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Sample records for subcutaneous counterpulsation device

  1. Comparison of an extraaortic counterpulsation device versus intraaortic balloon pumping in severe cardiac failure.

    PubMed

    Zelano, J A; Ko, W; Lazzaro, R; Lazenby, W D; Topaz, S; Kolff, W J; Isom, O W; Krieger, K H

    1991-01-01

    A valveless, single orifice polyurethane ventricle was implanted on the brachiocephalic artery in sheep (n = 14) to provide extraaortic counterpulsation. In parallel, an intraaortic balloon was placed in the descending thoracic aorta. Both devices were pneumatically driven by a standard intraaortic balloon pump (IABP) console at a preload of 40 cc. Severe cardiac failure was induced with high dosages of esmolol. Measured parameters were aortic pressure (PA) and flow (QA), coronary flow (QC), and left ventricular pressure (PLV). Tension time index (TTI), total QA and QC, and end-diastolic aortic pressure (EDP) were computed to compare the efficacy of counterpulsation between assisted and unassisted conditions. Three conditions of inflation/deflation timing were examined: Normal timing (NT), early inflation (EI), and late deflation (LD). Results indicated that extraaortic counterpulsation device actuation yielded statistically significant increases in QC, and significant decreases in EDP and TTI for all timing conditions examined, when compared with unassisted conditions. Flow was significantly increased only for EI and NT timing conditions. Counterpulsation delivered with IABP yielded statistically significant increases in EDP for LD timing, and significant decreases in TTI for NT only. These results indicate that EACD is much less dependent on inflation/deflation timing when compared with IABP. The extraaortic counterpulsation device consistently increases QC and decreases TTI, which enhances the oxygen supply/consumption ratio (S/C) of the left ventricle. The intraaortic balloon pump does not significantly increase S/C in severe cardiac failure, and will increase afterload if deflation timing is not properly set.

  2. 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

  3. 21 CFR 870.5225 - External counter-pulsating device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Therapeutic Devices § 870.5225 External... patient condition; (ii) Reliabilities of the mechanical and electrical systems must be established...

  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.

  5. 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

  6. 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)....

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. Counterpulsation with symphony prevents retrograde carotid, aortic, and coronary flows observed with intra-aortic balloon pump support.

    PubMed

    Giridharan, Guruprasad A; Bartoli, Carlo R; Spence, Paul A; Dowling, Robert D; Koenig, Steven C

    2012-07-01

    A counterpulsation device (Symphony) is being developed to provide long-term circulatory support for advanced heart failure (HF) patients. In acute animal experiments, flow waveform patterns in the aortic, carotid, and coronary arteries were compared during Symphony and intra-aortic balloon pump (IABP) support. Human data were examined for similarities. The 30-mL Symphony was compared to a 40-mL IABP in calves with cardiac dysfunction (80-100 kg, n = 8). Aortic pressures and aortic, carotid, and coronary artery flows were simultaneously recorded at baseline (devices off) and during 1:1 and 1:2 support. Forward, retrograde, and mean flows were calculated and compared for each test condition. Findings were also compared to aortic flow measurements recorded in HF patients (n = 21) supported by 40-mL IABP. IABP caused significant retrograde flows in the aorta, coronary (IABP: -24 ± 8 mL/min, Symphony: -6 ± 2 mL/min, baseline: -2 ± 1 mL/min, P < 0.05), and carotid arteries (IABP: -30 ± 5 mL/min, Symphony: -0 ± 0 mL/min, baseline: -0 ± 0 L/min, P < 0.05) during ventricular systole compared to the Symphony. IABP support produced higher diastolic pressure and flow augmentation compared to Symphony. Due to retrograde flows during IABP support, Symphony provided higher overall coronary, carotid, and aortic flows. Similar reduction in total aortic flows due to retrograde flow was observed in HF patients during IABP support. Counterpulsation with an IABP via aortic volume displacement produces retrograde flows during rapid balloon deflation that reduces total flow. Counterpulsation with Symphony via volume removal eliminates retrograde flow and improves total flow more than that achieved with IABP. The Symphony may provide long-term hemodynamic benefits in HF patients.

  2. 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.

  3. 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

  4. 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.

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. Have we given up on intra-aortic balloon counterpulsation in post-myocardial infarction cardiogenic shock?

    PubMed

    Acharji, Subasit; Mathur, Atish; Lakshmanadoss, Umashankar; Prasad, Hari; Singh, Maninder; Kaluski, Edo

    2013-11-01

    The recently published Intra-aortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial concluded that intra-aortic counterpulsation (IACP) does not reduce 30-day mortality in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI) for whom early revascularization strategy was planned. The study resulted in downgrading IACP in post-AMI CS patients by certain professional organizations like the European Society of Cardiology. Although this is the largest and most important CS study of this decade, it suffers from considerable shortcomings: (1) time intervals from chest-pain onset or AMI recognition to revascularization, enrollment, and IACP initiation are not disclosed; (2) 86.6% of the treatment arm initiated IACP only post-percutaneous coronary intervention (PCI), and 4.3 % did not receive IACP at all; (3) 17.4% of the control arm crossed over to IACP or other mechanical support, mostly due to protocol violations; (4) there is no adjudication of the mortality events; (5) follow-up is limited to 30 days; and (5) both methodology (especially IACP device size) and quality of IACP are not evaluated and documented. Because the study assessed mostly the efficacy and safety of IACP initiated post-PCI, the study conclusions should not be extrapolated to IACP pre-PCI or during PCI in CS. Moreover, IACP had a favorable effect on the mortality of younger patients. Intra-aortic counterpulsation should remain the first line of mechanical circulatory support for the hemodynamically compromised AMI patients with or without CS who are undergoing primary PCI. Early upgrade to more advanced mechanical circulatory support should be considered for selective suitable candidates who remain in refractory CS despite revascularization and IACP.

  10. 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

  11. A new approach to assist postoperative heart failure in an animal model: juxta-aortic counterpulsation.

    PubMed

    Fischer, Edmundo I Cabrera; Christen, Alejandra I; Risk, Marcelo R; Pessana, Franco M; de Forteza, Eduardo

    2002-10-01

    Aortic counterpulsation is a useful technique frequently used in postcardiotomy heart failure. An acute heart failure model in open chest sheep was chosen to evaluate hemodynamic improvement with a counterpulsation balloon pump in juxta-aortic position. This was achieved with a manufactured Dacron prosthesis and a balloon pump placed between the prosthesis and the aorta. Juxta-aortic balloon pump counterpulsation in acute experimental heart failure resulted in a significant improvement of hemodynamic parameters: increase of cardiac output (from 0.86 +/- 0.04 to 1.29 +/- 0.09 L/min, p < 0.05) and cardiac index (from 0.03 +/- 0.01 to 0.04 +/- 0.01 L/min per kg, p < 0.05), and decrease of systemic vascular resistance (from 89.76 +/- 6.69 to 66.56 +/- 6.02 mm Hg/L per min, p < 0.05). The extent of aortic diastolic pressure change evaluated through the diastolic and systolic areas beneath the aortic pressure curve (DABAC/SABAC) index before cardiac failure induction showed a significant increase compared with unassisted values (from 0.81 +/- 0.10 to 1.12 +/- 0.09, p < 0.05). Assisted values of DABAC/SABAC index after heart failure induction also showed a significant increase compared with unassisted values (from 0.78 +/- 0.21 to 1.17 +/- 0.38, p < 0.05). Treatment of experimental acute heart failure by juxta-aortic balloon pump counterpulsation allows an effective hemodynamic improvement in open chest sheep.

  12. 78 FR 79304 - Cardiovascular Devices; Reclassification of External Counter-Pulsating Devices for Treatment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ... 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 FR... FR 7966; February 5, 1980). Therefore, section 501(f)(2)(B) of the FD&C Act requires that a PMA...

  13. [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

  14. Modulation of the Foreign Body Reaction for Implants in the Subcutaneous Space: Microdialysis Probes as Localized Drug Delivery/Sampling Devices

    PubMed Central

    Mou, Xiaodun; Lennartz, Michelle R; Loegering, Daniel J; Stenken, Julie A

    2011-01-01

    Modulation of the foreign body reaction is considered to be an important step toward creation of implanted sensors with reliable long-term performance. In this work, microdialysis probes were implanted into the subcutaneous space of Sprague-Dawley rats. The probe performance was evaluated by comparing collected endogenous glucose concentrations with internal standard calibration (2-deoxyglucose, antipyrine, and vitamin B12). Probes were tested until failure, which for this work was defined as loss of fluid flow. In order to determine the effect of fibrous capsule formation on probe function, monocyte chemoattractant protein-1/CC chemokine ligand 2 (MCP-1/CCL2) was delivered locally via the probe to increase capsule thickness and dexamethasone 21-phosphate was delivered to reduce capsule thickness. Probes delivering MCP-1 had a capsule that was twice the thickness (500–600 μm) of control probes (200–225 μm) and typically failed 2 days earlier than control probes. Probes delivering dexamethasone 21-phosphate had more fragile capsules and the probes typically failed 2 days later than controls. Unexpectedly, extraction efficiency and collected glucose concentrations exhibited minor differences between groups. This is an interesting result in that the foreign body capsule formation was related to the duration of probe function but did not consistently relate to probe calibration. PMID:21722577

  15. [The compression and storage of enhanced external counterpulsation waveform based on DICOM standard].

    PubMed

    Hu, Ding; Xie, Shuqun; Yu, Donglan; Zheng, Zhensheng; Wang, Kuijian

    2010-04-01

    The development of external counterpulsation (ECP) local area network system and extensible markup language (XML)-based remote ECP medical information system conformable to digital imaging and communications in medicine (DICOM) standard has been improving the digital interchangeablity and sharability of ECP data. However, the therapy process of ECP is a continuous and longtime supervision which builds a mass of waveform data. In order to reduce the storage space and improve the transmission efficiency, the waveform data with the normative format of ECP data files have to be compressed. In this article, we introduced the compression arithmetic of template matching and improved quick fitting of linear approximation distance thresholding (LADT) in combimation with the characters of enhanced external counterpulsation (EECP) waveform signal. The DICOM standard is used as the storage and transmission standard to make our system compatible with hospital information system. According to the rules of transfer syntaxes, we defined private transfer syntax for one-dimensional compressed waveform data and stored EECP data into a DICOM file. Testing result indicates that the compressed and normative data can be correctly transmitted and displayed between EECP workstations in our EECP laboratory. PMID:20481329

  16. [The compression and storage of enhanced external counterpulsation waveform based on DICOM standard].

    PubMed

    Hu, Ding; Xie, Shuqun; Yu, Donglan; Zheng, Zhensheng; Wang, Kuijian

    2010-04-01

    The development of external counterpulsation (ECP) local area network system and extensible markup language (XML)-based remote ECP medical information system conformable to digital imaging and communications in medicine (DICOM) standard has been improving the digital interchangeablity and sharability of ECP data. However, the therapy process of ECP is a continuous and longtime supervision which builds a mass of waveform data. In order to reduce the storage space and improve the transmission efficiency, the waveform data with the normative format of ECP data files have to be compressed. In this article, we introduced the compression arithmetic of template matching and improved quick fitting of linear approximation distance thresholding (LADT) in combimation with the characters of enhanced external counterpulsation (EECP) waveform signal. The DICOM standard is used as the storage and transmission standard to make our system compatible with hospital information system. According to the rules of transfer syntaxes, we defined private transfer syntax for one-dimensional compressed waveform data and stored EECP data into a DICOM file. Testing result indicates that the compressed and normative data can be correctly transmitted and displayed between EECP workstations in our EECP laboratory.

  17. 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

  18. 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

  19. Arterial compliance is a main variable determining the effectiveness of intra-aortic balloon counterpulsation: quantitative data from an in vitro study.

    PubMed

    Papaioannou, Theodoros G; Mathioulakis, Dimitrios S; Nanas, John N; Tsangaris, Sokratis G; Stamatelopoulos, Stamatios F; Moulopoulos, Spyridon D

    2002-05-01

    Quantitative data concerning the effect of arterial compliance (AC) on the effectiveness of intra-aortic balloon counterpulsation (IABC) are lacking. The main objective of this study was to investigate the relationship between AC and IABC performance. For this purpose we constructed a Windkessel, lumped-element, hydraulic model of the systemic circulation. The model consisted of a left ventricular assist device (LVAD), a compliance chamber, a peripheral resistor and two open reservoirs. Two Datascope Driving systems were used to operate the LVAD and intra-aortic balloon. We studied the effect of arterial compliance on the effectiveness of IABC at different levels of mean pressure (55, 75 and 95 mmHg) and heart rates (80, 100, 120 bpm). Three indices were used to evaluate IABC performance: the reduction of systolic and end-diastolic "arterial" pressure and the augmentation of diastolic pressure, induced by the IABC. A 22% decrease in AC (1.8-1.4 ml/mmHg) lead to a 30-40% increase in the indices of IABC performance, independently from pressure. In conclusion, arterial compliance significantly affects IABC efficacy and it could be considered as a further clinical criterion to decide IABC application. PMID:11996846

  20. Subcutaneous solitary fibrous tumor.

    PubMed

    Yoshida, Yuichi; Kubota, Yumiko; Yamaguchi, Takahiro; Iwasaki, Hiroshi; Nakayama, Juichiro

    2004-12-01

    We describe a unique case of subcutaneous solitary fibrous tumor (SFT) in a 56-year-old female patient. The patient had been aware of a painless soft mass in her back for ten years. The lesion was surgically excised. Histological examination revealed that the well-defined mass was composed of a proliferation of spindle-shaped fibroblastic cells and polygonal cells embedded in a fibrous matrix corresponding to the so-called "patternless pattern". A prominent pericytomatous pattern (hemangiopericytoma-like structures), focal myxoid changes, and thick hyalinized collagen fibers were also observed. Immunohistochemical stainings for CD34 and bcl-2 were positive in the tumor cells. These features are compatible with SFT. We suggest that SFT should be included in the differential diagnosis of subcutaneous spindle cell tumors.

  1. [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

  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.

  3. 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.

  4. Bypass surgery for left main coronary artery disease. Reduced perioperative myocardial infarction with preoperative intra-aortic balloon counterpulsation.

    PubMed Central

    Tahan, S R; Geha, A S; Hammond, G L; Cohen, L S; Langou, R A

    1980-01-01

    From July 1975 to December 1977, 91 consecutive patients with left main coronary artery disease defined by cardiac catheterisation as greater than or equal to 50 per cent luminal narrowing underwent coronary bypass surgery. Prospective examination of the preoperative and postoperative clinical course of these patients was performed to determine the incidence of perioperative myocardial infarction. Intra-aortic balloon counterpulsation was instituted preoperatively in 35 patients, and these patients were classed as group A. Fifty-six patients did not receive the intra-aortic balloon pump and were classed as group B. Of 26 demographic, clinical, haemodynamic, and operative descriptors, only two were found to be significantly different between the two groups: the severity and the pattern of angina. Group A had a higher percentage of patients with class IV angina (80% vs 45%) and a greater proportion with unstable angina (37% vs 7%). Despite these differences group A patients had only a 3 per cent incidence of perioperative myocardial infraction while group B had a 23 per cent perioperative infarction rate. It is suggested that perioperative intra-aortic balloon counterpulsation can reduce the risk of perioperative myocardial infraction in patients with left main coronary artery stenosis. PMID:6965866

  5. 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

  6. Passive tobacco exposure may impair symptomatic improvement in patients with chronic angina undergoing enhanced external counterpulsation

    PubMed Central

    Efstratiadis, Stilianos; Kennard, Elizabeth D; Kelsey, Sheryl F; Michaels, Andrew D

    2008-01-01

    Background The adverse effects of tobacco abuse on cardiovascular outcomes are well-known. However, the impact of passive smoke exposure on angina status and therapeutic response is less well-established. We examined the impact of second-hand smoke (SHS) exposure on symptomatic improvement in patients with chronic ischemic coronary disease undergoing enhanced external counterpulsation (EECP). Methods This observational study included 1,026 non-smokers (108 exposed and 918 not-exposed to SHS) from the Second International EECP Patient Registry. We also assessed angina response in 363 current smokers. Patient demographics, symptomatic improvement and quality of life assessment were determined by self-report prior and after EECP treatment. Results Non-smoking SHS subjects had a lower prevalence of prior revascularization (85% vs 90%), and had an increased prevalence of stroke (13% vs 7%) and prior smoking (72% vs 61%; all p < 0.05) compared to non-smokers without SHS exposure. Despite comparable degrees of coronary disease, baseline angina class, medical regimens and side effects during EECP, fewer SHS non-smokers completed a full 35-hour treatment course (77% vs 85%, p = 0.020) compared to non-smokers without SHS. Compared to non-smokers without SHS, non-smoking SHS subjects had less angina relief after EECP (angina class decreased ≥ 1 class: 68% vs 79%; p = 0.0082), both higher than that achieved in current smokers (66%). By multivariable logistic regression, SHS exposure was an independent predictor of failure to symptomatic improvement after EECP among non-smokers (OR 1.81, 95% confidence intervals 1.16–2.83). Conclusion Non-smokers with SHS exposure had an attenuated improvement in anginal symptoms compared to those without SHS following EECP. PMID:18798998

  7. [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

  8. Pulmonary artery balloon counterpulsation for right ventricular failure. An experimental evaluation.

    PubMed

    Jett, G K; Siwek, L G; Picone, A L; Applebaum, R E; Jones, M

    1983-09-01

    Right ventricular (RV) failure frequently occurs in patients undergoing correction of congenital cardiac defects, as well as in other clinical settings. RV hypertrophy was created in 10 neonatal lambs by pulmonary artery (PA) banding. Twelve months later RV hypertrophy was present (RV weight/body weight = 2.71 +/- 0.31 gm/kg); RV systolic pressures were elevated (65 +/- 9 mm Hg) and the average gradient across the PA band was 38 +/- 9 mm Hg. RV failure was produced in all animals by performing a right ventriculotomy. Four unassisted (control) animals died shortly after separation from bypass. Six experimental animals underwent pulmonary artery balloon counterpulsation (PABCP). A Dacron graft anastomosed to the proximal PA served as a reservoir for a 40 ml intra-aortic balloon pump system. PABCP effectively reversed RV failure, low cardiac output, and systemic arterial hypotension. Periods with PABCP on and off in each animal were compared. PABCP increased cardiac output from 1.45 +/- 0.16 to 2.03 +/- 0.13 L/min (p less than 0.0001) and increased aortic systolic pressure from 78 +/- 7 to 99 +/- 6 mm Hg (p less than 0.0004). PABCP produced a significant reduction in RV peak systolic pressure from 56 +/- 5 to 41 +/- 3 mm Hg (p less than 0.0001). PA peak pressure distal to the band increased from 31 +/- 2 to 40 +/- 1 mm Hg (p less than 0.0001). Right atrial pressure decreased from 14 +/- 1 to 11 +/- 1 mm Hg (p less than 0.0001) with PABCP, and RV end-diastolic pressure fell from 15 +/- 1 to 11 +/- 1 mm Hg (p less than 0.0001). RV stroke work index increased 49% from 0.081 +/- 0.011 to 0.121 +/- 0.017 gm X m/kg/beat (p less than 0.01), and RV systolic pressure time index decreased 38% from 1140 +/- 79 to 710 +/- 65 mm Hg sec/min (p less than 0.0001). Thus PABCP in the presence of RV dysfunction can produce substantial improvement in RV function and in overall cardiac function and may prove clinically useful in managing patients in refractory RV failure.

  9. Subcutaneous transport of extravascular blood

    NASA Astrophysics Data System (ADS)

    Winnem, Andreas Meyer; Randeberg, Lise Lyngsnes; Larsen, Eivind L. P.; Lilledahl, Magnus B.; Haaverstad, Rune; Haugen, Olav A.; Skallerud, Bjørn; Svaasand, Lars O.

    2006-02-01

    An objective method for dating of soft tissue injuries is highly desired in forensic medicine. To achieve this, obtaining a fundamental understanding of extravascular blood behavior is necessary. Porcine blood mixed with fluorescein was inserted subcutaneously on an anaesthetized pig. The fluorescence build-up was measured as a function of time, using a fiber probe setup. Fluorescence measurements proved to be a suitable tool for monitoring the temporal distribution of fluid in a subcutaneous hemorrhage. Reasonable values for the fluid velocity was obtained by monitoring the fluorescein distribution around the infusion point. Further theoretical work and development of the experimental technique is necessary to obtain a good understanding of subcutaneous transport of blood.

  10. [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

  11. Immediate reconstruction after subcutaneous mastectomy.

    PubMed

    Maillard, G F; Garey, L J

    1989-01-01

    We describe an improved technique for subcutaneous mastectomy using two surgical approaches, one through a short axillary incision and the other through an inframmary incision. Pathological breast tissue is removed from the prepectoral space through the lower incision and a silicone implant is placed in the retropectoral space through the axillary approach. A further modification is described using a laterally rotated inframmary dermis flap to reinforce the lateral margin of the retropectoral space containing the prosthesis.

  12. 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.

  13. 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

  14. Subcutaneous chronic implantable defibrillation systems in humans.

    PubMed

    Cappato, Riccardo; Smith, Warren M; Hood, Margaret A; Crozier, Ian G; Jordaens, Luc; Spitzer, Stefan G; Ardashev, Andrey V; Boersma, Lucas; Lupo, Pierpaolo; Grace, Andrew A; Bardy, Gust H

    2012-09-01

    The recent introduction of subcutaneous implantable cardioverter defibrillator (S-ICD) has raised attention about the potential of this technology for clinical use in daily clinical practice. We review the methods and results of the four studies conducted in humans for approval of this innovative technology for daily practice. Two studies using a temporary S-ICD system (acute human studies) were conducted to search for an appropriate lead configuration and energy requirements. For this purpose, 4 S-ICD configurations were tested in 78 patients at the time of transvenous (TV)-ICD implantation. The optimal configuration was tested in 49 more patients to comparatively assess the subcutaneous defibrillation threshold (S-DFT) versus the standard TV-ICD. Long-term implants were evaluated in 55 patients using an implanted system (chronic human study). The acute humans studies led to an optimal S-ICD configuration comprising a parasternal electrode and left anterolateral thoracic pulse generator. Both configurations successfully terminated 98% of induced ventricular fibrillation (VF), but significantly higher energy levels were required with S-ICD than with TV-ICD systems (36.6 ± 19.8 J vs. 11.1 ± 8.5 J). In the chronic study, all 137 VF episodes induced at time of implant were detected with a 98% conversion rate. Two pocket infections and four lead revisions were required during 10 ± 1 months of follow-up. During this period, survival was 98%, and 12 spontaneous ventricular tachyarrhythmias were detected and treated by the device. These data show that the S-ICD systems here consistently detected and converted VF induced at time of implant as well as sustained ventricular tachyarrhythmias occurring during follow-up (248). PMID:22426601

  15. ENHANCED EXTERNAL COUNTERPULSATION REDUCES INDICES OF CENTRAL BLOOD PRESSURE AND MYOCARDIAL OXYGEN DEMAND IN PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION

    PubMed Central

    Beck, Darren T.; Casey, Darren P.; Martin, Jeffrey S.; Sardina, Paloma D.; Braith, Randy W.

    2015-01-01

    Enhanced external counterpulsation (EECP) therapy decreases angina episodes and improves quality of life in patients with left ventricular dysfunction (LVD). However, the underlying mechanisms relative to the benefits of EECP therapy in patients with LVD have not been fully elucidated. The purpose of this study was to investigate the effects of EECP on indices of central hemodynamics, aortic pressure wave reflection characteristics and estimates of LV load and myocardial oxygen demand in patients with LVD. Patients with chronic stable angina and left ventricular ejection fraction (LVEF) <40%, but > 30%, were randomized to either an EECP (LVEF=35.1±4.6%; n=10) or sham-EECP (LVEF=34.3±4.2%; n=7) group. Pulse wave analysis (PWA) of the central aortic pressure waveform (AoPW) and LV function were evaluated by applanation tonometry before and after 35 1-hr sessions of EECP or Sham EECP. EECP therapy was effective in reducing indices of left ventricular wasted energy (LVEw) and myocardial oxygen demand (TTI) by 25% and 19%, respectively. In addition, indices of coronary perfusion pressure (DTI) and subendocardial perfusion (SEVR) were increased by 9% and 30% after EECP, respectively. Our data indicate that EECP may be useful as adjuvant therapy for improving functional classification in heart failure patients through reductions in central blood pressure, aortic pulse pressure, wasted left ventricular energy, and myocardial oxygen demand which suggests improvements in ventricular-vascular interactions. PMID:25676084

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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 ...

  1. Subcutaneous or intramuscular insulin injections.

    PubMed Central

    Smith, C P; Sargent, M A; Wilson, B P; Price, D A

    1991-01-01

    To find out whether diabetic children may inject their insulin intramuscularly rather than subcutaneously, a random sample of 32 patients aged 4.3-17.9 (median 11.3) years was studied. Distance from skin to muscle fascia was measured by ultrasonography at standard injection sites on the outer arm, anterior and lateral thigh, abdomen, buttock, and calf. Distances were greater in girls (n = 15) than in boys (n = 17). Whereas in most boys the distances were less than the length of the needle (12.5 mm) at all sites except the buttock, in most girls, the distances were greater than 12.5 mm except over the calf. Over the fascial plane just lateral to the rectus muscle the distance from skin to peritoneum was less than 12.5 mm in 14 of the 17 boys and one of the 15 girls. Twenty five of the 32 children injected at an angle of 90 degrees, and 24 children raised a skinfold before injecting. By raising a skinfold over the anterior thigh, the distance from skin to muscle fascia was increased by 19% (range 0-38%). We conclude that most boys and some girls who use the perpendicular injection technique may often inject insulin into muscle, and perhaps on occasions into the peritoneal cavity. PMID:1863105

  2. Massive Preperitoneal Hematoma after a Subcutaneous Injection

    PubMed Central

    Yoshikawa, Kentaro; Lefor, Alan Kawarai; Kubota, Tadao; Mizokami, Ken

    2016-01-01

    Preperitoneal hematomas are rare and can develop after surgery or trauma. A 74-year-old woman, receiving systemic anticoagulation, developed a massive preperitoneal hematoma after a subcutaneous injection of teriparatide using a 32-gauge, 4 mm needle. In this patient, there were two factors, the subcutaneous injection of teriparatide and systemic anticoagulation, associated with development of the hematoma. These two factors are especially significant, because they are widely used clinically. Although extremely rare, physicians must consider this potentially life-threatening complication after subcutaneous injections, especially in patients receiving anticoagulation. PMID:27738545

  3. 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

  4. 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

  5. Efficacy of Enhanced External Counterpulsation in Patients With Chronic Refractory Angina on Canadian Cardiovascular Society (CCS) Angina Class

    PubMed Central

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

    2015-01-01

    Abstract 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 I2 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, I2 = 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, I2 = 32.7%, P = 0.1668). After 3 large studies were excluded, the pooled proportion was 82% (95%CI 0.79–0.86, I2 = 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

  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. Rescue peri-operative management of the patient with giant electrical storm and severe left ventricular dysfunction: support by levosimendan and intraaortic balloon counterpulsation.

    PubMed

    Vanek, Tomas; Kolesar, Miroslav; Nejedly, Michal; Jirmar, Radovan

    2008-08-01

    We present a case of a 62-year-old male patient (coronary heart disease, and stenosis of aortic valve) with severe left ventricular dysfunction (left ventricular ejection fraction 20%, left ventricular end-diastolic diameter 80 mm, end-diastolic volume 329 ml) who developed giant electrical storm (on the whole 115 episodes of pulseless ventricular tachycardia treated by antiarrhythmics and electrical discharges) with low-elevation of cardiac biomarkers. The patient was referred to emergent cardiac surgery (double coronary bypass grafting, aortic valve replacement, and implantation of left ventricular epicardial electrode). Levosimendan and intraaortic balloon counterpulsation were used for successful weaning from the cardiopulmonary bypass; no other arrhythmia appeared in the post-bypass period. Postoperatively no arrhythmic events were detected, and repeated echocardiographic examinations of the patient in good general condition showed gradual improvement of left ventricular ejection fraction (30-35%), likewise in other parameters (left ventricular end-diastolic diameter 72 mm, end-diastolic volume 285 ml).

  8. [The enhanced external counterpulsation as a method of non-invasive auxiliary blood circulation used for the combined rehabilitative treatment of the patients surviving after ischemic stroke (a review)].

    PubMed

    Eneeva, M A; Kostenko, E V; Razumov, A N; Petrova, L V; Bobyreva, S N; Nesuk, O M

    2015-01-01

    The present review of the foreign and domestic literature is concerned with the application of the method of enhanced external counterpulsation (EECP) therapy for the treatment of the patients presenting with various diseases. It is shown that many recent publications report extensive investigations of the clinical and neurophysiological aspects of the application of this method for the combined regenerative treatment of the patients surviving after ischemic stroke (IS). The possibility of the influence of EECP therapy on the system of regulation of the cerebral blood flow, the formation of collateral circulation in the ischemic tissue, and the cellular-humoral mechanisms are considered. It is concluded that the introduction of enhanced external counterpulsation therapy into the program of the combined rehabilitative treatment on an individual basis for the patients surviving after ischemic stroke is pathogenetically substantiated as promoting regression of clinical, neurological, and neuropsychological disorders.

  9. 21 CFR 880.5965 - Subcutaneous, implanted, intravascular infusion port and catheter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... port and catheter. 880.5965 Section 880.5965 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... port and catheter. (a) Identification. A subcutaneous, implanted, intravascular infusion port and... catheter is either preattached to the port or attached to the port at the time of device placement....

  10. 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

  11. [Relationship between sexual maturation and subcutaneous fat].

    PubMed

    García Llop, L A; Ramada Benedito, A; Rodríguez-Estecha, P

    1990-10-01

    Due to the great variability at the beginnings and the period of the puberty, authors have studied the modifications of the subcutaneous-fat and their relation with the sexual maturating. They have measured the skinfold thickness of biceps, triceps, subscapular and suprailiac in 358 boys from 10 to 15 years old and 424 girls from 8 to 14 years old inrelation to sexual maturating through the stages described by Tanner. It has been found more subcutaneous fat in girls than in boys (p less than 0.05). The boys increase their subcutaneous fat until the stage 3 (except the skinfold triceps) and decrease later (except the skinfold subscapular). In boys, the analysis of varianza, show that the variations are related with the sexual maturating and not with chronologic age. PMID:2278437

  12. Local reactions from subcutaneous allergen immunotherapy.

    PubMed

    Coop, Christopher A

    2013-12-01

    Local reactions from subcutaneous allergen immunotherapy are very common during the course of immunotherapy. These local reactions are not bothersome to patients. Local reactions from immunotherapy also do not predict future local or systemic reactions. This review discusses the studies that show that local reactions are not predictive of future reactions and that dose adjustments for local reactions from allergen immunotherapy are unnecessary. The article also focuses on factors that lead to patient noncompliance with immunotherapy and evaluates methods to prevent local reactions from subcutaneous allergen immunotherapy. PMID:24283844

  13. 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

  14. Local reactions from subcutaneous allergen immunotherapy.

    PubMed

    Coop, Christopher A

    2013-12-01

    Local reactions from subcutaneous allergen immunotherapy are very common during the course of immunotherapy. These local reactions are not bothersome to patients. Local reactions from immunotherapy also do not predict future local or systemic reactions. This review discusses the studies that show that local reactions are not predictive of future reactions and that dose adjustments for local reactions from allergen immunotherapy are unnecessary. The article also focuses on factors that lead to patient noncompliance with immunotherapy and evaluates methods to prevent local reactions from subcutaneous allergen immunotherapy.

  15. Subcutaneous mycoses: chromoblastomycosis, sporotrichosis and mycetoma.

    PubMed

    Bonifaz, Alexandro; Vázquez-González, Denisse; Perusquía-Ortiz, Ana María

    2010-08-01

    Subcutaneous mycoses are common in subtropical and tropical regions of the world. They are rarely observed in Europe. These mycoses are heterogeneous, but all are caused by penetrating trauma of the skin. Most cases in Europe are observed in returning travelers, aid workers, archaeologists and immigrants. Therefore, a careful, thorough history is essential in order to reach a proper diagnosis. We provide up-to-date epidemiological, clinical, diagnostic, and therapeutic data on the three most important imported subcutaneous mycoses in Europe: chromoblastomycosis, sporotrichosis and mycetoma.

  16. [Report of case of subcutaneous cysticercosis].

    PubMed

    Vidal, Sylvia

    2013-06-01

    Infection of the larval form (cysticerco) of Taenia in any tissue or organ is known as the disease cysticercosis. Many sites of infection have been documented but the central nervous system has been the most common. It present a case report of a 19 years old patient with a subcutaneous cysticercosis confirmed with biopsy.

  17. The subcutaneous ICD—current evidence and challenges

    PubMed Central

    Patel, Kiran Haresh Kumar

    2014-01-01

    The subcutaneous implantable cardioverter-defibrillator (S-ICD) represents an exciting development in ICD technology. It has relative advantages over traditional transvenous systems, particularly for young patients in whom the lifetime risk of device-related complications may be deemed to be unacceptably high. While data relating to device longevity and long term safety profile is yet to be accrued, several recent studies have demonstrated good clinical efficacy comparable to transvenous ICDs. Indeed, new techniques have also been developed to simplify the S-ICD implantation procedure and attempts have been made to address challenges pertaining to T-wave oversensing to reduce the delivery of inappropriate shocks. The impact of inappropriate shocks and lack of anti-tachycardia pacing (ATP) function are not only contentious matters, but also have important implications for patients in whom the S-ICD would be suitable. It is envisaged that subsequent models of this device will be less cumbersome, with the possibility that an entirely leadless pacemaker-defibrillator will one day be possible. Although the S-ICD may not completely replace transvenous devices in its current form, evidence suggests that it is a viable alternative particularly in preventing sudden cardiac death in non-pacing dependent patients. PMID:25610802

  18. 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

  19. 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

  20. 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

  1. 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.

  2. The histopathology of subcutaneous minocycline pigmentation.

    PubMed

    Bowen, Anneli Ririe; McCalmont, Timothy H

    2007-11-01

    Hyperpigmentation associated with prolonged minocycline use is well documented. The histopathology of cutaneous minocycline pigment is characterized by deposition of brown/black, Fontana-Masson, and Perls' positive granules deposited along elastic fibers in the papillary dermis and occurring within macrophages along vessels and eccrine units in the dermis. The subcutis may also be involved; however, the specific subcutaneous findings associated with minocycline hyperpigmentation have not been well established. We present the histopathologic findings of 4 cases of minocycline hyperpigmentation with subcutaneous involvement. Green-gray, flocculent, nonrefractile globules within macrophages were found in the subcutis of all patients. Two of 4 cases exhibited lipomembraneous changes that were also associated with pigment. These distinctive findings may provide additional clues to enable a diagnosis of drug-induced hyperpigmentation to be offered, even in the absence of a clear clinical history. PMID:17939935

  3. 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.

  4. Subcutaneous Emphysema following Emergent Surgical Conventional Tracheostomy

    PubMed Central

    Ardekian, Leon; Barak, Michal; Rachmiel, Adi

    2014-01-01

    In maxillofacial surgery, tracheostomy is indicated in congenital, inflammatory, oncologic, or traumatic respiratory obstruction. In traumatic cases, however, it is sometimes hard to implement. We describe subcutaneous emphysema following emergent surgical conventional tracheostomy performed after stab injury to the floor of the mouth. We analyze the course that led to this complication and discuss suggestions on how to avoid it. In addition, we review the literature to improve our knowledge and practice regarding this entity. Massive subcutaneous neck emphysema occurred because ventilation started at the time when the hemorrhage was not completely managed and the tracheal tube was not fully secured. In traumatic cases with profound bleeding, hemorrhage management must be performed carefully. The recommendation not to ventilate until the hemorrhage is completely managed should be observed. PMID:25383149

  5. Intranasal versus subcutaneous rubella vaccination in schoolgirls.

    PubMed

    Midulla, M; Assensio, A M; Balducci, L; Vanni, O; Msstropasqua, S

    1976-01-01

    In this study a venous blood specimen was drawn and, at the same time, rubella vaccine was given to 1906 schoolgirls mostly in the pre-pubertal age. To assess the pre-vaccination immune status and the effect of the vaccine, a second blood sample was taken 6 weeks later and tested for rubella HAI antibody simultaneously with the first one. RA 27/3 rubella vaccine administered by intranasal route to 81 girls produced a 100% seroconversion rate and the same vaccine strain, given by subcutaneous route to 460 girls, produced a 94.73% seroconversion rate. Among the 1, 365 schoolgirls who received subcutaneous Cendehill vaccine, the seroconversion rate was 86.68%. Side effects were mild and transient and occurred, as headache, most frequently among the girls who received RA 27/3 vaccine by intranasal route.

  6. Can glucose be monitored accurately at the site of subcutaneous insulin delivery?

    PubMed

    Ward, W Kenneth; Castle, Jessica R; Jacobs, Peter G; Cargill, Robert S

    2014-05-01

    Because insulin promotes glucose uptake into adipocytes, it has been assumed that during measurement of glucose at the site of insulin delivery, the local glucose level would be much lower than systemic glucose. However, recent investigations challenge this notion. What explanations could account for a reduced local effect of insulin in the subcutaneous space? One explanation is that, in humans, the effect of insulin on adipocytes appears to be small. Another is that insulin monomers and dimers (from hexamer disassociation) might be absorbed into the circulation before they can increase glucose uptake locally. In addition, negative cooperativity of insulin action (a lower than expected effect of very high insulin concentrations)may play a contributing role. Other factors to be considered include dilution of interstitial fluid by the insulin vehicle and the possibility that some of the local decline in glucose might be due to the systemic effect of insulin. With regard to future research, redundant sensing units might be able to quantify the effects of proximity, leading to a compensatory algorithm. In summary, when measured at the site of insulin delivery, the decline in subcutaneous glucose level appears to be minimal, though the literature base is not large. Findings thus far support (1) the development of integrated devices that monitor glucose and deliver insulin and (2) the use of such devices to investigate the relationship between subcutaneous delivery of insulin and its local effects on glucose. A reduction in the number of percutaneous devices needed to manage diabetes would be welcome. PMID:24876621

  7. 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

  8. 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

  9. Implantable pulse oximetry on subcutaneous tissue.

    PubMed

    Theodor, Michael; Ruh, Dominic; Subramanian, Sivaraman; Forster, Katharina; Heilmann, Claudia; Beyersdorf, Friedhelm; Plachta, Dennis; Manoli, Yiannos; Zappe, Hans; Seifert, Andreas

    2014-01-01

    Blood oxygen saturation is one of the most prominent measurement parameters in daily clinical routine. However up to now, it is not possible to continuously monitor this parameter reliably in mobile patients. High-risk patients suffering from cardiovascular diseases could benefit from long-term monitoring of blood oxygen saturation. In this paper, we present a minimally invasive, implantable patient monitor which is capable of monitoring vital signs. The capability of this multimodal sensor to subcutaneously determine blood pressure, pulse and ECG has been demonstrated earlier. This paper focuses on monitoring of blood oxygen saturation. Even though the signal amplitudes are much weaker than for standard extracorporeal measurements, photoplethysmographic signals were recorded with high quality in vivo directly on subcutaneous muscle tissue. For the first time, it has been shown that blood oxygen saturation can be measured with an implantable, but extravascular sensor. The sensor was implanted for two weeks in a sheep and did not cause any complications. This opens new perspectives for home monitoring of patients with cardiovascular diseases. PMID:25570396

  10. 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

  11. Sonographic Findings of Subcutaneous Sarcoidosis in 3 Cases.

    PubMed

    Tada, Saori; Watanabe, Tsuneo; Suzuki, Chigusa; Nohisa, Yuzuru; Shinoda, Koichi; Furuta, Nobuyuki; Ito, Hiroyasu; Okumura, Yoko; Shu, En; Seishima, Mariko

    2015-08-01

    Subcutaneous sarcoidosis occurs infrequently among cases of cutaneous sarcoidosis. To our knowledge, few studies have described the sonographic characteristics of subcutaneous sarcoidosis. Here we report the sonographic characteristics of 3 cases of this condition. Our results revealed 4 features: (1) an irregular hypoechoic appearance, (2) heterogeneous echogenicity, (3) perilesional hyperechoic changes, and (4) abnormal Doppler signals. Sonography is a rapid, simple, and noninvasive procedure that is useful for initial evaluation of granulomatous lesions such as subcutaneous sarcoidosis.

  12. 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

  13. Subcutaneous IgG in neurologic diseases.

    PubMed

    Berger, Melvin

    2014-01-01

    Subcutaneous administration of IgG (SCIG) has become widely used in primary immune deficiency diseases but it has only recently been studied for maintenance therapy in autoimmune peripheral neuropathies, such as chronic idiopathic demyelinating polyneuropathy and multifocal motor neuropathy. Weekly self-administration of SCIG is safe and well-tolerated, and results in steady-state serum IgG levels, as contrasted with the peaks and troughs of monthly immune globulin (human) for intravenous use. Freedom from the need for venous access or medical personnel for infusions, flexibility in scheduling, convenience of home therapy, and improved clinical stability due to the steady-state IgG levels, lead many patients to prefer SCIG to immune globulin (human) for intravenous use. Long-term studies are needed to determine if the constant IgG levels and clinical stability translate into better long-term outcomes.

  14. [ANSYS simulation of subcutaneous pustule electrical characteristics].

    PubMed

    Liu, Baohua; Wang, Xuan; Zhu, Honglian; Wang, Guoyong

    2011-12-01

    With the growing number of clinical surgery, post-operative surgical wound infection has become a very difficult clinical problem. In the treatments of it, non-invasive test of wound infection and healing status has a significance in clinical medicine practice. In this paper, beginning with the electrical properties of skin tissue structure and on the basis of the electromagnetism and the human anatomy, using the finite element analysis software, we applied safe voltage on the 3D skin model, performed the subcutaneous pustule simulation study and gained the relational curve between depth and radius of the pustule model. The simulation results suggested that the method we put forward could be feasible, and it could provide basis for non-invasive detection of wound healing and wound infection status.

  15. Subcutaneous rhabdomyosarcoma in an old rabbit

    PubMed Central

    PARK, Chun-Ho; NAKAJIMA, Chikage; KIMITSUKI, Kazunori; SHIWA, Nozomi; TSUCHIDA, Yasuhiko; BOONSRIROJ, Hassadin

    2016-01-01

    An 11-year-old castrated male rabbit presented with a subcutaneous mass in the right hind limb. The mass comprised solid and myxoid areas. Solid areas were characterized by a storiform or interlacing pattern of spindle cells, strap cells, multinucleated giant cells and round cells with eccentrically located nuclei, whereas the myxoid areas were composed predominantly of elongated fusiform cells with hyperchromatic nuclei embedded in Alcian Blue-positive myxoid stroma. Immunohistochemically, tumor cells in both areas were positive for desmin and vimentin. Ultrastructurally, the tumor cells in the solid areas had abundant myofilaments with electron dense Z-band structures. Based on these pathological findings, this case was diagnosed as rhabdomyosarcoma in a rabbit. PMID:27264737

  16. Relative Bioavailability of a Single Dose of Belimumab Administered Subcutaneously by Prefilled Syringe or Autoinjector in Healthy Subjects

    PubMed Central

    Murtaugh, Thomas; Gilbert, Jane; Barton, Matthew E.; Fire, Joseph; Groark, James; Fox, Norma Lynn; Roth, David; Gordon, David

    2015-01-01

    Abstract Intravenous belimumab is approved for the treatment of systemic lupus erythematosus; subcutaneous self‐administration would enable greater patient access. This study assessed relative bioavailability, tolerability, and safety of 1 subcutaneous dose of self‐administered belimumab by healthy subjects using a single‐use autoinjector or prefilled syringe. Subjects (randomized 1:1:1:1) self‐administered belimumab 200 mg subcutaneously (abdomen or thigh) by prefilled syringe or autoinjector. Pharmacokinetics, adverse events (AEs), injection‐site pain, and administration errors were recorded. Of 81 subjects, 5 experienced administration errors and were excluded from pharmacokinetic analyses. Mean serum belimumab concentration profiles were similar for both devices, with a weak trend toward higher concentrations for thigh injection compared with abdominal injections. Maximum observed serum concentration was slightly higher with the autoinjector (27.0 vs 25.3 µg/mL) and area under the concentration–time curve slightly lower (701 vs 735 day · μg/mL), compared with the prefilled syringe. Incidence of AEs was 51% (41 of 81 subjects; headache was most common), with no serious or severe AEs. Median injection‐site pain scores were low (0 after 1 hour). Device handling was reported as acceptable by ≥95% of autoinjector users and ≥90% of prefilled syringe users for each characteristic assessed. These results support the use of either device for belimumab subcutaneous administration. PMID:27163500

  17. 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

  18. 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

  19. Subcutaneous implantation of Gore-Tex for facial reconstruction.

    PubMed

    Schoenrock, L D; Chernoff, W G

    1995-04-01

    Subcutaneous implantation of Gore-Tex for facial reconstruction allows physicians to recontour the soft tissues of the face and to augment areas that are deficient of subcutaneous tissue for genetic, aging, and traumatic reasons. This article discusses the use of Gore-Tex in multiple implant sites and presents novel ideas for both facial and cervical augmentation.

  20. Case report. Subcutaneous phaeohyphomycosis due to Cladosporium cladosporioides.

    PubMed

    Gugnani, H C; Sood, N; Singh, B; Makkar, R

    2000-01-01

    A case of subcutaneous phaeohyphoymycosis caused by Cladosporium cladosporioides in a 25-year-old male is described. The clinical presentation was an elevated scaly suppurating lesion with sinuses on the right leg. The lesion healed completely with oral fluconazole therapy. The present report constitutes the first record of cutaneous or subcutaneous infection due to Cl. cladosporioides from India.

  1. [Subcutaneous sarcoidosis as the first manifestation of systemic disease].

    PubMed

    Calzado, Leticia; Galera, Carmen María; Arrue, Itziar; Rodríguez-Peralto, José L; López, Sara; Guerra, Aurora; Vanaclocha, Francisco

    2005-01-01

    There are dermatological symptoms in up to 25% of patients with sarcoidosis, and the appearance of specific subcutaneous nodules as a manifestation of this entity is rare. They may even predate other manifestations of sarcoidosis. We present the case of a 38-year-old woman with asymptomatic subcutaneous nodules in the limbs, which corresponded to deep sarcoid granulomas in the histological study. She did not present with any extracutaneous indications. The imaging tests performed revealed right paratracheal adenopathies. This led to the diagnosis of sarcoidosis, in both its subcutaneous and pulmonary forms (stage I). Subcutaneous sarcoidosis is probably an underdiagnosed entity, as fewer than 40 cases are reflected in literature. Its value lies in the fact that it may be the first manifestation of extracutaneous or systemic sarcoidosis, which means that this form of sarcoidosis must be considered in the differential diagnosis of subcutaneous nodular lesions; close follow-up of these patients is also necessary.

  2. Is it time to reconsider subcutaneous administration of epoetin?

    PubMed

    Patel, Tejas V; Robinson, Kris; Singh, Ajay K

    2007-10-01

    Anemia treatment in nondialysis chronic kidney disease (ND-CKD) and dialysis CKD patients (D-CKD) has been recently scrutinized in the literature and by the lay press. New evidence suggests that patients receiving epoetin and achieving higher hemoglobin have a higher risk of death and cardiovascular complications. Data from the Centers for Medicare & Medicaid Services demonstrate upward spiraling costs of injectables, especially epoetin, in the care of CKD patients. There is considerable literature favoring the use of subcutaneous administration of epoetin compared to intravenous route in hemodialysis patients. Evidence clearly shows that the subcutaneous route achieves the target hemoglobin level at a lower administered dose. Thus, the same clinical effect can be achieved at a lower cost. Despite the economic and evidentiary justifications for subcutaneous administration of epoetin, adoption of this strategy has been limited, especially in the United States. Reasons include: inflexibility by dialysis providers because of reduced profitability, claims that patients oppose the subcutaneous route because of pain at the site of injection, concerns regarding pure red cell aplasia associated with subcutaneous administration, and greater hemoglobin cycling with the subcutaneous route. In this article, the advantages and disadvantages of the subcutaneous route are reviewed. PMID:17970510

  3. Noninvasive mapping of subcutaneous vasculature with high resolution photoacoustic imaging

    NASA Astrophysics Data System (ADS)

    Lao, Yeqi; Xing, Da; Yang, Sihua

    2007-11-01

    As a novel hybrid imaging modality, photoacoustic (PA) imaging combines the merits of high optical contrast, good ultrasonic resolution and sufficient imaging depth, which may be of great benefit to noninvasively detect and monitor the pathological changes of subcutaneous vasculature, e.g., congenital vascular tumor and vascular malformation. In this paper, we apply a set of photoacoustic imaging system to image a sample of subcutaneous blood vessels, which is used to simulate the location of human's subcutaneous vasculature. Furthermore, an image of subcutaneous vasculature of the abdomen in a mouse is acquired in vivo. Laser pulses at a wavelength of 532 nm from a Q-switched Nd:YAG laser are employed as light source to generate PA signals in the experiments, because the optical absorption of whole blood is much stronger than that of other tissues at this wavelength. A needle polyvinylidene fluoride (PVDF) hydrophone with a diameter of 1mm is used to capture PA signals through a circular scan. The experimental results show that detailed structural information of subcutaneous vasculature, such as the shape and position of the blood vessels and the vessel branching, is clearly revealed by the PA imaging system. The spatial resolution of the PA imaging system reaches 80μm. Moreover, the reconstructed image of a mouse's abdomen in vivo demonstrates that this technique is suitable for noninvasive subcutaneous vasculature imaging. All of the results prove that the PA imaging can be used as a helpful tool for monitoring the pathological changes of subcutaneous vasculature.

  4. 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

  5. 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

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

    PubMed

    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. PMID:27630637

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

    PubMed

    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.

  8. 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.

  9. Tracheal Perforation and Widespread Subcutaneous Emphysema in a Horse

    PubMed Central

    Caron, J. P.; Townsend, H. G. G.

    1984-01-01

    A twelve year old Quarterhorse mare exhibited subcutaneous emphysema of the head, neck, upper forelimbs and thorax, and walked with a stiff gait, characterized by decreased flexion of the forelimbs. Endoscopy of the trachea revealed a small tracheal wound ninety centimeters from the external nares. The location of the lesion corresponded with a seroma present at the base of the neck. The subcutaneous emphysema and the seroma resolved without specific therapy. Blunt trauma was suggested as the cause of the tracheal lesion and subsequent subcutaneous emphysema. ImagesFigure 1. PMID:17422449

  10. 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. PMID:27630637

  11. Sonographic surface localization of subcutaneous foreign bodies and masses.

    PubMed

    Creel, Stephanie A; Girish, Gandikota; Jamadar, David A; Morag, Yoav; Jacobson, Jon A

    2009-01-01

    We report a sonographic technique of skin marking of the projection of nonpalpable subcutaneous foreign bodies and masses using a paperclip. Localization and marking of the overlying skin assists in preoperative planning and further management.

  12. 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

  13. Optimizing anaemia management with subcutaneous administration of epoetin.

    PubMed

    Besarab, Anatole

    2005-06-01

    European and US guidelines for renal anaemia management recommend subcutaneous (s.c.) epoetin as the preferred route of administration in pre-dialysis, peritoneal dialysis and haemodialysis patients. However, the restriction of Eprex/Erypro to intravenous (i.v.) administration in Europe has increased the interest of health care professionals regarding the optimal route of administration for all epoetin formulations. There are five major considerations for the 'optimal' route of epoetin administration: efficacy; dosing frequency; convenience; safety and tolerability; and cost. Although epoetin bioavailability is lower after s.c. administration, its efficacy is higher, owing to its prolonged elimination half-life compared with i.v. epoetin. Several studies and clinical surveys comparing s.c. and i.v. administration have demonstrated that equivalent target haemoglobin levels can be maintained at much lower doses of epoetin when administered s.c. Furthermore, s.c. epoetin dosing frequency can be reduced in some patients to once every 2 weeks, without compromising efficacy. Devices such as the Reco-Pen have been specifically designed to facilitate self-administration of s.c. epoetin-beta. An upsurge in the incidence of pure red cell aplasia (PRCA) was linked to the epoetin-alpha product Eprex/Erypo in Europe, and an increase in PRCA cases of the same magnitude was not seen in patients taking other epoetin products s.c. Therefore, PRCA should not be used as an argument against s.c. administration. The reduced dose with s.c. administration of epoetin-beta provides significant cost benefits, without compromising either safety or efficacy, and may also increase patient satisfaction and compliance with treatment. PMID:15958820

  14. [The enlightenment of Fu's subcutaneous needling on pain medicine].

    PubMed

    Li, Gui-Feng; Fu, Zhong-Hua

    2014-06-01

    Fu's subcutaneous needling (FSN) is a modern approach developed from traditional Chinese acupuncture. It could give some stimulation in the subcutaneous region that has a quick and long-lasting effect on soft tissue injuries and some of the internal medicine diseases. It is a safe approach without adverse reaction. Through analysis of the features and possible mechanism of FSN, it is believed that research on mechanism of FSN is beneficial to the development of modern medicine, especially to pain management.

  15. The role of the subcutaneous zone in karst hydrology

    NASA Astrophysics Data System (ADS)

    Williams, Paul W.

    1983-02-01

    The subcutaneous zone is the upper weathered layer of rock beneath the soil, but above the permanently saturated (phreatic) zone. It is of particular hydrological importance in karst because of its high secondary permeability, arising from the considerable chemical solution in this zone. However, corrosional enlargement of fissures diminishes with depth; thus permeability decreases in the same direction with the result that percolation is inhibited, except down widened master joints and faults. Storage of water consequently occurs in this zone, particularly after storms. The upper surface of this suspended saturated layer in the subcutaneous zone is defined by a perched water table, which slopes towards points of rapid vertical percolation. The potential induces lateral water movement converging on the most permeable areas such as beneath dolines. Leakage from the subcutaneous store sustains slow percolation in the vadose zone. Cross-correlation of rainfall with percolation rates in caves in New Mexico, U.S.A., and New Zealand reveal response lags of 2-14 weeks with no apparent relationship to depth below the surface. Other percolation sites show no correlation with rainfall; interpreted as being a consequence of considerable friction in tight fissure networks. The recognition of storage and rapid as well as very slow percolation from the subcutaneous zone requires re-interpretation of the components of hydrographs from karst springs and of some conceptual models of karst aquifers. The importance of subcutaneous storage in sustaining baseflow discharge at some sites must be recognised, as must the contribution of subcutaneous water to flood hydrographs. Methods of estimating the volumes of subcutaneous and phreatic components of karst-spring flood hydrographs are presented. The paper concludes with a discussion of the significance of subcutaneous hydrologic processes for an understanding of karst geomorphology. The desirability of explaining karst landform

  16. Pyrenochaeta romeroi causing subcutaneous phaeohyphomycotic cyst in a diabetic female.

    PubMed

    Yadav, Sarita; Agarwal, Ruchi; Singh, Sundeep; Goel, Shikha

    2015-06-01

    Opportunistic subcutaneous fungal infections are increasing in present times due to increasing incidence of many medical conditions causing immunosupression like diabetes, AIDS, organ transplant recipients and anticancer therapy. Pyrenochaeta romeroi, a fungus from the dematiaceae group, first described by Borelli in 1959, is saprophyte to soil and plants.We present a rare case of subcutaneous phaeohyphomycotic cyst in a diabetic female caused by P. romeroi.

  17. Pyrenochaeta romeroi causing subcutaneous phaeohyphomycotic cyst in a diabetic female

    PubMed Central

    Yadav, Sarita; Agarwal, Ruchi; Singh, Sundeep; Goel, Shikha

    2015-01-01

    Opportunistic subcutaneous fungal infections are increasing in present times due to increasing incidence of many medical conditions causing immunosupression like diabetes, AIDS, organ transplant recipients and anticancer therapy. Pyrenochaeta romeroi, a fungus from the dematiaceae group, first described by Borelli in 1959, is saprophyte to soil and plants.We present a rare case of subcutaneous phaeohyphomycotic cyst in a diabetic female caused by P. romeroi. PMID:25941632

  18. Subcutaneous pleomorphic adenomas in two different areas of the face.

    PubMed

    Tsukuno, Mari; Nakamura, Akiko; Takai, Shigeharu; Kurihara, Kunihiro

    2002-01-01

    A 41-year-old woman developed two subcutaneous pleomorphic adenomas on her face. Pleomorphic adenoma usually arises as a benign tumour of a major salivary gland and often develops multifocally within the gland. These two pleomorphic adenomas originated in the subcutaneous layer of the face, also multifocally. They were excised, she made a good recovery, and she had no signs of recurrence a year later.

  19. Role of subcutaneous apomorphine in parkinsonian voiding dysfunction.

    PubMed

    Christmas, T J; Kempster, P A; Chapple, C R; Frankel, J P; Lees, A J; Stern, G M; Milroy, E J

    Ten patients with Parkinson's disease and urinary symptoms underwent urodynamic assessments before and after subcutaneous administration of the dopamine receptor agonist apomorphine. Voiding efficiency improved after apomorphine injection, with an increase in mean and maximum flow rates in nine patients and reduction in post-micturition residual volume in six. Although the effect on detrusor behaviour was variable, subcutaneous apomorphine may be of use in both the assessment and treatment of voiding dysfunction in patients with Parkinson's disease.

  20. 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

  1. 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

  2. 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

  3. Initial experience of subcutaneous implantable cardioverter defibrillators in Singapore: a case series and review of the literature

    PubMed Central

    Lim, Tien Siang Eric; Tan, Boon Yew; Ho, Kah Leng; Lim, Chuh Yih Paul; Teo, Wee Siong; Ching, Chi-Keong

    2015-01-01

    Transvenous implantable cardioverter defibrillators are a type of implantable cardiac device. They are effective at reducing total and arrhythmic mortality in patients at risk of sudden cardiac death. Subcutaneous implantable cardioverter defibrillators (S-ICDs) are a new alternative that avoids the disadvantages of transvenous lead placement. In this case series, we report on the initial feasibility and safety of S-ICD implantation in Singapore. PMID:26512151

  4. The use of percutaneous left ventricular assist device in high-risk percutaneous coronary intervention and cardiogenic shock.

    PubMed

    Akhondi, Andre Babak; Lee, Michael S

    2013-01-01

    Patients with high-risk coronary lesions may be denied coronary artery bypass grafting due to excessive comorbidities. Percutaneous coronary intervention (PCI) may be a feasible revascularization strategy in high-risk patients who present with ST-elevation myocardial infarction and cardiogenic shock. Historically, the use if intra-aortic balloon pump (IABP) has been used in high-risk PCI and cardiogenic shock. However, recent data has shown that elective IABP insertion did not reduce the incidence of major cardiovascular events following PCI. The use of a left ventricular assist device is a reasonable and safe alternative compared with IABP counterpulsation, giving greater cardiac output and hemodynamic support in patients undergoing high-risk PCI and in those with severe cardiogenic shock. This review outlines a case of severe cardiogenic shock and hemodynamic instability where high-risk PCI is a reasonable option.

  5. 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

  6. 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.

  7. Long-term experience with subcutaneous ICD leads: a comparison among three different types of subcutaneous leads.

    PubMed

    Kettering, Klaus; Mewis, Christian; Dörnberger, Volker; Vonthein, Reinhard; Bosch, Ralph F; Seipel, Ludger; Kühlkamp, Volker

    2004-10-01

    ICDs provide protection against sudden cardiac death in patients with life-threatening arrhythmias. Nevertheless, efficacy of defibrillation remains an important issue to guarantee the future safety of patients who receive an ICD. There is a significant number of patients who need an additional subcutaneous lead to obtain a defibrillation safety margin of at least 10 J between the maximum output of the ICD and the energy needed for ventricular defibrillation. However, few data exists about the long-term performance of different types of subcutaneous leads. Therefore, the aim of this study was to analyze the long-term experience with three different types of subcutaneous leads. The study included 132 patients (109 men, 23 women; mean age 59.8 years [SD +/- 10.7 years]). All of them received a subcutaneous lead in addition to a single chamber or dual chamber ICD between October 1990 and April 2002. Two patients received a second subcutaneous lead after the first lead had been removed so that a total of 134 subcutaneous leads were evaluated. Inclusion criteria for the implantation of an additional subcutaneous lead were (1) unsuccessful ventricular defibrillation at implant without a subcutaneous lead, (2) insufficient safety margin (< 10 J) between the maximum output of the ICD and the energy needed for ventricular defibrillation, or (3) clinical evaluation of a new subcutaneous lead (Medtronic 13014). There were no significant differences between the three study groups with regard to age, sex, underlying cardiac disease, left ventricular ejection fraction, NYHA class assessment and clinical arrhythmia. The results of the DFT testing during follow-up (prehospital discharge test and 1 and 3 years) were compared to the baseline value obtained during the implantation procedure. All lead related complications were analyzed. Eighty-two single element subcutaneous array electrodes (SQ-A1), 31 subcutaneous three-finger electrodes (SQ-A3), and 21 subcutaneous patch

  8. 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

  9. 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.

  10. Inadvertent subcutaneous injection of hypertonic saline solution during lipofilling.

    PubMed

    Kerfant, N; Philandrianos, C; Alliez, A; Casanova, D

    2013-08-01

    Subcutaneous infiltration with a mixture of plain saline and adrenaline is a useful option in lipoharvesting for autologous fat grafting. This report presents the case of 34-year-old woman who experienced inadvertent subcutaneous injection of hypertonic saline solution during body fat harvesting. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

  11. Management of severely brittle diabetes by continuous subcutaneous and intramuscular insulin infusions: evidence for a defect in subcutaneous insulin absorption.

    PubMed Central

    Pickup, J C; Home, P D; Bilous, R W; Keen, H; Alberti, K G

    1981-01-01

    Severely brittle diabetes is defined as a rare subtype of insulin-dependent diabetes with wide, fast, unpredictable, and inexplicable swings in blood glucose concentration, often culminating in ketoacidosis or hypoglycaemic coma. To assess the role of inappropriate type, amount, or timing of insulin treatment and the route of administration as a cause of severe brittleness six patients with continuous subcutaneous insulin infusion, which provides a high degree of optimisation of dosage with exogenous insulin in stable diabetics. The glycaemic control achieved during continuous subcutaneous insulin infusion was compared with that during continuous intramuscular insulin infusion. Six patients with non-brittle diabetes were also treated by continuous subcutaneous insulin infusion. These patients achieved the expected improvement in glycaemic control (mean +/- SD plasma glucose concentration 5.1 +/- 2.3 mmol/l (92 +/- 41 mg/100 ml)), but not the patients with brittle diabetes remained uncontrolled with continuous subcutaneous infusion (13.6 +/- 5.8 mmol/1 (245 +/- 105 mg/100 ml) compared with 10.3 +/- 4.1 mmol/l (186 +/- 74 mg/100 ml) during treatment with optimised conventional subcutaneous injections). During continuous intramuscular infusion, however, glycaemic control in five of the patients with brittle diabetes was significantly improved (7.7 +/- 2.6 mmol/l (139 +/- 47 mg/100 ml). The remaining patient with brittle diabetes, previously safely controlled only with continuous intravenous insulin, did not respond to continuous intramuscular infusion. It is concluded that in five of the six patients with brittle diabetes studied here impaired or irregular absorption of insulin from the subcutaneous site played a more important part in their hyperlability than inappropriate injection strategies. This absorption defect was presumably bypassed by the intramuscular route. PMID:6780019

  12. 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.

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

    PubMed Central

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

    2015-01-01

    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

  14. 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.

  15. Endocrine modulators of mouse subcutaneous adipose tissue beige adipocyte markers

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The stromal vascular fraction (SVF) of subcutaneous adipose tissue contains precursors that can give rise to beige adipocytes. Beige adipocytes are characterized by the expression of specific markers, but it is not clear which markers best evaluate beige adipocyte differentiation. Both regulators of...

  16. Human omental and subcutaneous adipose tissue exhibit specific lipidomic signatures.

    PubMed

    Jové, Mariona; Moreno-Navarrete, José María; Pamplona, Reinald; Ricart, Wifredo; Portero-Otín, Manuel; Fernández-Real, José Manuel

    2014-03-01

    Despite their differential effects on human metabolic pathophysiology, the differences in omental and subcutaneous lipidomes are largely unknown. To explore this field, liquid chromatography coupled with mass spectrometry was used for lipidome analyses of adipose tissue samples (visceral and subcutaneous) selected from a group of obese subjects (n=38). Transcriptomics and in vitro studies in adipocytes were used to confirm the pathways affected by location. The analyses revealed the existence of obesity-related specific lipidome signatures in each of these locations, attributed to selective enrichment of specific triglycerides, glycerophospholipids, and sphingolipids, because these were not observed in adipose tissues from nonobese individuals. The changes were compatible with subcutaneous enrichment in pathways involved in adipogenesis, triacylglyceride synthesis, and lipid droplet formation, as well as increased α-oxidation. Marked differences between omental and subcutaneous depots in obese individuals were seen in the association of lipid species with metabolic traits (body mass index and insulin sensitivity). Targeted studies also revealed increased cholesterol (Δ56%) and cholesterol epoxide (Δ34%) concentrations in omental adipose tissue. In view of the effects of cholesterol epoxide, which induced enhanced expression of adipocyte differentiation and α-oxidation genes in human omental adipocytes, a novel role for cholesterol epoxide as a signaling molecule for differentiation is proposed. In summary, in obesity, adipose tissue exhibits a location-specific differential lipid profile that may contribute to explaining part of its distinct pathogenic role.

  17. 27 MHz hybrid evanescent-mode applicators (HEMA) with flexible heating field for deep and safe subcutaneous hyperthermia.

    PubMed

    Franconi, C; Vrba, J; Montecchia, F

    1993-01-01

    A new class of low-frequency electromagnetic applicators for hyperthermic treatment of superficial and subcutaneous tissues is described. These applicators employ an air-filled waveguide segment which is operating below the cut-off frequency, the evanescent modes of which are energized by suitable exciters to produce model field components. Direct radiators are integrated into the waveguide to generate additional direct field components. All field components may be combined in different power level ratio, phase, and orientation, to provide a composite heating field exhibiting a large variety of field sizes, shapes, and penetration features. The composite field emerging from the waveguide aperture propagates within the tissue to be heated through a non-critical air-gap. These versatile heating devices appear of potential interest to heat a variety of deep and localized subcutaneous tissues to therapeutic temperatures without injury to access fat layers of substantial thickness.

  18. Influence of circulating epinephrine on absorption of subcutaneously injected insulin

    SciTech Connect

    Fernqvist, E.; Gunnarsson, R.; Linde, B.

    1988-06-01

    Effects of epinephrine (Epi) infusion on the absorption of subcutaneously injected 125I-labeled soluble human insulin (10 U) from the thigh or the abdomen were studied in 16 healthy subjects and from the thigh in 10 insulin-dependent diabetic (IDDM) patients. Epi was infused at 0.3 (high dose) or 0.1 (low dose; healthy subjects) nmol.kg-1.min-1 i.v., resulting in arterial plasma Epi levels of approximately 6 and 2 nM, respectively. Saline was infused on a control day. Insulin absorption was measured as disappearance of radioactivity from the injection site and as appearance of plasma immunoreactive insulin (IRI). Adipose tissue blood flow was measured with the 133Xe clearance technique. First-order disappearance rate constants of 125I from the thigh depot decreased approximately 40-50% during the high dose of Epi compared with control (P less than .001). The corresponding decrease from the abdominal depot was approximately 40% (P less than .001), whereas no significant change was found during the low Epi dose. IRI fell compared with control in all groups at the high Epi dose. The Epi-induced depression of insulin absorption occurred despite unaltered or even slightly increased subcutaneous blood flow. The results indicate that circulating Epi at levels seen during moderate physical stress depresses the absorption of soluble insulin from subcutaneous injection sites to an extent that might be important for glycemic control in IDDM patients. Furthermore, dissociation is found between changes in insulin absorption and subcutaneous blood flow during Epi infusion, suggesting that factors other than blood flow may also influence the absorption of subcutaneously injected insulin.

  19. 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

  20. 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.

  1. Enhanced External Counterpulsation Treatment May Intervene The Advanced Atherosclerotic Plaque Progression by Inducing The Variations of Mechanical Factors: A 3D FSI Study Based on in vivo Animal Experiment.

    PubMed

    Du, Jianhang; Wang, Liang

    2015-12-01

    Growing evidences suggest that long-term enhanced external counter-pulsation (EECP) treatment can inhibit the initiation of atherosclerotic lesion by improving the hemodynamic environment in aortas. However, whether this kind procedure will intervene the progression of advanced atherosclerotic plaque remains elusive and causes great concern in its clinical application presently. In the current paper, a pilot study combining animal experiment and numerical simulation was conducted to investigate the acute mechanical stress variations during EECP intervention, and then to assess the possible chronic effects. An experimentally induced hypercholesterolemic porcine model was developed and the basic hemodynamic measurement was performed in vivo before and during EECP treatment. Meanwhile, A 3D fluid-structure interaction (FSI) model of blood vessel with symmetric local stenosis was developed for the numerical calculation of some important mechanical factors. The results show that EECP augmented 12.21% of the plaque wall stress (PWS), 57.72% of the time average wall shear stress (AWSS) and 43.67% of the non-dimensional wall shear stress gradient (WSSGnd) at throat site of the stenosis. We suggest that long-term EECP treatment may intervene the advanced plaque progression by inducing the significant variations of some important mechanical factors, but its proper effects will need a further research combined follow-up observation in clinic. PMID:27263260

  2. Effect of Enhanced External Counterpulsation and Cardiac Rehabilitation on Quality of Life, Plasma Nitric Oxide, Endothelin 1 and High Sensitive CRP in Patients With Coronary Artery Disease: A Pilot Study

    PubMed Central

    Shakouri, Seyed Kazem; Razavi, Zeynab; Eslamian, Fariba; Sadeghi-Bazargani, Homayoun; Ghaffari, Samad

    2015-01-01

    Objective To investigate the effect of enhanced external counterpulsation (EECP) on plasma nitric oxide (NO), Endothelin 1 (ET1), high sensitive C-reactive protein (HSCRP) and quality of life (QoL) in patients with coronary artery disease (CAD). Methods We conducted a pilot randomized clinical trial in order to evaluate plasma NO, ET1, HSCRP and QoL before and after twenty sessions of EECP (group A) and cardiac rehabilitation (CR, group B) in 42 patients with CAD (21 in each group). Results Forty-two patients (33 male and 9 female) were included in the study. The mean age was 58.2±10 years. The mean HSCRP was 1.52±0.7 in the EECP group and it was reduced to 1.27±0.4 after intervention. The reduction in HSCRP was not statistically significant in EECP and CR groups with p=0.33 and p=0.27, respectively. There was not significant improvement of NO, ET1, and QoL in the EECP and CR groups shortly after therapy (p>0.05). Conclusion Although the short-term EECP treatment in CAD patients improved HSCRP, NO, ET1, and QoL compared with the baseline those improvements are not statistically significant. Further studies are necessary with large study groups and more sessions. PMID:25932415

  3. 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.

  4. Unveiling in Vivo Subcutaneous Thermal Dynamics by Infrared Luminescent Nanothermometers.

    PubMed

    Ximendes, Erving Clayton; Santos, Weslley Queiroz; Rocha, Uéslen; Kagola, Upendra Kumar; Sanz-Rodríguez, Francisco; Fernández, Nuria; Gouveia-Neto, Artur da Silva; Bravo, David; Domingo, Agustín Martín; del Rosal, Blanca; Brites, Carlos D S; Carlos, Luís Dias; Jaque, Daniel; Jacinto, Carlos

    2016-03-01

    The recent development of core/shell engineering of rare earth doped luminescent nanoparticles has ushered a new era in fluorescence thermal biosensing, allowing for the performance of minimally invasive experiments, not only in living cells but also in more challenging small animal models. Here, the potential use of active-core/active-shell Nd(3+)- and Yb(3+)-doped nanoparticles as subcutaneous thermal probes has been evaluated. These temperature nanoprobes operate in the infrared transparency window of biological tissues, enabling deep temperature sensing into animal bodies thanks to the temperature dependence of their emission spectra that leads to a ratiometric temperature readout. The ability of active-core/active-shell Nd(3+)- and Yb(3+)-doped nanoparticles for unveiling fundamental tissue properties in in vivo conditions was demonstrated by subcutaneous thermal relaxation monitoring through the injected core/shell nanoparticles. The reported results evidence the potential of infrared luminescence nanothermometry as a diagnosis tool at the small animal level. PMID:26845418

  5. 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.

  6. 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

  7. 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

  8. Unveiling in Vivo Subcutaneous Thermal Dynamics by Infrared Luminescent Nanothermometers.

    PubMed

    Ximendes, Erving Clayton; Santos, Weslley Queiroz; Rocha, Uéslen; Kagola, Upendra Kumar; Sanz-Rodríguez, Francisco; Fernández, Nuria; Gouveia-Neto, Artur da Silva; Bravo, David; Domingo, Agustín Martín; del Rosal, Blanca; Brites, Carlos D S; Carlos, Luís Dias; Jaque, Daniel; Jacinto, Carlos

    2016-03-01

    The recent development of core/shell engineering of rare earth doped luminescent nanoparticles has ushered a new era in fluorescence thermal biosensing, allowing for the performance of minimally invasive experiments, not only in living cells but also in more challenging small animal models. Here, the potential use of active-core/active-shell Nd(3+)- and Yb(3+)-doped nanoparticles as subcutaneous thermal probes has been evaluated. These temperature nanoprobes operate in the infrared transparency window of biological tissues, enabling deep temperature sensing into animal bodies thanks to the temperature dependence of their emission spectra that leads to a ratiometric temperature readout. The ability of active-core/active-shell Nd(3+)- and Yb(3+)-doped nanoparticles for unveiling fundamental tissue properties in in vivo conditions was demonstrated by subcutaneous thermal relaxation monitoring through the injected core/shell nanoparticles. The reported results evidence the potential of infrared luminescence nanothermometry as a diagnosis tool at the small animal level.

  9. Angiomyoma presenting as a painful subcutaneous mass: a diagnostic challenge

    PubMed Central

    Kumar, Sandeep; Hasan, Roumina; Maddukuri, Satish Babu; Mathew, Mary

    2014-01-01

    Angiomyoma of the extremity is a notoriously elusive preoperative diagnosis, as the list of differentials for its described classic clinical features of a painful mobile subcutaneous mass is quite vast. Imaging features described for angiomyomas are far from being specific. On ultrasound, angiomyomas are mostly described as a well-defined solid mass lesion showing robust internal vascularity. On T2-weighted MRI they have been described as homogenous to heterogeneously hyperintense relative to skeletal muscle. We report a pathologically proven angiomyoma around the knee joint in a middle aged man, describe its clinical and imaging features, and outlay an approach in diagnosing this rare entity as a differential for painful subcutaneous mass lesions. PMID:25323285

  10. 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

  11. Meckel’s diverticulum manifested by a subcutaneous abscess

    PubMed Central

    Karatepe, Oguzhan; Adas, Gokhan; Altıok, Merih; Ozcan, Deniz; Kamali, Sedat; Karahan, Servet

    2009-01-01

    This case report describes an extremely rare complication of a Meckel’s diverticulum: enterocutaneous fistula of the diverticulum. The presence of Meckel’s diverticulum is a well known entity, but subcutaneous perforation of the diverticulum is very rare. Here we report the case of a patient with the complaint of a right lower quadrant abscess, preoperatively diagnosed as enterocutaneous fistula, which was determined intraoperatively to be a fistula resulting from Meckel’s diverticulum. PMID:20027688

  12. Late complication after tropic storm accident: subcutaneous and intracranial actinomycetoma.

    PubMed

    Verma, Shyam B; Nayak, Suresh; Pasale, Ravindra K; Kittner, Thomas; Wollina, Uwe

    2008-12-01

    We report a 53-year-old farmer who developed subcutaneous and cerebral masses 24 years after penetrating trauma during a tropic storm. Computed tomography scans, magnetic resonance imaging and histopathology disclosed actinomycetoma, a disease that rarely develops after trauma and is only occasionally seen with intracranial manifestation. Clinically, the cutaneous manifestation resembled acne keloidalis nuchae or dissecting folliculitis of the scalp. He was treated by neurosurgery and antibiosis.

  13. 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.

  14. Differential responses of visceral and subcutaneous fat depots to nutrients.

    PubMed

    Einstein, Francine H; Atzmon, Gil; Yang, Xiao-Man; Ma, Xiao-Hui; Rincon, Marielisa; Rudin, Eric; Muzumdar, Radhika; Barzilai, Nir

    2005-03-01

    Increased visceral adiposity is a pivotal component of the metabolic syndrome. Differential gene expression patterns of fat-derived peptides (FDPs) in visceral fat and subcutaneous fat have been characterized in the fasting state. Here we examined whether delivery of nutrients differentially affects the expression of FDPs in visceral fat versus subcutaneous fat (in the fed state). We increased the rate of glucose flux into adipose tissue of normal rats (n = 16) by hyperglycemia or hyperinsulinemia using the clamp technique. Glucose uptake was associated with increased expression of FDPs, including resistin ( approximately 5-fold), adiponectin ( approximately 2-fold), leptin ( approximately 15-fold), plasminogen activating inhibitor-1 ( approximately 10-fold), and angiotensinogen ( approximately 4-fold) in visceral fat, but markedly less in subcutaneous fat. Cytokine expression derived mainly from vascular/stromal/macrophage components of adipose tissue was less dramatically increased. Infusion of glucosamine amplified the results obtained by increasing glucose uptake into adipose tissue, suggesting that flux through the hexosamine biosynthetic pathway may serve as a mechanism for "nutrient sensing." Nutrient-dependent expression of FDPs in visceral fat was also associated with increased plasma levels of several FDPs. Because a biologic sensing pathway can dynamically couple daily food intake to abnormal plasma levels of important FDPs, we challenge the practice of obtaining plasma levels after fasting to assess risk factors for metabolic syndrome.

  15. An improved technique for immediate retropectoral reconstruction after subcutaneous mastectomy.

    PubMed

    Maillard, G F; Garey, L J

    1987-09-01

    Subcutaneous mastectomy is becoming an operation of choice in certain cases of premalignant and other breast pathology. We describe a technique for simultaneous subcutaneous mastectomy and retropectoral implantation of a silicone prosthesis. Gentle blunt prepectoral, retromammary dissection is performed through an axillary incision as far inferiorly as the inframammary fold, where a fibrous bridge between the anterior surface of the pectoralis major muscle and the skin prevents dissection any lower. Through the same incision, the retropectoral space is dissected to about 5 cm below the inframammary fold. A second incision is made in the inframammary fold to join the retromammary plane of the first dissection. The gland is then dissected subcutaneously and removed through the inframammary incision. A silicone implant is introduced retropectorally through the axillary incision, thus avoiding splitting the pectoralis major. Satisfactory results have been obtained in 23 bilateral and 14 unilateral cases; it is important that the dissection be performed carefully in order to prevent the implant from riding up too high in its musculoaponeurotic sling.

  16. Immunoexpression of p53 in cutaneous and subcutaneous leiomyosarcomas.

    PubMed

    Fernandez-Flores, Angel; Monteagudo, Carlos

    2016-10-01

    The diagnosis of malignancy in cutaneous and subcutaneous smooth muscle tumors is based on subtle criteria. Therefore, any ancillary technique useful in this differential diagnosis is always welcome. In this report, we study the immunoexpression of p53 in 19 malignant smooth muscle tumors of the skin (15 cutaneous leiomyosarcomas, 2 subcutaneous leiomyosarcomas, and 2 cutaneous metastases of leiomyosarcoma), as well as in 1 leiomyoma with cellular atypia, therefore complementing a previous study on p53 immunoexpression in leiomyomas of the skin. The p53 staining was positive in 12 (63.16%) of 19 leiomyosarcomas. Percentages of immunostaining in the positive cases varied from 2% to 95%. Ten (66.66%) of 15 cutaneous leiomyosarcomas were positive for p53, and in 4 of these cases, immunoexpression was demonstrated by more than 50% of the cells. Five (33.33%) cutaneous leiomyosarcomas did not show any expression of p53. Of the 2 subcutaneous leiomyosarcomas, one was negative for p53 and the other expressed the marker in 70% of the cells. The only atypical leiomyoma included in the study did not express p53. Of the 2 cutaneous metastases of leiomyosarcoma, one was negative and the other expressed p53 in 20% of the cells. The current study supports our previous conclusions that p53 immunoexpression in more than 1% of the cells in a cutaneous smooth muscle tumor is indicative of malignancy. However, we believe that additional studies on atypical leiomyoma are needed.

  17. Continuous subcutaneous infusion of morphine vs. hydromorphone: a controlled trial.

    PubMed

    Miller, M G; McCarthy, N; O'Boyle, C A; Kearney, M

    1999-07-01

    Seventy-four patients were included in a double-blind, randomized, controlled trial comparing the analgesic efficacy and adverse effects of hydromorphone and morphine delivered by continuous subcutaneous infusion. Patients completed the Memorial Pain Assessment Card and a checklist of opioid-related adverse effects immediately before commencing subcutaneous infusion and 24, 48, and 72 hours later. An assessment tool was developed for the 60 patients who were too ill to complete their own questionnaire. The tool demonstrated excellent inter-rater reliability. Thirty-four percent of patients in the hydromorphone group and 27% of those in the morphine group died before completion of the study (P = 0.66). The hydromorphone group required more analgesia for breakthrough pain in the first 24 hours of the study (P = 0.03) and had a greater improvement in the behavior of frowning on movement and the comfort visual analogue scale (P = 0.08) over the course of the study. Adverse effects were rare and similar in both groups. This study found hydromorphone to be at least as effective as morphine when delivered by continuous subcutaneous infusion.

  18. Immunoexpression of p53 in cutaneous and subcutaneous leiomyosarcomas.

    PubMed

    Fernandez-Flores, Angel; Monteagudo, Carlos

    2016-10-01

    The diagnosis of malignancy in cutaneous and subcutaneous smooth muscle tumors is based on subtle criteria. Therefore, any ancillary technique useful in this differential diagnosis is always welcome. In this report, we study the immunoexpression of p53 in 19 malignant smooth muscle tumors of the skin (15 cutaneous leiomyosarcomas, 2 subcutaneous leiomyosarcomas, and 2 cutaneous metastases of leiomyosarcoma), as well as in 1 leiomyoma with cellular atypia, therefore complementing a previous study on p53 immunoexpression in leiomyomas of the skin. The p53 staining was positive in 12 (63.16%) of 19 leiomyosarcomas. Percentages of immunostaining in the positive cases varied from 2% to 95%. Ten (66.66%) of 15 cutaneous leiomyosarcomas were positive for p53, and in 4 of these cases, immunoexpression was demonstrated by more than 50% of the cells. Five (33.33%) cutaneous leiomyosarcomas did not show any expression of p53. Of the 2 subcutaneous leiomyosarcomas, one was negative for p53 and the other expressed the marker in 70% of the cells. The only atypical leiomyoma included in the study did not express p53. Of the 2 cutaneous metastases of leiomyosarcoma, one was negative and the other expressed p53 in 20% of the cells. The current study supports our previous conclusions that p53 immunoexpression in more than 1% of the cells in a cutaneous smooth muscle tumor is indicative of malignancy. However, we believe that additional studies on atypical leiomyoma are needed. PMID:27649950

  19. Subcutaneous Emphysema, Pneumomediastinum, and Pneumorrhachis after Cocaine Inhalation

    PubMed Central

    Atmaca Temrel, Tuğba; Şener, Alp; İçme, Ferhat; Pamukçu Günaydın, Gül; Gökhan, Şervan; Otal, Yavuz; Kurtoğlu Çelik, Gülhan; Özhasenekler, Ayhan

    2015-01-01

    Introduction. The most prominent complications of cocaine use are adverse effects in the cardiovascular and central nervous systems. Free air in the mediastinum and subcutaneous tissue may be observed less frequently, whereas free air in the spinal canal (pneumorrhachis) is a very rare complication of cocaine abuse. In this report we present a case of pneumorrhachis that developed after cocaine use. Case. A 28-year-old male patient was admitted to the emergency department with shortness of breath, chest pain, and swelling in the neck and face which started four hours after he had sniffed cocaine. On physical examination, subcutaneous crepitations were felt with palpation of the jaw, neck, and upper chest area. Diffuse subcutaneous emphysema, pneumomediastinum, and pneumorrhachis were detected in the computed tomography imaging. The patient was treated conservatively and discharged uneventfully. Discussion. Complications such as pneumothorax, pneumomediastinum, and pneumoperitoneum that are associated with cocaine use may be seen due to increased intrathoracic pressure. The air then may flow into the spinal canal resulting in pneumorrhachis. Emergency physicians should know the possible complications of cocaine use and be prepared for rare complications such as pneumorrhachis. PMID:26236511

  20. Caliper vs. Lipometer--Comparing Two Methods of Subcutaneous Body Fat Measurement by Bland-Altman Diagrams.

    PubMed

    Tafeit, Erwin; Kaimbacher, Petra Silke; Wallner-Liebmann, Sandra Johanna; Reibnegger, Gilbert; Cvirn, Gerhard; Jürimäe, Jaak; Saar, Meeli; Maestu, Jarek; Purge, Priit; Lätt, Evelin; Jürimäe, Toivo

    2015-09-01

    Skinfold Calipers are widely used to obtain subcutaneous adipose tissue thickness because of its non-invasive, simple and inexpensive technique. Nevertheless, Caliper skinfold thicknesses have the disadvantage of measuring compressed adipose tissue and double layers of skin, which might reduce the precision of these results. In contrast, the computerized optical device Lipometer was developed to permit a quick, precise and non-invasive determination of non-compressed mono layers of subcutaneous adipose tissue thickness. In the present paper we investigate the hypothesis that Caliper skinfold thicknesses are significantly different from subcutaneous adipose tissue thicknesses in mm, which can be measured by Lipometer. Caliper and Lipometer results were obtained from 371 Estonian boys aged between 9.0 and 12.8 years. Measurements were performed at six different body sites: triceps, biceps, upper back, upper abdomen, hip and front thigh. Caliper measurements were systematically higher than Lipometer results in a range between 1.2 mm (hip) and 11.08 mm (front thigh). The limits of agreement analysis provided intervals from 7.5 mm (biceps) up to 30.14 mm (front thigh). Comparing Caliper and Lipometer results very low measurement agreement was found. The two methods provided very poor interchangeability.

  1. Effect of a single element subcutaneous array electrode added to a transvenous electrode configuration on the defibrillation field and the defibrillation threshold.

    PubMed

    Kühlkamp, V; Dörnberger, V; Khalighi, K; Mewis, C; Suchalla, R; Ziemer, G; Seipel, L

    1998-12-01

    Even with the use of biphasic shocks, up to 5% of patients need an additional subcutaneous lead to obtain a defibrillation safety margin of at least 10 J. The number of patients requiring additional subcutaneous leads may even increase, because recent generation devices have a < 34 J maximum output in order to decrease their size. In 20 consecutive patients, a single element subcutaneous array lead was implanted in addition to a transvenous lead system consisting of a right ventricular (RV) and a vena cava superior lead using a single infraclavicular incision. The RV lead acted as the cathode; the subcutaneous lead and the lead in the subclavian vein acted as the anode. The biphasic defibrillation threshold was determined using a binary search protocol. Patients were randomized as to whether to start them with the transvenous lead configuration or the combination of the transvenous lead and the subcutaneous lead. In addition, a simplified assessment of the defibrillation field was performed by determining the interelectrode area for the transvenous lead only and the transvenous lead in combination with the subcutaneous lead from a biplane chest X ray. The intraoperative defibrillation threshold was reconfirmed after 1 week, after 3 months, and after 12 months. The mean defibrillation threshold with the additional subcutaneous lead was significantly (P = 0.0001) lower (5.7 +/- 2.9 J) than for the transvenous lead system (9.5 +/- 4.6 J). With the subcutaneous lead, the impedance of the high voltage circuit decreased from 48.9 +/- 7.4 omega to 39.2 +/- 5.0 omega. In the frontal plane, the interelectrode area increased by 11.3% +/- 5.5% (P < 0.0001) and in the lateral plane by 29.5% +/- 12.4% (P < 0.0001). The defibrillation threshold did not increase during follow-up. Complications with the subcutaneous electrode were not observed during a follow-up of 15.8 +/- 2 months. The single finger array lead is useful in order to lower the defibrillation threshold and can be

  2. Detecting Body Fat–A Weighty Problem BMI versus Subcutaneous Fat Patterns in Athletes and Non-Athletes

    PubMed Central

    Kruschitz, Renate; Wallner-Liebmann, Sandra J.; Hamlin, Michael J.; Moser, Maximilian; Ludvik, Bernhard; Schnedl, Wolfgang J.; Tafeit, Erwin

    2013-01-01

    We aimed to describe the relationship between BMI and the subcutaneous adipose tissue topography within young athletes and non-athletic controls, to comparatively evaluate the diagnostic powers of subcutaneous adipose tissue thicknesses at different body sites, furthermore to explore appropriate cut-offs to discriminate between athletes and controls. Measurements were determined in 64 males and 42 females, who were subsequently separated into two even groups (athletes and non-athletes). The optical device LIPOMETER was applied at standardised body sites to measure the thickness of subcutaneous adipose tissue layers. To calculate the power of the different body sites and the BMI to discriminate between athletes and non-athletes, receiver operating characteristic curve analysis was performed. In men, the neck (optimal cut-off value 2.3 mm) and trunk (optimal cut-off value 15.5 mm) provided the strongest discrimination power: with 90.6% (58 of 64) of the subjects being correctly classified into athletes or non-athletes. Discrimination power of the BMI values was 64.1% (41 of 64 were correctly classified). In women, the upper back (optimal cut-off value 3.3 mm) and arms (optimal cut-off value 15.9 mm) provided the strongest discrimination power with 88.1% (37 of 42 being correctly classified). When using BMI to discriminate between athletes and non-athletes only 52.4% (22 of 42) were correctly classified. These results suggest that compared to BMI levels, subcutaneous fat patterns are a more accurate way of discriminating between athletes and non-athletes. In particular the neck and the trunk compartment in men and the upper back and arms compartment in women, were the best sites to discriminate between young athletes and non-athletes on the basis of their fat patterns. PMID:23991025

  3. 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

  4. Comparison of the efficacy of a subcutaneous array electrode with a subcutaneous patch electrode, a prospective randomized study.

    PubMed

    Kühlkamp, V; Dörnberger, V; Mewis, C; Seipel, L

    2001-05-01

    The patch electrode and the array electrode are the two types of subcutaneous leads available as an adjunct to a transvenous lead system in patients with high defibrillation thresholds. A prospective randomized study was conducted in 30 consecutive patients comparing the efficacy and the long-term performance of a patch electrode with an array electrode. After determination of the defibrillation threshold for the transvenous lead alone, a subcutaneous patch or an array electrode was implanted in random order. Adding a patch electrode decreased the defibrillation threshold in seven out of 15 patients (47%) from 13.2+/-6.6 to 10.5+/-5.1 J (P<0.05). In 13 out of 15 patients (87%), the implantation of an array electrode caused a significant lowering of the defibrillation threshold from 15.4+/-6.6 to 8.2+/-5.0 J (P<0.0001). The array electrode was significantly more effective in lowering the defibrillation threshold than the patch electrode (P<0.01). Complications during follow-up associated with the subcutaneous patch electrode were observed in four patients whereas no complications were associated with the array electrode (P<0.01). The additional implantation of an array electrode is more effective and associated with fewer complications compared to a patch electrode.

  5. Subcutaneous fluid administration in elderly subjects: Validation of an under-used technique

    SciTech Connect

    Lipschitz, S.; Campbell, A.J.; Roberts, M.S.; Wanwimolruk, S.; McQueen, E.G.; McQueen, M.; Firth, L.A. )

    1991-01-01

    In a crossover study in six volunteers over the age of 65, absorption of 500 mL of normal saline given subcutaneously was compared with that given intravenously. Tritiated water and technetium pertechnetate were used as water tracers. Tritium radioisotope levels in the blood increased in a smooth curve during subcutaneous infusion, reaching equilibrium levels within 60 minutes. The area under the curve after subcutaneous infusion was almost identical to that after intravenous infusion in all subjects. Radioactivity could not be demonstrated at the subcutaneous site 1 hour after completion of the infusion. Subcutaneous infusion is an effective method of giving fluid to elderly people and deserves more widespread use.

  6. Combination prophylactic therapy with rifampin increases efficacy against an experimental Staphylococcus epidermidis subcutaneous implant-related infection.

    PubMed

    Stavrakis, Alexandra I; Niska, Jared A; Shahbazian, Jonathan H; Loftin, Amanda H; Ramos, Romela Irene; Billi, Fabrizio; Francis, Kevin P; Otto, Michael; Bernthal, Nicholas M; Uslan, Daniel Z; Miller, Lloyd S

    2014-01-01

    The incidence of infections related to cardiac devices (such as permanent pacemakers) has been increasing out of proportion to implantation rates. As management of device infections typically requires explantation of the device, optimal prophylactic strategies are needed. Cefazolin and vancomycin are widely used as single agents for surgical prophylaxis against cardiac device-related infections. However, combination antibiotic prophylaxis may further reduce infectious complications. To model a localized subcutaneous implant-related infection, a bioluminescent strain of Staphylococcus epidermidis was inoculated onto a medical-procedure-grade titanium disc, which was placed into a subcutaneous pocket in the backs of mice. In vivo bioluminescence imaging, quantification of ex vivo CFU from the capsules and implants, variable-pressure scanning electron microscopy (VP-SEM), and neutrophil enhanced green fluorescent protein (EGFP) fluorescence in LysEGFP mice were employed to monitor the infection. This model was used to evaluate the efficacies of low- and high-dose cefazolin (50 and 200 mg/kg of body weight) and vancomycin (10 and 110 mg/kg) intravenous prophylaxis with or without rifampin (25 mg/kg). High-dose cefazolin and high-dose vancomycin treatment resulted in almost complete bacterial clearance, whereas both low-dose cefazolin and low-dose vancomycin reduced the in vivo and ex vivo bacterial burden only moderately. The addition of rifampin to low-dose cefazolin and vancomycin was highly effective in further reducing the CFU harvested from the implants. However, vancomycin-rifampin was more effective than cefazolin-rifampin in further reducing the CFU harvested from the surrounding tissue capsules. Future studies in humans will be required to determine whether the addition of rifampin has improved efficacy in preventing device-related infections in clinical practice.

  7. Differentiation and characterization of human facial subcutaneous adipocytes.

    PubMed

    Chon, Su-Hyoun; Pappas, Apostolos

    2015-01-01

    Aging is associated with the loss of facial subcutaneous fat and with increased abdominal subcutaneous fat. Site specific differences in adipocyte phenotype and/or gene expression may play a role in these age-related changes. In this study, we isolated and characterized human facial preadipocytes and investigated distinct metabolic properties such as a differentiation pattern in relation to abdominal preadipocytes. Subcutaneous preadipocytes were isolated from human facial and abdominal skin and cultured in the presence of differentiation factors including rosiglitazone, a known peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist, isobutyl-methyl xanthine (IBMX) and insulin. Differentiation was characterized microscopically and by quantitative real-time PCR. Unexpected superior adipogenic capacity of facial preadipocytes was observed; more facial preadipocytes differentiated in response to rosiglitazone than abdominal preadipocytes and facial preadipocytes retained their ability to differentiate through passage 11 compared with passage 5 for abdominal preadipocytes. Experiments confirmed a reduced lipolysis response in facial versus abdominal adipocytes after exposure to isoproterenol, which was consistent with the reduced β2-adrenergic receptor expression by 60% in the facial cells. The expression of other lipid metabolic gene markers was similar in both facial and abdominal adipocytes with the exception of β3-adrenergic receptor which was only found in abdominal adipose tissue. Gene profiling, by microarray analysis, identified that several HOX genes are robustly reduced in facial adipocytes compared to abdominal adipocytes, suggesting different characteristics between the 2 fat depots. These differences may have implications for development of treatments for facial fat loss during aging.

  8. Biocompatibility of acetazolamide pastes in the subcutaneous tissue of rats.

    PubMed

    Mori, Graziela Garrido; Moraes, Ivaldo Gomes de; Nunes, Daniele Clapes; Castilho, Lithiene Ribeiro; Poi, Wilson Roberto

    2009-01-01

    This aim of this study was to investigate the biocompatibility of two experimental acetazolamide (AZ)-based pastes in the subcutaneous tissue of rats. Both pastes contained AZ as the main component in similar concentration. The vehicle in experimental paste 1 was saline, while experimental paste 2 was prepared with propylene glycol. Sixty polyethylene tubes were sealed at one end with gutta-percha (GP), which served as a control. Half of the tubes were filled with paste 1 and half with paste 2. The tubes were implanted in the subcutaneous tissue of 15 rats, being 4 tubes for each animal. The animals were killed 7, 15 and 45 days after surgery and the specimens were processed in laboratory. The histological sections were stained with hematoxylin and eosin and were analyzed by light microscopy. Scores were assigned to level of inflammatory process: 1- none; 2- mild; 3- moderate; 4- severe. The data were analyzed statistically by the Kruskal-Wallis test (p< or =0.05). Paste 1 produced an inflammatory process at 7 days. However, the intensity of this inflammation decreased with time and was nearly absent at 45 days. No statistically significant difference (p>0.05) was observed between the control (GP) and paste 1. However, paste 2 produced inflammatory response at all study periods and differed significantly (p<0.05) from the control. In conclusion, in the present study, the experimental AZ-based paste 1 was considered as biocompatible as the control matrial (GP), while experimental paste 2 was irritating to rat subcutaneous tissue.

  9. Biocompatibility evaluation of alendronate paste in rat's subcutaneous tissue.

    PubMed

    Mori, Graziela Garrido; de Moraes, Ivaldo Gomes; Nunes, Daniele Clapes; Castilho, Lithiene Ribeiro; Poi, Wilson Roberto; Capaldi, Maria Luciana P Manzoli

    2009-04-01

    Alendronate is a known inhibitor of root resorption and the development of alendronate paste would enhance its utilization as intracanal medication. Therefore, this study aimed to investigate the biocompatibility of experimental alendronate paste in subcutaneous tissue of rats, for utilization in teeth susceptible to root resorption. The study was conducted on 15 male rats, weighing approximately 180-200 grams. The rats' dorsal regions were submitted to one incision on the median region and, laterally to the incision, the subcutaneous tissue was raised and gently dissected for introduction of two tubes, in each rat. The tubes were sealed at one end with gutta-percha and taken as control. The tubes were filled with experimental alendronate paste. The animals were killed at 7, 15 and 45 days after surgery and the specimens were processed in laboratory. The histological sections were stained with hematoxylin-eosin and analyzed by light microscopy. Scores were assigned to the inflammatory process and statistically compared by the Tukey test (P < 0.05). Alendronate paste promoted severe inflammation process at 7 days, with statistically significant difference compared to the control (P < 0.05%). However, at 15 days, there was a regression of inflammation and the presence of connective tissue with collagen fibers, fibroblasts and blood vessels was observed. After 45 days, it was observed the presence of well-organized connective tissue, with collagen fibers and fibroblasts, and few inflammatory cells. No statistical difference was observed between the control and experimental paste at 15 and 45 days. The experimental alendronate paste was considered biocompatible with subcutaneous tissue of rat.

  10. 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.

  11. 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

  12. Differentiation and characterization of human facial subcutaneous adipocytes

    PubMed Central

    Chon, Su-Hyoun; Pappas, Apostolos

    2014-01-01

    Aging is associated with the loss of facial subcutaneous fat and with increased abdominal subcutaneous fat. Site specific differences in adipocyte phenotype and/or gene expression may play a role in these age-related changes. In this study, we isolated and characterized human facial preadipocytes and investigated distinct metabolic properties such as a differentiation pattern in relation to abdominal preadipocytes. Subcutaneous preadipocytes were isolated from human facial and abdominal skin and cultured in the presence of differentiation factors including rosiglitazone, a known peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist, isobutyl-methyl xanthine (IBMX) and insulin. Differentiation was characterized microscopically and by quantitative real-time PCR. Unexpected superior adipogenic capacity of facial preadipocytes was observed; more facial preadipocytes differentiated in response to rosiglitazone than abdominal preadipocytes and facial preadipocytes retained their ability to differentiate through passage 11 compared with passage 5 for abdominal preadipocytes. Experiments confirmed a reduced lipolysis response in facial versus abdominal adipocytes after exposure to isoproterenol, which was consistent with the reduced β2-adrenergic receptor expression by 60% in the facial cells. The expression of other lipid metabolic gene markers was similar in both facial and abdominal adipocytes with the exception of β3-adrenergic receptor which was only found in abdominal adipose tissue. Gene profiling, by microarray analysis, identified that several HOX genes are robustly reduced in facial adipocytes compared to abdominal adipocytes, suggesting different characteristics between the 2 fat depots. These differences may have implications for development of treatments for facial fat loss during aging. PMID:26167398

  13. 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

  14. 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

  15. 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.

  16. [Transition from intravenous to subcutaneous prostacyclin in pulmonary hypertension].

    PubMed

    Escribano Subías, Pilar; Cea-Calvo, Luis; Tello de Menesses, Rocío; Gómez Sánchez, Miguel A; Delgado Jiménez, Juan F; Sáenz de la Calzada, Carlos

    2003-08-01

    Treatment of arterial pulmonary hypertension with epoprostenol (intravenous prostacyclin) improves survival and quality of life, but the need for an implanted central venous catheter is associated with frequent complications, that often (as in the case of infection or dislodgment) are serious and require catheter replacement. Treprostinil is a prostacyclin analogue suitable for continuous subcutaneous administration. We report the successful transition from intravenous epoprostenol to subcutaneuos treprostinil in four patients with severe pulmonary hypertension who suffered from serious complications associated with the epoprostenol infusion system.

  17. 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

  18. 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

  19. 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

  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. Mechanisms of Aeroallergen Immunotherapy: Subcutaneous Immunotherapy and Sublingual Immunotherapy.

    PubMed

    Ozdemir, Cevdet; Kucuksezer, Umut Can; Akdis, Mübeccel; Akdis, Cezmi A

    2016-02-01

    Allergen immunotherapy (AIT) is an effective way to treat allergic disorders, targeting the underlying mechanisms and altering the disease course by inducing a long-lasting clinical and immune tolerance to allergens. Although sublingual and subcutaneous routes are used in daily practice, many novel ways to decrease side effects and duration and increase efficacy have been pursued. Further studies are needed to develop biomarkers for the identification of AIT responder patients and also to use the developed knowledge in allergy prevention studies. Future directions in AIT include treatments for autoimmune diseases, chronic infections, organ transplantation, and breaking immune tolerance to cancer cells.

  3. 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

  4. 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.

  5. Recurrent spontaneous subcutaneous emphysema in a patient with rheumatoid arthritis.

    PubMed

    Adelowo, Olufemi; Akintayo, Richard Oluyinka; Olaosebikan, Hakeem; Oba, Rasheedat

    2015-10-15

    Pulmonary air leak syndromes are extremely rare complications of systemic autoimmune connective tissue diseases and the occurrence of spontaneous subcutaneous emphysema (SSE) from pulmonary leak in the absence of pneumothorax or pneumomediastinum is even rarer. We report a case of recurrent SSE in a patient with rheumatoid arthritis and interstitial lung disease. The SSE was managed conservatively each time and it resorbed over several days. There has been no previous documented report of SSE in the absence of pneumomediastinum, pneumothorax or pulmonary nodules in a patient with RA.

  6. Endoscopically Assisted Anterior Subcutaneous Transposition of Ulnar Nerve.

    PubMed

    Lui, Tun Hing

    2016-06-01

    Ulnar nerve compression at the elbow is the most common neuropathy of the upper extremity. Surgical options include in situ decompression, decompression with anterior transposition of the ulnar nerve, and medial epicondylectomy with or without decompression. With the advancement of endoscopic surgery, techniques of endoscopic in situ decompression of the ulnar nerve and endoscopic anterior transposition of ulnar nerve have been reported. This article describes a technique of endoscopically assisted anterior subcutaneous transposition of ulnar nerve that is composed of an open release and mobilization of the ulnar nerve at and distal to the cubital tunnel and endoscopic release and mobilization of the ulnar nerve proximal to the cubital tunnel. PMID:27656391

  7. Spontaneous subcutaneous emphysema and pneumomediastinum during second stage of labour.

    PubMed

    McGregor, Andrew; Ogwu, Christopher; Uppal, Talat; Wong, Muh Geot

    2011-01-01

    A 27-year-old healthy primigravida presented with spontaneous labour at 40 weeks gestation and proceeded to an unassisted vaginal delivery of a 3.2 kg infant. She immediately developed swelling in the neck and facial area associated with pleuritic chest pain. There was palpable crepitus throughout her anterior chest wall and neck. CT confirmed pneumomediastinum. She was managed with oxygen and analgesia in the intensive care unit and subsequently discharged with resolution of her symptoms. Postpartum pneumomediastinum with subcutaneous emphysema is treated conservatively after cardiac and embolic causes have been excluded; however, there is no consensus on the management of subsequent pregnancies.

  8. 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

  9. 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

  10. 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.

  11. Primary subcutaneous hydatid cyst in the left distal thigh.

    PubMed

    Mahmoudi, Abdelhalim; Rachidi, Charifa Alaoui; Khattala, Khalid; Chater, Lamiae; Bouabdallah, Youssef; Afifi, My Abderrahmane

    2012-11-01

    Human cystic echinococcosis, a zoonotic infection caused by Echinococcus granulosus, remains a largely extended public health problem in endemic regions. Hydatid cyst disease can occur in all viscera and soft tissues, although the liver and the lungs are the most commonly involved organs. Primary hydatid disease of the soft tissue is extremely rare, even in endemic areas, and accounts for 0.5-5.4 % of all hydatid disease cases, with very little data on the incidence of subcutaneous echinococcosis. The paper will be focused on analyzing this extremely rare disease. A 14-year-old girl came to our Department of pediatric Surgery with a painless, round, palpable mass in the subcutaneous tissue of the distal anteromedial side of the left thigh. Based on clinical and laboratory findings and imaging techniques, we suspected a hydatid cyst. She was treated successfully with complete cyst excision. The macroscopic appearance suggested a hydatid cyst. Histopathologic examination of the specimen revealed a hydatid cyst. No other organ involvement has been detected. Hydatid disease should be considered in the differential diagnosis of all cystic masses in all anatomic locations, especially in regions where the disease is endemic.

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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

  17. 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

  18. The Entirely Subcutaneous Defibrillator (S-Icd): State of the Art and Selection of the Ideal Candidate

    PubMed Central

    Maria, Elia De; Olaru, Alina; Cappelli, Stefano

    2015-01-01

    The traditional transvenous defibrillator has been one of the greatest advancement in Cardiology in the last 30 years and has demonstrated to reduce arrhythmic and total mortality in selected patients. However the traditional defibrillator can have a high price to pay in terms of complications, the “weakest link” being the transvenous/endocardial leads. The entirely subcutaneous defibrillator (S-ICD) has recently entered into the clinical scenario and represents a valid alternative to the transvenous device. S-ICD can provide substantial advantages, especially among some subgroups of patients (i.e. after device infection, in young patients and arrhythmogenic syndromes). However, given its characteristics, it is fundamental to choose patients that can benefit the most. In this review we will describe advantages and limitations of the S-ICD and point-out how to select the “ideal candidate” for the implantation. PMID:25158682

  19. [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

  20. Subcutaneous emphysema of periorbital region after stainless steel crown preparation in a young child.

    PubMed

    Khandelwal, Vishal; Agrawal, Piyush; Agrawal, Deepak; Nayak, Prathibha Anand

    2013-05-22

    Subcutaneous emphysema occurs when air is forced beneath the tissue, leading to swelling, crepitus on palpation and has the potential to spread along the fascial planes. This report describes the youngest case of subcutaneous emphysema related to dental treatment that has been documented to date. In addition to the patient's age, the case is of interest because periorbital subcutaneous emphysema is a rarest complication of stainless steel crown procedure.

  1. 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.

  2. Vaginal reconstruction using perineal-thigh flaps with subcutaneous pedicle.

    PubMed

    Chen, Z; Chen, C; Chen, M; Zhang, J; Wu, N; Wang, J

    1991-03-01

    A technique of vaginal reconstruction using bilateral, perineal-thigh flaps with subcutaneous pedicle is described. In this procedure, the flaps were raised bilaterally and introduced into an artificial space between the urinary bladder and rectum. The blood supply for the flaps flows from the perineal artery through anastomotic branches to the external pudendal artery. The authors used the technique on four patients, and all the flaps survived entirely. There was no complication. According to a more than two-year follow-up survey, the reconstructed vaginas are expansible and contract little. No stent is needed. There is good sensitivity in the wall of the artificial vagina because sensory nerves run through the flaps.

  3. 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

  4. 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

  5. [Abdomen pendulum and subcutaneous injections: the complications. Two case reports].

    PubMed

    Benhaim, T; Sinna, R; Garson, S; Boloorchi, A; Crozet, C; Robbe, M

    2007-06-01

    The authors present the complications due to subcutaneous injections on two patients suffering from morbid obesity with an abdomen pendulum. In the first case, injections of heparin of low molecular weight at curative dose, for treatment of a pulmonary embolism, have been complicated with a giant abdominal wall haematoma, the biggest ever reported. The initial treatment was insufficient so we had to practice a dermolipectomy to take off the haematoma of four litters. In the second case, insulin injections were complicated with cellulitis of the abdominal wall and a surgical treatment has been practiced in emergency. The first case reminds us the importance to change the sites of injections and to accommodate the dose, surgical treatment staying as simple as possible. The second case allows us to report a rare complication, not often published but known with obese patients. These two cases illustrate the importance of therapeutic education of the patient and the fact that a simple injection can be life threatening.

  6. 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

  7. 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.

  8. Nanophase bone substitute in vivo response to subcutaneous implantation.

    PubMed

    Baskin, Jonathan Z; Vasanji, Amit; McMasters, James; Soenjaya, Yohannes; Barbu, Anca M; Eppell, Steven J

    2012-09-01

    A collagen-apatite composite designed as a load-bearing bone substitute implant is used to characterize the relationship between implant morphology and in vivo behavior. This nanophase bone substitute (NBS) is studied morphologically using a nondestructive imaging technique and biologically using the rodent subcutaneous model. Porosity and pore interconnectivity are correlated with histological outcomes showing cellular invasion occurs with average pore sizes below 100 μm. Crosslinking with D-ribose is shown to affect cellular infiltration in a dose-response manner. These data suggest that collagen-apatite bone substitutes can support cellular infiltration with pore size significantly smaller than 100 μm, an encouraging result regarding development of the NBS into a platform of biomaterials with enhanced mechanical properties. The data also indicate that increasing crosslinking density decreases cellular infiltration of NBS. Thus, modulating mechanical properties of the material by altering crosslink density is likely to produce decreased biological response within the material.

  9. Chlamydial infection of subcutaneous conjunctival transplants in guinea pigs.

    PubMed

    Pham, R T; Sung, M; Dawson, C R; Schachter, J

    1990-07-01

    The development and testing of candidate vaccines for trachoma are constrained because only humans and nonhuman primates are susceptible to conjunctival infection with Chlamydia trachomatis. Guinea pig inclusion conjunctivitis (GPIC), an analogous disease of guinea pigs, provides a useful, less expensive model to study ocular chlamydial infections. GPIC is caused by a Chlamydia psittaci strain whose external constituents are very similar to those of C. trachomatis. To develop a better model for studying GPIC immunity, conjunctival pockets were established under the abdominal skin of guinea pigs by subcutaneous implantation. Up to six implants could be produced in each animal. The success rate of implantation was 79.0% (n = 148). These pockets were then infected with GPIC. The organism was recovered from the autografts indicating local replication, and tests for serum antibody by microimmunofluorescence showed production of GPIC-specific antibody of IgG and IgM classes after infection. There was minimal antibody response after moderate inoculating doses to the implants, and the titers increased more slowly than after eye infection with GPIC; with higher concentration of the inoculum, however, the antibody response increased to the same levels as with the ocular challenge but more slowly. Inoculation of pockets with GPIC also produced acute inflammatory changes in infected autografts (n = 101). Histologic examination of infected grafts showed chlamydial inclusions in epithelial cells and significant infiltration with lymphocytes and polymorphonuclear cells. Subcutaneous autografts may provide a useful model for chronologic studies of chlamydial infection. The delayed immunologic response, however, suggests that these pockets of implanted epithelium do not have full access to the immune system.

  10. Metabolic characteristics of human subcutaneous abdominal adipose tissueafter overnight fast

    PubMed Central

    Humphreys, Sandy M.

    2012-01-01

    Subcutaneous abdominal adipose tissue is one of the largest fat depots and contributes the major proportion of circulating nonesterified fatty acids (NEFA). Little is known about aspects of human adipose tissue metabolism in vivo other than lipolysis. Here we collated data from 331 experiments in 255 healthy volunteers over a 23-year period, in which subcutaneous abdominal adipose tissue metabolism was studied by measurements of arterio-venous differences after an overnight fast. NEFA and glycerol were released in a ratio of 2.7:1, different (P < 0.001) from the value of 3.0 that would indicate no fatty acid re-esterification. Fatty acid re-esterification was 10.2 ± 1.4%. Extraction of triacylglycerol (TG) (fractional extraction 5.7 ± 0.4%) indicated intravascular lipolysis by lipoprotein lipase, and this contributed 21 ± 3% of the glycerol released. Glucose uptake (fractional extraction 2.6 ± 0.3%) was partitioned around 20–25% for provision of glycerol 3-phosphate and 30% into lactate production. There was release of lactate and pyruvate, with extraction of the ketone bodies 3-hydroxybutyrate and acetoacetate, although these were small numerically compared with TG and glucose uptake. NEFA release (expressed per 100 g tissue) correlated inversely with measures of fat mass (e.g., with BMI, rs = −0.24, P < 0.001). We examined within-person variability. Systemic NEFA concentrations, NEFA release, fatty acid re-esterification, and adipose tissue blood flow were all more consistent within than between individuals. This picture of human adipose tissue metabolism in the fasted state should contribute to a greater understanding of adipose tissue physiology and pathophysiology. PMID:22167523

  11. 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

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. A Comparison of Intraperitoneal and Subcutaneous Temperature in Freely Moving Rhesus Macaques

    PubMed Central

    Taffe, Michael A.

    2011-01-01

    Rationale The remote measurement of body temperature with radiotelemetry provides a minimally invasive and robust method for larger experimental animals such as Old World monkeys. Existing literature encompasses data using intraperitoneal (IP) and subcutaneous (SC) implantation locations which may affect inferences about body temperature. Methods The body temperature of four adult male rhesus monkeys was monitored with radiotelemetry devices implanted both IP and SC in each subject. Animals were recorded at 5 minute intervals for five months with the two transmitters being used in sequence on a weekly basis. Additional challenge with d-methamphetamine (0.32 mg/kg ; i.m.) was conducted to compare the magnitude of the hyperthermic response measured IP and SC. Results Normal daily temperatures differed by about 0.5–0.8°C across implant locations with IP temperature consistently higher. The difference was consistent across the circadian cycle and when compared 1, 3 or 5 months after surgical implantation. The magnitude of the hyperthermia response to methamphetamine was about 0.75°C when measured with either IP or SC implants. Conclusions The study shows that data derived from the two major implantation locations used in existing literature are likely to be comparable. PMID:21443893

  18. Massage-induced release of subcutaneously injected liposome-encapsulated drugs to the blood.

    PubMed

    Trubetskoy, V S; Whiteman, K R; Torchilin, V P; Wolf, G L

    1998-01-01

    Liposome-based, externally regulated drug delivery system is described in which liposome-encapsulated bioactive molecules can be delivered into the blood in response to simple mechanical action. Without any mechanical stimulation, subcutaneously injected 200 mm liposomes are usually trapped in the interstitial for prolonged time. However, upon lymphotropic stimulation (such as manual massage of the injection site), the liposomes can be mobilized into the blood via lymphatic pathway. Up to 40% of the injection dose can be delivered to the blood via lymphatic pathway from the injection site at the rabbit's front paw dorsum during 5 min manual massage cycle. Using vasoconstricting hormone angiotensin II as liposome-encapsulated pharmacological marker, we demonstrated that physiological response to encapsulated drug (average blood pressure increase) can also induced and modulated by massage. Massage itself was found to have no effect on the blood pressure. Modification of liposome surface with polyethylene glycol was found to increase blood localization of the liposome-encapsulated drug presumably due to decreasing the uptake of the drug carrier by lymph node macrophages. Pressure-dependent gaps between lymphatic capillary endothelial cells are thought to play the role of the size discrimination device allowing larger particulates into the lymphatics and, eventually into the blood after increase of interstitial pressure caused by injection site massage.

  19. 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

  20. Enhanced bioavailability of subcutaneously injected insulin by pretreatment with ointment containing protease inhibitors

    SciTech Connect

    Takeyama, M.; Ishida, T.; Kokubu, N.; Komada, F.; Iwakawa, S.; Okumura, K.; Hori, R. )

    1991-01-01

    The present study was undertaken to develop an ointment preparation containing a protease inhibitor for stabilizing subcutaneously injected insulin. The ointment containing the protease inhibitor, gabexate mesilate or nafamostat mesilate, was applied to the skin around the insulin injection site. Three results were obtained. First, gabexate and nafamostat inhibited insulin degradation in subcutaneous tissue homogenates in vitro. Second, after application of gabexate or nafamostat ointment, an appreciable amount of gabexate or nafamostat appeared in the subcutaneous tissue of rats or hairless mice and their concentrations were comparable to those seen in the in vitro experiment. Third, insulin degradation at the subcutaneous injection site in the rat was depressed after pretreatment with gabexate or nafamostat ointment. Pretreatment with gabexate or nafamostat ointment increased the plasma immunoreactive insulin (IRI) levels and the hypoglycermic effect of insulin in healthy volunteers. These results indicate that gabexate or nafamostat ointments stabilize subcutaneously injected insulin.

  1. 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.

  2. Subcutaneous tissue emphysema of the hand secondary to noninfectious etiology: a report of two cases.

    PubMed

    van der Molen, A B; Birndorf, M; Dzwierzynski, W W; Sanger, J R

    1999-05-01

    Subcutaneous emphysema of the hand can be benign and noninfectious in origin. Emphysema from gas-forming organisms is associated with systemic symptoms, whereas benign subcutaneous emphysema is not. High-pressure pneumatic tool injuries are a well-known cause of subcutaneous emphysema. Minor wounds in the web space skin may result in a transport of air across the defect, acting like a ball valve mechanism to trap and then force the air into the subcutaneous tissue, as illustrated by 1 of our patients. In the second patient, use of a high-vibration tool without apparent breach of skin was associated with extensive subcutaneous emphysema. The benign nature of the emphysema was revealed by a lack of local pain and inflammation in the presence of extensive crepitus and a lack of systemic symptoms. A noninfectious cause should always be considered. This may prevent unnecessary surgical intervention, which occurred in 1 of the 2 cases presented here.

  3. 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.

  4. 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.

    2015-09-01

    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.

  5. Monitoring of ketogenic diet for carnitine metabolites by subcutaneous microdialysis.

    PubMed

    Hack, Alexandra; Busch, Verena; Pascher, Bettina; Busch, Raymonde; Bieger, Iris; Gempel, Klaus; Baumeister, Friedrich A M

    2006-07-01

    The ketogenic diet (KD) provides ketones from the degradation of free fatty acids for energy metabolism. It is a therapeutic option for pharmacoresistant epilepsies. Carnitine is the carrier molecule that transports fatty acids across the mitochondrial membrane for degradation into ketones. The integrity of this transport system is a prerequisite for an adequate ketogenic response. For monitoring of tissue metabolism with KD, we used the sampling method of s.c. microdialysis (MD), which permits minimally invasive, frequent, and extensive metabolic monitoring independent of blood tests. By using this new method, we monitored changes in carnitine metabolism induced by KD, particularly in free carnitine (C0), acetylcarnitine (C2), and hydroxybutyrylcarnitine (C4OH). Correlation of microdialysate and tissue concentrations for carnitines in vitro was about 85%. Carnitine metabolism was monitored in seven children started on a KD for pharmacoresistant epilepsy after a conventional initial fasting period. Detected metabolic changes consisted of a slight decrease in s.c. C0 and a marked increase in C2/CO and C4OH/CO levels. The levels of s.c. C4OH strongly correlate with beta-hydroxybutyrate (beta-OHB) levels in plasma providing an additional parameter for the carnitine reserve of the body and reflect an optimal ketogenic energy supply. Subcutaneous MD allows close and extensive monitoring of metabolism with a KD.

  6. 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.

  7. 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

  8. Selection of patients for sublingual versus subcutaneous immunotherapy.

    PubMed

    Larenas Linnemann, Désirée E S; Blaiss, Michael S

    2014-01-01

    Allergen immunotherapy is the sole treatment for IgE-mediated allergic diseases directed at the underlying mechanism. The two widely accepted administration routes are sublingual (SLIT) and subcutaneous (SCIT). We reviewed how patients should best be selected for immunotherapy and how the optimal administration route can be defined. Before deciding SCIT or SLIT, appropriate selection of patients for allergen immunotherapy (AIT) is mandatory. To be eligible for AIT, subjects must have a clear medical history of allergic disease, with exacerbation of symptoms on exposure to one or more allergens and a corresponding positive skin or in vitro test. Then the route of administration should be based on: published evidence of clinical and immunologic efficacy (which varies per allergic disease and per allergen); mono- or multi-allergen immunotherapy, for SLIT multi-allergen immunotherapy was not effective; safety: adverse events with SLIT are more frequent, but less severe; and, costs and patient preferences, closely related to adherence issues. All these are discussed in the article.

  9. 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

  10. A Classic Case of Subcutaneous Cysticercosis: A Rare Case with Sonological Findings and Review of Literature

    PubMed Central

    Naren Satya, Srinivas M.; Mayilvaganan, Kamala Retnam; Amogh, V.N.; Balakrishna, B.V.; Gautam, Munnangi Satya; Prathyusha, Ivvala Sai

    2016-01-01

    Summary Background Cysticercosis is a parasitic infection caused by the larval stages of the pork tapeworm, Taenia solium. The subcutaneous form of the disease is a relatively rare clinical entity. Despite its rarity, it is imperative for a radiologist to be aware of this subcutaneous form of the disease and its various radiological patterns while evaluating any subcutaneous swelling. In this paper, we aimed to describe a typical case of ‘subcutaneous cysticercosis involving the left anterior chest wall’ with high resolution ultrasound findings. We also discussed the role of other imaging modalities in a case of subcutaneous cysticercosis. To the best of our knowledge, our case is only the second documented case report of sonological evaluation of subcutaneous cysticercosis involving the left anterior chest wall and the first case with high resolution ultrasound images of the lesion. Case Report An 11-year-old male presented with a painless, subcutaneous swelling over the left anterior chest wall for the last 2 months. High resolution ultrasound showed a well-defined, thin-walled, cystic lesion with an eccentric, echogenic focus in the subcutaneous plane. On change of the posture of the patient, this focus showed mobility. The hypoechoic area surrounding this cyst showed significant exudative fluid collection with diffuse, floating echoes and thin, incomplete internal septations. The adjacent soft tissues were thickened and irregular, suggestive of edema. This was followed by an excision biopsy. Histopathological examination revealed cysticercus cellulose parasite with an extensive mixed inflammatory cell infiltrate in the surrounding tissue. The patient was also administered oral antihelminthic therapy. Repeat ultrasound examination at the end of this management regimen showed complete healing with no e/o any remnant or recurrent cystic lesion, abscess or edema in the subcutaneous plane. Conclusions Subcutaneous cysticercosis is a relatively rare form of

  11. Glucose Sensing in the Peritoneal Space Offers Faster Kinetics Than Sensing in the Subcutaneous Space

    PubMed Central

    Burnett, Daniel R.; Huyett, Lauren M.; Zisser, Howard C.; Doyle, Francis J.

    2014-01-01

    The paramount goal in the treatment of type 1 diabetes is the maintenance of normoglycemia. Continuous glucose monitoring (CGM) technologies enable frequent sensing of glucose to inform exogenous insulin delivery timing and dosages. The most commonly available CGMs are limited by the physiology of the subcutaneous space in which they reside. The very same advantages of this minimally invasive approach are disadvantages with respect to speed. Because subcutaneous blood flow is sensitive to local fluctuations (e.g., temperature, mechanical pressure), subcutaneous sensing can be slow and variable. We propose the use of a more central, physiologically stable body space for CGM: the intraperitoneal space. We compared the temporal response characteristics of simultaneously placed subcutaneous and intraperitoneal sensors during intravenous glucose tolerance tests in eight swine. Using compartmental modeling based on simultaneous intravenous sensing, blood draws, and intraarterial sensing, we found that intraperitoneal kinetics were more than twice as fast as subcutaneous kinetics (mean time constant of 5.6 min for intraperitoneal vs. 12.4 min for subcutaneous). Combined with the known faster kinetics of intraperitoneal insulin delivery over subcutaneous delivery, our findings suggest that artificial pancreas technologies may be optimized by sensing glucose and delivering insulin in the intraperitoneal space. PMID:24622798

  12. Risk factors predictive of right ventricular failure after left ventricular assist device implantation.

    PubMed

    Drakos, Stavros G; Janicki, Lindsay; Horne, Benjamin D; Kfoury, Abdallah G; Reid, Bruce B; Clayson, Stephen; Horton, Kenneth; Haddad, Francois; Li, Dean Y; Renlund, Dale G; Fisher, Patrick W

    2010-04-01

    Right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation appears to be associated with increased mortality. However, the determination of which patients are at greater risk of developing postoperative RVF remains controversial and relatively unknown. We sought to determine the preoperative risk factors for the development of RVF after LVAD implantation. The data were obtained for 175 consecutive patients who had received an LVAD. RVF was defined by the need for inhaled nitric oxide for >/=48 hours or intravenous inotropes for >14 days and/or right ventricular assist device implantation. An RVF risk score was developed from the beta coefficients of the independent variables from a multivariate logistic regression model predicting RVF. Destination therapy (DT) was identified as the indication for LVAD implantation in 42% of our patients. RVF after LVAD occurred in 44% of patients (n = 77). The mortality rates for patients with RVF were significantly greater at 30, 180, and 365 days after implantation compared to patients with no RVF. By multivariate logistic regression analysis, 3 preoperative factors were significantly associated with RVF after LVAD implantation: (1) a preoperative need for intra-aortic balloon counterpulsation, (2) increased pulmonary vascular resistance, and (3) DT. The developed RVF risk score effectively stratified the risk of RV failure and death after LVAD implantation. In conclusion, given the progressively growing need for DT, the developed RVF risk score, derived from a population with a large percentage of DT patients, might lead to improved patient selection and help stratify patients who could potentially benefit from early right ventricular assist device implantation. PMID:20346326

  13. Paragonimiasis in the abdominal cavity and subcutaneous tissue: report of 3 cases.

    PubMed

    Lee, Chang Ho; Kim, Jong Hun; Moon, Woo Sung; Lee, Min Ro

    2012-12-01

    Paragonimiasis is a parasitic disease caused by the lung fluke, Paragonimus spp. Lung flukes may be found in various organs, such as the brain, peritoneum, subcutaneous tissues, and retroperitoneum, other than the lungs. Abdominal paragonimiasis raises a considerable diagnostic challenge to clinicians, because it is uncommon and may be confused with other abdominopelvic inflammatory diseases, particularly peritoneal tuberculosis, and peritoneal carcinomatosis. Also, subcutaneous paragonimiasis does not easily bring up clinical suspicion, due to its rarity. We herein report 2 cases of abdominal paragonimiasis and 1 case of subcutaneous paragonimiasis in Korea.

  14. Paragonimiasis in the Abdominal Cavity and Subcutaneous Tissue: Report of 3 Cases

    PubMed Central

    Lee, Chang Ho; Kim, Jong Hun; Moon, Woo Sung

    2012-01-01

    Paragonimiasis is a parasitic disease caused by the lung fluke, Paragonimus spp. Lung flukes may be found in various organs, such as the brain, peritoneum, subcutaneous tissues, and retroperitoneum, other than the lungs. Abdominal paragonimiasis raises a considerable diagnostic challenge to clinicians, because it is uncommon and may be confused with other abdominopelvic inflammatory diseases, particularly peritoneal tuberculosis, and peritoneal carcinomatosis. Also, subcutaneous paragonimiasis does not easily bring up clinical suspicion, due to its rarity. We herein report 2 cases of abdominal paragonimiasis and 1 case of subcutaneous paragonimiasis in Korea. PMID:23230333

  15. [Experiences with a subcutaneous, fully resorbable bridge in construction a double loop ileo- and colostomy].

    PubMed

    Wedell, J; Banzhaf, G; Meier zu Eissen, P; Schlageter, M

    1990-01-01

    Our experience with the subcutaneous absorbable bridge for constructing a temporary loop ileostomy and loop colostomy is described. The use of this subcutaneous absorbable bridge in 15 patients - 6 with loop ileostomy and 9 with loop colostomy - was almost without complications. The absorbable bridge is a progress for maturation of the stoma and for immediate postoperative as prospective fitting of a watertight appliance. The actual trend substituting the temporary loop colostomy by the loop ileostomy may be advanced by the unlimited use of the subcutaneous absorbable bridge for constructing a temporary loop ileostomy.

  16. Biocompatibility of Subcutaneously Implanted Plant-Derived Cellulose Biomaterials

    PubMed Central

    Pelling, Andrew E.

    2016-01-01

    There is intense interest in developing novel biomaterials which support the invasion and proliferation of living cells for potential applications in tissue engineering and regenerative medicine. Decellularization of existing tissues have formed the basis of one major approach to producing 3D scaffolds for such purposes. In this study, we utilize the native hypanthium tissue of apples and a simple preparation methodology to create implantable cellulose scaffolds. To examine biocompatibility, scaffolds were subcutaneously implanted in wild-type, immunocompetent mice (males and females; 6–9 weeks old). Following the implantation, the scaffolds were resected at 1, 4 and 8 weeks and processed for histological analysis (H&E, Masson’s Trichrome, anti-CD31 and anti-CD45 antibodies). Histological analysis revealed a characteristic foreign body response to the scaffold 1 week post-implantation. However, the immune response was observed to gradually disappear by 8 weeks post-implantation. By 8 weeks, there was no immune response in the surrounding dermis tissue and active fibroblast migration within the cellulose scaffold was observed. This was concomitant with the deposition of a new collagen extracellular matrix. Furthermore, active blood vessel formation within the scaffold was observed throughout the period of study indicating the pro-angiogenic properties of the native scaffolds. Finally, while the scaffolds retain much of their original shape they do undergo a slow deformation over the 8-week length of the study. Taken together, our results demonstrate that native cellulose scaffolds are biocompatible and exhibit promising potential as a surgical biomaterial. PMID:27328066

  17. Subcutaneous Administration of Bortezomib: A Pilot Survey of Oncology Nurses.

    PubMed

    Martin, Jasmine R; Beegle, Nancy L; Zhu, Yanyan; Hanisch, Ellen M

    2015-01-01

    Subcutaneous (SC) administration of the proteasome inhibitor bortezomib was approved in the United States and European Union in 2012. There is limited guidance regarding how to administer SC bortezomib and a general lack of clear direction on optimal techniques for administering SC chemotherapy injections. Nurses may be utilizing different techniques, and inconsistent techniques may result in injection-site reactions, causing patient discomfort and treatment cessatioin. This observational survey of oncology nurses in community oncology clinics aimed to identify techniques being used and explore nurses' opinions about SC bortezomib administration. A 44-question electronic survey was developed, based on the current literature regarding appropriate techniques for administering SC injections. A total of 43 nurses from 17 clinics in 12 states responded. The majority (74%) had been practicing oncology nursing for at more than 5 years. Respondents predominantly used and preferred the abdomen for injections (88%); 81% used a skin lift to ensure injection into adipose tissue. There was no relationship between the angle of insertion and the needle length; 51% used an air-bubble technique. Nurses took 3-5 (49%), 5-10 (35%), 10-30 (9%), or > 30 (7%) seconds to administer each mL of SC bortezomib injection. All nurses completely/somewhat agreed that practice guidelines would be important for standardizing SC bortezomib administration. Advanced practice registered nurses (APRNs) shared the responsibility for ordering SC bortezomib, according to 53% of respondents. These findings could help APRNs improve the quality of patient care, may help minimize adverse events and maximize effective therapy, and could help inform the development of practice guidelines. PMID:26705492

  18. Biocompatibility of Subcutaneously Implanted Plant-Derived Cellulose Biomaterials.

    PubMed

    Modulevsky, Daniel J; Cuerrier, Charles M; Pelling, Andrew E

    2016-01-01

    There is intense interest in developing novel biomaterials which support the invasion and proliferation of living cells for potential applications in tissue engineering and regenerative medicine. Decellularization of existing tissues have formed the basis of one major approach to producing 3D scaffolds for such purposes. In this study, we utilize the native hypanthium tissue of apples and a simple preparation methodology to create implantable cellulose scaffolds. To examine biocompatibility, scaffolds were subcutaneously implanted in wild-type, immunocompetent mice (males and females; 6-9 weeks old). Following the implantation, the scaffolds were resected at 1, 4 and 8 weeks and processed for histological analysis (H&E, Masson's Trichrome, anti-CD31 and anti-CD45 antibodies). Histological analysis revealed a characteristic foreign body response to the scaffold 1 week post-implantation. However, the immune response was observed to gradually disappear by 8 weeks post-implantation. By 8 weeks, there was no immune response in the surrounding dermis tissue and active fibroblast migration within the cellulose scaffold was observed. This was concomitant with the deposition of a new collagen extracellular matrix. Furthermore, active blood vessel formation within the scaffold was observed throughout the period of study indicating the pro-angiogenic properties of the native scaffolds. Finally, while the scaffolds retain much of their original shape they do undergo a slow deformation over the 8-week length of the study. Taken together, our results demonstrate that native cellulose scaffolds are biocompatible and exhibit promising potential as a surgical biomaterial. PMID:27328066

  19. Subcutaneous Venous Port Implantation in Patients with Bilateral Breast Surgery

    SciTech Connect

    Peynircioglu, Bora Arslan, E. Bengi; Cil, Barbaros E.; Geyik, Serdar; Hazirolan, Tuncay; Konan, Ali; Balkanci, Ferhun

    2007-06-15

    The purpose of this study was to evaluate the long-term follow-up results of subcutaneous venous ports implanted in patients with bilateral mastectomies. We retrospectively reviewed the hospital charts and the electronic database of 17 patients with bilateral mastectomies whom had venous port implantation in our interventional radiology suit. A total of 17 ports were implanted to the paramedian (n = 3) and anterolateral (standard; n = 12) chest wall, on the trapezius muscle (n = 1), and to the antecubital fossa (n = 1). The mean age was 48.29 years (range: 35-60 years). The mean time interval from time of surgery to port implantation was 34 months (range: 1-84 months). The mean follow-up time was 15 months (range: 7-39 months). Follow-up parameters and classification of the complications was defined according to the SIR guidelines. No procedure-related complication occurred. A single case of mild late infection was noted and the infection rate was 0.19/1000 catheter days. Infusion chemotherapy administration was still going on in eight patients. Two patients died during the follow-up and four patients were lost after 6 months. Port removal was performed in three patients at follow-up because of the end of treatment. One trapezius port and one paramedian port weres among the removed ports without any problem. Although we have a limited number of patients, port placement to the anterior chest wall, either paramedian or anterolateral, on the trapezius muscle or to the antecubital fossa depending on the extent of the bilateral breast surgeries that can be performed with low complication rates by a careful patient and anatomical location selection by involving the patients in the decision-making process. We believe that patient education and knowledge of possible complications have high importance in follow-up.

  20. Microstructural Inhomogeneity of Electrical Conductivity in Subcutaneous Fat Tissue

    PubMed Central

    Kruglikov, Ilja L.

    2015-01-01

    Microscopic peculiarities stemming from a temperature increase in subcutaneous adipose tissue (sWAT) after applying a radio-frequency (RF) current, must be strongly dependent on the type of sWAT. This effect is connected with different electrical conductivities of pathways inside (triglycerides in adipocytes) and outside (extra-cellular matrix) the cells and to the different weighting of these pathways in hypertrophic and hyperplastic types of sWAT. The application of the RF current to hypertrophic sWAT, which normally has a strongly developed extracellular matrix with high concentrations of hyaluronan and collagen in a peri-cellular space of adipocytes, can produce, micro-structurally, a highly inhomogeneous temperature distribution, characterized by strong temperature gradients between the peri-cellular sheath of the extra-cellular matrix around the hypertrophic adipocytes and their volumes. In addition to normal temperature effects, which are generally considered in body contouring, these temperature gradients can produce thermo-mechanical stresses on the cells’ surfaces. Whereas these stresses are relatively small under normal conditions and cannot cause any direct fracturing or damage of the cell structure, these stresses can, under some supportive conditions, be theoretically increased by several orders of magnitude, causing the thermo-mechanical cell damage. This effect cannot be realized in sWAT of normal or hyperplastic types where the peri-cellular structures are under-developed. It is concluded that the results of RF application in body contouring procedures must be strongly dependent on the morphological structure of sWAT. PMID:25734656

  1. Microfluidic Device

    NASA Technical Reports Server (NTRS)

    Tai, Yu-Chong (Inventor); Zheng, Siyang (Inventor); Lin, Jeffrey Chun-Hui (Inventor); Kasdan, Harvey (Inventor)

    2015-01-01

    Described herein are particular embodiments relating to a microfluidic device that may be utilized for cell sensing, counting, and/or sorting. Particular aspects relate to a microfabricated device that is capable of differentiating single cell types from dense cell populations. One particular embodiment relates a device and methods of using the same for sensing, counting, and/or sorting leukocytes from whole, undiluted blood samples.

  2. Microfluidic Device

    NASA Technical Reports Server (NTRS)

    Tai, Yu-Chong (Inventor); Zheng, Siyang (Inventor); Lin, Jeffrey Chun-Hui (Inventor); Kasdan, Harvey L. (Inventor)

    2016-01-01

    Described herein are particular embodiments relating to a microfluidic device that may be utilized for cell sensing, counting, and/or sorting. Particular aspects relate to a microfabricated device that is capable of differentiating single cell types from dense cell populations. One particular embodiment relates a device and methods of using the same for sensing, counting, and/or sorting leukocytes from whole, undiluted blood samples.

  3. Sealing device

    DOEpatents

    Garcia-Crespo, Andres Jose

    2013-12-10

    A sealing device for sealing a gap between a dovetail of a bucket assembly and a rotor wheel is disclosed. The sealing device includes a cover plate configured to cover the gap and a retention member protruding from the cover plate and configured to engage the dovetail. The sealing device provides a seal against the gap when the bucket assemply is subjected to a centrifugal force.

  4. Regulation of local subcutaneous blood flow in patients with psoriasis and effects of antipsoriatic treatment on subcutaneous blood flow

    SciTech Connect

    Klemp, P.

    1985-08-01

    Local regulation of the doubled subcutaneous blood flow (SBF) rates in psoriatic lesional skin was studied in 8 patients using a traumatic epicutaneous /sup 133/Xe labeling washout technique. Venous stasis of 40 mm Hg induced a significant reduction in the SBF (-34%, p less than 0.01), i.e., a normal vasoconstrictor response. Limb elevation of 40 cm above heart level induced no statistical changes in the SBF (p = 0.50), i.e., a normal local autoregulation response. This indicates normal, local regulation mechanisms of SBF in psoriasis. In another 8 patients, the effect on SBF of a 4-week antipsoriatic treatment with tar was studied in lesional and symmetrically nonlesional skin areas. One patient was clear of psoriasis on day 22, and was followed only to that time. The mean pretreatment SBF in lesional skin areas was 3.87 +/- SD 0.78 ml X (100 g X min)-1, which was not statistically different from measurements on days 3, 7, 14, and 21 after treatment had started. Between day 21 and day 28, the SBF decreased significantly to 3.38 +/- SD 0.78 ml X (100 g X min)-1, p less than 0.05. The difference between the pretreatment SBF and SBF at the end of treatment was statistically significant, p less than 0.05. The changes in SBF in symmetrically nonlesional skin areas were statistically nonsignificant during the period of treatment. Pretreatment SBF was 2.60 +/- SD 1.08 (N = 8), and on day 28 was 1.91 +/- SD 0.74 ml X (100 g X min)-1 (N = 7). However, the tendency of a decreasing SBF at the end of treatment was a clear trend, since SBF in 6 of 7 patients decreased during the third week and in the patient who was discharged on day 22, a decrease in the SBF was observed on days 14 and 21.

  5. Novel Closing Method Using Subcutaneous Continuous Drain for Preventing Surgical Site Infections in Radical Cystectomy

    PubMed Central

    Hirose, Yasuhiko; Ando, Ryosuke; Nakane, Akihiro; Etani, Toshiki; Iida, Keitaro; Akita, Hidetoshi; Okamura, Takehiko; Kohri, Kenjiro

    2014-01-01

    To reduce the incidence of surgical site infection (SSI) after radical cystectomy, a new closing method using subcutaneous continuous aspiration drain was developed and compared to the conventional closing method. The new method involved (a) closed aspiration with an indwelling aspiration drain without suture of the subcutaneous fat and (b) covering with hydrocolloid wound dressing after suture of the dermis with 4-0 absorbable thread and reinforcement using strips. The incidence of SSI was significantly improved by using the new method. Furthermore, univariate and multivariate analysis associated with SSI revealed that the new closing method was statistically correlated with 85% reduction of SSI (odds ratio: 0.15, 95% confidence interval: 0.03–0.69).Our new method using continuous aspiration with subcutaneous drain is useful for preventing SSI through removal of effusions and reduction of dead space by apposition of the subcutaneous fat. PMID:24734201

  6. [Cutaneous mycoses as a problem of the tropics. II. Subcutaneous tropical mycoses].

    PubMed

    Jeske, J

    2001-01-01

    Cutaneous mycoses are third among diseases after parasitic and infectious ones that pose problems for persons returning from the tropics. The paper presents semiotics of the following tropical subcutaneous mycoses: sporotrichosis, chromoblastomycosis, maduromycosis, pheohyphomycosis, zygomycosis and lobomycosis.

  7. BRAKE DEVICE

    DOEpatents

    O'Donnell, T.J.

    1959-03-10

    A brake device is described for utilization in connection with a control rod. The device comprises a pair of parallelogram link mechanisms, a control rod moveable rectilinearly therebetween in opposite directions, and shoes resiliently supported by the mechanism for frictional engagement with the control rod.

  8. Electrochromic devices

    DOEpatents

    Allemand, Pierre M.; Grimes, Randall F.; Ingle, Andrew R.; Cronin, John P.; Kennedy, Steve R.; Agrawal, Anoop; Boulton, Jonathan M.

    2001-01-01

    An electrochromic device is disclosed having a selective ion transport layer which separates an electrochemically active material from an electrolyte containing a redox active material. The devices are particularly useful as large area architectural and automotive glazings due to there reduced back reaction.

  9. PLASMA DEVICE

    DOEpatents

    Gow, J.D.; Wilcox, J.M.

    1961-12-26

    A device is designed for producing and confining highenergy plasma from which neutrons are generated in copious quantities. A rotating sheath of electrons is established in a radial electric field and axial magnetic field produced within the device. The electron sheath serves as a strong ionizing medium to gas introdueed thereto and also functions as an extremely effective heating mechanism to the resulting plasma. In addition, improved confinement of the plasma is obtained by ring magnetic mirror fields produced at the ends of the device. Such ring mirror fields are defined by the magnetic field lines at the ends of the device diverging radially outward from the axis of the device and thereafter converging at spatial annular surfaces disposed concentrically thereabout. (AFC)

  10. A case of axillary web syndrome with subcutaneous nodules following axillary surgery.

    PubMed

    Reedijk, Michael; Boerner, Scott; Ghazarian, Danny; McCready, David

    2006-06-01

    Axillary web syndrome (AWS) is a cause of morbidity in the early postoperative period following axillary surgery, which is characterized by cords of subcutaneous tissue extending from the axilla into the medial arm. Few reports have been published describing this entity, which results in pain and a limitation of shoulder abduction. Here, we report a case of AWS that was accompanied with sub-cutaneous nodules mimicking recurrence of breast cancer. PMID:16257525

  11. Subcutaneous and intermuscular fat characterisation of dry-cured Iberian hams.

    PubMed

    Timón, M L; Ventanas, J; Carrapiso, A I; Jurado, A; García, C

    2001-05-01

    The fatty acid composition of the triacylglycerols and free fatty acids of subcutaneous (internal and superficial layers) and intermuscular fat and the contribution of these fatty acids to the formation of volatile compounds were determined in dry-cured Iberian ham. The profile of the fatty acids and volatile compounds showed that lipolytic and oxidative processes occur more intensively in subcutaneous than intermuscular fat, however, few differences were found compared to those found in ham lean.

  12. Congenital subcutaneous arteriovenous malformation in a puppy: diagnosis with CT angiography.

    PubMed

    Proks, Pavel; Stehlik, Ladislav; Paninarova, Michaela; Irova, Katarina; Lorenzova, Jana; Necas, Alois

    2015-10-01

    A 4-month-old, 20 kg, intact male, cane corso dog was presented with a slowly growing subcutaneous lesion on the left caudoventral abdominal wall. Ultrasound and computed tomography angiography revealed a subcutaneous plexus of aberrant tortuous vessels directly connected with the superficial branch of the deep circumflex iliac artery and vein. The arteriovenous malformation (AVM) was successfully surgically removed. Early recognition and surgical removal of AVM can have excellent cosmetic results and prevents potential cardiovascular complications. PMID:26175066

  13. 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.

  14. Pharmacokinetics and pharmacodynamics comparison between subcutaneous and intravenous butorphanol administration in horses.

    PubMed

    Chiavaccini, L; Claude, A K; Lee, J H; Ross, M K; Meyer, R E; Langston, V C

    2015-08-01

    The study objective was to compare butorphanol pharmacokinetics and physiologic effects following intravenous and subcutaneous administration in horses. Ten adult horses received 0.1 mg/kg butorphanol by either intravenous or subcutaneous injections, in a randomized crossover design. Plasma concentrations of butorphanol were measured at predetermined time points using highly sensitive liquid chromatography-tandem mass spectrometry assay (LC-MS/MS). Demeanor and physiologic variables were recorded. Data were analyzed with multivariate mixed-effect model on ranks (P ≤ 0.05). For subcutaneous injection, absorption half-life and peak plasma concentration of butorphanol were 0.10 ± 0.07 h and 88 ± 37.4 ng/mL (mean ± SD), respectively. Bioavailability was 87%. After intravenous injection, mean ± SD butorphanol steady-state volume of distribution and clearance was 1.2 ± 0.96 L/kg and 0.65 ± 0.20 L/kg/h, respectively. Terminal half-lives for butorphanol were 2.31 ± 1.74 h and 5.29 ± 1.72 h after intravenous and subcutaneous administrations. Subcutaneous butorphanol reached and maintained target plasma concentrations >10 ng/mL for 2 ± 0.87 h (Mean ± SD), with less marked physiologic and behavioral effects compared to intravenous injection. Subcutaneous butorphanol administration is an acceptable alternative to the intravenous route in adult horses. PMID:25484250

  15. Pioglitazone enhances small-sized adipocyte proliferation in subcutaneous adipose tissue.

    PubMed

    Kajita, Kazuo; Mori, Ichiro; Hanamoto, Takayuki; Ikeda, Takahide; Fujioka, Kei; Yamauchi, Masahiro; Okada, Hideyuki; Usui, Taro; Takahashi, Noriko; Kitada, Yoshihiko; Taguchi, Kohichiro; Kajita, Toshiko; Uno, Yoshihiro; Morita, Hiroyuki; Ishizuka, Tatsuo

    2012-01-01

    The possibility that mature adipocytes proliferate has not been fully investigated. In this study, we demonstrate that adipocytes can proliferate. 5-bromo-2'-deoxyuridine (BrdU)-labeled adipocyte like cells, most of which were less than 30 μm in diameter, were observed in adipose tissue. Proliferating cell nuclear antigen (PCNA) was simultaneously detected in BrdU-labeled nuclei. Observation of individual mature adipocytes of smeared specimens on glass slides revealed that small sized adipocytes more frequently incorporated BrdU. Cultured mature adipocytes using the ceiling-cultured method showed clustering of proliferating cells in small-sized adipocytes. These small cultured adipocytes, but not large ones, extensively incorporated BrdU. Quantified analysis of BrdU incorporation demonstrated that mature visceral adipocytes, including epididymal, mesenteric and perirenal adipocytes, proliferated more actively than subcutaneous ones. On the other hand, treatment with pioglitazone (Pio), a ligand of peroxisome proliferator-activated receptor γ, containing food for 2w, elevated BrdU incorporation and expression of PCNA in mature adipocytes isolated from subcutaneous, but not visceral adipose tissue. Moreover, Pio induced increased BrdU-labeled small-sized subcutaneous adipocytes, which was associated with an increased number of total small adipocytes in subcutaneous adipose tissue. In conclusion, mature adipocytes have a subgroup representing the potential to replicate, and this proliferation is more active in visceral adipocytes. Treatment with Pio increases proliferation in subcutaneous adipocytes. These results may explain the mechanism of Pio-induced hyperplasia especially in subcutaneous adipocytes.

  16. Prdm16 determines the thermogenic program of subcutaneous white adipose tissue in mice.

    PubMed

    Seale, Patrick; Conroe, Heather M; Estall, Jennifer; Kajimura, Shingo; Frontini, Andrea; Ishibashi, Jeff; Cohen, Paul; Cinti, Saverio; Spiegelman, Bruce M

    2011-01-01

    The white adipose organ is composed of both subcutaneous and several intra-abdominal depots. Excess abdominal adiposity is a major risk factor for metabolic disease in rodents and humans, while expansion of subcutaneous fat does not carry the same risks. Brown adipose produces heat as a defense against hypothermia and obesity, and the appearance of brown-like adipocytes within white adipose tissue depots is associated with improved metabolic phenotypes. Thus, understanding the differences in cell biology and function of these different adipose cell types and depots may be critical to the development of new therapies for metabolic disease. Here, we found that Prdm16, a brown adipose determination factor, is selectively expressed in subcutaneous white adipocytes relative to other white fat depots in mice. Transgenic expression of Prdm16 in fat tissue robustly induced the development of brown-like adipocytes in subcutaneous, but not epididymal, adipose depots. Prdm16 transgenic mice displayed increased energy expenditure, limited weight gain, and improved glucose tolerance in response to a high-fat diet. shRNA-mediated depletion of Prdm16 in isolated subcutaneous adipocytes caused a sharp decrease in the expression of thermogenic genes and a reduction in uncoupled cellular respiration. Finally, Prdm16 haploinsufficiency reduced the brown fat phenotype in white adipose tissue stimulated by β-adrenergic agonists. These results demonstrate that Prdm16 is a cell-autonomous determinant of a brown fat-like gene program and thermogenesis in subcutaneous adipose tissues.

  17. Subcutaneous Fungal Cyst Masquerading as Benign Lesions – A Series of Eight Cases

    PubMed Central

    Varghese, Renu G’Boy; Phansalkar, Manjiri; Ramdas, Anita; K, Authy; G, Thangiah

    2015-01-01

    Background Subcutaneous fungal infections are caused by penetration of the causative fungi into the subcutaneous layer and are usually localised. We present a series of eight cases with subcutaneous fungal cystic lesions masquerading as benign lesions. Materials and Methods A retrospective study was conducted on subcutaneous fungal infections seen between January 2007 to July 2014 in the Department of Pathology. Eight patients with biopsy proven subcutaneous fungal infection were included. We collected and analysed their demographic, clinical and histopathological details. Results Among eight patients, six were male and two were female. The mean age was 47 years (Range: 21-70). All the eight patients presented with non-tender cystic swelling. The size of the swellings varied from a minimum of 3x3 cm to maximum of 10x4 cm. Out of eight, hand was involved in three, forearm in one, elbow in two, leg in one and foot in one. On H&E staining, all the cases showed fibro collagenous cyst wall, lined by histiocytes, granulomatous reaction, foreign body type of giant cells with acute and chronic inflammatory infiltrate containing fungal elements. Six were identified as hyalohyphomycosis and two were identified as phaeohyphomycotic cysts based on pigmentation of hyphae. Conclusion Fungal infection should be suspected in all subcutaneous cystic lesions. Excised tissue should always be sent for culture and histopathology. PMID:26557537

  18. Comparison of intravenous and subcutaneous exposure supporting dose selection of subcutaneous belimumab systemic lupus erythematosus Phase 3 program

    PubMed Central

    Yapa, S Wickramaratne Senarath; Roth, D; Gordon, D

    2016-01-01

    Background Belimumab is a recombinant, human, IgG1λ monoclonal antibody that targets B-lymphocyte stimulator. The intravenous formulation is indicated for the treatment of active, autoantibody-positive systemic lupus erythematosus (SLE). Belimumab has been formulated for subcutaneous (SC) administration to improve patient convenience. This post-hoc modeling and simulation analysis characterizes the population pharmacokinetics (PK) of SC belimumab, and compares the exposure profiles of the approved belimumab IV dose—10 mg/kg every four weeks—to the 200 mg SC weekly dose in SLE patients, highlighting key pharmacological differences relevant for clinicians. Methods Data from two Phase 1 studies in US American and Japanese healthy subjects were analyzed with a non-linear mixed effects modeling approach. The resulting SC population PK model and a previously developed IV population PK model were used to conduct simulation trials in a Phase 3 IV belimumab SLE patient population, comparing chronic exposure profiles and exposure ranges stratified by body weight tertiles for IV vs SC dosing. Results The PK of belimumab following SC administration was best described by a linear two-comment model. The estimates for clearance, steady-state volume of distribution, and bioavailability were 208 mL/day, 5250 mL, and 76%, respectively. After four weeks of SC dosing, simulated belimumab concentrations exceeded the steady-state trough concentrations of the IV dosing regimen. At steady state simulated serum profiles demonstrated comparable average belimumab concentrations (Cavg,ss) after IV and SC dosing. Simulated belimumab exposures demonstrated largely overlapping concentration ranges following 200 mg SC weekly and 10 mg/kg IV every four weeks dosing. Discussion The predicted Cavg,ss of belimumab in SLE patients was comparable following 200 mg SC weekly and 10 mg/kg IV every four weeks dosing. The simulated belimumab accumulation following SC weekly dosing

  19. Continuous subcutaneous insulin infusion versus multiple daily injections

    PubMed Central

    Karagianni, P; Sampanis, Ch; Katsoulis, Ch; Miserlis, Gr; Polyzos, S; Zografou, I; Stergiopoulos, S; Douloumbakas, I; Zamboulis, Ch

    2009-01-01

    Background and aim: Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Daily insulin Injections (MDI) are both strategies aiming to achieve a tight glycemic and metabolic control. However, the choice between them remains controversial. The aim of the present study was to compare the efficacy of MDI (three or more injections daily) with CSII on glycemic control in patients with Type 1 Diabetes Mellitus and assess satisfaction from treatment in the CSII group. Material and Methods: Seventeen patients with Type 1 Diabetes Mellitus on CSII (previously on MDI) and 17 patients on MDI, matched for age, gender, BMI and duration of diabetes, were retrospectively studied. Glucosylated Hemoglobin A1c (HbA1c), frequency of hypoglycaemias (assessed as self reported episodes), BMI and total units of insulin per day were evaluated at baseline and after 6 months in both groups. CSII group completed a questionnaire concerning motive for treatment selection, advantages, deficiencies and inconvenience at the end of the study. Satisfaction from treatment was assessed with a scale from 0 to10. Results: CSII group had more hypoglycaemic episodes at baseline than MDI group (16.2±2.8 vs 2.8±1.3, p<0,001). HbA1c (8.4±0.5 before vs 7.3±0.4 after, p<0.05) and total hypoglycaemic episodes per month (16.2±2.8 before vs 8.7±2.3 after, p<0.05) significantly decreased in CSII group 6 months after baseline. On the contrary, total hypoglycaemic episodes per month were increased in MDI group (2.8±1.3 before vs 10.8 ±2,6 after, p<0.05) in order to maintain HbA1c levels. No significant differences were observed in BMI in both groups. Total insulin demands were reduced in the CSII group (49.4±3.3 before vs 39.0±4.6 after, p<0.05) and remained unchanged in MDI group. None of the patients discontinued CSII therapy, while overall satisfaction rate in this group was high. The main motive for CSII selection was frequent hypoglycaemic episodes and glucose fluctuations (10/17). The

  20. Measuring subcutaneous temperature and differential rates of rewarming from hibernation and daily torpor in two species of bats.

    PubMed

    Currie, Shannon E; Körtner, Gerhard; Geiser, Fritz

    2015-12-01

    Prolonged and remote measurement of body temperature (Tb) in undisturbed small hibernators was not possible in the past because of technological limitations. Although passive integrated transponders (PITs) have been used previously to measure subcutaneous temperature (Tsub) during daily torpor in a small marsupial, no study has attempted to use these devices at Tbs below 10°C. Therefore, we investigated whether subcutaneous interscapular PITs can be used as a viable tool for measuring Tb in a small hibernating bat (Nyctophilus gouldi; Ng) and compared it with measurements of Tb during daily torpor in a heterothermic bat (Syconycteris australis; Sa). The precision of transponders was investigated as a function of ambient temperature (Ta) and remote Tsub readings enabled us to quantify Tsub-Tb differentials during steady-state torpor and arousal. Transponders functioned well outside the manufacturer's recommended range, down to ~5°C. At rest, Tsub and rectal Tb (Trec) were strongly correlated for both bat species (Ng r(2)=0.88; Sa r(2)=0.95) and this was also true for N. gouldi in steady-state torpor (r(2)=0.93). During induced rewarming Tsub increased faster than Trec in both species. Our results demonstrate that transponders can be used to provide accurate remote measurement of Tb in two species of bats during different physiological states, both during steady-state conditions and throughout dynamic phases such as rewarming from torpor. We show that, at least during rewarming, regional heterothermy common to larger hibernators and other hibernating bats is also present in bats capable of daily torpor.

  1. Candida albicans biofilm development on medically-relevant foreign bodies in a mouse subcutaneous model followed by bioluminescence imaging.

    PubMed

    Kucharíková, Soňa; Vande Velde, Greetje; Himmelreich, Uwe; Van Dijck, Patrick

    2015-01-01

    Candida albicans biofilm development on biotic and/or abiotic surfaces represents a specific threat for hospitalized patients. So far, C. albicans biofilms have been studied predominantly in vitro but there is a crucial need for better understanding of this dynamic process under in vivo conditions. We developed an in vivo subcutaneous rat model to study C. albicans biofilm formation. In our model, multiple (up to 9) Candida-infected devices are implanted to the back part of the animal. This gives us a major advantage over the central venous catheter model system as it allows us to study several independent biofilms in one animal. Recently, we adapted this model to study C. albicans biofilm development in BALB/c mice. In this model, mature C. albicans biofilms develop within 48 hr and demonstrate the typical three-dimensional biofilm architecture. The quantification of fungal biofilm is traditionally analyzed post mortem and requires host sacrifice. Because this requires the use of many animals to perform kinetic studies, we applied non-invasive bioluminescence imaging (BLI) to longitudinally follow up in vivo mature C. albicans biofilms developing in our subcutaneous model. C. albicans cells were engineered to express the Gaussia princeps luciferase gene (gLuc) attached to the cell wall. The bioluminescence signal is produced by the luciferase that converts the added substrate coelenterazine into light that can be measured. The BLI signal resembled cell counts obtained from explanted catheters. Non-invasive imaging for quantifying in vivo biofilm formation provides immediate applications for the screening and validation of antifungal drugs under in vivo conditions, as well as for studies based on host-pathogen interactions, hereby contributing to a better understanding of the pathogenesis of catheter-associated infections.

  2. Human subcutaneous tissue distribution of fluconazole: comparison of microdialysis and suction blister techniques

    PubMed Central

    Sasongko, Lucy; Williams, Kenneth M; Day, Richard O; McLachlan, Andrew J

    2003-01-01

    Aims To investigate uptake of fluconazole into the interstitial fluid of human subcutaneous tissue using the microdialysis and suction blister techniques. Methods A sterile microdialysis probe (CMA/60) was inserted subcutaneously into the upper arm of five healthy volunteers following an overnight fast. Blisters were induced on the lower arm using gentle suction prior to ingestion of a single oral dose of fluconazole (200 mg). Microdialysate, blister fluid and blood were sampled over 8 h. Fluconazole concentrations were determined in each sample using a validated HPLC assay. In vivo recovery of fluconazole from the microdialysis probe was determined in each subject by perfusing the probe with fluconazole solution at the end of the 8 h sampling period. Individual in vivo recovery was used to calculate fluconazole concentrations in subcutaneous interstitial fluid. A physiologically based pharmacokinetic (PBPK) model was used to predict fluconazole concentrations in human subcutaneous interstitial fluid. Results There was a lag-time (approximately 0.5 h) between detection of fluconazole in microdialysate compared with plasma in each subject. The in vivo recovery of fluconazole from the microdialysis probe ranged from 57.0 to 67.2%. The subcutaneous interstitial fluid concentrations obtained by microdialysis were very similar to the unbound concentrations of fluconazole in plasma with maximum concentration of 4.29 ± 1.19 µg ml−1 in subcutaneous interstitial fluid and 3.58 ± 0.14 µg ml−1 in plasma. Subcutaneous interstitial fluid-to-plasma partition coefficient (Kp) of fluconazole was 1.16 ± 0.22 (95% CI 0.96, 1.35). By contrast, fluconazole concentrations in blister fluid were significantly lower (P < 0.05, paired t-test) than unbound plasma concentrations over the first 3 h and maximum concentrations in blister fluid had not been achieved at the end of the sampling period. There was good agreement between fluconazole concentrations derived from microdialysis

  3. Subcutaneous Histiocytoid Sweet Syndrome Associated with Crohn Disease in an Adolescent

    PubMed Central

    Fernández-Torres, Rosa María; Castro, Susana; Moreno, Ana; Álvarez, Roberto; Fonseca, Eduardo

    2014-01-01

    We report a case of subcutaneous histiocytoid Sweet syndrome in an adolescent with Crohn disease. A 14-year-old boy with a 1-year history of ileocolonic and perianal Crohn disease, treated with infliximab and azathioprine, was admitted to the Pediatrics Department with malaise, abdominal pain, bloody diarrhea, and fever (39°C) from 15 days ago. Two days later, he developed cutaneous lesions consisting of tender, erythematous, and violaceous papules and nodules scattered over his legs, soles, and upper extremities. Laboratory studies revealed neutrophilia, microcytic anemia, and elevation of both erythrocyte sedimentation rate and C-reactive protein rate. A skin biopsy specimen showed deep dermal and predominantly septal inflammatory infiltrate in the subcutaneous tissue composed of polymorphonuclears, eosinophils, and mononuclear cells of histiocytic appearance. These histiocytoid cells stained positive for myeloperoxidase. Subcutaneous Sweet syndrome is a rare subtype of acute neutrophilic dermatosis, in which the infiltrate is exclusively or predominantly located in the subcutaneous tissue, causing lobular or septal panniculitis. It is often described in patients with an underlying haematological disorder or caused by drugs, but very rare in patients with inflammatory bowel disease, especially in childhood or adolescence. To our knowledge, this is the first case of subcutaneous histiocytoid type in a paediatric patient. PMID:24839565

  4. A single subcutaneous dose of tramadol for mild to moderate musculoskeletal trauma in the emergency department

    PubMed Central

    Cardozo, Alejandro; Silva, Carlos; Dominguez, Luis; Botero, Beatriz; Zambrano, Paulo; Bareno, Jose

    2014-01-01

    BACKGROUND: Mild to moderate musculoskeletal trauma is a common cause for an emergency room visit, and frequent pain is one of the cardinal symptoms of consultation. The objective of this study is to assess the perception of a single subcutaneous dose of 50 mg tramadol for pain management in patients with mild to moderate musculoskeletal trauma, likewise to appraise the perception of pain by subcutaneous injection. METHODS: A total of 77 patients, who met inclusion criteria, received a single subcutaneous dose of tramadol. Pain control was evaluated based on the verbal numerical pain scale (0–10) at baseline, 20 and 60 minutes; similarly, pain perception was evaluated secondary to subcutaneous injection of the analgesic. RESULTS: On admission, the average pain perceived by patients was 8; twenty minutes later, 89% of the patients reported five or less, and after sixty minutes, 94% had three or less on the verbal numerical pain scale. Of the patients, 88% reported pain perception by verbal numeric scale of 3 or less by injection of the drug, and 6.5% required a second analgesic for pain control. Two events with drug administration (soft tissue infection and mild abdominal rectus injection) were reported. CONCLUSION: We conclude that a single subcutaneous dose of tramadol is a safe and effective option for the management of patients with mild to moderate pain and musculoskeletal disease in the emergency department. PMID:25548601

  5. Privileged status of the subcutaneous site for skin allografts in rats.

    PubMed

    Hamilton, M S; Billingham, R E

    1979-09-01

    Evidence is presented that in rats the subcutaneous site can extend privilege to both major histocompatibility complex (MHC)-incompatible (FI X DA)F1 leads to FI and MHC-compatible LEW leads to FI skin allografts, approximately doubling the median survival time of similar grafts transplanted orthotopically. Unlike graft dosage, "gene" dosage was an important variable in that grafts from (FI X DA)F1 donors significantly outlived those from DA strain donors. Prior splenectomy of the hosts did not prejudice the capacity of their subcutaneous sites to extend privilege. It was found that the hemagglutinin response incited by subcutaneous grafts was significantly delayed compared with that evoked by similar grafts transplanted orthotopically or intraperitoneally. This observation, coupled with our inability to demonstrate the passage of India ink to regional lymph nodes after its injection into the dermis of established subcutaneous grafts of syngenic skin, is consistent with the concept that poor endowment of the subcutaneous milieu with both blood and lymph vessels is the principal factor underlying its hospitality to allografts. PMID:386584

  6. Subcutaneous histiocytoid Sweet's syndrome in a patient with myelodysplastic syndrome and acute myeloblastic leukemia.

    PubMed

    Srisuttiyakorn, Chutika; Reeve, Jennifer; Reddy, Swapna; Imaeda, Suguru; Lazova, Rossitza

    2014-05-01

    Subcutaneous histiocytoid Sweet’s syndrome is a rare variant of histiocytoid Sweet’s syndrome (SS). We present a 68-year-old woman with subcutaneous histiocytoid SS in association with refractory myelodysplastic syndrome transformed to acute myeloblastic leukemia (AML), status post induction chemotherapy and with persistent blasts (50%) in the bone marrow and blood, accompanied with neutropenia. The patient presented to the emergency room with fever and altered mental status. Clinical examination revealed approximately 20 scattered 0.5-2 cm, pink to pink-purple non-tender firm nodules on the legs and left arm. The differential diagnosis included Sweet’s syndrome (deep), leukemia cutis, infection, polyarteritis nodosa and erythema nodosum. Histopathologic examination of a biopsy from the left arm revealed a nodular infiltrate of neutrophils and histiocytoid mononuclear cells solely in the lobular compartment of the subcutaneous fat with focal areas of necrosis. Most cells in the infiltrate labeled with myeloperoxidase (MPO) including the histiocytoid cells. The cells were negative for CD34 and CD117. All special stains for microorganisms were negative. A diagnosis of subcutaneous histiocytoid SS was made. A subcutaneous histiocytoid SS should be suspected when a neutrophilic/histiocytoid panniculitis, occurring in the setting of myeloid disorders, is encountered and after exclusion of an infectious process and leukemia cutis.

  7. Cold- and Hot-Pack Contrast Therapy: Subcutaneous and Intramuscular Temperature Change

    PubMed Central

    Myrer, J. William; Measom, Gary; Durrant, Earlene; Fellingham, Gilbert W.

    1997-01-01

    Objective: To investigate the temperature changes in subcutaneous and intramuscular tissue during a 20-minute cold- and hot-pack contrast therapy treatment. Design and Setting: Subjects were randomly exposed to 20 minutes of contrast therapy (5 minutes of heat with a hydrocollator pack followed by 5 minutes of cold with an ice pack, repeated twice) and 20 minutes of cold therapy (ice pack only) in a university laboratory. Subjects: Nine men and seven women with no history of peripheral vascular disease and no allergy to cephalexin hydrochloride volunteered for the study. Measurements: Subcutaneous and intramuscular tissue temperatures were measured by 26-gauge hypodermic needle microprobes inserted into the left calf just below the skin or 1 cm below the skin and subcutaneous fat, respectively. Results: With contrast therapy, muscular temperature did not fluctuate significantly over the 20-minute period compared with the subcutaneous temperature, which fluctuated from 8°C to 14°C each 5-minute interval. When subjects were treated with ice alone, muscle temperature decreased 7°C and subcutaneous temperature decreased 17°C over the 20-minute treatment. Conclusions: Our results show that contrast therapy has little effect on deep muscle temperature. Therefore, if most of the physiologic effects attributed to cold and hot contrast therapy depend on substantial fluctuations in tissue temperature, contrast therapy needs to be reconsidered as a viable therapeutic modality. ImagesFig 1.Fig 2.Fig 3. PMID:16558456

  8. Photoacoustic imaging of angiogenesis in a subcutaneous islet transplant site in a murine model

    NASA Astrophysics Data System (ADS)

    Shi, Wei; Pawlick, Rena; Bruni, Antonio; Rafiei, Yasmin; Pepper, Andrew R.; Gala-Lopez, Boris; Choi, Min; Malcolm, Andrew; Zemp, Roger J.; Shapiro, A. M. James

    2016-06-01

    Islet transplantation (IT) is an established clinical therapy for select patients with type-1 diabetes. Clinically, the hepatic portal vein serves as the site for IT. Despite numerous advances in clinical IT, limitations remain, including early islet cell loss posttransplant, procedural complications, and the inability to effectively monitor islet grafts. Hence, alternative sites for IT are currently being explored, with the subcutaneous space as one potential option. When left unmodified, the subcutaneous space routinely fails to promote successful islet engraftment. However, when employing the previously developed subcutaneous "deviceless" technique, a favorable microenvironment for islet survival and function is established. In this technique, an angiocatheter was temporarily implanted subcutaneously, which facilitated angiogenesis to promote subsequent islet engraftment. This technique has been employed in preclinical animal models, providing a sufficient means to develop techniques to monitor functional aspects of the graft such as angiogenesis. Here, we utilize photoacoustic imaging to track angiogenesis during the priming of the subcutaneous site by the implanted catheter at 1 to 4 weeks postcatheter. Quantitative analysis on vessel densities shows gradual growth of vasculature in the implant position. These results demonstrate the ability to track angiogenesis, thus facilitating a means to optimize and assess the pretransplant microenvironment.

  9. PLASMA DEVICE

    DOEpatents

    Baker, W.R.; Brathenahl, A.; Furth, H.P.

    1962-04-10

    A device for producing a confined high temperature plasma is described. In the device the concave inner surface of an outer annular electrode is disposed concentrically about and facing the convex outer face of an inner annular electrode across which electrodes a high potential is applied to produce an electric field there between. Means is provided to create a magnetic field perpendicular to the electric field and a gas is supplied at reduced pressure in the area therebetween. Upon application of the high potential, the gas between the electrodes is ionized, heated, and under the influence of the electric and magnetic fields there is produced a rotating annular plasma disk. The ionized plasma has high dielectric constant properties. The device is useful as a fast discharge rate capacitor, in controlled thermonuclear research, and other high temperature gas applications. (AEC)

  10. Medical Device Safety

    MedlinePlus

    ... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Medical Devices Home Medical Devices Medical Device Safety Medical Device Safety Share Tweet Linkedin Pin it More sharing ...

  11. Ventricular assist device

    MedlinePlus

    VAD; RVAD; LVAD; BVAD; Right ventricular assist device; Left ventricular assist device; Biventricular assist device; Heart pump; Left ventricular assist system; LVAS; Implantable ventricular assist device

  12. Acute toxicity of T2 mycotoxin to the guinea-pig by inhalation and subcutaneous routes.

    PubMed Central

    Marrs, T. C.; Edginton, J. A.; Price, P. N.; Upshall, D. G.

    1986-01-01

    The acute inhalation and subcutaneous toxicity of T2 mycotoxin has been investigated in guinea-pigs. The toxicity by the two routes was quantitatively and qualitatively similar. The LCt50 was 5749 mg min m-3 and the subcutaneous LD50 1-2 mg kg-1. Histological changes in the decedents which were similar by both routes of administration were most marked in the lymphoreticular system but also occurred in the gut. Lymphocytolysis and phagocytosis occurred in both the cortex of the thymus and of the lymph nodes. Lymph nodes were more severely affected in the decedents among the animals dosed with T2 by the subcutaneous route. The small intestine exhibited dead and dying cells throughout the lamina propria after T2 by either route. Images Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 2 Fig. 3 PMID:3707855

  13. Subcutaneous Splenosis of the Abdominal Wall: Report of a Case and Review of the Literature

    PubMed Central

    Papakonstantinou, Evangelia; Kalles, Vasileios; Papapanagiotou, Ioannis; Piperos, Theodoros; Karakaxas, Dimitrios; Bonatsos, Vasileios; Tsoumakas, Konstantinos; Orfanos, Filotheos; Mariolis-Sapsakos, Theodoros

    2013-01-01

    Splenosis is a common benign condition that occurs after splenic rupture via trauma or surgery. The mechanism behind splenic cell autotransplantation begins with the splenic rupture, either from trauma or surgical removal. Splenosis is usually found incidentally and, unless symptomatic, surgical therapy is not indicated. Subcutaneous splenosis is an extremely rare form of splenosis, mostly observed in abdominal surgical scars. We report a case of subcutaneous splenosis, as well as a comprehensive review of the literature. In our case, a 43-year-old woman who had splenectomy after traumatic splenic rupture at the age of 7 years old presented for plastic reconstruction of her postoperative scar. Upon surgery, two asymptomatic subcutaneous nodules were incidentally discovered. The presence of splenic tissue was confirmed by the histological study. The nodules were not excised, as the patient was not symptomatic. PMID:23401837

  14. [Subcutaneous dirofilariasis due to Dirofilaria repens in Tunisia: a case involving the scrotum].

    PubMed

    Soussi, A; Farah Klibi, F; Zermani, R; Rammeh, S; Ismail, O; Zakraoui, A; Atallah, K; Ben Jilani, S

    2004-01-01

    Dirofilariasis is a rare anthroponotic disease encountered only in the old world with most cases having been reported from Italy. The dog is the reservoir of this parasite. Man is accidentally infected by mosquitoes. We report the case involving a 27-year-old man living in a rural region of northern Tunisia who presented with a subcutaneous abscess-like scrotal nodule. Microscopic examination of the surgical specimen unexpectedly revealed parasitic involvement. Morphologic examination led to diagnosis of subcutaneous dirofilariasis due to Dirofilaria repens. This case of subcutaneous dirofilariasis brings the total number of cases reported in Tunisia to 6 and is a reminder that this parasitic disease is present in our country and that its incidence is probably underestimated. The scrotum is a rare location that poses the problem of differential diagnosis with malignant tumor or can simulate a surgical emergency. Excision allows diagnosis and treatment.

  15. Histological study of subcutaneous fat at NIR laser treatment of the rat skin in vivo

    NASA Astrophysics Data System (ADS)

    Yanina, I. Y.; Svenskaya, Yu. I.; Navolokin, N. A.; Matveeva, O. V.; Bucharskaya, A. B.; Maslyakova, G. N.; Gorin, D. A.; Sukhorukov, G. B.; Tuchin, V. V.

    2015-07-01

    The goal of this work is to quantify impact of in vivo photochemical treatment using indocyanine green (ICG) or encapsulated ICG and NIR laser irradiation through skin of rat with obesity by the follow up tissue sampling and histochemistry. After 1 hour elapsed since 1-min light exposure samples of rat skin with subcutaneous tissue of thickness of 1.5-2.5 mm were taken by surgery from rats within marked 4-zones of the skin site. For hematoxylin-eosin histological examination of excised tissue samples, fixation was carried out by 10%-formaldehyde solution. For ICG and encapsulated ICG subcutaneous injection and subsequent 1-min diode laser irradiation with power density of 8 W/cm2, different necrotic regions with lipolysis of subcutaneous fat were observed. The obtained data can be used for safe layer-by-layer laser treatment of obesity and cellulite.

  16. Anti-inflammatory effect of bioflora probiotic administered orally or subcutaneously with live or dead bacteria.

    PubMed

    Laudanno, Om; Vasconcelos, L; Catalana, J; Cesolari, Ja

    2006-12-01

    The anti-inflammatory effect of Bioflora probiotic administered orally or subcutaneously with viable or nonviable bacteria was analyzed in two experimental models of randomly selected female Wistar rats. The use of indomethacin at a dose of 50 mg/kg was associated with gastric necrotic lesions and multiple erosions of the small intestine, with marked mucosal neutrophil infiltrate measured by myeloperoxidase (MPO). Probiotics prevented both gastrointestinal lesions and neutrophil infiltrate (p < 0.001). In the model of carrageenin-induced plantar edema in the rat, the oral or subcutaneous administration of Bioflora with live or dead bacteria proved to prevent plantar edema (p < 0.001). We concluded that Bioflora probiotic given orally or subcutaneously with live or dead bacteria has an anti-inflammatory effect. PMID:17080255

  17. Detection device

    DOEpatents

    Smith, Jay E.

    1984-01-01

    The present invention is directed to a detection device comprising: (1) an entrance chamber, (2) a central chamber, and (3) an exit chamber. The central chamber includes an ionizing gas, anode, and means for connecting the anode with an external power supply and pulse counter.

  18. Detection device

    DOEpatents

    Smith, J.E.

    1981-02-27

    The present invention is directed to a detection device comprising: (1) an entrance chamber; (2) a central chamber; and (3) an exit chamber. The central chamber includes an ionizing gas, anode, and means for connecting the anode with an external power supply and pulse counter.

  19. Electrochemical device

    DOEpatents

    Grimes, Patrick G.; Einstein, Harry; Bellows, Richard J.

    1988-01-12

    A tunnel protected electrochemical device features channels fluidically communicating between manifold, tunnels and cells. The channels are designed to provide the most efficient use of auxiliary power. The channels have a greater hydraulic pressure drop and electrical resistance than the manifold. This will provide a design with the optimum auxiliary energy requirements.

  20. Relationships between bioelectric impedance and subcutaneous adipose tissue thickness measured by LIPOMETER and skinfold calipers in children.

    PubMed

    Jürimäe, T; Sudi, K; Payerl, D; Leppik, A; Jürimäe, J; Müller, R; Tafeit, E

    2003-09-01

    The aim of this study was to compare the relationships between bioelectrical impedance and thicknesses of adipose tissue measured by traditional skinfold caliper (double thickness) or a LIPOMETER device (single non-compressed thickness) in 9- to 12-year-old boys ( n=52) and girls ( n=44). In total, nine skinfolds (triceps, subscapular, biceps, iliac crest, supraspinale, abdominal, front thigh, medial calf, mid-axilla) were measured. Measurement for the thickness of subcutaneous adipose tissue layers (SAT-layers) by LIPOMETER were performed at 15 body sites (neck, triceps, biceps, upper back, front chest, lateral chest, upper abdomen, lower abdomen, lower back, hip, front thigh, lateral thigh, rear thigh, inner thigh, calf). Body bioelectrical impedance was measured with a multiple-frequency impedance device Multiscan-5000 (Bodystat, UK). Impedance at 50 kHz highly correlated with body mass ( r=-0.47 in boys, r=-0.46 in girls, r=-0.47 in total group). The relationship with body height was significant only in girls ( r=-0.42). Skinfold thicknesses measured by caliper did not correlate significantly with body impedance at 50 kHz. SAT-layers measured by LIPOMETER at triceps, front thigh, lateral thigh and rear thigh sites in boys and at the lateral thigh site in girls correlated significantly with body impedance measured at 50 kHz. Stepwise multiple regression analysis indicated that the iliac crest and front thigh skinfold thicknesses measured by caliper characterized only 5.7-12.0% of the impedance at 50 kHz in the total group ( n=96). From the measured 15 SAT-layers, the most significant was the lateral thigh layer which characterized 20.0%, 11.9% and 13.6% of the impedance at 50 kHz in boys, girls and the total group, respectively. It was concluded that the influence of subcutaneous adipose tissue on body impedance is relatively low in children. However, SAT-layers have a slightly higher influence on body impedance than skinfold thicknesses measured by caliper. The

  1. Subcutaneous fatty acid composition of steers finished as weanlings or yearlings with and without growth promotants

    PubMed Central

    2013-01-01

    Background The current study evaluated the subcutaneous fatty acid (FA) composition of calf- and yearling-fed steers with or without growth promoting implants. Crossbred steers (n = 112; 267 ± 5.0 kg) of the same contemporary group were allocated to one of four production system and implant strategy based treatments in a completely randomized design with a 2 × 2 factorial arrangement of treatments. Results There were no interactions (P > 0.05) between production systems and growth promoting implants for the total and individual subcutaneous FA. Yearling as opposed to calf finishing reduced (P < 0.05) subcutaneous proportions of C20:3n-6, trans (t)12-18:1, C14:0, several minor cis-monounsaturated FA (c-MUFA; c9-14:1, c11-16:1, c11-18:1, c12-18:1, c13-18:1, c9-20:1 and c11-20:1), and increased (P < 0 .05) subcutaneous proportions of t11c15-18:2, total and individual branched-chain FA. Subcutaneous fat from steers implanted with growth promotants had higher (P < 0.05) proportions of total polyunsaturated FA (PUFA), total n-6 PUFA, C18:2n-6 and individual t-18:1 isomers (t6 to t10) compared to non-implanted steers. Conclusions Overall, current findings show that production systems and growth promotants led to only minor differences in subcutaneous FA composition of beef steers. PMID:24188642

  2. Mitochondrial respiration in subcutaneous and visceral adipose tissue from patients with morbid obesity.

    PubMed

    Kraunsøe, Regitze; Boushel, Robert; Hansen, Christina Neigaard; Schjerling, Peter; Qvortrup, Klaus; Støckel, Mikael; Mikines, Kári J; Dela, Flemming

    2010-06-15

    Adipose tissue exerts important endocrine and metabolic functions in health and disease. Yet the bioenergetics of this tissue is not characterized in humans and possible regional differences are not elucidated. Using high resolution respirometry, mitochondrial respiration was quantified in human abdominal subcutaneous and intra-abdominal visceral (omentum majus) adipose tissue from biopsies obtained in 20 obese patients undergoing bariatric surgery. Mitochondrial DNA (mtDNA) and genomic DNA (gDNA) were determined by the PCR technique for estimation of mitochondrial density. Adipose tissue samples were permeabilized and respirometric measurements were performed in duplicate at 37 degrees C. Substrates (glutamate (G) + malate (M) + octanoyl carnitine (O) + succinate (S)) were added sequentially to provide electrons to complex I + II. ADP ((D)) for state 3 respiration was added after GM. Uncoupled respiration was measured after addition of FCCP. Visceral fat contained more mitochondria per milligram of tissue than subcutaneous fat, but the cells were smaller. Robust, stable oxygen fluxes were found in both tissues, and coupled state 3 (GMOS(D)) and uncoupled respiration were significantly (P < 0.05) higher in visceral (0.95 +/- 0.05 and 1.15 +/- 0.06 pmol O(2) s(1) mg(1), respectively) compared with subcutaneous (0.76 +/- 0.04 and 0.98 +/- 0.05 pmol O(2) s(1) mg(1), respectively) adipose tissue. Expressed per mtDNA, visceral adipose tissue had significantly (P < 0.05) lower mitochondrial respiration. Substrate control ratios were higher and uncoupling control ratio lower (P < 0.05) in visceral compared with subcutaneous adipose tissue. We conclude that visceral fat is bioenergetically more active and more sensitive to mitochondrial substrate supply than subcutaneous fat. Oxidative phosphorylation has a higher relative activity in visceral compared with subcutaneous adipose tissue.

  3. Aerobic and anaerobic exercise capacities in obstructive sleep apnea and associations with subcutaneous fat distributions.

    PubMed

    Ucok, Kagan; Aycicek, Abdullah; Sezer, Murat; Genc, Abdurrahman; Akkaya, Muzaffer; Caglar, Veli; Fidan, Fatma; Unlu, Mehmet

    2009-01-01

    Obesity is a strong risk factor for the development and progression of sleep apnea. Responses to exercise by patients with obstructive sleep apnea syndrome (OSAS) are clinically relevant to reducing body weight and cardiovascular risk factors. This study aimed to clarify the aerobic and anaerobic exercise capacities and their possible relationships with other findings in patients with OSAS. Forty patients (30 males, 10 females) and 40 controls (30 males, 10 females) were enrolled in this study. Questionnaires (excessive daytime sleepiness, daytime tiredness, morning headache, waking unrefreshed, and imbalance), overnight polysomnography, indirect laryngoscopy, and aerobic and anaerobic exercise tests were performed. Triceps, subscapular, abdomen, and thigh skinfold thicknesses were measured. Subcutaneous abdominal fat (abdomen skinfold) was significantly higher in OSAS patients than in controls. Maximal anaerobic power and anaerobic capacity were not different significantly between the patients and controls. We found that aerobic capacity was significantly lower in OSAS patients than in controls. Aerobic capacity was negatively correlated with upper-body subcutaneous fat (triceps and subscapular skinfolds) but not correlated with subcutaneous abdominal fat in OSAS patients. In multivariate analyses using all patients, the apnea-hypopnea index remained a significant independent predictor of aerobic capacity after controlling for a variety of potential confounders including body mass index. Our data confirm that central obesity (subcutaneous abdominal fat) is prominent in patients with OSAS. Our results suggest that lower aerobic exercise capacity in patients with OSAS might be due to daily physical activity that is restricted by OSA itself. This study also suggests that the degree of subcutaneous abdominal fat cannot be used for predicting aerobic capacity level. We think that upper-body subcutaneous fat might be suitable for determining the physical fitness of

  4. Subcutaneous mycoses: an aetiological study of 15 cases in a tertiary care hospital at Dibrugarh, Assam, northeast India.

    PubMed

    Bordoloi, Pallabi; Nath, Reema; Borgohain, Mondita; Huda, M M; Barua, Shyamanta; Dutta, Debajit; Saikia, Lahari

    2015-06-01

    Subcutaneous mycoses are a group of fungal infections of dermis and subcutaneous tissue which consist of sporotrichosis, chromoblastomycosis, phaeohyphomycosis, hyalohyphomycosis, mycetoma, subcutaneous zygomycosis, rhinosporidiosis, lobomycosis and disseminated penicilliosis. A total of 46 consecutive patients with clinically suspected subcutaneous mycoses attending various departments of Assam Medical College and Hospital were included in this prospective study to know the prevalence of subcutaneous mycoses in this eastern part of Assam. Direct microscopy in 10 and 40 % KOH, histopathological examination of biopsied tissue, colony characteristics on Sabourauds dextrose agar media both at 25 and 37 °C and detailed morphology of each fungus on lactophenol cotton blue mount were the basis of identification of the fungi. Subcutaneous mycoses were confirmed in 32.6 % (n = 15) cases. Out of 15 positive cases of subcutaneous mycoses, chromoblastomycosis was detected in six cases (n = 40 %), hyalohyphomycosis in three cases (n = 20 %), and lymphocutaneous sporotrichosis, disseminated penicilliosis and mycetoma in two cases each (n = 13.3 % each). In this study, seven different species of fungus were found to be responsible for five different clinical types of subcutaneous mycosis. Cladosporium cladosporioides, Bipolaris spicifera and Curvularia lunata were responsible for chromoblastomycosis, Fusarium oxysporum and Aspergillus terreus for hyalohyphomycosis, C. lunata for mycetoma, Sporothrix schenckii for lymphocutaneous sporotrichosis and Penicillium marneffei for disseminated penicilliosis. C. cladosporioides and C. lunata were the commonest black fungi causing subcutaneous mycosis in this sub-Himalayan belt. Rare species C. cladosporioides, B. spicifera and C. lunata were found to be causing chromoblastomycosis in this study.

  5. Body Temperature Monitoring Using Subcutaneously Implanted Thermo-loggers from Holstein Steers.

    PubMed

    Lee, Y; Bok, J D; Lee, H J; Lee, H G; Kim, D; Lee, I; Kang, S K; Choi, Y J

    2016-02-01

    Body temperature (BT) monitoring in cattle could be used to early detect fever from infectious disease or physiological events. Various ways to measure BT have been applied at different locations on cattle including rectum, reticulum, milk, subcutis and ear canal. In other to evaluate the temperature stability and reliability of subcutaneous temperature (ST) in highly fluctuating field conditions for continuous BT monitoring, long term ST profiles were collected and analyzed from cattle in autumn/winter and summer season by surgically implanted thermo-logger devices. Purposes of this study were to assess ST in the field condition as a reference BT and to determine any location effect of implantation on ST profile. In results, ST profile in cattle showed a clear circadian rhythm with daily lowest at 05:00 to 07:00 AM and highest around midnight and rather stable temperature readings (mean±standard deviation [SD], 37.1°C to 37.36°C±0.91°C to 1.02°C). STs are 1.39°C to 1.65°C lower than the rectal temperature and sometimes showed an irregular temperature drop below the normal physiologic one: 19.4% or 36.4% of 54,192 readings were below 36.5°C or 37°C, respectively. Thus, for BT monitoring purposes in a fever-alarming-system, a correction algorithm is necessary to remove the influences of ambient temperature and animal resting behavior especially in winter time. One way to do this is simply discard outlier readings below 36.5°C or 37°C resulting in a much improved mean±SD of 37.6°C±0.64°C or 37.8°C±0.55°C, respectively. For location the upper scapula region seems the most reliable and convenient site for implantation of a thermo-sensor tag in terms of relatively low influence by ambient temperature and easy insertion compared to lower scapula or lateral neck.

  6. Molecular Diagnosis of Subcutaneous Spirometra erinaceieuropaei Sparganosis in a Japanese Immigrant

    PubMed Central

    Tappe, Dennis; Berger, Luise; Haeupler, Alexandra; Muntau, Birgit; Racz, Paul; Harder, Yves; Specht, Katja; Prazeres da Costa, Clarissa; Poppert, Sven

    2013-01-01

    We report a case of subcutaneous sparganosis in a 68-year-old female Japanese immigrant in Germany. The patient complained of a painless erythema caudal of the umbilicus with a palpable subcutaneous cherry-sized lump. Polymerase chain reaction on formalin-fixed parasite tissue identified Spirometra erinaceieuropaei as the causative agent; the proliferative form of sparganosis, which is caused by the branching and disseminating Sparganum proliferum, could, thus, be excluded. From the excised sparganum, an immunofluorescence test was established and revealed an antibody response directed against the parasite's tegument. Histological key features of the plerocercoid that facilitate diagnosis with different stains are presented. PMID:23166198

  7. Continuous subcutaneous insulin infusion in diabetes: patient populations, safety, efficacy, and pharmacoeconomics

    PubMed Central

    Battelino, Tadej; Danne, Thomas; Hovorka, Roman; Jarosz‐Chobot, Przemyslawa; Renard, Eric

    2015-01-01

    Summary The level of glycaemic control necessary to achieve optimal short‐term and long‐term outcomes in subjects with type 1 diabetes mellitus (T1DM) typically requires intensified insulin therapy using multiple daily injections or continuous subcutaneous insulin infusion. For continuous subcutaneous insulin infusion, the insulins of choice are the rapid‐acting insulin analogues, insulin aspart, insulin lispro and insulin glulisine. The advantages of continuous subcutaneous insulin infusion over multiple daily injections in adult and paediatric populations with T1DM include superior glycaemic control, lower insulin requirements and better health‐related quality of life/patient satisfaction. An association between continuous subcutaneous insulin infusion and reduced hypoglycaemic risk is more consistent in children/adolescents than in adults. The use of continuous subcutaneous insulin infusion is widely recommended in both adult and paediatric T1DM populations but is limited in pregnant patients and those with type 2 diabetes mellitus. All available rapid‐acting insulin analogues are approved for use in adult, paediatric and pregnant populations. However, minimum patient age varies (insulin lispro: no minimum; insulin aspart: ≥2 years; insulin glulisine: ≥6 years) and experience in pregnancy ranges from extensive (insulin aspart, insulin lispro) to limited (insulin glulisine). Although more expensive than multiple daily injections, continuous subcutaneous insulin infusion is cost‐effective in selected patient groups. This comprehensive review focuses on the European situation and summarises evidence for the efficacy and safety of continuous subcutaneous insulin infusion, particularly when used with rapid‐acting insulin analogues, in adult, paediatric and pregnant populations. The review also discusses relevant European guidelines; reviews issues that surround use of this technology; summarises the effects of continuous subcutaneous insulin

  8. Pulmonary hyalinizing granuloma with laryngeal and subcutaneous involvement: report of a case successfully treated with glucocorticoids.

    PubMed

    Shinohara, Takeshi; Kaneko, Takeshi; Miyazawa, Naoki; Nakatani, Yukio; Nishiyama, Harumi; Shoji, Akira; Ishigatsubo, Yoshiaki

    2004-01-01

    We report a case of pulmonary hyalinizing granuloma (PHG) with laryngeal and subcutaneous involvement. A 43-year-old man was admitted to our hospital for assessment of hoarseness. Cervical and chest computed tomography, respectively, revealed a laryngeal tumor and two pulmonary masses. Specimens obtained from the pulmonary masses were compatible with PHG. The histopathology of biopsy specimens from both the laryngeal tumor and a subcutaneous tumor resembled that of the resected lung masses. Although there is no established treatment for PHG, the laryngeal tumor was diminished and all other lesions disappeared with glucocorticoid treatment. PMID:14964583

  9. Subcutaneous emphysema, pneumomediastinum and pneumoperitoneum after unsuccessful ERCP: a case report

    PubMed Central

    2009-01-01

    Background The presence of subcutaneous emphysema, pneumomediastinum and pneumoperitoneum simultaneously is a rare complication of upper gastrointestinal endoscopy that usually indicates free perforation to the peritoneal cavity or the retroperitoneal space. Case presentation We report an unusual case of a self-limited subcutaneous emphysema, pneumomediastinum and pneumoperitoneum following an unsuccessful ERCP for removal of a common bile duct stone. Conclusion There was no radiological evidence of peritoneal or retroperitoneal perforation. This complication is distinct from pneumomediastinum and pneumoperitoneum due to perforation, and must be recognized, because it is benign and needs no surgical or radiological intervention. PMID:19192290

  10. Extended-release glipizide overdose presenting with delayed hypoglycemia and treated with subcutaneous octreotide

    PubMed Central

    Pelavin, Paul; Abramson, Erika; Pon, Steven; Vogiatzi, Maria G

    2013-01-01

    The onset of symptomatic hypoglycemia in children with ingestions of second-generation sulfonylureas has never been documented to be later than 21 hours post-ingestion. We report a case with the longest known interval, 45 hours, between ingestion of a sulfonylurea and the onset of hypoglycemia requiring medical intervention. The hypoglycemia was severe and required multiple dextrose boluses in addition to continuous dextrose infusion for 36 hours. This patient was also treated with multiple doses of subcutaneous octreotide because of persistent hypoglycemia despite the above management. This case represents the first report of subcutaneous octreotide used as a treatment for pediatric hypoglycemia secondary to sulfonylurea exposure. PMID:19449674

  11. Cavitary lung cancer presenting as subcutaneous emphysema on the contralateral side.

    PubMed

    Yalçinkaya, Serhat; Vural, Ahmet Hakan; Göncü, Mehmet Tugrul; Özyazicioglu, Ahmet Fatih

    2012-03-01

    Bronchocutaneous fistula is an extremely rare complication of lung cancer and is frequently seen following biopsy or radiotherapy. A 67-year old male patient was administered to our hospital due to sudden onset of shortness of breath and subcutaneous emphysema on the right side. Chest computed tomography revealed a cavitary lesion in the left upper lobe in connection with the subcutaneous emphysema on the right side through sternum and anterior chest wall. The pathological examination of the biopsy performed during tube insertion revealed a well-differentiated squamous cell carcinoma of the lung. The patient was referred for adjuvant therapy to local oncology hospital. He passed away 9 months following diagnosis. PMID:22159307

  12. Hemodynamic and energetic assessment of calves implanted with a left ventricular assist device (LVAD).

    PubMed

    Pantalos, G M; Marks, J D; Riebman, J B; Burton, N A; DePaulis, R; Kolff, W J

    1988-03-01

    Hemodynamic and ventricular energetic parameters were measured in calves implanted with the air driven Utah Ventricular Assist Device (UVAD). Uptake site was varied to determine the effect of control mode and vacuum augmentation of filing. Uptake was drawn solely from the left atrium or combined with a left ventricular apical vent. LVAD outflow returned to the descending, thoracic aorta. Control modes examined included asynchronous pumping as well as 1:1 and 1:2 synchronous diastolic counterpulsation. The 85cc LVAD, vacuum formed from PELLETHANE, was implanted acutely in four animals and chronically in six (7, 49 and 116 days paracorporeally, 1, 28 and 32 days intrathoracically). Instantaneous blood pressures, intramyocardial pressure, aortic outflow, oxygen consumption, LVAD output and drive parameters were recorded. LVAD output was independent of control mode when the natural heart rate was greater than or equal to 80 beats per minute. Intrathoracically positioned LVADs pumped a mean flow of approximately equal to 5 liters/min without vacuum augmentation of filling. Paracorporeally positioned LVADs pumped approximately equal to 3 liters/min mean flow without vacuum augmentation and up to approximately equal to 6 liters/min with 38 mm Hg of vacuum augmentation of filling. Instantaneous ascending aortic pressure and flow showed distinct beat-to-beat variation depending on LVAD control mode. Lower average ventricular afterload was observed when pumping the LVAD asynchronously or 1:2 synchronously. In one acute preparation, left ventricular myocardial oxygen consumption was reduced from the unassisted average control level by 37% for the asynchronous and 1:1 synchronous control modes with left atrial uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. LOADING DEVICE

    DOEpatents

    Ohlinger, L.A.

    1958-10-01

    A device is presented for loading or charging bodies of fissionable material into a reactor. This device consists of a car, mounted on tracks, into which the fissionable materials may be placed at a remote area, transported to the reactor, and inserted without danger to the operating personnel. The car has mounted on it a heavily shielded magazine for holding a number of the radioactive bodies. The magazine is of a U-shaped configuration and is inclined to the horizontal plane, with a cap covering the elevated open end, and a remotely operated plunger at the lower, closed end. After the fissionable bodies are loaded in the magazine and transported to the reactor, the plunger inserts the body at the lower end of the magazine into the reactor, then is withdrawn, thereby allowing gravity to roll the remaining bodies into position for successive loading in a similar manner.

  14. Laser device

    DOEpatents

    Scott, Jill R.; Tremblay, Paul L.

    2008-08-19

    A laser device includes a virtual source configured to aim laser energy that originates from a true source. The virtual source has a vertical rotational axis during vertical motion of the virtual source and the vertical axis passes through an exit point from which the laser energy emanates independent of virtual source position. The emanating laser energy is collinear with an orientation line. The laser device includes a virtual source manipulation mechanism that positions the virtual source. The manipulation mechanism has a center of lateral pivot approximately coincident with a lateral index and a center of vertical pivot approximately coincident with a vertical index. The vertical index and lateral index intersect at an index origin. The virtual source and manipulation mechanism auto align the orientation line through the index origin during virtual source motion.

  15. [Devic disease].

    PubMed

    Papeix, Caroline

    2006-11-01

    Devic disease, also known as neuromyelitis optica, is a severe rare condition characterized clinically by one or more episodes of optical neuritis and myelitis. Pathologically, it is characterized by extensive demyelination associated with axon loss and deposits of complement and immunoglobulins (IgM) within the lesions. Specific antibodies for this disease (IgG NMO) were recently identified. Immunosuppressive treatment is currently the best option for preventing relapse. PMID:17086129

  16. EXPERIMENTAL SUBCUTANEOUS CYSTICERCOSIS BY Taenia crassiceps IN BALB/c AND C57BL/6 MICE

    PubMed Central

    PEREIRA, Íria Márcia; LIMA, Sarah Buzaim; FREITAS, Aline de Araújo; VINAUD, Marina Clare; JUNIOR, Ruy de Souza LINO

    2016-01-01

    SUMMARY Human cysticercosis is one of the most severe parasitic infections affecting tissues. Experimental models are needed to understand the host-parasite dynamics involved throughout the course of the infection. The subcutaneous experimental model is the closest to what is observed in human cysticercosis that does not affect the central nervous system. The aim of this study was to evaluate macroscopically and microscopically the experimental subcutaneous cysticercosis caused by Taenia crassiceps cysticerci in BALB/c and C57BL/6 mice. Animals were inoculated in the dorsal subcutaneous region and macroscopic and microscopic aspects of the inflammatory process in the host-parasite interface were evaluated until 90 days after the inoculation (DAI). All the infected animals presented vesicles containing cysticerci in the inoculation site, which was translucent at 7 DAI and then remained opaque throughout the experimental days. The microscopic analysis showed granulation tissue in BALB/c mice since the acute phase of infection evolving to chronicity without cure, presenting 80% of larval stage cysticerci at 90 DAI. While C57BL/6 mice presented 67% of final stage cysticerci at 90 DAI, the parasites were surrounded by neutrophils evolving to the infection control. It is possible to conclude that the genetic features of susceptibility (BALB/c) or resistance (C57BL/6) were confirmed in an experimental subcutaneous model of cysticercosis. PMID:27410915

  17. Identification of Primo-Vascular System in Abdominal Subcutaneous Tissue Layer of Rats

    PubMed Central

    Lim, Chae Jeong; Lee, So Yeong; Ryu, Pan Dong

    2015-01-01

    The primo-vascular system (PVS) is a novel network identified in various animal tissues. However, the PVS in subcutaneous tissue has not been well identified. Here, we examined the putative PVS on the surface of abdominal subcutaneous tissue in rats. Hemacolor staining revealed dark blue threadlike structures consisting of nodes and vessels, which were frequently observed bundled with blood vessels. The structure was filled with various immune cells including mast cells and WBCs. In the structure, there were inner spaces (20–60 µm) with low cellularity. Electron microscopy revealed a bundle structure and typical cytology common with the well-established organ surface PVS, which were different from those of the lymphatic vessel. Among several subcutaneous (sc) PVS tissues identified on the rat abdominal space, the most outstanding was the scPVS aligned along the ventral midline. The distribution pattern of nodes and vessels in the scPVS closely resembled that of the conception vessel meridian and its acupoints. In conclusion, our results newly revealed that the PVS is present in the abdominal subcutaneous tissue layer and indicate that the scPVS tissues are closely correlated with acupuncture meridians. Our findings will help to characterize the PVS in the other superficial tissues and its physiological roles. PMID:26379751

  18. Aluminium overload after 5 years in skin biopsy following post-vaccination with subcutaneous pseudolymphoma.

    PubMed

    Guillard, Olivier; Fauconneau, Bernard; Pineau, Alain; Marrauld, Annie; Bellocq, Jean-Pierre; Chenard, Marie-Pierre

    2012-10-01

    Aluminium hydroxide is used as an effective adjuvant in a wide range of vaccines for enhancing immune response to the antigen. The pathogenic role of aluminium hydroxide is now recognized by the presence of chronic fatigue syndrome, macrophagic myofasciitis and subcutaneous pseudolymphoma, linked to intramuscular injection of aluminium hydroxide-containing vaccines. The aim of this study is to verify if the subcutaneous pseudolymphoma observed in this patient in the site of vaccine injection is linked to an aluminium overload. Many years after vaccination, a subcutaneous nodule was discovered in a 45-year-old woman with subcutaneous pseudolymphoma. In skin biopsy at the injection site for vaccines, aluminium (Al) deposits are assessed by Morin stain and quantification of Al is performed by Zeeman Electrothermal Atomic Absorption Spectrophotometry. Morin stain shows Al deposits in the macrophages, and Al assays (in μg/g, dry weight) were 768.10±18 for the patient compared with the two control patients, 5.61±0.59 and 9.13±0.057. Given the pathology of this patient and the high Al concentration in skin biopsy, the authors wish to draw attention when using the Al salts known to be particularly effective as adjuvants in single or repeated vaccinations. The possible release of Al may induce other pathologies ascribed to the well-known toxicity of this metal.

  19. Patient-derived orthotopic xenografts: better mimic of metastasis than subcutaneous xenografts.

    PubMed

    Hoffman, Robert M

    2015-08-01

    The majority of human solid tumours do not metastasize when grown subcutaneously in immunocompromised mice; this includes patient-derived xenograft (PDX) models. However, orthotopic implantation of intact tumour tissue can lead to metastasis that mimics that seen in patients. These patient-derived orthotopic xenograft (PDOX) models have a long history and might better recapitulate human tumours than PDX models.

  20. Persistence of antibody after subcutaneous vaccination with Wistar RA27/3 rubella vaccine.

    PubMed

    Hillary, I B

    1971-09-01

    After subcutaneous vaccination of rubella sero-negative children with Wistar RA 27/3 rubella vaccine, haemagglutination-inhibiting antibody titres were compared in sera taken 46 days and 2 years after vaccination. Antibody titres were well maintained in the absence of any known exposure to natural infection.

  1. Subcutaneous Marcaine Infiltration and Post-Operative Pain Perception after Percutaneous Nephrolithotomy

    NASA Astrophysics Data System (ADS)

    Haleblian, George E.; Leitao, Victor A.; Robinson, Marnie R.; Pierre, Sean A.; Sur, Roger L.; Preminger, Glenn M.

    2007-04-01

    Recent studies have shown a significant decrease in patient reported pain scores when operative incisions are infiltrated with subcutaneous local anesthetic. We hypothesize that patient reported pain and narcotic use could be further decreased for patients with post-percutaneous nephrolithotomy nephrostomy tubes if the nephrostomy tract and incision are infiltrated with local anesthetic.

  2. Sphenoid wing meningioma progression after placement of a subcutaneous progesterone agonist contraceptive implant.

    PubMed

    Piper, J G; Follett, K A; Fantin, A

    1994-04-01

    A causal relationship between sex steroids and meningioma proliferation has long been suspected. We report a case of the clinical progression of a sphenoid wing meningioma after the placement of Norplant, a subcutaneous contraceptive implant containing levonorgestrel, a progesterone agonist. Although not proof of causation, this observation lends further credence to the importance of progesterone receptors in the growth and possible treatment of meningiomas.

  3. Association between subcutaneous white adipose tissue and serum 25-hydroxyvitamin D in overweight and obese adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Cholecalciferol is known to be deposited in human adipose tissue, but the distribution of 25-hydroxyvitamin D (25(OH)D) in adipose tissue is not known. Objectives: To determine whether 25(OH)D is detectable in subcutaneous white adipose tissue (SWAT) in overweight and obese persons an...

  4. Pregnancy complicated by obesity induces global transcript expression alterations in visceral and subcutaneous fat.

    PubMed

    Bashiri, Asher; Heo, Hye J; Ben-Avraham, Danny; Mazor, Moshe; Budagov, Temuri; Einstein, Francine H; Atzmon, Gil

    2014-08-01

    Maternal obesity is a significant risk factor for development of both maternal and fetal metabolic complications. Increase in visceral fat and insulin resistance is a metabolic hallmark of pregnancy, yet not much is known how obesity alters adipose cellular function and how this may contribute to pregnancy morbidities. We sought to identify alterations in genome-wide transcription expression in both visceral (omental) and abdominal subcutaneous fat deposits in pregnancy complicated by obesity. Visceral and abdominal subcutaneous fat deposits were collected from normal weight and obese pregnant women (n = 4/group) at the time of scheduled uncomplicated cesarean section. A genome-wide expression array (Affymetrix Human Exon 1.0 st platform), validated by quantitative real-time PCR, was utilized to establish the gene transcript expression profile in both visceral and abdominal subcutaneous fat in normal weight and obese pregnant women. Global alteration in gene expression was identified in pregnancy complicated by obesity. These regions of variations led to identification of indolethylamine N-methyltransferase, tissue factor pathway inhibitor-2, and ephrin type-B receptor 6, not previously associated with fat metabolism during pregnancy. In addition, subcutaneous fat of obese pregnant women demonstrated increased coding protein transcripts associated with apoptosis as compared to lean counterparts. Global alteration of gene expression in adipose tissue may contribute to adverse pregnancy outcomes associated with obesity.

  5. Comparison of Mucosal, Subcutaneous and Intraperitoneal Routes of Rat Leptospira Infection

    PubMed Central

    Zilber, Anne-Laure; Belli, Patrick; Grezel, Delphine; Artois, Marc; Kodjo, Angeli; Djelouadji, Zoheira

    2016-01-01

    Leptospirosis is a zoonosis found worldwide that is caused by a spirochete. The main reservoirs of Leptospira, which presents an asymptomatic infection, are wild rodents, including the brown rat (Rattus norvegicus). Experimental studies of the mechanisms of its renal colonization in rats have previously used an intraperitoneal inoculation route. However, knowledge of rat-rat transmission requires the use of a natural route of inoculation, such as a mucosal or subcutaneous route. We investigated for the first time the effects of subcutaneous and mucosal inoculation routes compared to the reference intraperitoneal route during Leptospira infection in adult rats. Infection characteristics were studied using Leptospira renal isolation, serology, and molecular and histological analyses. Leptospira infection was asymptomatic using each inoculation route, and caused similar antibody production regardless of renal colonization. The observed renal colonization rates were 8 out of 8 rats, 5 out of 8 rats and 1 out of 8 rats for the intraperitoneal, mucosal and subcutaneous inoculation routes, respectively. Thus, among the natural infection routes studied, mucosal inoculation was more efficient for renal colonization associated with urinary excretion than the subcutaneous route and induced a slower-progressing infection than the intraperitoneal route. These results can facilitate understanding of the infection modalities in rats, unlike the epidemiological studies conducted in wild rats. Future studies of other natural inoculation routes in rat models will increase our knowledge of rat-rat disease transmission and allow the investigation of infection kinetics. PMID:27031867

  6. Visceral and subcutaneous adiposity measurements in adults: Influence of measurement site

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Excess abdominal adiposity is a known risk factor for cardiovascular diseases. Computed tomography can be used to examine the visceral (VAT) and subcutaneous (SAT) components of abdominal adiposity, but it is unresolved whether single-slice or multi-slice protocols are needed. Nine computed tomograp...

  7. Comparison of Mucosal, Subcutaneous and Intraperitoneal Routes of Rat Leptospira Infection.

    PubMed

    Zilber, Anne-Laure; Belli, Patrick; Grezel, Delphine; Artois, Marc; Kodjo, Angeli; Djelouadji, Zoheira

    2016-03-01

    Leptospirosis is a zoonosis found worldwide that is caused by a spirochete. The main reservoirs of Leptospira, which presents an asymptomatic infection, are wild rodents, including the brown rat (Rattus norvegicus). Experimental studies of the mechanisms of its renal colonization in rats have previously used an intraperitoneal inoculation route. However, knowledge of rat-rat transmission requires the use of a natural route of inoculation, such as a mucosal or subcutaneous route. We investigated for the first time the effects of subcutaneous and mucosal inoculation routes compared to the reference intraperitoneal route during Leptospira infection in adult rats. Infection characteristics were studied using Leptospira renal isolation, serology, and molecular and histological analyses. Leptospira infection was asymptomatic using each inoculation route, and caused similar antibody production regardless of renal colonization. The observed renal colonization rates were 8 out of 8 rats, 5 out of 8 rats and 1 out of 8 rats for the intraperitoneal, mucosal and subcutaneous inoculation routes, respectively. Thus, among the natural infection routes studied, mucosal inoculation was more efficient for renal colonization associated with urinary excretion than the subcutaneous route and induced a slower-progressing infection than the intraperitoneal route. These results can facilitate understanding of the infection modalities in rats, unlike the epidemiological studies conducted in wild rats. Future studies of other natural inoculation routes in rat models will increase our knowledge of rat-rat disease transmission and allow the investigation of infection kinetics.

  8. [Subcutaneous autograft with newly synthesized cartilage using ethisorb polymer in rabbits].

    PubMed

    Capitán Guarnizo, A; Viviente Rodríguez, E; Osete Albaladejo, J M; Torregrosa Carrasquer, C; Díaz Manzano, J A; Pérez-Mateos Cachá, J A; Sprekelsen Gassó, C

    2002-11-01

    We perform a subcutaneous autograft, in animals with preserved immunity (24 rabbits), of cartilage taken from the auricle, treated with tissue engineering thecnics and embeded in a reabsorbable polimer (Ethisorb) that acts as base. We observed a good quality cartilage with the expression of collagen type II and without graft rejection phenomenon.

  9. Pregnancy Complicated by Obesity Induces Global Transcript Expression Alterations in Visceral and Subcutaneous Fat

    PubMed Central

    Bashiri, Asher; Heo, Hye J.; Ben-Avraham, Danny; Mazor, Moshe; Budagov, Temuri; Einstein, Francine H.; Atzmon, Gil

    2014-01-01

    Maternal obesity is a significant risk factor for development of both maternal and fetal metabolic complications. Increase in visceral fat and insulin resistance is a metabolic hallmark of pregnancy, yet little is known how obesity alters adipose cellular function and how this may contribute to pregnancy morbidities. We sought to identify alterations in genome-wide transcription expression in both visceral (omental) and abdominal subcutaneous fat deposits in pregnancy complicated by obesity. Visceral and abdominal subcutaneous fat deposits were collected from normal weight and obese pregnant women (n=4/group) at time of scheduled uncomplicated cesarean section. A genome-wide expression array (Affymetrix Human Exon 1.0 st platform), validated by quantitative real-time PCR, was utilized to establish the gene transcript expression profile in both visceral and abdominal subcutaneous fat in normal weight and obese pregnant women. Global alteration in gene expression was identified in pregnancy complicated by obesity. These regions of variations lead to identification of indolethylamine N-methyltransferase (INMT), tissue factor pathway inhibitor-2 (TFPI-2), and ephrin type-B receptor 6 (EPHB6), not previously associated with fat metabolism during pregnancy. In addition, subcutaneous fat of obese pregnant women demonstrated increased coding protein transcripts associated with apoptosis compared to lean counterparts. Global alteration of gene expression in adipose tissue may contribute to adverse pregnancy outcomes associated with obesity. PMID:24696292

  10. Effects of subcutaneous transmitters on reproduction, incubation behavior, and annual return rates of female wood ducks

    USGS Publications Warehouse

    Hepp, G.R.; Folk, T.H.; Hartke, K.M.

    2002-01-01

    Radiotransmitters attached externally to breeding waterfowl can have a variety of negative effects. Implanted transmitters can reduce potential deleterious effects; abdominal implants are used most commonly in waterfowl. Methods also have been developed to implant transmitters subcutaneously, but effects of subcutaneous implants on adult ducks have not been evaluated. In this study, we subcutaneously implanted radiotransmitters in pre-laying female wood ducks (Aix sponsa, n = 62) and compared nest initiation date, incubation behavior, body mass, and annual return rates of radiomarked females to a group of females that were not radiomarked. Ninety-six percent (50 of 52) of radiomarked females that were monitored for the entire breeding season initiated nests. Nesting date of radiomarked adult females did not differ from that of adult females without radios, but radiomarked yearling females nested earlier than yearlings not receiving transmitters. We found no differences in early- and late-incubation body mass, incubation constancy, recess frequency, and incubation period between radiomarked females and those without radios. Annual return rates of females that initiated nests did not differ between radiomarked females and those not receiving radios. Data suggest that implanting radiotransmitters subcutaneously in pre-laying female wood ducks did not negatively impact subsequent reproduction, incubation behavior, and survival.

  11. Structure of the rat subcutaneous connective tissue in relation to its sliding mechanism.

    PubMed

    Kawamata, Seiichi; Ozawa, Junya; Hashimoto, Masakazu; Kurose, Tomoyuki; Shinohara, Harumichi

    2003-08-01

    Mammalian skin can extensively slide over most parts of the body. To study the mechanism of this mobility of the skin, the structure of the subcutaneous connective tissue was examined by light microscopy. The subcutaneous connective tissue was observed to be composed of multiple layers of thin collagen sheets containing elastic fibers. These piled-up collagen sheets were loosely interconnected with each other, while the outer and inner sheets were respectively anchored to the dermis and epimysium by elastic fibers. Collagen fibers in each sheet were variable in diameter and oriented in different directions to form a thin, loose meshwork under conditions without mechanical stretching. When a weak shear force was loaded between the skin and the underlying abdominal muscles, each collagen sheet slid considerably, resulting in a stretching of the elastic fibers which anchor these sheets. When a further shear force was loaded, collagen fibers in each sheet seemed to align in a more parallel manner to the direction of the tension. With the reduction or removal of the force, the arrangement of collagen fibers in each sheet was reversed and the collagen sheets returned to their original shapes and positions, probably with the stabilizing effect of elastic fibers. Blood vessels and nerves in the subcutaneous connective tissue ran in tortuous routes in planes parallel to the unloaded skin, which seemed very adaptable for the movement of collagen sheets. These findings indicate that the subcutaneous connective tissue is extensively mobile due to the presence of multilayered collagen sheets which are maintained by elastic fibers.

  12. Subcutaneous Panniculitis-Like T Cell Lymphoma Mimicking Early-Onset Nodular Panniculitis

    PubMed Central

    Shen, Guifen; Dong, Lingli; Zhang, Shengtao

    2016-01-01

    Patient: Male, 24 Final Diagnosis: Subcutaneous panniculitis-like T-cell lymphoma Symptoms: Fever • skin nodules Medication: — Clinical Procedure: Skin biopsy • PET-CT Specialty: Hematology Objective: Rare disease Background: Subcutaneous panniculitis-like T cell lymphoma is a very uncommon subtype of cutaneous T cell lymphoma. The manifestations of this rare disease are atypical at onset, and may mimic some rheumatic or dermatologic diseases, which causes the delay of diagnosis and treatment. Case Report: We report a 24-year-old man suffering from intermittent fever and skin nodules on the left anterior chest wall, who was initially misdiagnosed with nodular panniculitis and finally diagnosed with subcutaneous panniculitis-like T cell lymphoma through repeat examination of biopsy of the skin nodule. Positron emission tomography revealed extracutaneous adipose tissue involvement. Subsequently, hemophagocytic syndrome occurred while under a conventional dose of glucocorticoid, but remission was induced by treatment with cyclosporine A and high doses of dexamethasone. Conclusions: In order to avoid the delay diagnosis and inappropriate treatment of subcutaneous panniculitis-like T cell lymphoma, in addition to a thorough physical examination, PET-CT and disease-specific pathologic, immunophenotypic, and T cell receptor tests of the skin biopsy should be performed. Extracutaneous involvement, especially hemophagocytic syndrome, indicated worse prognosis. Even so, cyclosporine A plus high-dose corticosteroid could be an option of treatment. PMID:27342380

  13. The Use of B-Mode Ultrasound for Measuring Subcutaneous Fat Thickness on the Upper Arms.

    ERIC Educational Resources Information Center

    Weiss, Lawrence W.; Clark, Frank C.

    1985-01-01

    A study was carried out to investigate the potential use of B-mode ultrasound for measuring subcutaneous fat thickness at two arm sites. B-mode sonograms and skinfold measurements were found to be highly correlated for both men and women. (Author/MT)

  14. Onchocercosis mansonella co-infection presenting as a subcutaneous nodule in a child.

    PubMed

    Davies, John Q; Cohen, Marta C; Shackley, Fiona; Clarke, Tim C; Page, Richard E

    2007-01-01

    A 11-year-old girl presented with a subcutaneous lesion on the forehead, thought to be an implantation dermoid cyst. Microscopic examination revealed an onchocercoma. Microfilariae were found in the blood indicating a co-infection with Mansonella perstans. This case demonstrates the diagnostic difficulties of a parasitic co-infection uncommonly encountered in Europe. PMID:17613046

  15. [Subcutaneous stimulation as additional therapy to spinal cord stimulation in a post-laminectomy syndrome patient].

    PubMed

    Akbaş, Mert; Yeğin, Mehmet Arif; Özdemir, İrem; Göksu, Ethem; Akyüz, Mahmut

    2016-01-01

    Spinal cord stimulation as treatment of chronic low back pain via neuromodulation has been frequently performed in recent years. The dorsal column is stimulated by an electrode placed at the epidural region. In the case presently described, subcutaneous lead was implanted in a patient with failed back syndrome after spinal cord stimulation was inadequate to treat back and gluteal pain. A 65-year-old male had undergone surgery to treat lumbar disc herniation, after which he received physical therapy and multiple steroid injections due to unrelieved pain. He was admitted to the pain clinic with pain radiating to right gluteal muscle and leg. Spinal cord stimulation was performed and, as pain was not relieved, subcutaneous lead was applied to the right cluneal nerve distribution. Following treatment, the patient scored 1-2 on visual analog scale. Pain had been reduced by over 80%. Octad electrode was placed between T8 and T10 vertebrae after Tuohy needle was introduced to intervertebral area between L1 and L2. Paresthesia occurred in the right extremity. Boundaries were determined by area of right gluteal region in which paresthesia did not occur. Octad electrode was placed subcutaneously after vertical line was drawn from center point. Paresthesia occurred throughout the region. Pulse wave was 390-450 msec; frequency was 10-30 Hz. Subcutaneous electrode replacement is effective additional therapy when pain is not relieved by spinal cord stimulation. PMID:27225614

  16. The Experiences of School Nurses Caring for Students Receiving Continuous Subcutaneous Insulin Infusion Therapy

    ERIC Educational Resources Information Center

    Darby, Wendy

    2006-01-01

    Diabetes mellitus is the most common metabolic disorder in childhood. Today, children with diabetes are receiving new technologically advanced treatment options, such as continuous subcutaneous insulin infusion (CSII) therapy. School nurses are the primary health caregivers of children with diabetes during school hours. Therefore, it is important…

  17. Sustained Release of Protein Therapeutics from Subcutaneous Thermosensitive Biocompatible and Biodegradable Pentablock Copolymers (PTSgels)

    PubMed Central

    Schaefer, Elizabeth; Walsh, Mary; Newman, Donna; Salmon, Jacklyn; Amin, Rasidul; Weiss, Sidney; Grau, Ulrich; Velagaleti, Poonam

    2016-01-01

    Objective. To evaluate thermosensitive, biodegradable pentablock copolymers (PTSgel) for sustained release and integrity of a therapeutic protein when injected subcutaneously. Materials and Methods. Five PTSgels with PEG-PCL-PLA-PCL-PEG block arrangements were synthesized. In vitro release of IgG from PTSgels and concentrations was evaluated at 37°C. Released IgG integrity was characterized by SDS-PAGE. In vitro disintegration for 10GH PTSgel in PBS was monitored at 37°C over 72 days using gravimetric loss and GPC analysis. Near-infrared IgG in PTSgel was injected subcutaneously and examined by in vivo imaging and histopathology for up to 42 days. Results. IgG release was modulated from approximately 7 days to more than 63 days in both in vitro and in vivo testing by varying polymer composition, concentration of PTSgel aqueous solution, and concentration of IgG. Released IgG in vitro maintained structural integrity by SDS-PAGE. Subcutaneous PTSgels were highly biocompatible and in vitro IgG release occurred in parallel with the disappearance of subcutaneous gel in vivo. Conclusions. Modulation of release of biologics to fit the therapeutic need can be achieved by varying the biocompatible and biodegradable PTSgel composition. Release of IgG parallels disappearance of the polymeric gel; hence, little or no PTSgel remains after drug release is complete. PMID:27800184

  18. EXPERIMENTAL SUBCUTANEOUS CYSTICERCOSIS BY Taenia crassiceps IN BALB/c AND C57BL/6 MICE.

    PubMed

    Pereira, Íria Márcia; Lima, Sarah Buzaim; Freitas, Aline de Araújo; Vinaud, Marina Clare; Junior, Ruy de Souza Lino

    2016-07-11

    Human cysticercosis is one of the most severe parasitic infections affecting tissues. Experimental models are needed to understand the host-parasite dynamics involved throughout the course of the infection. The subcutaneous experimental model is the closest to what is observed in human cysticercosis that does not affect the central nervous system. The aim of this study was to evaluate macroscopically and microscopically the experimental subcutaneous cysticercosis caused by Taenia crassiceps cysticerci in BALB/c and C57BL/6 mice. Animals were inoculated in the dorsal subcutaneous region and macroscopic and microscopic aspects of the inflammatory process in the host-parasite interface were evaluated until 90 days after the inoculation (DAI). All the infected animals presented vesicles containing cysticerci in the inoculation site, which was translucent at 7 DAI and then remained opaque throughout the experimental days. The microscopic analysis showed granulation tissue in BALB/c mice since the acute phase of infection evolving to chronicity without cure, presenting 80% of larval stage cysticerci at 90 DAI. While C57BL/6 mice presented 67% of final stage cysticerci at 90 DAI, the parasites were surrounded by neutrophils evolving to the infection control. It is possible to conclude that the genetic features of susceptibility (BALB/c) or resistance (C57BL/6) were confirmed in an experimental subcutaneous model of cysticercosis. PMID:27410915

  19. Effect of Finishing System on Subcutaneous Fat Melting Point and Fatty Acid Composition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Angus-cross steers (n = 69) were used to determine the effect of finishing system on subcutaneous fat melting point and fatty acid composition. Three finishing systems were evaluated: 1) mixed pasture for 134 d [MP], 2) mixed pasture for 93 d and alfalfa for 41 d [AL], or 3) concentrate finishing f...

  20. The effects of hydralazine on lipolysis in subcutaneous adipose tissue in humans.

    PubMed

    Boon, Niels; Goossens, Gijs H; Blaak, Ellen E; Saris, Wim H M

    2007-12-01

    Recent evidence from animal research and in vitro experiments indicates that changes in dietary calcium intake could cause changes in lipolysis through alterations of the intracellular calcium concentration in adipocytes. The objective of the study was to examine whether the calcium antagonist hydralazine affects blood flow and lipolysis in subcutaneous abdominal adipose tissue in vivo in humans. Three different concentrations of hydralazine (12.2, 24.4, and 48.8 micromol/L) were locally administered in adipose tissue using the microdialysis technique to assess effects on lipolysis and blood flow in subcutaneous adipose tissue in the abdominal region. Subjects from the general community were studied ambulatorily at a university hospital. Eight healthy men (age, 33.1 +/- 3.3 years; body mass index, 24.2 +/- 0.2 kg/m(2)) were recruited by local announcement. Subcutaneous adipose tissue in the abdominal region was perfused with increasing concentrations of hydralazine. The main outcome measures were adipose tissue lipolysis and blood flow. Hydralazine had no effect on ethanol outflow-inflow ratios, but significantly increased interstitial glycerol concentration at the highest concentration (P < .05). The present results indicate that hydralazine increases lipolysis in abdominal subcutaneous adipose tissue in healthy lean subjects, but hydralazine had no significant effects on local blood flow in adipose tissue.

  1. A subcutaneous cellular implant for passive immunization against amyloid-β reduces brain amyloid and tau pathologies.

    PubMed

    Lathuilière, Aurélien; Laversenne, Vanessa; Astolfo, Alberto; Kopetzki, Erhard; Jacobsen, Helmut; Stampanoni, Marco; Bohrmann, Bernd; Schneider, Bernard L; Aebischer, Patrick

    2016-05-01

    Passive immunization against misfolded toxic proteins is a promising approach to treat neurodegenerative disorders. For effective immunotherapy against Alzheimer's disease, recent clinical data indicate that monoclonal antibodies directed against the amyloid-β peptide should be administered before the onset of symptoms associated with irreversible brain damage. It is therefore critical to develop technologies for continuous antibody delivery applicable to disease prevention. Here, we addressed this question using a bioactive cellular implant to deliver recombinant anti-amyloid-β antibodies in the subcutaneous tissue. An encapsulating device permeable to macromolecules supports the long-term survival of myogenic cells over more than 10 months in immunocompetent allogeneic recipients. The encapsulated cells are genetically engineered to secrete high levels of anti-amyloid-β antibodies. Peripheral implantation leads to continuous antibody delivery to reach plasma levels that exceed 50 µg/ml. In a proof-of-concept study, we show that the recombinant antibodies produced by this system penetrate the brain and bind amyloid plaques in two mouse models of the Alzheimer's pathology. When encapsulated cells are implanted before the onset of amyloid plaque deposition in TauPS2APP mice, chronic exposure to anti-amyloid-β antibodies dramatically reduces amyloid-β40 and amyloid-β42 levels in the brain, decreases amyloid plaque burden, and most notably, prevents phospho-tau pathology in the hippocampus. These results support the use of encapsulated cell implants for passive immunotherapy against the misfolded proteins, which accumulate in Alzheimer's disease and other neurodegenerative disorders.

  2. Perforation of an Occult Carcinoma of the Prostate as a Rare Differential Diagnosis of Subcutaneous Emphysema of the Leg.

    PubMed

    Velickovic, Mirko; Hockertz, Thomas

    2016-01-01

    We report a case of subcutaneous emphysema caused by perforation of the rectum due to a carcinoma of the prostate. Although rare, an abdominal cause must always be considered as a rare differential diagnosis of subcutaneous emphysema. As a matter of fact adequate diagnostic with rapid treatment is essential for the outcome. PMID:27597913

  3. Perforation of an Occult Carcinoma of the Prostate as a Rare Differential Diagnosis of Subcutaneous Emphysema of the Leg

    PubMed Central

    Hockertz, Thomas

    2016-01-01

    We report a case of subcutaneous emphysema caused by perforation of the rectum due to a carcinoma of the prostate. Although rare, an abdominal cause must always be considered as a rare differential diagnosis of subcutaneous emphysema. As a matter of fact adequate diagnostic with rapid treatment is essential for the outcome. PMID:27597913

  4. Snake venom components enhance pain upon subcutaneous injection: an initial examination of spinal cord mediators.

    PubMed

    Chacur, Marucia; Gutiérrez, José Maria; Milligan, Erin D; Wieseler-Frank, Julie; Britto, Luiz R G; Maier, Steven F; Watkins, Linda R; Cury, Yara

    2004-09-01

    Snakebites are a relevant public health problem in Central and South America. Snake bite envenomations cause intense pain, not relieved by anti-venom. The fangs of many species are short, causing subcutaneous injection. Fangs of larger species inflict subcutaneous or intramuscular envenomation. To understand pain induced by subcutaneous venom, this study examined spinal mechanisms involved in pain-enhancing effects of subcutaneous Lys49 and Asp49 secretory phospholipase-A(2) (sPLA2), two components of Bothrops asper snake venom showing highly different enzymatic activities. Unilateral intraplantar sPLA2-Lys49 (catalytically inactive) or sPLA2-Asp49 (catalytically active) into rat hindpaws each induced mechanical hyperalgesia (Randall-Selitto test), whereas only catalytically active sPLA2-Asp49 caused mechanical allodynia (von Frey test). Effects induced by both sPLA2s were inhibited by intrathecal fluorocitrate, a reversible glial metabolic inhibitor. In support, immunohistochemical analysis revealed activation of dorsal horn astrocytes and microglia after intraplantar injection of either sPLA2. Spinal proinflammatory cytokines, nitric oxide, and prostanoids each appear to be involved in the pain-enhancing effects of these sPLA2s. Blockade of interleukin-1 (IL1) inhibited hyperalgesia induced by both sPLA2s, while leaving allodynia unaffected. Blockade of tumor necrosis factor reduced responses to sPLA2-Asp49. An inhibitor of neuronal nitric oxide synthase, 7-nitroindazole (7-NI), inhibited hyperalgesia induced by both sPLA2s, without interfering with allodynia induced by sPLA2-Asp49. On the other hand, L-N(6)-(1-iminoethyl)lysine (L-NI), an inhibitor of the inducible nitric oxide synthase, did not alter any sPLA2-induced effect. Lastly, celecoxib, an inhibitor of cyclooxygenase-2, attenuated sPLA2 actions. These data provide the first evidence of spinal mediators involved in pain facilitation induced by subcutaneous venoms.

  5. Ten-Year Experience of Cutaneous and/or Subcutaneous Infections Due to Coelomycetes in France

    PubMed Central

    Guégan, Sarah; Garcia-Hermoso, Dea; Sitbon, Karine; Ahmed, Sarah; Moguelet, Philippe; Dromer, Françoise; Lortholary, Olivier

    2016-01-01

    Background. Coelomycetes are rarely but increasingly reported in association with human infections involving mostly skin and subcutaneous tissues, both in immunocompetent and immunocompromised patients. Coelomycetes constitute a heterogeneous group of filamentous fungi with distinct morphological characteristics in culture, namely an ability to produce asexual spores within fruit bodies. Methods. We included all cases of proven primary cutaneous and/or subcutaneous infections due to coelomycetes received for identification at the French National Reference Center for Invasive Mycoses and Antifungals between 2005 and 2014. Eumycetoma, chromoblastomycosis, and disseminated infections were excluded. Results. Eighteen cases were analyzed. The median age was 60.5 years. In all cases, patients originated from tropical or subtropical areas. An underlying immunodepression was present in 89% of cases. Cutaneous and/or subcutaneous lesions, mainly nodules, abscesses, or infiltrated plaques, were observed in distal body areas. Isolates of different genera of coelomycetes were identified: Medicopsis (6), Paraconiothyrium (3), Gloniopsis (3), Diaporthe (3), Peyronellaea (2), Lasiodiplodia (1). Lesion treatment consisted of complete (10) or partial (2) surgical excision and/or the use of systemic antifungal therapy, namely voriconazole (5) and posaconazole (4). Literature review yielded 48 additional cases of cutaneous and/or subcutaneous infections due to coelomycetes. Conclusions. Infectious diseases physicians should suspect coelomycetes when observing cutaneous and/or subcutaneous infections in immunocompromised hosts from tropical areas; a sequence-based approach is crucial for strains identification but must be supported by consistent phenotypic features; surgical treatment should be favored for solitary, well limited lesions; new triazoles may be used in case of extensive lesions, especially in immunocompromised patients. PMID:27419178

  6. Ten-Year Experience of Cutaneous and/or Subcutaneous Infections Due to Coelomycetes in France.

    PubMed

    Guégan, Sarah; Garcia-Hermoso, Dea; Sitbon, Karine; Ahmed, Sarah; Moguelet, Philippe; Dromer, Françoise; Lortholary, Olivier

    2016-04-01

    Background.  Coelomycetes are rarely but increasingly reported in association with human infections involving mostly skin and subcutaneous tissues, both in immunocompetent and immunocompromised patients. Coelomycetes constitute a heterogeneous group of filamentous fungi with distinct morphological characteristics in culture, namely an ability to produce asexual spores within fruit bodies. Methods.  We included all cases of proven primary cutaneous and/or subcutaneous infections due to coelomycetes received for identification at the French National Reference Center for Invasive Mycoses and Antifungals between 2005 and 2014. Eumycetoma, chromoblastomycosis, and disseminated infections were excluded. Results.  Eighteen cases were analyzed. The median age was 60.5 years. In all cases, patients originated from tropical or subtropical areas. An underlying immunodepression was present in 89% of cases. Cutaneous and/or subcutaneous lesions, mainly nodules, abscesses, or infiltrated plaques, were observed in distal body areas. Isolates of different genera of coelomycetes were identified: Medicopsis (6), Paraconiothyrium (3), Gloniopsis (3), Diaporthe (3), Peyronellaea (2), Lasiodiplodia (1). Lesion treatment consisted of complete (10) or partial (2) surgical excision and/or the use of systemic antifungal therapy, namely voriconazole (5) and posaconazole (4). Literature review yielded 48 additional cases of cutaneous and/or subcutaneous infections due to coelomycetes. Conclusions.  Infectious diseases physicians should suspect coelomycetes when observing cutaneous and/or subcutaneous infections in immunocompromised hosts from tropical areas; a sequence-based approach is crucial for strains identification but must be supported by consistent phenotypic features; surgical treatment should be favored for solitary, well limited lesions; new triazoles may be used in case of extensive lesions, especially in immunocompromised patients. PMID:27419178

  7. Electrooptical devices

    NASA Astrophysics Data System (ADS)

    Hurwitz, C. E.

    1980-03-01

    This report covers work carried out with support of the Department of the Air Force during the period 1 October 1979 through 31 March 1980. A part of this support was provided by the Rome Air Development Center. CW operation at temperatures up to 55 C has been achieved for GaInAsP/InP double-heterostructure (DH) lasers emitting at 1.5 micrometers, which were grown without a GaInAsP buffer layer. These devices are of interest for use as sources in fiber-optics communications systems, since the lowest transmission loss reported for fused-silica optical fibers occurs at 1.55 micrometers. Surface passivation techniques developed for InP and GaInAsP avalanche photodiodes have resulted in reductions of dark current as large as four orders of magnitude, to values as low as .0000016 A/sq cm at 0.9 V(b) where V(b) is the breakdown voltage. Devices consisting entirely of InP have been passivated with plasma-deposited Si3N4, and those with a GaInAsP layer but with the p-n junction in InP have been passivated with polyimide. Neither of these techniques successfully reduces dark currents in devices with the p-n junction in the GaInAsP, but a film of photoresist sprayed with SF6 as the propellant has given excellent results. The electrical characteristics in InP ion implanted with Sn, Ge, Si, and C have been investigated. All of these column IV elements yielded n-type conductivity and Sn, Ge, and Si showed high electrical activation; however, implanted C was found to have a net electrical activation of only about 5 percent.

  8. Microdialysis based monitoring of subcutaneous interstitial and venous blood glucose in Type 1 diabetic subjects by mid-infrared spectrometry for intensive insulin therapy

    NASA Astrophysics Data System (ADS)

    Heise, H. Michael; Kondepati, Venkata Radhakrishna; Damm, Uwe; Licht, Michael; Feichtner, Franz; Mader, Julia Katharina; Ellmerer, Martin

    2008-02-01

    Implementing strict glycemic control can reduce the risk of serious complications in both diabetic and critically ill patients. For this purpose, many different blood glucose monitoring techniques and insulin infusion strategies have been tested towards the realization of an artificial pancreas under closed loop control. In contrast to competing subcutaneously implanted electrochemical biosensors, microdialysis based systems for sampling body fluids from either the interstitial adipose tissue compartment or from venous blood have been developed, which allow an ex-vivo glucose monitoring by mid-infrared spectrometry. For the first option, a commercially available, subcutaneously inserted CMA 60 microdialysis catheter has been used routinely. The vascular body interface includes a double-lumen venous catheter in combination with whole blood dilution using a heparin solution. The diluted whole blood is transported to a flow-through dialysis cell, where the harvesting of analytes across the microdialysis membrane takes place at high recovery rates. The dialysate is continuously transported to the IR-sensor. Ex-vivo measurements were conducted on type-1 diabetic subjects lasting up to 28 hours. Experiments have shown excellent agreement between the sensor readout and the reference blood glucose concentration values. The simultaneous assessment of dialysis recovery rates renders a reliable quantification of whole blood concentrations of glucose and metabolites (urea, lactate etc) after taking blood dilution into account. Our results from transmission spectrometry indicate, that the developed bed-side device enables reliable long-term glucose monitoring with reagent- and calibration-free operation.

  9. OLED devices

    DOEpatents

    Sapochak, Linda Susan [Arlington, VA; Burrows, Paul Edward [Kennewick, WA; Bimalchandra, Asanga [Richland, WA

    2011-02-22

    An OLED device having an emission layer formed of an ambipolar phosphine oxide host material and a dopant, a hole transport layer in electrical communication with an anode, an electron transport layer in communication with a cathode, wherein the HOMO energy of the hole transport layer is substantially the same as the HOMO energy of the ambipolar host in the emission layer, and the LUMO energy of the electron transport layer is substantially the same as the LUMO energy of the ambipolar host in the emission layer.

  10. Device Connectivity

    PubMed Central

    Walsh, John; Roberts, Ruth; Morris, Richard

    2015-01-01

    Patients with diabetes have to take numerous factors/data into their therapeutic decisions in daily life. Connecting the devices they are using by feeding the data generated into a database/app is supposed to help patients to optimize their glycemic control. As this is not established in practice, the different roadblocks have to be discussed to open the road. That large telecommunication companies are now entering this market might be a big help in pushing this forward. Smartphones offer an ideal platform for connectivity solutions. PMID:25614015

  11. Electrospray device

    NASA Technical Reports Server (NTRS)

    Demmons, Nathaniel (Inventor); Martin, Roy (Inventor); Hruby, Vladimir (Inventor); Roy, Thomas (Inventor); Spence, Douglas (Inventor); Ehrbar, Eric (Inventor); Zwahlen, Jurg (Inventor)

    2011-01-01

    An electrospray device includes an electrospray emitter adapted to receive electrospray fluid; an extractor plate spaced from the electrospray emitter and having at least one aperture; and a power supply for applying a first voltage between the extractor plate and emitter for generating at least one Taylor cone emission through the aperture to create an electrospray plume from the electrospray fluid, the extractor plate as well as accelerator and shaping plates may include a porous, conductive medium for transporting and storing excess, accumulated electrospray fluid away from the aperture.

  12. Electrochromic device

    SciTech Connect

    Schwendemanm, Irina G.; Polcyn, Adam D.; Finley, James J.; Boykin, Cheri M.; Knowles, Julianna M.

    2011-03-15

    An electrochromic device includes a first substrate spaced from a second substrate. A first conductive member is formed over at least a portion of the first substrate. A first electrochromic material is formed over at least a portion of the first conductive member. The first electrochromic material includes an organic material. A second conductive member is formed over at least a portion of the second substrate. A second electrochromic material is formed over at least a portion of the second conductive member. The second electrochromic material includes an inorganic material. An ionic liquid is positioned between the first electrochromic material and the second electrochromic material.

  13. Diversionary device

    DOEpatents

    Grubelich, Mark C.

    2001-01-01

    A diversionary device has a housing having at least one opening and containing a non-explosive propellant and a quantity of fine powder packed within the housing, with the powder being located between the propellant and the opening. When the propellant is activated, it has sufficient energy to propel the powder through the opening to produce a cloud of powder outside the housing. An igniter is also provided for igniting the cloud of powder to create a diversionary flash and bang, but at a low enough pressure to avoid injuring nearby people.

  14. Electroexplosive device

    NASA Technical Reports Server (NTRS)

    Menichelli, V. J. (Inventor)

    1978-01-01

    An electroexplosive device is presented which employs a header having contact pins hermetically sealed with glass passing through from a connector end of the header to a cavity filled with a shunt layer of a new nonlinear resistive composition and a heat-sink layer of a new dielectric composition having good thermal conductivity and capacity. The nonlinear resistive layer and the heat-sink layer are prepared from materials by mixing with a low temperature polymerizing resin. The resin is dissolved in a suitable solvent and later evaporated. The resultant solid composite is ground into a powder, press formed into the header and cured (polymerized) at about 250 to 300 F.

  15. Foreign body response to subcutaneous biomaterial implants in a mast cell-deficient Kit(w-Sh) murine model.

    PubMed

    Avula, M N; Rao, A N; McGill, L D; Grainger, D W; Solzbacher, F

    2014-05-01

    Mast cells (MCs)_are recognized for their functional role in wound-healing and allergic and inflammatory responses - host responses that are frequently detrimental to implanted biomaterials if extended beyond acute reactivity. These tissue reactions impact especially on the performance of sensing implants such as continuous glucose monitoring (CGM) devices. Our hypothesis that effective blockade of MC activity around implants could alter the host foreign body response (FBR) and enhance the in vivo lifetime of these implantable devices motivated this study. Stem cell factor and its ligand c-KIT receptor are critically important for MC survival, differentiation and degranulation. Therefore, an MC-deficient sash mouse model was used to assess MC relationships to the in vivo performance of CGM implants. Additionally, local delivery of a tyrosine kinase inhibitor (TKI) that inhibits c-KIT activity was also used to evaluate the role of MCs in modulating the FBR. Model sensor implants comprising polyester fibers coated with a rapidly dissolving polymer coating containing drug-releasing degradable microspheres were implanted subcutaneously in sash mice for various time points, and the FBR was evaluated for chronic inflammation and fibrous capsule formation around the implants. No significant differences were observed in the foreign body capsule formation between control and drug-releasing implant groups in MC-deficient mice. However, fibrous encapsulation was significantly greater around the drug-releasing implants in sash mice compared to drug-releasing implants in wild-type (e.g. MC-competent) mice. These results provide insights into the role of MCs in the FBR, suggesting that MC deficiency provides alternative pathways for host inflammatory responses to implanted biomaterials. PMID:24406200

  16. Foreign body response to subcutaneous biomaterial implants in a mast cell-deficient Kit(w-Sh) murine model.

    PubMed

    Avula, M N; Rao, A N; McGill, L D; Grainger, D W; Solzbacher, F

    2014-05-01

    Mast cells (MCs)_are recognized for their functional role in wound-healing and allergic and inflammatory responses - host responses that are frequently detrimental to implanted biomaterials if extended beyond acute reactivity. These tissue reactions impact especially on the performance of sensing implants such as continuous glucose monitoring (CGM) devices. Our hypothesis that effective blockade of MC activity around implants could alter the host foreign body response (FBR) and enhance the in vivo lifetime of these implantable devices motivated this study. Stem cell factor and its ligand c-KIT receptor are critically important for MC survival, differentiation and degranulation. Therefore, an MC-deficient sash mouse model was used to assess MC relationships to the in vivo performance of CGM implants. Additionally, local delivery of a tyrosine kinase inhibitor (TKI) that inhibits c-KIT activity was also used to evaluate the role of MCs in modulating the FBR. Model sensor implants comprising polyester fibers coated with a rapidly dissolving polymer coating containing drug-releasing degradable microspheres were implanted subcutaneously in sash mice for various time points, and the FBR was evaluated for chronic inflammation and fibrous capsule formation around the implants. No significant differences were observed in the foreign body capsule formation between control and drug-releasing implant groups in MC-deficient mice. However, fibrous encapsulation was significantly greater around the drug-releasing implants in sash mice compared to drug-releasing implants in wild-type (e.g. MC-competent) mice. These results provide insights into the role of MCs in the FBR, suggesting that MC deficiency provides alternative pathways for host inflammatory responses to implanted biomaterials.

  17. Scheme for Creating a Subcutaneous Tunnel to Place an Indwelling Implantable Central Venous Access System in the Forearm

    SciTech Connect

    Yamamoto, Kazuhiro Tanikake, Masato; Arimoto, Hiroshi; Utsunomiya, Keita; Narabayashi, Isamu; Narumi, Yoshifumi

    2008-11-15

    We report a method that we have devised in which a secure subcutaneous tunnel is prepared during the placement of an indwelling central venous reservoir in the forearm. Subjects included 69 cases in which a procedure for implanting an indwelling reservoir in the forearm was performed between June 2006 and May 2007. For the subcutaneous tunnel, a 22-G Cathelin needle was advanced from the puncture site, turning toward the subcutaneous pocket side to the deep subcutaneous area. A 14-G Surflo IV catheter was then advanced along the 22-G Cathelin needle from the subcutaneous pocket. With the tip of the 14-G Surflo IV catheter emerging above the skin at the puncture site, the inner needle of the 14-G Surflo IV catheter and the 22-G Cathelin needle were removed. The catheter was passed through the outer 14-G Surflo IV catheter to emerge on the subcutaneous pocket site, then the outer needle of the Surflo catheter was also removed, and a connection to the port was made to create the subcutaneous tunnel. In all 69 cases, the subcutaneous tunnel in the forearm of the nondominant arm was successfully created within a short period of time (100% success rate). No problems were observed due to slack in the catheter until removal of the sutures 1 week later and for 3 months after treatment. With this method, we believe that a subcutaneous tunnel can be prepared in which the contained catheter has minimal freedom of movement, and which minimizes any damage induced by slack in the catheter within the subcutaneous tunnel.

  18. Subcutaneous abdominal fat and thigh muscle composition predict insulin sensitivity independently of visceral fat.

    PubMed

    Goodpaster, B H; Thaete, F L; Simoneau, J A; Kelley, D E

    1997-10-01

    Whether visceral adipose tissue has a uniquely powerful association with insulin resistance or whether subcutaneous abdominal fat shares this link has generated controversy in the area of body composition and insulin sensitivity. An additional issue is the potential role of fat deposition within skeletal muscle and the relationship with insulin resistance. To address these matters, the current study was undertaken to measure body composition, aerobic fitness, and insulin sensitivity within a cohort of sedentary healthy men (n = 26) and women (n = 28). The subjects, who ranged from lean to obese (BMI 19.6-41.0 kg/m2), underwent dual energy X-ray absorptiometry (DEXA) to measure fat-free mass (FFM) and fat mass (FM), computed tomography to measure cross-sectional abdominal subcutaneous and visceral adipose tissue, and computed tomography (CT) of mid-thigh to measure muscle cross-sectional area, muscle attenuation, and subcutaneous fat. Insulin sensitivity was measured using the glucose clamp technique (40 mU.m-2.min-1), in conjunction with [3-3H]glucose isotope dilution. Maximal aerobic power (VO2max) was determined using an incremental cycling test. Insulin-stimulated glucose disposal (Rd) ranged from 3.03 to 16.83 mg.min-1.kg-1 FFM. Rd was negatively correlated with FM (r = -0.58), visceral fat (r = -0.52), subcutaneous abdominal fat (r = -0.61), and thigh fat (r = -0.38) and positively correlated with muscle attenuation (r = 0.48) and VO2max (r = 0.26, P < 0.05). In addition to manifesting the strongest simple correlation with insulin sensitivity, in stepwise multiple regression, subcutaneous abdominal fat retained significance after adjusting for visceral fat, while the converse was not found. Muscle attenuation contributed independent significance to multiple regression models of body composition and insulin sensitivity, and in analysis of obese subjects, muscle attenuation was the strongest single correlate of insulin resistance. In summary, as a component of

  19. Optoelectronic device

    DOEpatents

    Bonekamp, Jeffrey E.; Boven, Michelle L.; Gaston, Ryan S.

    2014-09-09

    The invention is an optoelectronic device comprising an active portion which converts light to electricity or converts electricity to light, the active portion having a front side for the transmittal of the light and a back side opposite from the front side, at least two electrical leads to the active portion to convey electricity to or from the active portion, an enclosure surrounding the active portion and through which the at least two electrical leads pass wherein the hermetically sealed enclosure comprises at the front side of the active portion a barrier material which allows for transmittal of light, one or more getter materials disposed so as to not impede the transmission of light to or from the active portion, and a contiguous gap pathway to the getter material which pathway is disposed between the active portion and the barrier material.

  20. CLOSURE DEVICE

    DOEpatents

    Linzell, S.M.; Dorcy, D.J.

    1958-08-26

    A quick opening type of stuffing box employing two banks of rotatable shoes, each of which has a caraming action that forces a neoprene sealing surface against a pipe or rod where it passes through a wall is presented. A ring having a handle or wrench attached is placed eccentric to and between the two banks of shoes. Head bolts from the shoes fit into slots in this ring, which are so arranged that when the ring is rotated a quarter turn in one direction the shoes are thrust inwardly to cramp the neopnrene about the pipe, malting a tight seal. Moving the ring in the reverse direction moves the shoes outwardly and frees the pipe which then may be readily removed from the stuffing box. This device has particular application as a closure for the end of a coolant tube of a neutronic reactor.

  1. PLASMA DEVICE

    DOEpatents

    Baker, W.R.

    1961-08-22

    A device is described for establishing and maintaining a high-energy, rotational plasma for use as a fast discharge capacitor. A disc-shaped, current- conducting plasma is formed in an axinl magnetic field and a crossed electric field, thereby creating rotational kinetic enengy in the plasma. Such energy stored in the rotation of the plasma disc is substantial and is convertible tc electrical energy by generator action in an output line electrically coupled to the plasma volume. Means are then provided for discharging the electrical energy into an external circuit coupled to the output line to produce a very large pulse having an extremely rapid rise time in the waveform thereof. (AE C)

  2. Electrophoresis device

    NASA Technical Reports Server (NTRS)

    Rhodes, P. H.; Snyder, R. S. (Inventor)

    1982-01-01

    A device for separating cellular particles of a sample substance into fractionated streams of different cellular species includes a casing having a distribution chamber, a separation chamber, and a collection chamber. The electrode chambers are separated from the separation chamber interior by means of passages such that flow variations and membrane variations around the slotted portion of the electrode chamber do not enduce flow perturbations into the laminar buffer curtain flowing in the separation chamber. The cellular particles of the sample are separated under the influence of the electrical field and the separation chamber into streams of different cellular species. The streams of separated cells enter a partition array in the collection chamber where they are fractionated and collected.

  3. Calculating the Dose of Subcutaneous Immunoglobulin for Primary Immunodeficiency Disease in Patients Switched From Intravenous to Subcutaneous Immunoglobulin Without the Use of a Dose-Adjustment Coefficient

    PubMed Central

    Fadeyi, Michael; Tran, Tin

    2013-01-01

    Primary immunodeficiency disease (PIDD) is an inherited disorder characterized by an inadequate immune system. The most common type of PIDD is antibody deficiency. Patients with this disorder lack the ability to make functional immunoglobulin G (IgG) and require lifelong IgG replacement therapy to prevent serious bacterial infections. The current standard therapy for PIDD is intravenous immunoglobulin (IVIG) infusions, but IVIG might not be appropriate for all patients. For this reason, subcutaneous immunoglobulin (SCIG) has emerged as an alternative to IVIG. A concern for physicians is the precise SCIG dose that should be prescribed, because there are pharmacokinetic differences between IVIG and SCIG. Manufacturers of SCIG 10% and 20% liquid (immune globulin subcutaneous [human]) recommend a dose-adjustment coefficient (DAC). Both strengths are currently approved by the FDA. This DAC is to be used when patients are switched from IVIG to SCIG. In this article, we propose another dosing method that uses a higher ratio of IVIG to SCIG and an incremental adjustment based on clinical status, body weight, and the presence of concurrent diseases. PMID:24391400

  4. Continuous subcutaneous levetiracetam in the management of seizures at the end of life: a case report.

    PubMed

    Wells, Geoffrey Howard; Mason, Louise D; Foreman, Emma; Chambers, John

    2016-03-01

    We report the case of a man who developed seizures on a background of recurrent metastatic squamous cell carcinoma with intracranial involvement. Initial seizure control with enteral levetiracetam was achieved, and when enteral and intravenous (i.v.) access was no longer available, a continuous subcutaneous infusion (CSCI) of levetiracetam successfully controlled his seizures without the need for sedating anticonvulsants. As a result, end-of-life care was able to be given with the patient retaining the ability to communicate with his family and healthcare staff. This report adds to the sparse but growing evidence base for the use of subcutaneous levetiracetam to manage seizures in palliative and end-of-life care. PMID:26744359

  5. Avoiding Breast Animation Deformity with Pectoralis-Sparing Subcutaneous Direct-to-Implant Breast Reconstruction.

    PubMed

    Kobraei, Edward M; Cauley, Ryan; Gadd, Michele; Austen, William G; Liao, Eric C

    2016-05-01

    There is renewed interest in sparing the pectoralis major muscle in implant breast reconstruction, placing the implant in the subcutaneous position. This advance is made reliable by improvements in mastectomy skin flap quality, evolution of technique, and increased awareness of breast animation deformity. This retrospective review presents 13 patients (23 breasts) reconstructed immediately with placing the definitive implant in the subcutaneous space without disruption of the underlying chest muscles. None of the 13 patients had breast animation deformity postoperatively. One patient experienced an early hematoma, and 3 patients had small seromas that resolved uneventfully. One morbidly obese patient undergoing chemotherapy using a nearby chest port experienced infection requiring implant removal. This study describes an early experience, demonstrates feasibility, and discusses patient selection considerations that are important because we continue to evolve breast reconstruction approaches.

  6. Investigation of the mechanisms that influence the accretion of bovine intramuscular and subcutaneous adipose tissue

    SciTech Connect

    Miller, M.F.

    1987-01-01

    The understanding of the mechanisms that differ between breeds of cattle and their ability to deposit intramuscular adipose tissue is imperative to profitable beef production. Thus, the interactions among breeds, metabolic substrates and specific hormones in bovine intramuscular and subcutaneous adipose tissue were investigated. Subcutaneous and intramuscular adipose tissues were obtained from 10 Angus and 9 Santa Gertrudis steers immediately postmortem. The adipose tissues were incubated for 2 h and 48 h with and without 1 mU/ml insulin and 30 mg/ml bovine serum albumin (BSA) to measure the incorporation of /sup 14/C-labeled acetate and glucose into lipid fractions. At the same chronological age, Angus steers had a more youthful lean maturity score, higher USDA marbling scores and higher USDA quality grades than carcasses from Santa Gertrudis steers.

  7. [An surgical case of right pulmonary coccidioidomycosis--with subcutaneous coccidiomycosis in the left wrist].

    PubMed

    Masuda, K; Kumamoto, K; Machida, T

    1997-10-01

    Coccidioides is an afferent fungus disease. In Japan, there have been only a few surgical reports on coccidioides disease. We report a 39-year-old male who was diagnosed as having coccidioides disease by biopsy of subcutaneous nodules in the left wrist. The patient also showed a tumor image (1.5 x 1.0 cm) in S4 in the right lung. He had previously lived in Fresno, California on business between 1988 and 1993. After biopsy of the subcutaneous nodules, Itraconazole (200 mg), an anti-fungal drug, was orally administered for the lesion in the right lung for about 6 months. Since the tumor image revealed no improvement through this treatment, the tumor was resected. Histopathological examination by Grocott staining demonstrated the spherical form Coccidioides, i.e., endospores. Only 5 cases of resected pulmonary coccidioidal lesions have been reported in Japan including this case. We must be careful when handling coccidioidal culture because of its strong infectiosity.

  8. Genetic diversity of Dirofilaria spp. isolated from subcutaneous and ocular lesions of human patients in Ukraine.

    PubMed

    Rossi, Alice; Peix, Álvaro; Pavlikovskaya, Tamara; Sagach, Olga; Nikolaenko, Svetlana; Chizh, Nina; Kartashev, Vladimir; Simón, Fernando; Siles-Lucas, Mar

    2015-02-01

    This short communication describes the phylogenetic analysis of 48 Dirofilaria worms isolated from human patients in Ukraine. 102 cases were both of subcutaneous (47; 46.1%) and ocular (54; 52.9%) locations. Worms from 44 patients (15 subcutaneous and 29 ocular) were subjected to DNA extraction and amplification of a specific fragment of the 12S rRNA subunit, and sequences were used for phylogenetic analysis. Results showed that 13.8% of the ocular cases analyzed at molecular level were caused by Dirofilaria immitis. Very few cases of ocular human dirofilariosis due to D. immitis have been described in the literature to date, majority of them attributed to Dirofilaria repens. Our results show that ocular dirofilariosis cannot be excluded in areas of low endemicity for D. repens were D. immitis is also present. PMID:25447827

  9. Avoiding Breast Animation Deformity with Pectoralis-Sparing Subcutaneous Direct-to-Implant Breast Reconstruction

    PubMed Central

    Kobraei, Edward M.; Cauley, Ryan; Gadd, Michele; Austen, William G.

    2016-01-01

    Summary: There is renewed interest in sparing the pectoralis major muscle in implant breast reconstruction, placing the implant in the subcutaneous position. This advance is made reliable by improvements in mastectomy skin flap quality, evolution of technique, and increased awareness of breast animation deformity. This retrospective review presents 13 patients (23 breasts) reconstructed immediately with placing the definitive implant in the subcutaneous space without disruption of the underlying chest muscles. None of the 13 patients had breast animation deformity postoperatively. One patient experienced an early hematoma, and 3 patients had small seromas that resolved uneventfully. One morbidly obese patient undergoing chemotherapy using a nearby chest port experienced infection requiring implant removal. This study describes an early experience, demonstrates feasibility, and discusses patient selection considerations that are important because we continue to evolve breast reconstruction approaches. PMID:27579232

  10. Primary subcutaneous inguinal hydatid cyst: diagnosis by fine needle aspiration cytology.

    PubMed

    Bagga, Permeet Kaur; Bhargava, Satish Kumar; Aggarwal, Neema; Chander, Yogesh

    2014-08-01

    Hydatid disease or human cystic echinococcosis, recognized by ancient scholars such as Hippocrates, Galen and Rhazes, is one of the oldest diseases known to man. Though hydatid cyst may develop in almost any part of the body, a solitary primary subcutaneous localization is an extremely rare entity. We herein report a case of primary subcutaneous inguinal hydatid cyst which was diagnosed by fine needle aspiration cytology. Radiological examination done subsequently corroborated with the cytodiagnosis of Hydatid cyst and did not show involvement of any other organ or site. Histopathological examination of surgically removed cyst confirmed the diagnosis of Hydatid cyst. Hydatid disease should be considered in the differential diagnosis of all unusual swellings in soft tissues, especially in regions where the disease is endemic. PMID:25302206

  11. Solitary subcutaneous mucinosis surrounded by bizarre-shaped, factor XIIIa-positive cells with intranuclear vacuoles.

    PubMed

    Terui, T; Aiba, S; Tagami, H

    1998-05-01

    We describe a subcutaneous mucinosis developing in the right cheek of a 38-year-old man. Histologic examination revealed bipolar fibroblast-like cells embedded in a well demarcated mucinous stroma in the subcutis without a manifest reticulin network. In addition, bizarre, sometimes multinucleate, cells with intranuclear vacuoles were found at the periphery of the mucinous stroma. Immunohistologically, both the bipolar fibroblastic cells and bizarre-shaped cells were positive for vimentin, but were negative for smooth muscle A-actin, desmin, CD34, S100, trypsin, or chymotrypsin. However, the latter reacted to anti-factor XIIIa antibody, suggesting that they are derived from dermal dendritic cells. We think that this solitary subcutaneous mucinosis is a unique variant of cutaneous focal mucinosis, because neither a reticulin network nor reactivity to anti-smooth muscle A-actin antibody were demonstrable.

  12. Gene expression changes in subcutaneous adipose tissue due to Cushing's disease

    PubMed Central

    Hochberg, Irit; Harvey, Innocence; Tran, Quynh T; Stephenson, Erin J; Barkan, Ariel L; Saltiel, Alan R; Chandler, William F; Bridges, Dave

    2015-01-01

    Glucocorticoids have major effects on adipose tissue metabolism. To study tissue mRNA expression changes induced by chronic elevated endogenous glucocorticoids, we performed RNA sequencing on the subcutaneous adipose tissue from patients with Cushing's disease (n=5) compared to patients with nonfunctioning pituitary adenomas (n=11). We found a higher expression of transcripts involved in several metabolic pathways, including lipogenesis, proteolysis and glucose oxidation as well as a decreased expression of transcripts involved in inflammation and protein synthesis. To further study this in a model system, we subjected mice to dexamethasone treatment for 12 weeks and analyzed their inguinal (subcutaneous) fat pads, which led to similar findings. Additionally, mice treated with dexamethasone showed drastic decreases in lean body mass as well as increased fat mass, further supporting the human transcriptomic data. These data provide insight to transcriptional changes that may be responsible for the comorbidities associated with chronic elevations of glucocorticoids. PMID:26150553

  13. Gene expression changes in subcutaneous adipose tissue due to Cushing's disease.

    PubMed

    Hochberg, Irit; Harvey, Innocence; Tran, Quynh T; Stephenson, Erin J; Barkan, Ariel L; Saltiel, Alan R; Chandler, William F; Bridges, Dave

    2015-10-01

    Glucocorticoids have major effects on adipose tissue metabolism. To study tissue mRNA expression changes induced by chronic elevated endogenous glucocorticoids, we performed RNA sequencing on the subcutaneous adipose tissue from patients with Cushing's disease (n=5) compared to patients with nonfunctioning pituitary adenomas (n=11). We found a higher expression of transcripts involved in several metabolic pathways, including lipogenesis, proteolysis and glucose oxidation as well as a decreased expression of transcripts involved in inflammation and protein synthesis. To further study this in a model system, we subjected mice to dexamethasone treatment for 12 weeks and analyzed their inguinal (subcutaneous) fat pads, which led to similar findings. Additionally, mice treated with dexamethasone showed drastic decreases in lean body mass as well as increased fat mass, further supporting the human transcriptomic data. These data provide insight to transcriptional changes that may be responsible for the comorbidities associated with chronic elevations of glucocorticoids. PMID:26150553

  14. Myxopapillary ependymoma masquerading as subcutaneous sacrococcygeal non-healing ulcer: case report.

    PubMed

    Zaidi, Shaesta Naseem; AlKhalidi, Hisham; Al-Rikabi, Ammar Cherkees

    2014-01-01

    Ependymomas outside the confines of the cranium and spinal cord are rare. The occurrence of these tumors in an extradural, sacrococcygeal, or subcutaneous location may prove challenging, particularly in the absence of any obvious central nervous system connection. The origin of these tumors from sub.cutaneous sacrococcygeal ependymal rests is postulated on the basis of earlier reports. We describe 1 such rare extradural case of myxopapillary ependymoma in a 30-year-old female, which presented as a non-healing ulcer in the left gluteal area. It was initially diagnosed and was being treated as an infected epidermoid cyst. Clinical and histopathological features are described, and a brief review of published reports is presented. PMID:25266190

  15. Subcutaneous hemangiosarcoma induced by a foreign body (steel staple) in a cat

    PubMed Central

    Tan, Rommel Max; Singh, Kuldeep; Sandman, Kristi

    2013-01-01

    An 8-year-old, female domestic shorthair cat was presented with a ventral abdominal subcutaneous mass. A radiograph showed that the center of the mass contained what appeared to be steel sutures, presumed to be from an ovariohysterectomy performed 7 years earlier. The excised mass was irregular and contained numerous pockets filled with friable necrotic material and hemorrhages that were dissected by fibrous connective tissue bands. Multiple tangled and fragmented pieces of steel staples were deeply embedded within the mass. Histologically, the mass was non-encapsulated, densely cellular, and infiltrative. Neoplastic cells lined caverns and channels and were factor VIII-positive by immunohistochemistry. The neoplastic cells were oval to round with granular cytoplasm and vesicular nucleus and exhibited moderate cellular and nuclear pleomorphism. A diagnosis of subcutaneous hemangiosarcoma was made. To our knowledge, this is the first report of foreign body associated hemangiosarcoma and the first case of steel staple associated neoplasm in domestic animals. PMID:24082166

  16. Incidental Detection Microfilaria in Subcutaneous Breast Nodule of Lactating Female Fnac: A Rare Case Report

    PubMed Central

    Gupta, Prashant; Yadav, Soma; Pahawa, H.S

    2014-01-01

    Filariasis is a major public health problem which is faced in tropical countries like India. Its diagnosis is made by using peripheral blood smears. However, microfilaria has been detected incidentally during FNACs of various lesions, which were done in clinically unsuspected cases. We are reporting here, an uncommon case of filariasis, which caused a nodular, subcutaneous swelling in left breast of a 30 year old lactating female. A nodular subcutaneous swelling can be caused in breast of a lactating female by lactational associated mastitis, but filaria causing a nodular swelling in a lactating breast is a rare presentation. Aspiration of the swelling demonstrated enormous pathogen presence caused by Woucheria bancrofti and the patient responded well to six weeks of daily anti-filarial treatment with diethylcarbamazine citrate. PMID:25120989

  17. Venous thrombosis after abdominal surgery. A comparison between subcutaneous heparin and antithrombotic stockings, or both

    SciTech Connect

    Rasmussen, A.; Hansen, P.T.; Lindholt, J.; Poulsen, T.D.; Toftdahl, D.B.; Gram, J.; Toftgaard, C.; Jespersen, J.

    1988-01-01

    In an open controlled study, 248 consecutive patients (age more than 40 yrs) admitted for major abdominal surgery were randomized to one of three prophylactic antithrombotic treatments. Eighty-five patients received subcutaneous heparin, 74 patients had graduated compression stockings to the knee (TED stockings), and 89 patients had both subcutaneous heparin and stockings. Treatment began on the evening before operation and continued to complete mobilization, or for not less than five days postoperatively. On the fourth or fifth postoperative day, the patients underwent a /sup 99m/Tc-plasmin test of the lower limbs as a test for deep vein thrombosis. There were 29.7% positive tests in the stocking group, 29.4% in the group with heparin prophylaxis, and 25.8% in the combined group. Differences between treatments were not statistically significant.

  18. Subcutaneous Rhinosporidiosis Masquerading as Soft Tissue Tumor: Diagnosed by Fine-Needle Aspiration Cytology

    PubMed Central

    Kishan Prasad, HL; Rao, Chandrika; Girisha, BS; Shetty, Vikram; Permi, Harish S; Jayakumar, Meera; Kiran, HS

    2015-01-01

    Rhinosporidiosis is a chronic granulomatous lesion caused by Rhinosporidium seeberi. It frequently involves nasopharynx and ocular region. Presenting as cutaneous and subcutaneous mass is extremely rare. This report describes the FNA cytology of rhinosporidiosis occurring as a soft tissue mass in the right mid thigh region. We present a rare case of a 71-year-old male, who presented with multiple subcutaneous soft tissue mass lesions in the posteromedial aspect of mid right thigh region since 2 weeks. Local examination revealed multiple firm to hard mass with skin over the swelling was unremarkable. CT of the right thigh showed a heterogeneous lesion with infiltrative margins in the thigh. Clinically soft tissue sarcoma was considered. Diagnostic FNAC was performed showing numerous mature and immature sporangias with giant cell reaction. Hence, an excision biopsy confirmed the rhinosporidiosis. To conclude, the FNAC diagnosis of rhinosporidiosis is specific. Preoperative diagnosis is possible even in cases with unusual clinical presentations. PMID:25814750

  19. Locally recurrent subcutaneous and muscular hydatid cysts of the leg: an unusual case report.

    PubMed

    Ouakrim, Redouane; Amziane, Zouhir; Younes, Ouchrif; Eloukili, Issam; Kharmaz, Mohammed; Lamrani, Moulay Omar; Elbardouni, Ahmed; Mahfoud, Mustapha; Saleh, Berrada Mohammed

    2015-01-01

    We report a rare case of 50-year-old Moroccan woman with local recurrence of a subcutaneous hydatid cyst in proximity to the medial surface of the tibia and another cyst at the tibialis posterior muscle in the absence of liver, lung und spleen involvement. The first surgery was done in another hospital three years ago; no adjuvant treatment was performed after surgery. Recurrence was diagnosed according to the MRI appearance, serological and pathological findings. The patient underwent complete excision of the subcutaneous cyst with two centimeters of the medial gastrocnemius muscle; the tibialis posterior muscle cyst was intraoperatively drained and irrigated with scolicidal agent as it was next to the posterior tibial pedicle. A periopertive anthelmintic chemotherapy was administered. Two years after the patient showed no recurrence. This case report and literature review describe an approach to the diagnosis and management of this pathological entity. PMID:26587132

  20. Subcutaneous dextrose for rehydration of elderly patients – an evidence-based review

    PubMed Central

    Turner, Tari; Cassano, Anne-Marie

    2004-01-01

    Background In the Rehabilitation and Aged Care Services Program at Southern Health in Victoria, saline hypodermoclysis is a relatively common method of rehydration. However, there were questions about the safety and effectiveness of subcutaneous infusion of other fluids and, in particular, dextrose solutions. This review aimed to assess the safety and effectiveness of rehydration of elderly patients with subcutaneous 5% dextrose solutions compared with intravenous 5% dextrose solutions. Methods We searched the Cochrane Library, Medline, IDIS, CINAHL, Current Contents, Premedline, Australasian Medical Index, the Joanna Briggs Institute, the US National Guideline Clearinghouse and bibliographies of retrieved articles. Searching was undertaken in July 2003. Studies selected were primary studies (or systematic reviews of primary studies) providing evidence as to the effectiveness and safety of subcutaneous infusion of dextrose solutions for rehydration of elderly patients. We included articles published in English in the last 10 years. Data were extracted by a single researcher. Results From our search we identified 15 potentially relevant articles. We obtained the full text of these articles to determine their relevance. After application of the inclusion criteria, four articles remained for appraisal including one systematic review, two randomised controlled trials and one cohort study. Conclusion The four studies appraised all provide evidence that appropriate volumes of subcutaneous dextrose infusions (in the form of half-normal saline-glucose 5%, 40 g/L dextrose and 30 mmol/L NaCl, or 5% dextrose solution and 4 g/L NaCl, or two-thirds 5% glucose and one-third normal saline) can be used effectively for the treatment of dehydration, with similar rates of adverse effects to intravenous infusion. The evidence in this area is limited, and larger randomised controlled trials using validated outcome measures would be useful to confirm these results. PMID:15086959

  1. Prolonged hypoglycemic effect in diabetic dogs due to subcutaneous administration of insulin in liposomes

    SciTech Connect

    Stevenson, R.W.; Patel, H.M.; Parsons, J.A.; Ryman, B.E.

    1982-06-01

    The biologic action of insulin entrapped in liposomes (phospholipid vesicles) has been investigated following subcutaneous injection to dogs made diabetic with a combination of alloxan and streptozotocin. The fate of the liposomally entrapped material was determined by injecting rats subcutaneously with either /sup 125/I-insulin or the labeled polysaccharide /sup 14/C-inulin, incorporated in liposomes labeled with /sup 3/H-cholesterol. Injection of liposome insulin (0.75 U/kg) to five diabetic dogs resulted in a mean (+/- SEM) blood glucose fall from 16.4 +/- 0.8 to 2.9 +/- 0.4 mmol/L. The glucose level had still not returned to baseline after 24 h and, correspondingly, immunoreactive insulin (IRI) could still be detected in frozen and thawed plasma 24 h after injection. In contrast, the hypoglycemic effect of the same dose of free insulin with or without empty liposomes virtually ended within 8 h and IRI levels returned to baseline by 3 h after injection. In experiments on rats with liposomally entrapped /sup 125/I-insulin or /sup 14/C-inulin the proportion of the injected dose of tracer recoverable by excision of the injection site remained constant after about 1 h and 70% of the dose was still fixed in subcutaneous tissue for at least 5 h thereafter. When the plasma collected 3 h after subcutaneous injection of labeled liposomes containing /sup 125/I-insulin was passed through a column of Sepharose 6B, 50-75% of the /sup 125/I-activity was found in the fractions associated with intact liposomes. One possibility for the persistence of the hypoglycemic effect and of measurable IRI following injection of liposome insulin could be the presence of intact liposomes in the circulation for many hours after adsorption had ceased.

  2. Free Fatty Acid Storage in Human Visceral and Subcutaneous Adipose Tissue

    PubMed Central

    Ali, Asem H.; Koutsari, Christina; Mundi, Manpreet; Stegall, Mark D.; Heimbach, Julie K.; Taler, Sandra J.; Nygren, Jonas; Thorell, Anders; Bogachus, Lindsey D.; Turcotte, Lorraine P.; Bernlohr, David; Jensen, Michael D.

    2011-01-01

    OBJECTIVE Because direct adipose tissue free fatty acid (FFA) storage may contribute to body fat distribution, we measured FFA (palmitate) storage rates and fatty acid (FA) storage enzymes/proteins in omental and abdominal subcutaneous fat. RESEARCH DESIGN AND METHODS Elective surgery patients received a bolus of [1-14C]palmitate followed by omental and abdominal subcutaneous fat biopsies to measure direct FFA storage. Long chain acyl-CoA synthetase (ACS) and diacylglycerol acyltransferase activities, CD36, fatty acid-binding protein, and fatty acid transport protein 1 were measured. RESULTS Palmitate tracer storage (dpm/g adipose lipid) and calculated palmitate storage rates were greater in omental than abdominal subcutaneous fat in women (1.2 ± 0.8 vs. 0.7 ± 0.4 μmol ⋅ kg adipose lipid−1 ⋅ min−1, P = 0.005) and men (0.7 ± 0.2 vs. 0.2 ± 0.1, P < 0.001), and both were greater in women than men (P < 0.0001). Abdominal subcutaneous adipose tissue palmitate storage rates correlated with ACS activity (women: r = 0.66, P = 0.001; men: r = 0.70, P = 0.007); in men, CD36 was also independently related to palmitate storage rates. The content/activity of FA storage enzymes/proteins in omental fat was dramatically lower in those with more visceral fat. In women, only omental palmitate storage rates were correlated (r = 0.54, P = 0.03) with ACS activity. CONCLUSIONS Some adipocyte FA storage factors correlate with direct FFA storage, but sex differences in this process in visceral fat do not account for sex differences in visceral fatness. The reduced storage proteins in those with greater visceral fat suggest that the storage factors we measured are not a predominant cause of visceral adipose tissue accumulation. PMID:21810594

  3. Ultrasonographic evaluation of visceral and subcutaneous abdominal fat tissue before and after bariatric surgery.

    PubMed

    Djurić-Stefanović, A; Vasin, D; Jovanović, S; Lazić, Lj; Kovac, J; Popović, I; Bajec, Dj; Saranović, Dj

    2013-01-01

    Visceral fat is considered a key factor in the development of metabolic syndrome and other pathological conditions and diseases associated with obesity. Therefore, analysis of the dynamics of reducing the amount of abdominal visceral fat is important for evaluating the therapeutic effects of different modalities of obesity treatment, including bariatric surgery. In 53 obese patients visceral and subcutaneous abdominal adipose tissue was measured by ultrasonography (US) before and after bariatric surgery, in the period of 1, 3, 6 months. At the same time, standard anthropometric parameters were assessed: body mass (m), BMI, waist circumference (WC), and hip circumference (HC). Five diameters of the visceral abdominal fat (VAF) were measured: IAFT (Intraabdominal Fat Thickness), LV (Lienal Vein), VF (Visceral Fat), MES sum (Mesenterial leafs) and Max PFT (Maximal Preperitoneal Fat Thickness), and three diameters of the subcutaneous abdominal adipose tissue (SCAF): Min SFT (Minimal Subcutaneous Fat), and MaxSFTa and MaxSFTb (Maximal Subcutaneous Fat Thickness a and b). Statistically significant decrease in all anthropometric parameters, except HC was registered 1, 3 and 6 months after the surgery. We registered the decline of almost all US diameters of abdominal adipose tissue in the follow-up period, but statistically significant decrease were found only in the diameters of visceral adipose tissue: IAFT after 1 and 3 months (p = 0.031 and p = 0.027); VF after 1 month (p = 0.031), LV after 6 months (p = 0.011), and MESsum after 3 and 6 months (p = 0.001 and p = 0.028), as well as MaxSFTb, at 1 month follow-up (p = 0.015). In the short-term follow-up period after the bariatric surgery, there was a significant decrease in body mass, BMI and WC, and ultrasonography revealed a significant reduction in the diameters of the visceral abdominal fat.

  4. [Consensus document on continuous subcutaneous insulin infusion (CSII) treatment in paediatrics with type I diabetes].

    PubMed

    Barrio Castellanos, R; García Cuartero, B; Gómez Gila, A; González Casado, I; Hermoso López, F; Luzuriaga Tomás, C; Oyarzabal Irigoyen, M; Rica Etxebarria, I; Rodríguez Rigual, M; Torres Lacruz, M

    2010-05-01

    This article reports on the Spanish Position Statement for the Diabetes Pediátric Group for the Spanish Pediatric Endocrinology Society (SEEP) on continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes. The practical issues about their indications, appropriate candidates, feasibility, and limits are outlined. The conclusions are based on the comprehensive review and balanced assessment of the evidence base on the international consensus and consensual answers to these questions for the participants.

  5. Subcutaneous anchor attachment increases retention of radio transmitters on Xantus' and marbled murrelets

    USGS Publications Warehouse

    Newman, Scott H.; Takekawa, John Y.; Whitworth, Darrell L.; Burkett, Esther E.

    1999-01-01

    We modified a subcutaneous anchor attachment and achieved transmitter reten- tion times that exceeded those reported previously for other attachments used on alcids. Traditional suture and epoxy attachment methods were used on Xantus' Murrelets in 1995 and 1996, while the modified attachment was used for Xantus' Murrelets in 1996 and 1997 and Marbled Murrelets in 1997. Modifications included use of an inhalant anesthetic, placing the anchor in a more cranial position on the back, application of marine epoxy, and place- ment of a single subcutaneous non-absorbable suture at the caudal end of the radio to hold the radio in place initially. We located 22 of 56 (39%) Xantus' Murrelets radio-marked using suture and epoxy during aerial surveys in 1995 and 1996. Of birds radio-marked using the subcutaneous anchor attachment, we located 92 of 113 (81%) Xantus' Murrelets marked in 1996 and 1997 and all 28 (100%) Marbled Murrelets marked in 1997 during aerial surveys. The maximum confirmed duration for the subcutaneous anchor transmitter attachment was 51 d for Xantus' Murrelets and 78 d for Marbled Murrelets versus 41 d for the suture and epoxy attachment used on Xantus' Murrelets. Recapture rates of radio-marked Xantus' Mur- relets were similar to recapture rates of unmarked Xantus' Murrelets. Our post-release ob- servations indicated negligible short-term physical effects from the attachment procedure, while telemetry data and examination of recaptured murrelets indicated no evidence of infection or other long-term physical effects. Breeding behavior of some murrelets was not disrupted; however, further evaluation of potential effects of this attachment technique on breeding and behavior is needed.

  6. Effect of absorption promoters on subcutaneous absorption of human epidermal growth factor in rats.

    PubMed

    Murakami, T; Misaki, M; Kojima, Y; Yamada, M; Yuki, M; Higashi, Y; Amagase, H; Fuwa, T; Yata, N

    1993-03-01

    Subcutaneous administration of human epidermal growth factor (hEGF) to rats gave a significantly smaller value of area under the curve (AUC) of concentration in plasma of immunoreactive hEGF versus time than intravenous administration, probably because the slow entry rate into the blood circulation and consequently the enzymic degradation of hEGF at the injection site. In the present study, absorption promoters such as sodium caprate, N-acylamino acids, disodium ethylenediamine-tetraacetate (EDTA), and sodium glycocholate were used because they were expected to inhibit the enzymic degradation of hEGF at the injection site and to facilitate the entry of hEGF into the blood circulation. Coadministration of an absorption promoter with hEGF significantly increased the entry rate and AUC value of immunoreactive hEGF compared with the case without the absorption promoter. The enzymic degradation of hEGF in the supernatant of the rat subcutaneous tissue homogenates and in the buffer solution containing leucine aminopeptidase or protease was markedly inhibited by the presence of the absorption promoters except EDTA. On the other hand, only EDTA increased the initial entry rate of FITC-dextran (M(r), 4000), which is not metabolized at the injection site, although all absorption promoters including EDTA markedly increased the extravasation of Evans blue. Thus, the increased subcutaneous bioavailability of hEGF in the presence of absorption promoters (except EDTA) was mainly attributed to the inhibitory effect of absorption promoters against the enzymic degradation of hEGF at the subcutaneous tissues. PMID:7680713

  7. First Probable Case of Subcutaneous Infection Due to Truncatella angustata: a New Fungal Pathogen of Humans?

    PubMed Central

    Żak, Iwona; Tyrak, Jerzy; Bryk, Agata

    2015-01-01

    Truncatella angustata is a coelomycetous fungus, typically associated with vascular plants as either an endophyte or a pathogen. This organism has not previously been implicated in human disease. This report describes a case of T. angustata subcutaneous infection in an immunocompetent patient. A conclusive diagnosis was achieved through partial sequencing of ribosomal DNA (rDNA) cluster. The patient was successfully treated with voriconazole followed by itraconazole. PMID:25809973

  8. Determination of oxygen tension in the subcutaneous tissue of cosmonauts during the Salyut-6 mission

    NASA Technical Reports Server (NTRS)

    Baranski, S.; Bloszczynski, R.; Hermaszewski, M.; Kubiczkowa, J.; Piorko, A.; Saganiak, R.; Sarol, Z.; Skibniewsky, F.; Stendera, J.; Walichnowski, W.

    1982-01-01

    A polarographic technique was used to measure the oxygen tension in subcutaneous tissue of the forearm of a cosmonaut prior to, after, and on the fourth day of a space mission performed by Salut-6. A drop in the oxygen exchange rate in the peripheral tissues during weightlessness was observed. The mechanisms of this change are studied, taking into consideration the blood distribution in the organism and microcirculation disorders reflected by a decreased blood flow rate in arterial-venous junctions.

  9. Treatment of malignant effusion by oncolytic virotherapy in an experimental subcutaneous xenograft model of lung cancer

    PubMed Central

    2013-01-01

    Background Malignant pleural effusion (MPE) is associated with advanced stages of lung cancer and is mainly dependent on invasion of the pleura and expression of vascular endothelial growth factor (VEGF) by cancer cells. As MPE indicates an incurable disease with limited palliative treatment options and poor outcome, there is an urgent need for new and efficient treatment options. Methods In this study, we used subcutaneously generated PC14PE6 lung adenocarcinoma xenografts in athymic mice that developed subcutaneous malignant effusions (ME) which mimic pleural effusions of the orthotopic model. Using this approach monitoring of therapeutic intervention was facilitated by direct observation of subcutaneous ME formation without the need of sacrificing mice or special imaging equipment as in case of MPE. Further, we tested oncolytic virotherapy using Vaccinia virus as a novel treatment modality against ME in this subcutaneous PC14PE6 xenograft model of advanced lung adenocarcinoma. Results We demonstrated significant therapeutic efficacy of Vaccinia virus treatment of both advanced lung adenocarcinoma and tumor-associated ME. We attribute the efficacy to the virus-mediated reduction of tumor cell-derived VEGF levels in tumors, decreased invasion of tumor cells into the peritumoral tissue, and to viral infection of the blood vessel-invading tumor cells. Moreover, we showed that the use of oncolytic Vaccinia virus encoding for a single-chain antibody (scAb) against VEGF (GLAF-1) significantly enhanced mono-therapy of oncolytic treatment. Conclusions Here, we demonstrate for the first time that oncolytic virotherapy using tumor-specific Vaccinia virus represents a novel and promising treatment modality for therapy of ME associated with advanced lung cancer. PMID:23635329

  10. Integrated device architectures for electrochromic devices

    SciTech Connect

    Frey, Jonathan Mack; Berland, Brian Spencer

    2015-04-21

    This disclosure describes systems and methods for creating monolithically integrated electrochromic devices which may be a flexible electrochromic device. Monolithic integration of thin film electrochromic devices may involve the electrical interconnection of multiple individual electrochromic devices through the creation of specific structures such as conductive pathway or insulating isolation trenches.

  11. The socio-economical impact of intravenous (IV) versus subcutaneous (SC) administration of trastuzumab: future prospectives

    PubMed Central

    Papadmitriou, K.; Trinh, X.B.; Altintas, S.; Van Dam, P.A.; Huizing, M.T.; Tjalma, W.A.A.

    2015-01-01

    Trastuzumab was the first targeted therapy for HER2 positive breast cancer. It has become the standard of care for HER2 positive metastatic breast cancer since 2000 and in the adjuvant setting since 2006. Adjuvant it is given for a year and in patients with metastatic disease until progression. The standard mode of administration is intravenous. Recently a subcutaneous form has become available. A phase III study showed that there is no difference between the intravenous and subcutaneous form in terms of safety and efficacy. The patient’s preference however significantly favoured the subcutaneous form. It is estimated that the use of the SC form could contribute to a cost saving between 758 and 2576 euro per annual course. For Belgium alone this could mean an estimated saving of 1.4 to 4.6 million euros per year. The potential benefit of the SC administration for healthcare facilities could be further increased when applied in a LEAN working day-care chemotherapy unit. After reviewing the existing literature we suggest to further validate the potential financial impact of SC trastuzumab compared to the traditional IV form and to introduce a scientific proposal incorporating the benefits of this formulation in a LEAN working healthcare unit. PMID:26977267

  12. The Effect of Subcutaneous Fat on Electrical Impedance Myography: Electrode Configuration and Multi-Frequency Analyses

    PubMed Central

    Li, Le; Li, Xiaoyan; Hu, Huijing; Shin, Henry

    2016-01-01

    This study investigates the impact of the subcutaneous fat layer (SFL) thickness on localized electrical impedance myography (EIM), as well as the effects of different current electrodes, varying in distance and direction, on EIM output. Twenty-three healthy subjects underwent localized multi-frequency EIM on their biceps brachii muscles with a hand-held electrode array. The EIM measurements were recorded under three different configurations: wide (or outer) longitudinal configuration 6.8 cm, narrow (or inner) longitudinal configuration 4.5 cm, and narrow transverse configuration 4.5 cm. Ultrasound was applied to measure the SFL thickness. Coefficients of determination (R2) of three EIM variables (resistance, reactance, and phase) and SFL thickness were calculated. For the longitudinal configuration, the wide distance could reduce the effects of the subcutaneous fat when compared with the narrow distance, but a significant correlation still remained for all three EIM parameters. However, there was no significant correlation between SFL thickness and reactance in the transverse configuration (R2 = 0.0294, p = 0.434). Utilizing a ratio of 50kHz/100kHz phase was found to be able to help reduce the correlation with SFL thickness for all the three configurations. The findings indicate that the appropriate selection of the current electrode distance, direction and the multi-frequency phase ratio can reduce the impact of subcutaneous fat on EIM. These settings should be evaluated for future clinical studies using hand-held localized arrays to perform EIM. PMID:27227876

  13. Evaluation of the analgesic effect of subcutaneous methadone after cesarean section

    PubMed Central

    Jabalameli, Mitra; Kalantari, Forough

    2014-01-01

    Background: Inadequate pain control has a significant role in maternal and neonatal health in early post-partum period which interferes with breastfeeding and has a negative influence on child normal growth. The aim of this study is evaluation of subcutaneous methadone effectiveness on post-operative pain control. Materials and Methods: Double blind randomized prospective clinical trial involving 60 term pregnancy patients through 2008 to 2009 Undergo cesarean. Inclusion criteria: Prime gravid candidate of elective cesarean and spinal anesthesia class 1 or 2. Known case of drug allergy and methadone interaction, addiction, uncontrolled medical disease excluded. Case group injected 10 mg of subcutaneous methadone in the site of incision before final suture. Morphine was a pain reliever in follow up examination. Data include mean of pain, nausea and vomiting, MAP, etc., collected and analyzed by independent-T test and Man Whitney test. Results: Although mean usage of morphine between groups was not significant statistically but the mean pain severity (P value < 0.05) and mean satisfactory (P value = 0.02) was statistically significant between groups. Other parameters were not statistically significant. Conclusion: We suggest subcutaneous methadone as a safe pain reliever in post cesarean section patients. PMID:25337527

  14. Using shared needles for subcutaneous inoculation can transmit bluetongue virus mechanically between ruminant hosts

    PubMed Central

    Darpel, Karin E.; Barber, James; Hope, Andrew; Wilson, Anthony J.; Gubbins, Simon; Henstock, Mark; Frost, Lorraine; Batten, Carrie; Veronesi, Eva; Moffat, Katy; Carpenter, Simon; Oura, Chris; Mellor, Philip S.; Mertens, Peter P. C.

    2016-01-01

    Bluetongue virus (BTV) is an economically important arbovirus of ruminants that is transmitted by Culicoides spp. biting midges. BTV infection of ruminants results in a high viraemia, suggesting that repeated sharing of needles between animals could result in its iatrogenic transmission. Studies defining the risk of iatrogenic transmission of blood-borne pathogens by less invasive routes, such as subcutaneous or intradermal inoculations are rare, even though the sharing of needles is common practice for these inoculation routes in the veterinary sector. Here we demonstrate that BTV can be transmitted by needle sharing during subcutaneous inoculation, despite the absence of visible blood contamination of the needles. The incubation period, measured from sharing of needles, to detection of BTV in the recipient sheep or cattle, was substantially longer than has previously been reported after experimental infection of ruminants by either direct inoculation of virus, or through blood feeding by infected Culicoides. Although such mechanical transmission is most likely rare under field condition, these results are likely to influence future advice given in relation to sharing needles during veterinary vaccination campaigns and will also be of interest for the public health sector considering the risk of pathogen transmission during subcutaneous inoculations with re-used needles. PMID:26853457

  15. Isolated subcutaneous implantation of a borderline ovarian tumor: A case report and review of the literature

    PubMed Central

    Banys-Paluchowski, Malgorzata; Yeganeh, Borsu; Luettges, Jutta; Maibach, Achim; Langenberg, Ruediger; Krawczyk, Natalia; Paluchowski, Peter; Maul, Holger; Gebauer, Gerhard

    2016-01-01

    Laparoscopy-related tumor implantations of gynecological malignancies into the subcutaneous tissue are rarely diagnosed. We report an interesting case of a 46-year-old female who presented with an abdominal subcutaneous metastasis of a borderline ovarian tumor. The patient received a laparoscopic unilateral adnexectomy for a solid-cystic tumor of the right ovary. Histopathological workup showed a papillary borderline tumor of mucinous type. Nine days later she underwent a hysterectomy, left adnexectomy, appendectomy and omentectomy. Exploration of the peritoneum revealed no intraperitoneal implants. Further exploration showed a non-invasive implant of a borderline tumor in the subcutaneous tissue above the fascia that had no contact to the peritoneum. It is hypothesized that tumor cells may have been implanted during a previous laparoscopy, the most recent of which had been fourteen years prior to her current presentation. Various risk factors for port-site malignancies have been identified. Tumor manipulation and extraction of tumor tissue without a protective bag may contribute to development of trocar-site metastasis. PMID:27081651

  16. Comparative gene array analysis of progenitor cells from human paired deep neck and subcutaneous adipose tissue.

    PubMed

    Tews, D; Schwar, V; Scheithauer, M; Weber, T; Fromme, T; Klingenspor, M; Barth, T F; Möller, P; Holzmann, K; Debatin, K M; Fischer-Posovszky, P; Wabitsch, M

    2014-09-01

    Brown and white adipocytes have been shown to derive from different progenitors. In this study we sought to clarify the molecular differences between human brown and white adipocyte progenitors cells. To this end, we performed comparative gene array analysis on progenitor cells isolated from paired biopsies of deep and subcutaneous neck adipose tissue from individuals (n = 6) undergoing neck surgery. Compared with subcutaneous neck progenitors, cells from the deep neck adipose tissue displayed marked differences in gene expression pattern, including 355 differentially regulated (>1.5 fold) genes. Analysis of highest regulated genes revealed that STMN2, MME, ODZ2, NRN1 and IL13RA2 genes were specifically expressed in white progenitor cells, whereas expression of LRRC17, CNTNAP3, CD34, RGS7BP and ADH1B marked brown progenitor cells. In conclusion, progenitors from deep neck and subcutaneous neck adipose tissue are characterized by a distinct molecular signature, giving rise to either brown or white adipocytes. The newly identified markers may provide potential pharmacological targets facilitating brown adipogenesis. PMID:25102227

  17. Dysfunction of human subcutaneous fat arterioles in obesity alone or obesity associated with Type 2 diabetes.

    PubMed

    Georgescu, Adriana; Popov, Doina; Constantin, Anamaria; Nemecz, Miruna; Alexandru, Nicoleta; Cochior, Daniel; Tudor, Aura

    2011-05-01

    The aim of the present study was to examine the effects of obesity alone and obesity associated with Type 2 diabetes on the structure, vascular reactivity and response to insulin of isolated human subcutaneous fat arterioles; these effects were correlated with the expression of insulin signalling proteins. Periumbilical subcutaneous adipose tissue was explanted during surgery, small arterioles (internal diameter 220 ± 40 μm) were dissected out and investigated by electron microscopy, myography and immunoblotting. Compared with the subcutaneous arterioles of lean subjects, obesity activated the endothelium, enhanced the accumulation of collagen within vascular wall and increased the sensitivity of adrenergic response; obesity also diminished eNOS (endothelial NO synthase) protein expression, NO production, and endothelium-dependent and insulin-induced vasodilatation, as well as the protein expression of both IRS (insulin receptor substrates)-1 and IRS-2 and of the downstream molecules in the insulin signalling pathway, such as PI3K (phosphoinositide 3-kinase), phospho-Akt and Akt. When obesity was associated with Type 2 diabetes, these changes were significantly augmented. In conclusion, obesity alone or obesity associated with Type 2 diabetes alters human periumbilical adipose tissue arterioles in terms of structure, function and biochemsitry, including diminished eNOS expression and reduced levels of IRS-1, IRS-2, PI3K and Akt in the insulin signalling pathway. PMID:20979575

  18. Subcutaneously Administered Self-Cleaving Hydrogel-Octreotide Conjugates Provide Very Long-Acting Octreotide.

    PubMed

    Schneider, Eric L; Henise, Jeff; Reid, Ralph; Ashley, Gary W; Santi, Daniel V

    2016-07-20

    We developed a long-acting drug-delivery system that supports subcutaneous administration of the peptidic somatostatin agonist octreotide-a blockbuster drug used to treat acromegaly and neuroendocrine tumors. The current once-a-month polymer-encapsulated octreotide, Sandostatin LAR, requires a painful intragluteal injection through a large needle by a health-care professional. To overcome such shortcomings, Tetra-PEG hydrogel microspheres were covalently attached to the α-amine of d-Phe(1) or the ε-amine of Lys(5) of octreotide by a self-cleaving β-eliminative linker; upon subcutaneous injection in the rat using a small-bore needle, octreotide was slowly released. The released drug from the ε-octreotide conjugate showed a remarkably long serum half-life that exceeded two months. The α-octreotide conjugate had a half-life of ∼2 weeks, and showed an excellent correlation of in vitro and in vivo drug release. Pharmacokinetic models indicate these microspheres should support once-weekly to once-monthly self-administered subcutaneous dosing in humans. The hydrogel-octreotide conjugate shows the favorable pharmacokinetics of Sandostatin LAR without its drawbacks. PMID:27253622

  19. Modified method for external attachment of transmitters to birds using two subcutaneous anchors

    USGS Publications Warehouse

    Lewis, T.L.; Flint, P.L.

    2008-01-01

    Of the transmitter attachment techniques for birds, the subcutaneous anchor provides a secure attachment that yields relatively few secondary effects. However, the use of subcutaneous anchors has been limited by transmitter size and retention time. Using a modified method of attachment that utilized two subcutaneous anchors, we deployed 69 GPS transmitters, plus 13 VHF transmitters that were similar in size and weight to GPS models, on Pacific Black Brant (Branta bernicla nigricans). Prior to our study, only harnesses were used for attaching GPS transmitters on birds, mainly because GPS transmitters are too large for other external attachment techniques and implantation in the body cavity attenuates the GPS signal. Thus, to increase the size capacity of anchor attachment and to avoid the well-documented negative effects of harnesses on behavior and survival, we added a second anchor at the transmitter's posterior end. The double-anchor attachment technique was quickly and easily accomplished in the field, requiring bird handling times of <10 min. Incidental recoveries of tagged Brant indicate a high degree of transmitter retention. Five recaptured birds (4-6 weeks after deployment) and eight killed by hunters (3-6 mo after deployment) retained their GPS transmitters. For studies involving the use of relatively large transmitters, the double-anchor method appears to provide a viable alternative for external attachment. ?? 2008 Association of Field Ornithologists.

  20. The Effect of Subcutaneous Fat on Electrical Impedance Myography: Electrode Configuration and Multi-Frequency Analyses.

    PubMed

    Li, Le; Li, Xiaoyan; Hu, Huijing; Shin, Henry; Zhou, Ping

    2016-01-01

    This study investigates the impact of the subcutaneous fat layer (SFL) thickness on localized electrical impedance myography (EIM), as well as the effects of different current electrodes, varying in distance and direction, on EIM output. Twenty-three healthy subjects underwent localized multi-frequency EIM on their biceps brachii muscles with a hand-held electrode array. The EIM measurements were recorded under three different configurations: wide (or outer) longitudinal configuration 6.8 cm, narrow (or inner) longitudinal configuration 4.5 cm, and narrow transverse configuration 4.5 cm. Ultrasound was applied to measure the SFL thickness. Coefficients of determination (R2) of three EIM variables (resistance, reactance, and phase) and SFL thickness were calculated. For the longitudinal configuration, the wide distance could reduce the effects of the subcutaneous fat when compared with the narrow distance, but a significant correlation still remained for all three EIM parameters. However, there was no significant correlation between SFL thickness and reactance in the transverse configuration (R2 = 0.0294, p = 0.434). Utilizing a ratio of 50kHz/100kHz phase was found to be able to help reduce the correlation with SFL thickness for all the three configurations. The findings indicate that the appropriate selection of the current electrode distance, direction and the multi-frequency phase ratio can reduce the impact of subcutaneous fat on EIM. These settings should be evaluated for future clinical studies using hand-held localized arrays to perform EIM. PMID:27227876

  1. IFN-gamma role in granuloma formation in experimental subcutaneous cysticercosis.

    PubMed

    Freitas, Aline A; Moura, Vânia B L; Irusta, Vicente R C; Vinaud, Marina C; Oliveira, Milton A P; Lino-Júnior, Ruy S

    2016-09-01

    Cysticercosis is an infection caused by the metacestode larval stage of Taenia parasites in tissues and elicits a host-parasite reaction in which the immune response may be decisive in the disease development. The aim of this study was to evaluate the role of IFNγ (IFN-gamma) in the experimental model of subcutaneous infection with Taenia crassiceps (T. crassiceps) cysticerci using IFNγ knockout mice. Male C57BL/6 and C57BL/6 KO IFNγ mice 8-12 weeks of age were inoculated with T. crassiceps cysticerci into the subcutaneous tissue of the dorsum. At 7 and 30 (acute phase), 60 and 90 (chronic phase) days post infection, animals from each group had their blood and the subcutaneous tissues collected for serologic and pathological studies. IFNγ and IL-4 were dosed and the histopathological analysis was performed. In the presence of IFNγ there was the establishment of a mixed Th1/Th2 systemic immune profile. This profile also locally induced the granuloma formation which was constituted by cells that played important roles in the parasitary destruction and that were likely associated to the Th1 axis of mixed immune response. On the other hand, the absence of IFNγ appears to favor the parasitary growth which may be related to the development of a systemic Th2 immune response. This profile influenced the granuloma formation with immunoregulatory properties and appears to be important in the collagen synthesis. PMID:27334396

  2. Subcutaneous granuloma annulare of the scalp in childhood: a case report and review of the literature.

    PubMed

    Sabuncuoğlu, Hakan; Oge, Kamil; Söylemezoğlu, Figen; Sağlam, Arzu

    2007-01-01

    Granuloma annulare is a benign inflammatory skin lesion of unknown etiology that is usually seen in adults and children and subtypes of it includes localized granuloma annulare, generalized granuloma annulare, subcutaneous granuloma annulare and arcuate dermal erythema. Etiology and pathogenesis of granuloma annulare are obscure, although there is much evidence for an immunologic mechanism. Precipitating factors are insect bites, sunburn, photochemotherapy, drugs, physical trauma, acute phlebitis and sepsis after surgery. Some investigators were suggested a relationship of granuloma annulare to a latent or clinically manifest diabetes or rheumatoid arthritis. In contrast, an association of subcutaneous granuloma annulare with these diseases in childhood has not been reported in the literature. Subcutaneous granuloma annulare of the scalp is rare lesion in childhood and nodules on the scalp are usually non-, or slightly mobile, whereas lesions on the extremities are freely mobile. For definitive diagnosis, a biopsy should be performed but wide surgical intervention or medical treatment is not indicated. In case of recurrence, no additional diagnostic studies are necessary. PMID:17918673

  3. Pharmacokinetics and milk penetration of orbifloxacin after intravenous, subcutaneous, and intramuscular administration to lactating goats.

    PubMed

    Marín, P; Escudero, E; Fernández-Varón, E; Cárceles, C M

    2007-09-01

    The single-dose disposition kinetics of orbifloxacin were determined in clinically normal lactating goats (n = 6) after intravenous, subcutaneous, and intramuscular administration of 2.5 mg of orbifloxacin/kg of body weight. Orbifloxacin concentrations were determined by HPLC with fluorescence detection. The concentration-time data were analyzed by compartmental and noncompartmental kinetic methods. Steady-state volume of distribution and clearance of orbifloxacin after intravenous administration were 1.13 +/- 0.08 L/kg and 0.40 +/- 0.11 L/h x kg, respectively. Following subcutaneous and intramuscular administration, orbifloxacin achieved maximum plasma concentrations of 1.85 +/- 0.20 and 1.66 +/- 0.14 mg/L at 1.25 +/- 0.22 and 0.87 +/- 0.38 h, respectively. The absolute bioavailabilities after subcutaneous and intramuscular routes were 108.96 +/- 17.61% and 105.01 +/- 15.61%, respectively. Orbifloxacin penetration from the blood into the milk was rapid and showed high levels of concentrations in milk secretion. From this data, orbifloxacin could have success against susceptible mastitis pathogens in goats.

  4. Expression of ceramide-metabolising enzymes in subcutaneous and intra-abdominal human adipose tissue

    PubMed Central

    2012-01-01

    Background Inflammation and increased ceramide concentrations characterise adipose tissue of obese women with high liver fat content compared to equally obese women with normal liver fat content. The present study characterises enzymes involved in ceramide metabolism in subcutaneous and intra-abdominal adipose tissue. Methods Pathways leading to increased ceramide concentrations in inflamed versus non-inflamed adipose tissue were investigated by quantifying expression levels of key enzymes involved in ceramide metabolism. Sphingomyelinases (sphingomyelin phosphodiesterases SMPD1-3) were investigated further using immunohistochemistry to establish their location within adipose tissue, and their mRNA expression levels were determined in subcutaneous and intra-abdominal adipose tissue from both non-obese and obese subject. Results Gene expression levels of sphingomyelinases, enzymes that hydrolyse sphingomyelin to ceramide, rather than enzymes involved in de novo ceramide synthesis, were higher in inflamed compared to non-inflamed adipose tissue of obese women (with high and normal liver fat contents respectively). Sphingomyelinases were localised to both macrophages and adipocytes, but also to blood vessels and to extracellular regions surrounding vessels within adipose tissue. Expression levels of SMPD3 mRNA correlated significantly with concentrations of different ceramides and sphingomyelins. In both non-obese and obese subjects SMPD3 mRNA levels were higher in the more inflamed intra-abdominal compared to the subcutaneous adipose tissue depot. Conclusions Generation of ceramides within adipose tissue as a result of sphingomyelinase action may contribute to inflammation in human adipose tissue. PMID:22974251

  5. Detection of canine skin and subcutaneous tumors by visible and near-infrared diffuse reflectance spectroscopy

    NASA Astrophysics Data System (ADS)

    Cugmas, Blaž; Plavec, Tanja; Bregar, Maksimilijan; Naglič, Peter; Pernuš, Franjo; Likar, Boštjan; Bürmen, Miran

    2015-03-01

    Cancer is the main cause of canine morbidity and mortality. The existing evaluation of tumors requires an experienced veterinarian and usually includes invasive procedures (e.g., fine-needle aspiration) that can be unpleasant for the dog and the owner. We investigate visible and near-infrared diffuse reflectance spectroscopy (DRS) as a noninvasive optical technique for evaluation and detection of canine skin and subcutaneous tumors ex vivo and in vivo. The optical properties of tumors and skin were calculated in a spectrally constrained manner, using a lookup table-based inverse model. The obtained optical properties were analyzed and compared among different tumor groups. The calculated parameters of the absorption and reduced scattering coefficients were subsequently used for detection of malignant skin and subcutaneous tumors. The detection sensitivity and specificity of malignant tumors ex vivo were 90.0% and 73.5%, respectively, while corresponding detection sensitivity and specificity of malignant tumors in vivo were 88.4% and 54.6%, respectively. The obtained results show that the DRS is a promising noninvasive optical technique for detection and classification of malignant and benign canine skin and subcutaneous tumors. The method should be further investigated on tumors with common origin.

  6. Effect of hydrogen injected subcutaneously on testicular tissues of rats exposed to cigarette smoke

    PubMed Central

    Chen, Song; Jiang, Wei

    2015-01-01

    Smoking is one of the most common reasons inducing reactive oxygen species in semen. High concentration of active oxygen will cause decrease of sperm density and viability and induce oxidative injury of sperm DNA which has become the hot spot in male infertility. Although hydrogen was found to be an effective remover of active oxygen in liver, heart, kidney and brain, the same effect has not been discussed in reproductive system. The aim of this study was to investigate the protective effect of hydrogen against cigarette smoke-induced damage in rat reproductive system. Adult male Wistar rats were randomly divided into four groups to conduct this experiment, results showed that rats in SK+HSI group (passive smoking and hydrogen subcutaneous injection group) exhibited larger amount of sperm count, smaller sperm deformation rate, higher levels of testosterone and SOD in serum and testis, lower levels of MDA in testis and less morphologic abnormalities compared to SK+NSI group (passive smoking and nitrogen subcutaneous injection group). As a consequence, we concluded that injected subcutaneously exerted protective effects on reproductive system injury of male rats exposed to cigarette smoke through inhibiting oxidative damage. PMID:26131139

  7. Familial lipoprotein lipase-activity deficiency: study of total body fatness and subcutaneous fat tissue distribution.

    PubMed

    Brun, L D; Gagné, C; Julien, P; Tremblay, A; Moorjani, S; Bouchard, C; Lupien, P J

    1989-10-01

    Total body fatness and subcutaneous fat tissue distribution were evaluated in 19 hyperchylomicronemic patients. Eleven were males, aged 10 to 57 years, and eight were females, aged 13 to 46 years. Familial lipoprotein-lipase-activity deficiency was diagnosed by the absence of lipoprotein-lipase activity in the plasma withdrawn ten and 20 minutes after intravenous injection of ten units of heparin per kilogram of body weight. The 19 patients had skin-fold measurements for evaluation of subcutaneous fat distribution. Fifteen also underwent body density measurements by underwater weighing. Percent body fat was calculated from body density. These anthropometric data were plotted against the regression curves of 1638 normal controls of both sexes (aged 10 to 54 years) for fat tissue weight, percent body fat, subcutaneous fat/total fat mass ratio and trunk/extremity skin-fold ratio. Impairments in the process of building fat tissue reserves could not be shown in the 19 hyperchylomicronemic patients, in spite of the absence of lipoprotein-lipase activity in their postheparin plasma. It is hypothesized that normal fat tissue mass in these patients could be due partly to de novo synthesis of fatty acids by adipocytes, hydrolysis of plasma triglycerides by hepatic lipase, and/or contribution of a specific fat-tissue lipase to the catabolism of plasma triglyceride-rich lipoproteins.

  8. Biocompatibility of a calcium hydroxide-propolis experimental paste in rat subcutaneous tissue.

    PubMed

    Mori, Graziela Garrido; Rodrigues, Sindineia da Silva; Shibayama, Sheila Tieko; Pomini, Marcelo; do Amaral, Cristhiane Olivia Ferreira

    2014-01-01

    Intracanal medications are fundamental for disinfection of the root canal system and participate in periapical repair, so their biocompatibility is of utmost importance to avoid tissue damage. This study evaluated the biocompatibility of a experimental paste of calcium hydroxide and propolis in the subcutaneous tissue of rats. The study was conducted on 15 male Wistar rats. Two incisions were made on the dorsal region of each animal for introduction of 4 tubes: one tube was empty; one contained zinc oxide-eugenol cement, and the two other tubes were filled with experimental paste. After 7, 14 and 30 days, the animals were euthanized and the specimens were subjected to histotechnical preparation. The hematoxylin and eosin-stained histological sections were analyzed by light microscopy. Scores were established according to the inflammatory process and statistically compared by the Tukey test (α = 5%). The analysis of histological sections showed non-significant or mild inflammatory reaction in the connective tissue in contact with the empty tubes in all study periods while the contact of subcutaneous tissue with zinc oxide-eugenol elicited moderate or severe inflammation similarly without significant difference among the study periods. The connective tissue was moderately inflamed at 7 days when contacting the experimental paste, but the inflammatory process was non-significant or mild at 14 and 30 days. The experimental paste was biocompatible with the tissues after 14 days of subcutaneous implantation.

  9. An abnormal lymphatic phenotype is associated with subcutaneous adipose tissue deposits in Dercum’s disease

    PubMed Central

    Rasmussen, John C.; Herbst, Karen L.; Aldrich, Melissa B.; Darne, Chinmay D.; Tan, I-Chih; Zhu, Banghe; Guilliod, Renie; Fife, Caroline A.; Maus, Erik A.; Sevick-Muraca, Eva M.

    2014-01-01

    Objective Investigational, near-infrared fluorescence (NIRF) lymphatic imaging was used to assess lymphatic architecture and contractile function in participants diagnosed with Dercum’s disease, a rare, poorly understood disorder characterized by painful lipomas in subcutaneous adipose tissues. Design and Methods After informed consent and as part of an FDA-approved feasibility study to evaluate lymphatics in diseases in which their contribution has been implicated, three women diagnosed with Dercum’s disease and four control subjects were imaged. Each participant received multiple intradermal and subcutaneous injections of indocyanine green (ICG, total dose ≤400µg) in arms, legs, and/or trunk. Immediately after injection, ICG was taken up by the lymphatics and NIRF imaging was conducted. Results The lymphatics in the participants with Dercum’s disease were intact and dilated, yet sluggishly propelled lymph when compared to control lymphatics. Palpation of regions containing fluorescent lymphatic pathways revealed tender, fibrotic, tubular structures within the subcutaneous adipose tissue that were associated with painful nodules, and, in some cases, masses of fluorescent tissue indicating that some lipomas may represent tertiary lymphoid tissues. Conclusions These data support the hypothesis that Dercum’s disease may be a lymphovascular disorder and suggest a possible association between abnormal adipose tissue deposition and abnormal lymphatic structure and function. PMID:25044620

  10. Prevention of fatty liver in transition dairy cows by subcutaneous injections of glucagon.

    PubMed

    Nafikov, R A; Ametaj, B N; Bobe, G; Koehler, K J; Young, J W; Beitz, D C

    2006-05-01

    The main objective of this study was to test the extent to which injecting glucagon subcutaneously for 14 d beginning at d 2 postpartum would prevent fatty liver development in transition dairy cows. Twenty-four multiparous Holstein cows were fed 6 kg of cracked corn in addition to their standard diet during the last 30 d of a dry period to induce postpartum development of fatty liver. Glucagon at either 7.5 or 15 mg/d or saline (control) was injected subcutaneously 3 times daily for 14 d beginning at d 2 postpartum. Glucagon at 15 mg/ d prevented liver triacylglycerol accumulation in postpartum dairy cows. Glucagon at 7.5 mg/d showed potential for fatty liver prevention. Glucagon increased concentration of plasma glucose and insulin and decreased plasma nonesterified fatty acid concentrations. No effects of glucagon were detected on plasma beta-hydroxybutyrate concentrations. Glucagon affected neither feed intake nor milk production. Moreover, milk composition was not altered by glucagon. Milk urea N concentrations decreased, and plasma urea N concentrations tended to decrease during glucagon administration, indicating that glucagon may improve protein use. Liver glycogen concentrations were not affected by glucagon. No significant differences in body condition scores were detected among treatments throughout the study. These results indicate that subcutaneous glucagon injections can prevent fatty liver in transition dairy cows without causing major production and metabolite disturbances.

  11. [Subcutaneous Taenia crassiceps-cysticercosis in a dog with Cushing's syndrome].

    PubMed

    Nolte, A; Strube, C; Raue, K; Brämer, C; Baumgärtner, W; Wohlsein, P

    2016-01-01

    A male, 12-year-old Cairn terrier suffering from Cushing's syndrome with two therapy-resistant inflammatory subcutaneous lesions was examined pathomorphologically and parasitologically. Within the subcutaneous tissue, there was a suppurative to necrotizing and histiocytic inflammation present with the formation of caverns. Intralesional whitish-grey cysts with a diameter of 1-4 mm were detected. Molecular investigations of the cysts confirmed the preliminary morphological identification as Cysticercus longicollis. The adenohypophysis showed an infiltrative growing carcinoma. Cysticercus longicollis is the metacestode of Taenia (T.) crassiceps, a tapeworm of foxes and coyotes. Small rodents are typical intermediate hosts, in which the metacestode develops within the body cavities as well as in the subcutis. Subcutaneous cysticercosis after infection with eggs of T. crassiceps is also described in different domestic animal species and in humans, who represent aberrant intermediate hosts. Immunosuppression due to Cushing's syndrome, probably caused by the tumor of the adenohypophysis, may have played a role in the pathogenesis of the present case. PMID:26763526

  12. Using shared needles for subcutaneous inoculation can transmit bluetongue virus mechanically between ruminant hosts.

    PubMed

    Darpel, Karin E; Barber, James; Hope, Andrew; Wilson, Anthony J; Gubbins, Simon; Henstock, Mark; Frost, Lorraine; Batten, Carrie; Veronesi, Eva; Moffat, Katy; Carpenter, Simon; Oura, Chris; Mellor, Philip S; Mertens, Peter P C

    2016-01-01

    Bluetongue virus (BTV) is an economically important arbovirus of ruminants that is transmitted by Culicoides spp. biting midges. BTV infection of ruminants results in a high viraemia, suggesting that repeated sharing of needles between animals could result in its iatrogenic transmission. Studies defining the risk of iatrogenic transmission of blood-borne pathogens by less invasive routes, such as subcutaneous or intradermal inoculations are rare, even though the sharing of needles is common practice for these inoculation routes in the veterinary sector. Here we demonstrate that BTV can be transmitted by needle sharing during subcutaneous inoculation, despite the absence of visible blood contamination of the needles. The incubation period, measured from sharing of needles, to detection of BTV in the recipient sheep or cattle, was substantially longer than has previously been reported after experimental infection of ruminants by either direct inoculation of virus, or through blood feeding by infected Culicoides. Although such mechanical transmission is most likely rare under field condition, these results are likely to influence future advice given in relation to sharing needles during veterinary vaccination campaigns and will also be of interest for the public health sector considering the risk of pathogen transmission during subcutaneous inoculations with re-used needles. PMID:26853457

  13. Vascularized subcutaneous human liver tissue from engineered hepatocyte/fibroblast sheets in mice.

    PubMed

    Sakai, Yusuke; Yamanouchi, Kosho; Ohashi, Kazuo; Koike, Makiko; Utoh, Rie; Hasegawa, Hideko; Muraoka, Izumi; Suematsu, Takashi; Soyama, Akihiko; Hidaka, Masaaki; Takatsuki, Mitsuhisa; Kuroki, Tamotsu; Eguchi, Susumu

    2015-10-01

    Subcutaneous liver tissue engineering is an attractive and minimally invasive approach used to curative treat hepatic failure and inherited liver diseases. However, graft failure occurs frequently due to insufficient infiltration of blood vessels (neoangiogenesis), while the maintenance of hepatocyte phenotype and function requires in vivo development of the complex cellular organization of the hepatic lobule. Here we describe a subcutaneous human liver construction allowing for rapidly vascularized grafts by transplanting engineered cellular sheets consisting of human primary hepatocytes adhered onto a fibroblast layer. The engineered hepatocyte/fibroblast sheets (EHFSs) showed superior expression levels of vascularization-associated growth factors (vascular endothelial growth factor, transforming growth factor beta 1, and hepatocyte growth factor) in vitro. EHFSs developed into vascularized subcutaneous human liver tissues contained glycogen stores, synthesized coagulation factor IX, and showed significantly higher synthesis rates of liver-specific proteins (albumin and alpha 1 anti-trypsin) in vivo than tissues from hepatocyte-only sheets. The present study describes a new approach for vascularized human liver organogenesis under mouse skin. This approach could prove valuable for establishing novel cell therapies for liver diseases.

  14. Assessment of the interstitial fluid in the subcutaneous tissue of healthy adults using ultrasonography

    PubMed Central

    Ueda-Iuchi, Terumi; Ohno, Naoki; Miyati, Tosiaki; Dai, Misako; Okuwa, Mayumi; Nakatani, Toshio; Sanada, Hiromi; Sugama, Junko

    2015-01-01

    Objective: Lymphoedema involves swelling, especially in the subcutaneous tissues. For lymphoedema management to be successful, it is necessary to remove the interstitial fluid. Subcutaneous echogenicity may be associated with interstitial fluid, but echogenicity is not an indicator for the evaluation of management because we do not directly compare echogenicity with the interstitial fluid. We aimed to identify an outcome indicator for the evaluation of interstitial fluid using ultrasonography. We assessed the correlation between echogenicity and transverse relaxation rate (R2) on magnetic resonance imaging. Methods: This was an observational study. Healthy adults with leg swelling after activity for >8 h were recruited. The legs of 13 women were evaluated using ultrasonography, magnetic resonance imaging and measurements of the limb circumference before and after an intervention to reduce the swelling. Results: Echogenicity in the oedema group was greater than that of the controls. Echogenicity decreased with reductions in oedema. The range of the strongest correlations with the changes in R2 occurred at echogenicity values of 48–144 (Pearson’s correlation coefficient: r = −0.63 and p < 0.01). Thus, it was possible to evaluate the interstitial fluid using echogenicity. Conclusion: The outcome indicators for the evaluation of interstitial fluid using ultrasonography were echogenicities in the range of 48–144, and these values were valid for assessing the interstitial fluid in the subcutaneous tissue. PMID:27092255

  15. Laser device

    DOEpatents

    Scott, Jill R.; Tremblay, Paul L.

    2004-11-23

    A laser device includes a target position, an optical component separated a distance J from the target position, and a laser energy source separated a distance H from the optical component, distance H being greater than distance J. A laser source manipulation mechanism exhibits a mechanical resolution of positioning the laser source. The mechanical resolution is less than a spatial resolution of laser energy at the target position as directed through the optical component. A vertical and a lateral index that intersect at an origin can be defined for the optical component. The manipulation mechanism can auto align laser aim through the origin during laser source motion. The laser source manipulation mechanism can include a mechanical index. The mechanical index can include a pivot point for laser source lateral motion and a reference point for laser source vertical motion. The target position can be located within an adverse environment including at least one of a high magnetic field, a vacuum system, a high pressure system, and a hazardous zone. The laser source and an electro-mechanical part of the manipulation mechanism can be located outside the adverse environment. The manipulation mechanism can include a Peaucellier linkage.

  16. Laser device

    DOEpatents

    Scott, Jill R.; Tremblay, Paul L.

    2007-07-10

    A laser device includes a target position, an optical component separated a distance J from the target position, and a laser energy source separated a distance H from the optical component, distance H being greater than distance J. A laser source manipulation mechanism exhibits a mechanical resolution of positioning the laser source. The mechanical resolution is less than a spatial resolution of laser energy at the target position as directed through the optical component. A vertical and a lateral index that intersect at an origin can be defined for the optical component. The manipulation mechanism can auto align laser aim through the origin during laser source motion. The laser source manipulation mechanism can include a mechanical index. The mechanical index can include a pivot point for laser source lateral motion and a reference point for laser source vertical motion. The target position can be located within an adverse environment including at least one of a high magnetic field, a vacuum system, a high pressure system, and a hazardous zone. The laser source and an electro-mechanical part of the manipulation mechanism can be located outside the adverse environment. The manipulation mechanism can include a Peaucellier linkage.

  17. Sumatriptan (subcutaneous route of administration) for acute migraine attacks in adults

    PubMed Central

    Derry, Christopher J; Derry, Sheena; Moore, R Andrew

    2014-01-01

    Background Migraine is a highly disabling condition for the individual and also has wide-reaching implications for society, healthcare services, and the economy. Sumatriptan is an abortive medication for migraine attacks, belonging to the triptan family. Subcutaneous administration may be preferable to oral for individuals experiencing nausea and/or vomiting Objectives To determine the efficacy and tolerability of subcutaneous sumatriptan compared to placebo and other active interventions in the treatment of acute migraine attacks in adults. Search methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, online databases, and reference lists for studies through 13 October 2011. Selection criteria We included randomised, double-blind, placebo- and/or active-controlled studies using subcutaneous sumatriptan to treat a migraine headache episode, with at least 10 participants per treatment arm. Data collection and analysis Two review authors independently assessed trial quality and extracted data. We used numbers of participants achieving each outcome to calculate relative risk (or ‘risk ratio’) and numbers needed to treat to benefit (NNT) or harm (NNH) compared to placebo or a different active treatment. Main results Thirty-five studies (9365 participants) compared subcutaneous sumatriptan with placebo or an active comparator. Most of the data were for the 6 mg dose. Sumatriptan surpassed placebo for all efficacy outcomes. For sumatriptan 6 mg versus placebo the NNTs were 2.9, 2.3, 2.2, and 2.1 for pain-free at one and two hours, and headache relief at one and two hours, respectively, and 6.1 for sustained pain-free at 24 hours. Results for the 4 mg and 8 mg doses were similar to the 6 mg dose, with 6 mg significantly better than 4 mg only for pain-free at one hour, and 8 mg significantly better than 6 mg only for headache relief at one hour. There was no evidence of increased migraine relief if a second dose of sumatriptan 6

  18. Telomere length differences between subcutaneous and visceral adipose tissue in humans

    SciTech Connect

    Lakowa, Nicole; Trieu, Nhu; Flehmig, Gesine; Lohmann, Tobias; Schön, Michael R.; Dietrich, Arne; Zeplin, Philip Helge; Langer, Stefan; Stumvoll, Michael; Blüher, Matthias; Klöting, Nora

    2015-02-13

    Adipocyte hypertrophy and hyperplasia have been shown to be associated with shorter telomere length, which may reflect aging, altered cell proliferation and adipose tissue (AT) dysfunction. In individuals with obesity, differences in fat distribution and AT cellular composition may contribute to obesity related metabolic diseases. Here, we tested the hypotheses that telomere lengths (TL) are different between: (1) abdominal subcutaneous and omental fat depots, (2) superficial and deep abdominal subcutaneous AT (SAT), and (3) adipocytes and cells of the stromal vascular fraction (SVF). We further asked whether AT TL is related to age, anthropometric and metabolic traits. TL was analyzed by quantitative PCR in total human genomic DNA isolated from paired subcutaneous and visceral AT of 47 lean and 50 obese individuals. In subgroups, we analyzed TL in isolated small and large adipocytes and SVF cells. We find significantly shorter TL in subcutaneous compared to visceral AT (P < 0.001) which is consistent in men and subgroups of lean and obese, and individuals with or without type 2 diabetes (T2D). Shorter TL in SAT is entirely due to shorter TL in the SVF compared to visceral AT (P < 0.01). SAT TL is most strongly correlated with age (r = −0.205, P < 0.05) and independently of age with HbA1c (r = −0.5, P < 0.05). We found significant TL differences between superficial SAT of lean and obese as well as between individuals with our without T2D, but not between the two layers of SAT. Our data indicate that fat depot differences in TL mainly reflect shorter TL of SVF cells. In addition, we found an age and BMI-independent relationship between shorter TL and HbA1c suggesting that chronic hyperglycemia may impair the regenerative capacity of AT more strongly than obesity alone. - Highlights: • Telomere lengths (TL) differ between fat depots mainly due to different lengths in SVF. • TL is not associated with gender, BMI and T2D. • The tendency for

  19. Medical devices: US medical device regulation.

    PubMed

    Jarow, Jonathan P; Baxley, John H

    2015-03-01

    Medical devices are regulated by the US Food and Drug Administration (FDA) within the Center for Devices and Radiological Health. Center for Devices and Radiological Health is responsible for protecting and promoting the public health by ensuring the safety, effectiveness, and quality of medical devices, ensuring the safety of radiation-emitting products, fostering innovation, and providing the public with accurate, science-based information about the products we oversee, throughout the total product life cycle. The FDA was granted the authority to regulate the manufacturing and marketing of medical devices in 1976. It does not regulate the practice of medicine. Devices are classified based on complexity and level of risk, and "pre-1976" devices were allowed to remain on the market after being classified without FDA review. Post-1976 devices of lower complexity and risk that are substantially equivalent to a marketed "predicate" device may be cleared through the 510(k) premarket notification process. Clinical data are typically not needed for 510(k) clearance. In contrast, higher-risk devices typically require premarket approval. Premarket approval applications must contain data demonstrating reasonable assurance of safety and efficacy, and this information typically includes clinical data. For novel devices that are not high risk, the de novo process allows FDA to simultaneously review and classify new devices. Devices that are not legally marketed are permitted to be used for clinical investigation purposes in the United States under the Investigational Device Exemptions regulation.

  20. Subcutaneous versus intravenous administration of heparin in the treatment of deep vein thrombosis; which do patients prefer? A randomized cross-over study.

    PubMed

    Robinson, A M; McLean, K A; Greaves, M; Channer, K S

    1993-02-01

    Patient preference for intravenous or subcutaneous heparin in the treatment of deep venous thrombosis was assessed in a randomized cross-over study. Twenty patients with venographically proven deep venous thrombosis were randomized to receive subcutaneous or intravenous heparin for 3 days followed by 3 days of the other treatment. Discomfort at the injection site, assessed by visual analogue scale, was significantly less for the subcutaneous than the intravenous administration route (P < 0.001), mobility was thought to be better when receiving subcutaneous heparin (P < 0.005) and patients' overall preference was for subcutaneous treatment (P < 0.001). PMID:8506190

  1. Subcutaneous administration of muscarinic antagonists and triple-immunostaining of the levator auris longus muscle in mice.

    PubMed

    Wright, Megan; Kim, Amy; Son, Young-Jin

    2011-09-08

    Hind limb muscles of rodents, such as gastrocnemius and tibialis anterior, are frequently used for in vivo pharmacological studies of the signals essential for the formation and maintenance of mammalian NMJs. However, drug penetration into these muscles after subcutaneous or intramuscular administration is often incomplete or uneven and many NMJs can remain unaffected. Although systemic administration with devices such as mini-pumps can improve the spatiotemporal effects, the invasive nature of this approach can cause confounding inflammatory responses and/or direct muscle damage. Moreover, complete analysis of the NMJs in a hind limb muscle is challenging because it requires time-consuming serial sectioning and extensive immunostaining. The mouse LAL is a thin, flat sheet of muscle located superficially on the dorsum of the neck. It is a fast-twitch muscle that functions to move the pinna. It contains rostral and caudal portions that originate from the midline of the cranium and extend laterally to the cartilaginous portion of each pinna. The muscle is supplied by a branch of the facial nerve that projects caudally as it exits the stylomastoid foramen. We and others have found LAL to be a convenient preparation that offers advantages for the investigation of both short and long-term in vivo effects of drugs on NMJs and muscles. First, its superficial location facilitates multiple local applications of drugs under light anesthesia. Second, its thinness (2-3 layers of muscle fibers) permits visualization and analysis of almost all the NMJs within the muscle. Third, the ease of dissecting it with its nerve intact together with the pattern of its innervation permits supplementary electrophysiological analysis in vitro. Last, and perhaps most importantly, a small applied volume (-50 μl) easily covers the entire muscle surface, provides a uniform and prolonged exposure of all its NMJs to the drug and eliminates the need for a systemic approach.

  2. Plasma insulin profiles after subcutaneous injection: how close can we get to physiology in people with diabetes?

    PubMed

    Home, P D

    2015-11-01

    Many people with diabetes rely on insulin therapy to achieve optimal blood glucose control. A fundamental aim of such therapy is to mimic the pattern of 'normal' physiological insulin secretion, thereby controlling basal and meal-time plasma glucose and fatty acid turnover. In people without diabetes, insulin release is modulated on a time base of 3-10 min, something that is impossible to replicate without intravascular glucose sensing and insulin delivery. Overnight physiological insulin delivery by islet β cells is unchanging, in contrast to requirements once any degree of hyperglycaemia occurs, when diurnal influences are evident. Subcutaneous pumped insulin or injected insulin analogues can approach the physiological profile, but there remains the challenge of responding to day-to-day changes in insulin sensitivity. Physiologically, meal-time insulin release begins rapidly in response to reflex activity and incretins, continuing with the rise in glucose and amino acid concentrations. This rapid response reflects the need to fill the insulin space with maximum concentration as early as 30 min after starting the meal. Current meal-time insulins, by contrast, are associated with a delay after injection before absorption begins, and a delay to peak because of tissue diffusion. While decay from peak for monomeric analogues is not dissimilar to average physiological needs, changes in meal type and, again, in day-to-day insulin sensitivity, are difficult to match. Recent and current developments in insulin depot technology are moving towards establishing flatter basal and closer-to-average physiological meal-time plasma insulin profiles. The present article discusses the ideal physiological insulin profile, how this can be met by available and future insulin therapies and devices, and the challenges faced by healthcare professionals and people with diabetes in trying to achieve an optimum plasma insulin profile. PMID:26041603

  3. Tolerability of Velcade (Bortezomib) subcutaneous administration using a maximum volume of 3 mL per injection site.

    PubMed

    Ng, Pamela; Incekol, Diana; Lee, Roy; Paisley, Emma; Dara, Celina; Brandle, Ian; Kaufman, Marina; Chen, Christine; Trudel, Suzanne; Tiedemann, Rodger; Reece, Donna; Kukreti, Vishal

    2015-08-01

    Subcutaneous injection is now commonly used as a standard for bortezomib administration. The bortezomib (Velcade(®)) product monograph recommends that intravenous injections be prepared at a concentration of 1 mg/mL, while subcutaneous injections may be prepared at a concentration of 2.5 mg/mL. Many institutions and subcutaneous administration guidelines use 2 mL as the maximum volume for subcutaneous injection. Using 2 mL as the maximum volume for injection would mean that many patients receiving bortezomib will receive two injections during each visit with common dosing parameters. In this prospective study evaluating a change to subcutaneous administration, bortezomib 1 mg/mL was administered subcutaneously at a higher maximum of 3 mL per injection site. For 57 individual patients, 339 doses were administered. Skin reactions were noted in 42% with all reactions being Grade 1 or 2. Patients tolerated subcutaneous injections well and only four patients were switched back to intravenous route. This is the first time that subcutaneous bortezomib of a volume up to a maximum of 3 mL (bortezomib 3 mg) per injection site has been reported. This higher single dose is well tolerated with limited skin reactions, no significant hypotension and facilitates ease of administration with only 5 patients needing two injections per visit. If the maximum volume for injection was kept at 2 mL, a total of 46 patients would have received two injections per visit.

  4. Comparison of Stromal/Stem Cells Isolated from Human Omental and Subcutaneous Adipose Depots: Differentiation and Immunophenotypic Characterization.

    PubMed

    Shah, Forum S; Li, Jie; Dietrich, Marilyn; Wu, Xiying; Hausmann, Mark G; LeBlanc, Karl A; Wade, James W; Gimble, Jeffrey M

    2014-01-01

    The emerging field of regenerative medicine has identified adipose tissue as an abundant source of stromal/stem cells for tissue engineering applications. Therefore, we have compared the differentiation and immunophenotypic features of adipose-derived stromal/stem cells (ASC) isolated from either omental or subcutaneous adipose depots. Human tissue samples were obtained from bariatric and plastic surgical practices at a university-affiliated teaching hospital and a private practice, respectively, with informed patient consent. Primary cultures of human ASC were isolated from adipose specimens within 24 h of surgery and culture expanded in vitro. The passaged ASC were induced to undergo adipogenic or osteogenic differentiation as assessed by histochemical methods or evaluated for surface antigen expression profiles by flow cytometry. ASC yields per unit weight of tissue were comparable between omental and subcutaneous depots. At passage 0, the immunophenotype of omental and subcutaneous ASC were not significantly different with the exception of CD105 and endoglin, a component of the transforming growth factor β receptor. The adipogenic differentiation of omental ASC was less robust than that of subcutaneous ASC based on in vitro histochemical and PCR assays. Although the yield and immunophenotype of ASC from omental adipose depots resembled that of subcutaneous ASC, omental ASC displayed significantly reduced adipogenic differentiation capacity following chemical induction. Further studies are necessary to evaluate and optimize the differentiation function of omental ASC in vitro and in vivo. Pending such analyses, omental ASC should not be used interchangeably with subcutaneous ASC for regenerative medical applications. PMID:26089088

  5. Connector device for building integrated photovoltaic device

    DOEpatents

    Keenihan, James R.; Langmaid, Joe A.; Eurich, Gerald K.; Lesniak, Michael J.; Mazor, Michael H.; Cleerman, Robert J.; Gaston, Ryan S.

    2015-11-10

    The present invention is premised upon a connector device and method that can more easily electrically connect a plurality of PV devices or photovoltaic system components and/or locate these devices/components upon a building structure. It also may optionally provide some additional sub-components (e.g. at least one bypass diode and/or an indicator means) and may enhance the serviceability of the device.

  6. Connector device for building integrated photovoltaic device

    DOEpatents

    Keenihan, James R.; Langmaid, Joseph A.; Eurich, Gerald K.; Lesniak, Michael J.; Mazor, Michael H.; Cleereman, Robert J.; Gaston, Ryan S.

    2014-06-03

    The present invention is premised upon a connector device and method that can more easily electrically connect a plurality of PV devices or photovoltaic system components and/or locate these devices/components upon a building structure. It also may optionally provide some additional sub-components (e.g. at least one bypass diode and/or an indicator means) and may enhance the serviceability of the device.

  7. Aluminium in allergen-specific subcutaneous immunotherapy--a German perspective.

    PubMed

    Kramer, Matthias F; Heath, Matthew D

    2014-07-16

    We are living in an "aluminium age" with increasing bioavailability of the metal for approximately 125 years, contributing significantly to the aluminium body burden of humans. Over the course of life, aluminium accumulates and is stored predominantly in the lungs, bones, liver, kidneys and brain. The toxicity of aluminium in humans is briefly summarised, highlighting links and possible causal relationships between a high aluminium body burden and a number of neurological disorders and disease states. Aluminium salts have been used as depot-adjuvants successfully in essential prophylactic vaccinations for almost 100 years, with a convincing positive benefit-risk assessment which remains unchanged. However, allergen-specific immunotherapy commonly consists of administering a long-course programme of subcutaneous injections using preparations of relevant allergens. Regulatory authorities currently set aluminium limits for vaccines per dose, rather than per treatment course. Unlike prophylactic vaccinations, numerous injections with higher proportions of aluminium-adjuvant per injection are applied in subcutaneous immunotherapy (SCIT) and will significantly contribute to a higher cumulative life dose of aluminium. While the human body may cope robustly with a daily aluminium overload from the environment, regulatory cumulative threshold values in immunotherapy need further addressing. Based on the current literature, predisposing an individual to an unusually high level of aluminium, such as through subcutaneous immunotherapy, has the potential to form focal accumulations in the body with the propensity to exert forms of toxicity. Particularly in relation to longer-term health effects, the safety of aluminium adjuvants in immunotherapy remains unchallenged by health authorities - evoking the need for more consideration, guidance, and transparency on what is known and not known about its safety in long-course therapy and what measures can be taken to prevent or

  8. Ultrarush schedule of subcutaneous immunotherapy with modified allergen extracts is safe in paediatric age

    PubMed Central

    Arêde, Cristina; Sampaio, Graça; Borrego, Luis Miguel

    2016-01-01

    Background Traditional subcutaneous immunotherapy up dosing with allergenic extracts has been shown to be associated with frequent adverse reactions. In recent studies it has been demonstrated that using modified extracts, namely allergoids, it is a safe and effective procedure particularly on accelerated schedules. However data assessing its safety in paediatric age is scarce. Objective To evaluate the safety profile in paediatric population of using modified allergen extracts, in an ultrarush schedule, to reach the maintenance dose in the first day. Methods We included children undergoing treatment with subcutaneous immunotherapy during a five-year period, using modified aeroallergen extracts, depigmented, polymerized with glutaraldehyde and adsorbed on aluminium hydroxide using an ultrarush induction phase. The type of adverse reactions during the ultrarush protocol was recorded. Results We studied 100 paediatric patients (57 males) with a mean age of 11.6 years (5 to 18 years; standard deviation, 3.3), all with moderate to severe persistent rhinitis, with or without allergic conjunctivitis, asthma and atopic eczema, sensitized to mites and/or pollens. All reached the maintenance dose of 0.5 mL in the first day, except 1 child. During the ultrarush protocol the total number of injections was 199. There were 21 local adverse reactions in 11 patients, 11 immediate and 10 delayed; from those, had clinical relevance 1 immediate and 4 delayed. Systemic reactions were recorded in 2 cases, both immediate and mild. Conclusion The ultrarush protocol, without premedication, was a safe alternative to be used in paediatric age during the induction phase of subcutaneous immunotherapy using allergoid depigmented extracts. PMID:26844218

  9. Aluminium in allergen-specific subcutaneous immunotherapy--a German perspective.

    PubMed

    Kramer, Matthias F; Heath, Matthew D

    2014-07-16

    We are living in an "aluminium age" with increasing bioavailability of the metal for approximately 125 years, contributing significantly to the aluminium body burden of humans. Over the course of life, aluminium accumulates and is stored predominantly in the lungs, bones, liver, kidneys and brain. The toxicity of aluminium in humans is briefly summarised, highlighting links and possible causal relationships between a high aluminium body burden and a number of neurological disorders and disease states. Aluminium salts have been used as depot-adjuvants successfully in essential prophylactic vaccinations for almost 100 years, with a convincing positive benefit-risk assessment which remains unchanged. However, allergen-specific immunotherapy commonly consists of administering a long-course programme of subcutaneous injections using preparations of relevant allergens. Regulatory authorities currently set aluminium limits for vaccines per dose, rather than per treatment course. Unlike prophylactic vaccinations, numerous injections with higher proportions of aluminium-adjuvant per injection are applied in subcutaneous immunotherapy (SCIT) and will significantly contribute to a higher cumulative life dose of aluminium. While the human body may cope robustly with a daily aluminium overload from the environment, regulatory cumulative threshold values in immunotherapy need further addressing. Based on the current literature, predisposing an individual to an unusually high level of aluminium, such as through subcutaneous immunotherapy, has the potential to form focal accumulations in the body with the propensity to exert forms of toxicity. Particularly in relation to longer-term health effects, the safety of aluminium adjuvants in immunotherapy remains unchallenged by health authorities - evoking the need for more consideration, guidance, and transparency on what is known and not known about its safety in long-course therapy and what measures can be taken to prevent or

  10. Role of hyaluronidase in subcutaneous spread and growth of group A streptococcus.

    PubMed

    Starr, Clarise Rivera; Engleberg, N Cary

    2006-01-01

    Group A streptococcus (GAS) depends on a hyaluronic acid (HA) capsule to evade phagocytosis and to interact with epithelial cells. Paradoxically, GAS also produces hyaluronidase (Hyl), an enzyme that cleaves HA. A common assumption is that Hyl digests structurally identical HA in human tissue to promote bacterial spread. We inactivated the gene encoding extracellular hyaluronidase, hylA, in a clinical Hyl(+) isolate. Hyl(+) and an isogenic Hyl(-) mutant were injected subcutaneously into mice with or without high-molecular-weight dextran blue. The Hyl(-) strain produced small lesions with dye concentrated in close proximity. The Hyl(+) strain produced identical lesions, but the dye diffused subcutaneously. However, Hyl(+) bacteria were not isolated from unaffected skin stained by dye diffusion. Thus, Hyl digests tissue HA and facilitates spread of large molecules but is not sufficient to cause subcutaneous diffusion of bacteria or to affect lesion size. GAS capsule expression was assayed periodically during broth culture and was reduced in Hyl(+) strains relative to Hyl(-) strains at the onset and the end of active capsule synthesis but not during peak synthesis in mid-exponential phase. Thus, Hyl is not sufficiently active to remove capsule during peak synthesis. To demonstrate a possible nutritional role for Hyl, GAS was shown to grow with N-acetylglucosamine but not d-glucuronic acid (both components of HA) as a sole carbon source. However, only Hyl(+) strains could grow utilizing HA as a sole carbon source, suggesting that Hyl may permit the organism to utilize host HA or its own capsule as an energy source.

  11. Chronic subcutaneous administration of kisspeptin-54 causes testicular degeneration in adult male rats.

    PubMed

    Thompson, Emily L; Murphy, Kevin G; Patterson, Michael; Bewick, Gavin A; Stamp, Gordon W H; Curtis, Annette E; Cooke, Jennifer H; Jethwa, Preeti H; Todd, Jeannie F; Ghatei, Mohammad A; Bloom, Stephen R

    2006-11-01

    The kisspeptins are KiSS-1 gene-derived peptides that signal through the G protein-coupled receptor-54 (GPR54) and have recently been shown to be critical regulators of reproduction. Acute intracerebroventricular or peripheral administration of kisspeptin stimulates the hypothalamic-pituitary-gonadal (HPG) axis. This effect is thought to be mediated via the hypothalamic gonadotropin-releasing hormone (GnRH) system. Chronic administration of GnRH agonists paradoxically suppresses the HPG axis after an initial agonistic stimulation. We investigated the effects of continuous peripheral kisspeptin administration in male rats by use of Alzet minipumps. Initially we compared the effects of acute subcutaneous administration of kisspeptin-10, -14, and -54 on the HPG axis. Kisspeptin-54 produced the greatest increase in plasma LH and total testosterone at 60 min postinjection and was used in the subsequent continuous administration experiments. Chronic subcutaneous long-term administration of 50 nmol kisspeptin-54/day for 13 days decreased testicular weight. Histological examination showed degeneration of the seminiferous tubules associated with a significant decrease in the circulating levels of the testes-derived hormone, inhibin B. Plasma free and total testosterone were also lower, although these changes did not reach statistical significance. Further studies examined the effects of shorter periods of continuous kisspeptin administration. Subcutaneous administration of 50 nmol kisspeptin-54 for 1 day increased plasma LH and testosterone. This effect was lost after 2 days of administration, suggesting a downregulation of the HPG axis response to kisspeptin following continuous administration. These findings indicate that kisspeptin may provide a novel tool for the manipulation of the HPG axis and spermatogenesis.

  12. Subcutaneous preconditioning increases invasion and metastatic dissemination in mouse colorectal cancer models

    PubMed Central

    Alamo, Patricia; Gallardo, Alberto; Pavón, Miguel A.; Casanova, Isolda; Trias, Manuel; Mangues, Maria A.; Vázquez, Esther; Villaverde, Antonio; Mangues, Ramon; Céspedes, Maria V.

    2014-01-01

    Mouse colorectal cancer (CRC) models generated by orthotopic microinjection of human CRC cell lines reproduce the pattern of lymphatic, haematological and transcoelomic spread but generate low metastatic efficiency. Our aim was to develop a new strategy that could increase the metastatic efficiency of these models. We used subcutaneous implantation of the human CRC cell lines HCT116 or SW48 prior to their orthotopic microinjection in the cecum of nude mice (SC+ORT). This subcutaneous preconditioning significantly enhanced metastatic dissemination. In the HCT116 model it increased the number and size of metastatic foci in lymph nodes, lung, liver and peritoneum, whereas, in the SW48 model, it induced a shift from non-metastatic to metastatic. In both models the number of apoptotic bodies in the primary tumour in the SC+ORT group was significantly reduced compared with that in the direct orthotopic injection (ORT) group. Moreover, in HCT116 tumours the number of keratin-positive tumour buddings and single epithelial cells increased at the invasion front in SC+ORT mice. In the SW48 tumour model, we observed a trend towards a higher number of tumour buds and single cells in the SC+ORT group but this did not reach statistical significance. At a molecular level, the enhanced metastatic efficiency observed in the HCT116 SC+ORT model was associated with an increase in AKT activation, VEGF-A overexpression and downregulation of β1 integrin in primary tumour tissue, whereas, in SW48 SC+ORT mice, the level of expression of these proteins remained unchanged. In summary, subcutaneous preconditioning increased the metastatic dissemination of both orthotopic CRC models by increasing tumour cell survival and invasion at the tumour invasion front. This approach could be useful to simultaneously study the mechanisms of metastases and to evaluate anti-metastatic drugs against CRC. PMID:24487410

  13. Morgellons disease: Analysis of a population with clinically confirmed microscopic subcutaneous fibers of unknown etiology

    PubMed Central

    Savely, Virginia R; Stricker, Raphael B

    2010-01-01

    Background: Morgellons disease is a controversial illness in which patients complain of stinging, burning, and biting sensations under the skin. Unusual subcutaneous fibers are the unique objective finding. The etiology of Morgellons disease is unknown, and diagnostic criteria have yet to be established. Our goal was to identify prevalent symptoms in patients with clinically confirmed subcutaneous fibers in order to develop a case definition for Morgellons disease. Methods: Patients with subcutaneous fibers observed on physical examination (designated as the fiber group) were evaluated using a data extraction tool that measured clinical and demographic characteristics. The prevalence of symptoms common to the fiber group was then compared with the prevalence of these symptoms in patients with Lyme disease and no complaints of skin fibers. Results: The fiber group consisted of 122 patients. Significant findings in this group were an association with tick-borne diseases and hypothyroidism, high numbers from two states (Texas and California), high prevalence in middle-aged Caucasian women, and an increased prevalence of smoking and substance abuse. Although depression was noted in 29% of the fiber patients, pre-existing delusional disease was not reported. After adjusting for nonspecific symptoms, the most common symptoms reported in the fiber group were: crawling sensations under the skin; spontaneously appearing, slow-healing lesions; hyperpigmented scars when lesions heal; intense pruritus; seed-like objects, black specks, or “fuzz balls” in lesions or on intact skin; fine, thread-like fibers of varying colors in lesions and intact skin; lesions containing thick, tough, translucent fibers that are highly resistant to extraction; and a sensation of something trying to penetrate the skin from the inside out. Conclusions: This study of the largest clinical cohort reported to date provides the basis for an accurate and clinically useful case definition for

  14. Lactate release from the subcutaneous tissue in lean and obese men.

    PubMed Central

    Jansson, P A; Larsson, A; Smith, U; Lönnroth, P

    1994-01-01

    Lactate concentration in the subcutaneous interstitial fluid and adipose tissue blood flow (ATBF, ml/100 g.min) were simultaneously measured with the microdialysis technique combined with 133Xe clearance in the abdominal and femoral subcutaneous adipose tissue in nine lean and nine obese men. The studies were performed both in the postabsorptive state and 2 h after an oral glucose load and the results compared to the lactate levels in arterialized venous plasma. After an overnight's fast, arterial lactate was 738 +/- 49 and 894 +/- 69 microM (mean +/- SE) (P < 0.05) in the lean and obese subjects, respectively. The interstitial lactate levels were significantly higher than blood lactate in both subject groups without any regional differences. Abdominal and femoral ATBF was 3.2 +/- 0.6 vs. 2.8 +/- 0.4 and 1.7 +/- 0.3 vs. 2.4 +/- 0.4 ml/100 g.min (P < 0.05) in lean and obese subjects, respectively. Mean apparent lactate release from the abdominal vs. femoral adipose tissue in the fasting state was 10.5 +/- 3.1 vs. 8.6 +/- 2.3 and 6.0 +/- 2.3 vs. 8.5 +/- 2.3 mumol/kg.min (NS) in lean and obese subjects, respectively. Both plasma and interstitial lactate levels increased significantly after an oral glucose load in both subject groups. However, apparent lactate release increased significantly only in the lean group. It is concluded that subcutaneous adipose tissue is a significant source of whole-body lactate release in the postabsorptive state and that this is further enhanced in obese subjects due to their large adipose mass. PMID:8282793

  15. In vivo determination of subcutaneous and abdominal adipose tissue depots in German Holstein dairy cattle.

    PubMed

    Raschka, C; Ruda, L; Wenning, P; von Stemm, C-I; Pfarrer, C; Huber, K; Meyer, U; Dänicke, S; Rehage, J

    2016-07-01

    Ultrasonography was used as a noninvasive method for quantitative estimation of the subcutaneous and abdominal adipose tissue depots in dairy cattle. The prediction model was created and validated with a total of 29 German Holstein cows; 6 were in early lactation (≤100 d in milk [DIM]) and 16 were in advanced lactation (101 to 292 DIM). Seven cows were nonpregnant and nonlactating and had been off milk for 350 to 450 d. Transcutaneous assessment of the thickness of subcutaneous and retroperitoneal adipose tissue was done at 16 sites on the body surface of all cows. After completion of the ultrasonographic measurements, the cows were slaughtered and the adipose depots were separately weighed. A stepwise multivariate regression analysis of the ultrasonographic variables was performed to estimate the slaughter weights of the different fat depots. Slaughter weights of the fat depots ranged from 5.0 to 43.0 kg for subcutaneous adipose tissue (SCAT), from 13.7 to 98.8 kg for abdominal adipose tissue (AAT), from 3.4 to 30.3 kg for retroperitoneal adipose tissue (RPAT), from 5.2 to 39.6 kg for omental adipose tissue (OMAT), and from 4.0 to 35.8 kg for mesenteric adipose tissue (MAT). The relationship between calculated amount of fat and slaughter weight of fat had coefficients of determination () and root mean square errors (kg) of 0.88 and 3.4, respectively, for SCAT; 0.94 and 6.1, respectively, for AAT; 0.94 and 1.7, respectively, for RPAT; 0.83 and 3.2, respectively, for OMAT; and 0.95 and 1.6, respectively, for MAT. The accuracy of ultrasonographic measurement of the different fat depots appears sufficient for the quantitative assessment of internal and subcutaneous fat stores in cows. This method is noninvasive and therefore allows safe and repeated monitoring of the amount of stored fat in different adipose tissue depots of German Holsteins cows.

  16. Maintenance of Normoglycemia in Diabetic Mice by Subcutaneous Xenografts of Encapsulated Islets

    NASA Astrophysics Data System (ADS)

    Lacy, Paul E.; Hegre, Orion D.; Gerasimidi-Vazeou, Andriani; Gentile, Frank T.; Dionne, Keith E.

    1991-12-01

    The goal of islet transplantation in human diabetes is to maintain the islet grafts in the recipients without the use of immunosuppression. One approach is to encapsulate the donor islets in permselective membranes. Hollow fibers fabricated from an acrylic copolymer were used to encapsulate small numbers of rat islets that were immobilized in an alginate hydrogel for transplantation in diabetic mice. The fibers were biocompatible, prevented rejection, and maintained normoglycemia when transplanted intraperitoneally; hyperglycemia returned when the fibers were removed at 60 days. Normoglycemia was also maintained by subcutaneous implants that had an appropriately constructed outer surface on the fibers.

  17. Congenital complex corneal choristoma associated with unilateral bony calvarial defects, subcutaneous nodules, and alopecia.

    PubMed

    Owen, Leah A; Ford, Joshua; Mamalis, Nick; Hoffman, Robert; Mifflin, Mark

    2015-04-01

    Complex corneal choristoma is a rare finding and its relationship with systemic disease is poorly understood. We present a 3-day-old boy with the constellation of left-sided congenital complex corneal choristoma, limbal dermoid, ipsilateral bony skull defects, and bilateral subcutaneous vascularized nodules with overlying alopecia and scalp nevi. To our knowledge this is the first case of complex choristoma involving the presence of associated bony calvarial defects. This presentation may contribute to a greater understanding of the systemic findings associated with the condition. Furthermore, it may shed light on the possible syndromic spectrum associated with complex choristoma and its underlying pathophysiology.

  18. Efficacy of subcutaneous administration of gonadotropin-releasing hormone agonist on idiopathic central precocious puberty.

    PubMed

    Liang, Yan; Wei, Hong; Zhang, Jianling; Hou, Ling; Luo, Xiaoping

    2006-01-01

    In order to assess the feasibility of subcutaneous administration of Triptorelin with 6-week intervals for the suppression of pituitary-gonadal axis and changes of clinical signs in girls with idiopathic central precocious puberty (ICPP), 46 girls with ICPP were treated with GnRHa. Triptorelin (Decapeptyl, 3.75 mg) was administered subcutaneously (SC) at 6-weeks intervals or intramuscularly (IM) at 4-weeks intervals randomly for more than 12 months consecutively. During GnRHa therapy, clinical parameters and laboratory data, including height, weight, pubertal stage, bone age, uterine volume and ovarian size, serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E2), were monitored and analyzed. It was found that both treatment regimes led to regression of precocious puberty and reversal of secondary sexual characteristics. Breast developments regressed. Uterine volume was decreased after treatment, but there was no statistically significant difference. Mean ovarian volume did not change significantly during treatment. The height velocity was decreased significantly from 6.3+/-1.4 cm/year to 5.8+/-1.2 cm/year in group SC and 6.7+/-1.3 cm/year to 5.4+/-1.0 cm/year in group IM, respectively. The rate of bone maturation was reduced significantly during treatment. The ratio of deltaBA/deltaCA was 1.2+/-0.2 or 1.3+/-0.3 at the onset of therapy and decreased significantly after the treatment to 0.7+/-0.2 or 0.9+/-0.1, respectively. The predicted adult height was increased significantly and progressively during therapy. The levels of serum LH, FSH and E2 returned to the prepubertal condition. No significant side effects of therapy were noted. The most common side effect during SC treatment was that a non-irritating, 1 cm in diameter mass was palpated at the site of subcutaneous injection in the abdominal wall of patients, which disappeared after 6-12 weeks. Two girls had minimal withdrawal vaginal bleeding episodes after the first

  19. Isolation on Chocolate Agar Culture of Legionella pneumophila Isolates from Subcutaneous Abscesses in an Immunocompromised Patient

    PubMed Central

    Cavalie, Laurent; Daviller, Benjamin; Dubois, Damien; Mantion, Benoît; Delobel, Pierre; Debard, Alexa; Prere, Marie-Françoise; Marchou, Bruno; Martin-Blondel, Guillaume

    2015-01-01

    Cutaneous infections due to Legionella species have rarely been reported (L. J. Padrnos, J. E. Blair, S. Kusne, D. J. DiCaudo, and J. R. Mikhael, Transpl Infect Dis 16:307–314, 2014; P. W. Lowry, R. J. Blankenship, W. Gridley, N. J. Troup, and L. S. Tompkins, N Engl J Med 324:109–113, 1991; M. K. Waldor, B. Wilson, and M. Swartz, Clin Infect Dis 16:51–53, 1993). Here we report the identification of Legionella pneumophila isolates, from subcutaneous abscesses in an immunocompromised patient, that grew in an unusual medium for Legionella bacteria. PMID:26292305

  20. [Subcutaneous atrophy following steroid injection in the treatment of trigger finger].

    PubMed

    Larsen, Peter Birk; Tjørnild, Michael Kjelager

    2014-11-10

    Trigger finger (TF), also known as stenosing tenosynovitis, is a rather common condition that causes entrapment of the flexor tendon at the site of the annular pulley. The accepted first-line treatment for TF is injection of long-acting corticosteroid in the involved flexor tendon sheath. This treatment is characterized by a high success rate and a low level of reported adverse effects in the literature. We report a case of subcutaneous atrophy after steroid injection in the treatment of TF. PMID:25394923

  1. Treatment of lower extremity oedema by subcutaneous drainage in a home hospice patient.

    PubMed

    Rodgers, Susan; Birkholz, Lorri; Hebert, Randy

    2013-04-29

    Lower extremity oedema is common in patients with advanced illness and can normally be managed with oral diuretics and elevation of the involved extremities. The management of oedema can be more complicated in home hospice patients, however. They tend to be more frail and are often less able to tolerate usual interventions. We present a case of a home hospice patient with severe oedema treated by creating subcutaneous tracts in his legs to allow drainage of excess interstitial fluid. The procedure was very successful in improving the patient's quality of life.

  2. Isolation on Chocolate Agar Culture of Legionella pneumophila Isolates from Subcutaneous Abscesses in an Immunocompromised Patient.

    PubMed

    Barigou, Mohammed; Cavalie, Laurent; Daviller, Benjamin; Dubois, Damien; Mantion, Benoît; Delobel, Pierre; Debard, Alexa; Prere, Marie-Françoise; Marchou, Bruno; Martin-Blondel, Guillaume

    2015-11-01

    Cutaneous infections due to Legionella species have rarely been reported (L. J. Padrnos, J. E. Blair, S. Kusne, D. J. DiCaudo, and J. R. Mikhael, Transpl Infect Dis 16:307-314, 2014; P. W. Lowry, R. J. Blankenship, W. Gridley, N. J. Troup, and L. S. Tompkins, N Engl J Med 324:109-113, 1991; M. K. Waldor, B. Wilson, and M. Swartz, Clin Infect Dis 16:51-53, 1993). Here we report the identification of Legionella pneumophila isolates, from subcutaneous abscesses in an immunocompromised patient, that grew in an unusual medium for Legionella bacteria. PMID:26292305

  3. Interpolated subcutaneous fat pedicle melolabial flap for large nasal lining defects

    PubMed Central

    Griffin, Garrett R.; Chepeha, Douglas C.; Moyer, Jeffrey S.

    2016-01-01

    Full-thickness nasal deformities are a reconstructive challenge. Restoration of a reliable internal lining is critical for a successful reconstruction. Septal hinge flaps are the workhorse for internal lining defects. However, these and other intranasal mucosal flaps are sometimes unavailable due to prior harvest or previous oncologic resection. We present the two-stage interpolated subcutaneous fat pedicle melolabial flap for lining large defects when traditional intranasal flaps are unavailable. This approach is particularly useful when one forehead flap has already been expended, preserving the patient's remaining forehead tissue for external cover. PMID:22965480

  4. Extradural sacrococcygeal subcutaneous ependymoma misdiagnosed as pilonidal disease: case report and review of the literature.

    PubMed

    McEachron, Kendall R; Gaertner, Wolfgang B

    2016-01-01

    Ependymoma is a type of glial tumor that arises from the ependymal lining of the ventricular system of the central nervous system. These tumors may present as a rare extraspinal variety at the sacrococcygeal region, and may be misdiagnosed as pilonidal disease in the post-sacral area or present with mass-effect symptoms on the bowel or bladder in the pre-sacral region. This is a case of soft tissue swelling at the post-sacral area that, after clinical examination, was diagnosed as pilonidal disease. Surgical excision and pathologic examination revealed a subcutaneous sacrococcygeal ependymoma. PMID:27432901

  5. Heparin and related drugs for venous thromboembolism prophylaxis: subcutaneous or intravenous continuous infusion?

    PubMed

    Izadpanah, Mandana; Khalili, Hossein; Dashti-Khavidaki, Simin; Mohammadi, Mostafa

    2015-03-01

    In this article, the most evidenced approaches of unfractionated heparin administration for prevention of venous thromboembolism in medical and surgical hospitalized patients will be reviewed. Present data were collected by searching Scopus, PubMed, MEDLINE, Science direct, Clinical trials and Cochrane database systematic reviews. Subcutaneous low doses of unfractionated heparin (10000-15000 IU) in two or three divided doses per day are commonly administrated for venous thromboembolism prevention in different medical and surgical populations. In some populations such as obese surgical and critically ill patients, due to altered pharmacokinetics behavior of unfractionated heparin, continuous intravenous infusion of the low doses of unfractionated heparin has been proposed.

  6. The Effect of Extended Injection of Subcutaneous Heparin on Pain Intensity and Bruising Incidence

    PubMed Central

    Ahmadi, Mostafa; Ahmadi, Raheleh; Saadati, Zoleykha; Mehrpour, Omid

    2016-01-01

    Background Reducing patients’ pain is one of the main goals of providing clinical services, which requires nursing skill. As a simple technique, increasing the duration of subcutaneous heparin injection may affect the intensity of pain and bruising. Objective The aim of this study was to assess the effect of increasing the heparin injection time on pain intensity and bruising associated with subcutaneous injection. Methods The present quasi-experimental study consisted of 86 patients, admitted to our hospital, who were treated with subcutaneous heparin injection. A McGill pain intensity questionnaire was used to measure pain severity in a purposive sampling. All of the subjects received subcutaneous heparin twice for 10 seconds. They also were injected twice with heparin infusion, although it was for 30 seconds this time. The interval between the two injections was 24 h, and the intensity of the pain was measured after each injection. The Pearson correlation coefficient was measured, and analysis of variance (ANOVA) and the t-test were used to analyze the data. Results Eighty patients received heparin. The body mass indexes were reported as 52 (60%) and 34 (40%) for subjects within the age range of 18.5–24.9 and 25–29.9, respectively. Regarding the mean of pain intensity, there was a significant difference between the 10 and 30 s injections (p < 0.05). Additionally, there was a significant difference in bruising rates between the two methods 48 and 72 h after injection (p < 0.05). The ANOVA test showed a significant association between gender and bruising (p = 0.001). Conclusion According to the results, by elevating the duration of heparin injection, the severity of pain was reduced, and, therefore, the patients felt more comfortable. Trial Registration The trial was registered at the Thai Clinical Trials Registry (TCTR) with the TCTR identification of TCTR20160221001. Funding This research was supported by the research cluster grant (88186-25/01/89) from

  7. Extradural sacrococcygeal subcutaneous ependymoma misdiagnosed as pilonidal disease: case report and review of the literature

    PubMed Central

    McEachron, Kendall R.; Gaertner, Wolfgang B.

    2016-01-01

    Ependymoma is a type of glial tumor that arises from the ependymal lining of the ventricular system of the central nervous system. These tumors may present as a rare extraspinal variety at the sacrococcygeal region, and may be misdiagnosed as pilonidal disease in the post-sacral area or present with mass-effect symptoms on the bowel or bladder in the pre-sacral region. This is a case of soft tissue swelling at the post-sacral area that, after clinical examination, was diagnosed as pilonidal disease. Surgical excision and pathologic examination revealed a subcutaneous sacrococcygeal ependymoma. PMID:27432901

  8. Medical Device Safety

    MedlinePlus

    A medical device is any product used to diagnose, cure, or treat a condition, or to prevent disease. They range from ... need one in a hospital. To use medical devices safely Know how your device works. Keep instructions ...

  9. Infrared criminalistic devices

    NASA Astrophysics Data System (ADS)

    Gibin, Igor S.; Savkov, E. V.; Popov, Pavel G.

    1996-12-01

    We are presenting the devices of near-IR spectral range in this report. The devices may be used in criminalistics, in bank business, in restoration works, etc. the action principle of these devices is describing briefly.

  10. Are Electronic Cardiac Devices Still Evolving?

    PubMed Central

    Mabo, P.

    2014-01-01

    Summary Objectives The goal of this paper is to review some important issues occurring during the past year in Implantable devices. Methods First cardiac implantable device was proposed to maintain an adequate heart rate, either because the heart’s natural pacemaker is not fast enough, or there is a block in the heart’s electrical conduction system. During the last forty years, pacemakers have evolved considerably and become programmable and allow to configure specific patient optimum pacing modes. Various technological aspects (electrodes, connectors, algorithms diagnosis, therapies, …) have been progressed and cardiac implants address several clinical applications: management of arrhythmias, cardioversion / defibrillation and cardiac resynchronization therapy. Results Observed progress was the miniaturization of device, increased longevity, coupled with efficient pacing functions, multisite pacing modes, leadless pacing and also a better recognition of supraventricular or ventricular tachycardia’s in order to deliver appropriate therapy. Subcutaneous implant, new modes of stimulation (leadless implant or ultrasound lead), quadripolar lead and new sensor or new algorithm for the hemodynamic management are introduced and briefly described. Each times, the main result occurring during the two past years are underlined and repositioned from the history, remaining limitations are also addressed. Conclusion Some important technological improvements were described. Nevertheless, news trends for the future are also considered in a specific session such as the remote follow-up of the patient or the treatment of heart failure by neuromodulation. PMID:25123732

  11. Monoaxial pedicle screws are superior to polyaxial pedicle screws and the two pin external fixator for subcutaneous anterior pelvic fixation in a biomechanical analysis.

    PubMed

    Vaidya, Rahul; Onwudiwe, Ndidi; Roth, Matthew; Sethi, Anil

    2013-01-01

    Purpose. Comparison of monoaxial and polyaxial screws with the use of subcutaneous anterior pelvic fixation. Methods. Four different groups each having 5 constructs were tested in distraction within the elastic range. Once that was completed, 3 components were tested in torsion within the elastic range, 2 to torsional failure and 3 in distraction until failure. Results. The pedicle screw systems showed higher stiffness (4.008 ± 0.113 Nmm monoaxial, 3.638 ± 0.108 Nmm Click-x; 3.634 ± 0.147 Nmm Pangea) than the exfix system (2.882 ± 0.054 Nmm) in distraction. In failure testing, monoaxial pedicle screw system was stronger (360 N) than exfixes (160 N) and polyaxial devices which failed if distracted greater than 4 cm (157 N Click-x or 138 N Pangea). The exfix had higher peak torque and torsional stiffness than all pedicle systems. In torsion, the yield strengths were the same for all constructs. Conclusion. The infix device constructed with polyaxial or monoaxial pedicle screws is stiffer than the 2 pin external fixator in distraction testing. In extreme cases, the use of reinforcement or monoaxial systems which do not fail even at 360 N is a better option. In torsional testing, the 2 pin external fixator is stiffer than the pedicle screw systems.

  12. Subcutaneous Trastuzumab for HER2-positive Breast Cancer – Evidence and Practical Experience in 7 German Centers

    PubMed Central

    Jackisch, C.; Müller, V.; Dall, P.; Neumeister, R.; Park-Simon, T.-W.; Ruf-Dördelmann, A.; Seiler, S.; Tesch, H.; Ataseven, B.

    2015-01-01

    A subcutaneous formulation of trastuzumab to treat patients with HER2-positive breast cancer is available since August 2013. The subcutaneous formulation is administered as a fixed dose of 600 mg over a period of up to 5 minutes. The HannaH trial compared subcutaneous with intravenous administration and found comparable pharmacokinetics, efficacy and tolerability for both administration forms of trastuzumab in the neoadjuvant setting. The randomized crossover study PrefHer reported a clear preference from the patientʼs point of view for subcutaneous over intravenous administration of trastuzumab. The accompanying time-and-motion study reported a reduction concerning the total time spent for the institution as well as for the patient receiving trastuzumab s. c.. The experience of 7 German centers largely corresponded with the results of these studies. Patients expressed a clear preference for subcutaneous trastuzumab administration, with the time saved by the subcutaneous administration route cited as the greatest benefit. Although the existing reimbursement terms mean that centers will receive a lower remuneration, the centersʼ overall evaluation of the subcutaneous administration route for trastuzumab was overwhelmingly positive. The greatest benefit cited by the centers was the flexibility in scheduling patient appointments. This increased flexibility improved conditions in some centers which were experiencing pressures due to a shortage of staff, particularly at peak times. The general consensus, however, was that the remuneration systems for oncological treatments urgently need to be amended to ensure that the real costs of treatment are covered, even if the administration route has changed. PMID:26166837

  13. CONTROL LIMITER DEVICE

    DOEpatents

    DeShong, J.A.

    1960-03-01

    A control-limiting device for monltoring a control system is described. The system comprises a conditionsensing device, a condition-varying device exerting a control over the condition, and a control means to actuate the condition-varying device. A control-limiting device integrates the total movement or other change of the condition-varying device over any interval of time during a continuum of overlapping periods of time, and if the tothl movement or change of the condition-varying device exceeds a preset value, the control- limiting device will switch the control of the operated apparatus from automatic to manual control.

  14. Aluminium adjuvants and adverse events in sub-cutaneous allergy immunotherapy.

    PubMed

    Exley, Christopher

    2014-01-01

    Sub-cutaneous immunotherapy is an effective treatment for allergy. It works by helping to modify or re-balance an individual's immune response to allergens and its efficacy is greatly improved by the use of adjuvants, most commonly, aluminium hydroxide. Aluminium salts have been used in allergy therapy for many decades and are assumed to be safe with few established side-effects. This assumption belies their potency as adjuvants and their potential for biological reactivity both at injection sites and elsewhere in the body. There are very few data purporting to the safety of aluminium adjuvants in allergy immunotherapy and particularly so in relation to longer term health effects. There are, if only few, published reports of adverse events following allergy immunotherapy and aluminium adjuvants are the prime suspects in the majority of such incidents. Aluminium adjuvants are clearly capable of initiating unwanted side effects in recipients of immunotherapy and while there is as yet no evidence that such are commonplace it is complacent to consider aluminium salts as harmless constituents of allergy therapies. Future research should establish the safety of the use of aluminium adjuvants in sub-cutaneous allergy immunotherapy. PMID:24444186

  15. Epiphany root canal sealer prepared with resinous solvent is irritating to rat subcutaneous tissues

    PubMed Central

    Daleffe, Élcio; Vieira-Ozório, José E.; Sousa-Neto, Manoel D

    2012-01-01

    Objective: This study assessed the biocompatibility of the Epiphany endodontic sealer prepared with resinous solvent of Epiphany system (Thinning resin) in rat subcutaneous tissues. Study Design: Polyethylene tubes were filled with the sealer and 4 groups were established: GI, Epiphany prepared with 1 drop of resinous solvent (RS); GII, Epiphany prepared with 1 drop of RS and photoactivated; GIII, Epiphany associated with self-etch primer and prepared with 1 drop of RS; GIV, Epiphany associated with self-etch primer, prepared with 1 drop of RS and photoactivated. The filled tubes were implanted into 4 different regions of the dorsum of 20 adult male rats. Results: After 7, 14 and 21 days, all groups presented a moderate to severe chronic inflammation, necrosis and foreign-body giant cells. At 42 days, although the intensity of chronic inflammatory reaction decreased, the other features still were observed. Conclusion: The Epiphany sealer prepared with the RS was irritating to rat subcutaneous tissues. Key words:Biocompatibility, Epiphany, methacrylate resin sealer, resinous solvent, root canal sealer. PMID:22322512

  16. [Life-threatening injuries of the subcutaneous ventral abdominal veins in dairy cows].

    PubMed

    Schmid, B; Muggli, E; Schmid, T; Nuss, K

    2011-05-01

    Injuries of the superficial veins on the ventral abdomen of dairy cows can result in life-threatening haemorrhage. Treatment of these injuries can be difficult because of the characteristics of the veins. Five cows aged 6.5 to 12 years were referred to the Animal Hospitale Zurich, because of intermittent haemorrhage from a ventral abdominal vein. Four of the cows were near term and one had calved two weeks before referral. Intermittent bleeding was seen from the highly convoluted and dilated subcutaneous tributaries to the cranial superficial epigastric vein (milk vein). The haematocrit of 2 cows was markedly lower than normal. Emergency slaughter of one of the cows was carried out because of advanced age. The other 4 cows were sedated and after application of local anaesthetic, the wounds were debrided and sutured. Two of the cows required a blood transfusion before being operated. There were no postoperative complications. This type of injury seems to occur predominantly in pluriparous dairy cows close to term, in which the tributaries to the milk vein have undergone varicose changes. Treatment should consist of surgical resection of the injured tissue and suturing of the venous wall, subcutaneous tissues and skin.

  17. ELBW survivors in early adulthood have higher hepatic, pancreatic and subcutaneous fat

    PubMed Central

    Crane, Justin D.; Yellin, Samuel A.; Ong, Frank J.; Singh, Nina P.; Konyer, Norman; Noseworthy, Michael D.; Schmidt, Louis A.; Saigal, Saroj; Morrison, Katherine M.

    2016-01-01

    Premature birth in conjunction with extremely low birth weight (<1 kg, ELBW) is associated with insulin resistance and increased cardiometabolic health risk compared to birth at full term with normal birth weight (NBW). However, little is known regarding the biologic mediators of these effects. Abdominal and ectopic lipid accumulation is linked to insulin resistance and metabolic dysfunction, yet whether ELBW survivors are predisposed to aberrant lipid deposition in adulthood is unknown. We used magnetic resonance imaging in a cohort of 16 NBW and 29 ELBW participants to determine if ELBW survivors have differences in pancreatic, hepatic, subcutaneous and visceral fat distribution compared to NBW participants. ELBW individuals had a higher proportion of liver and pancreatic fat compared to NBW subjects (P < 0.05). Abdominal subcutaneous fat, but not visceral fat, area was higher in ELBW survivors compared to NBW individuals. In multivariate analyses, tissue fat measures were most highly related to BMI and sex, but not preterm birth. This work highlights that fat deposition is enhanced in adults born preterm and suggests that ectopic fat accretion driven by their relatively greater adiposity may contribute to the higher rates of metabolic dysfunction seen in ELBW survivors. PMID:27530702

  18. Ultrastructure of the Subcutaneous Primo-Vascular System in Rat Abdomen.

    PubMed

    Lim, Chae Jeong; Lee, So Yeong; Ryu, Pan Dong

    2016-01-01

    Recently, we identified the primo-vascular system (PVS), a novel vascular network, in rat subcutaneous tissues. Little is known about the subcutaneous PVS (sc-PVS). Here, we examined the ultrastructure of the sc-PVS in the hypodermis at the rat abdominal midline by electron microscopy. On the surface of sc-PVS, we observed three types of cells: microcells (5-6 μm), large elliptical cells (>20 μm), and erythrocyte (3-4 μm). The inside of the sc-PVS was filled with numerous cells, which can be classified into three major groups: leucocytes, mast cells, and erythrocytes. The dense leucocytes and mast cells were easily noticed. The extracellular matrix of the sc-PVS was mainly composed of extensive fibers (79 ± 6.5 nm) tightly covered by micro- (0.5-1 μm) and nanoparticles (10-100 nm). In conclusion, the ultrastructural features, such as the resident cells on and in the sc-PVS and fiber meshwork covered by particles, indicate that sc-PVS might act as a circulatory channel for the flow and delivery of numerous cells and particles. Our findings will help understand the nature of various sc-PVS beneath-the-skin layers and how they relate to acupuncture meridians. PMID:27526159

  19. Therapeutic efficacy of monthly subcutaneous injection of daclizumab in relapsing multiple sclerosis

    PubMed Central

    Cohan, Stanley

    2016-01-01

    Despite the availability of multiple disease-modifying therapies for relapsing multiple sclerosis (MS), there remains a need for highly efficacious targeted therapy with a favorable benefit–risk profile and attributes that encourage a high level of treatment adherence. Daclizumab is a humanized monoclonal antibody directed against CD25, the α subunit of the high-affinity interleukin 2 (IL-2) receptor, that reversibly modulates IL-2 signaling. Daclizumab treatment leads to antagonism of proinflammatory, activated T lymphocyte function and expansion of immunoregulatory CD56bright natural killer cells, and has the potential to, at least in part, rectify the imbalance between immune tolerance and autoimmunity in relapsing MS. The clinical pharmacology, efficacy, and safety of subcutaneous daclizumab have been evaluated extensively in a large clinical study program. In pivotal studies, daclizumab demonstrated superior efficacy in reducing clinical and radiologic measures of MS disease activity compared with placebo or intramuscular interferon beta-1a, a standard-of-care therapy for relapsing MS. The risk of hepatic disorders, cutaneous events, and infections was modestly increased. The monthly subcutaneous self-injection dosing regimen of daclizumab may be advantageous in maintaining patient adherence to treatment, which is important for optimal outcomes with MS disease-modifying therapy. Daclizumab has been approved in the US and in the European Union and represents an effective new treatment option for patients with relapsing forms of MS, and is currently under review by other regulatory agencies. PMID:27672308

  20. Evaluation of borate bioactive glass scaffolds with different pore sizes in a rat subcutaneous implantation model.

    PubMed

    Deliormanli, Aylin M; Liu, Xin; Rahaman, Mohamed N

    2014-01-01

    Borate bioactive glass has been shown to convert faster and more completely to hydroxyapatite and enhance new bone formation in vivo when compared to silicate bioactive glass (such as 45S5 and 13-93 bioactive glass). In this work, the effects of the borate glass microstructure on its conversion to hydroxyapatite (HA) in vitro and its ability to support tissue ingrowth in a rat subcutaneous implantation model were investigated. Bioactive borate glass scaffolds, designated 13-93B3, with a grid-like microstructure and pore widths of 300, 600, and 900 µm were prepared by a robocasting technique. The scaffolds were implanted subcutaneously for 4 weeks in Sprague Dawley rats. Silicate 13-93 glass scaffolds with the same microstructure were used as the control. The conversion of the scaffolds to HA was studied as a function of immersion time in a simulated body fluid. Histology and scanning electron microscopy were used to evaluate conversion of the bioactive glass implants to hydroxyapatite, as well as tissue ingrowth and blood vessel formation in the implants. The pore size of the scaffolds was found to have little effect on tissue infiltration and angiogenesis after the 4-week implantation.

  1. Prevention of pulmonary metastasis from subcutaneous tumors by binary system-based sustained delivery of catalase.

    PubMed

    Hyoudou, Kenji; Nishikawa, Makiya; Ikemura, Mai; Kobayashi, Yuki; Mendelsohn, Adam; Miyazaki, Nobuhiko; Tabata, Yasuhiko; Yamashita, Fumiyoshi; Hashida, Mitsuru

    2009-07-20

    Catalase delivery can be effective in inhibiting reactive oxygen species (ROS)-mediated acceleration of tumor metastasis. Our previous studies have demonstrated that increasing the plasma half-life of catalase by pegylation (PEG-catalase) significantly increases its potency of inhibiting experimental pulmonary metastasis in mice. In the present study, a biodegradable gelatin hydrogel formulation was used to further increase the circulation time of PEG-catalase. Implantation of (111)In-PEG-catalase/hydrogel into subcutaneous tissues maintained the radioactivity in plasma for more than 14 days. Then, the effect of the PEG-catalase/hydrogel on spontaneous pulmonary metastasis of tumor cells was evaluated in mice with subcutaneous tumor of B16-BL6/Luc cells, a murine melanoma cell line stably expressing luciferase. Measuring luciferase activity in the lung revealed that the PEG-catalase/hydrogel significantly (P<0.05) inhibited the pulmonary metastasis compared with PEG-catalase solution. These findings indicate that sustaining catalase activity in the blood circulation achieved by the use of pegylation and gelatin hydrogel can reduce the incidence of tumor cell metastasis. PMID:19361547

  2. A Helix-Stabilizing Linker Improves Subcutaneous Bioavailability of a Helical Peptide Independent of Linker Lipophilicity.

    PubMed

    Zhang, Liang; Navaratna, Tejas; Thurber, Greg M

    2016-07-20

    Stabilized peptides address several limitations to peptide-based imaging agents and therapeutics such as poor stability and low affinity due to conformational flexibility. There is also active research in developing these compounds for intracellular drug targeting, and significant efforts have been invested to determine the effects of helix stabilization on intracellular delivery. However, much less is known about the impact on other pharmacokinetic parameters such as plasma clearance and bioavailability. We investigated the effect of different fluorescent helix-stabilizing linkers with varying lipophilicity on subcutaneous (sc) bioavailability using the glucagon-like peptide-1 (GLP-1) receptor ligand exendin as a model system. The stabilized peptides showed significantly higher protease resistance and increased bioavailability independent of linker hydrophilicity, and all subcutaneously delivered conjugates were able to successfully target the islets of Langerhans with high specificity. The lipophilic peptide variants had slower absorption and plasma clearance than their respective hydrophilic conjugates, and the absolute bioavailability was also lower likely due to the longer residence times in the skin. Their ease and efficiency make double-click helix stabilization chemistries a useful tool for increasing the bioavailability of peptide therapeutics, many of which suffer from rapid in vivo protease degradation. Helix stabilization using linkers of varying lipophilicity can further control sc absorption and clearance rates to customize plasma pharmacokinetics. PMID:27327034

  3. Electron microscopic observations of hepatic and subcutaneous hemangiosarcomas induced in mice exposed to vinyl chloride monomer.

    PubMed

    Suzuki, Y

    1981-01-01

    Both subcutaneous and hepatic hemangiosarcomas were induced in mice exposed to vinyl chloride monomer, and for the first time, the ultrastructure of hemangiosarcomas related to vinyl chloride exposure has been described. The subcutaneous hemangiosarcoma developed in a mouse's ear 29 weeks after exposure to 10 ppm vinyl chloride for 4 weeks, and the hepatic hemangiosarcoma was found in a mouse's liver at necropsy 56 weeks after exposure to 600 ppm vinyl chloride for 4 weeks. Both tumors showed a localized, cystic nodular appearance with a dark red tone. Histologically, an angiomatous architecture, the presence of neoplastic mesenchymal cell aggregates, focal necrosis, and hemorrhagic foci were common. Ultrastructurally, two neoplastic cell types, a mesenchymal and a well-differentiated endothelial cell type, were identified in both tumors. In addition, in the hepatic tumor, a pericyte-like neoplastic cell was also present. The incidence of hemangiosarcoma was much lower than that of lung tumors (alveologenic tumor) in mice exposed to vinyl chloride at the same concentrations for the same duration. This study suggests that there is no basic difference in ultrastructure between the vinyl chloride-induced hemangiosarcomas and hemangiosarcomas not related to this chemical exposure.

  4. Comparative analysis of tissue reactions to anesthetic solutions: histological analysis in subcutaneous tissue of rats.

    PubMed Central

    Ribeiro, Paulo Domingos; Sanches, Marcio Giampietro; Okamoto, Tetuo

    2003-01-01

    Postanesthetic pain is a relatively common complication after local anesthesia. This complication may be caused by the anesthetic technique or by the anesthetic solution used. Tissue reactions induced by the anesthetic solutions may be one of the factors resulting in pain after anesthesia. The objective of this study was to comparatively analyze tissue reactions induced by different anesthetic solutions in the subcutaneous tissue of rats. The following solutions were utilized: 2% lidocaine without vasoconstrictor; a 0.5% bupivacaine solution with 1:200,000 adrenaline; a 4% articaine solution and 2% mepivacaine, both with 1:100,000 adrenaline; and a 0.9% sodium chloride solution as a control. Sterilized absorbent paper cones packed inside polyethylene tubes were soaked in the solutions and implanted in the subcutaneous region. The sacrifice periods were 1, 2, 5, and 10 days after surgery. The specimens were prepared and stained with hematoxylin and eosin for histological analysis. The results showed that there is a difference in tissue irritability produced by the local anesthetic solutions. The results also showed that there is no relation between the concentration of the drug and the inflammatory intensity, that the mepivacaine and articaine solutions promoted less inflammatory reaction than the bupivacaine, and that the lidocaine solution produced the least intense inflammation. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 PMID:14959905

  5. Multifocal melanocytoma of the posterior fossa and subcutaneous scalp in the absence of neurocutaneous melanosis

    PubMed Central

    Pierson, Matt; Marwaha, Nitin; Guzman, Miguel; Mikulec, Anthony A.; Coppens, Jeroen R.

    2016-01-01

    Background: Primary leptomeningeal melanocytic neoplasms of the central nervous system are rare. Multifocal lesions typically occur in the setting of cutaneous melanosis. We present the first report of a posterior fossa melanocytoma and subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis. Case Description: We present the case of a 22-year-old male with decreased hearing on the right side, ataxia, nausea, vomiting and a scalp mass. Magnetic resonance imaging (MRI) demonstrated occipital and cerebellopontine (CP) angle masses. The patient underwent gross total resection of the scalp mass and subtotal resection of the CP angle mass. Pathologic examination revealed melanocytoma with intermediate grade. The patient underwent stereotactic radiosurgery to the residual CP angle tumor. This case represents, to the author's knowledge, the first report associating a posterior fossa melanocytoma with a subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis. Conclusion: This case introduces the first report of a new variant of multifocal melanocytoma which is not confined to the central nervous system. PMID:27656317

  6. ELBW survivors in early adulthood have higher hepatic, pancreatic and subcutaneous fat.

    PubMed

    Crane, Justin D; Yellin, Samuel A; Ong, Frank J; Singh, Nina P; Konyer, Norman; Noseworthy, Michael D; Schmidt, Louis A; Saigal, Saroj; Morrison, Katherine M

    2016-01-01

    Premature birth in conjunction with extremely low birth weight (<1 kg, ELBW) is associated with insulin resistance and increased cardiometabolic health risk compared to birth at full term with normal birth weight (NBW). However, little is known regarding the biologic mediators of these effects. Abdominal and ectopic lipid accumulation is linked to insulin resistance and metabolic dysfunction, yet whether ELBW survivors are predisposed to aberrant lipid deposition in adulthood is unknown. We used magnetic resonance imaging in a cohort of 16 NBW and 29 ELBW participants to determine if ELBW survivors have differences in pancreatic, hepatic, subcutaneous and visceral fat distribution compared to NBW participants. ELBW individuals had a higher proportion of liver and pancreatic fat compared to NBW subjects (P < 0.05). Abdominal subcutaneous fat, but not visceral fat, area was higher in ELBW survivors compared to NBW individuals. In multivariate analyses, tissue fat measures were most highly related to BMI and sex, but not preterm birth. This work highlights that fat deposition is enhanced in adults born preterm and suggests that ectopic fat accretion driven by their relatively greater adiposity may contribute to the higher rates of metabolic dysfunction seen in ELBW survivors. PMID:27530702

  7. Pulpal regeneration and root development after subcutaneous transplantation of cryopreserved immature teeth in rats.

    PubMed

    Temmerman, L; Vral, A; Meire, M; Verbeeck, R M; Deschepper, E; Dermaut, L R; De Pauw, G A

    2012-04-01

    The purpose of this in vivo study was to investigate revascularization and root growth after autotransplantation of cryopreserved immature teeth. Immature molar teeth were extracted in 4-week-old Wistar rats. In the test group, teeth were cryopreserved for 1 week and transplanted subcutaneously to the abdomen. In the control group, teeth were transplanted subcutaneously immediately after extraction. Material was collected in test and control animals at intervals of 1, 2, 4 and 10 weeks post-transplantation and histological and microradiographical examination was performed. Results showed that during the first weeks after transplantation, pulpal repair was similar in both groups although degenerated pulpal tissue was replaced slower in cryopreserved teeth and some differences in types of hard tissue formation were found between test and control teeth. After 10 weeks, the differences in the regenerated pulpal tissue between cryopreserved and control teeth observed during the first weeks were no longer detectable. No root growth was detected microradiographically 10 weeks after transplantation in any of the transplanted teeth. The presence of dentin-like tissue in the pulp cavity of some autotransplanted cryopreserved teeth, suggests survival of pulpal tissue after cryopreservation.

  8. Three cases of systemic amyloidosis successfully diagnosed by subcutaneous fat tissue biopsy of the hip.

    PubMed

    Arahata, Masahisa; Shimadoi, Shigeru; Yamatani, Satosi; Hayashi, Shin-Ichi; Miwa, Shigeharu; Asakura, Hidesaku; Nakao, Shinji

    2016-01-01

    Fine-needle aspiration biopsy of the abdominal fat pad is considered to be a minimally invasive procedure for diagnosing systemic amyloidosis. However, this procedure is sometimes difficult and can be dangerous for elderly patients whose abdominal fat layer is thin because of malnutrition. In such cases, alternative diagnostic methods are required. We report three elderly patients with heart failure complicated by malnutrition. In all cases, electrocardiogram showed low voltage in the limb leads and a pseudoinfarct pattern in the chest leads, and echocardiography showed left ventricular wall thickening with granular sparkling appearance. These patients were suspected of having amyloid cardiomyopathy but could not undergo myocardial biopsies because of their poor conditions. After failed attempts at biopsy of the abdominal fat pad or the other organs, subcutaneous fat tissue biopsy over the hip led to the diagnosis of systemic amyloidosis with cardiomyopathy. The resultant diagnosis guided us to choose the appropriate treatment for the patients. This article illustrates that subcutaneous fat tissue biopsy of the hip could be a useful procedure for diagnosing systemic amyloidosis in elderly patients, particularly when a fat tissue biopsy of the abdomen is associated with a high risk of complications because of malnutrition. PMID:27540285

  9. Effect of mevalonic acid on cholesterol synthesis in bovine intramuscular and subcutaneous adipocytes.

    PubMed

    Liu, Xiaomu; You, Wei; Cheng, Haijian; Zhang, Qingfeng; Song, Enliang; Wan, Fachun; Han, Hong; Liu, Guifen

    2016-02-01

    Mevalonic acid (MVA) is a key material in the synthesis of cholesterol; indeed, intracellular cholesterol synthesis is also called the mevalonic acid pathway. 3-Hydroxy-3-methylglutaryl-CoA reductase (HMGR) is an essential enzyme in cholesterol biosynthesis. This study suggests that MVA may play an important role in the differentiation of bovine adipose tissue in vivo. We investigated differential mRNA expression in bovine intramuscular preadipocytes (BIPs) and bovine subcutaneous preadipocytes (BSPs) by culturing cells from the longissimus dorsi muscle and subcutaneous fat tissues of Luxi yellow cattle. The morphology of lipid accumulation of bovine preadipocytes was detected by Oil Red O staining, and total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), and high-density lipoprotein cholesterol (HDLC) levels were measured. Temporospatial expression of HMGR was investigated by real-time quantitative polymerase chain reaction (PCR). The TC, LDLC, and HDLC content did not significantly differ over time but increased slowly with increasing MVA concentration. HMGR expression increased over time and with increasing concentrations of MVA. MVA increased adipose cell proliferation in a dose-dependent and time-dependent manner. MVA stimulated HMGR expression in two cell types and its influence on adipocyte differentiation.

  10. Therapeutic efficacy of monthly subcutaneous injection of daclizumab in relapsing multiple sclerosis.

    PubMed

    Cohan, Stanley

    2016-01-01

    Despite the availability of multiple disease-modifying therapies for relapsing multiple sclerosis (MS), there remains a need for highly efficacious targeted therapy with a favorable benefit-risk profile and attributes that encourage a high level of treatment adherence. Daclizumab is a humanized monoclonal antibody directed against CD25, the α subunit of the high-affinity interleukin 2 (IL-2) receptor, that reversibly modulates IL-2 signaling. Daclizumab treatment leads to antagonism of proinflammatory, activated T lymphocyte function and expansion of immunoregulatory CD56(bright) natural killer cells, and has the potential to, at least in part, rectify the imbalance between immune tolerance and autoimmunity in relapsing MS. The clinical pharmacology, efficacy, and safety of subcutaneous daclizumab have been evaluated extensively in a large clinical study program. In pivotal studies, daclizumab demonstrated superior efficacy in reducing clinical and radiologic measures of MS disease activity compared with placebo or intramuscular interferon beta-1a, a standard-of-care therapy for relapsing MS. The risk of hepatic disorders, cutaneous events, and infections was modestly increased. The monthly subcutaneous self-injection dosing regimen of daclizumab may be advantageous in maintaining patient adherence to treatment, which is important for optimal outcomes with MS disease-modifying therapy. Daclizumab has been approved in the US and in the European Union and represents an effective new treatment option for patients with relapsing forms of MS, and is currently under review by other regulatory agencies. PMID:27672308

  11. Subcutaneous Phaeohyphomycosis Caused by Phaeoacremonium Species in a Kidney Transplant Patient: The First Case in Korea

    PubMed Central

    Choi, Jonghyeon; Lee, Yangsoon; Chung, Hae-Sun; Koo, Ja-Seung; Kim, Yu Sun; Lee, Kyungwon; Chong, Yunsop

    2011-01-01

    Phaeohyphomycosis is a subcutaneous infection caused by dark pigmented fungi, including fungi of the species Phaeoacremonium, Alternaria, Exophiala, and Pyrenochaeta. In August 2005, a 54-yr-old man who had received a renal transplant 5 yr ago was admitted to our hospital with a subcutaneous mass on the third finger of the right hand; the mass had been present for several months. He had been receiving immunosuppressive agents for several years. He underwent excision of the mass, which was followed by aspiration of the wound for bacterial and fungal cultures. Many fungal hyphae were observed on the histology slide treated with periodic acid-Schiff stain. A few white waxy colonies with a woolly texture grew on the Sabouraud dextrose agar at 30℃ and changed to dark brown in color. Nucleotide sequencing of internal transcribed spacer regions revealed 100% homology to the Phaeoacremonium aleophilum anamorph and Togninia minima teleomorph (514 bp/514 bp). The patient completely recovered after wide surgical excision. Here, we report the first case of phaeohyphomycosis caused by Phaeoacremonium species in a kidney transplant patient in Korea. PMID:21779196

  12. Dynamic gene expression profiles during postnatal development of porcine subcutaneous adipose.

    PubMed

    Zhang, Jie; Ma, Jideng; Long, Keren; Jin, Long; Liu, Yihui; Zhou, Chaowei; Tian, Shilin; Chen, Lei; Luo, Zonggang; Tang, Qianzi; Jiang, An'an; Wang, Xun; Wang, Dawei; Jiang, Zhi; Wang, Jinyong; Li, Xuewei; Li, Mingzhou

    2016-01-01

    A better understanding of the control of lipogenesis is of critical importance for both human and animal physiology. This requires a better knowledge of the changes of gene expression during the process of adipose tissue development. Thus, the objective of the current study was to determine the effects of development on subcutaneous adipose tissue gene expression in growing and adult pigs. Here, we present a comprehensive investigation of mRNA transcriptomes in porcine subcutaneous adipose tissue across four developmental stages using digital gene expression profiling. We identified 3,274 differential expressed genes associated with oxidative stress, immune processes, apoptosis, energy metabolism, insulin stimulus, cell cycle, angiogenesis and translation. A set of universally abundant genes (ATP8, COX2, COX3, ND1, ND2, SCD and TUBA1B) was found across all four developmental stages. This set of genes may play important roles in lipogenesis and development. We also identified development-related gene expression patterns that are linked to the different adipose phenotypes. We showed that genes enriched in significantly up-regulated profiles were associated with phosphorylation and angiogenesis. In contrast, genes enriched in significantly down-regulated profiles were related to cell cycle and cytoskeleton organization, suggesting an important role for these biological processes in adipose growth and development. These results provide a resource for studying adipose development and promote the pig as a model organism for researching the development of human obesity, as well as being used in the pig industry.

  13. Visualisation of human subcutaneous blood vessels by increasing coherence probing depth

    SciTech Connect

    Proskurin, S G; Wang, R K

    2004-12-31

    An improved Fourier-domain rapid-scanning optical delay in the reference arm of a Michelson interferometer is described which allows the use of a low-power superluminescent diode (down to 0.2 mW) and of a few wavelengths simultaneously. The method of raster scanning and averaging in the sample arm of the interferometer within a pixel provides an additional increase in the signal-to-noise ratio by 4-10 dB and, in combination with optical clearing, an increase in the coherence probing depth for the human skin in vivo up to 1.5-1.6 mm. As a result, subcutaneous blood vessels are visualised for the first time and a signal from the bloodstream is detected in the transitional regime between reflected and diffusively scattered photons. The images of subcutaneous blood vessels of the human palm and finger in vivo are presented. The possibility of construction of a low-coherence Doppler spectrograph with a variable coherence length is discussed. (laser applications and other topics in quantum electronics)

  14. The need for chemical compatibility studies of subcutaneous medication combinations used in palliative care.

    PubMed

    Rose, Marie; Currow, David C

    2009-01-01

    When a person with a life-limiting illness is unable to swallow, the subcutaneous route of administration is a widely used way of administering many medications, either as repeated bolus injections or by continuous infusions to complement transdermal, sublingual, or rectal routes of administration. To optimize symptom control as changes are made from other routes of administration to subcutaneous delivery, basic principles for ensuring optimal net clinical benefit (therapeutic benefit and minimizing side effects) must be understood as fully as science will allow. Despite the widespread use of combinations of injectable medications in this clinical setting and the availability of the technology to do the studies, the limited work done suggests that there may be significant drug loss with some combinations of medications without any visual or physical changes apparent. Work needs to be done urgently to evaluate a wide range of medication combinations used extensively in hospice and palliative care for chemical compatibility, while ensuring the work that has been done in other areas (anesthetics, chronic pain) is adopted into practice as results become available. Almost all of these medications are off-patent and there is therefore no financial incentive for the pharmaceutical industry to do the studies on medications now produced generically. Other sources of funding need to be identified. At best, it is likely that optimal symptom control is at times compromised in palliative care without chemical compatibility data for combinations of injectable medications and, at worst, toxicity is generated unknowingly. PMID:19670019

  15. Three cases of systemic amyloidosis successfully diagnosed by subcutaneous fat tissue biopsy of the hip.

    PubMed

    Arahata, Masahisa; Shimadoi, Shigeru; Yamatani, Satosi; Hayashi, Shin-Ichi; Miwa, Shigeharu; Asakura, Hidesaku; Nakao, Shinji

    2016-01-01

    Fine-needle aspiration biopsy of the abdominal fat pad is considered to be a minimally invasive procedure for diagnosing systemic amyloidosis. However, this procedure is sometimes difficult and can be dangerous for elderly patients whose abdominal fat layer is thin because of malnutrition. In such cases, alternative diagnostic methods are required. We report three elderly patients with heart failure complicated by malnutrition. In all cases, electrocardiogram showed low voltage in the limb leads and a pseudoinfarct pattern in the chest leads, and echocardiography showed left ventricular wall thickening with granular sparkling appearance. These patients were suspected of having amyloid cardiomyopathy but could not undergo myocardial biopsies because of their poor conditions. After failed attempts at biopsy of the abdominal fat pad or the other organs, subcutaneous fat tissue biopsy over the hip led to the diagnosis of systemic amyloidosis with cardiomyopathy. The resultant diagnosis guided us to choose the appropriate treatment for the patients. This article illustrates that subcutaneous fat tissue biopsy of the hip could be a useful procedure for diagnosing systemic amyloidosis in elderly patients, particularly when a fat tissue biopsy of the abdomen is associated with a high risk of complications because of malnutrition.

  16. Dynamic gene expression profiles during postnatal development of porcine subcutaneous adipose

    PubMed Central

    Jin, Long; Liu, Yihui; Zhou, Chaowei; Tian, Shilin; Chen, Lei; Luo, Zonggang; Tang, Qianzi; Jiang, An’an; Wang, Xun; Wang, Dawei; Jiang, Zhi; Wang, Jinyong

    2016-01-01

    A better understanding of the control of lipogenesis is of critical importance for both human and animal physiology. This requires a better knowledge of the changes of gene expression during the process of adipose tissue development. Thus, the objective of the current study was to determine the effects of development on subcutaneous adipose tissue gene expression in growing and adult pigs. Here, we present a comprehensive investigation of mRNA transcriptomes in porcine subcutaneous adipose tissue across four developmental stages using digital gene expression profiling. We identified 3,274 differential expressed genes associated with oxidative stress, immune processes, apoptosis, energy metabolism, insulin stimulus, cell cycle, angiogenesis and translation. A set of universally abundant genes (ATP8, COX2, COX3, ND1, ND2, SCD and TUBA1B) was found across all four developmental stages. This set of genes may play important roles in lipogenesis and development. We also identified development-related gene expression patterns that are linked to the different adipose phenotypes. We showed that genes enriched in significantly up-regulated profiles were associated with phosphorylation and angiogenesis. In contrast, genes enriched in significantly down-regulated profiles were related to cell cycle and cytoskeleton organization, suggesting an important role for these biological processes in adipose growth and development. These results provide a resource for studying adipose development and promote the pig as a model organism for researching the development of human obesity, as well as being used in the pig industry. PMID:26989614

  17. [Anesthetic management of a patient with severe subcutaneous and mediastinal emphysema due to pertussis infection].

    PubMed

    Ideno, Satoshi; Miyazawa, Noriko; Ishikawa, Saki; Wakamiya, Rie; Shinto, Atsushi; Mikasa, Hiromi; Yamamoto, Shinichi

    2014-06-01

    A 20-month-old girl, with respiratory failure due to severe subcutaneous and mediastinal emphysema, was scheduled to undergo percutaneous drainage of emphysema and induction of extracorporeal membrane oxygenation. Paroxysm, a symptom of the infection of Bordetella pertussis, was the cause of emphysema. In patients with severe neck subcutaneous emphysema, management of difficult airway is the most important safety issue in the practice of anesthesia. Following the American Society of Anesthesiologist (ASA) guidelines for management of difficult airway, we prepared various types of equipment to facilitate intubation and surgeons were beside the patient during induction of anesthesia for emergency invasive airway access. To prevent the progression of emphysema, preservation of spontaneous breathing during the perioperative period was also important. Combined with propofol and midazolam, pethidine was an effective agent for safe anesthetic induction because it produces less respiratory depression compared to other opiate analgesics. In conclusion, this case demonstrates the importance of prediction of and preparation for difficult airway. Furthermore, anesthesiologists should consider the optimization of anesthesia to avoid progression of emphysema.

  18. Non psammomatous melanocytic schwannoma presenting as a subcutaneous nodule: A rare presentation of a rare lesion

    PubMed Central

    Gulati, Harveen Kaur; Joshi, Avinash R.; Anand, Mani; Deshmukh, S. D.

    2016-01-01

    Melanocytic schwannoma (MS) is an extremely rare soft tissue tumor accounting for less than 1% of all primitive nerve sheath tumors, with a predilection for spinal nerve involvement. To date, only 20 cases of cutaneous/subcutaneous MS have been described in literature. Here, we describe a case of MS presenting as a subcutaneous nodule in a 22-year-old male in right thigh. On examination, the nodule measured 2.5 × 2.0 × 1.5 cm with overlying skin showing a bluish hue and an ulcer. With a preoperative diagnosis of hemangioma, the patient was taken up for wide local excision and was diagnosed as a case of non psammomatous melanocytic schwannoma based on clinical, histological, and immunohistochemical studies. Immunohistochemistry revealed positivity with S-100, HMB-45, and Melan A with pericellular Laminin positivity. Carney's syndrome was ruled out. MS needs to be differentiated from other pigmented lesions like pigmented neurofibroma, Bednar tumor, cellular blue neavus, and especially malignant melanoma, which has an obvious ominous prognosis. Since MS can show unpredictable behavior especially in absence of overt malignant features, a long term follow up with or without radiotherapy is recommended. PMID:27366278

  19. The pharmacokinetics of subcutaneously injected Bimosiamose disodium in healthy male volunteers.

    PubMed

    Meyer, Michael; Beyer, Diana; Vollhardt, Karin; Woischwill, Christiane; Jilma, Bernd; Wolff, Gerhard

    2007-12-01

    Bimosiamose is a novel synthetic pan-selectin antagonist developed for the treatment of acute and chronic inflammatory disorders. Therefore the pharmacokinetics of Bimosiamose disodium were studied in healthy male volunteers after single and multiple subcutaneous injections. A randomized, double-blind, placebo-controlled dose escalation trial was carried out. The subjects received subcutaneous injections of placebo or 100, 200 or 300 mg Bimosiamose disodium into the abdomen. Plasma and urine concentrations of Bimosiamose were determined. The maximum plasma concentration was 2.17+/-0.70 microg/ml and the AUC(0-infinity) 11.1+/-2.9 h microg/ml after the highest dose on day 1 (mean+/-SD). For the apparent clearance CL/f 28.7+/-7.3 l/h and the terminal half life t(1/2) 3.7+/-0.6 h were calculated. The mean residence time MRT(infinity) of 5.5 to 6.3 h for s.c. injection exceeded that after i.v. infusion due to an extended absorption time. For multiple dosing, constant pre-dose concentrations of about 20 ng/ml may be reached after two subsequent doses of 200 or 300 mg Bimosiamose disodium once daily. Almost 15% of the administered drug was excreted unchanged in urine. Moreover, Bimosiamose was well tolerated. PMID:17876866

  20. Insulin Infusion Set: The Achilles Heel of Continuous Subcutaneous Insulin Infusion

    PubMed Central

    Heinemann, Lutz; Krinelke, Lars

    2012-01-01

    Continuous subcutaneous insulin infusion from an insulin pump depends on reliable transfer of the pumped insulin to the subcutaneous insulin depot by means of an insulin infusion set (IIS). Despite their widespread use, the published knowledge about IISs and related issues regarding the impact of placement and wear time on insulin absorption/insulin action is relatively small. We also have to acknowledge that our knowledge is limited with regard to how often patients encounter issues with IISs. Reading pump wearer blogs, for instance, suggests that these are a frequent source of trouble. There are no prospective clinical studies available on current IIS and insulin formulations that provide representative data on the type and frequency of issues with infusion sets. The introduction of new IISs and patch pumps may foster a reassessment of available products and of patient problems related to their use. The aim of this review is to summarize the current knowledge and recommendations about IISs and to highlight potential directions of IIS development in order to make insulin absorption safer and more efficient. PMID:22920824

  1. Limitations to the effectiveness of subcutaneous calcium solutions as a treatment for cows with milk fever.

    PubMed

    Fenwick, D C

    1994-04-23

    Serum calcium concentrations were determined in 164 cases of milk fever (mostly Jersey cows) attended in the course of practice in a cold, wet winter rainfall area where the cows calved at pasture. The mean calcium concentration of the cows receiving no calcium therapy subcutaneously before sampling (1.0 mmol/litre) was significantly (P < 0.01) less than the mean of 1.4 mmol/litre for cows receiving 300 ml of 33.3 or 40 per cent calcium borogluconate solution, which was significantly (P < 0.01) less than the mean of 2.1 mmol/litre for those receiving 600 ml subcutaneously. Neither the rectal temperature of the cows nor the average time interval between the injection of the two bottles and blood sampling had any effect on the serum calcium of the latter cows, whereas the rectal temperature but not the time interval had a significant (P < 0.01) effect on the serum calcium of the cows receiving 300 ml; the lower their temperature, the lower the calcium concentration. The mean (+/- sd) interval between treatment by the herdsman and veterinary attention for the cows receiving 300 ml (4.8 +/- 4.9 hours was significantly (P < 0.01) shorter than for the cows receiving 600 ml (12.0 +/- 9.4 hours). At the time of sampling, 48 per cent of the cows receiving 600 ml of calcium borogluconate solution had a serum calcium concentration below 2.0 mmol/litre.

  2. Estimating resting metabolic rate by biologging core and subcutaneous temperature in a mammal.

    PubMed

    Rey, Benjamin; Halsey, Lewis G; Hetem, Robyn S; Fuller, Andrea; Mitchell, Duncan; Rouanet, Jean-Louis

    2015-05-01

    Tri-axial accelerometry has been used to continuously and remotely assess field metabolic rates in free-living endotherms. However, in cold environments, the use of accelerometry may underestimate resting metabolic rate because cold-induced stimulation of metabolic rate causes no measurable acceleration. To overcome this problem, we investigated if logging the difference between core and subcutaneous temperatures (ΔTc-s) could reveal the metabolic costs associated with cold exposure. Using implanted temperature data loggers, we recorded core and subcutaneous temperatures continuously in eight captive rabbits (Oryctolagus cuniculus) and concurrently measured their resting metabolic rate by indirect calorimetry, at ambient temperatures ranging from -7 to +25°C. ΔTc-s showed no circadian fluctuations in warm (+23°C) or cold (+5°C) environments implying that the ΔTc-s was not affected by an endogenous circadian rhythm in our laboratory conditions. ΔTc-s correlated well with resting metabolic rate (R(2)=0.77) across all ambient temperatures except above the upper limit of the thermoneutral zone (+25°C). Determining ΔTc-s could therefore provide a complementary approach for better estimating resting metabolic rate of animals within and below their thermoneutral zone. Combining data from accelerometers with such measures of body temperature could improve estimates of the overall field metabolic rate of free-living endotherms.

  3. Robust separation of visceral and subcutaneous adipose tissues in micro-CT of mice.

    PubMed

    Shi, Bibo; Xie, Shuisheng; Berryman, Darlene; List, Ed; Liu, Jundong

    2013-01-01

    One of the common practices in obesity and diabetes studies is to measure the volumes and weights of various adipose tissues, among which, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) play critical yet different physiological roles in mouse aging. In this paper, a robust two-stage VAT/SAT separation framework for micro-CT mouse data is proposed. The first stage is to distinguish adipose from other tissue types, including background, soft tissue and bone, through a robust mixture of Gaussian model. Spatial recognition relevant to anatomical locations is carried out in the second step to determine whether the adipose is visceral or subcutaneous. We tackle this problem through a novel approach that relies on evolving the abdominal muscular wall to keep VAT/SAT separated. The VAT region of interest (ROI) is also automatically set up through an atlas based skeleton matching procedure. The results of our method are compared with VAT/SAT delineations by human experts, and a high classification accuracy is demonstrated on eight micro-CT mouse volume sets.

  4. Isolation and Differentiation of Adipose-Derived Stem Cells from Porcine Subcutaneous Adipose Tissues.

    PubMed

    Chen, Yu-Jen; Liu, Hui-Yu; Chang, Yun-Tsui; Cheng, Ying-Hung; Mersmann, Harry J; Kuo, Wen-Hung; Ding, Shih-Torng

    2016-03-31

    Obesity is an unconstrained worldwide epidemic. Unraveling molecular controls in adipose tissue development holds promise to treat obesity or diabetes. Although numerous immortalized adipogenic cell lines have been established, adipose-derived stem cells from the stromal vascular fraction of subcutaneous white adipose tissues provide a reliable cellular system ex vivo much closer to adipose development in vivo. Pig adipose-derived stem cells (pADSC) are isolated from 7- to 9-day old piglets. The dorsal white fat depot of porcine subcutaneous adipose tissues is sliced, minced and collagenase digested. These pADSC exhibit strong potential to differentiate into adipocytes. Moreover, the pADSC also possess multipotency, assessed by selective stem cell markers, to differentiate into various mesenchymal cell types including adipocytes, osteocytes, and chondrocytes. These pADSC can be used for clarification of molecular switches in regulating classical adipocyte differentiation or in direction to other mesenchymal cell types of mesodermal origin. Furthermore, extended lineages into cells of ectodermal and endodermal origin have recently been achieved. Therefore, pADSC derived in this protocol provide an abundant and assessable source of adult mesenchymal stem cells with full multipotency for studying adipose development and application to tissue engineering of regenerative medicine.

  5. Pharmacokinetics of tulathromycin after subcutaneous injection in North American bison (Bison bison).

    PubMed

    Bachtold, K; Alcorn, J; Matus, J; Boison, J; Woodbury, M

    2015-10-01

    Tulathromycin is approved for the treatment of respiratory disease in cattle and swine. It is intended for long-acting, single-dose injection therapy (Draxxin), making it particularly desirable for use in bison due to the difficulty in handling and ease of creating stress in these animals. The pharmacokinetic properties of tulathromycin in bison were investigated. Ten wood bison received a single 2.5 mg/kg subcutaneous injection of Draxxin. Serum concentrations were measured by liquid chromatography-mass spectrometry (LC-MS) detection. Tulathromycin demonstrated early maximal serum concentrations, extensive distribution, and slow elimination characteristics. The mean maximum serum concentration (Cmax) was 195 ng/mL at 1.04 h (tmax) postinjection. The mean area under the serum concentration-time curve, extrapolated to infinity (AUC0-inf ), was 9341 ng · h/mL. The mean apparent volume of distribution (Vd /F) and clearance (Cls/F) was 111 L/kg and 0.4 L/h/kg, respectively, and the mean half-life (t1/2) was 214 h (8.9 days). Compared to values for cattle, Cmax and AUC0-inf were lower in bison, while the Vd /F was larger and the t1/2 longer. Tissue distribution and clinical efficacy studies in bison are needed to confirm the purported extensive distribution of tulathromycin into lung tissue and to determine whether a 2.5 mg/kg subcutaneous dosage is adequate for bison.

  6. Aluminium adjuvants and adverse events in sub-cutaneous allergy immunotherapy

    PubMed Central

    2014-01-01

    Sub-cutaneous immunotherapy is an effective treatment for allergy. It works by helping to modify or re-balance an individual’s immune response to allergens and its efficacy is greatly improved by the use of adjuvants, most commonly, aluminium hydroxide. Aluminium salts have been used in allergy therapy for many decades and are assumed to be safe with few established side-effects. This assumption belies their potency as adjuvants and their potential for biological reactivity both at injection sites and elsewhere in the body. There are very few data purporting to the safety of aluminium adjuvants in allergy immunotherapy and particularly so in relation to longer term health effects. There are, if only few, published reports of adverse events following allergy immunotherapy and aluminium adjuvants are the prime suspects in the majority of such incidents. Aluminium adjuvants are clearly capable of initiating unwanted side effects in recipients of immunotherapy and while there is as yet no evidence that such are commonplace it is complacent to consider aluminium salts as harmless constituents of allergy therapies. Future research should establish the safety of the use of aluminium adjuvants in sub-cutaneous allergy immunotherapy. PMID:24444186

  7. Subcutaneous implantation of satellite transmitters with percutaneous antennae into male polar bears (Ursus maritimus)

    USGS Publications Warehouse

    Mulcahy, D.M.; Garner, G.

    1999-01-01

    Male polar bears (Ursus maritimus) have not been successfully instrumented with satellite transmitters because they readily shed collar-mounted transmitters. Seven male polar bears were captured on the pack ice off the northern coast of Alaska and surgically implanted with satellite transmitters with percutaneous antennae into the subcutaneous space of the dorsal cervical region. Transmitters failed prematurely with lifetimes of 30-161 days (x?? = 97 days). Efforts to relocate implanted bears after transmitters failed were not successful. The mean number of location solutions per transmitter was 204 (range 118-369). An average of 10% and 19% of the locations were accurate to <150 m and to 150-350 m, respectively. Our successful tracking of male polar bears, the high quality of locations obtained from transmitters with percutaneous antennae implanted in the subcutaneous space, and the low visibility of such units make further technical development worthwhile if the reason for premature failure of the transmitters can be determined. Copyright 1999 by American Association of Zoo Veterinarians.

  8. Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections.

    PubMed Central

    Hutin, Yvan; Hauri, Anja; Chiarello, Linda; Catlin, Mary; Stilwell, Barbara; Ghebrehiwet, Tesfamicael; Garner, Julia

    2003-01-01

    OBJECTIVE: To draw up evidence-based guidelines to make injections safer. METHODS: A development group summarized evidence-based best practices for preventing injection-associated infections in resource-limited settings. The development process included a breakdown of the WHO reference definition of a safe injection into a list of potentially critical steps, a review of the literature for each of these steps, the formulation of best practices, and the submission of the draft document to peer review. FINDINGS: Eliminating unnecessary injections is the highest priority in preventing injection-associated infections. However, when intradermal, subcutaneous, or intramuscular injections are medically indicated, best infection control practices include the use of sterile injection equipment, the prevention of contamination of injection equipment and medication, the prevention of needle-stick injuries to the provider, and the prevention of access to used needles. CONCLUSION: The availability of best infection control practices for intradermal, subcutaneous, and intramuscular injections will provide a reference for global efforts to achieve the goal of safe and appropriate use of injections. WHO will revise the best practices five years after initial development, i.e. in 2005. PMID:12973641

  9. Use of the subcutaneous venous network of the forearm to create an arteriovenous fistula.

    PubMed

    Gołębiowski, Tomasz; Letachowicz, Krzysztof; Letachowicz, Waldemar; Kusztal, Mariusz; Garcarek, Jerzy; Strempska, Beata; Weyde, Wacław; Klinger, Marian

    2015-10-01

    The reconstruction of vascular access in patients with kidney allograft failure is a challenging problem. A case of a 62-year-old man with transplanted kidney insufficiency is described. The patient was initially dialyzed with a wrist radial-cephalic arteriovenous fistula. In the post-transplantation period, the enormously dilated venous part of the anastomosis was ligated and the part of the vein suspected of being the source of bacteremia was excised. The man was referred to our department due to kidney allograft failure for vascular access creation. During preoperative assessment, we unexpectedly found a soft thrill on the forearm. Doppler ultrasound confirmed fistula patency, although the blood supply was not sufficient to perform dialysis. Angiography showed the blood flow from the radial artery to the cephalic vein, through a complicated vessel system consisting of inter alia a dilated vein of the subcutaneous venous network. We successfully used this vein as the vascular access outflow for fistula recreation. In conclusion, making use of veins of the subcutaneous venous network of the forearm for creation of a native fistula should be considered in selected cases. PMID:25881485

  10. Therapeutic efficacy of monthly subcutaneous injection of daclizumab in relapsing multiple sclerosis

    PubMed Central

    Cohan, Stanley

    2016-01-01

    Despite the availability of multiple disease-modifying therapies for relapsing multiple sclerosis (MS), there remains a need for highly efficacious targeted therapy with a favorable benefit–risk profile and attributes that encourage a high level of treatment adherence. Daclizumab is a humanized monoclonal antibody directed against CD25, the α subunit of the high-affinity interleukin 2 (IL-2) receptor, that reversibly modulates IL-2 signaling. Daclizumab treatment leads to antagonism of proinflammatory, activated T lymphocyte function and expansion of immunoregulatory CD56bright natural killer cells, and has the potential to, at least in part, rectify the imbalance between immune tolerance and autoimmunity in relapsing MS. The clinical pharmacology, efficacy, and safety of subcutaneous daclizumab have been evaluated extensively in a large clinical study program. In pivotal studies, daclizumab demonstrated superior efficacy in reducing clinical and radiologic measures of MS disease activity compared with placebo or intramuscular interferon beta-1a, a standard-of-care therapy for relapsing MS. The risk of hepatic disorders, cutaneous events, and infections was modestly increased. The monthly subcutaneous self-injection dosing regimen of daclizumab may be advantageous in maintaining patient adherence to treatment, which is important for optimal outcomes with MS disease-modifying therapy. Daclizumab has been approved in the US and in the European Union and represents an effective new treatment option for patients with relapsing forms of MS, and is currently under review by other regulatory agencies.

  11. Isolation and Differentiation of Adipose-Derived Stem Cells from Porcine Subcutaneous Adipose Tissues

    PubMed Central

    Chen, Yu-Jen; Liu, Hui-Yu; Chang, Yun-Tsui; Cheng, Ying-Hung; Mersmann, Harry J.; Kuo, Wen-Hung; Ding, Shih-Torng

    2016-01-01

    Obesity is an unconstrained worldwide epidemic. Unraveling molecular controls in adipose tissue development holds promise to treat obesity or diabetes. Although numerous immortalized adipogenic cell lines have been established, adipose-derived stem cells from the stromal vascular fraction of subcutaneous white adipose tissues provide a reliable cellular system ex vivo much closer to adipose development in vivo. Pig adipose-derived stem cells (pADSC) are isolated from 7- to 9-day old piglets. The dorsal white fat depot of porcine subcutaneous adipose tissues is sliced, minced and collagenase digested. These pADSC exhibit strong potential to differentiate into adipocytes. Moreover, the pADSC also possess multipotency, assessed by selective stem cell markers, to differentiate into various mesenchymal cell types including adipocytes, osteocytes, and chondrocytes. These pADSC can be used for clarification of molecular switches in regulating classical adipocyte differentiation or in direction to other mesenchymal cell types of mesodermal origin. Furthermore, extended lineages into cells of ectodermal and endodermal origin have recently been achieved. Therefore, pADSC derived in this protocol provide an abundant and assessable source of adult mesenchymal stem cells with full multipotency for studying adipose development and application to tissue engineering of regenerative medicine. PMID:27077225

  12. Pharmacokinetics of A40926 in rats after single intravenous and subcutaneous doses.

    PubMed Central

    Bernareggi, A; Danese, A; Cavenaghi, L

    1988-01-01

    A40926 is a new glycopeptide antibiotic with unique activity against Neisseria gonorrhoeae and high and prolonged levels in mouse blood (B. P. Goldstein, E. Selva, L. Gastaldo, M. Berti, R. Pallanza, F. Ripamonti, P. Ferrari, M. Denaro, V. Arioli, and G. Cassani, Antimicrob. Agents Chemother., 31:1961-1966, 1987). We studied the pharmacokinetics of A40926 in rats after single intravenous and subcutaneous 10-mg/kg (body weight) doses. Concentrations in plasma and urine were determined by microbiological assay. After intravenous administration, high concentrations of A40926, ranging from 132 mg/liter at 3 min to 0.7 mg/liter at 96 h, were found in plasma. Concentrations declined with a three-exponential decay correlated with a prolonged, biphasic distribution and a slow elimination (terminal half-life, 61.22 h). After completion of the distribution, the compound was widely distributed to the extravascular space. The rate-limiting step in the elimination of A40926 from the body appears to be the slow return from the deep compartment into the central one. A40926 was rapidly absorbed from the injection site after subcutaneous administration, and its availability was close to 90%. The percentage of the dose excreted in urine in 120 h was 35.9%. PMID:3364946

  13. [Extreme subcutaneous and intramuscular insulin resistance at type 1 diabetes mellitus].

    PubMed

    Pinheiro, Anielli; Tácito, Lúcia H B; Pires, Antônio C

    2011-04-01

    Insulin resistance signs reduced cellular response to this hormone and dysfunction of glucose transport to intracellular compartment. This phenomenon is associated to genetic factors and principally behavior factors correlating to obesity and its comorbidities, as type 2 diabetes mellitus, hypertension and dyslipidemia. However clinical factors of insulin resistance are still present at not obese type 1 diabetes in a known syndrome called type 1 diabetes mellitus with resistance to insulin administered subcutaneously and intramuscularly (DRIASM). This is a rare condition that consists into insulin resistance at subcutaneously and intramuscularly use and normal or near to normal sensitivity at intravenously way. Treatments until now proposed are ineffective and are related to frequent fails and complications. We report here two cases of DRIASM in 45 and 46 female patients that are different from others yet related because they have late diabetes type 1, sustained hyperglycemia associated to catabolic, microangiopathy and neuropathic complications without any ketoacidosis episode. The treatment vary from alternative ways for insulin infusion to inscription to a possible performance of pancreas transplantation like a experiment of definitive treatment. This report was approved by Research Ethic Committee from São José do Rio Preto medical school. PMID:21655874

  14. Subcutaneous implants for long-acting drug therapy in laboratory animals may generate unintended drug reservoirs

    PubMed Central

    Guarnieri, Michael; Tyler, Betty M.; DeTolla, Louis; Zhao, Ming; Kobrin, Barry

    2014-01-01

    Background: Long-acting therapy in laboratory animals offers advantages over the current practice of 2-3 daily drug injections. Yet little is known about the disintegration of biodegradable drug implants in rodents. Objective: Compare bioavailability of buprenorphine with the biodegradation of lipid-encapsulated subcutaneous drug pellets. Methods: Pharmacokinetic and histopathology studies were conducted in BALB/c female mice implanted with cholesterol-buprenorphine drug pellets. Results: Drug levels are below the level of detection (0.5 ng/mL plasma) within 4-5 days of implant. However, necroscopy revealed that interstitial tissues begin to seal implants within a week. Visual inspection of the implant site revealed no evidence of inflammation or edema associated with the cholesterol-drug residue. Chemical analyses demonstrated that the residues contained 10-13% of the initial opiate dose for at least two weeks post implant. Discussion: The results demonstrate that biodegradable scaffolds can become sequestered in the subcutaneous space. Conclusion: Drug implants can retain significant and unintended reservoirs of drugs. PMID:24459402

  15. Subcutaneous daidzein administration enhances recovery of skilled ladder rung walking performance following stroke in rats.

    PubMed

    Stout, Jessica M; Knapp, Austen N; Banz, William J; Wallace, Douglas G; Cheatwood, Joseph L

    2013-11-01

    Stroke is a devastating event which can result in permanent disability. Due to the lack of treatments available for use after stroke, compounds which work to limit cell loss, reduce behavioral deficits, and enhance recovery of function are needed. The isoflavone daidzein has been demonstrated to be neuroprotective when fed to rats beginning prior to stroke. Herein, we tested whether subcutaneous delivery of daidzein beginning at the time of stroke reduced injury and/or enhanced functional recovery over 14 days after stroke. Baseline performance on the skilled ladder rung walking task was recorded immediately before stroke (Day 0). Rats then underwent a unilateral permanent middle cerebral artery occlusion and received a subcutaneous minipump containing either daidzein dissolved in vehicle or vehicle alone. Performance on the skilled ladder rung walking task was recorded again on Day +3, Day +7, and Day +14 post-stroke. Rats were then euthanized and brains were collected for lesion volume analysis. The numbers of slight and deep forelimb slips on the task were recorded for 3 trials for each rat per day. Rats treated with daidzein exhibited fewer deep slips over the course of the experiment than rats which received only vehicle (p<0.05). No difference was detected in total forelimb slips or slight slips (p>0.05). Lesion volume was not different between groups (p>0.05). No differences were found in weight between groups during the study (p>0.05). PMID:23994543

  16. Three cases of systemic amyloidosis successfully diagnosed by subcutaneous fat tissue biopsy of the hip

    PubMed Central

    Arahata, Masahisa; Shimadoi, Shigeru; Yamatani, Satosi; Hayashi, Shin-ichi; Miwa, Shigeharu; Asakura, Hidesaku; Nakao, Shinji

    2016-01-01

    Fine-needle aspiration biopsy of the abdominal fat pad is considered to be a minimally invasive procedure for diagnosing systemic amyloidosis. However, this procedure is sometimes difficult and can be dangerous for elderly patients whose abdominal fat layer is thin because of malnutrition. In such cases, alternative diagnostic methods are required. We report three elderly patients with heart failure complicated by malnutrition. In all cases, electrocardiogram showed low voltage in the limb leads and a pseudoinfarct pattern in the chest leads, and echocardiography showed left ventricular wall thickening with granular sparkling appearance. These patients were suspected of having amyloid cardiomyopathy but could not undergo myocardial biopsies because of their poor conditions. After failed attempts at biopsy of the abdominal fat pad or the other organs, subcutaneous fat tissue biopsy over the hip led to the diagnosis of systemic amyloidosis with cardiomyopathy. The resultant diagnosis guided us to choose the appropriate treatment for the patients. This article illustrates that subcutaneous fat tissue biopsy of the hip could be a useful procedure for diagnosing systemic amyloidosis in elderly patients, particularly when a fat tissue biopsy of the abdomen is associated with a high risk of complications because of malnutrition. PMID:27540285

  17. Effect of subcutaneous insulin detemir on glucose flux, lipolysis and electroencephalography in type 1 diabetes.

    PubMed

    Herring, R; Knight, R; Shojaee-Moradie, F; Johnsen, S; Umpleby, A M; Jackson, N; Jones, R; Dijk, D-J; Russell-Jones, D L

    2015-11-01

    The aim of the present study was to investigate the effects of subcutaneous detemir on glucose flux, lipid metabolism and brain function. Twelve people with type 1 diabetes received, in random order, 0.5 units/kg body weight detemir or NPH insulin. Glucose concentration was clamped at 5 mmol/l then increased to 10 mmol/l. Glucose production rate (glucose Ra), glucose uptake (glucose Rd) and glycerol production (glycerol Ra) were measured with a constant intravenous infusion of [6,6(2) H(2)]glucose and [(2)H(5)]glycerol. Electroencephalography direct current (DC) and alternating current (AC) potentials were measured. While detemir induced similar effects on glucose Ra, glucose Rd and glycerol Ra during euglycaemia compared with NPH, it triggered a distinct negative shift in DC potentials, with a significant treatment effect in frontal cerebrocortical channels (p < 0.001). AC spectral power showed significant differences in theta and alpha frequencies during euglycaemia (p = 0.03). Subcutaneous detemir exerts different effects on brain function when compared with NPH in people with type 1 diabetes. This may be an important mechanism behind the limitation of weight gain with detemir. PMID:26272173

  18. Multifocal melanocytoma of the posterior fossa and subcutaneous scalp in the absence of neurocutaneous melanosis

    PubMed Central

    Pierson, Matt; Marwaha, Nitin; Guzman, Miguel; Mikulec, Anthony A.; Coppens, Jeroen R.

    2016-01-01

    Background: Primary leptomeningeal melanocytic neoplasms of the central nervous system are rare. Multifocal lesions typically occur in the setting of cutaneous melanosis. We present the first report of a posterior fossa melanocytoma and subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis. Case Description: We present the case of a 22-year-old male with decreased hearing on the right side, ataxia, nausea, vomiting and a scalp mass. Magnetic resonance imaging (MRI) demonstrated occipital and cerebellopontine (CP) angle masses. The patient underwent gross total resection of the scalp mass and subtotal resection of the CP angle mass. Pathologic examination revealed melanocytoma with intermediate grade. The patient underwent stereotactic radiosurgery to the residual CP angle tumor. This case represents, to the author's knowledge, the first report associating a posterior fossa melanocytoma with a subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis. Conclusion: This case introduces the first report of a new variant of multifocal melanocytoma which is not confined to the central nervous system.

  19. The acceptability of self-administration of subcutaneous Depo-Provera.

    PubMed

    Lakha, Fatim; Henderson, Charlotte; Glasier, Anna

    2005-07-01

    Depo-Provera (depot medroxyprogesterone acetate, or DMPA) is an important contraceptive option for women worldwide. Currently, it is only available in intramuscular form requiring regular quarterly routine attendance at a health facility. A new subcutaneous preparation has been developed. This is self-administrable and could potentially reduce need for routine attendance to an annual visit. In a questionnaire survey of 176 women currently using DMPA, 67% would prefer to self-administer. Of the 33% who did not wish to self-administer, the most common reasons were a fear of needles (62%) and concern regarding incorrect administration (43%). In a second survey of 313 women not currently using DMPA, 64% of women said they would prefer to attend less often for contraceptive supplies. Twenty-six percent of women who had never used DMPA and 40% of ex-users would seriously consider DMPA if self-administration were possible. Our findings would suggest that the advent of subcutaneous self-administrable Depo-Provera with appropriate training and reminder system is likely to be beneficial and popular with many women.

  20. Autologous tissue patch rich in stem cells created in the subcutaneous tissue

    PubMed Central

    Garcia-Gomez, Ignacio; Gudehithlu, Krishnamurthy P; Arruda, Jose A L; Singh, Ashok K

    2015-01-01

    AIM: To investigate whether we could create natural autologous tissue patches in the subcutaneous space for organ repair. METHODS: We implanted the following three types of inert foreign bodies in the subcutaneous tissue of rats to produce autologous tissue patches of different geometries: (1) a large-sized polyvinyl tube (L = 25 mm, internal diameter = 7 mm) sealed at both ends by heat application for obtaining a large flat piece of tissue patch for organ repair; (2) a fine polyvinyl tubing (L = 25 mm, internal diameter = 3 mm) for creating cylindrically shaped grafts for vascular or nerve repair; and (3) a slurry of polydextran particle gel for inducing a bladder-like tissue. Implantation of inert materials was carried out by making a small incision on one or either side of the thoracic-lumbar region of rats. Subcutaneous pockets were created by blunt dissection around the incision into which the inert bodies were inserted (1 or 2 per rat). The incisions were closed with silk sutures, and the animals were allowed to recover. In case of the polydextran gel slurry 5 mL of the slurry was injected in the subcutaneous space using an 18 gauge needle. After implanting the foreign bodies a newly regenerated encapsulating tissue developed around the foreign bodies. The tissues were harvested after 4-42 d of implantation and studied by gross examination, histology, and histochemistry for organization, vascularity, and presence of mesenchymal stem cells (MSCs) (CD271+CD34+ cells). RESULTS: Implanting a large cylindrically shaped polyvinyl tube resulted in a large flat sheet of tissue that could be tailored to a specific size and shape for use as a tissue patch for repairing large organs. Implanting a smaller sized polyvinyl tube yielded a cylindrical tissue that could be useful for repairing nerves and blood vessels. This type of patch could be obtained in different lengths by varying the length of the implanted tube. Implanting a suspension of inert polydextran suspension

  1. Dietary conjugated linoleic acids increase intramuscular fat deposition and decrease subcutaneous fat deposition in Yellow Breed × Simmental cattle.

    PubMed

    Zhang, Haibo; Dong, Xianwen; Wang, Zhisheng; Zhou, Aiming; Peng, Quanhui; Zou, Huawei; Xue, Bai; Wang, Lizhi

    2016-04-01

    This study was conducted to estimate the effect of dietary conjugated linoleic acids (CLA) on intramuscular and subcutaneous fat deposition in Yellow Breed × Simmental cattle. The experiment was conducted for 60 days. The results showed that the average backfat thickness, (testicles + kidney + pelvic) fat percentage and subcutaneous fat percentage in dietary CLA were significantly lower than in the control group, while intramuscular the fat percentage was significantly higher. Compared to the control group, the Longissimus muscle enzyme activities of lipoprotein lipase (LPL), fatty acid synthase (FAS) and acetyl-coenzyme A carboxylase (ACC) in dietary CLA and the subcutaneous fat enzyme activities of LPL, hormone-sensitive lipase (HSL) and carnitine palmitoyltransferase-1 (CPT-1) were significantly increased. Similarly, compared to the control group, the Longissimus muscle sterol regulatory element binding protein 1 (SREBP-1), FAS, stearoyl-coenzyme A desaturase (SCD), ACC, peroxisome proliferator-activated receptor γ (PPARγ), heart fatty-acid binding protein (H-FABP) and LPL gene expression in dietary CLA were significant increased, as were the subcutaneous fat of PPARγ, H-FABP, LPL, CPT-1 and HSL in dietary CLA. These results indicated that dietary CLA increases IMF deposition mainly by the up-regulation of lipogenic gene expression, while decreasing subcutaneous fat deposition mainly by the up-regulation of lipolytic gene expression.

  2. Dietary whole cottonseed depresses lipogenesis but has no effect on stearoyl coenzyme desaturase activity in bovine subcutaneous adipose tissue.

    PubMed

    Page, A M; Sturdivant, C A; Lunt, D K; Smith, S B

    1997-09-01

    The primary objective of this study was to determine the effect of long-term feeding of whole cottonseed (WCS) on lipogenesis and stearoyl-coenzyme A desaturase activity in growing steers. Brangus steers were fed either a control, cornbased diet (n = 11) or 30% WCS (n = 12). The 30% WCS contributed an estimated 6.6% additional lipid to the diet. Steers fed the added WCS had greater live weights (P = 0.04) and kidney, pelvic, and heart fat (P = 0.005). Subcutaneous fat thickness was not different (P = 0.20) between treatment groups, although WCS elicited an increase in the proportion of large diameter subcutaneous adipocytes. The rate of [U-14C]acetate incorporation into fatty acids in subcutaneous adipose tissue was reduced by dietary WCS (171.4 vs 122.1 nmol x 100 mg adipose tissue-1 x 2 hr-1, P = 0.03), indicating that the increased dietary fat depressed de novo lipogenesis. Hepatic desaturase activity was much lower than that of subcutaneous adipose tissue, a feature common to cattle. We anticipated that added WCS also would depress stearoyl-coenzyme A desaturase activity in subcutaneous adipose tissue and liver due to its cyclopropene fatty acid content. Instead, desaturase activity was numerically (although not significantly) greater in liver (P = 0.37) and adipose tissue (P = 0.23). PMID:9417995

  3. Diet-induced changes in subcutaneous adipose tissue blood flow in man: effect of beta-adrenoceptor inhibition.

    PubMed

    Simonsen, L; Bülow, J; Astrup, A; Madsen, J; Christensen, N J

    1990-06-01

    The effect of a carbohydrate-rich meal on subcutaneous adipose tissue blood flow was studied with and without continuous i.v. infusion of propranolol in healthy volunteers. The subcutaneous adipose tissue blood flow was measured with the 133Xe washout method in three different locations: the forearm, the thigh and the abdomen. The subjects were given a meal consisting of white bread, jam, honey and apple juice (about 2300 kJ). The meal induced a twofold increase in blood flow in the examined tissues. Propranolol abolished the flow increase in the thigh and the abdomen and reduced it in the forearm. This indicates that the mechanism for the flow increase is elicited by a stimulation of vascular beta-adrenoceptors in the subcutaneous adipose tissue, since the beta-adrenoceptor inhibition did not affect the overall metabolic and hormonal responses to the meal.

  4. Renal capsule xenografting and subcutaneous pellet implantation for the evaluation of prostate carcinogenesis and benign prostatic hyperplasia.

    PubMed

    Nicholson, Tristan M; Uchtmann, Kristen S; Valdez, Conrad D; Theberge, Ashleigh B; Miralem, Tihomir; Ricke, William A

    2013-01-01

    New therapies for two common prostate diseases, prostate cancer (PrCa) and benign prostatic hyperplasia (BPH), depend critically on experiments evaluating their hormonal regulation. Sex steroid hormones (notably androgens and estrogens) are important in PrCa and BPH; we probe their respective roles in inducing prostate growth and carcinogenesis in mice with experiments using compressed hormone pellets. Hormone and/or drug pellets are easily manufactured with a pellet press, and surgically implanted into the subcutaneous tissue of the male mouse host. We also describe a protocol for the evaluation of hormonal carcinogenesis by combining subcutaneous hormone pellet implantation with xenografting of prostate cell recombinants under the renal capsule of immunocompromised mice. Moreover, subcutaneous hormone pellet implantation, in combination with renal capsule xenografting of BPH tissue, is useful to better understand hormonal regulation of benign prostate growth, and to test new therapies targeting sex steroid hormone pathways. PMID:24022657

  5. Distinct subcutaneous emphysema following surgical wisdom tooth extraction in a patient suffering from 'Gilles de la Tourette syndrome'.

    PubMed

    Tomasetti, Patrick; Kuttenberger, Johannes; Bassetti, Renzo

    2015-01-01

    Subcutaneous emphysema is a rare complication in oral surgery. In most cases, it resolves spontaneously. However, air might disperse into deeper facial spaces causing life-threatening complications such as compression of the tracheobronchial tree or the development of pneumomediastinum. Moreover, microorganisms might spread from the oral cavity into deeper spaces. Hence, rapid diagnosis of subcutaneous emphysema is important. Characteristic signs are both a shiftable swelling and crepitation. In this case report, a 30-year-old man, suffering from the Gilles de la Tourette Syndrome, with a distinct subcutaneous emphysema after bilateral surgical wisdom tooth extraction is presented. Induced by a specific motor tic, air accumulated from the periorbital through to the parapharyngeal region. Applying a 10-cm-long Redon drainage tube as air valve, 10 days after wisdom teeth extraction, the patient was asymptomatic with complete resolution of the emphysema.

  6. [Correction of anemia in chronic kidney failure with lyophilized recombinant human erythropoietin using a subcutaneous approach].

    PubMed

    Amar, M; Cendoroglo Neto, M; Canziani, M E; Nadaletto, M A; Ajzen, H; Draibe, S A

    1994-01-01

    The recombinant human erythropoietin (rHuEPO) by subcutaneous route has been considered the drug of choice for the correction of the anemia of chronic renal patients. PURPOSE--To evaluate the efficacy of a new preparation of rHuEPO in the correction of the anemia of chronic renal patients maintained by haemodialysis, exclusively administered by subcutaneous route, studying the adverse effects and searching for predictive factors for the response to this medication. METHODS--Twelve patients in regular haemodialysis were treated with freeze-dried rHuEPO by subcutaneous route during 18 months with initial doses of 20U/kg/dialysis. They were submitted to a careful clinical and laboratory monitoring for all this study. RESULTS--Eleven patients ended the study reaching the target hematocrit (Htc) of 30% and keeping it during the whole period of the study. The mean correction and maintenance doses of rHuEPO were 65U/kg/dialysis and 51U/kg/dialysis respectively. At the 12th week of the study a significative increase of Htc (18.4 +/- 3.5% vs. 25.4% +/- 3.8%, p < 0.05) was demonstrated. An increase of the erythrocytes and hemoglobin was concomitantly observed. Leucocytes and platelets increased significantly from the 24th week and kept steadily until the end of study. Just potassium increased in the biochemistry analysis of the patients at the 4th and the 12th week of the study returning to the basal values at the 24th week. The evolution of the iron metabolism parameters demonstrated an intermitent and statistically significant decrease of transferrin saturation at the 1st, 12th and 24th week, returning to the basal levels at the end of study. The serum ferritin did not change (582.7 +/- 700, 9ng/mL vs. 700.0 +/- 651, 6ng/nL). The weight and the blood pressure did not change either, although 2 normotensive patients became hypertensive and 2 others with controlled hypertension needed drug rearrange for blood pressure control (36%). A patient had a seizure episode with a full

  7. Subcutaneous adipose tissue fatty acid desaturation in adults with and without rare adipose disorders

    PubMed Central

    2012-01-01

    Background Elevated stearoyl-CoA desaturase activity has been described in obese states, with an increased desaturation index (DI) suggesting enhanced lipogenesis. Differences in the DI among various phenotypes of abnormal adiposity have not been studied. Abnormal accumulation of subcutaneous adipose tissue occurs in rare adipose disorders (RADs) including Dercum's disease (DD), multiple symmetric lipomatosis (MSL), and familial multiple lipomatosis (FML). Examining the DI in subcutaneous fat of people with DD, MSL and FML may provide information on adipose tissue fatty acid metabolism in these disorders. The aims of this pilot study were: 1) to determine if differences in adipose tissue DIs are present among RADs, and 2) to determine if the DIs correlate to clinical or biochemical parameters. Methods Subcutaneous adipose tissue was obtained from human participants with DD (n = 6), MSL (n = 5), FML (n = 8) and obese Controls (n = 6). Fatty acid composition was determined by gas chromatography/mass spectrometry. The DIs (palmitoleic/palmitic, oleic/stearic, vaccenic/stearic ratios) were calculated from the gas chromatogram peak intensities. SCD1 gene expression was determined. Spearman's correlations between the DIs and available clinical or biochemical data were performed. Results In DD subjects, the vaccenic/stearic index was lower (p < 0.05) in comparison to Controls. Percent of total of the saturated fatty acid myristic acid was higher in DD compared with Controls and FML. Percent of monounsaturated vaccenic acid in DD trended lower when compared with Controls, and was decreased in comparison to FML. In MSL, total percent of the polyunsaturated fatty acids was significantly lower than in the Control group (p < 0.05). In the total cohort of subjects, the palmitoleic/palmitic and oleic/stearic DIs positively correlated with age, BMI, and percent body fat. Conclusions The positive associations between the DIs and measures of adiposity (BMI and percent body fat

  8. Subanesthetic, Subcutaneous Ketamine Infusion Therapy in the Treatment of Chronic Nonmalignant Pain.

    PubMed

    Zekry, Olfat; Gibson, Stephen B; Aggarwal, Arun

    2016-06-01

    This study was designed to describe the efficacy and toxicity of subcutaneous ketamine infusions and sublingual ketamine lozenges for the treatment of chronic nonmalignant pain. Data were collected prospectively on 70 subjects managed in an academic, tertiary care hospital between 2007 and 2012 who received between 3 and 7 days of subanesthetic, subcutaneous ketamine infusion. Data were analyzed for efficacy, adverse effects, and reduction in use of opioid medication. We also analyzed whether subsequent treatment with sublingual ketamine lozenges resulted in longer-term efficacy of the beneficial effects of the initial ketamine infusion. There was a significant reduction in pain intensity measured by numerical rating scale (NRS) from mean of 6.38 before ketamine to 4.60 after ketamine (P < .005) that was sustained for between 3 months and 6 years. In subjects on opioids, there was a significant reduction in opioid use at the end of the ketamine infusion from a mean morphine equivalent dose (MMED) of 216 mg/day before ketamine to 89 mg/day after ketamine (P < .005). The overall reduction in opioid use after ketamine infusion was 59%. No subjects increased their use of opioids during their hospitalization for the ketamine infusion. A small proportion of subjects who responded to the infusion were continued on ketamine lozenges. This group was followed for between 3 months and 2 years. The use of ketamine lozenges after the infusion resulted in 31% of these subjects being able to cease their use of opioids compared with only 6% who did not receive ketamine lozenges. Eleven percent of subjects who received lozenges subsequently increased their opioid usage. Adverse effects were fairly common, but only mild, with 46% of patients experiencing light-headedness and dizziness, 25% tiredness and sedation, 12% headaches, 12% hallucinations, and 8% vivid dreams. Adverse effects were easily managed by reducing the rate of the ketamine infusion. The administration of

  9. Subcutaneous Allergic Sensitization to Protease Allergen Is Dependent on Mast Cells but Not IL-33: Distinct Mechanisms between Subcutaneous and Intranasal Routes.

    PubMed

    Kamijo, Seiji; Suzuki, Mayu; Hara, Mutsuko; Shimura, Sakiko; Ochi, Hirono; Maruyama, Natsuko; Matsuda, Akira; Saito, Hirohisa; Nakae, Susumu; Suto, Hajime; Ichikawa, Saori; Ikeda, Shigaku; Ogawa, Hideoki; Okumura, Ko; Takai, Toshiro

    2016-05-01

    Protease activity of papain, a plant-derived occupational allergen homologous to mite major allergens, is essential to IgE/IgG1 production and lung eosinophilia induced by intranasal papain administration in mice, and IL-33 contributes to these responses. In this work, we investigate skin and Ab responses induced by s.c. papain administration into ear lobes and responses induced by subsequent airway challenge with papain. Subcutaneous papain injection induced swelling associated with increased epidermal thickness, dermal inflammation, serum IgE/IgG1 responses, and Th2 cytokine production in draining lymph node cells restimulated in vitro. These responses were markedly less upon s.c. administration of protease inhibitor-treated papain. Results obtained by using mast cell-deficient mice and reconstitution of tissue mast cells suggested the contribution of mast cells to papain-specific IgE/IgG1 responses and eosinophil infiltration. The responses were equivalent between wild-type and IL-33(-/-) mice. After the subsequent airway challenge, the s.c. presensitized wild-type mice showed more severe lung eosinophilia than those without the presensitization. The presensitized IL-33(-/-) mice showed modest lung eosinophilia, which was absent without the presensitization, but its severity and IgE boost by the airway challenge were markedly less than the presensitized wild-type mice, in which protease activity of inhaled papain contributed to the responses. The results suggest that mechanisms for the protease-dependent sensitization differ between skin and airway and that cooperation of mast cell-dependent, IL-33-independent initial sensitization via skin and protease-induced, IL-33-mediated mechanism in re-exposure via airway to protease allergens maximizes the magnitude of the transition from skin inflammation to asthma in natural history of progression of allergic diseases. PMID:27001956

  10. Comparison of immunological changes between subcutaneous and intravenous route of administration of IL-2 in cancer patients.

    PubMed

    Nouri, A M; Lowdell, M; Entazami, Z; Tezabwala, B U; Goode, A; Oliver, R T

    1996-01-01

    The effects of the route of administration of interleukin 2 (IL-2) on the immunological parameters of patients with various malignancies were investigated. The percent mean values for IL-2 receptor (Tac) positive cells among mononuclear cells in patients receiving IL-2 subcutaneously (5 cases) or intravenously (6 cases) were 7 and 7%, respectively. The corresponding values of post-IL-2 treatment peak were 18 and 16%. Similarly, the values for class II antigen expressing cells were 12 and 16% and 25 and 26%. In no case the difference between the values for the subcutaneous or the intravenous route reached significance. Using the 51Cr release assay, the mean percent killing activity of IL-2-activated mononuclear cells against Daudi tumour target cells for the subcutaneously and the intravenously treated groups were 27 and 14% and the corresponding values for the post-IL-2 treatment peak were 59% (p > 0.05) and 69% (p > 0.05), respectively. The similar values using K562 tumour as target were 17 and 8%, and the corresponding values for post-treatment peak were 55% (p > 0.05) and 23% (p > 0.05). In all cases the cytotoxic values for the post-IL-2 treatment were significantly greater than the pre-IL-2 values. The mean (+/- SD) values for serum beta2-m levels for 6 subcutaneously and 5 intravenously IL-2-treated patients were 6.5 +/- 4.6 and 5.7 +/- 3.4 mg/l (p > 0.05). The corresponding values for post-IL-2 (15 days) were 9.1 +/- 3.4 and 9.9 +/- 5.1 mg/1, respectively. These results demonstrate that there is no significant difference in the immunological parameters in cancer patients receiving IL-2 via subcutaneous or intravenous routes and provide further support for the current trend for clinical trials to concentrate on outpatients subcutaneous administration.

  11. Skin and subcutaneous mycoses in tilapia (Oreochromis niloticus) caused by Fusarium oxysporum in coinfection with Aeromonas hydrophila

    PubMed Central

    Cutuli, M. Teresa; Gibello, Alicia; Rodriguez-Bertos, Antonio; Blanco, M. Mar; Villarroel, Morris; Giraldo, Alejandra; Guarro, Josep

    2015-01-01

    Subcutaneous mycoses in freshwater fish are rare infections usually caused by oomycetes of the genus Saprolegnia and some filamentous fungi. To date, Fusarium infections in farmed fish have only been described in marine fish. Here, we report the presence of Fusarium oxysporum in subcutaneous lesions of Nile tilapia (Oreochromis niloticus). Histopathologic evaluation revealed granuloma formation with fungal structures, and the identity of the etiological agent was demonstrated by morphological and molecular analyses. Some of the animals died as a result of systemic coinfection with Aeromonashydrophila PMID:26155462

  12. Rare Aggressive Behavior of MDM2-Amplified Retroperitoneal Dedifferentiated Liposarcoma, with Brain, Lung and Subcutaneous Metastases

    PubMed Central

    Ben Salha, Imen; Zaidi, Shane; Noujaim, Jonathan; Miah, Aisha B.; Fisher, Cyril; Jones, Robin L.; Thway, Khin

    2016-01-01

    Dedifferentiated liposarcoma (DDL) is a histologically pleomorphic sarcoma, traditionally defined as well-differentiated liposarcoma with abrupt transition to high grade, non-lipogenic sarcoma. It can occur as part of recurrent well-differentiated liposarcoma, or may arise de novo. DDL most frequently occurs within the retroperitoneum, and while it is prone to local recurrence, it usually has a lower rate of metastasis than other pleomorphic sarcomas. We describe a case of retroperitoneal dedifferentiated liposarcoma in a 63-year-old male, who showed MDM2 amplification with fluorescence in situ hybridization, which displayed unusually aggressive behavior, with brain, lung and subcutaneous soft tissue metastases. As previous reports of metastatic liposarcoma have largely grouped DDL in with other (genetically and clinically distinct) liposarcoma subtypes, we highlight and discuss the rare occurrence of brain metastasis in MDM2-amplified retroperitoneal liposarcoma. PMID:27746879

  13. High-Dose Subcutaneous Immunoglobulins for the Treatment of Severe Treatment-Resistant Polymyositis

    PubMed Central

    Patrick, Cherin; Jean-Christophe, Delain; Jean-Charles, Crave; Odile, Cartry

    2014-01-01

    Polymyositis is a rare debilitating condition characterized by chronic inflammation and muscle weakness. Standard treatments include corticosteroids and immunosuppressants; however, resistance to these regimens may develop. Intravenous immunoglobulins (IVIg) are thus recommended for patients with drug-resistant polymyositis. The patient presented a resistant polymyositis with severe muscle weakness, increasing dysphagia, and significant loss in weight. Subcutaneous immunoglobulins (SCIg) were initiated after failure of steroids and immunosuppressive drugs. SCIg was given twice per week (2 then 1.3 g/kg/month). Clinical recovery was observed within 2 months after the SCIg initiation. After several injections, the patient showed a progressive improvement in muscle strength. Serum creatine kinase activity decreased to normal levels, and dysphagia was resolved. The SC injections were generally well tolerated and good patient satisfaction was reported. This promising observation suggests that SCIg may be useful in active and refractory polymyositis. PMID:25140268

  14. Pleomorphic Adenoma in Subcutaneous Plane of the Neck: A Rare Entity

    PubMed Central

    Kamath, Bharat; Bhukebag, Prasad

    2015-01-01

    Heterotopic Salivary Gland Tissue (HSGT) is salivary tissue found in locations not normally host to it. Neoplasms occurring in these heterotopic tissues are very rare. Review of literature has revealed the neck to be host to HSGT and rarely, tumourigenic changes in these inclusions have been observed. We present a clinically unsuspected case of an ectopic pleomorphic adenoma of lower neck in which the ectopic salivary tissue was found in subcutaneous plane, which to the best of our knowledge has not been reported and was proved only on cytology and histopathology. There is a probability of this tumour undergoing malignant transformation. Therefore, these tumours need to be promptly diagnosed, adequately treated and should be included in the differential diagnosis of neck masses. PMID:26500955

  15. Osteoinduction by a collagen mineral composite combined with isologous bone marrow in a subcutaneous rat model.

    PubMed

    Alvis, Mark; Lalor, Peggy; Brown, Melissa K C; Thorn, Malahki R; Block, Jon E; Hornby, Samantha; Berg, Richard; Reddi, A Hari

    2003-01-01

    In a subcutaneous implant rat model, Collagraft alone (n=8), Collagraft plus isologous bone marrow (n=8), and marrow alone (n=8) were evaluated. Twelve rats were euthanized at 11 days and 12 at 21 days. Explants were evaluated histologically for evidence of bone formation, and osteogenic activity was determined by an assay for alkaline phosphatase. Histological bone formation was absent in all groups at 11 days. At 21 days, in the Collagraft alone and bone marrow alone groups, no bone induction was noted. In contrast, 21-day specimens from the Collagraft plus bone marrow group showed newly formed bone. Alkaline phosphatase activity was negligible (<0.05 units/mg) in all 11-day specimens. Activity in Collagraft plus bone marrow specimens at 21 days (0.38 units/mg) was significantly higher than any other group (P<.001 for all comparisons). This study demonstrates that Collagraft plus bone marrow is an osteoinductive matrix. PMID:12555839

  16. Subcutaneous immunoglobulins in the treatment of chronic immune-mediated neuropathies

    PubMed Central

    Leussink, Verena I.; Hartung, Hans-Peter; Kieseier, Bernd C.; Stettner, Mark

    2016-01-01

    Intravenous immunoglobulins represent an established therapy for the treatment of chronic immune-mediated neuropathies, specifically chronic inflammatory demyelinating polyradiculoneuropathies (CIDPs) as well as multifocal motor neuropathies (MMNs). For the treatment of antibody deficiency syndromes, subcutaneous immunoglobulins (SCIgs) have represented a mainstay for decades. An emerging body of evidence suggests that SCIg might also exhibit clinical efficacy in CIDP and MMN. This article reviews the current evidence for clinical effectiveness, as well as safety of SCIg for the treatment of immune-mediated neuropathies, and addresses remaining open questions in this context. We conclude that despite the need for controlled long-term studies to demonstrate long-term efficacy of SCIg in immune-mediated neuropathies, SCIg may already represent a potential therapeutic alternative for selected patients. PMID:27366241

  17. Subcutaneous rupture of the flexor hallucis longus tendon: a case report.

    PubMed

    Noda, Daisuke; Yoshimura, Ichiro; Kanazawa, Kazuki; Hagio, Tomonobu; Naito, Masatoshi

    2012-01-01

    It is well known that rupture of the flexor hallucis longus tendon can be associated with open injuries and that closed rupture of the flexor hallucis longus tendon is rare. Tendon injuries of the foot can occur secondary to direct, indirect, or repetitive injury. Repetitive tendon injuries can cause tendinitis or stenosing tenosynovitis. Tendinitis is associated with internal tendon injury that can present with tendon thickening, mucinoid degeneration, nodule development, or in situ partial tears. Stenosing tenosynovitis is the development of tendon adhesions within the tendon sheath that interfere with tendon gliding, known as trigger toe. The flexor hallucis longus tendon is susceptible to injury along its entire course. A total of 35 cases of complete or partial closed ruptures of the flexor hallucis longus tendon have been reported. We present the case of complete subcutaneous rupture of the flexor hallucis longus tendon associated with trauma at the proximal phalangeal head. PMID:22153296

  18. [Subcutaneous immunoglobulin and support program: what level of interest of patients?].

    PubMed

    Bourdin, A; Berger, J; Früh, A; Spertini, F; Bugnon, O

    2015-04-01

    Two different routes of administration exist for the immunoglobulin therapy: intravenous (Ig IV - monthly administration in medical setting) and subcutaneous (Ig SC - weekly self-administration at home). According to the literature, efficacy and safety are similar,. but Ig SC could improve quality of life and treatment satisfaction. The Policlinique Médicale Universitaire of Lausanne has developed an interdisciplinary program for the long-term support of Ig SC patients. Moreover, it conducted an exploratory survey interviewing Ig IV patients about their interest for Ig SC: patients interested judged less favourably efficacy and/or tolerance of Ig IV and considered that Ig SC would improve their motivation for treatment and its impact on their private and professional life. PMID:26040165

  19. Subcutaneous cervical emphysema and pneumomediastinum due to a diastatic rupture of the cecum

    PubMed Central

    VECCHIO, R.; INTAGLIATA, E.; BASILE, F.; SPATARO, C.; GIULIA, G.; LEANZA, V.; MARCHESE, S.

    2015-01-01

    Pneumomediastinum usually occurs after esophageal or chest trauma. Subcutaneous cervical emphysema as a presentation of non-traumatic colonic perforation following colorectal cancer or diverticulitis, is very rare. We report a case of a patient with rectal cancer who developed a diastatic cecum retroperitoneal perforation with a secondary pneumo-mediastinum and cervical emphysema. The patient was in treatment with a neoadjuvant chemo-radiotherapy for a low rectal cancer. Treatment consisted in an emergency right hemi-colectomy with ileostomy and performance of distal colonic fistula. The Authors discuss the occurrence of pneumomediastinum and cervical emphysema complicating rectal cancer, pointing out ethio-pathogenesis, clinical presentation, diagnosis and treatment. The importance of performing a diverting colostomy when neoadjuvant chemotherapy is scheduled in patients with stenotic rectal cancer, although not clinically occluded PMID:26888704

  20. Plasma Cell Neoplasm Manifesting Initially as a Sub-Cutaneous Supra-Orbital Swelling.

    PubMed

    Jaiswal, Riddhi; Agarwal, Garima; Singh, Sudhir

    2016-01-01

    Multiple myeloma is a plasma cell neoplasm seen usually in patients over 50 years of age. Some cases may be asymptomatic initially and are detected during a routine test like complete blood count. They only require a close follow-up and monitoring. However, around 1% of these monoclonal gammopathy of undetermined significance progress to multiple myeloma every year and then they need to be taken care of by chemotherapy, targeted therapy, bisphosphonates and 6 monthly urine and bone examinations. Here, we present a case of 35-year-old female with an initial symptom of a vague backache along with a left subcutaneous supra-orbital swelling which was diagnosed as multiple myeloma by aspiration cytology and confirmed by ancillary tests. She has since been on treatment with bortezomib and prednisone and is responding well. PMID:26955130