modupeola Omotara; Shehu, Sani Mohammed; Abubakar, Nasiru; Mohammed, Umar; Jabo, Bashir

    2009-01-01

    Human infection by Dicrocoelium dendriticum, a zoonotic liver fluke, is uncommon and soft tissue manifestation is extremely rare. The infection has no specific clinical signs or symptoms and diagnosis may be missed completely, thus treatment may be delayed. Diagnosis in humans is by identification of the eggs in the stool, while a living or dead fluke is rarely seen. The present report concerns the case of a 7-year-old child who presented with recurrent right flank subcutaneous nodules containing a live fluke on excision, and tissue histology showed characteristic brown operculated ova of D dendriticum. This is the first extraintestinal soft tissue presentation in such a setting. It is important to know the life cycle and natural habitat of this rare human parasite in order to make a correct diagnosis and institute early treatment in patients who have become infected. PMID:21829430

  6. Subcutaneous mycoses. Part 1: subcutaneous mycoses due to non-dermatophytes.

    PubMed

    Romano, C

    2013-12-01

    Subcutaenous mycoses are increasingly reported in the literature for various reasons. Firstly, life expectancy has increased and even patients with cancer and/or immunodepression live longer, making them susceptible to these infections. Secondly, diagnostic techniques for mycoses have improved. Dermatologists have now begun to suspect subcutaneous mycoses when faced with certain clinical pictures and are aware of the need for histopathological examination and culture of lesion biopsy material on appropriate culture media. This review considers the clinical, histopathological and mycological aspects of the most common subcutaneous mycoses and outlines how to treat them. A better understanding of these mycoses enables early diagnosis and treatment of infections that are sometimes life-threatening. PMID:24442042

  7. Efficacy of Enhanced External Counterpulsation in Patients With Chronic Refractory Angina on Canadian Cardiovascular Society (CCS) Angina Class: An Updated Meta-Analysis.

    PubMed

    Zhang, Chunmei; Liu, Xiangjuan; Wang, Xiaomeng; Wang, Qi; Zhang, Yun; Ge, Zhiming

    2015-11-01

    A growing number of patients with chronic artery disease suffer from angina, despite the optimal medical management (ie, β-blockers, calcium channel blockers, and long-acting nitrates) and revascularization. Currently, enhanced external counterpulsation (EECP) therapy has been verified as a noninvasive, safe therapy for refractory angina. The study was designed to evaluate the efficacy of EECP in patients with chronic refractory angina according to Canadian Cardiovascular Society (CCS) angina class.We identified systematic literature through MEDLINE, EMBASE, the Cochrane Clinical Trials Register Database, and the ClinicalTrials. gov Website from 1990 to 2015. Studies were considered eligible if they were prospective and reported data on CCS class before and after EECP treatment. Meta-analysis was performed to assess the efficacy of EECP therapy by at least 1 CCS angina class improvement, and proportion along with the 95% confidence interval (CI) was calculated. Statistical heterogeneity was calculated by I statistic and the Q statistic. Sensitivity analysis was addressed to test the influence of trials on the overall pooled results. Subgroup analysis was applied to explore potential reasons for heterogeneity.Eighteen studies were enrolled in our meta-analysis. Pooled analysis showed 85% of patients underwent EECP had a reduction by at least one CCS class (95%CI 0.81-0.88, I = 58.5%, P < 0.001). The proportion of patients enrolled at primarily different studies with chronic heart failure (CHF) improved by at least 1 CCS class was about 84% after EECP (95%CI 0.81-0.88, I = 32.7%, P = 0.1668). After 3 large studies were excluded, the pooled proportion was 82% (95%CI 0.79-0.86, I = 18%, P = 0.2528). Funnel plot indicated that some asymmetry while the Begg and Egger bias statistic showed no publication bias (P = 0.1495 and 0.2859, respectively).Our study confirmed that EECP provided an effective treatment for patients who were unresponsive to medical management and

  8. Inappropriate shock for myopotential over-sensing in a patient with subcutaneous ICD.

    PubMed

    Corzani, Alessandro; Ziacchi, Matteo; Biffi, Mauro; Diemberger, Igor; Martignani, Cristian; Boriani, Giuseppe

    2015-01-01

    Inappropriate ICD shocks are common adverse events; they are mainly due to supraventricular arrhythmias and secondly are related to noise, undersensing, oversensing, device malfunctions. We present a case of inappropriate device therapy due to myopotential oversensing in a patient with a subcutaneous ICD (s-ICD). A 58 years old male with an s-ICD during the device interrogation showed a previous episode of suspected sustained ventricular tachycardia at 210 bpm, which was effectively treated with ICD shock. The patient experienced the electrical shock while holding a big gas-cylinder in his arms. The EGM analysis revealed many irregular ventricular signals of low amplitude lasting for 24 s and interrupted by the shock. The device showed no malfunctions. This is the first case report of inappropriate S-ICD shock related to myopotential over-sensing. By recording intracardiac EGM, we demonstrated that the noise was created by the activity of the pectorals muscles. PMID:25820052

  9. Perforated diverticulitis of the sigmoid colon causing a subcutaneous emphysema

    PubMed Central

    Kassir, Radwan; Abboud, Karine; Dubois, Joelle; Baccot, Sylviane; Debs, Tarek; Favre, Jean-Pierre; Gugenheim, Jean; Gastaldi, Pauline; Amor, Imed Ben; Tiffet, Olivier

    2014-01-01

    INTRODUCTION Although diverticular disease of the colon is frequent, perforated diverticulitis causing subcutaneous emphysema is a uncommon entity. We wish to present this extremely rare case of perforated colonic diverticulum in the subcutaneous tissue, which is the first one that we have encountered in our practice, along with the accompanying diagnostic and therapeutic issues and a review of the literature. PRESENTATION OF CASE We report the case of an 83-year-old man who admitted to the emergency room due to an abdominal subcutaneous emphysema. Physical examination revealed a severe subcutaneous emphysema especially in the left iliac fossa and abdominal pain. An urgent contrast enhanced abdominal CT scan showed multiple diverticula in the sigmoid colon and multiple air bubbles in the subcutaneous tissue. The exploratory laparotomy identified a perforation of diverticular in subcutaneous tissue. Forty centimeters of colon were resected. The subcutaneous emphysema resolved without specific treatment. The postoperative period was uncomplicated. DISCUSSION Subcutaneous emphysema of anterior abdomen wall is an obvious physical sign but its etiology is complex to determine and may be potentially lethal. The pathophysiological mechanism involved is the emergence of a pressure gradient between the peritoneum and surrounding structures, causing rupture of the anterior abdominal wall, allowing gas from a perforation to diffuse along tissue planes. CONCLUSION This physical sign may be of especial value in elderly patient groups amongst whom perforation may be less clinically obvious. General surgeons should bear in mind this rare complication of colonic diverticulosis. PMID:25437673

  10. Subcutaneous wounding postirradiation reduces radiation lethality in mice.

    PubMed

    Garrett, Joy; Orschell, Christie M; Mendonca, Marc S; Bigsby, Robert M; Dynlacht, Joseph R

    2014-06-01

    The detonation of an improvised nuclear device during a radiological terrorist attack could result in the exposure of thousands of civilians and first responders to lethal or potentially lethal doses of ionizing radiation (IR). There is a major effort in the United States to develop phamacological mitigators of radiation lethality that would be effective particularly if administered after irradiation. We show here that giving female C57BL/6 mice a subcutaneous surgical incision after whole body exposure to an LD50/30 X-ray dose protects against radiation lethality and increases survival from 50% to over 90% (P = 0.0001). The increase in survival, at least in part, appears to be due to enhanced recovery of hematopoiesis, notably red blood cells, neutrophils and platelets. While a definitive mechanism has yet to be elucidated, we propose that this approach may be used to identify potentially novel mechanisms and pathways that could aid in the development of novel pharmacological radiation countermeasures. PMID:24811864

  11. Recent advances in the entirely subcutaneous ICD System.

    PubMed

    Bettin, Markus; Reinke, Florian; Rath, Benjamin; Köbe, Julia; Eckardt, Lars

    2015-01-01

    The entirely subcutaneous implantable cardioverter defibrillator (S-ICD(®)) is emerging as a widely accepted therapeutic alternative to a conventional implantable cardioverter defibrillator (ICD) for prevention of sudden cardiac death. Essentially, the S-ICD(®) is promising in terms of reduction of electrode-related complications such as lead failure and infections. The conventional transvenous ICD has proven efficacy in various randomized clinical trials. The first results of S-ICD(®) studies confirm efficacy and safety in primary and secondary prevention as well. Owing to basic differences between S-ICD(®) and transvenous ICD-such as limited programming options and lack of pacing-not all patients are eligible for the S-ICD(®). Concerns exist regarding inappropriate shocks due to T-wave oversensing, dimensions of the device, and shorter battery longevity. However, the S-ICD(®) should be considered a useful supplementation of ICD therapy in those patients at risk for sudden cardiac death who are not expected to require pacing due to bradycardia or antitachycardic pacing. PMID:26097719

  12. Interferon Beta-1a Subcutaneous Injection

    MedlinePlus

    ... used syringes or automatic injection devices in a puncture resistant container that is out of the reach ... doctor or pharmacist about how to discard the puncture-resistant container.Always look at the medication in ...

  13. Continuous subcutaneous insulin infusion: practical issues

    PubMed Central

    Saboo, Banshi D.; Talaviya, Praful A.

    2012-01-01

    The growing number of individuals with diabetes mellitus has prompted new way of treating these patients, continuous subcutaneous insulin infusion (CSII) or insulin pump therapy is an increasingly form of intensive insulin therapy. An increasing number of individuals with diabetes mellitus individuals of all ages have started using insulin pump therapy. Not everyone is a good candidate for insulin pump therapy, and the clinician needs to be able to determine which patients are able to master the techniques required and to watch for the adverse reactions that may develop. Insulin pump increases quality of life of patient with diabetes mellitus with increasing satisfaction with treatment and decrease impact of diabetes mellitus. Manual errors by insulin pump users may lead to hypo or hyperglycemia, resulting into diabetic ketoacidosis (DKA) sometimes. Some of practical aspect is associated with insulin pump therapy such as selection of candidates, handling of pump and selection of site, and pump setting, henceforth this review is prepared to explore and solve the practical problems or issues associated with pump therapy. PMID:23565394

  14. Sublingual or subcutaneous immunotherapy for allergic rhinitis?

    PubMed

    Durham, Stephen R; Penagos, Martin

    2016-02-01

    Allergen immunotherapy is effective in patients with allergic rhinitis (AR) and, unlike antiallergic drugs, has been shown to modify the underlying cause of the disease, with proved long-term benefits. Subcutaneous immunotherapy (SCIT) has been the gold standard, whereas sublingual immunotherapy (SLIT) has emerged as an effective and safe alternative. Previous Cochrane systematic reviews and meta-analyses have confirmed that both SLIT and SCIT are effective in patients with seasonal AR, whereas evidence for their efficacy in patients with perennial disease has been less convincing. Recent large, adequately powered trials have demonstrated reductions in both symptoms and use of rescue medication in patients with seasonal and those with perennial AR. Here we appraise evidence for SCIT versus SLIT based on indirect evidence from Cochrane reviews and recent well-powered double-blind, randomized controlled trials versus placebo and the limited direct evidence available from randomized blind head-to-head comparisons. At present, based on an overall balance of efficacy and side effects, the patient is in equipoise. Pending definitive comparative trials, choice might be determined largely by the local availability of SCIT and SLIT products of proved value and personal (patient) preference. PMID:26853126

  15. Subcutaneous Phaeohyphomycosis Due to Pyrenochaeta romeroi Mimicking a Synovial Cyst

    PubMed Central

    Dinh, Aurélien; Levy, Bruno; Bouchand, Frédérique; Davido, Benjamin; Duran, Clara; Cristi, Marin; Felter, Adrien; Salomon, Jérôme; Ait Ammar, Nawel

    2016-01-01

    Opportunistic subcutaneous fungal infections are increasing nowadays due to the growing number of medical conditions causing immunosuppression, especially organ transplant. The incidence rate of subcutaneous phaeohyphomycosis is very low. Most studies found are case reports. They showed a wide variation of clinical presentations. Pyrenochaeta romeroi, a fungus from the Dematiaceae group is a saprophyte found in soil and plants and a possible causative agent of phaeohyphomycosis. We present a rare case of subcutaneous phaeohyphomycosis caused by P. romeroi mimicking a synovial cyst in a diabetic patient.

  16. [Drugs administration by subcutaneous injection within palliative care].

    PubMed

    Tanguy-Goarin, Charlotte; Cogulet, Virginie

    2010-01-01

    Drugs delivery by subcutaneous injection is often the last resort/appeal for a doctor anxious to limit the aggressive and invasive treatments, particularly within palliative care. A review was made to list the drugs which can be administered by this route. Concerned antibiotics are teicoplanin, netilmicin and gentamicin with a risk of skin necrosis for aminoglycosids. Midazolam is useful in various indications and can be associated with morphine in case of dyspnoea. Data about subcutaneous injection of dexamethasone, clonazepam, haloperidol and levomepromazine are published; it is the same for fentanyl, nefopam, ondansetron and metoclopramide. The subcutaneous injection of these quoted drugs is possible, but requires further studies. PMID:21176759

  17. Injection therapy for the management of superficial subcutaneous lipomas.

    PubMed

    Amber, Kyle T; Ovadia, Steven; Camacho, Ivan

    2014-06-01

    Superficial subcutaneous lipomas are common benign tumors of the subcutaneous adipose tissue. Removal of superficial subcutaneous lipomas is achieved with simple surgical excision for the purposes of improved cosmesis, removing painful lipomas, or for the removal of a lipoma affecting function through mass effect. As research in localized fat reduction has improved, therapies successful in this domain have been applied to the management of lipomas as a surgical alternative. In this review article, the authors review the basic science of injection therapies used in the management of lipomas as well as their potential efficacy and limitations. PMID:25013540

  18. Extensive subcutaneous emphysema complicating a percutaneous Mumford procedure.

    PubMed

    Saseendar, Shanmugasundaram; Tan, Si Heng Sharon; Vijayan, Sandeep; Pawaskar, Aditya; Kumar, Veerasingam Prem

    2016-06-01

    Subcutaneous emphysema may be a part of a life-threatening pneumomediastinum or pneumothorax and usually does not occur alone. A case of a 75-year-old lady who underwent a percutaneous Mumford procedure for acromioclavicular osteoarthrosis has been reported. She developed extensive subcutaneous emphysema of the neck, chest, bilateral shoulders, and upper arms, in the absence of pneumomediastinum or pneumothorax, during the procedure. Isolated subcutaneous emphysema as a complication of a percutaneous Mumford procedure has not been reported so far in the English literature. The possible mechanism of this complication is discussed. Understanding the mechanism is essential in avoiding this preventable complication. PMID:25059337

  19. Injection Therapy for the Management of Superficial Subcutaneous Lipomas

    PubMed Central

    Ovadia, Steven; Camacho, Ivan

    2014-01-01

    Superficial subcutaneous lipomas are common benign tumors of the subcutaneous adipose tissue. Removal of superficial subcutaneous lipomas is achieved with simple surgical excision for the purposes of improved cosmesis, removing painful lipomas, or for the removal of a lipoma affecting function through mass effect. As research in localized fat reduction has improved, therapies successful in this domain have been applied to the management of lipomas as a surgical alternative. In this review article, the authors review the basic science of injection therapies used in the management of lipomas as well as their potential efficacy and limitations. PMID:25013540

  20. Left ventricular assist devices in patients with end-stage heart failure: suggestion of an alternative treatment based on clinically well-known concepts.

    PubMed

    Fantidis, Panayotis; Sánchez, Eladio; Tarhini, Ibrahim; Khan, Ijaz; Pineda, Tomas; Corrales, Juan Antonio; González, José Ramón

    2014-11-01

    Encouraging results were obtained by using left ventricular assist devices (LVADs) in patients with end-stage heart failure (HF) that exhibits extremely high mortality and who were not candidates for heart transplantation. By using this so-called destination therapy (DT), a substantial percentage of these patients achieved sufficient improvement in cardiac function to permit the explantation of the device. The combination of mechanical and pharmacological therapy increased the frequency and durability of myocardial recovery as compared with other therapeutic approaches. Although cardiac transplantation, LVADs, and cardiac resynchronization therapy have provided a major advance in DT, their limitations stimulate the search for alternative therapies. We discuss the limitations of these 3 treatment options for end-stage HF. Also, we propose and discuss the possible advantages of a new intracorporeal procedure that works continuously as intraaortic balloon counterpulsation without an extracorporeal or intracorporeal computer-controlled mechanism. PMID:24482491

  1. Injection site reactions after subcutaneous oligonucleotide therapy.

    PubMed

    van Meer, Leonie; Moerland, Matthijs; Gallagher, Jolie; van Doorn, Martijn B A; Prens, Errol P; Cohen, Adam F; Rissmann, Robert; Burggraaf, Jacobus

    2016-08-01

    Oligonucleotides (ONs) are short fragments of nucleic acids, currently being investigated as therapeutic agents. When administered subcutaneously (sc), ONs cause a specific local reaction originating around the injection site, such as erythema, itching, discomfort and pain, including more severe manifestations such as ulceration or necrosis. These injection site reactions (ISRs) are common, but rather poorly described in the literature. With this review, we aim to provide an overview on the extent of the problem of ISRs, based on reported incidence. A structured literature search was performed to identify reported incidence and clinical features of ISRs which yielded 70 manuscripts that contained information regarding ISRs. The data from literature was combined with data on file available at our institution. All sc administered ONs described in the literature lead to the occurrence of ISRs. The percentage of trial subjects that developed ISRs ranged from 22 to 100% depending on ON. The majority of ONs caused ISRs in more than 70% of the trial subjects. The severity of the observed reactions varied between different ONs. Occurrence rate as well as severity of ISRs increases with higher doses. For chemistry and target of the compounds, no clear association regarding ISR incidence or severity was identified. All ONs developed to date are associated with ISRs. Overcoming the problem of ISRs might add greatly to the potential success of sc-administered ONs. Knowledge of these skin reactions and their specific immunostimulatory properties should be increased in order to obtain ONs that are more suitable for long-term use and clinically applicable in a broader patient population. PMID:27061947

  2. Hyaluronidase facilitated subcutaneous immunoglobulin in primary immunodeficiency

    PubMed Central

    Jolles, Stephen

    2013-01-01

    Immunoglobulin (Ig)-replacement therapy represents the mainstay of treatment for patients with primary antibody deficiency and is administered either intravenously (IVIg) or subcutaneously (SCIg). While hyaluronidase has been used in clinical practice for over 50 years, the development of a high-purity recombinant form of this enzyme (recombinant human hyaluronidase PH20) has recently enabled the study of repeated and more prolonged use of hyaluronidase in facilitating the delivery of SC medicines. It has been used in a wide range of clinical settings to give antibiotics, local anesthetics, insulin, morphine, fluid replacement, and larger molecules, such as antibodies. Hyaluronidase has been used to help overcome the limitations on the maximum volume that can be delivered into the SC space by enabling dispersion of SCIg and its absorption into lymphatics. The rate of facilitated SCIg (fSCIg) infusion is equivalent to that of IVIg, and the volume administered at a single site can be greater than 700 mL, a huge increase over conventional SCIg, at 20–40 mL. The use of fSCIg avoids the higher incidence of systemic side effects of IVIg, and it has higher bioavailability than SCIg. Data on the long-term safety of this approach are currently lacking, as fSCIg has only recently become available. fSCIg may help several areas of patient management in primary antibody deficiency, and the extent to which it may be used in future will depend on long-term safety data and cost–benefit analysis.

  3. Application of subcutaneous talc in hernia repair and wide subcutaneous dissection dramatically reduces seroma formation and postoperative wound complications.

    PubMed

    Klima, David A; Brintzenhoff, Rita A; Tsirline, Victor B; Belyansky, Igor; Lincourt, Amy E; Getz, Stanley; Heniford, B Todd

    2011-07-01

    Wound complications after large ventral hernia repairs when combined with wide subcutaneous dissection (OVHR/WSD) are common (33 to 66%). We evaluate a novel technique of applying talc to wound subcutaneous tissues to decrease wound complications. We accessed our prospectively collected surgical outcomes database for OVHR/WSD procedures performed. Patients were divided into those that did and did not receive subcutaneous talc (TALC vs NOTALC). Demographics intraoperative and outcomes data were collected and analyzed. The study included 180 patients (n = 74 TALC, n = 106 NOTALC). Demographics were all similar, but hernias were larger in the TALC group. TALC patients had their drains removed earlier (14.6 vs 25.6 days; P < 0.001) with dramatic reduction in postoperative seromas requiring intervention (20.8 to 2.7%; P < 0.001) and cellulitis (39.0 to 20.6%; P = 0.007). Short-term follow-up demonstrates significantly higher recurrence rates in the NOTALC group with each recurrence related to infection. The use of talc in the subcutaneous space of OVHR/WSD results in significantly earlier removal of subcutaneous drains, fewer wound complications, and a decrease in early hernia recurrence. Use of talc in the subcutaneous space at the time of wound closure is an excellent technique to decrease wound complications in large subcutaneous dissections. PMID:21944353

  4. Pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum and subcutaneous emphysema following diagnostic colonoscopy.

    PubMed

    Marwan, K; Farmer, K C; Varley, C; Chapple, K S

    2007-07-01

    Colonic perforation is an unusual complication of colonoscopy. We present a case of pneumothorax, pneumomediastinum, pneumoperitoneum and extensive subcutaneous emphysema resulting from a diagnostic colonoscopy. To our knowledge, only two such cases have been described previously. PMID:17688713

  5. Use of subcutaneous immunoglobulin in primary immune deficiencies

    PubMed Central

    Aydıner, Elif Karakoç; Kıykım, Ayça; Barış, Safa; Özen, Ahmet; Barlan, Işıl

    2016-01-01

    Aim: Immunoglobulin replacement therapy is required to reduce the frequency and severity of infections in patients with primary antibody deficiencies. Immunoglobulin G (IgG) can be administered intramuscularly, intravenously or subcutaneously. We aimed to evaluate the efficacy, dose adjustment and adverse events in subcutaneous immunoglobulin therapy by retrospectively presenting the records of 16 patients who received subcutaneous immunoglobulin therapy. Material and Methods: The demographic findings, clinical and laboratory findings, subcutaneous immunoglobulin dosage and dose frequency, infusion time, area and methods, adverse events and frequency of infections were obtained from patient files and recorded. Results: Sixteen patients (seven female, nine male) aged between 0–33 years who were diagnosed with primary immune deficiency and treated with subcutaneous immunoglobulin were enrolled. All patients had been receiving intravenous imunoglobulin (5–10%) at a dose of 0.33–1.25 gr/kg/dose with two-four week intervals before subcutaneous immunoglobulin. Subcutaneous immunoglobulin (10%) was administered at a dose of 0.03–0.43 gr/kg/dose with one-two week intervals. No significant difference was found between serum through IgG levels before administration of intravenous imunoglobulin and steady state IgG levels during subcutaneous immunoglobulin therapy. When five patients whose serum through IgG levels were below 600 mg/dL were evaluated, however, a significant increase was found in steady state IgG levels with subcutaneous immunoglobulin therapy (p=0.043). In a ten-month follow-up period, seven infections were observed in four patients (three upper respiratory infectons, two lower respiratory tract infections and three acute gastroenteritis). No acute severe bacterial infection was observed. Local advers reaction was reported in only 10 of 180 infusions (6%). No serious adverse events were reported. All 16 patients were willing to continue IgG replacement

  6. Identification of Mouse Mesenteric and Subcutaneous in vitro Adipogenic Cells

    PubMed Central

    Miyata, Yugo; Otsuki, Michio; Kita, Shunbun; Shimomura, Iichiro

    2016-01-01

    Fat accumulation and the dysfunction of visceral white adipose tissue (WAT), but not subcutaneous WAT, cause abnormalities in whole body metabolic homeostasis. However, no current drugs specifically target visceral WAT. The primary reason for this is that a practical in vitro culture system for mesenteric adipocytes has not been established. To resolve this issue, we sought to identify in vitro adipogenic cells in mesenteric and subcutaneous WATs. First, we examined the expression pattern of surface antigens in stromal-vascular fraction (SVF) cells from mouse mesenteric and subcutaneous WATs, and found the expression of 30 stem cell-related surface antigens. Then, to evaluate the adipogenic ability of each fraction, we performed in vitro screening, and identified five candidate markers for mesenteric adipogenic cells and one candidate marker for subcutaneous adipogenic cells. To investigate whether in vitro adipogenic ability accurately reflects the conditions in vivo, we performed transplantation experiments, and identified CD9− CD201+ Sca-1− cells and CD90+ cells as mesenteric and subcutaneous in vitro adipogenic cells, respectively. Furthermore, mature adipocytes derived from mesenteric and subcutaneous adipogenic cells maintained each characteristic phenotype in vitro. Thus, our study should contribute to the development of a useful culture system for visceral adipocytes. PMID:26884347

  7. Subcutaneous sarcoidosis: a clinical analysis of nine patients.

    PubMed

    Ando, Masaru; Miyazaki, Eishi; Hatano, Yutaka; Nishio, Suehiro; Torigoe, Chihiro; Yamasue, Mari; Mukai, Yutaka; Nureki, Shin-Ichi; Kadota, Jun-Ichi

    2016-09-01

    Subcutaneous sarcoidosis is the specific subset of cutaneous sarcoidosis frequently associated with systemic disease. However, the disease activity, severity, and prognosis have not yet been elucidated due to the limited number of reported cases. The purpose of this study was to identify the clinical, laboratory, and prognostic differences between subcutaneous sarcoidosis and other type of cutaneous sarcoidosis. All patients with sarcoidosis diagnosed histopathologically from 2000 to 2012 at our institution were enrolled. The clinical, laboratory, chest X-ray, and pulmonary function test results were retrospectively evaluated in the patients with cutaneous sarcoidosis. In the 130 patients with sarcoidosis, cutaneous sarcoidosis was diagnosed in 37 patients (28.4 %), and 9 (6.9 %) of these patients had subcutaneous sarcoidosis. The serum levels of soluble interleukin-2 receptor (sIL-2R) were significantly elevated in the group of patients with subcutaneous sarcoidosis in comparison to the patients with other types of cutaneous sarcoidosis, whereas there was no significant difference in the severity score between the two groups. Following a 2-year observation period, three patients were in remission, five patients demonstrated stable disease, and one patient had progressive disease. Subcutaneous sarcoidosis may be associated with the disease activity, although it was not found to be associated with the disease severity and it was not a predictive factor for the prognosis. Furthermore, the prevalence of subcutaneous sarcoidosis may be higher than that in previously reported series. PMID:27449952

  8. Fabrication of subcutaneous veins phantom for vessel visualization system

    NASA Astrophysics Data System (ADS)

    Cheng, Kai; Narita, Kazuyuki; Morita, Yusuke; Nakamachi, Eiji; Honda, Norihiro; Awazu, Kunio

    2013-09-01

    The technique of subcutaneous veins imaging by using NIR (Near Infrared Radiation) is widely used in medical applications, such as the intravenous injection and the blood sampling. In the previous study, an automatic 3D blood vessel search and automatic blood sampling system was newly developed. In order to validate this NIR imaging system, we adopted the subcutaneous vein in the human arm and its artificial phantom, which imitate the human fat and blood vessel. The human skin and subcutaneous vein is characterized as the uncertainty object, which has the individual specificity, non-accurate depth information, non-steady state and hardly to be fixed in the examination apparatus. On the other hand, the conventional phantom was quite distinct from the human's characteristics, such as the non-multilayer structure, disagreement of optical property. In this study, we develop a multilayer phantom, which is quite similar with human skin, for improvement of NIR detection system evaluation. The phantom consists of three layers, such as the epidermis layer, the dermis layer and the subcutaneous fat layer. In subcutaneous fat layer, we built a blood vessel. We use the intralipid to imitate the optical scattering characteristics of human skin, and the hemoglobin and melanin for the optical absorption characteristics. In this study, we did two subjects. First, we decide the fabrication process of the phantom. Second, we compared newly developed phantoms with human skin by using our NIR detecting system, and confirm the availability of these phantoms.

  9. Oral, subcutaneous, and intravenous pharmacokinetics of ondansetron in healthy cats

    PubMed Central

    Quimby, J. M.; Lake, R. C.; Hansen, R. J.; Lunghofer, P. J.; Gustafson, D. L.

    2014-01-01

    Ondansetron is a 5-HT3 receptor antagonist that is an effective anti-emetic in cats. The purpose of this study was to evaluate the pharmacokinetics of ondansetron in healthy cats. Six cats with normal complete blood count, serum biochemistry, and urinalysis received 2 mg oral (mean 0.43 mg/kg), subcutaneous (mean 0.4 mg/kg), and intravenous (mean 0.4 mg/kg) ondansetron in a cross-over manner with a 5-day wash out. Serum was collected prior to, and at 0.25, 0.5, 1, 2, 4, 8, 12, 18, and 24 h after administration of ondansetron. Ondansetron concentrations were measured using liquid chromatography coupled to tandem mass spectrometry. Noncompartmental pharmacokinetic modeling and dose interval modeling were performed. Repeated measures anova was used to compare parameters between administration routes. Bioavailability of ondansetron was 32% (oral) and 75% (subcutaneous). Calculated elimination half-life of ondansetron was 1.84 ± 0.58 h (intravenous), 1.18 ± 0.27 h (oral) and 3.17 ± 0.53 h (subcutaneous). The calculated elimination half-life of subcutaneous ondansetron was significantly longer (P < 0.05) than oral or intravenous administration. Subcutaneous administration of ondansetron to healthy cats is more bioavailable and results in a more prolonged exposure than oral administration. This information will aid management of emesis in feline patients. PMID:24330064

  10. Oral, subcutaneous, and intravenous pharmacokinetics of ondansetron in healthy cats.

    PubMed

    Quimby, J M; Lake, R C; Hansen, R J; Lunghofer, P J; Gustafson, D L

    2014-08-01

    Ondansetron is a 5-HT3 receptor antagonist that is an effective anti-emetic in cats. The purpose of this study was to evaluate the pharmacokinetics of ondansetron in healthy cats. Six cats with normal complete blood count, serum biochemistry, and urinalysis received 2 mg oral (mean 0.43 mg/kg), subcutaneous (mean 0.4 mg/kg), and intravenous (mean 0.4 mg/kg) ondansetron in a cross-over manner with a 5-day wash out. Serum was collected prior to, and at 0.25, 0.5, 1, 2, 4, 8, 12, 18, and 24 h after administration of ondansetron. Ondansetron concentrations were measured using liquid chromatography coupled to tandem mass spectrometry. Noncompartmental pharmacokinetic modeling and dose interval modeling were performed. Repeated measures anova was used to compare parameters between administration routes. Bioavailability of ondansetron was 32% (oral) and 75% (subcutaneous). Calculated elimination half-life of ondansetron was 1.84 ± 0.58 h (intravenous), 1.18 ± 0.27 h (oral) and 3.17 ± 0.53 h (subcutaneous). The calculated elimination half-life of subcutaneous ondansetron was significantly longer (P < 0.05) than oral or intravenous administration. Subcutaneous administration of ondansetron to healthy cats is more bioavailable and results in a more prolonged exposure than oral administration. This information will aid management of emesis in feline patients. PMID:24330064

  11. Absorption Kinetics of Subcutaneously Administered Ceftazidime in Hypoperfused Guinea Pigs

    PubMed Central

    Ebihara, Tsuyoshi; Oshima, Shinji; Okita, Mitsuyoshi; Shiina, Sayumi; Negishi, Akio; Ohara, Kousuke; Ohshima, Shigeru; Iwasaki, Hiroyuki; Yoneyama, Akira; Kitazumi, Eiji; Kobayashi, Daisuke

    2014-01-01

    Background Pneumonia is the most common cause of death in patients with severe motor and intellectual disabilities (SMID), and intravenous ceftazidime (CAZ) is a widely used treatment for such infections. However, intravenous administration in patients with SMID may be difficult because of insufficient vascular development. Objectives The aim of our study was to determine the feasibility of subcutaneous drug administration by mentholated warm compresses (WMCs) as an alternative delivery method for ceftazidime in patients with SMID. Methods CAZ was subcutaneously administered to the abdominal region of naphazoline-treated hypoperfused guinea pigs, which were used as a hemodynamic model of patients with SMID. MWCs or warm compresses (WCs) were applied to the injection site to increase blood flow. We calculated the cumulative CAZ absorption over time by using the deconvolution method. Results Application of MWCs or WCs increased blood flow at the administration site and increased CAZ plasma levels. Application of MWCs or WCs after subcutaneous CAZ injection led to higher CAZ plasma levels than the mutant prevention concentration for a longer period than was observed for CAZ administration without the application of MWCs or WCs. Conclusions The application of MWCs or WCs enhanced subcutaneous CAZ absorption by increasing blood flow. MWCs and WCs are considered to be safe and routine methods to induce defecation after surgery on the digestive system; thus, the combination of these methods and subcutaneous CAZ administration is a potential method for treating pneumonia in patients with SMID. PMID:26649076

  12. [Measles and subcutaneous emphysema. Presentation of 3 cases].

    PubMed

    Montesano-Delfín, J R; Mascareñas-Ponce, A

    1991-03-01

    This is a three case study report of children with measles which later progressed to bronchopneumonia and subcutaneous emphysema. All three children were from farming families, and none had been previously vaccinate against measles. For a period of six months, 183 cases of measles were treated at our hospital of which only three worsened to subcutaneous emphysema, demonstrating an incidence rate of 1.6%; they also showed to have bronchopneumonia, with severe coughing episodes; which made us recall the possible physiopathology principle of the pressure gradient theory behind this complication proposed by Bloch in 1968. The factors related to our patients suggested a more severe and aggresive type of measles with a greater probability of having complications. The prognostic value of the severity of this type of measles in the presence of subcutaneous emphysema is limited and its management should be primarly focused on treating the added bronchial problem. PMID:2064747

  13. Subcutaneous fluid administration and the hydration of older people.

    PubMed

    Gabriel, Janice

    Hypodermoclysis, or the subcutaneous administration of fluids, is a method of rehydration that is not routinely used in the UK. Yet it is a simple and effective method of fluid administration for individuals with mild-to-moderate dehydration, especially for the frail and elderly (Sasson and Shvartzman, 2001). Subcutaneous infusion is an alternative route of parenteral administration. It provides a number of advantages over the intravenous route for those individuals unable to tolerate enteral fluids, as it is associated with fewer complications, as well as a wider range of infusion sites. This makes it particularly advantageous for frail and/or older patients requiring low-volume hydration in the community setting. This article discusses indications and contraindications for subcutaneous infusions, as well as patient assessment, placement, securement and potential complications. PMID:25158361

  14. Subcutaneous fluid administration and the hydration of older people.

    PubMed

    Gabriel, Janice

    2014-07-01

    Hypodermoclysis, or the subcutaneous administration of fluids, is a method of rehydration that is not routinely used in the UK. Yet it is a simple and effective method of fluid administration for individuals with mild-to-moderate dehydration, especially for the frail and elderly ( Sasson and Shvartzman, 2001 ). Subcutaneous infusion is an alternative route of parenteral administration. It provides a number of advantages over the intravenous route for those individuals unable to tolerate enteral fluids, as it is associated with fewer complications, as well as a wider range of infusion sites. This makes it particularly advantageous for frail and/or older patients requiring low-volume hydration in the community setting. This article discusses indications and contraindications for subcutaneous infusions, as well as patient assessment, placement, securement and potential complications. PMID:25062366

  15. Cutaneous and Subcutaneous Metastases From Atypical Laryngeal Carcinoids

    PubMed Central

    Wang, Kui-Rong; Jia, Yuan-Jing; Zhou, Shui-Hong; Wang, Qin-Ying; Bao, Yang-Yang; Feng, Zhi-Ying; Yao, Hong-Tian; Fan, Jun

    2016-01-01

    Abstract The incidence of cutaneous and subcutaneous metastases from atypical laryngeal carcinoids is approximately 20%. However, the pathogenesis and natural history of, and prognostic factors for, the condition remain poorly understood. We reported a 54-year-old female presented with cutaneous and subcutaneous metastases from atypical laryngeal carcinoid. Laryngoscopy revealed a 0.5 × 1.5-cm reddish mass on the laryngeal surface of the epiglottis. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy. Routine pathology revealed atypical laryngeal carcinoid. Immunohistochemical staining of the sections of primary tumor was positive for cytokeratin, chromogranin A, synaptophysin, hypoxia-inducible factor-1α, P53, and CD56. GLUT-1, p-Akt, and PI3K were negative. The Ki-67 index was 15%. Supraglottic laryngectomy and selective right-neck dissection were performed. After 6 months, the patient complained of pain in the right wall of the chest; multiple cutaneous and subcutaneous nodules were evident at that site and in the abdomen. An abdominal nodule was biopsied and pathology revealed that the atypical metastatic carcinoid had metastasized to both cutaneous and subcutaneous areas of the abdomen. Chemotherapy was then prescribed. Currently, the intrathecal drug delivery system remains in place. No local recurrence has been detected. Furthermore, we systematically reviewed clinical manifestations of the disease, pathogenesis, prognostic factors, and treatment. The metastasis rate (cutaneous and subcutaneous) was approximately 12.2%. Thirty patients (62.5%) with cutaneous and subcutaneous metastases exhibited contemporaneous lymph node invasion. The 3-, 5-, and 10-year survival rates were 44.0%, 22.0%, and 13.0%, respectively. The prognosis of patients with atypical laryngeal carcinoids was poor. Relevant prognostic factors included the level of p53, human papilloma virus status, certain hypoxic markers, and distant metastasis. No

  16. Magnetic resonance imaging in patients with a subcutaneous implantable cardioverter-defibrillator

    PubMed Central

    Keller, Jiří; Neužil, Petr; Vymazal, Josef; Janotka, Marek; Brada, Jiří; Žáček, Radovan; Vopálka, Roman; Weichet, Jiří; Reddy, Vivek Y.

    2015-01-01

    Aims Our aim was to evaluate the potential for safely imaging patients with a new type of implantable cardioverter-defibrillator called the subcutaneous implantable cardioverter-defibrillator (S-ICD) in a 1.5 T magnetic resonance imaging (MRI) scanner. With the increasing number of patients with cardiac implantable devices who are indicated for MRI, there is a growing need for establishing MRI compatibility of cardiac implantable devices. Methods and Results Patients with implanted S-ICD systems underwent one or more types of anatomical MRI scans. The S-ICD was programmed off and patients were monitored throughout the imaging procedure. Device function was evaluated pre- and post-scan. Patients were asked to report immediately any pain, torqueing movement, or heating sensation in the area of the pocket or electrode. Fifteen patients underwent a total of 22 examinations at 1.5 T. Scans included brain, spine, knee, and heart. Two patients were re-scanned due to complaints of heating over the can during lumbar scans, which was caused by a thermistor probe placed on the skin to measure skin temperature. All the remaining scans occurred without incident. No evidence of device malfunction was observed. Conclusion This study is the first to domonstrate the feasibility of exposing S-ICD patients to MRI using the scanning and monitoring protocol described. More data are required to support S-ICD as a MRI conditional device. PMID:25687749

  17. Anisotropic bioelectrical impedance determination of subcutaneous fat thickness

    NASA Astrophysics Data System (ADS)

    Hernández-Becerra, P. A. I.; Delgadillo-Holtfort, I.; Balleza-Ordaz, M.; Huerta-Franco, M. R.; Vargas-Luna, M.

    2014-11-01

    Preliminary results have shown that bioelectrical impedance measurements performed on different parts of the human body strongly depend upon the subcutaneous fat of the considered region. In this work, a method for the determination of subcutaneous fat thickness is explored. Within this method the measurement of the bioelectrical impedance response of the fat-muscle system, both along the direction defined by the muscle fibers and along the corresponding perpendicular direction, are performed. Measurements have been carried out on human female and male subjects of ages around 25 years old at the region of the biceps. Correlation has been performed with skinfold caliper measurements.

  18. Low-cost near-infrared measurement of subcutaneous fat for newborn malnutrition

    NASA Astrophysics Data System (ADS)

    McEwan, A. L.; Bian, S.; Gargiulo, G. D.; Morhard, R.; Jones, P.; Mustafa, F. H.; Bek, B. Emily; Jeffery, H. E.

    2014-04-01

    Low fat composition in newborns exposes them to an immediate risk of increased mortality and morbidity, inhibited physical and cognitive development and to diabetes and obesity diseases in later life. Information about nutritional and dietary status of newborns can be accessed by measuring the amount of fat composition in the body. The functions of subcutaneous fat involve energy storage, thermo-insulation and a physical buffer. Current technologies for newborn body fat monitoring are: a device based on air displacement plethesmography (PeaPod), dual-energy Xray, and underwater weighting. However they are bulky, expensive, immobile, and require technical expertise. We propose an alternative portable measurement system of in-vitro for subcutaneous fat that uses diffuse near-infrared light reflectance measurement system. We also introduce an in-vitro three-layered tissue model mimicking the subcutaneous fat layer in newborns together with a preliminary study to measure fat using dual-wavelength nearinfrared light. Based on the output data from these measurements, we have proposed a suitable transmission and scattering model. This model estimated the amount of reflected light collected by a photodetector after incident light is scattered in several fat layers. Our portable sensor is low cost and does not require training hence it is suitable for mass use in the developing world. It consists of a single LED and two photodetectors (900 nm and 1000 nm). The photodetectors wavelengths were chosen to be sensitive to fat as it exhibits a peak in the wavelength at 930 nm and to water at which exhibits a peak at 980 nm; the latter is used, to remove hydration bias. Results on a porcine tissue model demonstrate differentiation as low as 2 mm fat which is a relevant screening thickness to indicate low percentage body fat.

  19. Subcutaneous phaeohyphomycosis due to Phialemoniopsis ocularis successfully treated by voriconazole

    PubMed Central

    Desoubeaux, Guillaume; García, Dania; Bailly, Eric; Augereau, Olivier; Bacle, Guillaume; De Muret, Anne; Bernard, Louis; Cano-Lira, José F.; Garcia-Hermoso, Dea; Chandenier, Jacques

    2014-01-01

    We report a case of subcutaneous infection in a 67 year-old Cambodian man who presented with a 5-month history of swelling of the right foot. Histopathology was compatible with phaeohyphomycosis and the hyphomycete Phialemoniopsis ocularis was identified by the means of morphological and molecular techniques. The patient responded well to a 6-month oral treatment with voriconazole alone. PMID:24936402

  20. Localized interstitial granuloma annulare induced by subcutaneous injections for desensitization.

    PubMed

    Spring, Philipp; Vernez, Maxime; Maniu, Christa-Maria; Hohl, Daniel

    2013-06-01

    We describe a patient with interstitial granuloma annulare associated with subcutaneous injection therapy (SIT) for desensitization to a type I allergy. Asymptomatic, erythematous, violaceous annular patches were located at the injection sites on both her arms. Medical history revealed perennial rhinoconjonctivitis treated with SIT (Phostal Stallergen® cat 100% and D. pteronyssinus/D.farinae 50%:50%). PMID:24011321

  1. Nitroxynil. Anthelmintic activity in cattle following subcutaneous injection.

    PubMed

    Wellington, A C

    1978-07-01

    Nitroxynil injected subcutaneously at 10 mg/kg live mass achieved Class A efficacy when evaluated by the non parametric method against adult Fasciola gigantica. Haemonchus placei, Bonustomum phlebotomum and Oesophagostomum radiatum in cattle. The compound was not effective against adult Cooperia spp. at the same dosage. PMID:569707

  2. Efficacy and tolerability of 16% subcutaneous immunoglobulin compared with 20% subcutaneous immunoglobulin in primary antibody deficiency.

    PubMed

    Niebur, H B; Duff, C M; Shear, G F; Nguyen, D; Alberdi, T K; Dorsey, M J; Sleasman, J W

    2015-09-01

    Multiple subcutaneous immunoglobulin (SCIG) products are available to treat primary antibody deficiency (PAD). The efficacy and tolerability of 16% SCIG (Vivaglobin(®) ) was compared with 20% SCIG (Hizentra(®) ) in PAD subjects. The study was a prospective, single-centre, open-label study of PAD subjects transitioning Vivaglobin to equivalent Hizentra doses, rounded to the nearest vial size. Comparisons included immunoglobulin (Ig)G levels; tetanus, varicella and Streptococcus pneumoniae titres; adverse events (AEs), annual infection rate and quality of life during 8 weeks of Vivaglobin and 24 weeks of Hizentra. Thirty-two subjects (aged 2-75 years) participated. Rounding to the nearest Hizentra vial size resulted in a 12·8% (± 2·9%) increase in SCIG dose. Median immunoglobulin (Ig)G level following 8 weeks of Vivaglobin was similar to 24 weeks of Hizentra (1050 versus 1035 mg/dl, respectively; P = 0·77). Both products had similar protective titres to tetanus, varicella and serotypes of S. pneumoniae, which were variable but well above protective levels. After 12 weeks of Hizentra, subjects reported fewer local site reactions compared with Vivaglobin. Switching products resulted in increased systemic AEs in some subjects but, overall, not significantly higher than during Vivaglobin treatment. Average infusion time decreased from 104·7 min (3·3 sites) with Vivaglobin to 70·7 min (2·2 sites) with Hizentra (P = 0·0005). Acute serious bacterial infections were similar. Treatment satisfaction was superior with Hizentra. Hizentra and Vivaglobin have similar pharmacokinetics and efficacy. Although transition to a different SCIG product initially increased AEs, Hizentra is well tolerated and can be infused more rapidly and with fewer sites compared to Vivaglobin. PMID:25761372

  3. Deep subcutaneous adipose tissue is more saturated than superficial subcutaneous adipose tissue.

    PubMed

    Lundbom, J; Hakkarainen, A; Lundbom, N; Taskinen, M-R

    2013-04-01

    Upper body abdominal subcutaneous adipose tissue (SAT) can be divided into deep SAT (DSAT) and superficial SAT (SSAT) depots. Studies on adipose tissue fatty acid (FA) composition have made no distinction between these two depots. The aim of this study is to determine whether DSAT and SSAT differ in FA composition. We studied the FA composition of DSAT and SSAT in 17 male and 13 female volunteers using non-invasive proton magnetic resonance spectroscopy in vivo. Magnetic resonance imaging was used to differentiate between DSAT and SSAT. Adipose tissue spectra were analysed for lipid unsaturation, or double bond (DB) content, and polyunsaturation (PU), according to previously validated methods. The DSAT depot was more saturated than the SSAT depot, in both men (0.833 ± 0.012 vs 0.846 ± 0.009 DB, P<0.002) and women (0.826 ± 0.018 vs 0.850 ± 0.018 DB, P<0.002). In contrast, PU did not differ between DSAT and SSAT in either men (0.449 ± 0.043 vs 0.461 ± 0.044 PU, P=0.125) or women (0.411 ± 0.070 vs 0.442 ± 0.062 PU, P=0.234) and displayed a close correlation between the depots (R=0.908, P<0.001, n=30). The higher saturation in DSAT compared with SSAT can be attributed to a higher ratio of saturated to monounsaturated FAs. These results should be taken into account when determining the FA composition of SAT. PMID:22641063

  4. Devices for insulin administration.

    PubMed

    Selam, J L; Charles, M A

    1990-09-01

    There is a significant need for revised, safe, and more effective insulin-delivery methods than subcutaneous injections in the treatment of both type I (insulin-dependent) and type II (non-insulin-dependent) diabetes. The aim of this review is to describe the rationale and methods for better use of injection and infusion devices for intensive insulin therapy and to describe results of animal and human research that will lead to an implantable artificial pancreas. Injection devices, e.g., jet injectors, insulin pens, and access ports, cannot be considered as a major breakthrough in the quest for improved control, although they may improve the patient's comfort. External pumps have benefits over multiple injections and conventional insulin therapy only in specific subgroups of patients, e.g., those with recurrent severe hypoglycemia, but only when used by experienced personnel. The external artificial pancreas (Biostator) is also to be used by experienced personnel for limited clinical and research applications, e.g., surgery of the diabetic patient. The development of an implantable version of the artificial pancreas is linked to progress in the field of reliable long-duration glucose sensors. Finally, programmable implantable insulin pumps, used as an open-loop delivery system, are the most promising alternative to intensive subcutaneous insulin strategies in the short term, although clear evidence of improved safety and efficacy remains to be documented. PMID:2226111

  5. Devices for the treatment of diabetes: today.

    PubMed

    Scheen, A J

    1992-04-01

    Although single or multiple daily subcutaneous injections of insulin with syringes are the mainstay of insulin delivery techniques for the treatment of diabetes mellitus, several other methods are now available. The present paper will review the main problems occurring with the classical subcutaneous insulin therapy and the possible solutions given by the use of new devices, including more particularly insulin jet injectors, pens, and portable pumps. This review has to be considered as an introduction to the presentations of this symposium devoted to implantable pumps, glucose sensors, and artificial pancreas, respectively. PMID:10078238

  6. Automated Discrimination Method of Muscular and Subcutaneous Fat Layers Based on Tissue Elasticity

    NASA Astrophysics Data System (ADS)

    Inoue, Masahiro; Fukuda, Osamu; Tsubai, Masayoshi; Muraki, Satoshi; Okumura, Hiroshi; Arai, Kohei

    Balance between human body composition, e.g. bones, muscles, and fat, is a major and basic indicator of personal health. Body composition analysis using ultrasound has been developed rapidly. However, interpretation of echo signal is conducted manually, and accuracy and confidence in interpretation requires experience. This paper proposes an automated discrimination method of tissue boundaries for measuring the thickness of subcutaneous fat and muscular layers. A portable one-dimensional ultrasound device was used in this study. The proposed method discriminated tissue boundaries based on tissue elasticity. Validity of the proposed method was evaluated in twenty-one subjects (twelve women, nine men; aged 20-70 yr) at three anatomical sites. Experimental results show that the proposed method can achieve considerably high discrimination performance.

  7. Effects of a hyperbaric environment on subcutaneous adipose tissue topography (SAT-top).

    PubMed

    Möller, Reinhard; Horejsi, Renate; Tafeit, Erwin; Fraidl, Michaela; Dietmaier, Gabriele; Anegg, Udo; Klemen, Huberta; Wallner-Liebmann, Sandra

    2010-12-01

    The physiological reactions of the body in scuba diving situation can be simulated in a pressure chamber by increasing the ambient pressure. In this study the influence of a hyperbaric environment of 6 bar on the changes of the subcutaneous adipose tissue (SAT) thicknesses on different body sites in 68 voluntary men with undersea diving experience was investigated. Measurements of SAT-topography (SAT-Top) were performed with the optical device Lipometer before and after hyperbaric exposure. We observed a significant increase of the SAT-layers of the upper body zones, upper abdomen (+24.5%), lower abdomen (+21%) and front chest (+19%) after hyperbaric exposure. This increase of volume can be assumed to the nitrogen accumulation in fat cells at increased ambient pressures. In conclusion we describe for the first time in detail the influence of a hyperbaric environment on quantitative and topographic changes of SAT. PMID:21874714

  8. Conductivities of epidermis, dermis, and subcutaneous tissue at intermediate frequencies.

    PubMed

    Wake, K; Sasaki, K; Watanabe, S

    2016-06-21

    Novel data for the conductivities of the tissues composing the skin, which are the epidermis, dermis and subcutaneous tissue, were obtained at intermediate frequencies by in vitro measurement. The conductivity of the epidermis was determined from those of the dermis and bulk skin. The conductivities of the dermis and subcutaneous tissue were almost constant from 10 kHz to 1 MHz. On the other hand, a frequency dependence was observed for the epidermis; the conductivity decreases with decreasing frequency. It was found that the conductivity of bulk skin is not determined by that of the dermis but by that of the epidermis. The presented data are expected to contribute to the assessment of safety and to the research and development of medical applications. PMID:27224275

  9. Cyclosporin in subcutaneous panniculitis-like T-cell lymphoma.

    PubMed

    Rojnuckarin, Ponlapat; Nakorn, Thanyaphong Na; Assanasen, Thamathorn; Wannakrairot, Pongsak; Intragumtornchai, Tanin

    2007-03-01

    Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare form of hematologic malignancy characterized by lesions in subcutaneous fat associated with systemic symptoms. The standard treatment of the disease, currently, is not established, but CHOP or CHOP-like regimens are usually given. We report, herein, 4 cases of SPTCL diagnosed by histopathology and immunohistochemistry who were refractory to CHOP and/or ESHAP and/or fludarabine-based regimen, but showed rapid improvement within weeks after oral cyclosporin 4 mg/kg/day. Three sustained complete remission for the durations of 8 - 9 months off-treatments. T-cell receptor gene rearrangement revealed polyclonality in 3 cases and monoclonality in 1 case. Our data suggest the benefit of incorporating cyclosporin into the treatment regimen for SPTCL. PMID:17454599

  10. Pneumomediastinum, subcutaneous emphysema and pneumorrhachis in asthmatic children.

    PubMed

    Colavita, L; Cuppari, C; Pizzino, M R; Sturiale, M; Mondello, B; Monaco, F; Barone, M; Salpietro, C

    2016-01-01

    Pneumomediastinum (PM), subcutaneous emphysema (SE) and pneumorrhachis (also known as epidural air (EDA) or epidural emphysema) are very rare findings in children. PM is defined as the passage of air from intra-alveolar space to interstitium and, later, to the mediastinum. From the mediastinum, the air may catch up subcutaneous tissue (usually of the neck) and/or epidural space via the cervical fascial planes and neural foramina, forming respectively SE and EDA. The PM can be divided in spontaneous (or idiopathic) and secondary PM. Only few studies have evaluated the exact incidence of PM and its complications in children, and to define the correct diagnostic work up, treatment and outpatient follow-up. We report the case of a 9-year-old child with undiagnosed asthma that, during severe asthmatic flare secondary to acute infection of high airway, developed PM, SE and EDA. PMID:27358152

  11. Subcutaneous emphysema: diagnostic clue in the emergency room.

    PubMed

    Martí de Gracia, Milagros; Gutiérrez, Félix Guerra; Martínez, Marta; Dueñas, Virginia Pérez

    2009-09-01

    The objective of this study was to illustrate the wide spectrum of subcutaneous emphysema in the emergency room; to show the key findings on computed tomography, plain radiographs, and echography; and to discuss the differential diagnoses. Subcutaneous emphysema is a common finding in emergency department imaging studies. It has a great importance due to its broad casualty, some of them totally benign, but others potentially lethal. We retrospectively reviewed our database of emergency pathology, analyzing its origins and associated features. SE was associated to traumatic, iatrogenic, or infectious causes (necrotizing fasciitis, Fournier gangrene). It also was found associated with thoracic (causing pneumothorax and pneumomediastinum) and abdominal pathology related to intraperitoneal and retroperitoneal gas. Diagnostic difficulties and differential diagnoses are emphasized. Radiologists must be aware of abnormal gas in soft tissue because it may be the main or unique sign leading to an underlying pathology, which can be lethal. PMID:19184143

  12. Disseminated subcutaneous Mycobacterium fortuitum infection in a dog.

    PubMed

    Fox, L E; Kunkle, G A; Homer, B L; Manella, C; Thompson, J P

    1995-01-01

    A 15-month-old 27.7-kg sexually intact male Doberman Pinscher was examined because of multiple subcutaneous abscesses on the neck, trunk, and limbs that developed 2 months after a dog bite and were refractory to antibiotic treatment. Incubation of a biopsy specimen at 37 C on a Lowenstein-Jensen agar slant for 8 days yielded growth of a Runyon's Group IV mycobacterium, and disseminated subcutaneous Mycobacterium sp infection was diagnosed. The organism was identified as M fortuitum, and was susceptible to amikacin, doxycycline, cefoxitin, minocycline, trimethoprim/sulfadiazine, and sulfisoxazole. Lesions resolved after 8 months of treatment with doxycycline (5 mg/kg of body weight, PO, q 12 h). The cause of dissemination was unknown; however, delay in debridement of the bite wound and corticosteroid use in initial wound management may have potentiated dissemination. PMID:7744663

  13. Pharmaceutical amyloidosis associated with subcutaneous insulin and enfuvirtide administration

    PubMed Central

    D’Souza, Anita; Theis, Jason D.; Vrana, Julie A.; Dogan, Ahmet

    2014-01-01

    Protein and peptide drugs administered subcutaneously, such as insulin can be amyloidogenic and result in localized amyloid deposits at the sites of medication injections. These iatrogenic amyloidoses typically present as a localized subcutaneous nodule or skin reaction at the site of administration, and often pose diagnostic challenges. We have analyzed the amyloid proteome in 52 cases of insulin and enfuvirtide associated amyloidosis using laser microdissection/tandem mass spectrometry. We show that the deposits are composed of the drug, as well as other amyloid precursor proteins such as apolipoproteins A-I, A-IV, E and serum amyloid protein. Mass spectrometry-based amyloid sub-typing allows for accurate amyloid diagnosis with resultant therapeutic and prognostic implications. This insight into the amyloid proteome in drug-induced amyloidosis may help further understand pathogenesis of amyloid fibril formation. PMID:24446896

  14. Subcutaneous administration of carrier erythrocytes: slow release of entrapped agent

    SciTech Connect

    DeLoach, J.R.; Corrier, D.E.

    1988-08-01

    Carrier erythrocytes administered subcutaneously in mice release encapsulated molecules at the injection site and through cells that escape the injection site. One day postinjection, the efflux of encapsulated (/sup 14/C)sucrose, (/sup 3/H)inulin, and /sup 51/Cr-hemoglobin from the injection site was 45, 55, and 65%, respectively. Intact carrier erythrocytes escaped the injection site and entered the blood circulation carrying with them the encapsulated molecules. Most of the encapsulated (/sup 3/H)inulin that reached whole blood circulated within erythrocytes. Small but measurable numbers of encapsulated molecules were trapped within lymph nodes. Subcutaneous injection of carrier erythrocytes may allow for limited extravascular tissue targeting of drugs.

  15. Subcutaneous Injection of Mercury: “Warding Off Evil”

    PubMed Central

    Prasad, Venkat L.

    2004-01-01

    Deliberate injection of mercury, especially subcutaneous injection, is rare but is seen in psychiatric patients, individuals who attempt suicide, those who are accidentally injected, and boxers who wish to build muscle bulk. Metallic mercury plays a major role in ethnic folk medicine. Neurologic and renal complications can result from high systemic levels of mercury, and subcutaneous injection usually results in sterile abscesses. Urgent surgical evacuation and close monitoring for neurologic and renal functions as well as chelation (if toxicity is indicated) are key aspects of treatment. Education of the adverse effects and dangers of mercury is important, especially in pregnant women and children. As increased immigration changes demographic patterns, proper disposal of mercury and preventing its sale and use should become urgent societal priorities. Psychiatric consultation should be obtained whenever appropriate. PMID:15345347

  16. [Subcutaneous emphysema as a complication of tooth extraction].

    PubMed

    Vacić, Aca

    2004-01-01

    Subcutaneous emphysema is a rare complication in dentistry, which may lead to diagnostic errors and inadequate therapy. A 17 year old female patient, in whom the separation of tooth roots was performed by the use of air-powered drill during the extraction of the first right lower molar, is presented in this paper. During the intervention, swelling of the right half of the face and the lower eyelid suddenly occurred, accompanied with simultaneous feeling of choking, and pressure in the neck and chest. Because of the suspicion of the allergic reaction, the patient was administered antihistaminic agent, together with parenteral corticosteroid, and was sent to an institution where she was treated as an in-patient. During hospitalization, subcutaneous emphysema of the face and neck was diagnosed by physical and x-ray examination. The emphysema completely disappeared after the use of oxygen and antibiotics. PMID:15552542

  17. Conductivities of epidermis, dermis, and subcutaneous tissue at intermediate frequencies

    NASA Astrophysics Data System (ADS)

    Wake, K.; Sasaki, K.; Watanabe, S.

    2016-06-01

    Novel data for the conductivities of the tissues composing the skin, which are the epidermis, dermis and subcutaneous tissue, were obtained at intermediate frequencies by in vitro measurement. The conductivity of the epidermis was determined from those of the dermis and bulk skin. The conductivities of the dermis and subcutaneous tissue were almost constant from 10 kHz to 1 MHz. On the other hand, a frequency dependence was observed for the epidermis; the conductivity decreases with decreasing frequency. It was found that the conductivity of bulk skin is not determined by that of the dermis but by that of the epidermis. The presented data are expected to contribute to the assessment of safety and to the research and development of medical applications.

  18. Ectopic (subcutaneous) Paragonimus miyazakii infection in a dog.

    PubMed

    Madarame, H; Suzuki, H; Saitoh, Y; Tachibana, M; Habe, S; Uchida, A; Sugiyama, H

    2009-09-01

    Ectopic infection with Paragonimus miyazakii was determined to be the cause of a subcutaneous inguinal mass in a 15-month-old, male, boar-hunting dog. On histologic examination, the mass comprised granulomatous panniculitis, intralesional adult trematodes and eggs, and lymphadenitis. Extrapulmonary paragonimosis in animals is rare. This appears to be the first report in a dog of ectopic P. miyazakii infection with mature trematodes and eggs that involved the inguinofemoral lymphocenter and surrounding subcutis. PMID:19429999

  19. Pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema complicating acute silicosis.

    PubMed

    Dixit, Ramakant; Meena, Manoj; Patil, Chetan B

    2015-01-01

    A case of acute silicosis complicating as spontaneous pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema is described in a 35-year-old male engaged in stone crusher unit. Diagnosis was established on clinical and radiological assessment and supported by occupational history of the patient. This case is unique one as all these 3 complications at the same time are very uncommon in acute silicosis. PMID:26190738

  20. Cervicothoracic Subcutaneous Emphysema and Pneumomediastinum After Third Molar Extraction.

    PubMed

    Picard, Maxime; Pham Dang, Nathalie; Mondie, Jean Michel; Barthelemy, Isabelle

    2015-12-01

    Third molar extraction is one of the most common interventions in dental and maxillofacial surgery. Complications are frequent and well documented, with swelling, pain, bleeding, infection, and lingual or alveolar nerve injury being the most common. This report describes a case of subcutaneous extensive emphysema and pneumomediastinum that occurred 4 days after extraction of an impacted right mandibular third molar. The management and etiology of this case and those reported in the literature are discussed. PMID:26341684

  1. Lymphocytic panniculitis: an algorithmic approach to lymphocytes in subcutaneous tissue.

    PubMed

    Shiau, Carolyn J; Abi Daoud, Marie S; Wong, Se Mang; Crawford, Richard I

    2015-12-01

    The diagnosis of panniculitis is a relatively rare occurrence for many practising pathologists. The smaller subset of lymphocyte-predominant panniculitis is further complicated by the diagnostic consideration of T cell lymphoma involving the subcutaneous tissue, mimicking inflammatory causes of panniculitis. Accurate classification of the panniculitis is crucial to direct clinical management as treatment options may vary from non-medical therapy to immunosuppressive agents to aggressive chemotherapy. Many diseases show significant overlap in clinical and histological features, making the process of determining a specific diagnosis very challenging. However, with an adequate biopsy including skin and deep subcutaneous tissue, a collaborative effort between clinician and pathologist can often lead to a specific diagnosis. This review provides an algorithmic approach to the diagnosis of lymphocyte-predominant panniculitis, including entities of septal-predominant pattern panniculitis (erythema nodosum, deep necrobiosis lipoidica, morphea profunda and sclerosing panniculitis) and lobular-predominant pattern panniculitis (lupus erythematous panniculitis/lupus profundus, subcutaneous panniculitis-like T cell lymphoma, cutaneous γ-δ T cell lymphoma, Borrelia infection and cold panniculitis). PMID:26602413

  2. Identification of progesterone receptor in human subcutaneous adipose tissue.

    PubMed

    O'Brien, S N; Welter, B H; Mantzke, K A; Price, T M

    1998-02-01

    Sex steroids are postulated to play a role in adipose tissue regulation and distribution, because the amount and location of adipose tissue changes during puberty and menopause. Because of the nature of adipose tissue, receptors for the female sex steroids have been difficult to demonstrate. To date, estrogen receptor messenger RNA and protein have been identified in human subcutaneous adipose tissue, but the presence of progesterone receptor (PR) has not been reported. In this study, we demonstrate PR message by Northern blot analysis in RNA isolated from the abdominal subcutaneous adipose tissue of premenopausal women. These preliminary studies revealed that PR messenger RNA levels are higher in the stromal-vascular fraction as opposed to the adipocyte fraction. Western blot analysis demonstrates both PR protein isoforms (human PR-A and human PR-B) in human subcutaneous adipose tissue. Using an enzyme-linked immunosorbent assay, total PR could be quantitated. These studies substantiate that sex steroid receptors are present in human adipose tissue, thereby providing a direct route for regulation of adipose tissue by female sex steroids. PMID:9467566

  3. Pharmacokinetics of cephalexin in calves after intravenous and subcutaneous administration.

    PubMed

    Garg, S K; Chaudhary, R K; Srivastava, A K

    1996-01-01

    The pharmacokinetics of cephalexin was investigated in male calves following a single intravenous (i.v.) and subcutaneous (s.c.) administration (10 mg/kg). The distribution rate constant and distribution half-life were 3.34 +/- 1.22 h-1 and 0.32 +/- 0.08 h, respectively. The values of elimination half-lives following i.v. and s.c. administration were 3.17 +/- 1.30 and 2.56 +/- 0.24 h, respectively. The absorption half-life following s.c. administration was 0.09 +/- 0.01 h. The apparent volume of distribution was 0.65 +/- 0.16 and 0.46 +/- 0.07 L/kg and total body clearance was 2.96 +/- 0.46 and 1.66 +/- 0.31 ml/kg/min, respectively, following i.v. and s.c. administration. Systemic availability following subcutaneous administration was found to be almost complete (103.08%). The satisfactory intravenous dosage regimen of cephalexin for calves would be 11.3 mg/kg as the priming dose followed by 10.0 mg/kg as the maintenance dose to be repeated at 6-h intervals. However, the subcutaneous dosage regimen of cephalexin in calves would be 8.0 mg/kg followed by 7.05 mg/kg at 8-h intervals. PMID:8908743

  4. Regression of diabetic macular edema after subcutaneous exenatide.

    PubMed

    Sarao, Valentina; Veritti, Daniele; Lanzetta, Paolo

    2014-01-01

    The aim of this study is to report a case of complete regression of diabetic macular edema after subcutaneous injection of exenatide in a patient with type 2 diabetes mellitus. This study is an interventional case report. Blood investigations, complete ophthalmic examinations and optical coherence tomography were performed. A 55-year-old female affected by poorly controlled type 2 diabetes mellitus presented with visual impairment due to macular edema in the right eye. The left eye showed mild edema without visual loss. Best-corrected visual acuity (BCVA) was 20/80 and 20/20, respectively. The patient was encouraged to improve metabolic control, and the antidiabetic therapy was modified combining exenatide 10 μg subcutaneously twice daily to her regimen of oral metformin. The patient did not receive any ocular treatment. A complete tomographic resolution of macular edema was observed after 1 month and BCVA improved to 20/63. These findings were confirmed for the entire 6-month follow-up duration. No ocular or non-ocular adverse events were recorded. This is the first reported case of complete regression of macular edema in a diabetic patient after subcutaneous injection of exenatide. PMID:23925692

  5. Sonographic evaluation of visceral and subcutaneous fat in obese children*

    PubMed Central

    Sakuno, Telma; Tomita, Letícia Mary; Tomita, Carolina Mywa; Giuliano, Isabela de Carlos Back; Ibagy, Amanda; Perin, Nilza Maria Medeiros; Poeta, Lisiane Schilling

    2014-01-01

    Objective To evaluate sonographic measurements of visceral and subcutaneous fat in children, and to investigate the usefulness of preperitoneal fat (PF) and the abdominal wall fat index (AFI) as parameters to determine visceral fat and presence of nonalcoholic fatty liver disease (NAFLD) in obese children. Materials and Methods A case-control study of a sample including 44 children (22 cases and 22 controls) matched by sex and age. The Student t test and the Fisher exact test were utilized in the descriptive and bivariate analysis. Results The sonographic parameters evaluated - subcutaneous cell tissue, PF and intraperitoneal fat, and NAFLD - presented high statistical association with body mass index. NAFLD was observed in eight obese patients (36.36%), and PF and AFI were the variables with highest statistical significance, with p < 0.0001. Conclusion Ultrasonography is useful tool in the differentiation and quantification of visceral and subcutaneous fat in children. The measures of PF and AFI are useful in the assessment of visceral fat and NAFLD in obese children. PMID:25741071

  6. Grapefruit oil attenuates adipogenesis in cultured subcutaneous adipocytes.

    PubMed

    Haze, Shinichiro; Sakai, Keiko; Gozu, Yoko; Moriyama, Mio

    2010-07-01

    We investigated the effects of different essential oils on adipogenesis in rat subcutaneous adipocytes. Subcutaneous preadipocytes were cultured in Dulbecco's Modified Eagle Medium (DMEM) containing insulin, transferrin, fibroblast growth factor, dexamethasone, indomethacin, fetal bovine serum, and an essential oil at 37 degrees C in 5% CO2 to induce their differentiation. After 7 days, the number of viable cells and the amount of triglycerides accumulated in the cells were determined. Differentiation markers such as the enzymatic activity of glycerol-3-phosphate dehydrogenase (GPDH) and the expression of GPDH and peroxisome proliferator-activated receptor gamma (PPAR gamma) genes were also measured, as well as the intracellular Ca2+ levels. We found that grapefruit oil inhibited the accumulation of triglycerides in a dose-dependent manner at concentrations of 50 to 400 microg/mL. Furthermore, it suppressed the expression of GPDH and caused a 70% decrease in the enzymatic activity of GPDH at a concentration of 50 microg/mL. Grapefruit oil also caused a nearly 2-fold increase in the intracellular concentration of Ca2+ and suppressed the expression of PPAR gamma genes. Our results demonstrate that grapefruit oil efficiently inhibits adipogenesis in cultured subcutaneous preadipocytes and adipocytes. PMID:20143292

  7. Frontal Sinus Mucopyocele Presenting as a Subcutaneous Forehead Mass.

    PubMed

    Carmichael, Ryan A; Kang, David R

    2015-11-01

    Mucoceles of the paranasal sinuses are benign, chronic, expanding lesions that characteristically develop because of obstruction of the sinus ostium. The frontal sinus is the most common sinus to be affected by a mucocele, which usually results from trauma or inflammatory processes. Patients with these lesions frequently present with visual complaints of decreased visual acuity, visual field abnormalities, proptosis, ptosis, displacement of the globe, or restricted ocular movements secondary to erosion through the thin bone of the superior orbit and compression on the globe. Often, intracranial extension of frontal sinus mucoceles is also present from erosion through the posterior table of the frontal sinus. Very rarely, they will present as a subcutaneous forehead mass or swelling. To the best of our knowledge, only 5 cases of a frontal sinus mucocele presenting as a forehead subcutaneous mass has been previously reported. We report the case of an 80-year-old woman with a history of remote forehead trauma who presented with a frontal sinus mucopyocele manifesting as a subcutaneous forehead mass eroding through the skin. PMID:26044600

  8. Subcutaneous infusion: non-metal cannulae vs metal butterfly needles.

    PubMed

    Torre, Maria Carrion

    2002-07-01

    This review aimed to evaluate the effectiveness of non-metal cannulae compared to metal butterfly needles in maintaining subcutaneous infusion sites in patients receiving palliative care. The Cochrane Library, Medline, Pre-Medline, Embase, CINAHL, Amed and Cancerlit were searched for relevant studies. Controlled trials comparing non-metal cannulae with metal butterfly needles for giving subcutaneous infusion to palliative care patients were included. The outcome considered was site duration in terms of hours of patency or until change was required. Four trials met the inclusion criteria although overall quality was poor due to low follow-up. Studies examined either Teflon or Vialon-coated catheters. All studies showed non-metal cannulae to be superior to metal. In individual studies estimates in mean increase in duration of the site range from 21 to 159 hours. It seems that non-metal cannulae are more effective in maintaining the duration of subcutaneous infusion sites than butterfly needles. Both types of non-metal catheter showed clear benefits. This review has not examined other outcomes but in general adverse effects lead to the removal of the catheter and so would be reflected in the outcome of considered. Although historically non-metal cannulae have been considerably more expensive there is now little difference between metal and Teflon-coated catheters. This review recommends the use of non-metal cannulae in preference to butterfly needles. PMID:12131852

  9. Comparison of subcutaneous and intravenous continuous glucose monitoring accuracy in an operating room and an intensive care unit.

    PubMed

    Munekage, Masaya; Yatabe, Tomoaki; Sakaguchi, Masahiko; Kitagawa, Hiroyuki; Tamura, Takahiko; Namikawa, Tsutomu; Hanazaki, Kazuhiro

    2016-06-01

    Although we have used an intravenous continuous glucose monitor for blood glucose management, a previous study reported that a subcutaneous continuous glucose monitor was also reliable for use in critically ill patients. The aim of this study was to compare the subcutaneous and intravenous continuous glucose monitors. This was an observational trial (UMIN-CTR, ID:000013338). We included patients who were admitted to our intensive care units (ICU) after hepato-biliary pancreatic surgery. Continuous blood glucose measurement was performed from the beginning of the operation to ICU discharge using the intravenous continuous monitor STG-55 (Nikkiso, Tokyo, Japan) and the subcutaneous continuous monitor iPro2 (Medtronic Japan, Tokyo, Japan). The STG-55 measured the glucose level in real time, and the iPro2 measured this every 5 min. We compared glucose levels obtained using the two devices every 5 min using a Bland-Altman plot and a regression analyses. A total of 3592 comparative samples in 15 cases were analyzed. The mean glucose level measured using the STG-55 was 139 ± 21 mg/dl, and that measured using the iPro2 was 144 ± 31 mg/dl. A linear regression line had the equation of the form y = 0.225x + 106. The coefficient of determination was 0.11, and the F-test significance level was set as p < 0.01. The mean of the differences was -5.2 mg/dl, with a 95 % agreement limit of -67 to + 57 mg/dL. The percent error was 44 %. In conclusion, the current study suggests that subcutaneous and intravenous continuous glucose monitoring was not highly correlated during either surgery or ICU stay. PMID:26721825

  10. Subcutaneous extraskeletal osteosarcoma of the forearm: a case report and review of the literature.

    PubMed

    Healy, Christopher; Kahn, Leonard B; Kenan, Samuel

    2016-09-01

    Extraskeletal osteosarcoma (ESOS) originating in the subcutaneous tissue is a rare occurrence, accounting for less than 10 % of ESOS cases. Osteosarcoma of extraskeletal origin accounts for approximately 2-4 % of all osteosarcomas, and 1 % of soft tissue sarcomas. We report a case of an 80-year-old female with an isolated primary subcutaneous tumor of the forearm. After imaging, surgical excision, and pathological analysis, the diagnosis of a subcutaneous osteosarcoma was made. This report documents the clinical and pathological findings of subcutaneous ESOS in this case, along with a review of previous cases of subcutaneous ESOS. PMID:27357312

  11. Subcutaneous adipose tissue topography (SAT-Top) development in children and young adults.

    PubMed

    Tafeit, Erwin; Möller, Reinhard; Jurimae, Toivo; Sudi, Karl; Wallner, Sandra Johanna

    2007-06-01

    The importance of body composition measurements to elucidate the dynamics of related diseases in pediatrics is gaining recognition. The methods used should not expose subjects to high doses of radiation and require substantial cooperation. The Lipometer is a new optical device that enables the non-invasive, quick and safe determination of the thickness of subcutaneous adipose tissue (SAT) layers (in mm) at any site of the human body. The topographic specification of 15 evenly distributed body sites, which makes it possible to precisely measure subcutaneous body fat distribution, is called subcutaneous adipose tissue topography (SAT-Top). SAT-Top was determined in more than 1000 children and young adults between the ages of 7 and 21. In this paper we describe the SAT-Top development of these subjects through different age groups and the differences between male and female SAT-Top development in each age group. SAT layer profiles (medians of the 15 body sites) for boys and girls in age group 1 (7-9 yrs) show a very similar pattern for both sexes, followed by slightly decreasing SAT layer thicknesses in boys and increasing values in girls in the subsequent age groups. Between age group 3 (11-13 yrs) and age group 7 (19-21 yrs) male and female SAT-Top is significantly different. The discriminating power between male and female SAT-Top was investigated by stepwise discriminant analysis, which provided no significant results for age group 1 (7-9 yrs), about 73% correct classification for age group 2 (9-11 yrs) and 3 (11-13 yrs), 83% for age group 4 (13-15 yrs), and about 91-93% for the following age groups (15-21 yrs). It is known that SAT development is the same in both sexes until puberty, when girls gain relatively more fat mass than boys to reach a higher body-fat percentage as adults. This paper presents a precise description of SAT development in boys and girls from childhood to adolescence, which provides a basis for further investigations. PMID:17847915

  12. Subcutaneous Immunotherapy Improves the Symptomatology of Allergic Rhinitis

    PubMed Central

    Lourenço, Edmir Américo; Caldeira, Eduardo José; Carvalho, César Alexandre Fabrega; Cunha, Marcelo Rodriques; Carvalho, Marcus Vinícius Henriques; Passos, Saulo Duarte

    2015-01-01

    Introduction The relevance of allergic rhinitis is unquestionable. This condition affects people's quality of life and its incidence has increased over the last years. Objective Thus, this study aims to analyze the effectiveness of subcutaneous injectable immunotherapy in cases of nasal itching, sneeze, rhinorrhea and nasal congestion in allergic rhinitis patients. Methods In the present study, the same researcher analyzed the records of 281 patients. Furthermore, the researchers identified allergens through puncture cutaneous tests using standardized extracts containing acari, fungi, pet hair, flower pollen, and feathers. Then, the patients underwent treatment with subcutaneous specific immunotherapy, using four vaccine vials for desensitization, associated with environmental hygiene. The authors analyzed conditions of nasal itching, sneeze, rhinorrhea, and nasal congestion throughout the treatment, and assigned them with a score ranging from zero (0), meaning absence of these symptoms to three (3), for severe cases. The symptoms were statistically compared in the beginning, during, and after treatment. Results In this study, authors analyzed the cases distribution according to age and the evolution of symptomatology according to the scores, comparing all phases of treatment. The average score for the entire population studied was 2.08 before treatment and 0.44 at the end. These results represent an overall improvement of ∼79% in symptomatology of allergic rhinitis in the studied population. Conclusion The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the quality of life of patients, proving itself as an important therapeutic tool for these pathological conditions. PMID:26722338

  13. Pharmacokinetics of intravenous and subcutaneous cefovecin in alpacas.

    PubMed

    Cox, S; Sommardahl, C; Seddighi, R; Videla, R; Hayes, J; Pistole, N; Hamill, M; Doherty, T

    2015-08-01

    The purpose of this study was to determine the pharmacokinetics of cefovecin after intravenous and subcutaneous dose of 8 mg/kg to alpacas. Bacterial infections requiring long-term antibiotic therapy such as neonatal bacteremia, pneumonia, peritonitis, dental, and uterine infections are a significant cause of morbidity and mortality in this species. However, few antimicrobials have been evaluated and proven to have favorable pharmacokinetics for therapeutic use. Most antimicrobials that are currently used require daily injections for many days. Cefovecin is a long-acting cephalosporin that is formulated for subcutaneous administration, and its long-elimination half-life allows for 14-day dosing intervals in dogs and cats. The properties of cefovecin may be advantageous for medical treatment of camelids due to its broad spectrum, route of administration, and long duration of activity. Pharmacokinetic evaluation of antimicrobial drugs in camelids is essential for the proper treatment and prevention of bacterial disease, and to minimize development of antibiotic resistant bacterial strains due to inadequate antibiotic concentrations. Cefovecin mean half-life, volume of distribution at steady-state, and clearance after intravenous administration were 10.3 h, 86 mL/kg, and 7.07 mL·h/kg. The bioavailability was 143%, while half-life, C(max), and T(max) were 16.9 h, 108 μg/mL, and 2.8 h following subcutaneous administration. In the absence of additional microbial susceptibility data for alpaca pathogens, the current cefovecin dosage regimen prescribed for dogs (8 mg/kg SC every 14 days) may need to be optimized for the treatment of infections in this species. PMID:25407784

  14. Subcutaneous Immunotherapy Improves the Symptomatology of Allergic Rhinitis.

    PubMed

    Lourenço, Edmir Américo; Caldeira, Eduardo José; Carvalho, César Alexandre Fabrega; Cunha, Marcelo Rodriques; Carvalho, Marcus Vinícius Henriques; Passos, Saulo Duarte

    2016-01-01

    Introduction The relevance of allergic rhinitis is unquestionable. This condition affects people's quality of life and its incidence has increased over the last years. Objective Thus, this study aims to analyze the effectiveness of subcutaneous injectable immunotherapy in cases of nasal itching, sneeze, rhinorrhea and nasal congestion in allergic rhinitis patients. Methods In the present study, the same researcher analyzed the records of 281 patients. Furthermore, the researchers identified allergens through puncture cutaneous tests using standardized extracts containing acari, fungi, pet hair, flower pollen, and feathers. Then, the patients underwent treatment with subcutaneous specific immunotherapy, using four vaccine vials for desensitization, associated with environmental hygiene. The authors analyzed conditions of nasal itching, sneeze, rhinorrhea, and nasal congestion throughout the treatment, and assigned them with a score ranging from zero (0), meaning absence of these symptoms to three (3), for severe cases. The symptoms were statistically compared in the beginning, during, and after treatment. Results In this study, authors analyzed the cases distribution according to age and the evolution of symptomatology according to the scores, comparing all phases of treatment. The average score for the entire population studied was 2.08 before treatment and 0.44 at the end. These results represent an overall improvement of ∼79% in symptomatology of allergic rhinitis in the studied population. Conclusion The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the quality of life of patients, proving itself as an important therapeutic tool for these pathological conditions. PMID:26722338

  15. Orthorexia Nervosa with Hyponatremia, Subcutaneous Emphysema, Pneumomediastimum, Pneumothorax, and Pancytopenia

    PubMed Central

    Park, Sang Won; Kim, Jeong Yup; Go, Gang Ji; Jeon, Eun Sil; Pyo, Heui Jung

    2011-01-01

    30-year-old male was admitted with general weakness and drowsy mental status. He had eaten only 3-4 spoons of brown rice and fresh vegetable without salt for 3 months to treat his tic disorder, and he had been in bed-ridden state. He has had weight loss of 14 kg in the last 3 months. We report a patient with orthorexia nervosa who developed hyponatremia, metabolic acidosis, subcutaneous emphysema, mediastinal emphysema, pneumothorax, and pancytopenia and we will review the literature. Also, we mention to prevent refeeding syndrome, and to start and maintain feeding in malnourished patients. PMID:21998605

  16. Orthorexia nervosa with hyponatremia, subcutaneous emphysema, pneumomediastimum, pneumothorax, and pancytopenia.

    PubMed

    Park, Sang Won; Kim, Jeong Yup; Go, Gang Ji; Jeon, Eun Sil; Pyo, Heui Jung; Kwon, Young Joo

    2011-06-01

    30-year-old male was admitted with general weakness and drowsy mental status. He had eaten only 3-4 spoons of brown rice and fresh vegetable without salt for 3 months to treat his tic disorder, and he had been in bed-ridden state. He has had weight loss of 14 kg in the last 3 months. We report a patient with orthorexia nervosa who developed hyponatremia, metabolic acidosis, subcutaneous emphysema, mediastinal emphysema, pneumothorax, and pancytopenia and we will review the literature. Also, we mention to prevent refeeding syndrome, and to start and maintain feeding in malnourished patients. PMID:21998605

  17. 3D Multispectral Light Propagation Model For Subcutaneous Veins Imaging

    SciTech Connect

    Paquit, Vincent C; Price, Jeffery R; Meriaudeau, Fabrice; Tobin Jr, Kenneth William

    2008-01-01

    In this paper, we describe a new 3D light propagation model aimed at understanding the effects of various physiological properties on subcutaneous vein imaging. In particular, we build upon the well known MCML (Monte Carlo Multi Layer) code and present a tissue model that improves upon the current state-of-the-art by: incorporating physiological variation, such as melanin concentration, fat content, and layer thickness; including veins of varying depth and diameter; using curved surfaces from real arm shapes; and modeling the vessel wall interface. We describe our model, present results from the Monte Carlo modeling, and compare these results with those obtained with other Monte Carlo methods.

  18. [Pneumoperitoneum, pneumoretroperitoneum, bilateral pneumothorax, pneumomediastinum and subcutaneous emphysema due ERCP].

    PubMed

    Menéndez, Pablo; Padilla, David; Villarejo, Pedro; García, Alberto

    2012-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) has become an essential procedure in the diagnosis and treatment of biliopancreatic diseases. Complications of this procedure are potentially serious, being necessary to know how to recognize them for the application of the appropriate treatment. We report the case of a 79-year-old woman who developed a massive subcutaneous emphysema, bilateral pneumothorax, retropneumomediastinum, retropneumoperitoneum and pneumoperitoneum due to iatrogenic duodenal injury secondary to ERCP. The clinical suspicion for early diagnosis of iatrogenic injury after ERCP will determine the correct treatment of this complication and will achieve better outcomes. PMID:22476185

  19. Secondary hypogammaglobulinemia in Waldmann's disease treated with subcutaneous immunoglobulins.

    PubMed

    Patuzzo, G; Tinazzi, E; Micheletti, M; Puccetti, A; Lunardi, C

    2016-03-01

    Primary intestinal lymphangiectasia (PIL) is rare disorder characterized by congenital malformation or obstruction of intestinal lymphatic drainage; it is responsible for protein losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia. A low-fat diet associated with medium-chain triglyceride supplementation is the cornerstone of PIL management. The administration of intravenous immunoglobulins does not always lead to satisfactory plasma levels and therefore the replacement therapy with immunoglobulins is controversial. We describe here the case of a patient with PIL and severe hypogammaglobulinemia treated with immunoglobulins. The striking aspect of this case is the clinical and serological benefit obtained with the subcutaneous compared to the intravenous immunoglobulins administration. PMID:26934740

  20. Subcutaneous and Pulmonary Dirofilariasis with Evidence of Splenic Involvement

    PubMed Central

    Selvachandran, Adarsha

    2016-01-01

    Cases of human dirofilariasis have been reported in several countries around the world, including a large number in the Atlantic and Gulf Coast regions of the United States. Most commonly, these cases have subcutaneous or pulmonary involvement; however, there have been few reports of dirofilariasis involving structures such as large vessels, mesentery, the spermatic cord, and liver. We present a case of an unusual presentation of human dirofilariasis presenting as a shoulder abscess and what is presumed to be pulmonary and splenic involvement in a 55-year-old female. PMID:27579206

  1. Subcutaneous and Pulmonary Dirofilariasis with Evidence of Splenic Involvement.

    PubMed

    Selvachandran, Adarsha; Foley, Raymond J

    2016-01-01

    Cases of human dirofilariasis have been reported in several countries around the world, including a large number in the Atlantic and Gulf Coast regions of the United States. Most commonly, these cases have subcutaneous or pulmonary involvement; however, there have been few reports of dirofilariasis involving structures such as large vessels, mesentery, the spermatic cord, and liver. We present a case of an unusual presentation of human dirofilariasis presenting as a shoulder abscess and what is presumed to be pulmonary and splenic involvement in a 55-year-old female. PMID:27579206

  2. Homozygous Familial Hypercholesterolemia Associated with Symmetric Subcutaneous Lipomatosis

    PubMed Central

    Dawoud, Noha Mohammed; Bakry, Ola Ahmed; Seleit, Iman

    2015-01-01

    Homozygous familial hypercholesterolemia is an autosomal dominant disorder of lipid metabolism, characterized by reduced clearance of low-density lipoprotein-cholesterol and a high risk of rapid development of cardiovascular diseases. Its incidence is relatively rare and estimated to be one in one million in general populations. Here, we report homozygous familial hypercholesterolemia in two Egyptian young siblings, presented with cutaneous, tendinous xanthomas, and corneal arcus. One of them has symmetric subcutaneous lipomatosis, which has not been reported before in association with familial hypercholesterolemia. PMID:26288434

  3. Subcutaneous Adipose Tissue Topography in Long-Term Enterally Fed Children and Healthy Controls.

    PubMed

    Kaimbacher, Petra Silke; Wallner-Liebmann, Sandra Johanna; Dunitz-Scheer, Marguerite; Scheer, Peter Jaron Zwi; Cvirn, Gerhard; Schrabmair, Walter; Schnedl, Wolfgang Johann; Hamlin, Michael John; Tafeit, Erwin

    2015-09-01

    In the context of enteral feeding in children the influence on growth and the question of fat resorption is of great interest. We, therefore, measured the thickness of subcutaneous body fat in a sample of long-term enterally fed toddlers and healthy controls. In 33 long-term enterally fed toddlers (10 girls, 23 boys) and 275 healthy controls (128 girls, 147 boys) subcutaneous body fat was measured by means) of the optical device Lipometer. All participants were divided into three age groups (infants, toddlers and children). The height (p=0. 014, -11.7 cm, -12.5%) and weight (p=0.012, -3.0 kg, -21.9%) of long-term enterally fed female toddlers were significantly lower than healthy controls, while male enterally fed toddlers had lower values in all anthropometric measures compared to healthy controls: height (p=0.003, -8.0 cm, -8.4%), weight (p<0.001, -3.5 kg, -24.8%), BMI (p=0.004, -1.3 BMI), Z-score BMI (p=0.001, -1.2 Z-score BMI), upper arm circumference (p<0.001, -1.6 cm, -10.1%) and waist circumference (p<0.001, -6.2 cm, -12.5%). Tube fed toddlers showed a similar body fat distribution when compared to healthy controls, but demonstrated significantly lower values of anthropometric measurements. The results indicate that long-term enterally fed children have ample fat stores but lack physical development. PMID:26898055

  4. Evaluation of Intradermal and Subcutaneous Infusion Set Performance Under 24-Hour Basal and Bolus Conditions

    PubMed Central

    McVey, Elaine; Keith, Steven; Herr, Joshua K.; Sutter, Diane; Pettis, Ronald J.

    2015-01-01

    Background: This study sought to assess the function and delivery reliability of intradermal (ID) infusion sets used with commercial insulin pumps. Method: Healthy subjects (n = 43) were randomized to either ID or subcutaneous (SC) arms, and received basal/bolus placebo delivery for 24 hours. Subjects received 4 of 8 infusion set combinations (ID: microneedle design A or B, with 2 pump brands [Animas or MiniMed]; SC: Teflon Quickset or steel Rapid-D, Animas pump only, with or without overtaping) and were evaluated for pump occlusion alarms, fluid leakage, pain, and tissue tolerability. A novel algorithm was developed to determine flow consistency based on fluid pressure, and the duration and occurrence rate for periods of unalarmed but interrupted flow (“silent occlusions’”) were compared. Results: ID delivery was successfully maintained over the 24-hour infusion period. The number of silent occlusions was lower for ID microneedle cannula design B than A (P < .01) and lower for Rapid-D SC device compared to Quick-set (P = .03). There was no significant difference in the number of occlusion alarms between the ID and SC devices with the Animas pump. However, the pumps tested with ID devices had significantly different alarm rates (MiniMed 29.5%, Animas 0%, P < .001). Leakage and tissue tolerability were comparable across devices. Conclusion: The ID infusion set reliably delivered diluent for an extended 24-hour period in healthy subjects and was well tolerated. Silent occlusion flow interruptions could be detected in both ID and SC infusion sets using a proprietary algorithm. This algorithm is a promising method for quantitatively evaluating infusion set flow performance. PMID:26319228

  5. A passive biodegradable implant for subcutaneous soft-tissue trauma monitoring.

    PubMed

    Rigelsford, Jonathan M; Al-Azzawi, Baraa F; Davenport, Christopher James; Novodvorsky, Peter

    2015-05-01

    In-body medical devices can play an important role in clinical monitoring and diagnosis of diseases. Wireless devices implanted within a patient have to be physically small, and must overcome the challenges of having a little or no onboard electrical power and the highly attenuating electromagnetic propagation environment which is the human body. In this paper, we investigate the use of biodegradable implant to monitor the healing of soft-tissue trauma and to allow early stage diagnosis of infection. The implantable tag is designed to degrade in a predetermined and controlled method, the stage of which can be measured from outside the body without the need for further surgical intervention. The speed of degradation of the tag depends on the temperature and acidity of the subcutaneous tissue in which the tag is implanted. We show that as the electrical length of the tag pattern increases due to degradation, the resonant frequency changes significantly, and this change in resonant frequency can be detected from outside the patient. Results are presented showing the tag's performance at normal and oblique incidence, and techniques for miniaturizing and enhancing the tag's response sensitivity are given. As the entire tag is biodegradable, there is no need for further postoperative surgery to remove it from the patient at the end of its useful life. PMID:25826811

  6. Augmented reality based real-time subcutaneous vein imaging system.

    PubMed

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-07-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed. PMID:27446690

  7. Anterior subcutaneous internal fixation for treatment of unstable pelvic fractures

    PubMed Central

    2014-01-01

    Background Fractures of the pelvic ring including disruption of the posterior elements in high-energy trauma have both high morbidity and mortality rates. For some injury pattern part of the initial resuscitation includes either external fixation or plate fixation to close the pelvic ring and decrease blood loss. In certain situations – especially when associated with abdominal trauma and the need to perform laparotomies – both techniques may put the patient at risk of either pintract or deep plate infections. We describe an operative approach to percutaneously close and stabilize the pelvic ring using spinal implants as an internal fixator and report the results in a small series of patients treated with this technique during the resuscitation phase. Findings Four patients were treated by subcutaneous placement of an internal fixator. Screw fixation was carried out by minimally invasive placement of two supra-acetabular iliac screws. Afterwards, a subcutaneous transfixation rod was inserted and attached to the screws after reduction of the pelvic ring. All patients were allowed to fully weight-bear. No losses of reduction or deep infections occurred. Fracture healing was uneventful in all cases. Conclusion Minimally invasive fixation is an alternative technique to stabilize the pelvic ring. The clinical results illustrate that this technique is able to achieve good results in terms of maintenance of reduction the pelvic ring. Also, abdominal surgeries no longer put the patient at risk of infected pins or plates. PMID:24606833

  8. Regulation of human subcutaneous adipocyte differentiation by EID1.

    PubMed

    Vargas, Diana; Shimokawa, Noriaki; Kaneko, Ryosuke; Rosales, Wendy; Parra, Adriana; Castellanos, Ángela; Koibuchi, Noriyuki; Lizcano, Fernando

    2016-02-01

    Increasing thermogenesis in white adipose tissues can be used to treat individuals at high risk for obesity and cardiovascular disease. The objective of this study was to determine the function of EP300-interacting inhibitor of differentiation (EID1), an inhibitor of muscle differentiation, in the induction of beige adipocytes from adipose mesenchymal stem cells (ADMSCs). Subcutaneous adipose tissue was obtained from healthy women undergoing abdominoplasty. ADMSCs were isolated in vitro, grown, and transfected with EID1 or EID1 siRNA, and differentiation was induced after 48 h by administering rosiglitazone. The effects of EID1 expression under the control of the aP2 promoter (aP2-EID1) were also evaluated in mature adipocytes that were differentiated from ADMSCs. Transfection of EID1 into ADMSCs reduced triglyceride accumulation while increasing levels of thermogenic proteins, such as PGC1α, TFAM, and mitochondrial uncoupling protein 1 (UCP1), all of which are markers of energy expenditure and mitochondrial activity. Furthermore, increased expression of the beige phenotype markers CITED1 and CD137 was observed. Transfection of aP2-EID1 transfection induced the conversion of mature white adipocytes to beige adipocytes, as evidenced by increased expression of PGC1α, UCP1, TFAM, and CITED1. These results indicate that EID1 can modulate ADMSCs, inducing a brown/beige lineage. EID1 may also activate beiging in white adipocytes obtained from subcutaneous human adipose tissue. PMID:26643909

  9. Cervicofacial subcutaneous emphysema associated with dental laser treatment.

    PubMed

    Mitsunaga, S; Iwai, T; Kitajima, H; Yajima, Y; Ohya, T; Hirota, M; Mitsudo, K; Aoki, N; Yamashita, Y; Omura, S; Tohnai, I

    2013-12-01

    Cervicofacial subcutaneous emphysema is a rare complication of dental procedures. Although most cases of emphysema occur incidentally with the use of a high-speed air turbine handpiece, there have been some reports over the past decade of cases caused by dental laser treatment. Emphysema as a complication caused by the air cooling spray of a dental laser is not well known, even though dental lasers utilize compressed air just as air turbines and syringes do. In this study, we comprehensively reviewed cases of emphysema attributed to dental laser treatment that appeared in the literature between January 2001 and September 2012, and we included three such cases referred to us. Among 13 cases identified in total, nine had cervicofacial subcutaneous and mediastinal emphysema. Compared with past reviews, the incidence of mediastinal emphysema caused by dental laser treatment was higher than emphysema caused by dental procedure without dental laser use. Eight patients underwent CO2 laser treatment and two underwent Er:YAG laser treatment. Nine patients had emphysema following laser irradiation for soft tissue incision. Dentists and oral surgeons should be cognizant of the potential risk for iatrogenic emphysema caused by the air cooling spray during dental laser treatment and ensure proper usage of lasers. PMID:24320897

  10. Augmented reality based real-time subcutaneous vein imaging system

    PubMed Central

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-01-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed. PMID:27446690

  11. Subcutaneous Implants of Buprenorphine-Cholesterol-Triglyceride Powder in Mice

    PubMed Central

    DeTolla, L.; Sanchez, R.; Khan, E.; Tyler, B.; Guarnieri, M.

    2014-01-01

    Subcutaneous drug implants are convenient systems for the long-term delivery of drugs in animals. Lipid carriers are logical tools because they generally allow for higher doses and low toxicity. The present study used an US Food and Drug Administration Target Animal Safety test system to evaluate the safety of a subcutaneous implant of a cholesterol-triglyceride-buprenorphine powder in 120 BALB/c mice. Mice were evaluated in 4- and 12-day trials with 1- and 5-fold doses of the intended 3 mg/kg dose of drug. One male mouse treated with three 3 mg/kg doses and surgery on days 0, 4, and 8 died on day 9. The cause of death was not determined. In the surviving 119 mice there was no evidence of skin reaction at the site of the implant. Compared to control animals treated with saline, weight measurements, clinical pathology, histopathology, and clinical observations were unremarkable. These results demonstrate that the lipid carrier is substantially safe. Cholesterol-triglyceride-drug powders may provide a valuable research tool for studies of analgesic and inflammatory drug implants in veterinary medicine. PMID:26464927

  12. [Lung Cancer Incidentally Detected by a Subcutaneous Nodule at the Drainage Site for Pneumothorax].

    PubMed

    Okamoto, Jumpei; Matsumoto, Isao; Saito, Daisuke; Yoshida, Shuhei; Takada, Munehisa; Tamura, Masaya; Takemura, Hirofumi; Ikeda, Hiroko

    2016-08-01

    A 43-year-old male patient underwent thoracic drainage for the treatment of right pneumothorax. After 6 months, the patient visited our department because of a subcutaneous nodule found at the drainage site. Chest computed tomography revealed a mass lesion associated with a cavity in the right upper lobe of the lung and a subcutaneous nodule. Surgical resection was performed and both the pulmonary lesion and subcutaneous nodule were found to be adenocarcinoma. Although immunohistochemical analysis suggested that the pulmonary lesion was primary lung cancer, there were neither intrathoracic exposure of the tumor nor tumor cells in the pleural lavage cytology. The expression pattern of subcutaneous tumor in the right chest was slightly different from that of the lung lesion by immunohistochemistry. Therefore, it was difficult to determine whether this subcutaneous nodule was a tumor implantation through the drainage procedure or subcutaneous metastasis from the primary tumor. PMID:27476564

  13. Technical Tip for Proximal Release During Open Carpal Tunnel Release Using a Subcutaneous Pocket.

    PubMed

    Nikkhah, Dariush; Sadr, Amir H; Akhavani, Mohammed Ali

    2016-06-01

    Technical steps to avoid incomplete proximal release of the carpal tunnel are described. Local anaesthesia is infiltrated as a subcutaneous bleb over the distal wrist crease and extending 2-3 cm over the forearm fascia. Tumescence of local anaesthesia into the subcutaneous plane helps create a pocket between the forearm fascia and subcutaneous tissues. Intraoperatively a subcutaneous pocket is made above the transverse carpal ligament and antebrachial fascia with blunt dissection. A retractor is placed under the pocket, which facilitates optimal visualization to allow reliable complete proximal release of compression.The authors have found that this technique is reproducible and reliable across their collective experience. PMID:27454649

  14. [Subcutaneous immunoglobulin. Treatment in chronic inflammatory demyelinating polyradiculo-neuropathy].

    PubMed

    Nogués, Martín A; Varela, Francisco J; Seminario, Gisela; Insúa, María C; Bezrodnik, Liliana

    2016-01-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired disease that may affect nerve roots and peripheral nerves. Despite its low incidence, diagnosis is particularly important because there are different effective treatments. Human immunoglobulin is one of the mainstays of the treatment. Although there are few studies up to date, subcutaneous immunoglobulin (IgSC) has been proposed as an alternative to intravenous administration with similar efficacy. We present three cases with definite CIDP, classified according to the European Federation of Neurological Societies / Peripheral Nerve, Society (EFNS /PNS) criteria in which was used SCIgG as a treatment after success with the intravenous route. The Overall Neuropathy Limitations Scale (ONLS) was used to estimate the changes in the muscular strength before and after treatment. PMID:26826992

  15. In vivo longitudinal photoacoustic imaging of subcutaneous tumours in mice

    NASA Astrophysics Data System (ADS)

    Laufer, Jan; Johnson, Peter; Zhang, Edward; Treeby, Bradley; Cox, Ben; Pedley, Barbara; Beard, Paul

    2011-03-01

    Photoacoustic tomography can provide high resolution 3D images of vascular networks, making it well suited to characterising the development of tumour vasculature and its response to treatment. In this study, photoacoustic images to depths of up to 9 mm were obtained using an all optical ultrasound detection scheme. Two type of colorectal tumours (LS174T and SW1222) implanted subcutaneously in a mouse were studied. 3D photoacoustic images were obtained in vivo revealing the different vascular architectures of each tumour type and their evolution over a period of several days. The results suggest that photoacoustic imaging could play a role in providing essential pre-clinical information on tumour pathophysiology and eliciting the biological mechanisms underlying anti-angiogenic therapies and other treatments.

  16. Subcutaneous infection by Ochroconis mirabilis in an immunocompetent patient

    PubMed Central

    Shi, Dongmei; Lu, Guixia; Mei, Huan; de Hoog, G. Sybren; Samerpitak, Kittipan; Deng, Shuwen; Shen, Yongnian; Liu, Weida

    2016-01-01

    Recently, the taxonomy of Ochroconis (Ascomycota, Pezizomycotina, Venturiales, Sympoventuriaceae) has been revised with the recognition of an additional genus, Verruconis. Ochroconis comprises mesophilic saprobes that occasionally infect vertebrates which mostly are cold-blooded, while Verruconis contains thermophilic species which is a neurotrope in humans and birds. On the basis of molecular data it is noted that only a single Ochroconis species regularly infects immunocompetent human hosts. Here we report a subcutaneous infection due to Ochroconis mirabilis in a 50-year-old immunocompetent female patient. In vitro antifungal susceptibility tests revealed that terbinafine was the most effective drug. The patient was successfully cured with oral administration of terbinafine 250 mg daily in combination with 3 times of topical ALA-photodynamic therapy for 9 months. PMID:27182484

  17. Subcutaneous blood flow in early male pattern baldness

    SciTech Connect

    Klemp, P.; Peters, K.; Hansted, B.

    1989-05-01

    The subcutaneous blood flow (SBF) was measured by the /sup 133/Xe washout method in the scalp of 14 patients with early male pattern baldness. Control experiments were performed in 14 normal haired men matched for age. The SBF in the scalp of the normal individuals was about 10 times higher than previously reported SBF values in other anatomical regions. In patients with early male pattern baldness, SBF was 2.6 times lower than the values found in the normal individuals (13.7 +/- 9.6 vs 35.7 +/- 10.5 ml/100 g/min-1). This difference was statistically significant (p much less than 0.001). A reduced nutritive blood flow to the hair follicles might be a significant event in the pathogenesis of early male pattern baldness.

  18. In Vivo Fluorescence Reflectance Imaging with Subcutaneous Mouse Tumor Models.

    PubMed

    Cao, Jie; Zhou, Mingzhou

    2016-01-01

    Optical imaging is undoubtedly one of the most versatile and widely used imaging techniques in both research and clinical practice. Among optical imaging technologies, fluorescence imaging is the most popularly used and has become an essential tool in biomedical science. A key component of fluorescence imaging is fluorescence-producing reporters, including fluorescent dyes and conjugates, as well as fluorescent proteins. For in vivo imaging applications, fluorophores with long emission at the near-infrared (NIR) region are generally preferred to overcome the photon attenuation in living tissue. Here, we describe the in vivo fluorescence imaging of an integrin αυβ3 targeted NIR fluorescent probe (cRGD-ICG-Der-02) using subcutaneous mouse tumor models. PMID:27283414

  19. Subcutaneous Fluid Administration: A Potentially Useful Tool in Prehospital Care

    PubMed Central

    Arthur, Annette O.; Goodloe, Jeffrey M.; Thomas, Stephen H.

    2012-01-01

    Mass casualty incidents (MCIs) and disaster medical situations are ideal settings in which there is need for a novel approach to infusing fluids and medications into a patient's intravascular space. An attractive new approach would avoid the potentially time-consuming needlestick and venous cannulation requiring a trained practitioner. In multiple-patient situations, trained practitioners are not always available in sufficient numbers to enable timely placement of intravenous catheters. The novel approach for intravascular space infusion, described in this paper involves the preadministration of the enzyme, human recombinant hyaluronidase (HRH), into the subcutaneous (SC) space, via an indwelling catheter. The enzyme “loosens” the SC space effectively enhancing the absorption of fluids and medication. PMID:22649733

  20. Subcutaneous infection by Ochroconis mirabilis in an immunocompetent patient.

    PubMed

    Shi, Dongmei; Lu, Guixia; Mei, Huan; de Hoog, G Sybren; Samerpitak, Kittipan; Deng, Shuwen; Shen, Yongnian; Liu, Weida

    2016-03-01

    Recently, the taxonomy of Ochroconis (Ascomycota, Pezizomycotina, Venturiales, Sympoventuriaceae) has been revised with the recognition of an additional genus, Verruconis. Ochroconis comprises mesophilic saprobes that occasionally infect vertebrates which mostly are cold-blooded, while Verruconis contains thermophilic species which is a neurotrope in humans and birds. On the basis of molecular data it is noted that only a single Ochroconis species regularly infects immunocompetent human hosts. Here we report a subcutaneous infection due to Ochroconis mirabilis in a 50-year-old immunocompetent female patient. In vitro antifungal susceptibility tests revealed that terbinafine was the most effective drug. The patient was successfully cured with oral administration of terbinafine 250 mg daily in combination with 3 times of topical ALA-photodynamic therapy for 9 months. PMID:27182484

  1. Residue depletion of tilmicosin in cattle after subcutaneous administration.

    PubMed

    Jiang, Haiyang; Ding, Shuangyang; Li, Jiancheng; An, Dianjin; Li, Cun; Shen, Jianzhong

    2006-07-12

    A study of tissue residue depletion of tilmicosin in cattle was conducted after a single subcutaneous injection at the therapeutic level of 10 mg per kg body weight. Eighteen cross cattle were treated with the tilmicosin oil formulation (30%). Three treated animals (two males and one female) were selected randomly to be scarified at 1, 7, 14, 28, and 35 days withdrawal after injection. Samples of the injection site and of muscle, liver, kidney, and fat were collected. Tilmicosin residue concentrations were determined using a high-performance liquid chromatography (HPLC) method with a UV detector at 290 nm. Using a statistical method recommended by the Committee for Veterinary Medical Products of European Medical Evaluation Agency, the withdrawal time of 34 days was established when all tissue residues except samples in the injection site were below the accepted maximum residue limits. PMID:16819937

  2. Subcutaneous Injection Volume of Biopharmaceuticals-Pushing the Boundaries.

    PubMed

    Mathaes, Roman; Koulov, Atanas; Joerg, Susanne; Mahler, Hanns-Christian

    2016-08-01

    Administration into the subcutaneous (SC) tissue is a typical route of delivery for therapeutic proteins, especially for frequent treatments, long-term regimens, or self-administration. It is currently believed that the maximum volume for SC injections is approximately 1.5 mL. Larger SC injection volumes are considered to be associated with injection pain and adverse events at the injection site. However, no controlled clinical studies and actual evidence exist to support this assumption. In this review, we discuss current and publically available data related to SC administration volumes. We conclude that injection volumes higher than 3.5 mL are worth exploring if required for the development of efficacious drug treatments. Studying tissue back pressure, injection site leakage, local tolerability, and injection-related adverse events, such as injection pain, should be considered for the development of higher SC injection volumes. PMID:27378678

  3. Differential gene expression between visceral and subcutaneous fat depots.

    PubMed

    Atzmon, G; Yang, X M; Muzumdar, R; Ma, X H; Gabriely, I; Barzilai, N

    2002-01-01

    Abdominal obesity has been linked to the development of insulin resistance and Type 2 diabetes mellitus (DM2). By surgical removal of visceral fat (VF) in a variety of rodent models, we prevented insulin resistance and glucose intolerance, establishing a cause-effect relationship between VF and the metabolic syndrome. To characterize the biological differences between visceral and peripheral fat depots, we obtained perirenal visceral (VF) and subcutaneous (SC) fat from 5 young rats. We extracted mRNA from the fat tissue and performed gene array hybridization using Affymetrix technology with a platform containing 9 000 genes. Out of the 1 660 genes that were expressed in fat tissue, 297 (17.9 %) genes show a two-fold or higher difference in their expression between the two tissues. We present the 20 genes whose expression is higher in VF fat (by 3 - 7 fold) and the 20 genes whose expression is higher in SC fat (by 3 - 150 fold), many of which are predominantly involved in glucose homeostasis, insulin action, and lipid metabolism. We confirmed the findings of gene array expression and quantified the changes in expression in VF of genes involved in insulin resistance (PPARgamma leptin) and its syndrome (angiotensinogen and plasminogen activating inhibitor-1, PAI-1) by real-time PCR (qRT-PCR) technology. Finally, we demonstrated increased expression of resistin in VF by around 12-fold and adiponectin by around 4-fold, peptides that were not part of the gene expression platform. These results indicate that visceral fat and subcutaneous fat are biologically distinct. PMID:12660871

  4. Minced Skin for Tissue Engineering of Epithelialized Subcutaneous Tunnels

    PubMed Central

    Fossum, Magdalena; Zuhaili, Baraa; Hirsch, Tobias; Spielmann, Malte; Reish, Richard G.; Mehta, Priyesh

    2009-01-01

    We used minced, autologous skin for neoepithelialization of surgically created subcutaneous tunnels in a large animal model. Partial-thickness skin grafts were harvested from the back region of five 50–60 kg Yorkshire pigs. The skin was minced to 0.8 × 0.8 × 0.3 mm particles. Silicone-latex tubes were covered with fibrin, rolled in minced skin, and placed in subcutaneous tunnels created in the abdominal area. For comparison, single cell suspensions of keratinocytes and fibroblasts in fibrin or fibrin only were transplanted on tubes. Tunnels were extracted after 14, 21, and 28 days for microscopic evaluation. All tubes transplanted with minced skin particles showed neoepithelialization. The epithelium was stratified and differentiated after 2 weeks in vivo, and the stratum corneum was directed toward the implanted tube. No epithelium formed from tubes transplanted with single cell suspensions, and only sparse keratinocytes could be detected by serial sectioning and immunostaining on day 14, but not later. No epithelial lining was found in tunnels with fibrin-only-coated tubes. Epithelial cysts could be found the first 2 weeks after transplantation in the minced skin group but not later. In conclusion, a minced skin technique could serve as a potential source for tissue engineering of tubular conduits for reconstructive purposes of the urethra and for cutaneous stomas for bladder catheterization, or intestinal irrigations. The method would have the advantage of being simple and expeditious and not requiring in vitro culturing. PMID:19292681

  5. Facilitated subcutaneous immunoglobulin (fSCIg) therapy--practical considerations.

    PubMed

    Ponsford, M; Carne, E; Kingdon, C; Joyce, C; Price, C; Williams, C; El-Shanawany, T; Williams, P; Jolles, S

    2015-12-01

    There is an increasing range of therapeutic options for primary antibody-deficient patients who require replacement immunoglobulin. These include intravenous immunoglobulin (IVIg), subcutaneous immunoglobulin (SCIg), rapid push SCIg and most recently recombinant human hyaluronidase-facilitated SCIg (fSCIg). Advantages of fSCIg include fewer needle punctures, longer infusion intervals and an improved adverse effect profile relative to IVIg. Limited real-life experience exists concerning the practical aspects of switching or starting patients on fSCIg. We describe the first 14 patients who have been treated with fSCIg at the Immunodeficiency Centre for Wales (ICW), representing more than 6 patient-years of experience. The regimen was well tolerated, with high levels of satisfaction and no increase in training requirement, including for a treatment-naive patient. Two patients discontinued fSCIg due to pain and swelling at the infusion site, and one paused therapy following post-infusion migraines. Ultrasound imaging of paired conventional and facilitated SCIg demonstrated clear differences in subcutaneous space distribution associated with a 10-fold increase in rate and volume delivery with fSCIg. Patient profiles for those choosing fSCIg fell into two main categories: those experiencing clinical problems with their current treatment and those seeking greater convenience and flexibility. When introducing fSCIg, consideration of the type and programming of infusion pump, needle gauge and length, infusion site, up-dosing schedule, home training and patient information are important, as these may differ from conventional SCIg. This paper provides guidance on practical aspects of the administration, training and outcomes to help inform decision-making for this new treatment modality. PMID:26288095

  6. Standardized Scalp Massage Results in Increased Hair Thickness by Inducing Stretching Forces to Dermal Papilla Cells in the Subcutaneous Tissue

    PubMed Central

    Kobayashi, Kazuhiro; Hama, Takanori; Murakami, Kasumi; Ogawa, Rei

    2016-01-01

    Objective: In this study, we evaluated the effect of scalp massage on hair in Japanese males and the effect of stretching forces on human dermal papilla cells in vitro. Methods: Nine healthy men received 4 minutes of standardized scalp massage per day for 24 weeks using a scalp massage device. Total hair number, hair thickness, and hair growth rate were evaluated. The mechanical effect of scalp massage on subcutaneous tissue was analyzed using a finite element method. To evaluate the effect of mechanical forces, human dermal papilla cells were cultured using a 72-hour stretching cycle. Gene expression change was analyzed using DNA microarray analyses. In addition, expression of hair cycle-related genes including IL6, NOGGIN, BMP4, and SMAD4 were evaluated using real-time reverse transcription-polymerase chain reaction. Results: Standardized scalp massage resulted in increased hair thickness 24 weeks after initiation of massage (0.085 ± 0.003 mm vs 0.092 ± 0.001 mm). Finite element method showed that scalp massage caused z-direction displacement and von Mises stress on subcutaneous tissue. In vitro, DNA microarray showed gene expression change significantly compared with nonstretching human dermal papilla cells. A total of 2655 genes were upregulated and 2823 genes were downregulated. Real-time reverse transcription-polymerase chain reaction demonstrated increased expression of hair cycle–related genes such as NOGGIN, BMP4, SMAD4, and IL6ST and decrease in hair loss–related genes such as IL6. Conclusions: Stretching forces result in changes in gene expression in human dermal papilla cells. Standardized scalp massage is a way to transmit mechanical stress to human dermal papilla cells in subcutaneous tissue. Hair thickness was shown to increase with standardized scalp massage. PMID:26904154

  7. Biocompatibility of fluoride-coated magnesium-calcium alloys with optimized degradation kinetics in a subcutaneous mouse model.

    PubMed

    Drynda, Andreas; Seibt, Juliane; Hassel, Thomas; Bach, Friedrich Wilhelm; Peuster, Matthias

    2013-01-01

    The principle of biodegradation has been considered for many years in the development of cardiovascular stents, especially for patients with congenital heart defects. A variety of materials have been examined with regard to their suitability for cardiovascular devices. Iron- and magnesium-based stents were investigated intensively during the last years. It has been shown, that iron, or iron based alloys have slow degradation kinetics whereas magnesium-based systems exhibit rapid degradation rates. Recently we have developed fluoride coated binary magnesium-calcium alloys with reduced degradation kinetics. These alloys exhibit good biocompatibility and no major adverse effects toward smooth muscle and endothelial cells in in vitro experiments. In this study, these alloys were investigated in a subcutaneous mouse model. Fluoride coated (fc) magnesium, as well as MgCa0.4%, MgCa0.6%, MgCa0.8%, MgCa1.0%, and a commercially available WE43 alloy were implanted in form of (fc) cylindrical plates into the subcutaneous tissue of NMRI mice. After a 3 and 6 months follow-up, the (fc) alloy plates were examined by histomorphometric techniques to assess their degradation rate in vivo. Our data indicate that all (fc) alloys showed a significant corrosion. For both time points the (fc) MgCa alloys showed a higher corrosion rate in comparison to the (fc) WE43 reference alloy. Significant adverse effects were not observed. Fluoride coating of magnesium-based alloys can be a suitable way to reduce degradation rates. However, the (fc) MgCa alloys did not exhibit decreased degradation kinetics in comparison to the (fc) WE43 alloy in a subcutaneous mouse model. PMID:22767427

  8. Lipometer subcutaneous adipose tissue topography (SAT-Top) reflects serum leptin levels varying in circadian rhythms

    NASA Astrophysics Data System (ADS)

    Moeller, Reinhard; Tafeit, Erwin; Sudi, Karl; Vrecko, Karoline; Horejsi, Renate; Hinghofer-Szalkay, Helmut G.; Reibnegger, Gilbert

    1998-05-01

    Recent advances in obesity research have shown that the product of the ob-gene named leptin is related to total body fast mass in humans. There is, however, a debate if leptin levels are pulsatile and linked to body fat distribution. In this study we therefore investigated the subcutaneous adipose tissue topography (SAT-Top) measured by means of the newly developed device Lipometer and leptin levels during a 24 hours beginning at 0715am ending the same time in the next day. Blood samples for measurement of leptin were taken every 3 hours in a male subject. Measurements of SAT-Top were performed at 15 body sites from neck to calf at the left and right body site at the same time interval. We observed an almost symmetrically reaction of the left and right body site with a maximum of the mean value of all body sites in the evening at 0715pm. There was a negative correlation between serum leptin levels and SAT-Top using the set of certain body sites (R2 equals 0.80, p equals 0.01). If these combination of body sites is inversed and set against serum leptin levels, both curves show almost identical shape and time dependence. We conclude that SAT-Top by means of Lipometer is changed in a short time and related to leptin levels in the investigated male subject.

  9. Towards a low-cost mobile subcutaneous vein detection solution using near-infrared spectroscopy.

    PubMed

    Juric, Simon; Flis, Vojko; Debevc, Matjaz; Holzinger, Andreas; Zalik, Borut

    2014-01-01

    Excessive venipunctures are both time- and resource-consuming events, which cause anxiety, pain, and distress in patients, or can lead to severe harmful injuries. We propose a low-cost mobile health solution for subcutaneous vein detection using near-infrared spectroscopy, along with an assessment of the current state of the art in this field. The first objective of this study was to get a deeper overview of the research topic, through the initial team discussions and a detailed literature review (using both academic and grey literature). The second objective, that is, identifying the commercial systems employing near-infrared spectroscopy, was conducted using the PubMed database. The goal of the third objective was to identify and evaluate (using the IEEE Xplore database) the research efforts in the field of low-cost near-infrared imaging in general, as a basis for the conceptual model of the upcoming prototype. Although the reviewed commercial devices have demonstrated usefulness and value for peripheral veins visualization, other evaluated clinical outcomes are less conclusive. Previous studies regarding low-cost near-infrared systems demonstrated the general feasibility of developing cost-effective vein detection systems; however, their limitations are restricting their applicability to clinical practice. Finally, based on the current findings, we outline the future research direction. PMID:24883388

  10. Towards a Low-Cost Mobile Subcutaneous Vein Detection Solution Using Near-Infrared Spectroscopy

    PubMed Central

    Flis, Vojko; Debevc, Matjaz; Holzinger, Andreas; Zalik, Borut

    2014-01-01

    Excessive venipunctures are both time- and resource-consuming events, which cause anxiety, pain, and distress in patients, or can lead to severe harmful injuries. We propose a low-cost mobile health solution for subcutaneous vein detection using near-infrared spectroscopy, along with an assessment of the current state of the art in this field. The first objective of this study was to get a deeper overview of the research topic, through the initial team discussions and a detailed literature review (using both academic and grey literature). The second objective, that is, identifying the commercial systems employing near-infrared spectroscopy, was conducted using the PubMed database. The goal of the third objective was to identify and evaluate (using the IEEE Xplore database) the research efforts in the field of low-cost near-infrared imaging in general, as a basis for the conceptual model of the upcoming prototype. Although the reviewed commercial devices have demonstrated usefulness and value for peripheral veins visualization, other evaluated clinical outcomes are less conclusive. Previous studies regarding low-cost near-infrared systems demonstrated the general feasibility of developing cost-effective vein detection systems; however, their limitations are restricting their applicability to clinical practice. Finally, based on the current findings, we outline the future research direction. PMID:24883388

  11. Visualization of subcutaneous insulin injections by x-ray computed tomography

    NASA Astrophysics Data System (ADS)

    Thomsen, M.; Poulsen, M.; Bech, M.; Velroyen, A.; Herzen, J.; Beckmann, F.; Feidenhans'l, R.; Pfeiffer, F.

    2012-11-01

    We report how the three-dimensional structure of subcutaneous injections of soluble insulin can be visualized by x-ray computed tomography using an iodine based contrast agent. The injections investigated are performed ex vivo in porcine adipose tissue. Full tomography scans carried out at a laboratory x-ray source with a total acquisition time of about 1 min yield CT-images with an effective pixel size of 109 × 109 μm2. The depots are segmented using a modified Chan-Vese algorithm and we are able to observe differences in the shape of the injection depot and the position of the depot in the skin among equally performed injections. To overcome the beam hardening artefacts, which affect the quantitative prediction of the volume injected, we additionally present results concerning the visualization of two injections using synchrotron radiation. The spatial concentration distribution of iodine is calculated to show the dilution of the insulin drug inside the depot. Characterisation of the shape of the depot and the spatial concentration profile of the injected fluid is important knowledge when improving the clinical formulation of an insulin drug, the performance of injection devices and when predicting the effect of the drug through biomedical simulations.

  12. Subcutaneous Emphysema, Pneumomediastinum, Pneumoretroperitoneum, and Pneumoscrotum: Unusual Complications of Acute Perforated Diverticulitis

    PubMed Central

    Fosi, S.; Giuricin, V.; Girardi, V.; Di Caprera, E.; Costanzo, E.; Di Trapano, R.; Simonetti, G.

    2014-01-01

    Pneumomediastinum, and subcutaneous emphysema usually result from spontaneous alveolar wall rupture and, far less commonly, from disruption of the upper airways or gastrointestinal tract. Subcutaneous neck emphysema, pneumomediastinum, and retropneumoperitoneum caused by nontraumatic perforations of the colon have been infrequently reported. The main symptoms of spontaneous subcutaneous emphysema are swelling and crepitus over the involved site; further clinical findings in case of subcutaneous cervical and mediastinal emphysema can be neck and chest pain and dyspnea. Radiological imaging plays an important role to achieve the correct diagnosis and extension of the disease. We present a quite rare case of spontaneous subcutaneous cervical emphysema, pneumomediastinum, and pneumoretroperitoneum due to perforation of an occult sigmoid diverticulum. Abdomen ultrasound, chest X-rays, and computer tomography (CT) were performed to evaluate the free gas extension and to identify potential sources of extravasating gas. Radiological diagnosis was confirmed by the subsequent surgical exploration. PMID:25136471

  13. Increased Depth of Subcutaneous Fat is Protective against Abdominal Injuries in Motor Vehicle Collisions

    PubMed Central

    Wang, Stewart C.; Bednarski, Brian; Patel, Smita; Yan, Alice; Kohoyda-Inglis, Carla; Kennedy, Theresa; Link, Elizabeth; Rowe, Stephen; Sochor, Mark; Arbabi, Saman

    2003-01-01

    The objective of this study was to determine the effect of differences in subcutaneous fat depth on adult injury patterns in motor vehicle collisions. Sixty-seven consecutive adult crash subjects aged 19–65 who received computed tomography of their chest, abdomen and pelvis as part of their medical evaluation and who consented to inclusion in the Crash Injury Research Engineering Network (CIREN) study were included. Subcutaneous fat was measured just lateral to the rectus abdominus muscle in a transverse section taken through the subject at the level of L4. Women had significantly greater subcutaneous fat depth than men. Increased subcutaneous fat depth was associated with significantly decreased injury severity to the abdominal region of females. A similar trend was noted in males although it did not reach statistical significance. Our findings suggest that increased subcutaneous fat may be protective against injuries by cushioning the abdominal region against injurious forces in motor vehicle collisions. PMID:12941250

  14. Iatrogenic Lower Extremity Subcutaneous Emphysema after Prolonged Robotic-Assisted Hysterectomy

    PubMed Central

    Vetter, Monica Hagan; Mutscheller, Chelsea; Cardenas-Goicoechea, Joel

    2015-01-01

    Subcutaneous emphysema is a known complication of carbon dioxide insufflation, an essential component of laparoscopy. The literature contains reports of hypercarbia, pneumothorax, or pneumomediastinum. However, isolated lower extremity subcutaneous emphysema remains a seldom-reported complication. We report a case of unilateral lower extremity subcutaneous emphysema following robotic-assisted hysterectomy, bilateral salpingooophorectomy, staging, and anterior/posterior colporrhaphy for carcinosarcoma and vaginal prolapse. On postoperative day 1, the patient developed tender crepitus and bruising of her right ankle. Radiography confirmed presence of subcutaneous air. Vital signs and laboratory findings were unremarkable. Her symptoms spontaneously improved over time, and she was discharged in good condition on day 2. In stable patients with postoperative extremity swelling or pain with crepitus on exam, the diagnosis of iatrogenic subcutaneous emphysema must be considered. PMID:26788387

  15. Enhanced bioavailability of subcutaneously injected insulin coadministered with collagen in rats and humans

    SciTech Connect

    Hori, R.; Komada, F.; Iwakawa, S.; Seino, Y.; Okumura, K. )

    1989-09-01

    The present study was undertaken to develop an agent that stabilizes insulin injected subcutaneously. {sup 125}I-Porcine insulin with 0.2 U/kg unlabeled porcine insulin was subcutaneously injected with or without collagen in the rat under the depilated skin of the back. At various times, the radioactivity in subcutaneous tissue was assayed for insulin and its metabolites by gel filtration. The degradation and absorption rate constants of insulin at the subcutaneous injection site were estimated according to a one-compartment model. The degradation rate constant of insulin in the presence of collagen at the injection site was less than half of the control rate. The inhibition was confirmed by increases in the immunoreactive insulin plasma levels and the hypoglycemic effect in rats and healthy volunteers. We postulate that collagen prevents insulin from being degraded by inhibiting proteolytic enzymes, mainly collagenase-like peptidase, in subcutaneous tissue.

  16. A case report of severe ulcerative colitis with mediastinal and subcutaneous emphysema.

    PubMed

    Terasaki, Kei; Okuyama, Yusuke; Ueda, Tomohiro; Matsuyama, Kiichi; Urata, Yoji; Yoshida, Norimasa

    2016-03-01

    A 17-year-old boy developed prominent mediastinal and subcutaneous emphysema while receiving treatment with 5-aminosalicylic acid (5-ASA) and oral corticosteroids for severe ulcerative colitis. We ruled out infection and initiated oral administration of tacrolimus, after which both the underlying disease and mediastinal and subcutaneous emphysema improved. However, he continued to experience repeated bouts of ulcerative colitis, so we ultimately opted for surgical intervention. Although mediastinal and subcutaneous emphysema is rare, it is one of the known extra-intestinal complications and can be particularly concerning. In this patient, mediastinal and subcutaneous emphysema might have been caused by the vulnerability of pulmonary alveolar walls to steroid medication and the increase of pulmonary alveolar pressure with abdominal pain and breath holding. Here, we report a case of inflammatory bowel disease with mediastinal and subcutaneous emphysema, along with a review of the literature. PMID:26947047

  17. A history of growth hormone injection devices.

    PubMed

    Fidotti, E

    2001-05-01

    In the early 1960s, growth hormone (GH) deficiency was treated by intramuscular injection of GH extracted from human pituitary glands. Since then, there have been many advances in treatment encompassing the route of administration, the injection product and the injection device. This review considers the advances in injection device that have already taken place and how they have benefited the patient, particularly in terms of reduced pain and improved convenience. In the future, needle-free injection techniques and depot formulations of GH are likely to offer alternatives to daily subcutaneous injections. PMID:11393569

  18. Liposome-mediated DNA immunisation via the subcutaneous route.

    PubMed

    Perrie, Y; McNeil, S; Vangala, A

    2003-01-01

    Compared to naked DNA immunisation, entrapment of plasmid-based DNA vaccines into liposomes by the dehydration-rehydration method has shown to enhance both humoural and cell-mediated immune responses to encoded antigens administered by a variety of routes. In this paper, we have investigated the application of liposome-entrapped DNA and their cationic lipid composition on such potency after subcutaneous immunisation. Plasmid pI.18Sfi/NP containing the nucleoprotein (NP) gene of A/Sichuan/2/87 (H3N2) influenza virus in the pI.18 expression vector was incorporated by the dehydration-rehydration method into liposomes composed of 16 micromol egg phosphatidylcholine (PC), 8 micromoles dioleoyl phosphatidylethanolamine (DOPE) or cholesterol (Chol) and either the cationic lipid 1,2-diodeoyl-3-(trimethylammonium) propane (DOTAP) or cholesteryl 3-N-(dimethyl amino ethyl) carbamate (DC-Chol). This method, entailing mixing of small unilamellar vesicles (SUV) with DNA, followed by dehydration and rehydration, yielded incorporation values of 90-94% of the DNA used. Mixing or rehydration of preformed cationic liposomes with 100 microg plasmid DNA also led to similarly high complexation values (92-94%). In an attempt to establish differences in the nature of DNA association with these various liposome preparations their physico-chemical characteristics were investigated. Studies on vesicle size, zeta potential and gel electrophoresis in the presence of the anion sodium dodecyl sulphate (SDS) indicate that, under the conditions employed, formulation of liposomal DNA by the dehydration-rehydration generated submicron size liposomes incorporating most of the DNA in a manner that prevents DNA displacement through anion competition. The bilayer composition of these dehydration-rehydration vesicles (DRV(DNA)) can also further influence these physico-chemical characteristics with the presence of DOPE within the liposome bilayer resulting in a reduced vesicle zeta potential. Subcutaneous

  19. Subcutaneous electronic identification in cattle: a field study.

    PubMed

    Løken, T; Vatn, G; Kummen, E

    2011-09-01

    The use of injectable transponders in cattle for identification purposes, for up to 30 months, was investigated. Passive electronic transponders, encapsulated in either polymer or glass, were injected subcutaneously into either the ear base or the earlobe of 652 calves in three populations. The animals were clinically examined weekly, and transponder signalling was checked immediately before and after injection, after two weeks and after about eight months. About 10 per cent of animals in one population were also checked after 20 and 30 months. No severe clinical or visible pathological changes were observed, and the calves' welfare was not apparently affected by the procedure. None of the transponders migrated from their injection sites. Eight months after injection, a signal was detected from 98.2 per cent of transponders injected in the ear base and from 90.5 per cent of those in the earlobe. At 20 and 30 months after injection, 10.4 per cent and 2.6 per cent of transponders, respectively, had ceased to signal. Thus, most transponders in the calves' ear base demonstrated functionality for up to 30 months. PMID:21813580

  20. Retention of bacterial lipopolysaccharide at the site of subcutaneous injection.

    PubMed Central

    Yokochi, T.; Inoue, Y.; Yokoo, J.; Kimura, Y.; Kato, N.

    1989-01-01

    The tissue distribution of Klebsiella pneumoniae O3 lipopolysaccharide (KO3 LPS) was studied in mice injected subcutaneously (s.c.) or intraperitoneally (i.p.) with 125I-labeled KO3 LPS. Marked retention of KO3 LPS radioactivity could be found at the site of s.c. injection for several weeks. On the other hand, about 85% of the radioactivity rapidly disappeared from the peritoneal cavity within 6 h after i.p. injection. The long-term presence of KO3 LPS at the injection site was also supported by experiments with 51Cr-labeled KO3 LPS and immunoblotting and immunofluorescence staining methods. The R-form LPS lacking the O-specific polysaccharide chain of KO3 LPS and the lipid A fraction of KO3 LPS seemed to remain at the site in larger amounts and for longer times than KO3 LPS. There were no marked differences in the retention pattern at the injection site among KO3 LPS, Escherichia coli LPS, Salmonella typhosa LPS, and Salmonella enteritidis LPS. However, much less radioactivity accumulated in the livers and spleens of mice injected with either KO3 LPS or S. typhosa LPS compared with the other LPS preparations. It was suggested that retention of LPS at the site of s.c. injection may play an important role in the development of various biological actions of s.c. injected LPS. Images PMID:2722239

  1. Periodontal regeneration of transplanted rat teeth subcutaneously after cryopreservation.

    PubMed

    Izumi, N; Yoshizawa, M; Ono, Y; Kobayashi, T; Hamamoto, Y; Saito, C

    2007-09-01

    The periodontal regeneration of transplanted teeth after cryopreservation in liquid nitrogen overnight was previously examined using an animal model. The results showed that overnight cryopreservation did not have any severe adverse effects on periodontal healing. For clinical application, it is necessary to make the period of storage longer than in the preliminary study. In this study, the regeneration of periodontal tissues after cryopreservation for 4 weeks was examined. The maxillary molars of 4-week-old Wistar rats were extracted and transplanted into the abdominal subcutaneous tissue either immediately or after cryopreservation in a deep freezer at -80 degrees C. The donor teeth were frozen in a rate-controlling freezer. At 1, 2 and 4 weeks after transplantation, they were excised and observed under light microscopy. The cryopreserved teeth had acellular cementum with a rough surface at 1 week. With an increase in cementoblasts and the appearance of periodontal ligament and alveolar bone, the surface had become smooth at 2 weeks. There was no progressive root resorption. Although the process took somewhat more time, the teeth cryopreserved for 4 weeks showed regeneration that was similar to that of the immediately transplanted teeth. PMID:17804198

  2. Thickness estimation of the subcutaneous fat using coaxial probe.

    PubMed

    Ramezani, Mohammad Hossein; Nadimi, Esmaeil S

    2016-03-01

    In this Letter, a non-invasive method for thickness estimation of the subcutaneous fat layer of abdominal wall is presented by using a coaxial probe. Fat layer has the highest impact on the averaged attenuation parameter of the abdominal wall due to its high thickness and low permittivity. The abdominal wall is modelled as a multi-layer medium and an analytical model for the probe is derived by calculation of its aperture admittance facing to this multi-layer medium. The performance of this model is then validated by a numerical simulation using finite-difference-time-domain (FDTD) analysis. Simulation results show the high impact of the probe dimension and fat layer thickness on the sensitivity of the measured permittivity. The authors further investigate this sensitivity by statistical analysis of the permittivity variations. Finally, measuring in different locations relative to the body surface is presented as a solution to estimate the fat layer thickness in the presence of uncertainty of model parameters. PMID:27222737

  3. Tissue distribution of subcutaneously administered aluminum chloride in weanling rabbits

    SciTech Connect

    Du Val, G.; Grubb, B.R.; Bentley, P.J.

    1986-01-01

    The purpose of the investigation was to determine blood and tissue levels of aluminum (Al) in normal young rabbits. Furthermore, tissue distribution and accumulation of Al were determined as related to blood concentration in Al-dosed rabbits. The levels of Al accumulated were determined in different tissues of growing rabbits after continuous subcutaneous administration of Al chloride (3.78 mg/d) for 28 d. No signs of toxicity were apparent from comparisons of hematocrit or weight gain between control and Al-dosed rabbits. The largest concentration of the Al was observed in bone, which was also found to have the highest levels in the control rabbit tissues. Following bone, the experimental animals showed the greatest increase of Al levels in kidney cortex, kidney medulla, liver, testes, skeletal muscle, heart, brain white matter, and brain hippocampus, in that order. No significant difference was found in brain grey matter between control and experimental animals. As the brain tissue of the Al-treated animals had the lowest Al level of the tissues measured, it appears that there is a partial blood-brain barrier to entry of Al.

  4. Subcutaneous blood pressure monitoring with an implantable optical sensor.

    PubMed

    Theodor, Michael; Ruh, Dominic; Fiala, Jens; Förster, Katharina; Heilmann, Claudia; Manoli, Yiannos; Beyersdorf, Friedhelm; Zappe, Hans; Seifert, Andreas

    2013-10-01

    We introduce a minimally invasive, implantable system that uses pulse transit time to determine blood pressure. In contrast to previous approaches, the pulse wave is detected by a photoplethysmographic (PPG) signal, acquired with high quality directly on subcutaneous muscle tissue. Electrocardiograms (ECG) were measured with flexible, implantable electrodes on the same tissue. PPG detection is realized by a flat 20 mm x 6 mm optoelectronic pulse oximeter working in reflection mode. The optical sensor as well as the ECG electrodes can be implanted using minimally invasive techniques, with only a small incision into the skin, making long-term monitoring of blood pressure in day-to-day life for high-risk patients possible. The in vivo measurements presented here show that the deviation to intra-arterial reference measurements of the systolic blood pressure in a physiologically relevant range is only 5.5 mmHg, demonstrated for more than 12 000 pulses. This makes the presented sensor a grade B blood pressure monitor. PMID:23657895

  5. Gradual pore formation in natural origin scaffolds throughout subcutaneous implantation

    PubMed Central

    Martins, Ana M.; Kretlow, James D.; Costa-Pinto, Ana R.; Malafaya, Patrícia B.; Fernandes, Emanuel M.; Neves, Nuno M.; Alves, Catarina M.; Mikos, Antonios G.; Kasper, F. Kurtis; Reis, Rui L.

    2012-01-01

    The present study employed a rat subcutaneous implantation model to investigate gradual in situ pore formation in a self-regulating degradable chitosan-based material, which comprises lysozyme incorporated into biomimetic calcium phosphate (CaP) coatings at the surface in order to control the scaffold degradation and subsequent pore formation. Specifically, the in vivo degradation of the scaffolds, the in situ pore formation and the tissue response were investigated. Chitosan or chitosan/starch scaffolds were studied with and without a CaP coating in the presence or absence of lysozyme for a total of 6 experimental groups. Twenty-four scaffolds per group were implanted, and eight scaffolds were retrieved at each of three time points (3, 6 and 12 weeks). Harvested samples were analyzed for weight loss, micro-computed tomography, and histological analysis. All scaffolds showed pronounced weight loss and pore formation as a function of time. The highest weight loss was 29.8 ± 1.5%, obtained at week 12 for CaP chitosan/starch scaffolds with lysozyme incorporated. Moreover, all experimental groups showed a significant increase in porosity after 12 weeks. At all time points no adverse tissue reaction was observed, and as degradation increased, histological analysis showed cellular ingrowth throughout the implants. Using this innovative methodology, the ability to gradually generate pores in situ was clearly demonstrated in vivo. PMID:22213676

  6. Photovoltaic device

    DOEpatents

    Reese, Jason A.; Keenihan, James R.; Gaston, Ryan S.; Kauffmann, Keith L.; Langmaid, Joseph A.; Lopez, Leonardo C.; Maak, Kevin D.; Mills, Michael E.; Ramesh, Narayan; Teli, Samar R.

    2015-06-02

    The present invention is premised upon an improved photovoltaic device ("PV device"), more particularly to an improved photovoltaic device with a multilayered photovoltaic cell assembly and a body portion joined at an interface region and including an intermediate layer, at least one interconnecting structural member, relieving feature, unique component geometry, or any combination thereof.

  7. Photovoltaic device

    SciTech Connect

    Reese, Jason A.; Keenihan, James R.; Gaston, Ryan S.; Kauffmann, Keith L.; Langmaid, Joseph A.; Lopez, Leonardo C.; Maak, Kevin D.; Mills, Michael E.; Ramesh, Narayan; Teli, Samar R.

    2015-09-01

    The present invention is premised upon an improved photovoltaic device ("PV device"), more particularly to an improved photovoltaic device (10) with a multilayered photovoltaic cell assembly (100) and a body portion (200) joined at an interface region (410) and including an intermediate layer (500), at least one interconnecting structural member (1500), relieving feature (2500), unique component geometry, or any combination thereof.

  8. Clinical performance of a low cost near infrared sensor for continuous glucose monitoring applied with subcutaneous microdialysis.

    PubMed

    Ben Mohammadi, Lhoucine; Klotzbuecher, T; Sigloch, S; Welzel, K; Goeddel, M; Pieber, T R; Schaupp, L

    2015-08-01

    In this work we present a low cost, minimally invasive, and chip-based near infrared (NIR) sensor, combined with subcutaneous microdialysis, for continuous glucose monitoring (CGM). The sensor principle is based on difference absorption spectroscopy in the 1st overtone band known to be dominated by glucose-specific absorption features. The device comprises a multi-emitter LED and InGaAs-photodiodes, which are located on a single electronic board (non-disposable part), connected to a personal computer via Bluetooth. The disposable part consists of a chip containing the fluidic connections for microdialysis, two fluidic channels acting as optical transmission cells and total internally reflecting mirrors for in- and out-coupling of the light to the chip and to the detectors. The use of the sensor in conjunction with a subcutaneous microdialysis catheter to separate the glucose from the cells and proteins has been demonstrated to be extremely useful and advantageous for obtaining continuous glucose monitoring data and detecting glycemic levels in real time for a long period. Several in vitro and in vivo experiments were conducted to test the reliability of the device. In vitro measurements showed a linear relationship between glucose concentration and the integrated difference signal with a coefficient of determination of 99 % at the physiological concentration range. Clinical trial on 6 subjects with Type 1 diabetes showed that the NIR-CGM sensor data reflects the blood reference values adequately, if a proper calibration and signal drift compensation is applied. The MARD (mean absolute relative difference) value taken on retrospective data over all subjects is 8.5 % (range 6-11.5 %). PMID:26141039

  9. Comparative efficacy of subcutaneous versus oral methotrexate in active rheumatoid arthritis.

    PubMed

    Islam, M S; Haq, S A; Islam, M N; Azad, A K; Islam, M A; Barua, R; Hasan, M M; Mahmood, M; Safiuddin, M; Rahman, M M; Osmany, M F; Bari, N; Rumki, R S; Rashid, F B

    2013-07-01

    This prospective study was conducted in rheumatology clinic under the department of medicine of Bangabandhu Sheikh Mujib Medical University from December 2004 to December 2005 to asses the efficacy, safety and compliance of subcutaneous methotrexate (MTX) in active rheumatoid arthritis (RA) patients. A total of 92 active rheumatoid arthritis patients according to American College of Rheumatology (ACR) criteria were recruited for the trial for six months. Among them 46 cases belonged to injectable MTX group and 46 cases belonged to oral MTX group. Mean±SD age of patients was 45.54±12.42 vs. 44.63±13.99 years in subcutaneous group and oral group respectively. In the subcutaneous group 41 were female and 5 male; in the oral group 34 were female and 12 male. Mean duration of the disease was 49.74 months in subcutaneous group and 49 months in oral group. RA test was positive in 35 cases in both groups whereas Rose Waaler test was positive in 19 patients in subcutaneous group and 14 patients in oral group. At 24 week, response rate of ACR 20 was significantly higher in subcutaneous MTX than oral MTX group (93% vs. 80%, p=0.02). Similarly ACR 50 response was significantly higher in subcutaneous MTX than in oral group (89% vs. 72%, p=0.03). ACR 70 response was not significantly higher in SCMTX group then oral group (11% vs. 9 %, p=0.72). Adverse effects were relatively less in subcutaneous MTX and most common side effects were nausea (37% vs. 63%), vomiting (11% vs. 30%), dyspepsia (29% vs. 48%), dizziness (4l% vs. 52%) and alopecia (72% vs. 85%). The results of the study demonstrated that subcutaneous MTX was significantly more effective than oral MTX at the same dosage in active Rheumatoid arthritis patients with no increase in side effects. PMID:23982537

  10. A numerical method to enhance the performance of a cam-type electric motor-driven left ventricular assist device.

    PubMed

    Huang, Huan; Yang, Ming; Lu, Cunyue; Xu, Liang; Zhuang, Xiaoqi; Meng, Fan

    2013-10-01

    Pulsatile left ventricular assist devices (LVADs) driven by electric motors have been widely accepted as a treatment of heart failure. Performance enhancement with computer assistance for this kind of LVAD has seldom been reported. In this article, a numerical method is proposed to assist the design of a cam-type pump. The method requires an integrated model of an LVAD system, consisting of a motor, a transmission mechanism, and a cardiovascular circulation. Performance indices, that is, outlet pressure, outlet flow, and pump efficiency, were used to select the best cam profile from six candidates. A prototype pump connected to a mock circulatory loop (MCL) was used to calibrate the friction coefficient of the cam groove and preliminarily evaluate modeling accuracy. In vitro experiments show that the mean outlet pressure and flow can be predicted with high accuracy by the model, and gross geometries of the measurements can also be reproduced. Simulation results demonstrate that as the total peripheral resistance (TPR) is fixed at 1.1 mm Hg.s/mL, the two-cycle 2/3-rise profile is the best. Compared with other profiles, the maximum increases of pressure and flow indices are 75 and 76%, respectively, and the maximum efficiency increase is over 51%. For different TPRs (0.5∼1.5 mm Hg.s/mL) and operation intervals (0.1∼0.4 s) in counterpulsation, the conclusion is also acceptable. PMID:23634991