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Sample records for buttocks

  1. An unusual stab wound to the buttock

    Directory of Open Access Journals (Sweden)

    Ashraf F Hefny

    2013-01-01

    Full Text Available Stab wounds to the buttock are uncommon injuries that are rarely seen in surgical civilian practice. Although, the wound appears trivial, it may cause major life-threatening visceral and vascular injuries. Failure to detect these injuries may lead to serious morbidity and mortality. Herein, we report a patient with a single gluteal stab wound, which was initially sutured and treated conservatively. Two days later, patient developed fever, lower abdominal pain and tenderness with leakage of fecal material from the wound. Exploratory laparotomy revealed an extraperitoneal rectal perforation for which a Hartmann′s procedure was performed. Computed tomography scanning is recommended as a diagnostic tool for stable patients having buttock stab wounds. Diverging colostomy is the standard surgical procedure for extraperitonal rectal injuries that cannot be properly visualized and repaired during a laparotomy. More evidence is needed to assess the fecal non-diversion approach in the treatment of these patients.

  2. Thallium-201 buttock scans. Noninvasive testing for gluteal muscle ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Toshima, Masahiro; Fujimura, Mitsuo; Nishiya, Yasushi; Shuuke, Noriji; Nakajima, Kenichi [Toyama Prefectural Central Hospital (Japan)

    1997-08-01

    To evaluate the perfusion of the gluteal muscle, single-photon emission computed tomography (SPECT) using thallium-201 was performed in 23 patients of arteriosclerotic obstructive disease. The SPECT image of the buttock was obtained by a rotating digital gamma camera on the prone position. Patients underwent treadmill exercise until buttock or leg pain appeared, of which 17 patients complained buttock pain. The transaxial stress and redistribution images were analyzed and the uptake and washout rate were calculated in each segment of the gluteal muscle. The gluteal muscle was clearly visualized by the stress thallium SPECT. In the ischemic buttock, which was confirmed by angiography, the thallium uptake was significantly reduced compared with the normal buttock during exercise. The washout rate in the ischemic buttock was lower than that of the normal buttock and correlated with the degree of the stenosis of the internal iliac artery. The washout rate in the 16 patients with vasculogenic buttock claudication were under 10%. The vascular reconstruction improved buttock claudication, resulting in increase of the thallium uptake and washout rate of the ischemic gluteal muscle. The thallium-201 SPECT is useful to evaluate the perfusion of the gluteal muscles and the responsiveness to surgical treatment. (author)

  3. Development of a percentile based three-dimensional model of the buttocks in computer system

    Science.gov (United States)

    Wang, Lijing; He, Xueli; Li, Hongpeng

    2016-05-01

    There are diverse products related to human buttocks, which need to be designed, manufactured and evaluated with 3D buttock model. The 3D buttock model used in present research field is just simple approximate model similar to human buttocks. The 3D buttock percentile model is highly desired in the ergonomics design and evaluation for these products. So far, there is no research on the percentile sizing system of human 3D buttock model. So the purpose of this paper is to develop a new method for building three-dimensional buttock percentile model in computer system. After scanning the 3D shape of buttocks, the cloud data of 3D points is imported into the reverse engineering software (Geomagic) for the reconstructing of the buttock surface model. Five characteristic dimensions of the buttock are measured through mark-points after models being imported into engineering software CATIA. A series of space points are obtained by the intersecting of the cutting slices and 3D buttock surface model, and then are ordered based on the sequence number of the horizontal and vertical slices. The 1st, 5th, 50th, 95th, 99th percentile values of the five dimensions and the spatial coordinate values of the space points are obtained, and used to reconstruct percentile buttock models. This research proposes a establishing method of percentile sizing system of buttock 3D model based on the percentile values of the ischial tuberosities diameter, the distances from margin to ischial tuberosity and the space coordinates value of coordinate points, for establishing the Nth percentile 3D buttock model and every special buttock types model. The proposed method also serves as a useful guidance for the other 3D percentile models establishment for other part in human body with characteristic points.

  4. A finite element model of the human buttocks for prediction of seat pressure distributions.

    Science.gov (United States)

    Verver, M M; van Hoof, J; Oomens, C W J; Wismans, J S H M; Baaijens, F P T

    2004-08-01

    Seating comfort is becoming increasingly important for the automotive industry. Car manufacturers use seating comfort to distinguish their products from those of competitors. However, the development and design of a new, more comfortable seat is time consuming and costly. The introduction of computer models of human and seat will accelerate this process. The contact interaction between human and seat is an important factor in the comfort sensation of subjects. This paper presents a finite element (FE) model of the human buttocks, able to predict the pressure distribution between human and seating surface by its detailed and realistic geometric description. A validation study based on volunteer experiments shows reasonable correlation in pressure distributions between the buttocks model and the volunteers. Both for simulations on a rigid and a soft cushion, the model predicts realistic seat pressure distributions. A parameter study shows that a pressure distribution at the interface between human and seat strongly depends on variations in human flesh and seat cushion properties.

  5. Cutaneous angiosarcoma of the buttock complicated by severe thrombocytopenia: A case report

    OpenAIRE

    Nagao, Kaoru; Suzuki, Kayo; Yasuda, Taketoshi; HORI, TAKESHI; HACHINODA, JUN; Kanamori, Masahiko; Kimura, Tomoatsu

    2013-01-01

    Angiosarcoma (AS) is an aggressive, malignant endothelial cell tumor of vascular or lymphatic origin, the presentation and clinical behavior of which may vary according to its location. This is the case report of a 56-year-old woman with cutaneous angiosarcoma (CAS) of the buttock complicated by severe thrombocytopenia. A review of the literature revealed that only nine cases of CAS with thrombocytopenia have been previously reported. The prognosis of CAS complicated by thrombocytopenia is po...

  6. Inverted verrucous carcinoma of the buttock mimicking abscess and gossypiboma: MR and pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Bing; Gorbachova, Tetyana; Rodgers, Shuchi K. [Einstein Medical Center Philadelphia, Department of Radiology, Philadelphia, PA (United States); Belser, Paul [Einstein Medical Center Montgomery, Department of Pathology, East Norriton, PA (United States); Schiowitz, Robert [Einstein Medical Center Montgomery, Department of Surgery, East Norriton, PA (United States)

    2015-09-15

    Verrucous carcinoma (VC) is an uncommon, low-grade variant of squamous cell carcinoma. Its benign histologic appearance and indolent course may lead to a delayed diagnosis. We report a rare case of an inverted verrucous carcinoma of the buttock presenting as a slow-growing subcutaneous lesion with a draining sinus and no exophytic component, clinically mimicking abscess and gossypiboma, with magnetic resonance imaging (MRI) and pathologic correlation. Biopsy of the lesional base is mandatory for accurate diagnosis. An enhancement pattern with a convoluted undulating appearance in a subcutaneous lesion displayed on MRI should raise a consideration of inverted VC in the differential diagnosis. (orig.)

  7. Merkel cell carcinoma of right buttock in an elderly patient: a case report

    Directory of Open Access Journals (Sweden)

    Shiromani Debbarma

    2015-11-01

    Full Text Available Merkel cell carcinoma is a rare primary cutaneous tumor. So far, few cases have been reported.  Herewith we report a case of an 87-years-old male with painless, ulceroproliferative growth measuring 6x6 cm, over right upper outer quadrant of buttock; stage IIB (TNM, T3cNoMo. Patient received neo-adjuvant chemotherapy, injection of carboplatin 420 mg (day one and etoposide 140 mg (day one to three three weekly for three cycles followed external beam radiotherapy by Cobalt 60. At three months post-treatment follow-up, clinically no evidence of residual disease or recurrences noted. The purpose of reporting this case was to emphasize to its rarity, early asymptomatic clinical course leading to possibility of delayed diagnosis and paramount importance of high index of clinical suspicion in definitive diagnosis for better treatment result.

  8. Late-onset fistula presenting as buttock abscess in two patients with ileo-anal J-pouches for ulcerative colitis.

    Science.gov (United States)

    Banerjee, S; Farquharson, M; Cecil, T D; Gold, D; Moran, B J

    2004-03-01

    Two cases are described of patients who presented with a buttock abscess 3 and 5 years after restorative proctocolectomy for ulcerative colitis. In both the abscess was secondary to a fistula, which was shown on further investigation to be a track traversing the greater sciatic notch. Both patients had had an ileo-anal J-pouch after a proctectomy which had included a mesorectal excision. The possibility that these unusual fistulae might be more common following removal of the mesorectum rather than a close rectal dissection is explored.

  9. Colocación de implantes glúteos y de cadera: una alternativa para mejorar el contorno en hipoplasia glúteo-trocantérea Placement of buttock and hip implants: an alternative for contour improvement in buttock and hips hypoplasia

    Directory of Open Access Journals (Sweden)

    L. Cárdenas-Camarena

    2012-03-01

    Full Text Available La mejoría del contorno glúteo y de caderas en un paciente varón que desea un contorno femenino es difícil de conseguir cuando no es posible disponer de una cantidad de grasa suficiente para inyectar y lograr una mejoría integral. Presentamos la técnica quirúrgica utilizada en un paciente transexual masculino que había tenido dos intentos fallidos de feminizar su contorno de glúteos y caderas. Utilizamos implantes ovales de silicona cohesiva, tanto para la región glútea como para las caderas, inyectando grasa en las áreas de transición entre los dos implantes. Con esta combinación obtuvimos un contorno femenino integral, eliminando por completo el aspecto masculino de la región glúteo-trocantérea. En conclusión, pensamos que la combinación empleada supone una opción novedosa y no descrita hasta el momento para el tratamiento de pacientes transexuales que buscan un contorno glúteo más femenino de forma integral, con resultados predecibles y muy gratificantes, que mejora las deficiencias que los pacientes masculinos tienen en esta zona en comparación con el contorno de los glúteos femeninos.Improvement of the gluteal and hip contour in patients seeking a more feminine shape is difficult to achieve, specially for those who don't have enough fat to transfer from other areas of the body. We describe the surgical technique used to improve hips and buttocks contour in a genetic male transsexual. This patient previously underrwent two unsuccessful surgeries to feminize his hip and buttock contour. Our successful approach involved the use of an oval-shaped cohesive silicone gel implants placed in both, the hip and buttock areas, along with fat injection in the areas between the two implants. A natural, feminine contour was achieved using the combination of buttock and hip implants with lipofilling using patient's own fat. These procedures completely eliminated the male contour previously noted in the gluteal trochanteric region

  10. A Pain in the Buttock

    Directory of Open Access Journals (Sweden)

    Zachary C. Landman

    2011-01-01

    Full Text Available Spondylolysis, a fracture of the pars interarticularis, is a common source back pain in children and adolescents. While the incidence is significantly higher in Asian and Inuit populations, it is never seen in nonambulatory children and is most commonly associated with athletic activities that involve extension or rotational deformity about the spine suggesting a functional component. Given that the associated pain is typically insidious in onset, lacks preceding trauma, and is accompanied by muscular spasm, prompt diagnosis requires a high index of suspicion, familiarity with provocative testing, and knowledge of the appropriate radiographic evaluation. Treatment requires cessation of athletic activity, bracing, and rest for a minimum of four to six weeks, or until symptomatic and radiographic resolution.

  11. 臀大肌下间隙软组织肉瘤屏障切除术相关问题探讨%Barrier resection of the buttock soft tissue sarcoma

    Institute of Scientific and Technical Information of China (English)

    江仁兵; 白靖平; 锡林宝勒日; 龚磊; 何祖胜; 周阳

    2011-01-01

    Objective To explore the feasibility of barrier resection to treat the buttock soft tissue sarcoma and prevent the related surgical complications. Methods (1)The gluteal fascia, the walls of the subgluteus maximus space, superior gluteal artery and sciatic nerve of the pelvic extius were observed on the six specimens. (2) The therapeutic results were analyzed on 15 cases suffered from soft tissue sarcoma of the buttock. Results (1) The muscle, tendon, ligaments and fascia on the subgluteus maximus space have barrier effects on stopping the development of the soft tissue sarcoma of the buttock. (2) The gluteal artery on the pelvic extius was surrounded by fibrous connective tissue at the internal edge of the greater sciatic formaen about lcm. (3) The loosed space between sciatic nerve and infrapiriform foramen was surrounded by adipose tissue. (4)In 15 cases followed up about 6 to 36 months, averagely 24 months, 12 were free of disease, 2 died from pulmonary metastasis, 1 given up the treatment after recurrence. All patients appeared lower limb claudication, 3 suffered from superior gluteal artery damage and followed hemostasis treatment. Conclusions (1) Barrier resection is an ideal method for treating soft tissue sarcoma of the buttock. (2) Iliac bone incision is the suitable way to prevent the bleeding of superior gluteal artery during the operation.%目的 探讨臀大肌下间隙软组织肉瘤屏障切除术可行性和并发症的防治.方法 (1)对3具6侧成人臀部标本的臀肌筋膜、臀大肌下间隙各壁组成、臀上动脉、坐骨神经出盆处进行解剖观察.(2)对15例臀部软组织肉瘤屏障切除术的治疗结果进行分析.结果 (1)臀大肌下间隙各壁的肌肉、肌腱、韧带、筋膜对软组织肉瘤生长具有屏障作用.(2)臀上动脉出盆处并不游离,在坐骨大孔内缘1 cm左右有一层致密的纤维结缔组织包绕固定臀上动脉.(3)坐骨神经与梨状肌下孔之间间隙较疏

  12. Buttocks island shape fasciocataneous flap in the repair of sacrococcygeal pressure sores%臀部岛状筋膜皮瓣修复骶尾部褥疮的临床应用

    Institute of Scientific and Technical Information of China (English)

    邱福奎; 廖文伦; 朱丽娟

    2009-01-01

    Objective To discuss the application and effect of buttocks island shape fascivcataneous flap in the repair of sacrococcygeal pressure sore.Methods According to the donor anatomical characteristis and the recipient damaged situation,taking superior gluteal as the rotatory point,four lobate island shape fasciocataneous flap were designed.The depth of got flap reached the deep fascia, but did not damage the gluteus maximus, the flap was rotated 90 degree to repair injured areas.Then the donor area were won over and sutured.Results From 2000 years to 2008 years the clinical practice were performed in 14 patients, after the technique the flap completely survived, the quality of flap was soft, the appearance of flaps was satisfied.Conclusion The clinical effect of the buttocks island shape fasciocataneus flap in the repair of sacrococcygeal pressure scors is satisfied.its appearance is full, also does not affect the activity of the hip joint.%目的 探讨臀部岛状筋膜皮瓣修复骶尾部褥疮的应用及效果.方法 根据供区解剖特点和受区病损情况进行皮瓣设计,以臀上动脉为旋转点设计四叶岛状筋膜瓣,皮瓣仅达深筋膜,不损伤臀大肌,旋转90°修复创面,供区拉拢缝合.结果 2000~2008年临床应用14例,术后皮瓣全部成活,皮瓣质地柔软,外形满意.结论 应用臀部岛状筋膜皮瓣修复骶尾部褥疮临床效果满意,外形饱满,且不影响髋关节活动.

  13. Treatment of refractory wounds on the buttock and sacrococcygeal region using skin flap and free skin graft transplantation%皮瓣及皮片移植治疗臀骶尾部难愈创面

    Institute of Scientific and Technical Information of China (English)

    张绪生; 刘毅; 张斌; 肖斌; 张鲜英

    2009-01-01

    A total of 121 patients with the refractory wounds on the bttock and sacrococcygeal region were selected.There were 109 cases of paraplegia and pressure sore,including 48 cases of sinus tract type,45 cases of ulcer type,11 cases of mixed type,and 5 cases of multiple occurrence type.There were 12 cases of non-paraplegia,containing 8 cases of electric burn,3 cases of trauma,and 1 case of local blockage infection.After resection of the necrotic tissues,synovial bursa and parabiotic tissues,the wounds were repaired by primary surgical procedures with local skin flaps,myocutaneous flaps and free skin grafting.After resection of the necrotic tissues,the wounds were recovered by secondary procedures with myocutaneous flaps and free skin grafting.After resection of the necrotic tissues,the exposed wounds were healed by dressing change.Of the 121 cases,the primary surgical reconstructed of the wounds were found in 78 cases,with the cure rate of 64.46%.The secondary surgical reconstructed of the wounds were in 39 cases,with the cure rate of 32.23%.The wounds of 4 cases were recovered by dressing change after debridement,with the cure rate of 3.31%.It might be the most effective ways to deal with the refractory wounds on the buttock and sacrococcygeal region that improving the local blood circulation by dressing change,physiotherapy and torrefaction and treating the wounds in the perioperative stage by cleaning the wounds,unobstructed effluvium secretion and avoiding long-pressure of the wounds.%纳入121例臀骶尾部压疮患者,其中截瘫压疮109例,包括窦道型48例,溃疡型45例,混合型11例,多发型5例;非截瘫创面12例,包括电烧伤8例,外伤3例,局部封闭感染1例.切除坏死组织、滑膜囊及间生态组织,Ⅰ期局部皮瓣、肌皮瓣加皮片移植修复;彻底切除坏死组织,Ⅱ期选用皮瓣加皮片移植覆盖创面;清除坏死组织及死骨,伤口开放换药愈合.121例患者中伤口Ⅰ期愈合78例,愈合率64.46%;

  14. Asynchronous abdomino-parasacral resection of a giant pelvic lipoma protruding to the left buttock

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    Masanori Sato

    2014-01-01

    CONCLUSION: The asynchronous abdomino-parasacral approach with several turnings of the patient's body and plastic bag packing of the tumor were advantageous to manage en bloc resection of the giant pelvic lipoma presented in this case study.

  15. Biomechanics Analysis of Pressure Ulcer Using Damaged Interface Model between Bone and Muscle in the Human Buttock

    Science.gov (United States)

    Slamet, Samuel Susanto; Takano, Naoki; Tanabe, Yoshiyuki; Hatano, Asako; Nagasao, Tomohisa

    This paper aims at building up a computational procedure to study the bio-mechanism of pressure ulcer using the finite element method. Pressure ulcer is a disease that occurs in the human body after 2 hours of continuous external force. In the very early stage of pressure ulcer, it is found that the tissues inside the body are damaged, even though skin surface looks normal. This study assumes that tension and/or shear strain will cause damage to loose fibril tissue between the bone and muscle and that propagation of damaged area will lead to fatal stage. Analysis was performed using the finite element method by modeling the damaged fibril tissue as a cutout. By varying the loading directions and watching both tensile and shear strains, the risk of fibril tissue damage and propagation of the damaged area is discussed, which may give new insight for the careful nursing for patients, particularly after surgical treatment. It was found that the pressure ulcer could reoccur for a surgical flap treatment. The bone cut and surgical flap surgery is not perfect to prevent the bone-muscle interfacial damage.

  16. CLINICAL APPLICATION OF "LUMBAR THREE-POINT NEEDLING" IN TREATMENT OF LUMBAR AND BUTTOCK DISEASES

    Institute of Scientific and Technical Information of China (English)

    王黎; 赖新生

    2001-01-01

    "Lumbar three-point needling", meaning puncturing Shenshu (BL 23), Dachangshu (BL 25) and Ciliao(BL 32) at the same time, is a commonly used acupuncture method in the treatment of lumbocrural diseases. Points supplemented according to symptoms. Weizhong(BL 40) is supplemented for lumbar vertebra hypertrophy spondylitis; Weizhong (BL 40) and Kunlun(BL 60) supplemented for acute lumbar muscle sprain; Zhibian (BL 54), Huantiao (GB 30) and Ahshi points supplemented for nervi cluniam superior inflammation, and Sanyinjiao (SP 6) and Mingmen(GV 4) supplemented for impotence. Gauge-28 2 curt long needles are used. The needles are inserted perpendicularly into Shenshu(BL 23), Dachengshu(BL 25) and Ciliao(BL 32) to a depth of about 1.2 --- 1.5 cun. Other supplementary points are needled and stimulated with routine manipulations, generally the reducing method is used for excess syndrome, and the reinforcing method applied to deficiency syndrome. The author, on the basis of many years of clinical practice, considers that "lumbar three-point needling" is fairly effective in treating lumbosacral diseases.

  17. Silicone Granuloma in the Buttocks Incidentally Detected by 18F-FDG PET/CT 30 Years After Free Liquid Silicone Injections.

    Science.gov (United States)

    Ohnona, Jessica; Durand, Pauline; Amegnizin, Jean-Louis; Kerrou, Khaldoun

    2016-06-01

    A 59-year-old transexual (male to female) patient presented with a squamous cell carcinoma of the larynx. She underwent an F-FDG PET/CT for initial staging. The examination showed high F-FDG uptake of the primary lesion and a homolateral lymphadenopathy. Incidental heterogeneous uptake of round hyperdense lesions in the gluteal muscles and subcutaneous fat was visualized. The medical history revealed secondly that the patient had had free liquid silicone injections 30 years before the examination. Although the injection of free silicone is not practised since the 1980s, this incidental finding should prompt to check the patient's medical history over several decades.

  18. 臀部疣状皮肤结核误诊1例%A Case of Misdiagnosed Buttock Tuberculosis Verrucosa Cutis

    Institute of Scientific and Technical Information of China (English)

    黄俊萍; 刘涛

    2012-01-01

    患儿女,10岁,右臀部环状斑块8余年,曾多次误诊为股癣.皮损组织病理示:表皮角化不全,毛囊角栓,表皮假上皮瘤样增生;真皮浅中层弥漫炎细胞浸润,以淋巴细胞为主;真皮内可见上皮样细胞结节,浸润的细胞有淋巴细胞、多核巨细胞及组织细胞等.抗酸染色(-),PPD试验(3+).诊断:疣状皮肤结核.%A 10-year-old girl with right hip circular plaque more than 8 years was misdiagnosed as tinea cruris many times. Pathology results showed epidermis parakeratosis, folliculus pili keratotic plug, epidermis pseudoepi-thcliomatous hyperplasia. Intermediate dermis diffused inflammatory cells most of which were lymphocytes. Epithelioid cells nodules can he seen in dermis. Infiltration cells were lymphocytes, multinuclear giant cells and histiocytes. Acid-fast stain( - ) ,PPD test(3 + ). Diagnosis; tuberculosis verrucosa cutis.

  19. Spine Conditioning Program

    Science.gov (United States)

    ... buttocks) (middle and lower back) • Gluteus medias (buttocks) • Quadratus lumborum (lower back) • Hamstrings (back of thigh) • Abdominals Length ... 10 Days per week Daily Main muscles worked: Quadratus lumborum, erector spinae You should feel this stretch in ...

  20. Characteristics Analysis About Adult BMI, Percentage of Body Fat, and Ratio of Waist and Buttock in Two Low Latitudes and Subtropics Cities%两个低纬度亚热带城市成年人BMI、体脂百分比、腰臀比特征分析

    Institute of Scientific and Technical Information of China (English)

    戴霞

    2005-01-01

    两个低纬度亚热带城市(广州和深圳)具有不同的人群结构:本土人群和外来人群.对这两个城市人群的BMI、体脂百分比、腰臀比指标并结合国家国民体质监测数据作参照点进行分析,结果发现:低纬度亚热带本土人群具有BMI较小,体脂百分比较高,腰臀比小等特征.低纬度亚热带本土成年人腰臀比小,可能反映了该区域人群具有不同于其他地域人群的体脂分布特征.研究还发现:生活在低纬度亚热带的外来人群的主要体型特征变异不大.

  1. 臀大肌上部肌皮瓣转移修复骶尾部压疮患者的疗效分析%Analysis the effect of the upper muscular lfap of the upper part of the buttocks and the upper muscle skin lfap in the rehabilitation of the patients with the pressure ulcer in the sacral region

    Institute of Scientific and Technical Information of China (English)

    王强; 张艳

    2015-01-01

    ObjectiveThe purpose of this paper is to analyze and discuss the gluteus maximus myocutaneous lfap to repair the upper part of the curative effect of patients with sacrococcygeal.MethodsSelect 2012 April to 2014 April in our hospital treated 25 cases of patients with clinical data as the object of study, all patients with the superifcial branch of superior gluteal artery upper part gluteus maximum myocutaneous lfap pedicled repair, and rotate the sacrococcygeal pressure sores.Results25 patients after treatment, including 21 cases of lfap achieved completely survived, the remaining 4 cases of patients with skin lfap edge part necrosis phenomenon, after dressing treatment after the realization of healing, healing of the lfap after operation in patients with relatively stable, it can produce good effect.ConclusionThe gluteus maximus myocutaneous lfap to repair but not in patients with sacrococcygeal pressure sores has obvious advantages, the operation scheme is worth to promote and implement in the future clinical treatment process.%目的:本文主要是为了分析和探讨臀大肌上部肌皮瓣转移修复骶尾部压疮患者的疗效。方法选择2012年4月~2014年4月来我院接受治疗的25例患者作为研究对象,所有患者都以臀上动脉浅支为血管蒂的臀大肌上部肌皮瓣,并对其骶尾部压疮进行旋转修复。结果患者在接受治疗之后,其中皮瓣实现完全成活21例,皮瓣边缘部分出现坏死现象4例,经过换药处理之后实现愈合,手术之后患者的皮瓣愈合相对稳定,能够产生良好的疗效。结论臀大肌上部肌皮瓣对于修复患者骶尾部压疮有着显著的优势,其手术方案值得在今后的临床治疗过程中进行推广和实施。

  2. Anthropometric Survey (ANSUR) II Pilot Study: Methods and Summary Statistics

    Science.gov (United States)

    2009-04-01

    Cervicale : The superior palpable point of the spine of the seventh cervical vertebra . Dactylion III, right: The tip of the...Head Breadth Waist Back Length (Omphalion) Buttock-Knee Length Head Length Waist Circumference (Omphalion) Cervicale Height Hip Breadth, Sitting Waist...4) ACROMION-RADIALE LENGTH (23) BUTTOCK CIRCUMFERENCE (30) CERVICALE HEIGHT (33) CHEST CIRCUMFERENCE (99) STATURE (111) WAIST BACK LENGTH

  3. Epidermolysis bullosa

    Science.gov (United States)

    ... as the elbows, knees, ankles, and buttocks. Contact sports should be avoided. Patients with epidermolysis bullosa acquisita who are on steroids for longer than 1 month may need calcium and vitamin D supplements to prevent osteoporosis (thinning bones).

  4. Especially for Teens: Birth Control

    Science.gov (United States)

    ... at the same time each day. It contains hormones that prevent pregnancy. There are many types of birth control pills. ... arm or buttock every 3 months. It contains hormones that prevent pregnancy. What is the implant? The implant is a ...

  5. Genetics Home Reference: Miyoshi myopathy

    Science.gov (United States)

    ... tiptoe. As Miyoshi myopathy slowly worsens, the muscle weakness and atrophy spread up the leg to the muscles in the thigh and buttock and can also involve the upper arm and shoulder muscles. Eventually, affected individuals may have difficulty climbing ...

  6. Strongyloides stercoralis-hyperinfectie bij een harttransplantatiepatiënt

    NARCIS (Netherlands)

    Aalfs, A.S.; Van Hattem, S.; Schuttelaar, M.L.A.

    2013-01-01

    A heart transplantation patient with asymptomatic reticular petechiae and purpura on thighs and buttocks is described. Gastrointestinal manifestations preceded the skin manifestations. The symptoms were caused by a Strongyloides stercoralis hyperinfection, transmitted to the patient via the donor he

  7. Experimental Drug Shows Promise for Disfiguring Tumor Condition

    Science.gov (United States)

    ... her hip and buttock that rendered the girl wheelchair-bound and pain-ridden, Widemann said. "Her tumor ... to perform phase 1 trials specifically in the pediatric population before expanding to studies that evaluate efficacy," ...

  8. Osteoarthritis

    Science.gov (United States)

    ... also common sites of osteoarthritis. As with knee osteoarthritis, symptoms of hip osteoarthritis include pain and stiffness of the joint ... groin, inner thigh, buttocks, or even the knees. Osteoarthritis of the hip may limit moving and bending, making daily activities ...

  9. Insulin Injection

    Science.gov (United States)

    ... or buttocks. Do not inject insulin into muscles, scars, or moles. Use a different site for each ... you are using insulin.Alcohol may cause a decrease in blood sugar. Ask your doctor about the ...

  10. Breast Cancer: Treatment Options

    Science.gov (United States)

    ... the blood vessels to the chest wall. Gluteal free flap. The gluteal free flap uses tissue and muscle from the buttocks to ... surgery is much higher. The DIEP and gluteal free flap procedures are longer procedures and the recovery time ...

  11. Ischiogluteal bursitis: an uncommon type of bursitis

    Energy Technology Data Exchange (ETDEWEB)

    Van Mieghem, Isabelle M.; Boets, An; Sciot, Raf; Van Breuseghem, Iwan [Department of Radiology, University Hospitals, Catholic University Leuven, Leuven (Belgium)

    2004-07-01

    Ischiogluteal bursitis is a rare, infrequently recognized soft tissue mass of the buttock region. Of importance is the radiological differential diagnosis with other benign and malignant soft-tissue tumors. We describe the imaging findings of bursitis. (orig.)

  12. Effects of Anthropometrics and Body Size Changes on the Development of Personal Protective Equipment (PPE) Sizing Systems in the US Army

    Science.gov (United States)

    2016-08-01

    significantly exceed their allowable measurement error range (Buttock Circumference =12mm, Chest Circumference =14mm, and Waist Circumference =12mm [10]). With the...indicates that Buttock Circumference (M=55mm) increased more than Chest Circumference (M=37mm). For the measurement of Waist Circumference , a similar...43 60 71 84 117 Waist Circumference ANSUR 1988 877 84 726 751 810 869 935 1025 1086 ANSUR II 2012 943 109 731 777 859 939 1014 1135 1222 Delta

  13. 2012 Anthropometric Survey of U.S. Army Pilot Personnel: Methods and Summary Statistics

    Science.gov (United States)

    2016-05-01

    e.g., Weight, Buttock Circumference , and Waist Circumference ) had the largest increases in standard deviation substantially affecting product designs... Waist Circumference is nearly always chosen to set sample size because it has the highest CV of all commonly used body dimensions. As mentioned...7.19 468 9.98 901 X Waist Circumference 9.92 890 11.84 1268 X Buttock Circumference 6.29 358 7.69 535 X The sample size requirements in Table 18

  14. Squamous Cell Carcinoma in a Capybara (Hydrochoerus hydrochaeris)

    OpenAIRE

    2014-01-01

    ABSTRACT A 4-year and 2-month-old male capybara (Hydrochoerus hydrochaeris) was diagnosed with squamous cell carcinoma on the buttocks after chronic recurrent dermatosis. The capybara was euthanized, examined by computed tomography and necropsied; the tumor was examined histologically. Computed tomography showed a dense soft tissue mass with indistinct borders at the buttocks. Histological examination of the tumor revealed islands of invasive squamous epithelial tumor cells with a severe desm...

  15. Anthropometric Survey of U.S. Army Personnel: Summary Statistics, Interim Report for 1988

    Science.gov (United States)

    1989-03-01

    the level of the maximum circumference of the right calf. Cervicale The superior palpable point of the spine of the seventh cervical vertebra ...SITTING (10) BIACROMIAL BREADTH (12) BIDELTOID BREADTH (26) BLTCTOCK -KNEE LENGTH (27) BUTTOCK-POPLITEAL LENGTH (31) CERVICALE HEIGHT, SITTING (48...112) WAIST BREADTH 16 VISUAL INDEX - THIi STANDARD MEASUREMENTS (Continued) (24) BUTTOCK DEPTH (29) CALF HEIGHT (30) CERVICALE HEIGHT (32

  16. Transcutaneous Serdev Suture For Buttock’s Lift

    OpenAIRE

    Nikolay Serdev

    2012-01-01

    This article presents the author's technique and experience in the treatment of the flaccid "unhappy buttock" form with his surgical procedure of buttock lift by suture, without incision scars. The author first presented this new operation technique on a national level at the 2nd Annual Meeting of the National Bulgarian Society for Aesthetic Surgery and Aesthetic Medicine in Sofia on March 18, 1994 [1] and internationally at many scientific meetings over the world [2, 3, 4…]. The result is a ...

  17. Transcutaneous Serdev Suture For Buttock’s Lift

    Directory of Open Access Journals (Sweden)

    Nikolay Serdev

    2012-10-01

    Full Text Available This article presents the author's technique and experience in the treatment of the flaccid "unhappy buttock" form with his surgical procedure of buttock lift by suture, without incision scars. The author first presented this new operation technique on a national level at the 2nd Annual Meeting of the National Bulgarian Society for Aesthetic Surgery and Aesthetic Medicine in Sofia on March 18, 1994 [1] and internationally at many scientific meetings over the world [2, 3, 4…]. The result is a visual change in the buttock position to a higher one, which elongates the lower limbs and changes the proportions between lower and upper half of the body. The aim of this study is to describe a mini-invasive procedure of beautification of the buttock form without scars by creating a lifting effect on the buttock's subcutaneous tissue, using a suture that takes the inferiorly positioned deep fibrose tissue and fixes it upwards to the sacro-cutaneous fascia, discovered by the author. Aesthetic and technical considerations required properly sculpting the buttocks into a higher position, demonstrating nicely rounded form. Preoperative shape is discussed and patient evaluations, operative techniques, postoperative management and results after 4 years of experience are emphasized. 1032 female patients, and 26 male patients aged 18-62 years, with ptosis and cellulite on the buttocks were treated since 1993 on an outpatient basis by the "Serdev suture technique without visible scars". Important instrumentarium is a long, curved, elastic needle and Polycon semi-elastic Bulgarian antimicrobial polycaproamide long term (in 2 years absorbable surgical threads Polycon, produced in Bulgaria. This operation has been performed either alone or after ultrasonic assisted liposculpture (UAL that reduces the amount of fat and heaviness. All patients reported a high degree of satisfaction. A stable improvement in the buttock position and form was observed for the period

  18. A bipolar radiofrequency, infrared, vacuum and mechanical massage device for treatment of cellulite: a pilot study.

    Science.gov (United States)

    Hexsel, Doris M; Siega, Carolina; Schilling-Souza, Juliana; Porto, Manoela D; Rodrigues, Ticiana C

    2011-12-01

    Cellulite has a complex and multifactorial etiology. Synergistic action on treating cellulite has gained support in the treatment of cellulite. This study evaluated safety and efficacy of a bipolar radiofrequency, infrared, vacuum and mechanical massage device for cellulite treatment and reduction of body measures. This was a pilot study, which assessed 9 subjects who presented body mass index from 18 to 25 Kg/Kg and at least grade 6 in the Cellulite Severity Scale (CSS). All subjects underwent a 12-session treatment of posterior thighs and buttocks. There was a significant reduction of the hip circumference (p = 0.001), however, no changes in thigh circumferences were observed (p = 0.4). CSS has improved specifically on both buttocks [p = 0.002 (left side) and p = 0.038 (right side)], and no changes were observed on thighs. The studied device demonstrated efficacy in the reduction of cellulite severity and body circumference measures in the buttocks.

  19. Not What It Seems: Deep Tissue Infection Presenting as Cellulitis

    Directory of Open Access Journals (Sweden)

    Caroline T. Brandon

    2015-10-01

    Full Text Available A 34-year-old male with diabetes presented to the emergency department with four days of progressively worsening redness, swelling and pain to his left buttock. The patient denied fevers, chills, rectal pain or purulent drainage from his rectum. His initial vital signs were heart rate of 82; blood pressure of 146/92; and temperature of 98.2°F. The left buttock had a poorly circumscribed area of induration; however, there was no fluctuance or crepitace. Rectal exam was unremarkable. Because the patient’s buttock pain was disproportionate to his exam findings, a point-of-care ultrasound was performed to determine if a more extensive process was present. The ultrasound demonstrated cobblestoning, fascial thickening with edema, and a large 4.5cm fluid collection extending and adjacent to the rectum.

  20. Squamous cell carcinoma in a capybara (Hydrochoerus hydrochaeris).

    Science.gov (United States)

    Hamano, Takahisa; Terasawa, Fumio; Tachikawa, Yoshiharu; Murai, Atsuko; Mori, Takashi; El-Dakhly, Khaled; Sakai, Hiroki; Yanai, Tokuma

    2014-09-01

    A 4-year and 2-month-old male capybara (Hydrochoerus hydrochaeris) was diagnosed with squamous cell carcinoma on the buttocks after chronic recurrent dermatosis. The capybara was euthanized, examined by computed tomography and necropsied; the tumor was examined histologically. Computed tomography showed a dense soft tissue mass with indistinct borders at the buttocks. Histological examination of the tumor revealed islands of invasive squamous epithelial tumor cells with a severe desmoplastic reaction. Based on the pathological findings, the mass was diagnosed as a squamous cell carcinoma. This is the first study to report squamous cell carcinoma in a capybara.

  1. Pyoderma gangrenosum in a newborn--case report.

    Science.gov (United States)

    Carneiro, Francisca Regina Oliveira; Santos, Maria Amélia Lopes dos; Sousa, Brena Andrade de; Nascimento, Carla do Socorro Silva do; Amin, Gabriela Athayde; Moutinho, Ana Thais Machado

    2013-01-01

    Pyoderma gangrenosum is a rare, inflammatory, chronic and recurrent disease of unknown etiology, characterized by noninfectious, necrotizing and painful cutaneous ulcers. Usually it affects adults aged between 25 and 54 years old and rarely children (less than 4%), in which it mainly affects the head, face, buttocks, genital and perianal region. The disease presents a quick response to systemic corticosteroids. We report a case of a newborn with hemorrhagic and necrotic ulcers, distributed in the abdomen, buttocks and genital region with rapid and effective response to oral prednisone.

  2. Lichen planus and lupus erythematosus overlap syndrome

    Directory of Open Access Journals (Sweden)

    Chopra Adarsh

    1996-01-01

    Full Text Available A 45-year-old woman with livid plaques showing central atrophy and erythematous vesicular borders over both dorsa of feet and buttocks, and follicular and papular lesions over buttocks and lumbar area, was difficult to diagnose as either lichen planus (LP or lupus erythematosus (LE. The histological studies from two places showed features of both LE and LP. Laboratory findings were within normal limits first, but follow up studies for two years showed persistent albuminurea, leucopenia, arthritis and erythema over the exposed areas with same histology suggesting that eruption may be an unusual variant of LE.

  3. Accurate diagnosis and self-care support for women with lipoedema

    OpenAIRE

    Williams, Anne F; MacEwan, Isobel

    2016-01-01

    Lipoedema is a long term, progressive condition usually presenting as symmetrical enlargement of the legs and buttocks, and mainly affecting women. Distinct from obesity and lymphoedema, lipoedema is associated with an unusual distribution of diet-resistant inflammatory fat tissue. This article provides background to lipoedema diagnosis, and discusses self-care support for women with lipoedema.

  4. 2012 Anthropometric Survey of U.S. Army Personnel: Methods and Summary Statistics

    Science.gov (United States)

    2014-12-05

    fleshy components (e.g., Weight, Buttock Circumference , and Waist Circumference ) had the largest increases in standard deviation substantially affecting...female statistics and hypothesis testing for the most variable body dimensions (such as waist circumference ), but it is sufficient for most Army...dimensions (height, weight, sitting height, chest circumference , and waist circumference ) were compared to each other and to parameter estimates

  5. United States Marine Corps Assault Amphibian Vehicle Egress Study

    Science.gov (United States)

    2014-06-01

    42  Figure 10.  Boxplots for Chest Circumference per group ........................................ 43  Figure 11.  Boxplots of Waist Circumference ...Chest Circumference Summary Statistics ............................................. 43  Table 8.  Waist Circumference Summary Statistics...weight, chest depth, shoulder circumference , chest circumference , waist circumference , buttock circumference and shoulder breadth. Since subjects

  6. Multicentric extra-abdominal desmoid tumors arising in bilateral lower limbs

    Directory of Open Access Journals (Sweden)

    Nobuhiro Fukushima

    2010-03-01

    Full Text Available Extra-abdominal desmoid tumors preferentially affect the shoulders, arms, backs, buttocks, and thighs of young adults. Multicentric occurrence is rather rare but seems to be another distinctive feature of extra-abdominal desmoid tumors. In this article we report a rare case of multicentric extra-abdominal desmoid tumors arising in bilateral lower limbs.

  7. Percutaneous drainage of abscess in psoas compartment and epidural space; Case report and review of literature. [Radiological studies

    Energy Technology Data Exchange (ETDEWEB)

    Cwikiel, W. (Lund Univ. Hospital (Sweden). Dept. of Diagnostic Radiology)

    1991-03-01

    The history of a patient with neurological deficit symptoms secondary to a spinal epidural abscess connected with psoas abscess and several fistulas on the buttocks is described. Etiology, diagnosis, and treatment are discussed. Percutaneous drainage of the spinal epidural abscess is suggested as an alternative to surgery. (orig.).

  8. Cellulite: a review with a focus on subcision

    Science.gov (United States)

    Friedmann, Daniel P; Vick, Garrett Lane; Mishra, Vineet

    2017-01-01

    Cellulite is an alteration in skin topography most often found on the buttocks and posterolateral thighs of the majority of postpubertal females. This article aims to review the background, potential pathophysiology, and potential treatment options for cellulite, highlighting subcision as an ideal therapeutic option for this cosmetically distressing condition. PMID:28123311

  9. Trichophyton Schoenleinii-induced widespread tinea corporis mimicking parapsoriasis.

    Science.gov (United States)

    Mansouri, P; Farshi, S; Khosravi, A R; Naraghi, Z S; Chalangari, R

    2012-06-01

    We report a case of extensive tinea corporis in an 80-year-old woman on her forearms, thighs, legs, buttocks and trunk, mimicking parapsoriasis due to Trichophyton schoenleinii, without scalp involvement. Diagnosis of Trichophyton schoenleinii was confirmed by microscopy and mycological culture specimens.

  10. 49 CFR 572.43 - Lumbar spine and pelvis.

    Science.gov (United States)

    2010-10-01

    ... vertical plane which is tangent to the back of the dummy's buttocks. (3) Align the test probe so that at... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Side Impact Dummy 50th Percentile Male § 572.43 Lumbar spine and pelvis. (a) When the pelvis of a fully assembled dummy...

  11. The baboon syndrome

    DEFF Research Database (Denmark)

    Andersen, Klaus Ejner; Hjorth, N; Menné, T

    1984-01-01

    The catchword "baboon syndrome" is used to denote a characteristic distribution pattern of systemic allergic contact dermatitis. Diffuse erythema of the buttocks, upper inner surface of the thighs, and axillae are characteristic features. We describe 3 cases provoked by ampicillin, nickel...... and mercury. The condition may be overlooked and suspected of being a textile dermatitis or seborrhoeic dermatitis of the elderly....

  12. Lupus vulgaris of external nose.

    Science.gov (United States)

    Bhandary, Satheesh Kumar; Ranganna, B Usha

    2008-12-01

    Lupus vulgaris is the commonest form of cutaneous tuberculosis which commonly involve trunk and buttocks. Lupus vulgaris affecting nose and face, are rarely reported in India. This study reports an unusual case of lupus vulgaris involving the external nose that showed dramatic outcome after six months of anti- tubercular treatment.

  13. A disappearing neonatal skin lesion.

    LENUS (Irish Health Repository)

    Hawkes, Colin Patrick

    2012-01-31

    A preterm baby girl was noted at birth to have a firm, raised, non-tender skin lesion located over her right hip. She developed three similar smaller lesions on her ear, buttock and right knee. All lesions had resolved by 2 months of age.

  14. The role of natural and UV-induced skin pigmentation on low-fluence IPL-induced side effects

    DEFF Research Database (Denmark)

    Thaysen-Petersen, Daniel; Lin, Jennifer Y; Nash, Jf

    2014-01-01

    disproportionately. The aim of this study was to evaluate the influence of constitutive and facultative skin pigmentation on low-fluence intense pulsed light (IPL)-induced adverse skin effects. STUDY DESIGN/MATERIALS AND METHODS: Twenty-one subjects with Fitzpatrick skin type II-IV were enrolled. Two buttock blocks...

  15. A Chronic Disseminated Dermatophytosis Due to Trichophyton violaceum

    NARCIS (Netherlands)

    Zhan, Ping; Li, Zhi-Hua; Geng, Chengfang; Jiang, Qing; Jin, Yun; Dolatabadi, S.; Liu, Weida; de Hoog, G Sybren

    2015-01-01

    A 48-year-old female had presented dandruff and breakable hair for more than 40 years, dry scaly erythema on bilateral palms and feet accompanying with nail destruction for 20 years, and scaling papules on the buttock for 5 years. Direct microscopic examination showed endothrix anthroconidia within

  16. Effets d'une suppl\\'eance perceptive visuelle, auditive et tactile sur le contr\\^ole des pressions fessi\\`eres en position assise

    CERN Document Server

    Chenu, Olivier; Pinsault, Nicolas; Demongeot, Jacques; Payan, Yohan; Vuillerme, Nicolas; 10.3166/sth.2.229-239

    2009-01-01

    This article presents a study on different informative modalities of a percecptual supplementation device aiming at reducing overpressure at the buttock area. Visual, audio and tactile modalities are analysed and compared with a non-biofeedback session. In conclusion, modalities have a positive and equal effect, but they are not equally judged in term of comfort and disturbance with some other activities

  17. A fetal scalp electrode as a simple aid in the search for a lost needle fragment during sacrospinous ligament fixation

    NARCIS (Netherlands)

    Schoonenberg, M.P.G.; Kluivers, K.B.; Vierhout, M.E.

    2011-01-01

    A needle fragment was lost during a sacrospinous ligament fixation. This was recognized during the procedure, but could not be found at that moment. The patient complained of severe buttock pain postoperatively. The needle fragment was localized on CT scan of the pelvis. A fetal scalp electrode help

  18. Injuries from Combat Explosions in Iraq: Injury Type, Location, and Severity

    Science.gov (United States)

    2012-01-01

    caused by explosions will assist in the mitigation, treatment , and rehabilitation of the effects of these injuries . 2012 Elsevier Ltd. All rights...column injury except for cervical vertebral column, trunk, back and buttocks, upper extremity unspecified, hip, upper leg and thigh, knee, other... injuries due to explosions will improve themitigation, treatment , and rehabilitation of combat explosion consequences in survivors. This comprehensive

  19. Resolution of Low Back and Radicular Pain in a 40-year-old Male United States Navy Petty Officer after Collaborative Medical and Chiropractic Care

    Science.gov (United States)

    2009-12-08

    the low back, radiating into the right “hip” ( sacroiliac joint ), buttock, and leg and numbness in the lateral right foot. An examination was performed...2006;12(7):659-68. 12. Chou R, Qaseem A, Snow V, Casey D, Cross JH, Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical

  20. HUMAN SKIN MICROORGANISMS ARE DISTRIBUTED IN BIOFILM AGGREGATES AT WOUND EDGES

    DEFF Research Database (Denmark)

    Bay, L.; Agren, M. S.; Poulsen, Steen Seier

    2015-01-01

    -smoking healthy volunteers aged18 –49 yea rs were enrolled (NCT02116725). Suction blisters were raised on each but-tock by applying chambers with a 10 mm opening at 2380 mmHg and surface tem-perature of 408C. The blister roofs comprising the entire epidermis were excised. The60 wounds were scanned by OCT on day 0...

  1. Increased dermal mast cell prevalence and susceptibility to development of basal cell carcinoma in humans

    DEFF Research Database (Denmark)

    Grimbaldeston, Michele A; Skov, Lone; Finlay-Jones, John J;

    2002-01-01

    Exposure to ultraviolet B (UVB) radiation (280-320 nm) is the primary etiologic factor associated with the development of basal cell carcinoma (BCC). The outgrowth of these keratinocyte-derived skin lesions is enhanced by the ability of UVB to impair an immune response that would otherwise......, display variations in dermal mast cell prevalence. In a study of Danish and South Australian BCC patients and control subjects, one 4-mm punch biopsy of non-sun-exposed buttock skin was sampled from each participant. This skin site was investigated to avoid any changes in mast cell prevalence caused...... dermal area (expressed as mast cells per square millimeter). This technique enabled us to detect heterogeneity of dermal mast cell prevalence in buttock skin between individuals and provided evidence of an association between high dermal mast cell prevalence and BCC development in two diverse populations...

  2. Piriformis syndrome--a rare cause of extraspinal sciatica.

    Science.gov (United States)

    Arooj, Shumaila; Azeemuddin, Muhammad

    2014-08-01

    Piriformis syndrome is a rare entity resulting in severe unilateral isolated buttock pain shooting in nature, non discogenic in origin. MR imaging of pelvis plays an important role in such patients to see the normal anatomy of piriformis muscle and its relationship with sciatic nerve. A 35-year-old woman presented with one year history of radiating leg pain with normal MR lumbosacral spine. MRI pelvis showed an abnormal orientation of left sciatic nerve through cleaved fibers of the piriformis muscle. The patient's symptoms were relieved by surgical decompression. The purpose of this case report is to show the role and importance of MR imaging for tracing sciatic nerve and its relationship to the Piriformis muscle. MR imaging of pelvis for sciatic nerve plays an important role in symptomatic patients with isolated buttock pain having normal MRI lumbosacral spine.

  3. Piriformis Syndrome and Endoscopic Sciatic Neurolysis.

    Science.gov (United States)

    Knudsen, Joshua S; Mei-Dan, Omer; Brick, Mathew J

    2016-03-01

    Piriformis syndrome is the compression or the irritation of the sciatic nerve by the adjacent piriformis muscle in the buttock leading to symptoms that include buttock pain, leg pain, and altered neurology in the sciatic nerve distribution. Epidemiological figures of the prevalence are unknown, but are estimated to be about 12.2% to 27%. There is no consensus on the diagnostic criteria. Advancement in magnetic resonance imaging allows us to observe unilateral hyperintensity and bowing of the sciatic nerve. The pathophysiology of the disease includes single blunt trauma, overuse causing piriformis hypertrophy, and long-term microtrauma causing scarring. Treatments include physiotherapy, steroid injections, and surgery. Minimally invasive techniques are emerging with the hope that with less postoperative scar tissue formation, there will be less recurrence of the disease. In this chapter, senior author describes his technique for endoscopic sciatic neurolysis.

  4. Chronic expanding hematoma extending over multiple gluteal muscles associated with piriformis syndrome.

    Science.gov (United States)

    Kitagawa, Yasuyuki; Yokoyama, Munehiro; Tamai, Kensuke; Takai, Shinro

    2012-01-01

    We report on a patient with an unusual, slowly enlarging hematoma of the left buttock. A 62-year-old man presented with a 6-year history of an enlarging mass of the left buttock. He had first noted the mass 6 years earlier and had had sciatica of the left lower limb for the last 2 months. He denied any history of antecedent trauma. The lesion extended over 3 gluteal muscles (the gluteus medius, gluteus minimus, and piriformis). On microscopic examination, the lesion showed typical signs of chronic expanding hematoma. The sciatica was relieved after surgical removal of the lesion. The lesion had not recurred at the last follow-up 4 years after the operation. The present case suggested that chronic expanding hematoma can extend into multiple muscles due, perhaps, to long-term growth and the anatomical and functional conditions of the affected muscles. Our case also suggests that chronic expanding hematoma can be a cause of piriformis syndrome.

  5. Piriformis Syndrome With Variant Sciatic Nerve Anatomy: A Case Report.

    Science.gov (United States)

    Kraus, Emily; Tenforde, Adam S; Beaulieu, Christopher F; Ratliff, John; Fredericson, Michael

    2016-02-01

    A 68-year-old male long distance runner presented with low back and left buttock pain, which eventually progressed to severe and debilitating pain, intermittently radiating to the posterior thigh and foot. A comprehensive workup ruled out possible spine or hip causes of his symptoms. A pelvic magnetic resonance imaging neurogram with complex oblique planes through the piriformis demonstrated variant anatomy of the left sciatic nerve consistent with the clinical diagnosis of piriformis syndrome. The patient ultimately underwent neurolysis with release of the sciatic nerve and partial resection of the piriformis muscle. After surgery the patient reported significant pain reduction and resumed running 3 months later. Piriformis syndrome is uncommon but should be considered in the differential diagnosis for buttock pain. Advanced imaging was essential to guide management.

  6. Maximizing aesthetics in lateral-tension abdominoplasty and body lifts.

    Science.gov (United States)

    Lockwood, Ted E

    2004-10-01

    The high-lateral-tension abdominoplasty addresses the practical and theoretic faults of standard abdominoplasty design. Key features include limited direct undermining, increased lateral skin resection with highest-tension wound closure along lateral limbs, two-layer superficial fascial system repair, and significant truncal liposuction when needed. The high-lateral-tension design limits the unfavorable features of standard abdominoplasty and produces balanced natural aesthetic contours. The high-lateral-tension abdominoplasty is the foundation for treatment of more generalized relaxation problems in the circumferential trunk and thighs. For more significant thigh laxity and buttock ptosis, the lateral-tension abdominoplasty is combined with the transverse thigh/buttock lift to produce the lower body lift #2.

  7. Blunt injury to the inferior gluteal artery: case report of a rare "near miss" event

    Directory of Open Access Journals (Sweden)

    Chen Wei

    2008-10-01

    Full Text Available Abstract Traumatic injuries of the inferior gluteal artery are rare, the majority of which are aneurysms due to sharp or blunt trauma. We report the rare case of a "near miss" event of a patient with an acute hemorrhagic mass in the right buttock caused by blunt trauma to the inferior gluteal artery without "hard" clinical signs of vascular injury. Despite the unusual presentation, diffuse injury of the inferior gluteal artery branches was diagnosed by ultrasonography and angiography. This article highlights the importance of considering an arterial injury following blunt trauma to the buttock with subsequent pain and swelling. Appreciation of this rare injury pattern is necessary in order to facilitate rapid diagnosis and appropriate treatment.

  8. Dedifferentiated parosteal osteosarcoma with well-differentiated metastases

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Katsuhito; Morii, Takeshi; Yabe, Hiroo; Morioka, Hideo; Toyama, Yoshiaki [Keio University, School of Medicine, Department of Orthopaedic Surgery, Shinjuku-ku, Tokyo (Japan); Mukai, Makio [Keio University, School of Medicine, Division of Diagnostic Pathology, Shinjuku-ku, Tokyo (Japan)

    2006-10-15

    Metastases of dedifferentiated sarcoma usually contain a dedifferentiated component. We report a rare case of dedifferentiated parosteal osteosarcoma (dd-POS) with well-differentiated multiple metastases in a 65-year-old woman with a painful firm mass on her thigh. Radiological examination revealed that the mass arose from the surface of her femur without medullary involvement. Multiple intramuscular metastases were detected in her lower leg on MR imaging. Small subcutaneous palpable masses were identified on her left lower leg, buttock, chest wall and head. An open biopsy and above-the-knee amputation were performed, and the mass on her femur was diagnosed as a dd-POS. However, histological examination on the subcutaneous lesions in her lower leg, buttock and head showed low-grade conventional POS without dedifferentiated components. To the best of our knowledge, this is the first report of a dd-POS with multiple metastases that do not contain any dedifferentiated components. (orig.)

  9. The measurement of constitutive and facultative skin pigmentation and estimation of sun exposure in Caucasians with basal cell carcinoma and cutaneous malignant melanoma

    DEFF Research Database (Denmark)

    Lock-Andersen, J; Drzewiecki, K T; Wulf, H C

    1998-01-01

    and 174 matched controls and in 168 CMM patients and 176 matched controls. Measurements were performed at the forehead, the upper chest, the upper back, the lateral and medial aspects of the upper arm, and the buttocks. Self-estimation of sun exposure in childhood, in youth and in adulthood was performed...... by all subjects. There were no statistically significant differences in constitutive skin pigmentation at the buttocks between BCC patients and controls (P = 0.96) or between CMM patients and controls (P = 0.13). Facultative skin pigmentation in ultraviolet-exposed sites was not significantly different...... between BCC patients and controls except that women patients had higher pigmentation at the lateral side of the upper arm. For CMM, men patients had higher pigmentation at the lateral side of the upper arm. Self-estimations of sun exposure did not show differences between patients and controls...

  10. Monte Carlo dose reconstruction in case of a radiological accident: application to the accident in Chile in December 2005; Reconstitution de dose par calcul Monte Carlo en cas d'accident radiologique: application a l'accident du Chili de decembre 2005

    Energy Technology Data Exchange (ETDEWEB)

    Huet, C.; Clairand, I.; Trompier, F.; Bottollier-Depois, J.F. [Institut de Radioprotection et de Surete Nucleaire (IRSN), Dir. de la Radioprotection de l' Homme, 92 - Fontenay aux Roses (France); Bey, E. [Hopital d' Instruction des Armees Percy, 92 - Clamart (France)

    2007-10-15

    Following a radiological accident caused by a gamma-graphy source in Chile in December 2005 involving one victim, I.R.S.N. was contacted to perform the dosimetric reconstruction of the accident using numerical simulation. Tools developed in the laboratory, associating anthropomorphic mathematic or voxel phantoms with the Monte Carlo calculation code m.c.n.p.x., were used in order to determine the dose distribution on the left buttock and absorbed doses to critical organs. The dosimetric mapping show that the absorbed at the skin surface is very high (1900 Gy) but drops rapidly at deep. At a depth of 5 cm, it is 20 Gy. Calculations performed with a mathematical phantom indicate that average doses to the critical organs are relatively low. Moreover, possible bone marrow sites for puncture are identified. Based on the dosimetric mapping, an excision measuring 5 cm in depth by 10 cm in diameter was performed on the left buttock of the victim. (authors)

  11. Non-pigmented fixed drug eruption induced by eprazinone hydrochloride.

    Science.gov (United States)

    Tanabe, Kenichi; Tsuboi, Hiromi; Maejima, Hideki; Arai, Satoru; Katsuoka, Kensei

    2005-12-01

    A 68-year-old woman developed an upper respiratory tract infection in November 2002 and was treated with eprazinone hydrochloride, serrapeptase, carbocysteine and clarithromycin. Three days after the start of treatment, the patient noted erythema on her axilla, buttock and inguinal regions. The erythema subsided in 7 days although slight pigmentation remained. However, 7 days later the pigmentation completely disappeared. Oral eprazinone hydrochloride was given as a challenge, and 1 day later the erythema re-appeared in the same areas as on initial presentation (axilla, buttock, and inguinal regions). A fixed erythema without lasting pigmentation is attributed to eprazinone hydrochloride. Therefore, the patient was diagnosed as having a nonpigmented fixed drug eruption associated with eprazinone hydrochloride.

  12. Management of Klippel-Trenauny syndrome with multiple organ involvement

    Directory of Open Access Journals (Sweden)

    Nassiri Javad

    2007-01-01

    Full Text Available Klippel-Trenauny syndrome is a disturbance in the development of the mesodermal and ectodermal tissues occurring in utero, which is characterized by vascular nevi, varicose veins, soft tissue, and occasionally, bone hyperplasia. Our patient is a 6-year-old boy with presentation of left lower extremity over growth, abdominal mass, abdominal pain, bilateral buttock mass, rectal bleeding, and skin hemangiomatosis. The major problems of this case were involvement of the levator ani, external anal sphincter, and encasement of the sciatic nerves within the buttock mass. We concluded that the use of muscle and nerve stimulator for detection and saving sphincters and the nerves in these cases could improve the results of surgical resection.

  13. Sacral Fatigue Fracture in an Amateur Soccer Player

    Directory of Open Access Journals (Sweden)

    Georgios Tzoanos

    2013-01-01

    Full Text Available Sacral fatigue fractures represent a frequently overlooked cause of low-back and buttock pain in athletes. A high index of clinical suspicion and MRI utilization can provide the accurate diagnosis. A 38-year-old male amateur, midfielder, soccer player presented to our department with aggravating right buttock pain during the previous month, following an increase in training intensity and frequency on an artificial turf field. A point of maximal tenderness was demonstrated over the area of the right sacroiliac joint. No radiographic abnormalities were observed. MRI of the pelvis revealed the presence of a stress fracture in the right sacral ala. The patient underwent conservative treatment and resumed playing soccer 12 weeks later, with no residual or recurrent clinical complaints. Apart from the recent change in training regimen, decreased shock absorption related to the physical properties of old generation artificial turf may have also been involved in this case.

  14. Hair today, gone tomorrow: a comparison of body hair removal practices in gay and heterosexual men.

    Science.gov (United States)

    Martins, Yolanda; Tiggemann, Marika; Churchett, Libby

    2008-09-01

    Although hairlessness is rapidly becoming a component of the ideal male body, little research has examined men's concerns about their body hair or their hair removal practices. Samples of gay and heterosexual men completed questionnaires that assessed whether they had ever removed their back, buttock or pubic hair, the frequency with which they did so, the methods used and their self-reported reasons for removing this hair, as well as their level of appearance investment. Results indicated that many gay and heterosexual men remove their back, buttock and pubic hair regularly and that their primary reason for doing so is to maintain or improve their appearance. The frequency of hair removal was also associated with the motivational salience component of appearance investment. The findings offer further support to the premise that gay and heterosexual men exhibit similar body image concerns.

  15. 2010 Anthropometric Survey of U.S. Marine Corps Personnel: Methods and Summary Statistics

    Science.gov (United States)

    2013-06-01

    accommodation limit—typically the male 95th percentile—increased 2-3 cm for buttock circumference , chest circumference , and waist circumference . At a...OF PARTICIPANTS 619 NUMBER OF PARTICIPANTS 1301 220 (88) WAIST CIRCUMFERENCE (OMPHALION) The horizontal circumference of the waist , passing...42.31 106.60 41.97 99TH 109.80 43.23 221 (88) WAIST CIRCUMFERENCE (OMPHALION) FREQUENCIES FEMALES MALES F FPct CumF CumFPct CM F FPct

  16. Retraining Attentional Bias to Unhealthy Food Cues

    Science.gov (United States)

    2013-06-26

    65 MEASURES Anthropometric Indices Height, weight, waist circumference , hip circumference , and body fat were measured during baseline (Appendix E...was used to measure waist and hip circumference using published guidelines (2). Self-Report Questionnaires Self-report questionnaires were...buttocks ("pear" shape). The most practical way to determine whether you have too much abdominal fat is to measure your waist circumference : Women with

  17. Larva currens in a case of Organophosphorous poisoning

    Directory of Open Access Journals (Sweden)

    Rao D

    2006-01-01

    Full Text Available A 20-year-old healthy farmer consumed organophosphorous poison. On third day he developed diarrhoea and on fourth day linear serpiginous ulcers appeared on both buttocks. Clinically lesions were considered as decubitus ulcers. By stool examination and other laboratory investigations it was diagnosed as cutaneous larva currens due to S trongyloides stercoralis in a case of organophosphorus poisoning. Patient responded very well to a course of albendazole.

  18. Impact of a Health and Physical Readiness Program on Naval Air Station Productivity.

    Science.gov (United States)

    1986-03-01

    Testing Responsibilities who have been clinically evaluated and medically diagnosed (4) Height-Weight Screaning Tables as compulsive overeaters and in the...heels close to buttocks (approximately 10 inches) and arms folded across chest and feet held to floor by a partner. (2) Curl up touching elbows to thighs...3) Lie back touching shoulders to floor. (4) Repeat as many times as possible in two minutes. Timer begins with *Ready", "Set", "Go" to begin

  19. An unusual burn caused by hot argy wormwood leaf water

    Directory of Open Access Journals (Sweden)

    Feng Guo

    2011-09-01

    Full Text Available An unusual burn case caused by hot wormwood leaf water was discussed. A 29-year-old woman sustained a 7% second-degree burn on both buttocks and left thigh. This case report highlights a rare cause of a chemical burn that may become more common with increasing use of this Chinese traditional medicine. The prevention measures of this burn injury were also presented.

  20. Rationale for Treatment of Hip Abductor Pain Syndrome

    OpenAIRE

    Bewyer, Dennis C; Bewyer, Kathryn J

    2003-01-01

    Patients with lower back or buttock pain that radiates into the posterior or lateral leg are often referred to physical therapy with a diagnosis of sciatica. Often the physical exam does not reveal neurologic findings indicative of radiculopathy. Instead, there is hip abductor muscle pain and weakness. This syndrome involves muscle imbalances that result in overuse strain of the gluteus medius and gluteus minimus muscles, myofascial trigger points, and trochanteric bursitis. This paper descri...

  1. Zoledronic acid-associated symmetrical drug-related intertriginous and flexural exanthema (SDRIFE): report of baboon syndrome in a woman with recurrent metastatic breast cancer after receiving zoledronic acid

    OpenAIRE

    Cohen, Philip R.

    2015-01-01

    Background:  Baboon syndrome is a distinctive skin reaction in which the patient typically develops erythematous buttocks that appear similar to those of a baboon.  The non-contact allergenic variant of baboon syndrome is also referred to as symmetrical drug-related intertriginous and flexural exanthema (SDRIFE).  Zoledronic acid is a bisphosphonate that is used in patients with metastatic cancer to prevent bone complications. Purpose:  Zoledronic acid-associated baboon syndrome is ...

  2. A Supplement to the 1995 Matched Anthropometric Database of U.S. Marine Corps Personnel: Summary Statistics

    Science.gov (United States)

    1997-06-01

    level of the maximum protrusion of the light buttock. Cervicale : The superior palpable point of the spine of the seventh cervical vertebra ...vertical distance between the cervicale landmark at the base of the back of the neck and the tragi on landmark on the catilaginous flap of flesh in front of...the earhole is calculated as follows: STATlJRE minus TRAGION-TOP OF HEAD minus CERVICALE HEIGHT. 52 Neck Link Males Females Millimeters Inches

  3. Diagnosis and management of “an apparent mechanical” femoral mononeuropathy: a case study

    OpenAIRE

    Desmarais, Ariane; Descarreaux, Martin

    2007-01-01

    This report describes an apparent case of femoral nerve mononeuropathy in a 58-year-old equestrian due to mechanical stress. A woman presented at a chiropractic office complaining of right buttock pain radiating to the right groin and knee. A treatment plan, consisting of chiropractic adjustments in addition to stretching and myofascial therapy, was initiated. The goal was to reduce pain and inflammation in the sacroiliac articulation by restoring normal biomechanical function. A rehabilitati...

  4. Management of pilonidal sinus by Kshar Sutra, a minimally invasive treatment

    OpenAIRE

    2010-01-01

    A Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work. It is more common in men (as they have more hair) than in women. The most commonly used surgical techniques for this disorder include excision and primary closure and excision with reconstructive flap. However, the risk of recurrence or of developing an infection of the wound after the operation is high. Also, the patient requires longer hospitalizat...

  5. Diagnostic Methods in Piriformis Syndrome

    OpenAIRE

    Mariana BÂRZU

    2013-01-01

    An uncomon cause of sciatica is piriformis syndrome that involves deep buttock pain reffered to the leg. Piriformis syndrome is usually discribed as a neuromuscular disorder caused by compression or irritation of the sciatic nerve by the piriformis muscle. There are a lot of means to diagnose Piriformis syndrome, and to distinguish it from other pain inducing conditions. Unfortunatelly not every practitioner has the opportunity to use special means, and not every patient has the financial sup...

  6. NEURAL MOBILIZATION A THERAPEUTIC EFFICACY IN A PIRIFORMIS SYNDROME MODEL:AN EXPERIMENTAL STUDY

    OpenAIRE

    Rahul Krishnan Kutty; Hailay Gebremichael Gebrekidan; Wondwossen Terefe Lerebo; Mueez Abraha Gebretsadik

    2014-01-01

    Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle causing pain, tingling and numbness in the buttocks and along the sciatic nerve. Traditional exercise therapy program for sciatica primarily focuses on pain relief but, neural mobilization should be viewed as another form of manual therapy similar to joint mobilization. The focus of this study is to see the effectiveness of neural mobiliz...

  7. Pyoderma gangrenosum in a newborn - case report

    OpenAIRE

    2013-01-01

    Pyoderma gangrenosum is a rare, inflammatory, chronic and recurrent disease of unknown etiology, characterized by noninfectious, necrotizing and painful cutaneous ulcers. Usually it affects adults aged between 25 and 54 years old and rarely children (less than 4%), in which it mainly affects the head, face, buttocks, genital and perianal region. The disease presents a quick response to systemic corticosteroids. We report a case of a newborn with hemorrhagic and necrotic ulcers, distributed in...

  8. Identification and Validation of New Anthropometric Techniques for Quantifying Body Composition

    Science.gov (United States)

    1986-10-16

    the buttocks, where a skinfold can be picked up, with its long axis horizontal, in the posterior midline of the thigh just proximal to the gluteal ...cause pain , and the procedure is non--invasive. As a result, skinfold calipers are widely used in screening programs and in large anthropometric and...also had experience with the Ithaco ultrasound equipment and took great pains to obtain the best possible data with . .. .. the EchoScan equipment

  9. Superior gluteal nerve entrapment between two bellies of piriformis muscle

    OpenAIRE

    Yadav Y; Mehta V; Roy S; Suri R; Rath G

    2010-01-01

    A double belly composition of piriformis muscle with superior gluteal nerve entrapment between the two muscle masses was detected. Piriformis muscle and its relation to sciatic nerve has been suggested as a cause of piriformis syndrome. Patients suffering from buttock pain are most often diagnosed as having piriformis syndrome, where anatomical variation of the piriformis is an important contributor. The present variation showed two distinct bellies of piriformis muscle. Interestingly the sup...

  10. Deep gluteal syndrome

    OpenAIRE

    Martin, Hal David; Reddy, Manoj; Gómez-Hoyos, Juan

    2015-01-01

    Deep gluteal syndrome describes the presence of pain in the buttock caused from non-discogenic and extrapelvic entrapment of the sciatic nerve. Several structures can be involved in sciatic nerve entrapment within the gluteal space. A comprehensive history and physical examination can orientate the specific site where the sciatic nerve is entrapped, as well as several radiological signs that support the suspected diagnosis. Failure to identify the cause of pain in a timely manner can increase...

  11. Fifty-two Cases of the Piriformis Syndrome Treated by Centro-square Needling

    Institute of Scientific and Technical Information of China (English)

    ZOU Zhen

    2009-01-01

    @@ The piriformis syndrome refers to a clinical syndrome of the piriform muscle due to acute or chronic injury, with local aceptic inflammation,muscular spasm, congestion and swelling of the piriformis. It may cause pain in the buttocks, even the severe lancinating pain with a burning sensation radiating to the lower limb and the patient may have lameness or can not walk. For the treatment, the centro-square needling plus cupping was adopted. The results were satisfactory as reported in the following.

  12. Larva currens in a case of Organophosphorous poisoning

    OpenAIRE

    Rao D; Rao VRS

    2006-01-01

    A 20-year-old healthy farmer consumed organophosphorous poison. On third day he developed diarrhoea and on fourth day linear serpiginous ulcers appeared on both buttocks. Clinically lesions were considered as decubitus ulcers. By stool examination and other laboratory investigations it was diagnosed as cutaneous larva currens due to S trongyloides stercoralis in a case of organophosphorus poisoning. Patient responded very well to a course of albendazole.

  13. Ultraviolet radiation after exposure to a low-fluence IPL home-use device

    DEFF Research Database (Denmark)

    Thaysen-Petersen, Daniel; Erlendsson, Andres M; Nash, J F

    2015-01-01

    a low-fluence IPL treatment with a home-use device. Sixteen subjects with Fitzpatrick skin types (FST) II-V were enrolled. Three constitutive buttock blocks (4.4 × 6.4 cm) were each subdivided into four sites, randomized to one IPL exposure of 0, 7, 8, or 10 J/cm2 (spectral output 530-1100 nm). Blocks...

  14. Sexual Assault and Sexual Harassment in the U.S. Military: Top-Line Estimates for Active-Duty Service Members from the 2014 RAND Military Workplace Study

    Science.gov (United States)

    2014-01-01

    Study Survey DoD, in consultation with the White House National Security Staff, stipulated that the sample size for the RMWS was to include a census of...of Active-Duty DoD Respondents Who Completed Each Survey Module Survey Module Sample Size Respondents Response Rate WGRA Outcomes (prior form...include the buttocks, inner thigh, breast, groin, anus, vagina, penis and testicles. Top-Line Results from the RAND Military Workplace Study 41 12

  15. Human Decompression Trial With 1.3 ATA Oxygen in Helium

    Science.gov (United States)

    1998-06-01

    reported a "shooting pain" and paresthesia down his right buttock and leg during a right Babinski ; Babinski was downgoing bilaterally. Diver reported...neurological signs . USN TT6 (without extensions) was completed. Neurological exam after treatment was normal except for absent left-sided abdominal...to Neurology at NNMC and admitted for diagnostic testing. An EEG and MRI were obtained and found to be normal. No conclusive neurologic signs were

  16. An explorative study of non-invasive ultra-weak photon emission and the anti-oxidative influence of oral zinc sulphate in light-sensitive patients with erythropoietic protoporphyria

    DEFF Research Database (Denmark)

    Petersen, Anita Birgit; Philipsen, Peter Alshede; Wulf, Hans Christian

    2011-01-01

    from the buttock skin and dorsal hand before and after solar-simulated light (SUN) exposure. Blood samples were analysed routinely for plasma zinc, iron, ferritin, transferrin, haemoglobin, erythrocyte PPIX and Zn-PPIX. RESULTS: UPE in EPP patients resembled that seen in healthy individuals. Without...... correlation was found between plasma zinc concentration and the initial burst. CONCLUSION: Measurements of UPE can be used for monitoring UVA-induced oxidative processes in vivo in the skin of EPP patients....

  17. Clinical Practice Guideline Selection, Development, Implementation, and Evaluation

    Science.gov (United States)

    2000-02-01

    sacroiliac joint : The joint between the sacrum and ilium and associated ligaments. Sacrum: The triangular-shaped bone lying between the 5th lumbar...forming the sacroiliac joints . Sciatica: A syndrome characterised by pain radiating from the back into the buttock and into the lower extremity along its...sprains or strains, ligament tears, muscle tears, lumbar spinal stenosis, joint problems, irritated discs, “slipped discs”, improper lifting Clinical

  18. Blunt injury to the inferior gluteal artery: case report of a rare "near miss" event

    OpenAIRE

    Chen Wei; Pan Jinshe; Smith Wade R; Liu Huaijun; Zhang Qi; Zhang Yingze

    2008-01-01

    Abstract Traumatic injuries of the inferior gluteal artery are rare, the majority of which are aneurysms due to sharp or blunt trauma. We report the rare case of a "near miss" event of a patient with an acute hemorrhagic mass in the right buttock caused by blunt trauma to the inferior gluteal artery without "hard" clinical signs of vascular injury. Despite the unusual presentation, diffuse injury of the inferior gluteal artery branches was diagnosed by ultrasonography and angiography. This ar...

  19. Effectiveness of carboxytherapy in the treatment of cellulite in healthy women: a pilot study

    Science.gov (United States)

    Pianez, Luana Ramalho; Custódio, Fernanda Silva; Guidi, Renata Michelini; de Freitas, Jauru Nunes; Sant’Ana, Estela

    2016-01-01

    Background Carbon dioxide therapy, better known as carboxytherapy, relates to percutaneous infusion of medical carbon dioxide with therapeutic approaches, and its use in the treatment of localized fat has demonstrated good results. Gynoid lipodystrophy, also known as cellulite, affects 80%–90% of women after puberty, especially in the buttocks and thighs. Its etiology is complex and involves multifactorial aspects. Its treatment and evaluation require the use of new technologies (more effective and low-cost approaches). The objective was to investigate the effectiveness of carboxytherapy in the treatment of cellulite in the areas of buttocks and posterior thigh. Patients and methods Ten women, 29±6.1 years, were selected and all of them received eight treatment sessions, with an interval of 7 days between sessions. Standardized digital photographs were used to assess the severity of cellulite, and panoramic images were collected by ultrasound diagnosis. The evaluations were performed before the first treatment (baseline) and 7 days after the last treatment session of carboxytherapy. Results After the treatment, there was a significant reduction (P=0.0025) of the cellulite from degree III to degree II, and this improvement had correlation with the improvement in the organization of the fibrous lines and the disposal of adipose tissue lines of the treated regions observed through the panoramic ultrasound images diagnosis. Conclusion Carboxytherapy is an effective technique of treatment of cellulite in the buttocks region and posterior thighs of healthy women. PMID:27578994

  20. Biopsy-proven spontaneous regression of a rhabdomyomatous mesenchymal hamartoma.

    Science.gov (United States)

    Mazza, Joni M; Linnell, Erica; Votava, Henry J; Wisoff, Jeffrey H; Silverberg, Nanette B

    2015-01-01

    Rhabdomyomatous mesenchymal hamartoma (RMH) is a rare, benign, congenital tumor of the dermis and subcutaneous tissue comprised of skeletal muscle and adipose and adnexal elements. Although the majority of cases are an incidental finding in otherwise healthy patients, some have been reported in association with other anomalies. We present a full-term boy evaluated on day 2 of life for two lesions located on the midline of the lower back and right buttock that each appeared clinically as an atrophic, pink plaque. Ultrasound of the midline lesion revealed an underlying lipomyelomeningocele with a tethered cord in the spinal canal. Histopathology of the right buttock cutaneous lesion was consistent with a diagnosis of RMH. Surgical excision was performed on the midline intradural lipoma and the lesion on the buttock was monitored clinically. Repeat biopsy of this site at 1 year of age revealed complete spontaneous regression. This case highlights three interesting features: the association with an occult spinal dysraphism lipomyelomeningocele and tethered cord, the clinical presentation of an atrophic plaque as opposed to the more commonly reported raised lesions, and the phenomenon of spontaneous regression of the lesion. Most importantly, this final feature of regression in our patient suggests that, in the absence of symptoms, clinical observation of RMH lesions is warranted for spontaneous regression for 1 to 2 years provided that no functional deficit is noted and that the cutaneous or deeper lesions are not causing a medical problem.

  1. An integral topical gel for cellulite reduction: results from a double-blind, randomized, placebo-controlled evaluation of efficacy

    Directory of Open Access Journals (Sweden)

    Dupont E

    2014-02-01

    Full Text Available Eric Dupont,1 Michel Journet,2 Marie-Laure Oula,3 Juan Gomez,1 Claude Léveillé,4 Estelle Loing,5 Diane Bilodeau6 1Immanence IDC Inc, Québec, QC, Canada; 2Clinique de Dermatologie St-Joseph, Montréal, QC, Canada; 3Evalulab Inc, Mont-Royal, QC, Canada; 4Clinique de Chirurgie Esthétique du Québec Métropolitain, Lévis, QC, Canada; 5Lucas Meyer Cosmetics, Québec, QC, Canada; 6CosmeConsult, Québec, QC, Canada Background: Cellulite is a serious cosmetic concern for most of the 90% of women affected by it. Objective: To assess the clinical efficacy of a complex integral anti-cellulite gel. Methods: This double-blind, randomized, placebo-controlled study involved 44 healthy women, aged 25–55 years. Subjects had a normal to slightly overweight body mass index and presented slight to moderate cellulite on their thighs, buttocks, and/or hips at baseline. Subjects were randomly assigned to either the treated or placebo group and accordingly applied the active product or placebo on their hips, stomach, buttocks, and thighs, twice daily for 3 months. Skin tonicity, orange-peel aspect, and stubborn cellulite were assessed at day 0, 28, 56, and 84. A self-evaluation questionnaire was completed by all volunteers. Results: At the end of the study, an average of 81% of the subjects applying the active product presented improvement in their cellulite condition versus 32% for the placebo group (all descriptors and sites combined. At day 84, skin tonicity, orange-peel appearance, and stubborn cellulite were improved in a significant manner (P<0.05 over placebo, on all studied areas. Skin tonicity improved on average by +41% for buttocks, +35% for hips, and +31% for thighs. Orange peel appearance was reduced on average by -25% for buttocks, -22% for hips, and -22% for thighs. Stubborn cellulite was reduced on average by -19% for buttocks, -24% for hips, and -22% for thighs. Circumference measurements decreased in a significant manner (P<0.05 over placebo

  2. Advancing a smart air cushion system for preventing pressure ulcers using projection Moiré for large deformation measurements

    Science.gov (United States)

    Cheng, Sheng-Lin; Tsai, Tsung-Heng; Lee, Carina Jean-Tien; Hsu, Yu-Hsiang; Lee, Chih-Kung

    2016-03-01

    A pressure ulcer is one of the most important concerns for wheelchair bound patients with spinal cord injuries. A pressure ulcer is a localized injury near the buttocks that bear ischial tuberosity oppression over a long period of time. Due to elevated compression to blood vessels, the surrounding tissues suffer from a lack of oxygen and nutrition. The ulcers eventually lead to skin damage followed by tissue necrosis. The current medical strategy is to minimize the occurrence of pressure ulcers by regularly helping patients change their posture. However, these methods do not always work effectively or well. As a solution to fundamentally prevent pressure ulcers, a smart air cushion system was developed to detect and control pressure actively. The air cushion works by automatically adjusting a patient's sitting posture to effectively relieve the buttock pressure. To analyze the correlation between the dynamic pressure profiles of an air cell with a patient's weight, a projection Moiré system was adopted to measure the deformation of an air cell and its associated stress distribution. Combining a full-field deformation imaging with air pressure measured within an air cell, the patient's weight and the stress distribution can be simultaneously obtained. By integrating a full-field optical metrology with a time varying pressure sensor output coupled with different active air control algorithms for various designs, we can tailor the ratio of the air cells. Our preliminary data suggests that this newly developed smart air cushion has the potential to selectively reduce localized compression on the tissues at the buttocks. Furthermore, it can take a patient's weight which is an additional benefit so that medical personnel can reference it to prescribe the correct drug dosages.

  3. a Modal Analysis of Whole-Body Vertical Vibration, Using a Finite Element Model of the Human Body

    Science.gov (United States)

    Kitazaki, S.; Griffin, M. J.

    1997-02-01

    A two-dimensional model of human biomechanical responses to whole-body vibration has been developed, by using the finite element method. Beam, spring and mass elements were used to model the spine, viscera, head, pelvis and buttocks tissue in the mid-sagittal plane. The model was developed by comparison of the vibration mode shapes with those previously measured in the laboratory. At frequencies below 10 Hz, the model produced seven modes which coincided well with the measurements. The principal resonance of the driving point response at about 5 Hz consisted of an entire body mode, in which the head, spinal column and the pelvis move almost rigidly, with axial and shear deformation of tissue beneath the pelvis occurring in phase with a vertical visceral mode. The second principal resonance at about 8 Hz corresponded to a rotational mode of the pelvis, with a possible contribution from a second visceral mode. A shift of the principal resonance of the driving point response, when changing posture, was achieved only by changing the axial stiffness of the buttocks tissue. It is suggested that an increase in contact area between the buttocks and the thighs and the seat surface, when changing posture from erect to slouched, may decrease the axial stiffness beneath the pelvis, with a non-linear force-deflection relationship of tissue resulting in decreases in the natural frequencies. A change in posture from erect to slouched also increased shear deformation of tissue beneath the pelvis in the entire body mode, and the natural frequency was decreased as a result of the much lower shear stiffness of tissue compared to the axial stiffness.

  4. Injury and Disability: Identification and Reduction

    Science.gov (United States)

    2009-09-01

    7.7%), disorders of muscle , ligament and fascia (6.7%), and other disorders of bone and cartilage (6.4%). The top five musculoskeletal disease...Back & Buttock / / 847.9 / E x tr em it ie s U p p er Shoulder & Upper Arm 810-812 831 840 / Forearm & Elbow 813 832 841 / Wrist, hand...Shoulder & Upper Arm 880 887.2-.3 / 912, 923.0 Forearm & Elbow 881.x0-.x1 887.0-.1 / 923.1 Wrist, hand & Fingers 881.x2, 882 883 885-886 / 914-915

  5. Presence of accessory penis, colonic duplication and several other congenital anomalies in a child: a very rare association.

    Science.gov (United States)

    Chatterjee, Sayan; Mondal, Prabodh Chandra; Pandey, Shashi Bhushan; Achar, Arun

    2014-10-01

    An accessory penis is a very rare anomaly. Only five cases have been reported thus far to our knowledge. We present the case of a child aged 2 years and 10 months who had a penis-like structure (containing phallus and glans) attached to the right buttock. Associated anomalies were a non-communicating type of colonic duplication, a paramedian stenosed anal opening, a horse-shoe kidney, posterior urethral valves, scoliosis of the lumbo-sacral spine, polydactyly and equino-varus deformity of the right foot. As far as we can tell, this is the first report of an accessory penis associated with colonic duplication and other congenital anomalies.

  6. Lipoedema: presentation and management.

    Science.gov (United States)

    Todd, Marie

    2010-04-01

    Lipoedema is a distinct clinical condition characterized by bilateral, symmetrical enlargement of the buttocks and lower limbs owing to excess deposition of subcutaneous fat. It is found almost exclusively in women. The common features associated with this condition are 'column- shaped' legs with sparing of the feet, bruising, sensitivity to pressure, and orthostatic oedema. The progression to lipo-lymphoedema or morbid obesity is possible. Conservative measures used in the management of lymphoedema can prevent progression/limit the orthostatic oedema. Surgical procedures may also play a part in the management of lipoedema.

  7. The Seated Soldier Study: Posture and Body Shape in Vehicle Seats

    Science.gov (United States)

    2013-10-31

    blades, on spine, max anterior pt)* Standing 26 Height of Chest (max anterior pt) Standing 6.4.27 27 Waist Circumference at Omphalion Standing 6.4.88...28 Waist Height at Omphalion Standing 6.4.91 29 Bispinous Breadth Standing 30 Bicristal Breadth Standing 6.4.11 31 Hip Circumference at Buttocks...128 6 Waist Circumference (Omphalion) 732 819 868 916 1025 879 106 Waist Height (Omphalion) 907 951 970 997 1070 978 59 Weight (kg) 57 62 68 74 77 69

  8. Individualized Human CAD Models: Anthropmetric Morphing and Body Tissue Layering

    Science.gov (United States)

    2014-07-31

    Circumference 59.65 Axillary Arm Circumference 33.50 Heel Breadth 7.01 Trochanterion Height 92.83 Biacromial Breadth 39.70 Hip Breadth 34.18 Waist ...Breadth 30.93 Buttock Depth 24.86 Knee Circumference 38.64 Waist Circumference (Natural Indent) 83.99 Chest Breadth 32.15 Knee Height 50.48 Waist ... Circumference (Omphalion) 86.24 Chest Depth 24.32 Lateral Malleolus Height 6.71 Waist Depth 22.62 Chest Height 127.59 Neck Circumference 37.96 Waist Height

  9. Disseminated Cunninghamella bertholletiae infection with spinal epidural abscess in a kidney transplant patient: case report and literature review.

    Science.gov (United States)

    Navanukroh, O; Jitmuang, A; Chayakulkeeree, M; Ngamskulrungroj, P

    2014-08-01

    Cunninghamella bertholletiae is a rare cause of invasive mucormycosis. We report the case of a 42-year-old Thai woman who suffered from disseminated C. bertholletiae infection. The patient developed dry cough, sharp shooting pain in the left buttock referred to the left leg, and fever 1 month after undergoing deceased-donor kidney transplantation. Radiographic studies exhibited multiple pulmonary cavities, osteomyelitis of the sacral spine, epidural abscess along the lumbrosacral spine, and paravertebral soft tissue involvement. Surgical debridement of the epidural abscess concurrent with prolonged intravenous administration of amphotericin B resulted in a good outcome.

  10. The quadratus lumborum and low back pain.

    Science.gov (United States)

    de Franca, G G; Levine, L J

    1991-02-01

    Two cases of low back pain from quadratus lumborum myofascial trigger points are presented. One of the patients suffered from an acute episode while the other had a chronic condition. This condition may be more common than previously believed. The quadratus lumborum should be examined in patients presenting with flank pain as well as low back, buttock and lateral hip pain. Thoracolumbar joint dysfunction may often coexist with quadratus lumborum myofascitis and must be treated for optimal results. Myofascial therapy directed at restoring muscle length and function, coupled with joint manipulation to related dysfunctional areas, was implemented. Diagnosis and treatment are outlined.

  11. Cellulite: a review with a focus on subcision

    Directory of Open Access Journals (Sweden)

    Friedmann DP

    2017-01-01

    Full Text Available Daniel P Friedmann,1 Garrett Lane Vick,2 Vineet Mishra3 1Westlake Dermatology Clinical Research Center, Westlake Dermatology & Cosmetic Surgery, Austin, 2Department of Medicine, 3Division of Dermatology and Cutaneous Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA Abstract: Cellulite is an alteration in skin topography most often found on the buttocks and posterolateral thighs of the majority of postpubertal females. This article aims to review the background, potential pathophysiology, and potential treatment options for cellulite, highlighting subcision as an ideal therapeutic option for this cosmetically distressing condition. Keywords: gynoid lipodystrophy, fibrous septae, radiofrequency, vacuum-assisted subscision

  12. Postpartal sacral fracture without osteoporosis.

    Science.gov (United States)

    Rousière, M; Kahan, A; Job-Deslandre, C

    2001-02-01

    Stress fractures of the sacrum during pregnancy or the postpartum seem uncommon. We report a new case of nontrauma-related postpartal sacral fracture. Only four similar cases have been reported to date. The patient was 36 years of age and her fracture was diagnosed four weeks after her first delivery. Vitamin D levels were low, but there was no osteomalacia. Other standard laboratory tests were normal, as were absorptiometry measurements at the lumbar spine and femur. Rheumatologists should consider sacral fracture in pregnant or nursing patients with buttock pain. Magnetic resonance imaging is the diagnostic investigation of choice.

  13. Cellular blue naevus

    Directory of Open Access Journals (Sweden)

    Mittal R

    2001-01-01

    Full Text Available A 31-year-old man had asymptomatic, stationary, 1.5X2 cm, shiny, smooth, dark blue nodule on dorsum of right hand since 12-14 years. In addition he had developed extensive eruption of yellow to orange papulonodular lesions on extensors of limbs and buttocks since one and half months. Investigations confirmed that yellow papules were xanthomatosis and he had associated diabetes mellitus and hyperlipidaemia. Biopsy of blue nodule confirmed the clinical diagnosis of cellular blue naevus. Cellular blue naevus is rare and its association with xanthomatosis and diabetes mellitus were interesting features of above patients which is being reported for its rarity.

  14. Schwannoma of the conus medullaris: a rare case

    Institute of Scientific and Technical Information of China (English)

    Suat Canbay; Askin Esen Hasturk; Fatma Markoc; Sukru Caglar

    2011-01-01

    Intradural schwannoma of the conus medullaris is a rare form of spinal neoplasm,which commonly occurs in the lumbar region.Conus medullaris level is unusual for schwannomas.A 49-year-old woman presented with chronic sciatica,mild bladder dysfunction,and paresthesia in the buttocks.Magnetic resonance imaging of the spine showed a mass lesion in the conus medullaris region with nerve compression.The tumor was completely resected and diagnosed histologically as schwannoma.The patient recovered after surgery.Clinical and radiologic features of this rare tumor are reviewed and are accompanied by literature findings.

  15. THE GEBODIII Program User’s Guide and Description

    Science.gov (United States)

    1991-03-01

    Landmark Name lx, lY, lZ Left Tragion 2X, 2Y, 2Z Right Tragion 3X, 3Y, 3Z Cervicale 4X, 4Y, 4Z Tenth Rib Midspine 5X, 5Y, 5Z Posterior Superior Iliac...the right buttock. Calf Landmark (right and left): the level of the maximum circumference of the calf as established by measurement. Cervicale : the...superior tip of the spine of the 7th cervical vertebra . (The protrusion of the spinal column at the base of the neck.) Clavicale (right and left): The

  16. 1995 Matched Anthropometric Database of U.S. Marine Corps Personnel: Summary Statistics

    Science.gov (United States)

    1996-09-01

    the thigh or hip at the level ofthe maximum protrusion ofthe right buttock. Cervicale : The superior palpable point of the spine ofthe seventh...cervical vertebra . Dactylion III, right and left: The tip of the middle finger. Dorsal juncture of the calf and thigh: The juncture between the...95th 15.44 428.10 97th 16.85 398.80 97th 15.70 433.40 98th 17.06 404.10 98th 15.91 442.30 99th 17.41 413.00 99th 16.26 61 (20) Cervicale Height

  17. Creeping eruption of the hand in an Iranian patient: Cutaneous larva migrans

    Directory of Open Access Journals (Sweden)

    Zabihollah Shahmoradi

    2014-01-01

    Full Text Available Cutaneous larva migrans (CLM, a serpiginous cutaneous eruption is the most commonly acquired tropical dermatosis. It is caused by infection with hookworm larvae in tropical and sub-tropical areas, and people who have a history of travel in these countries. The most frequent location of CLM is the distal lower extremities or buttocks. We describe a case of 57-year-old Iranian female patient with CLM of hand (unusual site without traveling to endemic countries that was successfully treated with oral albendazole. To the best of our knowledge, this is the first report of CLM in Iran.

  18. Porokeratosis ptychotropica*

    Science.gov (United States)

    Tebet, Ana Carolina Franco; de Oliveira, Tatiana Gandolfi; de Oliveira, Anna Rita Ferrante Mitidieri; Moriya, Fabiolla Sih; de Oliveira Filho, Jayme; Cucé, Luiz Carlos

    2016-01-01

    Porokeratosis is a skin disorder clinically characterized by annular plaques with keratotic borders resembling the Great Wall of China and histopathologically by cornoid lamellae. The disease has several clinical variants. Porokeratosis ptychotropica, which has recently become part of these variants, is quite rare and little known. The entity is characterized by verrucous plaques – which may resemble a psoriasis plaque – that affect the regions of the buttocks, most commonly the gluteal cleft, with or without extremity involvement. Itching is often present. We report a rare case of porokeratosis ptychotropica and highlight its unusual manifestation (single plaque), the first case reported in the Brazilian literature.

  19. Pilonidal sinus (Nadi vrana): A case study

    OpenAIRE

    2010-01-01

    Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work for thousands of young people (mostly men) annually. The incidence of the disease is calculated to be 26 per 100,000 people. It occurs 2.2 times more often in men than in women. Age at presentation is 21 years for men and 19 years for women this case report describes a 22-year-old man with pilonidal sinus who was treated with ksharasutra.

  20. Pilonidal sinus (Nadi vrana): A case study.

    Science.gov (United States)

    Shinde, Pradeep; Toshikhane, Hemant

    2010-07-01

    Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work for thousands of young people (mostly men) annually. The incidence of the disease is calculated to be 26 per 100,000 people. It occurs 2.2 times more often in men than in women. Age at presentation is 21 years for men and 19 years for women this case report describes a 22-year-old man with pilonidal sinus who was treated with ksharasutra.

  1. PTU-associated cutaneous vasculitis with ANCA anti-MPO and anti-PR3 antibodies.

    Science.gov (United States)

    Jacobs, E M G; Hartkamp, A; Kaasjager, H A H

    2003-09-01

    A 36-year-old woman presented at our clinic with symmetrical, tender, palpable purpuric lesions on her lower legs and buttocks after restarting PTU therapy for relapsing Graves' disease. PTU-induced vasculitis was diagnosed with remarkable ANCA anti-MPO and anti-PR3 antibody positivity. The purpuric skin lesions resolved immediately after discontinuation of the drug and the ANCA titres lowered. In the presence of activated neutrophils, PTU could induce a high cytotoxity and injure the vessel walls. Treatment of choice is discontinuation of the drug. Sometimes more aggressive therapy as cyclophosphamide or plasmapheresis is warranted.

  2. Pancreatic panniculitis associated with acute pancreatitis and hemorrhagic pseudocysts: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Yong Suk; Kim, Mi Sung; Park, Chan Sub; Park, Ji Yeon; Park, Noh Hyuck [Kwandong Univ., Myongji Hospital, Goyang (Korea, Republic of)

    2012-10-15

    Pancreatic panniculitis is an inflammation and necrosis of fat at distant foci in patients with pancreatic disorders, most frequently, pancreatitis and pancreatic carcinoma. Clinically, pancreatic panniculitis is manifested by painless or painful subcutaneous nodules on the legs, buttocks, or trunk. The usual sites are the distal parts of the lower extremities. To the best of our knowledge, there have not been many reports for the radiologic findings of pancreatic panniculitis. In this article, we report a case of pancreatic panniculitis, including radiologic findings of CT and ultrasonography. The patient was presented with painful subcutaneous nodules on the trunk, and had underlying acute pancreatitis and hemorrhagic pseudocysts.

  3. Annular lupus vulgaris mimicking tinea cruris.

    Science.gov (United States)

    Heo, Young Soo; Shin, Won Woong; Kim, Yong Ju; Song, Hae Jun; Oh, Chil Hwan

    2010-05-01

    Cutaneous tuberculosis is an infrequent form of extrapulmonary tuberculosis. It is often clinically and histopathologically confused with various cutaneous disorders. A 36-year-old man attended our clinic with slowly progressive, asymptomatic, annular skin lesions on both the thighs and buttocks for 10 years. He consulted with many physicians and was improperly treated with an oral antifungal agent for several months under the diagnosis of tinea cruris, but no resolution of his condition was observed. A diagnosis of lupus vulgaris was made based on the histopathologic examination and the polymerase chain reaction assay. Anti-tuberculosis therapy was administered and the lesions started to regress.

  4. GENERAL ASPECTS

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    960566 Acute nectrotic fasciitis in infancy.Zhang Shaojin (张绍锦), et al.Dept Surg,Qinghai Child Hosp, Xining 810007.Chin JPediatr Surg 1996; 17(4): 237-239 Thirty infants of acute necrotic fascitis wereadmitted. Three cases had a history of intra-muscular injection. The situs of 26 cases werein lumbodorsal and buttocks. The offending or-ganism was a mixed infection of staphylococ-cus aureus, streptococcus, colibacillus or an-acrobic bacillus (bactericides fragile). Thetreatment included early multiple incision and

  5. [Lupus erythematosus panniculitis presenting as palpebral edema and parotiditis].

    Science.gov (United States)

    Pérez-Pastor, G; Valcuende, F; Tomás, G; Moreno, M

    2007-10-01

    Lupus erythematosus panniculitis or lupus erythematosus profundus is characterized by inflammation of the deep dermis and subcutaneous tissue. It can occur in isolation or associated with chronic systemic or discoid lupus erythematosus. It usually consists of nodules and hardened subcutaneous plaques on the forehead, cheeks, proximal extremities, and buttocks. Periorbital and parotid involvement are rare and can lead to misdiagnosis. We present the case of a patient with lupus erythematosus panniculitis who presented with palpebral edema and involvement of the periocular fat and parotid gland.

  6. Subcutaneous panniculitis-like T-cell lymphoma: MRI features and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Levine, Benjamin D.; Seeger, Leanne L.; Motamedi, Kambiz [UCLA-Santa Monica Medical Center and Orthopedic Hospital, Department of Radiological Sciences, Santa Monica, CA (United States); James, Aaron W. [UCLA-Santa Monica Medical Center and Orthopedic Hospital, Department of Pathology and Laboratory Medicine, Santa Monica, CA (United States)

    2014-09-15

    Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) represents a rare subclassification of peripheral T-cell lymphoma (PTCL). We present a case of a 21-year-old female who presented with a 1-month history of pain in the left buttock and hip, tender left inguinal lymph nodes, fevers, and night sweats. Percutaneous core needle biopsy was diagnostic for SPTCL with CD8+ cells positive for cytotoxic granules. Magnetic resonance imaging (MRI) features of SPTCL with a review of the literature are discussed. (orig.)

  7. Clinical experience of symptomatic sacral perineural cyst.

    Science.gov (United States)

    Jung, Ki Tae; Lee, Hyun Young; Lim, Kyung Joon

    2012-07-01

    Tarlov or perineural cysts are nerve root cysts found most commonly at the sacral spine level arising between covering layers of the perineurium and the endoneurium near the dorsal root ganglion and are usually asymptomatic. Symptomatic sacral perineural cysts are uncommon but sometimes require surgical treatment. A 69-year-old male presented with pain in the buttock. He was diagnosed as having a sacral cyst with magnetic resonance imaging. For the nonoperative diagnosis and treatment, caudal peridurography and block were performed. After the treatment, the patient's symptom was relieved. We suggest a caudal peridural block is effective in relieving pain from a sacral cyst.

  8. Ayurvedic Management for Gridhrasi with Special Reference to Sciatica- A Case Report

    OpenAIRE

    Satya Prakash; Sarvesh Kumar Singh

    2015-01-01

    Gridhrasi (sciatica) is one among Vata-vyadhi caused by aggravated Vata Doshas. It is characterized by burning, stinging or numbing pain that is felt in the buttock, thigh, leg or foot. It may or may not be associated with low back pain. Purpose of the study was to ameliorate the clinical manifestation of Gridhrasi. In this case report patient who suffered from Gridhrasi of the left leg since one year was treated with combined Ayurvedic regimen. Patrapinda Swedana for 21 days and Erandmuladi ...

  9. [Disseminated granuloma annulare].

    Science.gov (United States)

    Kansky, A

    1975-09-01

    A case of generalized granuloma annulare in a 55 year old man is reported. The disease appeared five years before the first admission to the hospital. A large number of bluish-red or skin-colour papules were scattered mainly around the earlobes, buttocks and on the extremities. Some of the lesions were lined up in rings or plaques. Small depigmented and brownish scars were present. Two biopsies revealed characteristic foci of complete collagen degeneration accompanied by a palisading infiltrate in the upper dermis. Treatment with tuberculostatics and antimalarics was without improvement. The lesions cleared after a course of prednison, but reappeared when the drug was discontinued.

  10. Pyogenic infections of the sacro-iliac joint.

    Science.gov (United States)

    Dunn, E J; Bryan, D M; Nugent, J T; Robinson, R A

    1976-01-01

    In 3 cases of pyogenic infection of the sacro-iliac joint, the diagnosis was difficult. Limp, buttock pain and upper sciatica were the most common presenting symptoms. Differential limitation of hip motion, positive straight leg raising, a positive Gaenslen test and pain on pelvic compression were frequent fingings. Increased E.S.R., W.B.C. count and fever were seen in 2/3 cases. Plain and tomographic X-rays are often helpful but bone scan has been helpful in localizing early lesions. Treatment after early diagnosis may consist of antibiotics and immobilization alone while in the more chronic cases surgical drainage and debridement may be necessary.

  11. Ulcerative lupus vulgaris over nose, leading to cosmetic deformity.

    Science.gov (United States)

    Nair, Pragya A; Mehta, Malay J; Patel, Bhumi B

    2015-01-01

    Lupus vulgaris (LV), is a chronic and progressive form of secondary cutaneous tuberculosis. In India, it is commonly seen over buttocks, thighs, and legs whereas involvement of nose is quite rare. Ulcerative variant particularly over nose causes destruction of cartilage, leading to irreversible deformities and contracture. High-index of suspicion is required for early diagnosis and prevention of cosmetic deformity. A case of LV over nose in a young male with ulceration is reported who responded well to anti-tubercular therapy, but left with scarring of nose, which could have been prevented if adequate awareness regarding extra-pulmonary cases would have been practiced.

  12. Patient are satisfied one year after decompression surgery for lumbar spinal stenosis

    DEFF Research Database (Denmark)

    Paulsen, Rune Tendal; Bouknaitir, Jamal Bech; Fruensgaard, Søren;

    2016-01-01

    INTRODUCTION: Lumbar spinal stenosis (LSS) is a clinical syndrome of buttock or lower extremity pain, which may occur with or without back pain. The syndrome is associated with diminished space available for the neural and vascular elements in the lumbar spine. LSS is typically seen in elderly...... and perioperative complications of spinal decompression surgery in LSS patients. METHODS: This study is a retrospective study based on prospectively collected data from 3,420 consecutive patients with clinical and magnetic resonance imaging confirmed LSS. Patients were treated with posterior decompression surgery...

  13. Corneal arcus and xanthomas in homozygous familial hypercholesterolemia: First report from China

    Directory of Open Access Journals (Sweden)

    Xin Meng

    2013-01-01

    Full Text Available We report the case of a 12-year-old male who developed corneal arcus and multiple skin lesions with a 10-year history of xanthomas. The lesions appeared over his fingers, hands, elbows, knees, buttocks and feet. Laboratory studies showed a total serum cholesterol level of 752.1 mg/dL; a triglyceride level of 96.6 mg/dL; a low-density lipoprotein cholesterol level of 661.3 mg/dL. Findings were consistent with homozygous familial hypercholesterolemia. To our knowledge, this is the first such case to be reported from China.

  14. Lupus erythematosus panniculitis presenting with initial periorbital swelling and positive antiphospholipid antibodies: A rare association

    Directory of Open Access Journals (Sweden)

    Jyotsna Oak

    2013-01-01

    Full Text Available Lupus erythematosus panniculitis (LEP, an unusual form of chronic cutaneous lupus erythematosus, is characterized by chronic inflammation and fibrosis of subcutaneous tissue. Clinically, it presents as subcutaneous nodules on common locations such as forehead, cheeks, proximal limbs and buttocks. Ulceration of the nodules may occur in certain cases. Very few case studies have reported the occurrence of early solitary periorbital involvement, highlighting the need for a high index of suspicion in such cases. We report here a case having generalized extensive LEP with initial manifestation of a solitary periorbital swelling, autoimmune hemolytic anemia, and associated antiphospholipid antibodies positivity.

  15. CT-guided corticosteroid injection as a therapeutic management for the pyriformis syndrome: case report.

    Science.gov (United States)

    Kabataş, Serdar; Gümüş, Burçak; Yilmaz, Cem; Caner, Hakan

    2008-07-01

    The pyriformis syndrome is a rare entrapment neuropathy in which the sciatic nerve is compromised by the pyriformis muscle or other local structures. It is an important cause of buttock pain that may often be accompanied by sciatica. The pain is usually increased by muscular contraction, palpation or prolonged sitting. The diagnosis relies on the clinical presentation and the electromyelography (EMG) findings. Other causes of symptoms should be excluded by careful examination and detailed neuroradiological studies of the lumbosacral spine, sacro-iliac and hip joints. A case of this syndrome seen in a 36-year-old man who recovered by CT-guided corticosteroid injection is reported.

  16. Lipectomy of the ilio-lumbosacral region.

    Science.gov (United States)

    Chamosa, Miguel

    2004-01-01

    In the past, several techniques for raising the gluteal mass have been described, all of which were based on dermolipectomies of major or minor extension. The main disadvantage of these dermolipectomies is the visible external scar. The author presents his technique for lipectomy of the ilio-lumbosacral region. It is proposed that multiplanar liposuction in this region lengthens the lumbar lordotic curve and results in upward traction on the buttocks, resulting in a more youthful contour of the region. The article describes a series of 98 patients with lipodystrophy of the ilio-lumbosacral area who underwent liposuction of the region and were highly satisfied with the results.

  17. Unilateral generalized keratosis pilaris following pregnancy.

    Science.gov (United States)

    Zhu, Jian-Wei; Lu, Zhong-Fa; Zheng, Min

    2014-10-01

    Keratosis pilaris (KP) is a common inherited disorder characterized by small folliculocentric keratotic papules that may have surrounding erythema, which gives the skin a stippled appearance resembling gooseflesh. The extensor surfaces of the upper arms, thighs, and buttocks commonly are affected, but a generalized presentation may occur. We report the case of a 29-year-old woman with unilateral generalized KP in the second month of her second pregnancy. Both a genetic mutation and pregnancy-induced hormonal changes played possible roles in the development and progress of unilateral generalized KP in this patient.

  18. Staphylococcus lugdunensis gluteal abscess in a patient with end stage renal disease on hemodialysis

    Directory of Open Access Journals (Sweden)

    Mansoor Mehmood

    2015-01-01

    Full Text Available A 57-year-old end stage renal disease patient on hemodialysis (HD presented with sepsis secondary to right buttock abscess and overlying cellulitis. She was started on broad-spectrum antibiotic therapy and underwent incision and drainage with marked improvement. Her cultures grew methicillin-resistant Staphylococcus lugdunensis. This bacterium is more virulent than other coagulase negative staphylococci and has been implicated in causing a variety of serious infections but it has been underreported as a cause of skin infections in HD patients and possible other patient populations.

  19. Chronic zosteriform cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Omidian M

    2006-01-01

    Full Text Available Cutaneous leishmanasis (CL may present with unusual clinical variants such as acute paronychial, annular, palmoplantar, zosteriform, erysipeloid, and sporotrichoid. The zosteriform variant has rarely been reported. Unusual lesions may be morphologically attributed to an altered host response or owing to an atypical strain of parasites in these lesions. We report a patient with CL in a multidermatomal pattern on the back and buttock of a man in Khozestan province in the south of Iran. To our knowledge, this is the first reported case of multidermatomal zosteriform CL. It was resistant to conventional treatment but responded well to a combination of meglumine antimoniate, allopurinol, and cryotherapy.

  20. Linear lichen planus in children--case report.

    Science.gov (United States)

    Horowitz, Marcia Raquel; Vidal, Marcela de Lima; Resende, Manuela Oliveira; Teixeira, Márcia Almeida Galvão; Cavalcanti, Silvana Maria de Morais; Alencar, Eliane Ruth Barbosa de

    2013-01-01

    Lichen planus is an uncommon disease in children, and only 2 to 3% of affected patients are under twenty years of age. This dermatosis may appear in several clinical forms, which vary according to the morphology and distribution of lesions. In less than 0.2% of all lichen planus cases, the lesions are distributed along the lines of Blaschko, and is a variant called linear lichen planus. This is a case report of a patient aged two years and eight months, who presented keratotic violaceous papules, affecting the abdomen, buttocks and right thigh, distributed along the lines of Blaschko. Histopathological examination confirmed a diagnosis of linear lichen planus.

  1. Pregabalin for Opioid-Refractory Pain in a Patient with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Konstantinos A. Kontoangelos

    2013-01-01

    Full Text Available Background. Ankylosing spondylitis (AS is a systemic inflammatory disease with chronic back pain as the most common presenting symptom. We present a case of a male patient with AS reporting symptoms of severe low back pain, buttock pain, and limited spinal mobility. After chronic treatment with opioids, we administered pregabalin at a dose of 300 mg as an analgesic agent while opioids were discontinued. Findings. Pain symptoms improved progressively, and opioids were gradually discontinued without any withdrawal symptoms reported. Conclusions. Pregabalin is potentially useful in the management of pain in patients with AS while effectively managing the discontinuation of opioid treatment.

  2. Ischiogluteal bursitis mimicking soft-tissue metastasis from a renal cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Voelk, M.; Gmeinwieser, J.; Manke, C.; Strotzer, M. [Department of Radiology, University Hospital, Regensburg (Germany); Hanika, H. [Department of Urology, St. Josef Hospital, Regensburg (Germany)

    1998-09-01

    We report a case of ischiogluteal bursitis mimicking a soft-tissue metastasis from a renal cell carcinoma. A 66-year-old woman suffered from pain over the left buttock 6 months after she was operated on for renal cell carcinoma of the left kidney. CT of the abdomen and pelvis revealed a tumor-like lesion adjacent to the left os ischii, which was suspected to be a soft-tissue metastasis. Percutaneous biopsy revealed no evidence of malignancy, but the histopathological diagnosis of chronic bursitis. (orig.) With 2 figs., 8 refs.

  3. Infections in Combat Casualties During Operations Iraqi and Enduring Freedom

    Science.gov (United States)

    2009-04-01

    2 996.66 Infection joint prosthesis 2 996.67 Infection orthopaedic device 12 Central nervous system 320.89 Meningitis other bacteria 1 320.9...Cellulitis arm 37 682.4 Cellulitis hand 16 682.5 Cellulitis/abscess buttock 1 682.6 Cellulitis leg 77 682.7 Cellulitis foot 30 682.9 Cellulitis/abscess...Abrasion hip/leg infected 3 916.3 Blister hip/leg infected 2 917.3 Blister foot and toes-infected 2 958.3 Post-trauma wound infection 35 997.62 Infection

  4. Septic shock in pregnancy due to pyogenic sacroiliitis: a case report

    Directory of Open Access Journals (Sweden)

    Moros María Lapresta

    2009-03-01

    Full Text Available Abstract Introduction Lower back pain due to sacroiliac joint dysfunction is a common symptom during pregnancy. However, infection of the sacroiliac joint is rare, even more so if no predisposing factors are present. Case presentation After the onset of unspecific acute pain in the left buttock region, a 31-year-old pregnant woman developed septic shock due to pyogenic sacroiliitis. The medical and obstetric management, treatment applied and patient's experience are described. Conclusion The correct diagnosis and treatment of pyogenic sacroiliitis during pregnancy may avoid joint and bone destruction in addition to maternal and fetal complications.

  5. Radiological Followup of the Evolution of Inflammatory Process in Sacroiliac Joint with Magnetic Resonance Imaging: A Case with Pyogenic Sacroiliitis

    Directory of Open Access Journals (Sweden)

    Muhammet Cinar

    2012-01-01

    Full Text Available Pyogenic sacroiliitis (PS is an acute form of sacroiliitis that mostly starts with very painful buttock pain. Here in this case, the followup magnetic resonance (MR images of a 49-year-old male patient with PS is displayed. After his sacroiliitis was documented by MR images, he was treated with the combination of rifampicin plus streptomycin and moxifloxacin. Serial MR investigations were done to disclose acute and subsequent imaging changes concerning sacroiliac joint and surrounding bone structures. Although after treatment all the symptoms were completely resolved, 20 months later changes suggesting active sacroiliitis on MR images were continuing.

  6. Use of pressure reducing seats and cushions in a community setting.

    Science.gov (United States)

    Collins, Fiona

    2002-01-01

    It is generally accepted that sitting for long periods of time without frequent repositioning or provision of appropriate cushions or chairs can lead to pressure ulcer development in people who are elderly, frail, immobile or neurologically impaired. When sitting, in comparison to lying, only a small surface area of the body is providing support, predominantly the buttocks and thighs, and the feet. Therefore, interface pressures are much greater in sitting than lying. Sitting for long periods of time can result in the person adopting poor posture, which in turn can lead to the development of pressure ulcers, particularly on the buttocks, sacrum, greater trochanter and heels. Assessment and provision of appropriate seating equipment for people at risk is often difficult for clinicians working in the community. This article aims to describe the problems experienced by people who sit for long periods of time, to discuss where people should go in order to obtain help with seating needs, and outline some of the potential solutions to poor seating which are available to community staff.

  7. A clinicoepidemiological study of 50 cases of cutaneous tuberculosis in a tertiary care teaching hospital in Pokhara, Nepal

    Directory of Open Access Journals (Sweden)

    Dwari Binayak

    2010-01-01

    Full Text Available Background: Cutaneous tuberculosis (TB is essentially an invasion of the skin by Mycobacterium tuberculosis, the same bacteria that causes pulmonary tuberculosis. Aim: This study was conducted to study the common types of cutaneous TB and to find the management pattern in a tertiary teaching hospital in Pokhara, Nepal. Materials and Methods: All the cases of cutaneous TB were biopsied and furthermore investigated by performing Mantoux test, sputum examination, fine needle aspiration cytology, chest X-ray and ELISA. Results: In this study, we found that tuberculosis verrucous cutis (48% had a higher incidence than other types of cutaneous TB. More males were affected than were females (1.2:1. Commonly affected sites were the limb and the buttock (48%. The most commonly affected age group was 16-25 years (40%. All cases (except two were more than 15 mm in size in the Mantoux test. The histopathological picture was typical in all except three cases. All patients were treated with antitubercular treatment as per the national guidelines. Conclusion: The most common type of cutaneous TB was tuberculosis verrucous cutis and the most commonly affected sites were the limb and the buttock. As cutaneous TB sometimes reflects the presence of pulmonary tuberculosis, its incidence should not be ignored.

  8. Persistence of lipoatrophy after a four-year long interruption of antiretroviral therapy for HIV1 infection: case report

    Directory of Open Access Journals (Sweden)

    Toro Giuseppe

    2005-10-01

    Full Text Available Abstract Background HIV-infected patients on long-term highly active antiretroviral therapy often present peculiar patterns of fat redistribution, referred to as lipodystrophy. In spite of recent investigations, it is not known whether and to what extent the main features of lipodystrophy – that is lipoatrophy of peripheral fat at face, limbs and buttocks, as well as fat accumulation at breasts, abdomen and the dorso-cervical region – can be reversible once clinically manifest. Case presentation A 35 year old Caucasian HIV infected female developed severe diffuse lipodystrophy while on highly active antiretroviral therapy. A remarkable increase of breast size, fat accumulation at waist, and a fat pad on her lumbar spine were paralleled by progressive and disfiguring lipoatrophy of face, limbs and buttocks. The patient decided to interrupt her therapy after 20 months, with a stably suppressed viremia and a CD4 lymphocyte count >500/μL. She could carry on a safe treatment interruption for longer than 4 years. Most sites of fat accumulation switched to nearly normal appearance, whereas lipoatrophy was substantially unchanged at all affected sites. Conclusion our observation provides pictorial evidence that lipoatrophy may not be reversible even under ideal circumstances. Therefore, strategies to prevent lipoatrophy should be considered when defining therapeutic regimens for HIV infected patients, especially those at high risk.

  9. Longitudinal evaluation of manual lymphatic drainage for the treatment of gynoid lipodystrophy*

    Science.gov (United States)

    Schonvvetter, Bianca; Soares, Juliana Laudicéia Marques; Bagatin, Ediléia

    2014-01-01

    BACKGROUND The gynoidlypodystrophy, known as cellulitis or cellulite, refers to a condition that gives the skin an undulating and uneven appearance, affecting 80-90% of women after puberty. OBJECTIVES to investigate the efficacy and safety of manual lymphatic drainage for cellulite management. METHODS this was an open, prospective, intervention study including 20 women aged from 20 to 40 years. Fourteen sessions of manual lymphatic drainage were performed once a week on lower limbs and buttocks. RESULTS Fifteen women completed the study. A significant improvement on quality of life was observed (p=0.018). A significant reduction (p=0.023), estimated at 0.3±0.8 cm, in hip circumference was found, but no difference was found in thighs circumference (p>0.05). A significant reduction elastic recuperation of skin on buttocks, which means skin elasticity worsening, was observed. All measures obtained by ultrasound images showed no changes (p>0.05). CONCLUSION manual lymphatic drainage was safe but not effective as an isolated approach for cellulite management. Further randomized, controlled or comparative studies about manual lymphatic drainage for cellulite control, as unique or combined therapeutic modality, are necessary. PMID:25184909

  10. Classroom furniture and anthropometric characteristics of Iranian high school students: proposed dimensions based on anthropometric data.

    Science.gov (United States)

    Dianat, Iman; Karimi, Mohammad Ali; Asl Hashemi, Ahmad; Bahrampour, Samira

    2013-01-01

    The study evaluated the potential mismatch between classroom furniture dimensions and anthropometric characteristics of 978 Iranian high school students (498 girls, 480 boys), aged 15-18 years. Nine anthropometric measurements (stature, sitting height, sitting shoulder height, popliteal height, hip breadth, elbow-seat height, buttock-popliteal length, buttock-knee length and thigh clearance) and five dimensions from the existing classroom furniture were measured and then compared together (using match criterion equations) to identify any potential mismatch between them. The results indicated a considerable mismatch between body dimensions of the students and the existing classroom furniture, with seat height (60.9%), seat width (54.7%) and desktop height (51.7%) being the furniture dimensions with a higher level of mismatch. The levels of mismatch varied between the high-school grade levels and between genders, indicating their special requirements and possible problems. The proposed dimensions of the classroom furniture more appropriate for the students were given. This additional information on students' anthropometry can be used by local furniture industries as a starting point for designing more appropriate furniture for school children, or used by schools to aid in furniture selection.

  11. Medical image of the week: necrotizing soft tissue infection

    Directory of Open Access Journals (Sweden)

    Taylor A

    2016-03-01

    Full Text Available No abstract available. Article truncated at 150 words. A 70-year-old man with a history of coronary artery disease, chronic back pain, and general debilitation presented to the emergency department with complaints of fever, weakness and right buttock discomfort. Physical exam was remarkable for a temperature of 101.7º F, and for moderate erythema of the skin of the right inguinal area and right buttock, with associated tenderness. Laboratory exam was significant for a WBC of 22.7 K/ɥL, erythrocyte sedimentation rate of 82 mm, and serum creatinine phosphokinase of 2856 U/L. CAT of the abdomen and pelvis demonstrated extensive gluteal and perineal soft tissue inflammation with gas formation, consistent with a necrotizing soft tissue infection (Figures 1 and 2. Three basic subsets of necrotizing soft tissue infections (NSTIs have been described. Type I infections are the most common form and are characterized by a polymicrobial process typically involving gram positive cocci, gram negative rods, and anaerobes. Type I infections occur ...

  12. Gluteal Compartment Syndrome Secondary to Pelvic Trauma.

    Science.gov (United States)

    Diaz Dilernia, Fernando; Zaidenberg, Ezequiel E; Gamsie, Sebastian; Taype Zamboni, Danilo E R; Carabelli, Guido S; Barla, Jorge D; Sancineto, Carlos F

    2016-01-01

    Gluteal compartment syndrome (GCS) is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death.

  13. Focal Hyperhidrosis Associated with Recurrent Urinary Tract Infections

    Science.gov (United States)

    Madhwapathi, Vidya; Ladoyanni, Evmorfia

    2016-01-01

    Hyperhidrosis affects almost 3% of the population and is characterized by sweating that occurs in excess of that needed for normal thermoregulation. It can occur as a primary disease or secondary to underlying clinical conditions. Hyperhidrosis can stem from neurogenic sympathetic over activity involving normal eccrine glands. We report the interesting case of a 75-year-old male patient with a 6-month history of new onset secondary focal hyperhidrosis of buttocks, pelvis, and upper thighs. Each time his symptoms worsened he was found to have culture positive urine samples for Escherichia coli (E. coli). He underwent urological investigation and was found to have urethral strictures and cystitis. The hyperhidrosis improved each time his urinary tract infection (UTI) was treated with antibiotics and continued to remain stable with a course of prophylactic trimethoprim. We hypothesize that the patient's urethral strictures led to inhibition in voiding which in turn increased the susceptibility to UTIs. Accumulation of urine and increased bladder pressure in turn raised sympathetic nerve discharge leading to excessive sweating. We recommend that a urine dip form part of the routine assessment of patients presenting with new onset focal hyperhidrosis of pelvis, buttocks, and upper thighs. Timely urological referral should be made for all male patients with recurrent UTI. To the authors' knowledge, there have been no other reports of UTI-associated focal hyperhidrosis. PMID:27379188

  14. The spectrum of pigmented purpuric dermatosis and mycosis fungoides: atypical T-cell dyscrasia.

    Science.gov (United States)

    Ladrigan, Manasi Kadam; Poligone, Brian

    2014-12-01

    We report the case of a healthy 17-year-old adolescent boy with an unremarkable medical history who presented with an asymptomatic fixed rash on the abdomen, buttocks, and legs. The rash initially developed in a small area on the right leg 2 years prior and had progressed slowly. Prior biopsies were consistent with pigmented purpura. Clinical examination revealed multiple annular purpuric patches on the abdomen, buttocks, and legs covering approximately 20% of the body surface area without lymphadenopathy or hepatosplenomegaly. Additional biopsies demonstrated changes consistent with mycosis fungoides (MF). T-cell receptor g gene rearrangements demonstrated clonality. The patient was diagnosed with stage IB MF of the pigmented purpura-like variant. The patient responded well to psoralen plus UVA therapy. It has been proposed that pigmented purpuric dermatosis (PPD) is a form of cutaneous T-cell lymphoid dyscrasia and that T-cell gene rearrangement studies should be obtained for prognostic evaluation in patients with widespread disease. In our patient, the clinical appearance of the lesions, pathologic findings, and gene rearrangement studies led to the diagnosis of MF. Until the potential for evolution of PPD to malignant disease is better understood, further evaluation of MF in patients with an unusual presentation of pigmented purpura is warranted.

  15. A multicenter study of cellulite treatment with a variable emission radio frequency system.

    Science.gov (United States)

    van der Lugt, Claudia; Romero, Carmen; Ancona, Dvora; Al-Zarouni, Marwan; Perera, Joanet; Trelles, Mario A

    2009-01-01

    Radio frequency (RF) systems have been reported as producing electrothermally mediated and subcutaneous effects. The present study evaluates a new approach to treat cellulite with a bipolar RF device. The buttocks of 50 patients were treated, 10 from each of five multinational centers with a novel bipolar RF technology set at 6 J/cm(3), which changes its frequency between 0.6 and 2.4 MHz according to impedance of tissue. Twelve weekly sessions were given for 12 minutes on each buttock, with a treatment end point of 42 degrees C external skin temperature. Cellulite changes and tissue condition were assessed before and immediately after the first session, before the final 12th session, and 2 months thereafter. The patient Satisfaction Index was recorded. Objective evaluation involved clinical photography, three-dimensional optical skin surface measurement, and histological findings. Almost all patients noted improvement of cellulite and body silhouette at the final session, which slightly decreased at the 2-month assessment. Improved skin appearance was objectively detected. Histological findings following the first session showed reactive edema and lysis of adipocyte membranes, possibly implicated in the final effects achieved. The RF technology used in the present multicenter study improved the general aspect of skin and cellulite, with high patient Satisfaction Index. Maintenance sessions might lead to even better and longer-lasting results.

  16. Injury of the gluteal aponeurotic fascia and proximal iliotibial band: anatomy, pathologic conditions, and MR imaging.

    Science.gov (United States)

    Huang, Brady K; Campos, Juliana C; Michael Peschka, Philippe Ghobrial; Pretterklieber, Michael L; Skaf, Abdalla Y; Chung, Christine B; Pathria, Mini N

    2013-01-01

    The fascia lata, or deep fascia of the thigh, is a complex anatomic structure that has not been emphasized as a potential source of pelvic and hip pain. This structure represents a broad continuum of fibrous tissue about the buttock, hip, and thigh that receives contributions from the posteriorly located aponeurotic fascia covering the gluteus medius muscle and from the more laterally located iliotibial band (ITB). At the pelvis and hip, the ITB consists of three layers that merge at the lower portion of the tensor fasciae latae muscle. The gluteal aponeurotic fascia and ITB merge at the buttock and hip before extending inferiorly to the Gerdy tubercle at the anterolateral tibia. Injuries to these anatomic structures are an underdiagnosed cause of pain and disability and may clinically mimic more common processes affecting the hip and proximal thigh. Categories of disease include overuse injuries, traumatic injuries, degenerative lesions, and inflammatory lesions. Familiarity with the anatomy and pathologic conditions of the fascia lata and its components is important in their recognition as a potential source of symptoms. This article illustrates the anatomy of this complex fascia through anatomic-pathologic correlation and describes the magnetic resonance imaging appearances of the pathologic conditions involving it.

  17. Concurrent presentation of erythrodermic lichen planus and squamous cell carcinoma: Coincidence or malignant transformation?

    Directory of Open Access Journals (Sweden)

    Neema M Ali

    2015-01-01

    Full Text Available Lichen planus is a common papulosquamous disorder affecting about 1-2% of the population, neoplastic transformation of cutaneous lichen planus lesions occurs very rarely. A 40 year old female patient presented with a 1 year history of developing multiple, itchy, pigmented lesions over both lower legs which gradually spread to involve the whole body. A few tense bullae were seen on the extremities. An erythematous fleshy lesion was seen on the upper aspect of the left buttock. Skin biopsy from a plaque on the right forearm showed features suggestive of lichen planus. Skin biopsy of a bullae showed a sub epidermal bulla filled with a mixed inflammatory infiltrate. Direct immunofluorescence revealed no immunoreactants along the basement membrane zone. A diagnosis of erythrodermic lichen planus with bullous lichen planus was made. Biopsy of fleshy lesion of left buttock revealed a moderately differentiated squamous cell carcinoma. Erythrodermic lichen planus with bullous lesions and secondary squamous cell carcinoma; these occurences in a single patient is extremely rare and has not been previously reported to the best of our knowledge.

  18. Concurrent Presentation of Erythrodermic Lichen Planus and Squamous Cell Carcinoma: Coincidence or Malignant Transformation?

    Science.gov (United States)

    Ali, Neema M; Bhat, Ramesh; Rao, Shwetha B

    2015-01-01

    Lichen planus is a common papulosquamous disorder affecting about 1-2% of the population, neoplastic transformation of cutaneous lichen planus lesions occurs very rarely. A 40 year old female patient presented with a 1 year history of developing multiple, itchy, pigmented lesions over both lower legs which gradually spread to involve the whole body. A few tense bullae were seen on the extremities. An erythematous fleshy lesion was seen on the upper aspect of the left buttock. Skin biopsy from a plaque on the right forearm showed features suggestive of lichen planus. Skin biopsy of a bullae showed a sub epidermal bulla filled with a mixed inflammatory infiltrate. Direct immunofluorescence revealed no immunoreactants along the basement membrane zone. A diagnosis of erythrodermic lichen planus with bullous lichen planus was made. Biopsy of fleshy lesion of left buttock revealed a moderately differentiated squamous cell carcinoma. Erythrodermic lichen planus with bullous lesions and secondary squamous cell carcinoma; these occurences in a single patient is extremely rare and has not been previously reported to the best of our knowledge.

  19. Silicone-Induced Granuloma after Injection for Cosmetic Purposes: A Rare Entity of Calcitriol-Mediated Hypercalcemia

    Directory of Open Access Journals (Sweden)

    Nidhi Agrawal

    2013-01-01

    Full Text Available Hypercalcemia is often a clue to the presence of unsuspected illness. We present an interesting case of an HIV-positive transgender female with a rare cause of silicone-induced granulomatous hypercalcemia. Although there have been a few case reports of silicone injections in dialysis patients causing hypercalcemia, this metabolic derangement secondary to silicone granulomas continues to be a unique entity with an unclear pathophysiology. We present a 45-year-old transgender HIV-positive female, with extensive silicone injections who presented with symptomatic hypercalcemia. Workup for malignancy and hyperparathyroidism was negative. 1,25-Dihydroxyvitamin D level and 24-hour urine calcium level were elevated. CT scan showed extensive high-density reticulonodular densities in the buttocks and gluteal muscle fascia extending upwards to the lumbar region, along with prominent external iliac and inguinal lymph nodes. Nuclear imaging showed diffuse heterogeneity and increased uptake in the buttocks, most consistent with granuloma calcifications, and an inguinal lymph node biopsy confirmed a foreign body giant cell reaction. The patient was started on prednisone and this resulted in decrease in serum and urinary calcium levels. Physicians should have a high index of suspicion for silicone-induced hypercalcemia considering the growing prevalence of body contour enhancement with injections, implants, and fillers using this material.

  20. Focal Hyperhidrosis Associated with Recurrent Urinary Tract Infections

    Directory of Open Access Journals (Sweden)

    Dina Ismail

    2016-01-01

    Full Text Available Hyperhidrosis affects almost 3% of the population and is characterized by sweating that occurs in excess of that needed for normal thermoregulation. It can occur as a primary disease or secondary to underlying clinical conditions. Hyperhidrosis can stem from neurogenic sympathetic over activity involving normal eccrine glands. We report the interesting case of a 75-year-old male patient with a 6-month history of new onset secondary focal hyperhidrosis of buttocks, pelvis, and upper thighs. Each time his symptoms worsened he was found to have culture positive urine samples for Escherichia coli (E. coli. He underwent urological investigation and was found to have urethral strictures and cystitis. The hyperhidrosis improved each time his urinary tract infection (UTI was treated with antibiotics and continued to remain stable with a course of prophylactic trimethoprim. We hypothesize that the patient’s urethral strictures led to inhibition in voiding which in turn increased the susceptibility to UTIs. Accumulation of urine and increased bladder pressure in turn raised sympathetic nerve discharge leading to excessive sweating. We recommend that a urine dip form part of the routine assessment of patients presenting with new onset focal hyperhidrosis of pelvis, buttocks, and upper thighs. Timely urological referral should be made for all male patients with recurrent UTI. To the authors’ knowledge, there have been no other reports of UTI-associated focal hyperhidrosis.

  1. Gluteal Compartment Syndrome Secondary to Pelvic Trauma

    Directory of Open Access Journals (Sweden)

    Fernando Diaz Dilernia

    2016-01-01

    Full Text Available Gluteal compartment syndrome (GCS is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death.

  2. Management of sacroiliac dysfunction and lower extremity lymphedema using a comprehensive treatment approach: a case report.

    Science.gov (United States)

    Crane, Patricia

    2009-01-01

    Sacroiliac joint (SIJ) dysfunction, a common source of low back and buttock pain, can occur from cumulative shear or torsional forces during activities such as walking that require weight to transfer from one extremity to the other. Individuals with lower extremity lymphedema may also experience SIJ dysfunction. The purpose of this article was to describe the examination, diagnosis, and intervention for a patient with lower extremity lymphedema and sacroiliac joint dysfunction. The patient was a 50-year-old female with increased left lower extremity lymphedema and left buttock and groin pain that was previously treated unsuccessfully with physical therapy. SIJ dysfunction was attributable to an alteration in gait pattern caused by increased limb volume associated with lymphedema. The patient was treated for 19 visits over six weeks with complete decongestive therapy (CDT), muscle energy techniques, core stabilization, and the application of a pelvic support belt. Objective changes include decreased lymphedema, increased lower abdominal and lumbar extension strength, and decreased Oswetry Disability Index ratings. The patient was able to ambulate community distances without an assistive device and to resume unsupervised strength and conditioning without pain.

  3. Confiabilidade intra e interexaminadores da fotogrametria na classificação do grau de lipodistrofia ginóide em mulheres assintomáticas Intra and inter-examiner reliability of photogrammetry in the classification of the degree of gynoid lypodystrophy in asymptomatic women

    Directory of Open Access Journals (Sweden)

    Ana Maria da Silva Mendonça

    2009-06-01

    photograph by two examiners on two one-year interval occasions; repeatability was assessed by a single examiner on two occasions one week apart. The Kappa index was applied. Results showed substantial correlation (κ=0.70 between examiners for cellulite degrees in upper buttock, and moderate correlation (κ=0.50 for cellulite degrees in lower buttock. As to repeatability, analyses showed excellent correlation (κ=0.81 for cellulitis degree in upper buttock and substantial correlation (κ=0.75 in lower buttock. The method proposed for classification of different gynoid lypodystrophy degrees by photogrammetry hence showed acceptable reliability intra and inter-examiner for the majority of evaluated regions, with the exception of the lower buttock.

  4. A comprehensive literature review of the pelvis and the lower extremity FE human models under quasi-static conditions.

    Science.gov (United States)

    Al-Dirini, R M A; Thewlis, D; Paul, G

    2012-01-01

    Finite Element Modeling (FEM) has become a vital tool in the automotive design and development processes. FEM of the human body is a technique capable of estimating parameters that are difficult to measure in experimental studies with the human body segments being modeled as complex and dynamic entities. Several studies have been dedicated to attain close-to-real FEMs of the human body (Pankoke and Siefert 2007; Amann, Huschenbeth et al. 2009; ESI 2010). The aim of this paper is to identify and appraise the state-of-the art models of the human body which incorporate detailed pelvis and/or lower extremity models. Six databases and search engines were used to obtain literature, and the search was limited to studies published in English since 2000. The initial search results identified 636 pelvis-related papers, 834 buttocks-related papers, 505 thigh-related papers, 927 femur-related papers, 2039 knee-related papers, 655 shank-related papers, 292 tibia-related papers, 110 fibula-related papers, 644 ankle-related papers, and 5660 foot-related papers. A refined search returned 100 pelvis-related papers, 45 buttocks-related papers, 65 thigh-related papers, 162 femur-related papers, 195 knee-related papers, 37 shank-related papers, 80 tibia-related papers, 30 fibula-related papers and 102 ankle-related papers and 246 foot-related papers. The refined literature list was further restricted by appraisal against a modified LOW appraisal criteria. Studies with unclear methodologies, with a focus on populations with pathology or with sport related dynamic motion modeling were excluded. The final literature list included fifteen models and each was assessed against the percentile the model represents, the gender the model was based on, the human body segment/segments included in the model, the sample size used to develop the model, the source of geometric/anthropometric values used to develop the model, the posture the model represents and the finite element solver used for the

  5. Effectiveness of carboxytherapy in the treatment of cellulite in healthy women: a pilot study

    Directory of Open Access Journals (Sweden)

    Pianez LR

    2016-08-01

    Full Text Available Luana Ramalho Pianez,1 Fernanda Silva Custódio,1 Renata Michelini Guidi,1-4 Jauru Nunes de Freitas,5-7 Estela Sant’Ana8-10 1Ibramed Center for Education and Advanced Training (CEFAI, Amparo, 2Santa Casa de Misericórdia Hospital, Porto Alegre, 3University of Campinas, Campinas, 4Ibramed Research and Development Department, Amparo, São Paulo, Brazil; 5Universitá Tor Vergata, Rome, Italy; 6Centro de Medicina Pesquisa e Ensino (CEMEPE, Belo Horizonte, 7Advanced Dermatology Studies Group (GDA, Rio de Janeiro, 8Federal University of São Carlos (UFSCAR, 9University of São Paulo (USP, São Carlos, 10Indústria Brasileira de Equipamentos Médicos (IBRAMED, Amparo, São Paulo, Brazil Background: Carbon dioxide therapy, better known as carboxytherapy, relates to percutaneous infusion of medical carbon dioxide with therapeutic approaches, and its use in the treatment of localized fat has demonstrated good results. Gynoid lipodystrophy, also known as cellulite, affects 80%–90% of women after puberty, especially in the buttocks and thighs. Its etiology is complex and involves multifactorial aspects. Its treatment and evaluation require the use of new technologies (more effective and low-cost approaches. The objective was to investigate the effectiveness of carboxytherapy in the treatment of cellulite in the areas of buttocks and posterior thigh.Patients and methods: Ten women, 29±6.1 years, were selected and all of them received eight treatment sessions, with an interval of 7 days between sessions. Standardized digital photographs were used to assess the severity of cellulite, and panoramic images were collected by ultrasound diagnosis. The evaluations were performed before the first treatment (baseline and 7 days after the last treatment session of carboxytherapy.Results: After the treatment, there was a significant reduction (P=0.0025 of the cellulite from degree III to degree II, and this improvement had correlation with the improvement in the

  6. Lower body lift with superficial fascial system suspension.

    Science.gov (United States)

    Lockwood, T

    1993-11-01

    Multiple body contour deformities of the trunk and thighs are commonly treated in separate stages to limit postoperative complications and disability. Recent advances in the surgical design of the medial thigh lift and the lateral thigh/buttock lift along with an understanding of the functional anatomy of the superficial fascial system have significantly improved results and decreased complications of trunk/thigh lifts. The enhanced safety of current trunk/thigh lifts has allowed new combinations to treat multiple body contour deformities in a single stage. Laxity of the entire lower trunk and thigh regions can be treated in one stage in selected patients. The lower body lift combines the transverse flank/thigh/buttock lift and the fascial anchoring medial thigh lift in one operation. In addition to the expected tightening of the flank, buttocks, and total thighs, this procedure results in a surprising degree of epigastric and hypogastric tightening of mild to moderate abdominal laxity without direct surgical undermining or umbilical transposition. Ten patients having the lower body lift alone or in combination with liposuction and other body contouring procedures were followed for 6 to 24 months. The primary indication for surgery is moderate to severe soft-tissue laxity of the lower trunk and thighs with minimal or mild residual fat deposits. Skin contour irregularities due to skin laxity (cellulite of laxity) or to postliposuction adhesions are frequently present and may be severe. Patients with significant fat deposits may be treated initially with liposuction 3 to 4 months earlier to become candidates for this procedure. Key technical elements of this procedure include (1) both supine and lateral decubitus positioning with the hip flexed and abducted to allow overcorrection, (2) appropriate direct surgical undermining through superficial fascial system zones of adherence in the superior thigh while avoiding the lymphatics of the femoral triangle, (3) more

  7. [Piriformis muscle syndrome: etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy].

    Science.gov (United States)

    Grgić, Vjekoslav

    2013-01-01

    The term 'piriformis syndrome' (PS), introduced by Robinson in 1947, implies a group of signs and symptoms caused by piriformis muscle (PM) disorders. Since PM disorders lead to irritation/compression of the anatomic structures passing under its belly, the main clinical PS signs and symptoms are actually the clinical signs and symptoms of irritation/ compression of neural and vascular structures passing through the infrapiriform foramen: sciatic nerve/SN, inferior gluteal nerve, posterior femoral cutaneous nerve, pudendal nerve, inferior gluteal artery and vein and inferior pudendal artery and vein. The clinical picture is usually dominated by signs and symptoms of irritation/compression of SN (SN irritation --> low back and buttock pain, sciatica,paresthesias in distribution of SN; SN compression --> low back and buttock pain,sciatica, paresthesias and neurologic deficit in distribution of SN). Irritation/compression of other structures can result in the following signs and symptoms: inferior gluteal nerve --> atrophy of gluteal muscles; posterior femoral cutaneous nerve --> pain, paresthesias and sensory disturbances in the posterior thigh; pudendal nerve --> pudendal neuralgia, painful sexual intercourse (dyspareunia), sexual dysfunction, urination and defecation problems; inferior gluteal artery --> ischemic buttock pain; inferior pudendal artery --> ischemic pain in the area of external sex organs, perineum and rectum, sexual dysfunction, urination and defecation problems; inferior gluteal vein --> venous stasis in gluteal area; inferior pudendal vein --> venous stasis in external sex organs and rectum. Functional/non-organic and organic PM disorders can cause PS: spasm, shortening, hypertrophy, anatomic variations, edema, fibrosis, adhesions, hematoma, atrophy, cyst, bursitis, abscess, myositis ossificans, endometriosis, tumors (functional disorders: PM spasm and shortening). The most common causes for PS are PM spasm, shortening and hypertrophy and anatomic

  8. Cutaneous presentation of disseminated histoplasmosis as a solitary peri-anal ulcer. Case report and discussion.

    Science.gov (United States)

    Hong, Janet H; Stetsenko, Galina Y; Pottinger, Paul S; George, Evan

    2016-05-01

    Disseminated histoplasmosis has a diverse and non-specific range of clinical signs and symptoms. In a significant minority of patients, cutaneous lesions are apparent at the time of initial presentation, affording an opportunity to establish the diagnosis from a skin biopsy. The most frequently reported clinical scenario in immunocompromised patients with cutaneous involvement is that of multiple papulo-nodular lesions on the face, trunk or extremities. The following report features an immunocompetent patient who presented with a solitary ulcerated plaque on the buttocks close to the anal verge. This case presentation underscores the broad spectrum of clinical presentations as well as the potential for diagnostic confusion with protozoa such as Leishmania or Trypanosoma species during histopathologic examination if special stains for fungal organisms are not performed.

  9. Unassisted smothering in a pillow.

    Science.gov (United States)

    Schmeling, Andreas; Fracasso, Tony; Pragst, Fritz; Tsokos, Michael; Wirth, Ingo

    2009-11-01

    We report the case of a 33-year-old man admitted to a psychiatric hospital because of paranoid schizophrenia. The man was found dead lying in his bed with the face pressed against a pillow and with elevated buttocks. The autopsy did not reveal a cause of death. The histological findings displayed the signs of the haemorrhagic-dysoric syndrome with acute emphysema; these findings are pathognomonic of obstructive asphyxia. The adverse effects of the neuroleptics demonstrated by the toxicological findings may have accelerated the loss of consciousness and facilitated the unusual position of the body. On the basis of the clinical history, the autopsy findings, the histological features and the toxicological results, asphyxia due to smothering was diagnosed as the cause of death.

  10. Clinical Application of Shenque (CV 8) plus Eight Battle Points for Obesity

    Institute of Scientific and Technical Information of China (English)

    LIU Xiao-hui; HANG Guo-qi

    2007-01-01

    In order to observe the therapeutic effect of Eight Battle Points for simple obesity.Methods:In the treatment of 98 cases of the patients with obesity by the oblique puncture of long needles into Eight Battle Points,the body weight,body weight index (BWI),waist circumference,buttock circumference and fat distribution rate of the patients were measured and assessed respectively before and after the treatments.And the changes of complications of obesity were observed before and after the treatments.Results:There were significant differences (P<0.05) in various indexes of obesity before and after acupuncture treatment.Conclusion:Acupuncture by puncturing Shenque(CV 8) plus Eight Battle Points is positive in the treatment of obesity and has a better therapeutic effect for complications of obesity.

  11. Braden量表在足部压疮风险预测中的应用%Application of Braden Scale in Risk Prediction of Heel Pressure Ulcers

    Institute of Scientific and Technical Information of China (English)

    潘夏蓁; 林碎钗; 姜丽萍

    2013-01-01

    目的 评估Braden量表在足部压疮风险预测中的诊断价值.方法 采用病例对照研究的方法,选择温州市某三级甲等医院124例臀部压疮患者和52例足部压疮患者作为压疮组,选取未发生任何部位压疮的患者120例作为对照组.应用Braden量表分别对两组患者进行诊断分析,通过灵敏度、特异度、ROC曲线等指标评价Braden量表在足部压疮风险预测中的诊断价值.结果 臀部压疮组与足部压疮组患者的疾病诊断及压疮分期差异有统计学意义(P<0.01).足部压疮组的平均Braden评分高于臀部压疮组,差异有统计学意义(P<0.05).Braden量表预测臀部压疮的灵敏度为54.0%,ROC曲线下面积为0.756;预测足部压疮的灵敏度为40.4%,ROC曲线下面积为0.674.结论 Braden量表预测足部压疮风险尚存在不足.%Objective To evaluate the diagnostic value of Braden scale in prediction of heel pressure ulcers. Methods A case control study was adopted in the study. Totally 124 patients with buttocks ulcers and 52 patients with heel ulcers from a grade-Ⅲ level-A hospital in Wenzhou were selected as ulcers group. A total of 120 patients without any ulcers were randomly selected as control group. Patients without ulcers and those with ulcers were diagnosed through Braden scale. The diagnostic value of the scale was verified with sensibility, specificity and ROC curve. Results The differences of diagnosis and staging statistical analysis between buttocks ulcers and heel ulcers were significant(P<0. 01). The Braden score of the heel ulcers group was significantly higher than that of the buttocks ulcers group(P<0. 05). The sensitivity and the area under curve(AUC) of ROC of Braden scale in prediction of buttocks ulcers were 54% and 0. 756, respectively. Those in prediction of heel ulcers were 40. 4% and 0. 674, respectively. Conclusion Braden scale has its limitations for prediction of heel pressure ulcers.

  12. The measurement of constitutive and facultative skin pigmentation and estimation of sun exposure in Caucasians with basal cell carcinoma and cutaneous malignant melanoma

    DEFF Research Database (Denmark)

    Lock-Andersen, J; Drzewiecki, K T; Wulf, H C

    1998-01-01

    In two identical and simultaneously performed case-control studies of basal cell carcinoma (BCC) and cutaneous malignant melanoma (CMM) with age-matched, sex-matched and residence-matched controls, skin pigmentation was measured objectively by skin reflectance spectroscopy in 145 BCC patients...... by all subjects. There were no statistically significant differences in constitutive skin pigmentation at the buttocks between BCC patients and controls (P = 0.96) or between CMM patients and controls (P = 0.13). Facultative skin pigmentation in ultraviolet-exposed sites was not significantly different...... between BCC patients and controls except that women patients had higher pigmentation at the lateral side of the upper arm. For CMM, men patients had higher pigmentation at the lateral side of the upper arm. Self-estimations of sun exposure did not show differences between patients and controls...

  13. [A Case of Fournier's Gangrene Caused by Small Intestinal Perforation during Bevacizumab Combination Chemotherapy].

    Science.gov (United States)

    Ishida, Takashi; Shinozaki, Hiroharu; Ozawa, Hiroki; Kobayashi, Toshimichi; Kato, Subaru; Wakabayashi, Taiga; Matsumoto, Kenji; Sasakura, Yuuichi; Shimizu, Tetsuichiro; Terauchi, Toshiaki; Kimata, Masaru; Furukawa, Junji; Kobayashi, Kenji; Ogata, Yoshiro

    2016-07-01

    A 51-year-old man underwent abdominoperineal resection for advanced rectal cancer at a hospital. He attended our outpatient clinic 58 months later with pain in the external genitalia, and was diagnosed with local pelvic recurrence and metastasis to the para-aortic lymph node and both adrenal glands. He received a total of 30 Gy of radiation for analgesia; subsequently, chemotherapy(mFOLFOX6 plus bevacizumab)was initiated. However, extreme left buttock and left femoral pain developed after the 6 courses of chemotherapy. Abdominal CT revealed Fournier's gangrene caused by small intestinal perforation. Emergency drainage under spinal anesthesia was immediately performed. Two additional drainage procedures were required thereafter and an ileostomy was constructed. The patient was discharged 100 days after the initial drainage. This is an extremely rare example of a bevacizumab-related small intestinal perforation that developed into Fournier's gan- grene.

  14. Postprandial lower limb pain: An unusual presentation of visceral arteries occlusion.

    Science.gov (United States)

    Patelis, Nikolaos; Papoutsis, Konstantinos; Liakopoulos, Dimitrios; Koutsoumpelis, Andreas; Bakogiannis, Christos; Georgopoulos, Sotirios

    2015-06-01

    This case report describes an atypical and unique presentation of mesenteric arteries occlusive disease. The patient presented with typical symptoms of chronic mesenteric ischemia, as well as with an atypical new symptom; postprandial buttock and lower limbs pain. Pain followed the time curve of the postprandial abdominal discomfort, starting 30 min after meals and gradually resolving within 2 h. The patient had been tolerating the signs of chronic mesenteric ischemia quite well by adjusting the quantity of food per meal to relieve symptoms. Angiography showed that the celiac artery, the superior mesenteric artery, and distal aorta were occluded, leaving the inferior mesenteric artery as the only feeding vessel of all abdominal viscera and both the lower limbs. Since an English medical literature search returned only one marginally similar case, we consider this case of iliac arteries' "steal syndrome" from the inferior mesenteric artery unique.

  15. Cosmeceuticals for cellulite.

    Science.gov (United States)

    Hexsel, Doris; Soirefmann, Mariana

    2011-09-01

    Cellulite is characterized by alterations to the skin surface, presenting as dimpled or puckered skin of the buttocks and posterior and lateral thighs. It mainly affects women. Cellulite occurrence is believed to be due to structural, inflammatory, morphological and biochemical alterations of the subcutaneous tissue. However, its pathogenesis is not completely understood. Topical treatments for cellulite include many agents, such those that increase the microcirculation flow, agents that reduce lipogenesis and promote lipolysis, agents that restore the normal structure of dermis and subcutaneous tissue, and agents that scavenge free radicals or prevent their formation. There are many cosmetic and medical treatments for cellulite. However, there is little clinical evidence of an improvement in cellulite, and none have been shown to lead to its resolution. The successful treatment of cellulite will ultimately depend upon our understanding of the physiopathology of cellulite adipose tissue.

  16. Piriformis syndrome, diagnosis and treatment.

    Science.gov (United States)

    Kirschner, Jonathan S; Foye, Patrick M; Cole, Jeffrey L

    2009-07-01

    Piriformis syndrome (PS) is an uncommon cause of sciatica that involves buttock pain referred to the leg. Diagnosis is often difficult, and it is one of exclusion due to few validated and standardized diagnostic tests. Treatment for PS has historically focused on stretching and physical therapy modalities, with refractory patients also receiving anesthetic and corticosteroid injections into the piriformis muscle origin, belly, muscle sheath, or sciatic nerve sheath. Recently, the use of botulinum toxin (BTX) to treat PS has gained popularity. Its use is aimed at relieving sciatic nerve compression and inherent muscle pain from a tight piriformis. BTX is being used increasingly for myofascial pain syndromes, and some studies have demonstrated superior efficacy to corticosteroid injection. The success of BTX in treating PS supports the prevailing pathoanatomic etiology of the condition and suggests a promising future for BTX in the treatment of other myofascial pain syndromes.

  17. Backrest Shape Affects Head–Neck Alignment and Seated Pressure

    Directory of Open Access Journals (Sweden)

    Atsuki Ukita

    2015-01-01

    Full Text Available Unstable back support against gravity results in a forward head posture and contributes to buttocks pressure ulcers. However, the association between these health problems and a wheelchair backrest is unclear. Our newly developed wheelchair (N-WC supports the back of the pelvis and thorax from obliquely underneath. The purpose of this study was to investigate the effect of different backrest shapes on head–neck alignment and seated pressure. Data from 28 healthy subjects were analyzed. Outcome measures were head–neck alignment angles, support angles of the backrest, and pressure distributions on the supporting surfaces. Compared with a typical wheelchair that has a flat backrest, the seat pressure decreased and the center of pressure was located in the middle of both the seat and backrest in the N-WC. Moreover, the head–neck alignment when seated in the N-WC was upright. These results highlight the importance of the shape of the wheelchair backrest.

  18. Subacute cutaneous lupus erythematosus presenting in childhood: a case report and review of the literature.

    Science.gov (United States)

    Berry, Tammy; Walsh, Erica; Berry, Ryan; DeSantis, Emily; Smidt, Aimee C

    2014-01-01

    A 2-year-old African American, Hispanic boy presented with well-defined, violaceous, annular dermal plaques without scale over the upper extremities, face, lower extremities, and buttocks. The clinical presentation and laboratory studies were consistent with a diagnosis of subacute cutaneous lupus erythematous (SCLE). SCLE presenting in childhood is exceedingly rare, with only eight cases previously reported. It is important to clinically differentiate SCLE from other eruptions more common to children, such as atopic dermatitis, urticarial drug eruptions, and psoriasis vulgaris, because progression to systemic lupus erythematous (SLE) may occur. SLE needs to be closely followed. We present the first case (to our knowledge) of SCLE in a child of African American or Hispanic descent and provide a table of other documented pediatric presentations of SCLE for comparison.

  19. CT findings of fibromatoses

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hak Nam; Choi, Yeon Hwa; Shin, Hyun Jun [Lee Rha Hospital, Chung Ju (Korea, Republic of)

    1991-03-15

    Fibromatoses constitute a group of benign fibroblastic soft tissue tumors with a tendency for local invasion and recurrence. CT provides excellent anatomic detail of soft tissue tumors and precise location, size, and extent of the tumors. The authors evaluated 7 CT scans of 6 pathologically proven aggressive fibromatoses during the last 4 years. Five lesions arose in the lower extremities: 4 in the buttocks and 1 in the thigh. One lesion arose in the upper back. The tumors were lobulated in contour and varied in size from 3.7 cm to 10.7 cm. Fibromatosis tumors were usually hypodense with muscle when no contrast medium was used and hyperdense with better delineation during infusion of the contrast medium. Three patients had recurrent disease after surgical removal. Fibromatosis may infiltrate the surrounding tissue beyond the margins, indicated on CT scans and by palpation at operation. Therefore the surgeon should plan a wide resection around the apparent limits of the fibromatosis.

  20. Water-friendly virtual reality pain control during wound care.

    Science.gov (United States)

    Hoffman, Hunter G; Patterson, David R; Magula, Jeff; Carrougher, Gretchen J; Zeltzer, Karen; Dagadakis, Stephen; Sharar, Sam R

    2004-02-01

    Recent research suggests that entering an immersive virtual environment can serve as a powerful nonpharmacologic analgesic for severe burn pain. The present case study describes an attempt to use water-friendly virtual reality (VR) technology with a burn patient undergoing wound care in a hydrotherapy tub. The patient was a 40-year-old male with 19% total body surface area deep flame/flash burns to his legs, neck, back, and buttocks. The virtual reality treatment decreased the patient's sensory and affective pain ratings and decreased the amount of time spent thinking about his pain during wound care. We believe that VR analgesia works by drawing attention away from the wound care, leaving less attention available to process incoming pain signals. The water-friendly VR helmet dramatically increases the number of patients with severe burns that could potentially be treated with VR (see http://www.vrpain.com).

  1. Pyomyositis after vaginal delivery.

    LENUS (Irish Health Repository)

    Gaughan, Eve

    2011-01-01

    Pyomyositis is a purulent infection of skeletal muscle that arises from haematogenous spread, usually with abscess formation. It can develop after a transient bacteraemia of any cause. This type of infection has never been reported before in the literature after vaginal delivery. A 34-year-old woman had progressive severe pain in the left buttock and thigh and weakness in the left lower limb day 1 post spontaneous vaginal delivery. MRI showed severe oedema of the left gluteus, iliacus, piriformis and adductor muscles of the left thigh and a small fluid collection at the left hip joint. She was diagnosed with pyomyositis. She had fever of 37.9°C immediately postpartum and her risk factors for bacteraemia were a mild IV cannula-associated cellulitis and labour itself. She required prolonged treatment with antibiotics before significant clinical improvement was noted.

  2. Peripheral nerve field stimulation for pruritus relief in a patient with notalgia paraesthetica.

    LENUS (Irish Health Repository)

    Ricciardo, Bernadette

    2012-02-01

    This case study is presented to exemplify the application of peripheral nerve field stimulation in the treatment of recalcitrant notalgia paraesthetica. The patient was a 60-year-old woman with severe and disabling notalgia paraesthetica. The itch persisted despite the use of several medications - topical and oral. Following a successful trial of peripheral nerve field stimulation with a temporary electrode, two subcutaneous electrodes were inserted into the affected area with a battery implanted subcutaneously in her right buttock. The patient was reviewed at 5 months post implantation. She reported a greater than 85% improvement in her itch. She also reported a major improvement in her quality of life, with particular improvement in her ability to sleep through the night. This case illustrates the possible utilization of peripheral nerve field stimulation in the treatment of notalgia paraesthetica, which is a common yet poorly understood and treated condition. Replication and controlled studies are required to determine the general applicability of this approach.

  3. Pseudoxanthoma-elasticum-like skin changes induced by penicillamine.

    Science.gov (United States)

    Bolognia, J L; Braverman, I

    1992-01-01

    The interference of penicillamine with collagen and elastin cross-linking can lead to wrinkling and anetoderma-like lesions in flexural areas as well as fragility and hemorrhagic blisters in pressure areas. These changes are seen primarily in patients with Wilson's disease or cystinuria who are on long-term therapy. This is a report of a patient with cystinuria on long-term, high-dose penicillamine who developed pseudoxanthoma-elasticum-like lesions. Coalescent yellow papules with a 'plucked-chicken skin' appearance were seen in the axillae and on the neck while redundant skin folds were noted in the anterior axillary line and lower buttocks. By light and electron microscopy, involved and uninvolved skin demonstrated 'lumpy-bumpy' dermal elastic fibers with no calcium deposition. These histologic changes are similar to those previously described in patients with penicillamine-induced skin lesions.

  4. Radiation recall phenomenon presenting as myositis triggered by carboplatin plus paclitaxel and related literature review.

    Science.gov (United States)

    Maeng, Chi Hoon; Park, Jun Sang; Lee, Seung Ah; Kim, Dong Hwan; Yun, Dong Hwan; Yoo, Seung-Don; Kim, Hee-Sang; Chon, Jinmann

    2014-01-01

    While most case reports to date are radiation recall dermatitis, radiation recall myositis, which is a distinct form of radiation recall phenomenon caused by carboplatin plus paclitaxel, has not been reported. We treated a 57-year-old female patient who suffered from recurrent cervical cancer. When the patient developed a new left sacral metastasis, salvage radiotherapy (total dose 60 Gy) was administered. Four weeks later, chemotherapy using carboplatin plus paclitaxel was initiated. Four months after chemotherapy, the patient complained of severe pain in her left buttock. On magnetic resonance imaging (MRI), edematous changes and increased signal densities of left gluteus maximus and medius muscles were noted suggesting myositis. The border of the high signal intensity territory of the muscles was sharp and clearly corresponded with the recent irradiation field. We concluded that the patient had radiation recall myositis triggered by paclitaxel-carboplatin. Symptoms were controlled by analgesics, and there was no recurrence.

  5. Histological Characteristics of Hair Follicle Structure of Hezuo Swine from Gansu Province

    Institute of Scientific and Technical Information of China (English)

    Lei WANG; Yanfei LIU

    2012-01-01

    The characteristics of skin hair follicle structure of Hezuo swine were in- vestigated using frozen section method and HE staining. Experimental results showed that the hair root, hair tip, outer sheath, inner sheath, hair follicle group, fi- brous sheath, outer epidermis, inner epidermis, sebaceous gland and other organiza- tional structures of hair follicles of Hezuo swine can be clearly observed. The hair follicle pore size varied extremely significantly (P〈0.01) among different parts, showing a downward trend of shoulder 〈 body side 〈 buttocks; the hair follicle density ranged from 5.59 to 7.26 hair follicles/mm^2. This study provides reference for the in-dustrial and medical applications.

  6. An Investigation of Integrated Sizing for US Army Men and Women

    Science.gov (United States)

    1981-08-01

    Height 33.20 1.15 31.31-35.09 34.12 Cervicale Height 55.93 0.91 54.43-57.43 57.33 Crotch Height 30.26 1.01 28.59-31.92 31.08 Shoulder Height 52.87 0.95...Axilla to Waist 9.13 0.95 7.56-10.70 9.30 Cervicale -Acromion 3.06 0.30 2.57- 3.55 3.05 Cerv - Bustpoint 9.09 0.74 7.86-10.32 9.33 Cervicale - Buttock... vertebra (approximately at the base of the neck). Men: the surface distance from the waist (at the level of the navel) to the seventh cervical

  7. Crawling patterns in neglected poliomyelitis in the Solomon Islands.

    Science.gov (United States)

    Cross, A B

    1977-11-01

    Two hundred and twenty-two adult crawling poliomyelitic cripples were investigated. Analysis showed that bilateral lower limb paralysis with or without trunk involvement was the most common residual lesion. Remarkably paralysis was confined to a single lower limb in six cases. The various crawling patterns can be classified into six broad groups which are described and illustrated. It is suggested that in a developing country this classification has a practical application in the assessment of patients for rehabilitation to crutch walking. Subjects in the "true quandruped progression" and "squatting gait" categories generally have an excellent potential for rehabilitation, as often do those in the "infant-like crawl" group. Caution should be exercised in attempting crutch walking for those in the "body-dragging" group, and there seems little indication for attempting to establish upright walking for those in the "buttock pivoting" and "minimal movement" groups.

  8. Avoidable cancers in the Nordic countries. Radiation

    DEFF Research Database (Denmark)

    Winther, J F; Ulbak, Kaare; Dreyer, L;

    1997-01-01

    Exposure to solar and ionizing radiation increases the risk for cancer in humans. Some 5% of solar radiation is within the ultraviolet spectrum and may cause both malignant melanoma and non-melanocytic skin cancer; the latter is regarded as a benign disease and is accordingly not included in our......, it was estimated that the exposure of the Nordic populations to natural sources of ionizing radiation other than radon and to medical sources will each give rise to an annual total of 2120 cancers at various sites. For all types of ionizing radiation, the annual total will be 4420 cancer cases, or 3.9% of all...... estimation of avoidable cancers. Under the assumption that the rate of occurrence of malignant melanoma of the buttocks of both men and women and of the scalp of women would apply to all parts of the body in people completely unexposed to solar radiation, it was estimated that approximately 95% of all...

  9. Diagnosis and management of "an apparent mechanical" femoral mononeuropathy: a case study.

    Science.gov (United States)

    Desmarais, Ariane; Descarreaux, Martin

    2007-12-01

    This report describes an apparent case of femoral nerve mononeuropathy in a 58-year-old equestrian due to mechanical stress. A woman presented at a chiropractic office complaining of right buttock pain radiating to the right groin and knee. A treatment plan, consisting of chiropractic adjustments in addition to stretching and myofascial therapy, was initiated. The goal was to reduce pain and inflammation in the sacroiliac articulation by restoring normal biomechanical function. A rehabilitation program to alleviate tension in the musculature was initiated to reduce mechanical stresses exerted on the femoral nerve. The patient received five treatments over a period of three weeks and became asymptomatic. Even though peripheral nerve entrapment is an uncommon condition, clinicians must not overlook the possibility of a femoral mononeuropathy as it can produce a complex presentation and lead to ineffective patient management.

  10. Atypical Frotteurism Associated with Voyeurism and Obsession in a Six-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Bidaki

    2016-05-01

    Full Text Available Introduction Frotteuristic sexual interest is a rare psychiatric disorder characterized by at least six months of recurrent and intense sexual arousal from touching or rubbing against a non-consenting person, usually in a crowd. Case Presentation A six-year-old boy was referred to the psychiatrist while accompanied by his mother and grandmother with the complaint of excessively rubbing his genitalia many times a day against his female family members’ bodies, primarily their buttocks. Conclusions Experts are advised to focus on diverse sexual history dimensions, especially uncontrollable masturbation behaviors, that can predict sexual interests. Although frotteurism is a rare psychiatric disorder, and although this case is atypical given the early childhood presentation of abnormal sexual behavior carried out secretly and not in a crowd, it is clear that frotteurism is the appropriate diagnosis after ruling out other more common disorders.

  11. Transient Neurological Symptoms after Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Zehra Hatipoglu

    2013-02-01

    Full Text Available Lidocaine has been used for more than 50 years for spinal anesthesia and has a remarkable safety record. In 1993, a new adverse effect, transient neurologic toxicity was described in patients recovering from spinal anesthesia with lidocaine. Transient neurological symptoms have been defined as pain in the lower extremities (buttocks, thighs and legs after an uncomplicated spinal anesthesia and after an initial full recovery during the immediate postoperative period (less than 24 h. The incidence of transient neurological symptoms reported in prospective, randomized trials varies from 4% to 37%. The etiology of transient neurological symptoms remains unkonwn. Despite the transient nature of this syndrome, it has proven to be difficult to treat effectively. Drug or some interventional therapy may be necessary. [Archives Medical Review Journal 2013; 22(1.000: 33-44

  12. Multisystem organ failure after large volume injection of castor oil.

    Science.gov (United States)

    Smith, Silas W; Graber, Nathan M; Johnson, Rudolph C; Barr, John R; Hoffman, Robert S; Nelson, Lewis S

    2009-01-01

    We report a case of multisystem organ failure after large volume subcutaneous injection of castor oil for cosmetic enhancement. An unlicensed practitioner injected 500 mL of castor oil bilaterally to the hips and buttocks of a 28-year-old male to female transsexual. Immediate local pain and erythema were followed by abdominal and chest pain, emesis, headache, hematuria, jaundice, and tinnitus. She presented to an emergency department 12 hours postinjection. Persistently hemolyzed blood samples complicated preliminary laboratory analysis. She rapidly deteriorated despite treatment and developed fever, tachycardia, hemolysis, thrombocytopenia, hepatitis, respiratory distress, and anuric renal failure. An infectious diseases evaluation was negative. After intensive supportive care, including mechanical ventilation and hemodialysis, she was discharged 11 days later, requiring dialysis for an additional 1.5 months. Castor oil absorption was inferred from recovery of the Ricinus communis biomarker, ricinine, in the patient's urine (41 ng/mL). Clinicians should anticipate multiple complications after unapproved methods of cosmetic enhancement.

  13. Primary atypical sacral meningioma- not always benign

    Energy Technology Data Exchange (ETDEWEB)

    Bhadra, A.K.; Casey, A.T.H.; Saifuddin, A.; Briggs, T.W. [Royal National Orthopaedic Hospital, Stanmore, London (United Kingdom)

    2007-06-15

    We present a case of an atypical recurrent meningioma of the sacrum with pulmonary metastasis in a 31-year-old man. He presented with deep-seated buttock pain and urinary hesitancy for 3 months. MRI revealed a lesion occupying the central and left side of the sacral canal at the S1-S2 level. Surgical excision of the lesion via a posterior approach was undertaken, and the patient became symptom-free post-operatively. Histology confirmed atypical meningioma. Eight months later he re-presented with similar symptoms, and MRI confirmed local recurrence. The patient underwent left hemisacrectomy. Six months later he again presented with low back pain and MRI confirmed a second local recurrence. A CT scan of the chest showed multiple lung metastases. The patient died of a severe chest infection 18 months later. (orig.)

  14. The lesional skin of linear IgA bullous dermatosis expresses growth-regulated peptide (GRO)-alpha.

    Science.gov (United States)

    Tsunemi, Yuichiro; Ihn, Hironobu; Saeki, Hidehisa; Tamaki, Kunihiko

    2004-07-01

    The patient was a 62-year-old man with erythema with tense vesiculobullae and erosions on the bilateral elbows, right knee, and one buttock. A skin biopsy specimen revealed subepidermal blister formation with a predominant infiltration of neutrophils and papillary neutrophilic microabscesses. Direct immunofluorescence study showed linear deposition of IgA and weak deposition of IgG at the basement membrane zone of the lesional skin, and indirect immunofluorescence study showed linear deposition of IgA at the epidermal side of the 1M NaCl-separated normal skin. He was diagnosed with linear IgA bullous dermatosis. Immunohistochemical study revealed that the lesional and perilesional keratinocytes expressed growth-regulated peptide (GRO) -alpha, a potent chemoattractant for neutrophils. This suggests that GRO-alpha plays a role in the infiltration of neutrophils into the lesional skin and in bulla formation in linear IgA bullous dermatosis.

  15. Linear IgA dermatosis associated with ulcerative colitis: complete and sustained remission after total colectomy.

    Science.gov (United States)

    Vargas, Thiago Jeunon de Sousa; Fialho, Mônica; Santos, Luiza Tavares dos; Rodrigues, Palmira Assis de Jesus Barreto; Vargas, Ana Luisa Bittencourt Sampaio Jeunon; Sousa, Maria Auxiliadora Jeunon

    2013-01-01

    Linear IgA dermatosis has been increasingly associated with inflammatory bowel diseases, particularly ulcerative colitis. A 13-year-old male patient with an 11-month history of ulcerative colitis developed vesicles, pustules and erosions on the skin of the face, trunk and buttocks and in the oral mucosa. The work-up revealed a neutrophil-rich sub-epidermal bullous disease and linear deposition of IgA along the dermoepidermal junction, establishing the diagnosis of linear IgA dermatosis. The patient experienced unsatisfactory partial control of skin and intestinal symptoms despite the use of adalimumab, mesalazine, prednisone and dapsone for some months. After total colectomy, he presented complete remission of skin lesions, with no need of medications during two years of follow-up. A review of previously reported cases of the association is provided here and the role of ulcerative colitis in triggering linear IgA dermatosis is discussed.

  16. "You're naked, you're vulnerable": Sexual well-being and body image of women with lower limb lymphedema.

    Science.gov (United States)

    Winch, Caleb J; Sherman, Kerry A; Smith, Katriona M; Koelmeyer, Louise A; Mackie, Helen; Boyages, John

    2016-09-01

    Lower-limb lymphedema is an incurable illness manifesting as visible swelling enlarging the leg(s) and/or feet, buttocks, and genitals. This study used semi-structured interviews and thematic analysis to explore sexual well-being among women with primary (congenital) lymphedema (n=11) or secondary lymphedema associated with gynecological cancer (n=8). Five themes (subthemes) summarized women's responses, with Attractiveness and Confidence (Publicly Unattractive, Privately Unconfident, Lymphedema or Aging?) describing women's central concern. These body image-related concerns accounted for sexual well-being in association with Partner Support (Availability of Support, Languages of Support, Fears About Support) and the degree of Functional Interruptions (Lymphedema in Context, Enduring Impacts, Overcoming Interruptions). Successful Lymphedema Coping (Control, Acceptance) and self-perceived ability to fulfill a valued Sexual Role also affected sexual well-being. Few differences between women with primary versus secondary lymphedema were evident. Lymphedema clinicians should screen for sexual concerns and have referral options available.

  17. A CASE DISCUSSION ON PILONIDAL SINUS: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Hiremath Sangamesh

    2012-10-01

    Full Text Available A pilonidal sinus is an acquired condition seen more in males than females, as males have more hairs, the buttocks moves and hairs breaks off by friction and collect in the cleft which makes local inflammation turns to sinus formation. The commonly used surgical technique for this disorder includes excision, primary closure and excision with reconstructive flap. However patients require longer hospitalization, the risk of reoccurrence, and infection of wound after operation is high and expensive. We can see the similarity between shalyaja nadivrana described in Sushruta Samhita and pilonidal sinus. Sushruta advised many para-surgical techniques viz – kshara sutra for nadi vrana hence kshara sutra therapy was tried in a case of pilonidal sinus. Kshara sutra treatment not only minimizes complications and reoccurrences but also facilitates the patient to resume early working with less discomfort as well as reduced time and cost.

  18. Cutaneous in vivo metabolism of topical lidocaine formulation in human skin

    DEFF Research Database (Denmark)

    Rolsted, K; Benfeldt, E; Kissmeyer, A-M

    2009-01-01

    Little is known about the metabolising capacity of the human skin in relation to topically applied drugs and formulations. We chose lidocaine as a model compound since the metabolic pathways are well known from studies concerning hepatic metabolism following systemic drug administration. However......, the enzymes involved are also expressed in the skin. Hence, the aim of the current study was to investigate the extent of the cutaneous in vivo metabolism of topically applied lidocaine in human volunteers. A dose of 5 mg/cm(2) of Xylocaine(R) (5% lidocaine) ointment was applied onto the buttock skin...... of the volunteers. After 2 h, residual formulation was removed, and two 4-mm punch biopsies were taken from each volunteer. The quantity of lidocaine extracted from the skin samples (epidermis + dermis) was 109 +/- 43 ng/mm(2) skin. One metabolite (monoethylglycine xylidide, MEGX) was detected in skin from 7...

  19. Ultrasound-guided piriformis muscle injection. A new approach.

    Science.gov (United States)

    Bevilacqua Alén, E; Diz Villar, A; Curt Nuño, F; Illodo Miramontes, G; Refojos Arencibia, F J; López González, J M

    2016-12-01

    Piriformis syndrome is an uncommon cause of buttock and leg pain. Some treatment options include the injection of piriformis muscle with local anesthetic and steroids. Various techniques for piriformis muscle injection have been described. Ultrasound allows direct visualization and real time injection of the piriformis muscle. We describe 5 consecutive patients, diagnosed of piriformis syndrome with no improvement after pharmacological treatment. Piriformis muscle injection with local anesthetics and steroids was performed using an ultrasound technique based on a standard technique. All 5 patients have improved their pain measured by numeric verbal scale. One patient had a sciatic after injection that improved in 10 days spontaneously. We describe an ultrasound-guided piriformis muscle injection that has the advantages of being effective, simple, and safe.

  20. Piriformis syndrome: a cause of nondiscogenic sciatica.

    Science.gov (United States)

    Cass, Shane P

    2015-01-01

    Piriformis syndrome is a nondiscogenic cause of sciatica from compression of the sciatic nerve through or around the piriformis muscle. Patients typically have sciatica, buttocks pain, and worse pain with sitting. They usually have normal neurological examination results and negative straight leg raising test results. Flexion, adduction, and internal rotation of the hip, Freiberg sign, Pace sign, and direct palpation of the piriformis cause pain and may reproduce symptoms. Imaging and neurodiagnostic studies are typically normal and are used to rule out other etiologies for sciatica. Conservative treatment, including medication and physiotherapy, is usually helpful for the majority of patients. For recalcitrant cases, corticosteroid and botulinum toxin injections may be attempted. Ultrasound and other imaging modalities likely improve accuracy of injections. Piriformis tenotomy and decompression of the sciatic nerve can be done for those who do not respond.

  1. Diagnostic Methods in Piriformis Syndrome

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    Mariana BÂRZU

    2013-12-01

    Full Text Available An uncomon cause of sciatica is piriformis syndrome that involves deep buttock pain reffered to the leg. Piriformis syndrome is usually discribed as a neuromuscular disorder caused by compression or irritation of the sciatic nerve by the piriformis muscle. There are a lot of means to diagnose Piriformis syndrome, and to distinguish it from other pain inducing conditions. Unfortunatelly not every practitioner has the opportunity to use special means, and not every patient has the financial support to beneficiate of the same special means, represented by Computed tomography (CT, Magnetic resonance imaging (MRI, Electromyography (EMG and Neurography. For this reason, the present paper gathered the most popular functional tests used in the practice to diagnose the piriformis syndrome.

  2. Effect of a classroom-based behavioral intervention package on the improvement of children's sitting posture in Japan.

    Science.gov (United States)

    Noda, Wataru; Tanaka-Matsumi, Junko

    2009-03-01

    The present study evaluates the effect of a classroom-based behavioral intervention package to improve Japanese elementary school children's sitting posture in regular classrooms (N=68). This study uses a multiple-baseline design across two classrooms with a modified repeated reversal within each class. The article defines appropriate sitting posture as behavior composed of four components (feet, buttocks, back, and a whole body). The intervention package includes modeling, correspondence training, prompt, and reinforcement, among others. The authors counted the number of children with appropriate sitting posture in each classroom across all 28 sessions throughout the study. Interobserver agreement of appropriate sitting posture ranged from 80% to 100%. As a result of the intervention, the mean proportion of children with appropriate posture increased from approximately 20% to 90%. In addition, their academic writing productivity increased with the improved sitting posture. Teachers' acceptance of the intervention program proved to be excellent.

  3. Deep gluteal syndrome.

    Science.gov (United States)

    Martin, Hal David; Reddy, Manoj; Gómez-Hoyos, Juan

    2015-07-01

    Deep gluteal syndrome describes the presence of pain in the buttock caused from non-discogenic and extrapelvic entrapment of the sciatic nerve. Several structures can be involved in sciatic nerve entrapment within the gluteal space. A comprehensive history and physical examination can orientate the specific site where the sciatic nerve is entrapped, as well as several radiological signs that support the suspected diagnosis. Failure to identify the cause of pain in a timely manner can increase pain perception, and affect mental control, patient hope and consequently quality of life. This review presents a comprehensive approach to the patient with deep gluteal syndrome in order to improve the understanding of posterior hip anatomy, nerve kinematics, clinical manifestations, imaging findings, differential diagnosis and treatment considerations.

  4. Bilateral gluteal compartment syndrome and severe rhabdomyolysis after lumbar spine surgery.

    Science.gov (United States)

    Rudolph, Thomas; Løkebø, Jan Eirik; Andreassen, Lasse

    2011-07-01

    Gluteal compartment syndrome (GCS) is an extremely rare and potentially devasting disorder, most commonly caused by gluteal muscle compression in extend periods of immobilization. We report a 65-year-old obese man with hypertension, diabetes mellitus type 2 and hypercholesterolemia underwent lumbar spine surgery in knee-chest position because of degenerative lumbar stenosis. Perioperative hypotension occurred. After surgery, the patient developed increasing pain in the buttocks of both sides and oliguria with darkened urine. Stiffness, tenderness and painful swelling of patients gluteal muscles of both sides, high creatine phosphokinase level, myoglobulinuria and oliguria led to diagnosis of bilateral GCS, complicated by severe rhabdomyolysis (RM) and acute renal failure. In conclusion, obese patients with vascular risk factors and perioperative hypotension may be at risk for developing bilateral GCS and RM when performing prolonged lumbar spine surgery. Early diagnosis and treatment is important, as otherwise, the further course may be fatal.

  5. Accessory belly of piriformis, as a cause of superior gluteal neurovascular entrapment

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    Rimple Bansal

    2013-06-01

    Full Text Available During routine dissection on 50 years old male cadaver, an accessory belly of piriformis was observed. This accessory belly was superior and parallel to the main piriformis muscle. This was associated with emergence of superior gluteal nerve and superior gluteal artery between the two bellies. Piriformis muscle and its relation to sciatic nerve has been suggested as a cause of piriformis syndrome. But interestingly in the present case, superior gluteal nerve was interposed between two bellies that may help the clinicians to establish a rare yet important cause of piriformis syndrome and a rare cause of undiagnosed chronic pain in gluteal region. As superior gluteal artery was also interposed, so this rare variation holds interest to surgeons especially in isolated buttock claudication despite otherwise normal vascular investigations. [Int J Res Med Sci 2013; 1(3.000: 296-298

  6. Primary sacral hydatid cyst mimicking a neurogenic tumor in chronic low back pain: Case report and review of the literature

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    Manuel Segura-Trepichio

    2016-01-01

    Full Text Available Hydatid disease is caused by infection of Echinococcus granulosus. Bone hydatid cyst presentation without hepatic affectation is infrequent and occurs in 0,5-2% of cases. This rare condition makes clinicians not always aware of the disease, and as a result, misdiagnosis of spinal echinococcosis is common. We present a case of a 48-year-old female patient with primary sacral hydatidosis. Chronic low back pain radiating to the left buttock was the only symptom. The magnetic resonance imaging (MRI suggested a neurogenic tumor versus giant cell tumor. Biopsy and pathological study revealed a hydatid cyst. Anthelmintic and surgical treatment was performed. At 12 months after surgery, the patient is free of recurrence. In patients with chronic low back pain and a MR suggestive of neurogenic tumor, spinal hydatid cyst should be considered in the differential diagnosis. It is recommended the assistance of an anesthesiologist during biopsy to avoid an anaphylactic shock.

  7. Primary Sacral Hydatid Cyst Mimicking a Neurogenic Tumor in Chronic Low Back Pain: Case Report and Review of the Literature

    Science.gov (United States)

    Segura-Trepichio, Manuel; Montoza-Nuñez, Jose Manuel; Candela-Zaplana, David; Herrero-Santacruz, Josefa; Pla-Mingorance, Fernando

    2016-01-01

    Hydatid disease is caused by infection of Echinococcus granulosus. Bone hydatid cyst presentation without hepatic affectation is infrequent and occurs in 0,5-2% of cases. This rare condition makes clinicians not always aware of the disease, and as a result, misdiagnosis of spinal echinococcosis is common. We present a case of a 48-year-old female patient with primary sacral hydatidosis. Chronic low back pain radiating to the left buttock was the only symptom. The magnetic resonance imaging (MRI) suggested a neurogenic tumor versus giant cell tumor. Biopsy and pathological study revealed a hydatid cyst. Anthelmintic and surgical treatment was performed. At 12 months after surgery, the patient is free of recurrence. In patients with chronic low back pain and a MR suggestive of neurogenic tumor, spinal hydatid cyst should be considered in the differential diagnosis. It is recommended the assistance of an anesthesiologist during biopsy to avoid an anaphylactic shock. PMID:28163523

  8. Atypical cellular blue nevus or malignant blue nevus?*

    Science.gov (United States)

    Daltro, Luise Ribeiro; Yaegashi, Lygia Bertalha; Freitas, Rodrigo Abdalah; Fantini, Bruno de Carvalho; Souza, Cacilda da Silva

    2017-01-01

    Blue nevus is a benign melanocytic lesion whose most frequent variants are dendritic (common) blue nevus and cellular blue nevus. Atypical cellular blue nevus presents an intermediate histopathology between the typical and a rare variant of malignant blue nevus/melanoma arising in a cellular blue nevus. An 8-year-old child presented a pigmented lesion in the buttock since birth, but with progressive growth in the last two years. After surgical excision, histopathological examination revealed atypical cellular blue nevus. Presence of mitoses, ulceration, infiltration, cytological atypia or necrosis may occur in atypical cellular blue nevus, making it difficult to differentiate it from melanoma. The growth of blue nevus is unusual and considered of high-risk for malignancy, being an indicator for complete resection and periodic follow-up of these patients. PMID:28225968

  9. Aortoiliac occlusive disease presenting as sudden onset paraplegia.

    Science.gov (United States)

    Lai, Chien-Hung; Wang, Cheng-Hsien; Wu, Shih-Yun; Shih, Hong-Mo

    2014-07-01

    Thromboembolism and atherosclerotic stenosis both can cause arterial occlusion. Aortoiliac occlusive disease involving bifurcation of the aortoiliac artery induces symptoms of ischemia such as claudication and pain of buttocks and thighs, decreased bilateral femoral pulses, and impotence. Here, we describe a 58-year-old woman with a past history of atrial fibrillation and lacuna stroke with minimal right side weakness. She presented to our emergency department with sudden onset bilateral pain in the legs and paraplegia. A comprehensive examination revealed paresthesia and decreasing bilateral distal pulses. Computed tomographic imaging showed filling defects over the low abdominal aorta just above the bifurcation of the common iliac artery and bilateral femoral arteries. Acute aortic embolic occlusion was suspected. Her symptoms were resolved after emergent thrombectomy for acute limb ischemia. Physicians need to be aware of aortoiliac embolic occlusive disease which may present as acute paraplegia.

  10. Dressings as an adjunct to pressure ulcer prevention: consensus panel recommendations.

    Science.gov (United States)

    Black, Joyce; Clark, Michael; Dealey, Carol; Brindle, Christopher T; Alves, Paulo; Santamaria, Nick; Call, Evan

    2015-08-01

    The formulation of recommendations on the use of wound dressings in pressure ulcer prevention was undertaken by a group of experts in pressure ulcer prevention and treatment from Australia, Portugal, UK and USA. After review of literature, they concluded that there is adequate evidence to recommend the use of five-layer silicone bordered dressings (Mepilex Border Sacrum(®) and 3 layer Mepilex Heel(®) dressings by Mölnlycke Health Care, Gothenburg, Sweden) for pressure ulcer prevention in the sacrum, buttocks and heels in high-risk patients, those in Emergency Department (ED), intensive care unit (ICU) and operating room (OR). Literature on which this recommendation is based includes one prospective randomised control trial, three cohort studies and two case series. Recommendations for dressing use in patients at high risk for pressure injury and shear injury were also provided.

  11. [The treatment of type-1 diabetics with insulin-induced lipohypertrophy by liposuction].

    Science.gov (United States)

    Hauner, H; Olbrisch, R R

    1994-03-25

    Extensive areas of lipohypertrophy at the insulin injection sites on both thighs, upper arms and buttocks had developed in a 22-year-old woman with type 1 diabetes. Tissue biopsy showed fat cells of normal size, while the stromal cells in primary culture from the lipohypertrophy tissue demonstrated a greater degree of new fat-cell formation than normal fat tissue, i.e. there was fat-cell hyperplasia. Although the patient avoided these sites for insulin injection during the subsequent 18 months, the amount of excessive fat tissue did not decrease. As the very obvious fat pads distressed the patient, local liposuction was applied without complication at the six affected sites, removing a total of 2,000 ml of fat.-Liposuction is a low-risk curative procedure for removing extensive insulin-induced lipohypertrophic tissue and quickly achieves a cosmetically satisfactory result.

  12. Diagnosis of iliotibial band friction syndrome and ultrasound guided steroid injection.

    Science.gov (United States)

    Hong, Ji Hee; Kim, Ji Sub

    2013-10-01

    A 64-year-old woman visited our pain clinic with the pain of right lateral side of thigh for one year. Her pain always started from knee and was radiated to buttock area when symptom was severe. She showed significant tenderness at knee lateral side and local tightness at lateral thigh. Magnetic resonance image of the knee was performed and we could identify high signal intensity of iliotibial band through coronal and axial view. In spite of medication and physical stretching exercise of iliotibial band for one month, she did not show any improvement of pain. To alleviate her symptom, ultrasound guided local corticosteroid injection targeting beneath the iliotibial band was performed. After the procedure, the reduction of pain was significant and there was no need for further management.

  13. Superior gluteal nerve entrapment between two bellies of piriformis muscle

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    Yadav Y

    2010-12-01

    Full Text Available A double belly composition of piriformis muscle with superior gluteal nerve entrapment between the two muscle masses was detected. Piriformis muscle and its relation to sciatic nerve has been suggested as a cause of piriformis syndrome. Patients suffering from buttock pain are most often diagnosed as having piriformis syndrome, where anatomical variation of the piriformis is an important contributor. The present variation showed two distinct bellies of piriformis muscle. Interestingly the superior gluteal nerve was interposed between the two bellies. Such incidental findings on cadavers may help the clinicians to establish a rare yet important cause of piriformis syndrome. Furthermore, such observations are also relevant to the radiologists while interpreting MRI scans in cases of undiagnosed chronic gluteal pain.

  14. Penile calciphylaxis: a life-threatening condition successfully treated with sodium thiosulfate.

    Science.gov (United States)

    Sandhu, Gagangeet; Gini, Marcelo Barrios; Ranade, Aditi; Djebali, David; Smith, Steven

    2012-01-01

    Calciphylaxis or calcific uremic arteriolopathy is a life-threatening condition that predominantly affects patients with end-stage renal disease on hemodialysis. A prevalence of up to 4% and a 6-month mortality rate of up to 80% have been reported in those with proximal disease (thighs, abdomen wall, and buttocks). Penile calciphylaxis is very rare but has a mortality rate of 69% within 6 months. Its treatment is controversial. For small lesions, conservative treatment with local wound care and debridement may suffice. Partial or complete penectomy may be needed for more extensive lesions, and especially those associated with signs of local infection. In addition to surgical intervention, as with any other case of calcific uremic arteriolopathy, the cornerstones of therapy should be to keep serum phosphorus sodium thiosulfate was used in addition to the standard medical and surgical therapy. Two months after surgery, the patient's wound completely healed and he has experienced no new lesions over the past 11 months.

  15. A Reduction Grade of Lipodystrophy and Limited Side Effects after HAART Regimen with Raltegravir, Lamivudine, Darunavir and Ritonavir in an HIV-1 Infected Patient after Six Years of Antiretroviral Therapy

    Science.gov (United States)

    Antoni, A Degli; Weimer, LE; Fragola, V; Giacometti, A; Sozio, F

    2015-01-01

    ABSTRACT HIV-associated lipodystrophy commonly presents with fat loss in the face, buttocks, arms and legs, hypocomplementaemia, glomerulonephritis and autoimmune disorders. The exact mechanism of HIV-associated lipodystrophy is not fully elucidated. There is evidence indicating that it can be caused by both antiretroviral medications and HIV infection in the absence of antiretroviral medication. Lipodystrophy seems to be mainly due to HIV-1 protease inhibitors. Interference with lipid metabolism is postulated as pathophysiology. Also, the development of lipodystrophy is associated with specific nucleoside reverse transcriptase inhibitors (NRTI). Mitochondrial toxicity is postulated to be involved in the pathogenesis associated with NRTI. Here, we analyse the side effects and examine the impact of the highly active antiretroviral therapy (HAART) regimen including raltegravir, lamivudine, darunavir and ritonavir in an HIV-1 infected patient with severe lipodystrophy after six years of antiretroviral therapy. PMID:26426188

  16. Clinical and morphological study of calf enlargement following S-1 radiculopathy

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    Osvaldo J. M. Nascimento

    1992-09-01

    Full Text Available Calf enlargement following sciatica is a rare condition. It is reported the case of a 28-year-old woman who complained of repeated episodes of lower back pain radiating into the left buttock and foot. One year after the beginning of her symptoms, she noticed enlargement of her left calf. X-ray studies disclosed L5-S1 disk degeneration. EMG showed muscle denervation with normal motor conduction velocity. Open biopsies of the gastrocnemius muscles were performed. The left gastrocnemius muscle showed hypertrophic type 2 fibers in comparison with the right gastrocnemius. Electron microscopy showed mildly increased number of mitochondria in these fibers. A satisfactory explanation for denervation hypertrophy has yet to be provided.

  17. Cauda equina syndrome: the importance of complete multidisciplinary team management.

    Science.gov (United States)

    Shivji, Faiz; Tsegaye, Magnum

    2013-03-15

    A 44-year-old lady with a history of lumbar back pain presented to the emergency department complaining of severe back pain radiating to her buttocks. Positive examination findings were a loss of sensation in the perianal area and 348 ml of retained urine. An urgent MRI showed compression of the cauda equina by a herniated disc. The patient was operated upon that evening, having a lumbar 5/sacral 1 decompression and sequestrectomy. During follow-up, the patient was reviewed by a consultant spinal surgeon, a urologist and our cauda equina nurse at every appointment, as per the cauda equina pathway specifically designed and implemented by our spinal unit. This report shows the complex nature of cauda equina syndrome and broad functional deficit patients can suffer from. It shows the benefits of prompt diagnosis and surgery, together with intensive, multidisciplinary follow-up and treatment, all of which are possible by a specially created, cauda equina protocol.

  18. Penile herpes zoster: an unusual location for a common disease

    Directory of Open Access Journals (Sweden)

    Milan Bjekic

    2011-12-01

    Full Text Available Herpes zoster is a common dermatological condition which affects up to 20% of the population, most frequently involving the thoracic and facial dermatomes with sacral lesions occurring rarely and only a few reported cases of penile shingles. Case report: We report two cases of unusual penile clinical presentations of varicella zoster virus infection in immunocompetent men. The patients presented with grouped clusters of vesicles and erythema on the left side of penile shaft and posterior aspect of the left thigh and buttock, involving s2-s4 dermatomes. The lesions resolved quickly upon administration of oral antiviral therapy. Conclusion: Penile herpes zoster should not be overlooked in patients with unilateral vesicular rash.

  19. Cutaneous sarcoid-like granulomas in a patient with X-linked hyper-IgM syndrome.

    Science.gov (United States)

    Gallerani, Isabella; Innocenti, Damiano Degli; Coronella, Giordana; Berti, Samantha; Amato, Laura; Moretti, Silvia; Fabbri, Paolo

    2004-01-01

    We describe a 5-year-old boy with red-pink, firm, nodular lesions, with central resolution and prominent borders, localized to the face, backs of the hands, extensor surfaces of the arms and legs, and the buttocks. He also had recurrent bacterial respiratory infections. Quantitative immunoglobulin levels revealed hypogammaglobulinemia and increased IgM levels. Histopathologic examination of a nodular lesion revealed perivascular and periadnexal granulomas composed of epithelioid cells surrounded by a mantle of lymphocytes; three cultures for fungi and acid-fast bacilli were negative. Clinical, histopathologic, and immunologic studies supported a diagnosis of hyper-IgM (HIM) syndrome. The boy was treated with pulsed-dose antibiotics and intravenous gamma globulin every 3 weeks, with improvement of clinical symptoms. Skin lesions were treated with topical corticosteroids, with immediate recurrence upon cessation of therapy. To the best of our knowledge, this is the first description of cutaneous granulomas in HIM syndrome.

  20. A case of Gianotti Crosti syndrome with HBV infection.

    Science.gov (United States)

    Dikici, B; Uzun, H; Konca, C; Kocamaz, H; Yel, S

    2008-01-01

    Gianotti-Crosti syndrome (papular acrodermatitis of childhood), which was first described in 1955, is a nonspecific rash that usually consists of the abrupt onset of pink flesh coloring, smooth or lichenoid, flat-topped papules. It was first related to hepatitis B virus (HBV) infection; however, cases not associated with HBV infection were reported as well. Although a type of delayed hypersensitivity reaction is speculated as a cause, exact pathogenesis still remains unclear. The prognosis is favorable and successful management relies upon general supportive and symptomatic care. We report a seven-year-old boy diagnosed with Gianotti-Crosti syndrome with monomorphous papules on his cheeks, buttocks and extremities associated with hepatitis B virus infection.

  1. Gianotti-Crosti syndrome: case report of a pruritic acral exanthema in a child.

    Science.gov (United States)

    Llanora, Genevieve Villablanca; Tay, Clifton Ming; van Bever, Hugo Ps

    2012-07-01

    Gianotti-Crosti syndrome (GCS) is a sporadic dermatosis affecting mainly children. It is characterized by multiple, confluent, monomorphic and pruritic pink to red-brown papules or papulovesicles, distributed symmetrically on the face, extensor surfaces of the extremities and buttocks, commonly sparing the trunk, palms and soles. This can be preceded by a viral infection, and may be accompanied by fever, hepatosplenomegaly, or lymphadenopathy. Personal and family history of atopy appears to be a risk factor in the subsequent development of GCS, thus frequently diagnosed as atopic dermatitis. We report a case of a 4-year-old boy from our institution with generalized, pruritic, papulovesicular rashes on the face and extremities for one month. He was diagnosed to have atopic dermatitis and treated as such, before presentation to our institution. As the signs and symptoms in GCS are similar to atopic dermatitis, we suggest that this diagnosis be considered when presented with a similar case.

  2. Frequency and severity of diaper dermatitis with use of traditional Chinese cloth diapers: observations in 3- to 9-month-old children.

    Science.gov (United States)

    Liu, Na; Wang, Xuemin; Odio, Mauricio

    2011-01-01

    Chinese cloth diapers differ from disposable diapers in several respects that are central to our understanding of the etiology of diaper dermatitis (DD), yet there are no published reports on the dermatological correlates of this manner of infant care, which is prevalent among the world's second-largest pediatric population. The objective was to determine the prevalence and severity of DD in exclusive users of Chinese cloth diapers. This observational study was conducted during a single home visit to 694 Chinese children who were exclusive users of cloth diapers in five inland cities of China. During each home visit, study nurses documented the presence and severity of DD using a visual dermatological scale and conducted transepidermal water loss (TEWL) and pH measurements. Diaper dermatitis was rare in the buttocks and genital area of the children (Diaper dermatitis is common in children who use traditional Chinese cloth diapers, especially in the perianal and intertriginous regions.

  3. Acute generalized exanthematous pustulosis associated with spider bite*

    Science.gov (United States)

    Milman, Laura de Mattos; Müller, Giana Paula; Souza, Paulo Ricardo Martins; Grill, Aline Barcellos; Rhoden, Deise Louise Bohn; Mello-da-Silva, Carlos Augusto; Vettorato, Gerson

    2016-01-01

    Acute generalized exanthematous pustulosis (AGEP) is an acute febrile rash, usually induced by drugs, which recently has been linked to spider bite. We report a case of a male patient, 48 years old, with an erythematous rash accompanied by fever and small non-follicular pustules. He reported previous pain in the buttock with the onset of a necrotic plaque. The lesion was compatible with spider bite of the genus Loxosceles. According to the EuroSCAR group instrument, the patient scored +10 indicating definite diagnosis of AGEP. As the patient had a compatible lesion and had no other triggers of AGEP, in an Loxosceles endemic area, the AGEP would be associated with spider bite, as described in other publications. PMID:27579754

  4. Labor analgesia for the parturient with lumbar tattoos: what does an obstetrician need to know?

    Science.gov (United States)

    Kuczkowski, Krzysztof M

    2006-08-01

    Tattoos-ancient forms of permanent body ornamentation (body art) have today become popular fashion accessories worldwide. More than 50% of all tattoos are being done on women. In the recent years body tattooing in unconventional sites (e.g. lumbar and/or sacral area, lower abdomen, breast, and buttocks) has gained increasing popularity among young women (including in pregnancy). Although, the potential hazards of regional anesthesia in patients with lumbar tattoos remain controversial it may seem prudent to avoid a hollow needle insertion (possible tissue entrapment in its bore as the needle passes to the deeper structures) through a tattoo for neuraxial blocks. This author is not aware of any other review articles in English literature discussing implications, and complications of labor analgesia in parturients presenting with lumbar tattoos.

  5. Anthropometric database for the learning environment of high school and university students.

    Science.gov (United States)

    Dawal, Siti Zawiah; Zadry, Hilma Raimona; Azmi, Sharifah Nadya Syed; Rohim, Siti Rusyida; Sartika, Sari Julia

    2012-01-01

    This paper presents an anthropometric database of high school and university students from Kuala Lumpur, Malaysia. Forty-one high school participants (21 males and 20 females), 13-17 years old, and 143 university students (74 males and 69 females) took part in the study. Twenty-one static body dimensions were measured. The greatest mean differences in the anthropometric data between male and female high school students were found in the sitting elbow height. In addition, a comparison of anthropometric data of male and female university students showed that data for males and females were significantly different, except for buttock-popliteal length, sitting elbow height and thigh clearance. The primary aim of this study was to develop an anthropometric database that could be used as a primary reference in designing products, devices and equipment for ergonomic learning environments.

  6. Distant skeletal muscle metastasis from intrahepatic cholangiocarcinoma presenting as Budd-Chiari syndrome

    Institute of Scientific and Technical Information of China (English)

    Oh Sung Kwon; Young Sook Park; Jong Eun Joo; Dae Won Jun; Sang Heum Kim; Mee Yeon Chung; Nam In Kim; Moon Hee Song; Han Hyo Lee; Seung Hwan Kim; Yoon Ju Jo

    2007-01-01

    Intrahepatic cholangiocarcinoma is a malignant neoplasm arising from the biliary epithelium, which frequently invades adjacent organs or metastasizes to other visceral organs such as the lungs, bones, adrenals, and brain. However, distant skeletal muscle metastasis of cholangiocarcinoma has never been described before to the best of our knowledge and, furthermore, Budd-Chiari syndrome secondary to intrahepatic cholangiocarcinoma is also extremely rare. Here we present the first case overall of distant muscle metastasis from intrahepatic cholangiocarcinoma presenting as Budd-Chiari syndrome. A 44-year-old man admitted to the hospital with complaints of abdominal distension, edema of both legs, back pain and anorexia of 30 o" duration. Computed tomography and ultrasonography-guided percutaneous muscle biopsy established intrahepatic cholangiocarcinoma with disseminated thrombosis from inferior vena cava to bilateral iliac and femoral veins, and multiple skeletal muscle metastases in bilateral buttock and erector spinal muscle.

  7. Pr\\'{e}sentation d'une m\\'{e}thodologie d'\\'{e}valuation de la faisabilit\\'{e} de la substitution sensorielle par \\'{e}lectrostimulation linguale pour la pr\\'{e}vention des escarres chez le bl\\'{e}ss\\'{e} m\\'{e}dullaire parapl\\'{e}gique

    CERN Document Server

    Moreau-Gaudry, A; Chenu, O; Demongeot, J; Payan, Y; Moreau-Gaudry, Alexandre; Prince, Anne; Chenu, Olivier; Demongeot, Jacques; Payan, Yohan

    2006-01-01

    Pressure ulcers are recognized as a major health issue in individuals with spinal cord injuries and new approaches to prevent this pathology are necessary. An innovative health strategy is being developed through the use of computer and sensory substitution via the tongue in order to compensate for the sensory loss in the buttock area for individuals with paraplegia. This sensory compensation will enable individuals with spinal cord injuries to be aware of a localized excess of pressure at the skin/seat interface and, consequently, will enable them to prevent the formation of pressure ulcers by relieving the cutaneous area of suffering. This work reports an initial evaluation of this approach and the feasibility of creating an adapted behavior, with a change in pressure as a response to electro-stimulated information on the tongue.

  8. Two cases of burns caused by misuse of coagulation unit and monitoring.

    Science.gov (United States)

    Rolly, G

    1978-01-01

    Two cases of severe burns with monitoring apparatus are described. In a female patient of 45 years, a severe third degree burn occurred by misuse of coagulation apparatus (inversion of the poles of an older Bovie apparatus), in the presence of a non-floating ECG monitoring device. A high intensity current was established from the coagulation unit, via the earth plate under the buttocks, to the indifferent electrode placed on the chest, where burns occurred. In an 8 month female baby, having laparotomy for a neuroblastoma, a third degree burn of 5 cm diameter occurred with a non-floating ECG monitor. A twin-wired disposable earth plate was placed just beneath the indifferent ECG electrode on the leg. A burning current was established between the Bovie coagulation unit and the monitor.

  9. Postpartum Sacral Stress Fracture: An Atypical Case Report

    Directory of Open Access Journals (Sweden)

    Andrea Speziali

    2015-01-01

    Full Text Available Sacral stress fractures are common in elderly people. However, sacral stress fracture should be always screened in the differential diagnoses of low back pain during the postpartum period. We present a case of sacral fracture in a thirty-six-year-old woman with low back pain and severe right buttock pain two days after cesarean section delivery of a 3.9 Kg baby. The diagnosis was confirmed by MRI and CT scan, while X-ray was unable to detect the fracture. Contribution of mechanical factors during the cesarean section is not a reasonable cause of sacral fracture. Pregnancy and lactation could be risk factors for sacral stress fracture even in atraumatic delivery such as cesarean section. Our patient had no risk factors for osteoporosis except for pregnancy and lactation. Transient or focal osteoporosis is challenging to assess and it cannot be ruled out even if serum test and mineral density are within the normal range.

  10. Free anterolateral thigh perforator flap for sacroiliac defect: First case report in pediatric population

    Directory of Open Access Journals (Sweden)

    Alejandro E. Ramirez

    2016-08-01

    Full Text Available Soft tissue defects of the sacroiliac area, usually can be covered by local flaps. However, for more complex defects, free flap transfers became necessary. We report a case of reconstruction with a free anterolateral thigh (ALT perforator flap for coverage of a sacroiliac bone exposure in a child. A six-years-old boy, suffered a car accident, resulting in pelvic and sacral fractures, as well as degloving injuries of the left thigh, buttocks, and trunk. The patient evolved with an unstable scar over the sacroiliac region with bone exposure. ALT free flap was performed. Left superior gluteal vessels were used as the recipient vessels. A stable coverage was achieved without complications. This is the first case reported of a free ALT perforator flap for sacroiliac coverage in the pediatric population. In cases of complex reconstruction in children, free perforator flap is a safe choice and should be considered in the algorithm of treatment.

  11. RECOVERY OF LOWER DISCOPATHIES

    Directory of Open Access Journals (Sweden)

    Florina Paraschita

    2015-10-01

    Full Text Available Discopathy lumbar (DVL is characterized by localized back pain in the lumbar region and radiating to the buttocks and along the leg, under certain nerve pathways. The purpose of this study was to find the best treatment for improving pronounced as back pain in lumbar-sacral and cervical region. In the study took part two women aged 42 to 55 years, with disease acquired due to requesting or incorrect posture, one being a former athlete, the other being an accountant and sitting a lot on the chair because the profession. Patients with lower discopathies can improve spinal mobility and may relieve back pain through chiropractic methods, massage and electrotherapy. It is necessary to apply as early as possible a comprehensive program of recovery (Exercise WILLIAMS, showing continuity in time and aim to reduce or eliminate pain patient.

  12. Weight of Americans%美国人的体重问题

    Institute of Scientific and Technical Information of China (English)

    晓阳

    2004-01-01

    @@ Even as Americans have been gaining weight, they have cut their average fat intake from 36 to 34 percent of their total diets in the past 15 years. And indeed, cutting fat to control or lose weight makes sense. Fat has nine calories per gram.Protein and carbohydrates(碳水化合物) have just four.Moreover, the body uses fewer calories to metabolize fat than it does to metabolize other foods. Compared with protein and carbohydrates-which break down into amino acids and simple sugars, respectively, and can be used to strengthen and energize the body - dietary fat is more easily converted to body fat. Therefore, it's more likely to stay on buttocks,thighs and bellies.

  13. Immediate breast reconstruction using the free lumbar artery perforator flap and lateral thoracic vein interposition graft for recipient lateral thoracic artery anastomosis

    Directory of Open Access Journals (Sweden)

    Toshihiko Satake

    2016-01-01

    Full Text Available The lumbar artery perforator (LAP flap, which contains excess skin and fat tissue, love handles, that extends from the lower back to upper buttock, may provide an alternate tissue source for autologous breast reconstruction. However, LAP flap use during this procedure frequently requires vessel interposition grafts to correct the short flap pedicle length and mismatched recipient vessel calibre. A 46-year-old patient underwent a right nipple-sparing mastectomy using a lateral approach for ductal carcinoma in situ and immediate LAP flap breast reconstruction. The lateral thoracic vessel served as the recipient vessel, and a lateral thoracic vein interposition graft from the distal remnant was performed to adjust the arterial length and size discrepancy between the recipient lateral thoracic artery and pedicle artery. This procedure facilitates microsurgical anastomosis and medialisation of LAP flap to make a natural decollete line and create a cleavage for the reconstructed breast.

  14. A wireless lingual feedback device to reduce overpressures in seated posture: a feasibility study

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    Chenu, Olivier; Demongeot, Jacques; Payan, Yohan; 10.1371/journal.pone.0007550

    2009-01-01

    BACKGROUND: Pressure sores are localized injuries to the skin and underlying tissues and are mainly resulting from overpressure. Paraplegic peoples are particularly subjects to pressure sores because of long-time seated postures and sensory deprivation at the lower limbs. METHODOLOGY/PRINCIPAL FINDINGS: Here we report outcomes of a feasibility trial involving a biofeedback system aimed at reducing buttock overpressure whilst an individual is seated. The system consists of (1) pressure sensors, (2) a laptop coupling sensors and actuator (3) a wireless Tongue Display Unit (TDU) consisting of a circuit embedded in a dental retainer with electrodes put in contact with the tongue. The principle consists in (1) detecting overpressures in people who are seated over long periods of time, (2) estimating a postural change that could reduce these overpressures and (3) communicating this change through directional information transmitted by the TDU. Twenty-four healthy subjects voluntarily participated in this study. CON...

  15. Randomized Comparison of the Therapeutic Effect of Acupuncture, Massage, and Tachibana-Style-Method on Stiff Shoulders by Measuring Muscle Firmness, VAS, Pulse, and Blood Pressure

    Directory of Open Access Journals (Sweden)

    Kazuhiro Tachibana

    2012-01-01

    Full Text Available To compare the therapeutic efficacy of acupuncture, massage, and Tachibana-Ryojutsu (one of Japanese traditional body balance therapy techniques (SEITAI, on stiff shoulders, the subjects’ muscle firmness, blood pressure, pulse, VAS, and body temperature were measured before and after the treatment. Forty-seven volunteer subjects gave written informed consent to participate in this study. The subjects were randomly divided into three groups to receive acupuncture, massage, or Tachibana-Ryojutsu. Each therapy lasted for 90 seconds. The acupuncture treatment was applied by a retaining-needle at GB-21, massage was conducted softly on the shoulders, and Tachibana-Ryojutsu treated only the muscles and joints from the legs to buttocks without touching the shoulders or backs. The study indicated that the muscle firmness and VAS of the Tachibana-Ryojutsu group decreased significantly in comparison with the acupuncture and massage groups after treatment.

  16. Multiple hereditary exostoses and ischiofemoral impingement: a case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Yoong, Philip; Mansour, Ramy; Teh, James L. [Nuffield Orthopaedic Centre, Department of Radiology, Oxford (United Kingdom)

    2014-09-15

    To assess whether there is a significant difference in the ischiofemoral space in patients with multiple hereditary exostoses affecting the proximal femora compared to normal patients. Ischiofemoral impingement is an increasingly recognized cause of hip and buttock pain. This causes narrowing of the ischiofemoral space resulting in an abnormal quadratus femoris muscle. We performed a retrospective search for individuals with MHE with proximal femoral involvement on pelvic MRI over a 7-year period (2006-2013). Suitable patients were age- and sex-matched with a control group. The minimum ischiofemoral space (MIFS) was recorded in each hip, as was the presence of edema and atrophy of quadratus femoris and concomitant hip osteoarthrosis. MRI features suggestive of ischiofemoral impingement were defined as MIFS less than 10 mm or an abnormal quadratus femoris muscle. Twenty-one hips in 11 individuals with MHE were included in the study. A total of 42 hips were analyzed. The mean age was 37 years (range, 13-72 years) and 55 % were male. There was a significant difference (p < 0.05) in the MIHS in individuals with MHE (mean, 10.7 mm, range, 0-21 mm) compared to a control group (mean, 18.1 mm, range, 10.5-26.5 mm). MRI features suggestive of ischiofemoral impingement were seen in 13/21 (62 %) hips in the MHE group and 0/21 (0 %) in the control group. The reduced ischiofemoral space and associated quadratus femoris abnormalities in patients with MHE involving the proximal femora may account for hip/buttock symptoms in the absence of significant degenerative change. (orig.)

  17. Correlation between lumbar lordosis angle and degree of gynoid lipodystrophy (cellulite in asymptomatic women

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    Giovana Barbosa Milani

    2008-01-01

    Full Text Available INTRODUCTION: Gynoid lipodystrophy (cellulite has been cited as a common dermatological alteration. It occurs mainly in adult women and tends to gather around the thighs and buttocks. Its presence and severity have been related to many factors, including biotype, age, sex, circulatory changes, and, as some authors have suggested, mechanical alterations such as lumbar hyperlordosis. OBJECTIVE: To correlate the degree of cellulite with the angle of lumbar lordosis in asymptomatic women. METHODS: Fifty volunteers were evaluated by digital photos, palpation, and thermograph. The degree of cellulite was classified on a scale of 1-4. Analyses were performed on the superior, inferior, right and left buttocks (SRB, IRB, SLB, ILB, and the superior right and left thighs (SRT, SLT. The volunteers underwent a lateral-view X-ray, and the angle of lumbar lordosis was measured using Cobb's method (inferior endplate of T12 and the superior endplate of S. The data were statistically analyzed using ANOVA and Spearman's correlation. A significance level of 5% was adopted. RESULTS: Volunteers had a mean age of 26.1 ± 4.4 years and a mean body mass index of 20.7 ± 1.9 kg/m². There was no significant difference in lumbar lordosis angle between those with cellulite classes 2 and 3 (p > 0.297. There was also no correlation between lumbar lordosis angle and the degree of cellulite (p > 0.085 and r > 0.246. CONCLUSIONS: The analysis suggests that there is no correlation between the degree of cellulite and the angle of lumbar lordosis as measured using Cobb's method.

  18. Comfortable Driver’s Car Seat Dimensions Based on Malaysian Anthropometrics Data

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    Darliana MOHAMAD

    2016-03-01

    Full Text Available Background: Driving posture discomfort can contribute to musculoskeletal disorders (MSDs, injuries, lumbar pain and fatigue. The three main objectives of this study were to identify the level of awareness for correct and safe driving posture, health implication to their body parts and to propose a suitable car seat fit dimensions appropriate for Malaysian drivers’ population.Methods: The two methodologies used for the study conducted in 2014 were direct manual measurement of 62 anthropometric data involving 1312 subjects and using a survey questionnaire involving 136 subjects to perform subjective evaluation on driving posture discomfort based on 5 points Likert scale.Results: Results showed 77% of the subjects that took part in the survey agreed that driving posture may influence their discomfort during driving. In short the car drivers were aware on the importance of correct and safe driving posture. However, they are still lacking in terms of knowledge and exposure to practice the correct posture. In addition, survey respondents believed the body parts that experienced discomfort are the neck (50%, followed by the upper back (47.06%, lower back (45.59%, left buttock (39.71%, right buttock (38.97%, right shoulder (33.82% and then the right foot ankle (23.53%.Conclusion: Drivers’ awareness level and attitude toward correct and safe driving posture correlates positively to their physical health and comfort. Based on the Malaysian anthropometric data, this study has proposed a set of comfortable dimensions for driver’s seat: backrest width (480 mm and height (646 mm; cushion width (503 mm and length (381 mm. Keywords: Comfortable, Driving posture, Anthropometry, Car seat, Dimensions

  19. Tank tests of a family of flying-boat hulls

    Science.gov (United States)

    Shoemaker, James M; Parkinson, John B

    1934-01-01

    This report presents towing tests made in the N.A.C.A. tank of a parent form and five variations of a flying-boat hull. The beams of two of the derived forms were made the same as that of the parent and the lengths changed by increasing and decreasing the spacing of stations. The lengths of the two others of the derived forms were made the same as that of the parent while the beams were changed by increasing and decreasing the spacing of buttocks, all other widths being changed in proportion. The remaining derived form has the same length and beam as the parent, but the lines of the forebody were altered to give a planing bottom with no longitudinal curvature forward of the step. The test data were analyzed to determine the minimum resistance and the angle at which it occurs for all speeds and loads. The results of this analysis are given in the form of non dimensional curves for each model. The effect of variation in over-all size, as indicated by a "complete" test on any given hull, is pointed out. The effect of changing length alone by the spacing of buttocks, as well as the effects of the changes in length-beam ratio and longitudinal curvature that result from these operations are discussed. The difficulties encountered in interpreting test results of systematic families derived by the method used are emphasized. Further studies are suggested in which changes in the variable under consideration would not be obscured by secondary changes in other important variables.

  20. Sciatica caused by pyomyositis of the piriformis muscle in a pediatric patient.

    Science.gov (United States)

    Toda, Taihei; Koda, Masao; Rokkaku, Tomoyuki; Watanabe, Hitoshi; Nakajima, Arata; Yamada, Toshiyuki; Murakami, Ken-ichi; Nakajima, Hideyuki; Murakami, Masazumi

    2013-02-01

    Because the sciatic nerve leaves the pelvis through the greater sciatic notch underneath the piriformis muscle, any pathology of the piriformis muscle could result in entrapment of the sciatic nerve; this is widely known as piriformis muscle syndrome. Pyomyositis of the piriformis muscle may be a cause of piriformis muscle syndrome. Piriformis muscle syndrome caused by pyomyositis of the piriformis muscle in pediatric patients is rare. This article describes a case of sciatica caused by pyomyositis of the piriformis muscle in a pediatric patient. A 6-year-old boy presented with right buttock and thigh pain following a mild fever and sore throat. The pain worsened, and he became unable to walk. On admission, his temperature was 38.4°C. He reported severe right-sided buttock and lateral thigh pain. Positive Freiberg sign was observed. Laboratory examination revealed elevated white blood cell count and C-reactive protein level. T2-weighted magnetic resonance images of the pelvis revealed high-intensity changes of the piriformis muscle and iliosacral joint. Thus, piriformis syndrome caused by pyomyositis of the piriformis muscle was diagnosed. Oral antibiotics (10 mg/kg per day of cefdinir) were administered. Pain gradually decreased, and the patient was able to walk. Final follow-up examination at 6 months after symptom onset revealed no sciatic pain. Follow-up magnetic resonance imaging revealed normalized intensities of the piriformis muscle. The endopelvic fascia provides a route for infection from the pelvis to the piriformis. The pyomyositis of the piriformis muscle in the current case may have occurred secondary to the pyoarthritis of the sacroiliac joint. Endopelvic infections involving the piriformis muscle may mimic hip diseases in pediatric patients.

  1. Greater trochanteric pain syndrome due to tumoral calcinosis in a patient with chronic kidney disease.

    Science.gov (United States)

    Baek, Dongjin; Lee, Sang Eun; Kim, Woo-Jin; Jeon, Sanghoon; Lee, Kihwa; Jung, Jaewook; Joo, Hyunchul; Park, Jaehong; Kim, Yonghan; Choi, Young-gyun

    2014-01-01

    Tumoral calcinosis is a rare syndrome characterized by massive subcutaneous soft tissue deposits of calcium phosphate near the large joints. It is more prevalent in patients with chronic kidney disease undergoing dialysis. A 57-year-old woman was referred to our pain clinic with the complaint of severe pain in the left buttock and lateral hip. The patient had been suffering from chronic kidney disease for 10 years and had been undergoing peritoneal dialysis over the past 5 years. The patient's symptom was initially suspected to be of lumbar origin at the L5 level and a left L5 transforaminal epidural block was performed, but without success. Re-evaluation of the physical examination revealed severe tenderness over the left greater trochanter and piriformis muscle. On ultrasonographic evaluation, multiple mass-like lesions in the left buttock were observed. About 30 mL of fluid was aspirated from the cystic lesions, followed by 30 mL mixture of 0.08% levobupivacaine and triamcinolone 40 mg injected into the bursa under ultrasound guidance, which brought pain relief. Trochanteric bursitis was thought of as the cause of the symptoms. The patient was diagnosed with tumoral calcinosis based on the past medical history, simple plain radiographs, and hip magnetic resonance imaging (MRI). We diagnosed a case of greater trochanteric pain syndrome due to tumoral calcinosis related to chronic kidney disease in a patient whose symptoms had initially been considered to be radiating leg pain caused by lumbar spinal disease. We report our experience of symptomatic improvement following the repeated ultrasound-guided aspiration of calcific fluid and the injection of a mixture of local anesthetic and steroid.

  2. Chemotherapy-induced enterocutaneous fistula after perineal hernia repair using a biological mesh: a case report

    Directory of Open Access Journals (Sweden)

    Eriksen MH

    2014-01-01

    Full Text Available MH Eriksen, O Bulut Department of Surgical Gastroenterology, Hvidovre University Hospital, University of Copenhagen, Copenhagen, Denmark Abstract: This is the first reported case of an enterocutaneous fistula as a late complication to reconstruction of the pelvic floor with a Permacol™ mesh after a perineal hernia. A 70-year-old man had a reconstruction of the pelvic floor with a biological mesh because of a perineal hernia after laparoscopic abdominoperineal resection. Nine months after the perineal hernia operation, the patient had multiple metastases in both lungs and liver. The patient underwent chemotherapy, including bevacizumab, irinotecan, calcium folinate, and fluorouracil. Six weeks into chemotherapy, the patient developed signs of sepsis and complained of pain from the right buttock. Ultrasound examination revealed an abscess, which was drained, guided by ultrasound. A computed tomography scan showed a subcutaneous abscess cavity located in the right buttock with communication to the small bowel. Operative findings confirmed a perineal fistula from the distal ileum to perineum. A resection of the small bowel with primary anastomosis was performed. The postoperative course was complicated by fluid and electrolyte disturbances, but the patient was stabilized and finally discharged to a hospice for terminal care after 28 days of hospital stay. It seems that hernia repairs with biological meshes have lower erosion and infection rates compared with synthetic meshes, and so far, evidence suggests that biological grafts are safe and effective in the treatment of pelvic floor reconstruction. There have been no reports of enteric fistulas after pelvic reconstruction with biological meshes. However, the development of intestinal fistulas after chemotherapy with bevacizumab has been described in the literature. Our case report supports this association between bevacizumab and fistula formation among rectal cancer patients, as symptoms of a

  3. Vertical Vibration Transmission Through the Lumbar Spine of the Seated SUBJECT—FIRST Results

    Science.gov (United States)

    El-Khatib, A.; Guillon, F.; Dômont, A.

    1998-08-01

    Seven fresh, not embalmed, cadavers (58·1±6·6 years, 73±10·3 kg, 170·7±6·5 cm) were submitted, in the week following their death (7·1±3·1 days), to a whole-body vertical broad-band white random vibration in the bandwidth 0·8 to 25 Hz of about 1·5 m/s2r.m.s. Two postures were tested using the same rigid seat, each one with and without a lumbar support: seated erect and seated as in a car. Vibration was monitored on the floor, the seating in the vertical direction (buttocks-to-head), the five lumbar vertebrae and the sternum: vertical (buttocks to head) and longitudinal (back to chest). Biaxial accelerometers were mounted rigidly on the anterior face of the vertebral body, after the removal of the abdominal viscera. Analogue recordings of each channel were passed through an antialising filter (Fc=40 Hz) then sampled at 80 Hz (4096 samples/channel). The inclination of each accelerometer (α) was measured on the lateral X-ray taken for every trial, then the data were set in order to be in the same reference (Z=z/cos α,X=xcos α). Spectral analysis was performed with a frequency resolution of 0·3 Hz, on the basis of Welch's method. Thirty one overlapping sections (256 samples per section using a Hanning window with an overlap rate of 128 samples) of the estimated periodograms were averaged. Transfer and coherence functions were than estimated between the vertical seating acceleration and the measured accelerations at the upper levels. The first results showed that the vertical vibration transmission was constant throughout the lumbar spine. Inter-subject variability was the major source of disparity. Resonance phenomena were observed between 4 and 9 Hz and depended on posture.

  4. Pelvic morphology in ischiofemoral impingement

    Energy Technology Data Exchange (ETDEWEB)

    Bredella, Miriam A.; Azevedo, Debora C.; Oliveira, Adriana L.; Simeone, Frank J.; Chang, Connie Y.; Torriani, Martin [Massachusetts General Hospital, Department of Radiology, Musculoskeletal Imaging and Intervention, Boston, MA (United States); Stubbs, Allston J. [Wake Forest University School of Medicine, Department of Orthopedic Surgery, Division of Sports Medicine, Winston-Salem, NC (United States)

    2014-11-06

    To assess MRI measures to quantify pelvic morphology that may predispose to ischiofemoral impingement (IFI). We hypothesized that patients with IFI have a wider interischial distance and an increased femoral neck angle compared with normal controls. The study was IRB-approved and complied with HIPAA guidelines. IFI was diagnosed based on clinical findings (hip or buttock pain) and ipsilateral edema of the quadratus femoris muscle on MRI. Control subjects did not report isolated hip/buttock pain and underwent MRI for surveillance of neoplasms or to exclude pelvic fractures. Two MSK radiologists measured the ischiofemoral (IF) and quadratus femoris (QF) distance, the ischial angle as a measure of inter-ischial distance, and the femoral neck angle. The quadratus femoris muscle was evaluated for edema. Groups were compared using ANOVA. Multivariate standard least-squares regression modeling was used to control for age and gender. The study group comprised 84 patients with IFI (53 ± 16 years, 73 female, 11 male) and 51 controls (52 ± 16 years, 33 female, 18 male). Thirteen out of 84 patients (15 %) had bilateral IFI. Patients with IFI had decreased IF and QF distance (p < 0.0001), increased ischial angle (p = 0.004), and increased femoral neck angle (p = 0.02) compared with controls, independent of age and gender. Patients with IFI have increased ischial and femoral neck angles compared with controls. These anatomical variations in pelvic morphology may predispose to IFI. MRI is a useful method of not only assessing the osseous and soft-tissue abnormalities associated with IFI, but also of quantifying anatomical variations in pelvic morphology that can predispose to IFI. (orig.)

  5. Endovascular treatment of aortoiliac aneurysms: From intentional occlusion of the internal iliac artery to branch iliac stent graft

    Institute of Scientific and Technical Information of China (English)

    Stevo Duvnjak

    2016-01-01

    Approximately 20%-40% of patients with abdominal aortic aneurysms can have unilateral or bilateral iliac artery aneurysms and/or ectasia. This influences and compromises the distal sealing zone during endovascular aneurysm repair. There are a few endovascular techniques that are used to treat these types of aneurysms, including intentional occlusion/over-stenting of the internal iliac artery on one or both sides, the "bell-bottom" technique, and the more recent method of using an iliac branch stent graft. In some cases, other options include the "snorkel and sandwich" technique and hybrid interventions. Pelvic ischemia, represented as buttock claudication, has been reported in 16%-55% of cases; this is followed by impotence, which has been described in 10%-17% of cases following internal iliac artery occlusion. The bellbottom technique can be used for a common iliac artery up to 24 mm in diameter given that the largest diameter of the stent graft is 28 mm. There is a paucity of data and evidence regarding the "snorkel and sandwich" technique, which can be used in a few clinical scenarios. The hybrid intervention is comprised of a surgical operation, and is not purely endovascular. The newest branch stent graft technology enables preservation of the anterograde flow of important side branches. Technical success with the newest technique ranges from 85%-96.3%, and in some small series, technical success is 100%. Buttock claudication was reported in up to 4% of patients treated with a branch stent graft at 5-year follow-up. Mid- and short-term follow-up results showed branch patency of up to 88% during the 5-6-year period. Furthermore, branch graft occlusion is a potential complication, and it has been described to occur in 1.2%-11% of cases. Iliac branch stent graft placement represents a further development in endovascular medicine, and it has a high technical success rate without serious complications.

  6. Applying Manual Pressure before Benzathine Penicillin Injection for Rheumatic Fever Prophylaxis Reduces Pain in Children.

    Science.gov (United States)

    Derya, Emre-Yavuz; Ukke, Karabacak; Taner, Yavuz; Izzet, Ayhan Yusuf

    2015-06-01

    The purpose of this study was to evaluate the efficacy of applying manual pressure before benzathine penicillin injection and compare it with the standard injection technique in terms of reducing discomfort in children with rheumatic heart disease grouped by age and gender. This was a single-blind, randomized, crossover study. Fifty-one patients aged 7.1-19.9 years were recruited for this study carried out in the pediatric cardiology outpatient clinic. Twenty-nine were girls (56.9%). All subjects received an intramuscular injection of benzathine penicillin with manual pressure to one buttock or with the standard technique to the other buttock at 3-week intervals. The two techniques were used randomly. The subjects were blinded to the injection technique and a visual analogue scale was used after the procedure. Findings demonstrate that children experienced significantly less pain when they received injections with manual pressure (1.3 ± 0.9) compared with the standard injection (4.4 ± 1.6) technique. The perceived injection pain was negatively related to the age of the children in both techniques. Compared with boys, girls felt more pain, but the difference between each technique group according to gender was negligible. The application of manual pressure reduces pain in children under the stress of repeated intramuscular injections, which supports the suggestion that it should be used in routine practice. Manual pressure to the injection site is a simple, pain-reducing technique. Implementing this technique in routine practice may also promote adherence to the prophylaxis regimen, especially in children.

  7. 假体隆臀术:21例临床报告%Gluteal augmentation with silicone gel implant: clinical report on 21 cases

    Institute of Scientific and Technical Information of China (English)

    田方文; 陈光平; 徐荣阳; 邓正军; 徐斌; 赵正杰; 段家海; 张少军

    2013-01-01

    目的 探讨应用毛面圆形乳房假体隆臀的可行性及临床效果.方法 自2008年4月至2011年7月,对21例求美者采用Mentor圆形毛面硅凝胶假体行假体隆臀,于臀间沟处做手术切口,切开皮肤、皮下组织,将臀大肌起点处切开,分离出臀大肌下间隙并置入假体.结果 术后随访6~17个月,本组21例求美者伤口均Ⅰ期愈合,臀部外观挺拔,效果满意.无血肿、感染、臀部疼痛感、假体破裂等并发症发生.结论 应用毛面圆形乳房假体行隆臀术,术式安全、有效,效果满意.%Objective To explore the feasibility and clinical outcome of the application of gluteal augmentation with silicone gel prothesis. Methods In this study, totally 21 patients received gluteal augmentation surgeries with Mentor obscured circular prosthesis implant from April 2008 to September 2011. A hidden incision along coccyx groove was designed for the operation. From the incision, gluteus maximus was released from its origin for preparing the muscle plane for prosthesis implant.Results After 6 to 17 months follow-up, all 21 cases healed primarily with attractive buttock outcome. Satisfactory results were received without hematoma, infection, pain or prosthesis rupture occurred. Conclusion It is a safe and effective approach of gluteal augmentation with silicone gel prosthesis implant for buttock reshaping.

  8. Stress analyses coupled with damage laws to determine biomechanical risk factors for deep tissue injury during sitting.

    Science.gov (United States)

    Linder-Ganz, Eran; Gefen, Amit

    2009-01-01

    Deep tissue injury (DTI) is a potentially life-threatening form of pressure ulcer that onsets in muscle tissue overlying bony prominences and progresses unnoticeably to more superficial tissues. To minimize DTI, the efficacy of wheelchair cushions should be evaluated not only based on their performance in redistributing interface pressures but also according to their effects on stress concentrations in deep tissues, particularly muscles. However, a standard bioengineering approach for such analyses is missing in literature. The goals of this study were to develop an algorithm to couple finite element (FE) modeling of the buttocks with an injury threshold for skeletal muscle and with a damage-stiffening law for injured muscle tissue, from previous animal experiments, to predict DTI onset and progression for different patient anatomies and wheelchair cushions. The algorithm was also employed for identifying intrinsic (anatomical) biomechanical risk factors for DTI onset. A set of three-dimensional FE models of seated human buttocks was developed, representing different severities of pathoanatomical changes observed in chronically sitting patients: muscle atrophy and "flattening" of the ischial tuberosity (IT). These models were then tested with cushions of different stiffnesses representing products available on the market and semirigid supports. Outcome measures were the percentage of damaged muscle tissue volumes after 90 min and 110 min of simulated continuous immobilized sitting as well as muscle injury rates post-60 min, -90 min, and -110 min of continuous sitting. Damaged muscle volumes grew exponentially with the level of muscle atrophy. For example, simulation of a subject with 70% muscle atrophy sitting on a soft cushion showed damage to 33% of the muscle volume after 90 min of immobilized sitting, whereas a comparable simulation with a nonatrophied muscle yielded only 0.4% damaged tissue volume. The rates of DTI progression also increased substantially with

  9. Phakomatosis Pigmentovascularis Associated With Sturge–Weber Syndrome, Ota Nevus, and Congenital Glaucoma

    Science.gov (United States)

    Yang, Yangfan; Guo, Xiujuan; Xu, Jiangang; Ye, Yiming; Liu, Xiaoan; Yu, Minbin

    2015-01-01

    Abstract Phakomatosis pigmentovascularis (PPV) is a rare congenital malformation syndrome that is characterized by a combination of capillary abnormalities and dermal melanocytosis. We describe 3 cases of PPV combined with bilateral Sturge–Weber syndrome (SWS), Ota nevus, and congenital glaucoma. Case 1 was a 2-year-old boy. Facial port-wine stains distributed along the 3 branches of his trigeminal nerves, which suggested the existence of SWS. Gray-blue patches were spread over the frontal and temporal areas of bilateral face, waist, buttocks, and thigh. Bilateral triangular alopecia was found on the temporal scalp. The diagnosis of Ota nevus was made by the bilateral scleral malanocystosis. Increased intraocular pressure, enlarged cornea, and pathologic optic disc cupping supported the diagnoses of infantile bilateral glaucoma. Case 2 was a 4-year-old boy. Port-wine stains were found on the face along the 3 branches of the trigeminal nerve and distributed along the trunk, arms, and legs. Mongolian spots spread over his frontal and temporal areas of the bilateral face, waist, buttocks, thigh, abdomen, and back. Infantile glaucoma was found in both eyes. Ota nevus were found in the both eyes. Optic coherent tomography (OCT) scans revealed increased thickness of choroid. Case 3 was a 5-year-old boy. Besides Ota nevus and infantile glaucoma in both eyes, color Doppler ultrasonography showed choroidal hemagioma. OCT scan showed increased choroidal thickness. The bilateral triangular alopecia on the child's temporal scalp was similar to that of Case 1. Cases 1 and 2 presented with port-wine stain patches that were consistent with the characteristic manifestation of PPV type IIb. However, the CMTC of Case 3 met the diagnostic criteria for PPV type Vb. Case 1 was treated with trabeculotomies in both eyes. For Cases 2 and 3, surgical interventions were not considered due to the high risks of antiglaucomatous operation complications. We prescribed them antiglaucoma

  10. Phakomatosis Pigmentovascularis Associated With Sturge-Weber Syndrome, Ota Nevus, and Congenital Glaucoma.

    Science.gov (United States)

    Yang, Yangfan; Guo, Xiujuan; Xu, Jiangang; Ye, Yiming; Liu, Xiaoan; Yu, Minbin

    2015-07-01

    Phakomatosis pigmentovascularis (PPV) is a rare congenital malformation syndrome that is characterized by a combination of capillary abnormalities and dermal melanocytosis.We describe 3 cases of PPV combined with bilateral Sturge-Weber syndrome (SWS), Ota nevus, and congenital glaucoma.Case 1 was a 2-year-old boy. Facial port-wine stains distributed along the 3 branches of his trigeminal nerves, which suggested the existence of SWS. Gray-blue patches were spread over the frontal and temporal areas of bilateral face, waist, buttocks, and thigh. Bilateral triangular alopecia was found on the temporal scalp. The diagnosis of Ota nevus was made by the bilateral scleral malanocystosis. Increased intraocular pressure, enlarged cornea, and pathologic optic disc cupping supported the diagnoses of infantile bilateral glaucoma. Case 2 was a 4-year-old boy. Port-wine stains were found on the face along the 3 branches of the trigeminal nerve and distributed along the trunk, arms, and legs. Mongolian spots spread over his frontal and temporal areas of the bilateral face, waist, buttocks, thigh, abdomen, and back. Infantile glaucoma was found in both eyes. Ota nevus were found in the both eyes. Optic coherent tomography (OCT) scans revealed increased thickness of choroid. Case 3 was a 5-year-old boy. Besides Ota nevus and infantile glaucoma in both eyes, color Doppler ultrasonography showed choroidal hemagioma. OCT scan showed increased choroidal thickness. The bilateral triangular alopecia on the child's temporal scalp was similar to that of Case 1. Cases 1 and 2 presented with port-wine stain patches that were consistent with the characteristic manifestation of PPV type IIb. However, the CMTC of Case 3 met the diagnostic criteria for PPV type Vb.Case 1 was treated with trabeculotomies in both eyes. For Cases 2 and 3, surgical interventions were not considered due to the high risks of antiglaucomatous operation complications. We prescribed them antiglaucoma indications

  11. O babaçu (Orbignya phalerata martins como provável fator de risco de infecção humana pelo agente da cromoblastomicose no Estado do Maranhão, Brasil

    Directory of Open Access Journals (Sweden)

    Conceição de Maria P. e Silva

    1995-03-01

    Full Text Available Após estudo de 30pacientes portadores de cromoblastomicose, acompanhados no hospital dos servidores do Estado do Maranhão, verificou-se em 2 (6,6% lesões ná região glútea, diferindo do que geralmente se observa, pois na cromoblastomicose existe sempre história de microtraumatismo sofridos durante o trabalho na lavoura, propiciando o desenvolvimento mais freqüente das lesões nas extremidades, principalmente dos membros inferiores. Ambos pacientes, doentes há 10 anos, apresentavam lesões nodulares e verrugo-confluentes em placas coalescentes na região glútea direita. O diagnóstico etiológico foi firmado através de exame histopatológico e cultura, com isolamento de Fonsecaea pedrosoi. Na investigação epidemiológica do tipo de exposição verificou-se que os mesmos desempenhavam a profissão de quebradores de coco-babaçu, atividade relativamente comum no Estado. Parece evidente a relação entre o tipo de atividade profissional e o desenvolvimento da infecção.During a survey of 30 patients with chromoblastomycosis followed at the Hospital dos Servidores do Estado do Maranhão, the authors observed in 2 (6.6%patients with lesions on the buttock. This is an uncommon site for the initial lesions of chromoblastomycosis. There is often a history of microtraumatism during the farming job hence the more frequent development of lesions in the lower limbs. Both patients had 10 years disease, with the presence of nodules and vegetant warty lesions in coalescentplaques on the right buttock. Etiologic diagnosis made through histopatologic and culture exams, with Fonsecaea pedrosoi isolated, the epidemiological exposure of the patients, was suggested by the fact that both worked as babaçu coconut cutters a common activity in Maranhão State. The relation betweenthis kind of professional activity and the development of infection merits for the investigation.

  12. Treatment of relapse in herpes simplex on labial and facial areas and of primary herpes simplex on genital areas and "area pudenda" with low-power He-Ne laser or Acyclovir administered orally

    Science.gov (United States)

    Velez-Gonzalez, Mariano; Urrea-Arbelaez, Alejandro; Nicolas, M.; Serra-Baldrich, E.; Perez, J. L.; Pavesi, M.; Camarasa, J. M.; Trelles, Mario A.

    1996-01-01

    Sixty patients (greater than 16 yrs old) suffering primary or relapse genital herpes simplex viruses (HSV) and relapse labial HSV were appointed for this study. Three or more relapses were experienced per year. Patients (under treatment) were divided into two groups (distribution areas), corresponding to either labial herpes or genital herpes. These groups were sub-divided into 3 groups. The total number of labial or facial HSV patients was 36 (10 in group 1, 12 in group 2, 14 in group 3) and 24 for genital, buttocks, or 'area pudenda' HSV patients (6 in group 1, 8 in group 2, 10 in group 3). The design was a randomized, double- blind study. The setting was hospital and outpatient. The patients diagnosed as having the HVS disease were sent to the dermatology department and were assigned to a group at random. Treatment was begun as follows: During the treatment signs and symptoms were assessed and after the treatment, the relapses were also assessed (biochemical and hematological tests before and after the treatment) and the diagnosis of the HSV type I and II. The statistical evaluation of the results was performed and carried out with the SPSS and BMDP program. The relapses of the herpes infection in the lips and the face were significantly reduced (p less than 0.026) in patients treated with laser He-Ne and laser He-Ne plus Acyclovir. The interim between the relapses also increased significantly (p less than 0.005) in relation with the group treated with Acyclovir. The duration of the herpetic eruptions was clearly reduced in all locations in patients treated with laser He-Ne plus Acyclovir. No differences were noted between patients treated with laser He-Ne only or Acyclovir only. Therefore it is probable that therapeutic synergism took place. In relation with this, laser He-Ne shows the same therapeutic efficacy as Acyclovir taken orally. The association of Acyclovir and laser Ne-Ne could be an alternative method for the treatment of HSV in the face. The number

  13. A case report of glyphosate poisoning caused by hypodermic injection%1例皮下注射草甘膦致中毒病例报告

    Institute of Scientific and Technical Information of China (English)

    陆明峰; 徐继扬

    2015-01-01

    目的:探讨皮下注射草甘膦致中毒病例的临床特点及治疗对策。方法对1例右侧臀部皮下注射草甘膦致中毒病例的临床资料进行综合分析。结果皮下注射草甘膦后患者出现头晕、乏力、发热(体温39℃)和血压下降(由105/60 mmHg降至80/50 mmHg)等全身中毒反应,同时草甘膦注射部位局部软组织出现红肿疼痛,并出现小水泡。患者经大量补液、行注射部位皮肤切开引流术、抗感染及对症支持治疗10 d 后痊愈出院,注射部位无出现组织坏死,无重要器官功能损害。结论对于局部注射农药引起中毒的患者,在全身治疗的同时,作局部切开引流以清除组织内残留农药是治疗的关键。%Objective To analyze the clinical characteristics and treatment measures on a case of glyphosate poisoning caused by hypodermic injection .Methods The clinical data of a patient who suffered from glyphosate poisoning caused by hypodermic injection on the right buttock was comprehensively analyzed . Results After hypodermic injection with glyphosate, the patient was found to have dizziness , fatigue, fever (39 ℃), decreased blood pressure (from 105/60 to 80/50 mmHg) and other systemic toxic reactions , meanwhile the local soft tissue in injection area got swelling and pain and then blisters appeared on the skin of right buttock .The patient got recovery and discharged 10 days after treatment with a series of symptomatic support cure , such as a large amount of fluid infusion , anti infection , incision and drainage to the injection site skin.Tissue necrosis of the injection sites and important organ damage were not found .Conclusion The key point to achieve successful rescue for the poisoned patients with local injection pesticides is the operation of local incision and drainage for removing toxin from the tissue while the patients receive general treatment at the same time .

  14. Poorly differentiated carcinoma of the thyroid retrospective clinical and morphologic evaluation.

    Science.gov (United States)

    Hwang, T S; Suh, J S; Kim, Y I; Park, S H; Koh, C S; Cho, B Y; Oh, S K

    1990-03-01

    Five thyroid carcinomas showing clinically aggressive biologic behavior were retrospectively reviewed to evaluate the possible presence of morphologic differences from conventional thyroid carcinomas. They were originally diagnosed as follicular carcinomas, medullary carcinoma, papillary carcinoma, and mixed papillary and medullary carcinoma. There were three males and two females. The age at the time of initial diagnosis ranged from 36 years to 67 years (mean 56 years). The size of the tumor varied from 4.5cm to 10cm (mean diameter 7cm). One patient died of brain metastasis four years after the initial therapy and the other four patients are still alive with local recurrences and/or metastases to bone, spinal cord, lung, and buttock. Histologically these lesions are categorized into two different groups: insular variant and columnar cell variant. Insular variant was characterized by well-defined nests (insulae) that are composed of small, uniform cells, frequent tumor necrosis, and hyalinization of the stroma. Columnar cell variant was characterized by tall columnar cells with marked nuclear statification. All five cases stained positively for thyroglobulin and negatively for calcitonin. With the above clinical and histopathological findings, we interpreted these lesions as a poorly differentiated carcinoma, biologically in an intermediate position between well differentiated and anaplastic carcinomas. The rapid and often fatal outcome associated with these variants of poorly differentiated carcinoma warrants aggressive treatment at the time of diagnosis.

  15. A blanching technique for intradermal injection of the hyaluronic acid Belotero.

    Science.gov (United States)

    Micheels, Patrick; Sarazin, Didier; Besse, Stéphanie; Sundaram, Hema; Flynn, Timothy C

    2013-10-01

    With the proliferation of dermal fillers in the aesthetic workplace have come instructions from various manufacturers regarding dermal placement. Determination of injection needle location in the dermis has in large part been based on physician expertise, product and needle familiarity, and patient-specific skin characteristics. An understanding of the precise depth of dermal structures may help practitioners improve injection specificity. Unlike other dermal fillers that suggest intradermal and deep dermal injection planes, a new hyaluronic acid with a cohesive polydensified matrix may be more appropriate for the superficial dermis because of its structure and its high degree of integration into the dermis. To that end, the authors designed a small study to quantify the depth of the superficial dermis by means of ultrasound and histology. Using ultrasound resources, the authors determined the depths of the epidermis, the dermis, and the reticular dermis in the buttocks of six patients; the authors then extrapolated the depth of the superficial reticular dermis. Histologic studies of two of the patients showed full integration of the product in the reticular dermis. Following determination of injection depths and filler integration, the authors describe a technique ("blanching") for injection of the cohesive polydensified matrix hyaluronic acid into the superficial dermis. At this time, blanching is appropriate only for injection of the cohesive polydensified matrix hyaluronic acid known as Belotero Balance in the United States, although it may have applications for other hyaluronic acid products outside of the United States.

  16. Diagnosis and management of lipoedema in the community.

    Science.gov (United States)

    Todd, Marie

    2016-10-01

    Lipoedema is a chronic progressive adipose disorder that affects mainly women and presents as symmetrical enlargement of the buttocks and legs. It is commonly misdiagnosed as obesity or lymphoedema, but careful assessment will reveal a disproportionate enlargement below the waist which is resistant to dieting, sparing of the feet, legs are tender or painful to touch and bruise easily, there is occasional orthostatic oedema, and there is often significant psychological morbidity. Lipoedema is a oestrogen-regulated condition with onset around puberty in 78% of women, and there is often a strong family history. The condition is exacerbated by weight gain and there is increasing anecdotal evidence that women who are obese are seeking a diagnosis of lipoedema, either to procure NHS funded manual lymphatic drainage, or to medicalise their obesity and avoid acknowledging that the responsibility for their weight gain is lifestyle orientated. Management of lipoedema consists of accurate diagnosis, psychological care, management of orthostatic oedema, and prevention of progression through skin care and weight management.

  17. Early lipoedema diagnosis and the RCGP e-learning course.

    Science.gov (United States)

    Fetzer, Amy; Fetzer, Sharie

    2015-04-01

    Frequently misdiagnosed as obesity, lipoedema is chronic condition involving an abnormal build-up of fat cells in the legs, thighs and buttocks that cannot be shifted by exercise or dieting. Estimated to affect up to 11% of the female population, the condition is widely unknown by health professionals. This means women typically wait for many years before diagnosis. This allows the condition to progress unchecked, resulting in unnecessary deterioration and the development of associated comorbidities, as well as significant pain and mental anguish. A free, 30-minute Royal College of General Practitioners (RCGP) e-learning course created in partnership with Lipoedema UK aims to rectify this situation by educating nurses, GPs and other health professionals on how to diagnose and manage lipoedema in primary care. This article aims to describe the condition of lipoedema, how to recognise/diagnose it, current treatment options and the findings of a 240-patient survey carried out by Lipoedema UK in 2013 that included documenting the difficulties for patients in obtaining a diagnosis as well as the mental and physical effects of the condition.

  18. Estado confusional, lesión pulmonar y glúteos que languidecen. Efectos secundarios de procedimientos estéticos Seconday effects of aesthetic procedures

    Directory of Open Access Journals (Sweden)

    Julián Peña-Varela

    2009-03-01

    Full Text Available Los procedimientos estéticos a cargo de personal no médico son cada vez más frecuentes, muchos no controlados médicamente y promotores de efectos secundarios desde leves a graves. Se presenta el caso de una mujer de 29 años de edad, sin problemas de salud relevantes, quien acudió a un centro de estética para inyectarse silicio orgánico en sus glúteos, con la finalidad de aumentar su volumen, desarrolló posteriormente un síndrome de embolismo masivo.Aesthetic procedures performed by non medical personnel are increasing in frequency. Many are not medical controlled and cause side effects from mild to serious. We present the case of a 29-year-old woman, with no relevant health problems, who went to a aesthetics center to have organic silicon injected into her buttocks to increase volume, developing later a massive pulmonary embolism syndrome.

  19. Atypical Presentation of Thoracic Disc Herniation: Case Series and Review of the Literature

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    Ali Shirzadi

    2013-01-01

    Full Text Available Modern imaging has revealed that thoracic disc herniation (TDH has a prevalence of 11–37% in asymptomatic patients. Pain, sensory disturbances, myelopathy, and lower extremity weakness are the most common presenting symptoms, but other atypical extraspinal complaints, such as gastrointestinal or cardiopulmonary discomfort, may be reported. Our objective is to make providers familiar with TDH’s atypical symptoms to help avoid potential serious consequences created by a delay in diagnosis. We report the cases of two patients who each presented with atypical extraspinal symptoms secondary to a TDH. One patient presented with a chronic history of nausea, emesis, and chest tightness and MRI showed a large right paramedian disc herniation at T7-8. A second patient reported chronic constipation, buttock and leg burning pain, gait instability, and urinary frequency; an MRI of his thoracic spine demonstrated a central disc herniation at T10-11. TDH can present with vague extraspinal symptoms and unfamiliarity with these symptoms can lead to misdiagnosis with progression of the disease and unnecessary diagnostic tests and medical procedures. Therefore, TDH should be included in the differential diagnosis of patients with negative gastrointestinal, genitourinary, and cardiopulmonary system basic studies.

  20. Polymyalgia rheumatica in a married couple

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    Rüst CA

    2012-08-01

    Full Text Available Christoph Alexander Rüst,1 Beat Knechtle,1,2 Thomas Rosemann,1 Felix Wermelinger31Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland; 2St Gallen Health Center, St Gallen, Switzerland; 3Department of Rheumatology, University Hospital, University of Bern, SwitzerlandAbstract: The case of a married couple developing polymyalgia rheumatica (PMR consecutively is presented. The 55-year-old wife complained in June 2010 about pain in her neck. Case history, physical examination, and erythrocyte sedimentation rate (ESR of 80 mm/hour led to the diagnosis of PMR. In May 2011, her 66-year old husband complained about pain in his neck, shoulders, buttocks, and thighs. Considering anamnesis, physical examination, and ESR of 56 mm/hour, the diagnosis of PMR was made. Both wife and husband responded to steroid treatment. When the steroid dose was gradually reduced, both patients relapsed. In order to lower the cumulative dose of glucocorticoid therapy, 10 mg methotrexate per week was added. In the literature, six cases of polymyalgia rheumatica in married couples have been described to date. In four cases, polymyalgia rheumatica occurred first in the wife. The interval of the diagnosis between the spouses ranged from 0 to 89 months. Although in most of the previous case reports a genetic disposition and an infectious agent have been discussed, this hypothesis must be questioned.Keywords: husband, wife, erythrocyte sedimentation rate, C-reactive protein, polymyalgia rheumatica

  1. Comparison of oxytocin used in different ways to reduce postpartum hemorrhage%缩宫素不同用法对减少产后出血的比较

    Institute of Scientific and Technical Information of China (English)

    刘海青; 吕杰强

    2013-01-01

    Objective:To compare the clinical effects of preventing maternal postpartum hemorrhage (PPH) and shorten the time of the third stage of labor for puerpera with maternal buttocks intramuscular injection of oxytocin 20 U after natural childbirth and one with maternal umbilical vein injection of oxytocin 20 U after natural childbirth.Methods:298 cases of pregnant women were divided into the experiment group and the control,149 women who delivered in odd dates were in the group of experiment and accepted maternal umbilical vein injection of oxytocin 20 U after natural childbirth.149 women who delivered in even dates were in the group of control and accepted maternal buttocks intramuscular injection of oxytocin 20 U after natural childbirth.To observe the time of the third stage of labor,2 hours PPH volume,24 hours PPH volume and the incidence of PPH in two groups.Results:The duration of the third stage of labor in the group of experiment was (4.53 ± 1.80) min,the duration in the group of control was (5.23 ± 2.09) min,compared with the group of control,the average duration of the third stage of labor in the group of experiment was shorter (P<0.01); PPH volume in 2 hours of the experiment group was (207.72 ± 72.91) mL,the control was (235.91 ± 93.83) mL,2 hours average PPH volume in the experiment group was less than that in the control group (P<0.01); the 24 hours PPH volume in the group of experimental was (256.98 ± 79.91) mL,the group of control was (278.05 ± 101.43) mL,after 24 hours,the average PPH volume was less than that in the group of control (P<0.05).The incidence of PPH in the group of experiment was 1.3% (2/149),the group of control was 2.0% (3/149).Conclusion:After delivery,both maternal umbilical vein injection of oxytocin and maternal buttocks intramuscular injection of oxytocin had clinical effect of preventing maternal postpartum hemorrhage (PPH) for puerpera,maternal umbilical vein injection of oxytocin can shorten the time of the third

  2. Origin of Everything and the 21 Dimensions of the Universe

    Science.gov (United States)

    Loev, Mark

    2009-03-01

    The Dimensions of the Universe correspond with the Dimensions of the human body. The emotion that is a positive for every dimension is Love. The negative emotion that effects each dimension are listed. All seven negative emotions effect Peace, Love and Happiness. 21st Dimension: Happiness Groin & Heart 20th Dimension: Love Groin & Heart 19th Dimension: Peace Groin & heart 18th Dimension: Imagination Wave Eyes Anger 17th Dimension: Z Wave / Closed Birth 16th Dimension: Electromagnetic Wave Ears Anger 15th Dimension: Universal Wave Skin Worry 14th Dimension: Lover Wave Blood Hate 13th Dimension: Disposal Wave Buttocks Fear 12th Dimension: Builder Wave Hands Hate 11th Dimension: Energy Wave Arms Fear 10th Dimension: Time Wave Brain Pessimism 9th Dimension: Gravity Wave Legs Fear 8th Dimension: Sweet Wave Pancreas Fear 7th Dimension: File Wave Left Lung Fear 6th Dimension: Breathing Wave Right Lung Fear 5th Dimension: Digestive Wave Stomach Fear 4th Dimension: Swab Wave Liver Guilt 3rd Dimension: Space Wave Face Sadness 2nd Dimension: Line Wave Mouth Revenge 1st Dimension: Dot Wave Nose Sadness The seven deadly sins correspond: Anger Hate Sadness Fear Worry Pessimism Revenge Note: Guilt is fear

  3. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration

    Science.gov (United States)

    Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene

    2013-01-01

    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis. PMID:24392235

  4. A Case of Henoch-Schonlein Purpura Associated with Rotavirus Infection in an Elderly Asian Male and Review of the Literature

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    Tang, Chen; Scaramangas-Plumley, Daphne; Nast, Cynthia C.; Mosenifar, Zab; Edelstein, Marc A.; Weisman, Michael

    2017-01-01

    Patient: Male, 73 Final Diagnosis: Henoch-Schönlein purpura (HSP) Symptoms: Abdominal pain • bloating • blood in stool • nausea • vomiting Medication: — Clinical Procedure: EGD • colonoscopy • kidney biopsy • skin biopsy • arthrocentesis Specialty: Rheumatology Objective: Unknown ethiology Background: Henoch-Schönlein purpura (HSP), a small vessel vasculitis mediated by deposition of immune-complexes containing IgA in the skin, gut, and glomeruli, often presents with abdominal pain, purpuric rash in the lower extremities and buttocks, joint pain, and hematuria. The disease most commonly targets children but can affect adults who tend to have a worse prognosis. Case Report: We discuss a case of HSP in an elderly Chinese male who presented with severe proximal bowel inflammation, vasculitic rash, and proteinuria; he was found to have positive stool rotavirus and giardia. He improved significantly with high dose steroids. We believe rotavirus may have been a triggering event in this patient. A brief review of the literature is also presented. Conclusions: This is the first case report describing a classic presentation of HSP in an adult following a rotavirus infection. HSP can cause significant morbidity and mortality in adult patients predominantly from progressive renal failure; therefore careful management and monitoring is important. GI infections seem to be a common trigger for HSP and this case report suggests that rotavirus may be part of the spectrum. PMID:28174414

  5. Gluteal muscle contracture: diagnosis and management options

    Science.gov (United States)

    Rai, Saroj; Meng, Chunqing; Wang, Xiaohong; Chaudhary, Nabin; Jin, Shengyang; Yang, Shuhua; Wang, Hong

    2017-01-01

    Gluteal muscle contracture (GMC), a debilitating disease, exists all over the globe but it is much more prevalent in China. Patients typically present with abduction and external rotation of the hip and are unable to bring both the knees together while squatting. Multiple etiologies have been postulated, the commonest being repeated intramuscular injection into the buttocks. The disease is diagnosed primarily by clinical features but radiological features are necessary for the exclusion of other pathological conditions. Non-operative treatment with physiotherapy can be tried before surgery is considered but it usually fails. Different surgical techniques have been described and claimed to have a better outcome of one over another but controversy still exists. Based on published literatures, the clinical outcome is exceptionally good in all established methods of surgery. However, endoscopic surgery is superior to conventional open surgery in terms of cosmetic outcome with fewer complications. Nevertheless, its use has been limited by lack of adequate knowledge, instrumentations, and some inherent limitations. Above all, post-operative rehabilitation plays a key role in better outcome, which however should be started gradually. PMID:28059055

  6. Necrolytic migratory erythema without glucagonoma in a patient with short bowel syndrome.

    Science.gov (United States)

    Nakashima, Hiroko; Komine, Mayumi; Sasaki, Kiyo; Mitsui, Hiroshi; Fujimoto, Manabu; Ihn, Hironobu; Asahina, Akihiko; Kikuchi, Kanako; Tamaki, Kunihiko

    2006-08-01

    Necrolytic migratory erythema (NME) is an uncommon inflammatory dermatosis with a distinctive clinical and histological appearance. It shows irregular erythema, bullae, erosion, crusts and pigmentation. While it is typically associated with glucagonoma, some cases of NME without glucagonoma have been reported. Herein, we report a case of necrolytic migratory erythema associated with malabsorption 30 years after ileocolectomy. She presented erosive erythema with scale or partly flaccid bullae on her intergluteal cleft, buttock and extremities. Her laboratory data revealed essential amino acid deficiency and a slightly decreased serum zinc level, while her plasma glucagon level was low. With diagnosis of non-glucagonoma-associated NME with malabsorption due to short-bowel syndrome, she was treated and improved by i.v. amino acid supplement. Histological findings of NME include necrotic changes of keratinocytes in the upper epidermis, proliferation of those in the lower epidermis and inflammatory cell infiltration of upper dermis. We also examined the expression pattern of epidermal keratins (K6, K10) and Ki-67, one of the markers of proliferative activity, to assess the proliferation and differentiation of keratinocytes in a NME lesion by immunostaining. The findings with these immunostainings support the characteristics of HE-staining, and suggest hyponutrition may induce changing differentiation/proliferation of keratinocytes.

  7. Three-Directional Reconstruction of a Massive Perineal Defect after Wide Local Excision of Extramammary Paget's Disease

    Science.gov (United States)

    Cho, Seung Woo; Kwon, Sung Tack

    2016-01-01

    Extramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial malignancy that mainly involves the genital region, including the vulva, penis, scrotum, perianal, and periurethral areas. Although several treatment options exist, wide local excision with a safe margin is considered the treatment of choice. After resection of the lesion, it is often challenging to reconstruct the defect because defects in the perineal region require adequate volume for protection and are susceptible to infections, which is a particularly significant risk for large defects. We report a case of perivulvar EMPD that was reconstructed with three-directional local flaps after wide excision of the tumor. We covered the defect sequentially using the following 3 flaps: a gracilis myocutaneous flap from the left thigh, a bipedicled V-Y advancement flap from the lower abdomen, and an internal pudendal artery perforator-based island flap from the right buttock. To the best of our knowledge, this report is the first to describe a three-directional approach to extensive perivulvar reconstruction. PMID:27689055

  8. Cellulite: advances in treatment: facts and controversies.

    Science.gov (United States)

    Emanuele, Enzo

    2013-01-01

    Cellulite is traditionally considered a highly prevalent aesthetic condition in women. From a clinical standpoint, it is characterized by a cottage-cheese-like appearance of the skin, which can be most commonly found in certain areas of the body (eg, thighs, buttocks, and legs). Although cellulite is generally asymptomatic, the more severe stages can be accompanied by the appearance of painful nodules and increased local temperature, which are suggestive of an inflammatory reaction occurring in the dermis and in the underlying subcutaneous adipose tissue. Whether cellulite is a real disease or only a disturbing aesthetic issue is still a matter of controversy. This debate notwithstanding, it seems clear from market trends that there is considerable commercial interest in developing effective strategies aimed at reducing the cottage-cheese-like appearance of cellulite areas. Quite disturbingly, the majority of treatment attempts to date have been conducted in an empirical manner and without the application of rigorous scientific methodology. This is likely due--at least in part--to the lack of major, evidence-based pathophysiological insights into the nature of this condition. More stringent regulatory control is needed over commercial products aiming at improving the appearance of cellulite.

  9. [Cellulite].

    Science.gov (United States)

    Proebstle, T M

    2010-10-01

    Cellulite is a condition affecting the dermal and subdermal compartment and developing on thighs and buttocks of almost every woman. Macroscopically, cellulite is characterized by dimpling, visible either spontaneously or after provoking maneuvers. While published concepts on the pathophysiology of cellulite are in parts inconclusive or contradictory, there are at least some recent studies describing or confirming structural and anatomic changes on dermal and subdermal tissues: (1) A gender specific dimorphism with subdermal septae oriented orthogonally towards the skin surface as well as protrusion of fat tissue into the dermis. (2) These intradermal fat protrusions additionally correlate with the presence of cellulite. (3) There is also a correlation between the thickness of the subdermal fat layer and the presence of cellulite. (4) Cellulite also correlates with focal hypertrophic subcutaneous septae and a reduced density of septae in general. Treatment of cellulite aims at (1) the reduction of the subcutaneous fat layer, (2) increase in dermal thickness and elasticity and (3) dissection of hypertrophic connective tissue septae, responsible for the most pronounced dermal indentions. A variety of treatment options have evolved ranging from topical retinol to interstitial laser.

  10. Cellulite treatment: evidence and ethics, brief history, and emphasis on current practices including liposuction

    Science.gov (United States)

    de Riese, Cornelia

    2005-04-01

    According to Taber's Cyclopedic Medical Dictionary "cellulite" is defined as: "a non-technical term for subcutaneous deposits of fat, especially in the buttocks, legs, and thighs." These deposits result in puckered, dimply skin and they are a cause for major aesthetic concerns in affected patients. The etiology of this condition is still unclear. Female predilection is witnessed in clinical practice as it is reported in the literature. It remains a subject for further studies whether it is a structural problem of connective tissue or as suggested probably related to hormonal causes. Magnetic resonance imaging may provide some answers to these questions. Not knowing what is causing this nuisance makes it almost impossible to treat. No wonder that there is little scientific validation to support any of the many treatments that are advertised on the Internet or in women's magazines. This review focuses on mechanical and microinvasive interventions that claim to alleviate "cellulite": lipoplasty, liposcultpure, liposuction, subcision, and laser. Among the parameters analyzed are the proposed modes of action of these techniques as well as adverse events and complications that may occur. Of special interest will be the evidence that backs these procedures. Extracting reliable data is hampered by methodical problems with the design of most of the published trials. In essence, at this time there is no "cure" for cellulite. Safe treatment recommendations are related to healthy life style choices that include toning exercises, dietary changes, and weight loss.

  11. Cutaneous chemical burns in children - a comparative study.

    Science.gov (United States)

    Hardwicke, Joseph; Bechar, Janak; Bella, Husam; Moiemen, Naiem

    2013-12-01

    Exposure to chemicals is an unusual causation of cutaneous burns in children. The aim of this study is to look at childhood chemical burns and compare this to adult chemical burns from the same population. A total of 2054 patients were referred to the pediatric burns unit during the study period. This included 24 cutaneous chemical burns, equating to an incidence of 1.1%. Over half of the injuries occurred in the domestic setting. The mean total body surface area (TBSA) affected was 1.9%. When compared to a cohort of adult patients from the same population with cutaneous chemical burns, the TBSA affected was identical (1.9%) but distribution favored the buttock and perineum in children, rather than the distal lower limb in adults. Children presented earlier, had lower rates of surgical intervention and had a shorter length of stay in hospital (p Chemical burns in children are rare, but are becoming more common in our region. It is important to be aware of the characteristic distribution, etiology and need to identify children at risk of child protection issues.

  12. Atypical presentation of Merkel cell carcinoma positive to polyomavirus DNA detection: Experience from a single center

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    Iovino F

    2014-07-01

    Full Text Available Merkel cell carcinoma (MCC is a rare malignant tumor of the skin with tendency to rapid local progression and frequent spread to regional lymph nodes. In this paper we retrospectively describe the atypical presentation of 5 cases of Merkel cell carcinoma observed in our surgical department in the last ten years. Four patients had buttock localization whilst one patient had primary nodal presentation. Since integration of Merkel cell polyomavirus (MCPyV DNA into the tumor genome is frequently recorded in this type of cancer, we analyzed formalin-fixed paraffin embedded MCC tissue samples from our five patients for the presence of MCPyV DNA by means of polymerase chain reaction (PCR. MCPyV DNA was present in all five carcinomas. All patients were treated with wide surgical excision of the tumor and sentinel node biopsy. One patient had stage I disease, three patients had stage II disease, and one patient had stage III disease. Adjuvant radiotherapy was administered in all cases for local control. Chemotherapy was administered to the patient with primary nodal presentation and in stage III disease. Median time of follow-up was 84 months. None of the patients relapsed. Despite the low number of patients examined, our experience suggests that surgery is a necessary step whereas implementation of adjuvant therapy, radiotherapy and chemotherapy depends on individual risk assessment. Treatment outcome was very good, probably due to early detection of MCC.

  13. 腹腔镜下直肠癌根治术的体位摆放

    Institute of Scientific and Technical Information of China (English)

    尤晓光

    2013-01-01

    Under the goal discussion peritoneoscope Rectal Cancer root governing skill body posture place carries on smoothly regarding the surgery, guarantees in the patient technique the security, after and prevention technique complication practical significance. The method picks to 49 example peritoneoscope Rectal Cancer surgery patient has a specific use the low buttocks high left side Shan Tuijie Shi Wei body posture place. The result 49 example surgeries operate smoothly, does not have an example the body posture influence, the surgery is completed smoothly.After the technique makes a follow-up visit does not have an example obvious complication, after in the patient technique, the technique the security.%目的探讨腹腔镜下直肠癌根治术的体位摆放对于手术顺利进行,保证患者术中安全,及预防术后并发症的实际意义。方法对49例腹腔镜直肠癌手术患者采用头低臀高左侧单腿截石位的体位摆放。结果49例手术操作均顺畅,无一例受体位影响,手术顺利完成。术后随访无一例明显并发症,病人术中、术后安全。

  14. Neuroarthropathy of the hip following spinal cord injury

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    Bibek Banskota

    2011-01-01

    Full Text Available We present the case of a 33-year-old male who sustained a burst fracture D12 vertebrae with spinal cord injury (ASIA impairment scale A and a right mid-diaphysial femoral shaft fracture around 1.5 years back. The patient reported 1.5 years later with a swelling over the right buttock. Arthrotomy revealed serous fluid and fragmented bone debris. The biopsy showed a normal bony architecture with no evidence of infection and malignant cells. Hence, a diagnosis of Charcot′s hip was made. Charcot′s neuroarthropathy of the feet is a well-recognized entity in the setting of insensate feet resulting from causes such as diabetes or spina bifida. Although Charcot′s disease of the hips has been described, it is uncommon in association with spinal cord injury, syphilis and even with the use of epidural injection. The present case highlights the fact that neuroarthropathy of the hip can occur in isolation in the setting of a spinal cord injury, and this can lead to considerable morbidity.

  15. Cutaneous larva migrans in Hospital Kuala Lumpur, Malaysia: rate of correct diagnosis made by the referring primary care doctors.

    Science.gov (United States)

    Yap, Felix Boon-Bin

    2011-07-01

    A retrospective study was undertaken to determine the clinical features of cutaneous larva migrans (CLM) seen in the Department of Dermatology, Hospital Kuala Lumpur (Kuala Lumpur, Malaysia) and to assess the rate of correct diagnosis made by the referring primary care doctors. Clinical records of all 31 patients with CLM seen between January 2006 and June 2010 were retrieved. The majority of patients were male. The mean age was 32.2 years. Pruritus was reported in 83.9% of cases and serpiginous tracts in 100%. The mean lesion count was 4.4 and the mean duration of disease before presentation was 3.1 weeks. The majority of skin lesions were on the buttock and lower extremities. Only 45.2% of patients had the correct diagnosis made by the referring primary care doctors. Older age of patients and lower number of lesions were associated with a higher rate of correct diagnosis. The low rate of correct diagnosis made by the referring primary care doctors to the dermatologists in this study warrants the need for education of not only primary care doctors but also future primary care providers, consisting of medical students, house officers and junior medical officers.

  16. Lyme disease in Haryana, India

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    Vijayeeta Jairath

    2014-01-01

    Full Text Available Lyme disease is a multiorgan animal-borne disease caused by the spirochete Borrelia burgdorferi. This case series highlights its presence in Haryana, a nonendemic zone. The first case was a 27-year-old housewife who presented with an annular erythematous patch with a central papule following an insect bite on the left upper arm. The second case was a 32-year-old farmer who gave a history of insect bite on the right arm followed by the development of an erythematous patch with a central blister. The third case, a 17-year-old boy presented with a history of tick bite over right thigh and a typical bull′s eye lesion with central ulceration. These cases were managed with oral doxycycline 100 mg twice daily for 14 days. The fourth case was a 7-year-old boy with typical erythema migrans on the right check and neck while the fifth case, a 30-year-old housewife, presented with an erythematous patch with a central papule on the right buttock. These patients were treated with oral amoxycillin 25 mg/kg, thrice daily for 14 days. All patients showed IgM antibodies to B. burgdorferi. Treatment led to clearance of lesions in all the patients. Lyme borreliosis was diagnosed in these patients based on the history of established exposure to tick bites, presence of classic signs and symptoms, serology and the response to treatment.

  17. Deep gluteal space problems: piriformis syndrome, ischiofemoral impingement and sciatic nerve release

    Science.gov (United States)

    Carro, Luis Perez; Hernando, Moises Fernandez; Cerezal, Luis; Navarro, Ivan Saenz; Fernandez, Ana Alfonso; Castillo, Alexander Ortiz

    2016-01-01

    Summary Background Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included “piriformis syndrome”, a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. Methods This article describes the subgluteal space anatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist and orthopaedic surgeons in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments. Conclusion DGS is an under-recognized and multifactorial pathology. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. The whole sciatic nerve trajectory in the deep gluteal space can be addressed by an endoscopic surgical technique. Endoscopic decompression of the sciatic nerve appears useful in improving function and diminishing hip pain in sciatic nerve entrapments, but requires significant experience and familiarity with the gross and endoscopic anatomy. Level of evidence IV. PMID:28066745

  18. Dermoscopy of shagreen patch: A first report

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    Shivanand Gundalli

    2015-07-01

    Full Text Available The name is derived from French phrase peau chagrinee which is usually found on lower back, buttock and thigh. The major manifestations of Tuberous sclerosis include skin lesions in more than 95%, mental retardation in approximately 50%, autism, seizures in approximately 85%. The incidence at birth is estimated to be 1 in 5800. We report case of shagreen patch in a 27 year female which is present since birth. However there is no history of seizures or consanginous marriage in our case. Associated features are naevus comedonicus and naevus collagenosis, facial angiofibroma. Shagreen patch are present in mandibular area of face. Although, diagnosis is easy, it can be mistaken for inflammatory verrucous epidermal nevus, plaques of other inflammatory skin conditions. Diagnosis is usually on clinical background. Sometimes biopsy is necessary to confirm the diagnosis. Dermoscopy, a non-invasive, in vivo technique for the microscopic examination of pigmented skin lesions, has the potential to improve the diagnostic accuracy. Dermoscopy of Shagreen patch showed reddish-brown strands with white dots giving a cobblestone appearance It can be utilized as a diagnostic aide in the diagnosis of Shagreen patch. Authors evaluated the dermoscopic patterns of Shagreen patch and hence, it is useful in diagnosis.

  19. Unusual case of extradural choroid plexus papilloma of the sacral canal. Case report.

    Science.gov (United States)

    Kurtkaya-Yapicier, Ozlem; Scheithauer, Bernd W; Van Peteghem, Karl Peter; Sawicki, John E

    2002-07-01

    An unusual case of a sacral, extradural choroid plexus papilloma involving the S1-3 level is described. This 50-year-old woman presented with a 4-month history of pain involving her right buttock, perineum, and leg. Contrast-enhanced magnetic resonance (MR) imaging of the spine revealed a well-defined, mildly enhancing sacral canal mass at the S1-3 level; its appearance was consistent with that of a benign tumor. Intraoperatively, the lesion was found to be extradural in location and was entwined among nerve roots in the sacral canal. Microscopic examination of the gross totally resected tumor revealed typical features of a choroid plexus papilloma. Despite performing a thorough neuroimaging workup (craniospinal contrast-enhanced MR imaging) for an intracranial or spinal primary mass, none was found. The choroid plexus appeared entirely normal; however, both a cavum septum pellucidum and a cavum vergae were noted. Extraneural choroid plexus papilloma, specifically intrasacral, extradural choroid plexus papilloma has not been previously reported. The present example is thought to have arisen either from ectopic choroid plexus tissue or perhaps by metaplasia from ependymal rests.

  20. A baboon syndrome induced by intravenous human immunoglobulins: report of a case and immunological analysis.

    Science.gov (United States)

    Barbaud, A; Tréchot, P; Granel, F; Lonchamp, P; Faure, G; Schmutz, J L; Béné, M C

    1999-01-01

    Following the second series of intravenous human immunoglobulins (IVIg; 0.4 g/kg) prescribed to treat a sensorimotor polyneuritis, a 28-year-old woman developed pompholyx that recurred after each of the following monthly treatments with IVIg. During the administration of the 10th series, the patient developed a typical baboon syndrome. Immunohistochemical studies of a skin biopsy revealed an unexpected epidermal expression of P-selectin, usually expressed by endothelial cells. Patch, prick and intradermal tests performed with IVIg on the back, arms and buttocks gave negative results on immediate and delayed readings. IVIg were re-administered, with the informed consent of the patient, and induced a generalized maculopapular rash. This is the first reported case of baboon syndrome induced by IVIg. Although extensive skin testing was performed, all test sites remained negative. We wonder whether IVIg could reproduce immunological mechanisms involved in the 3 types of systemic contact dermatitis (pompholyx, baboon syndrome and maculopapular rash), including the epidermal expression of P-selectin.

  1. Chediak-Higashi: a case report

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    A Paymard

    2016-06-01

    Full Text Available Background & aim: Chédiak–Higashi syndrome, a rare autosomal recessive disorder characterized by immune deficiency, bleeding diathesis, recurrent bacterial infections, albinism dynamic and progressive neurological disorder, as well as major organs such as the liver and spleen lymphocytic infiltration is determined. The aim of this study was to report a case of a rare manifestation of the disease. Case Report: The case-study in the present report was a 4-month-old female that two months after vaccination had intermittent fever associated with fever, weakness, which lasted more than a week. After blood tests, ultrasound and examination of blood cells, Chédiak–Higashi syndrome diagnosis was made. In terms of blood cells, pancytopenia, platelets and fresh frozen plasma were administered to the patient to prevent bleeding. After Buttock infections, the patient was suffering from septicemia and septic shock followed by a lack of response to resuscitation and cardiopulmonary arrest and then died. Conclusion: In this patient all Chediak Higashi syndrome, including long fever, loss of appetite, frequent infections, albinism variable and multiple neurological deficit was seen. Chdyak Higashi syndrome is treatable with early diagnosis and bone marrow transplantation.

  2. [On Liu qin xi (six animal frolics) in Huai nan zi (Discourses of Master Huainanzi)].

    Science.gov (United States)

    Sun, Xiaozhong

    2014-05-01

    The six styles of the art of Daoyin recorded in Liu An's Huai nan zi (Discourses of Master Huainanzi) of the Western Han Dynasty was called the Liu qin xi which was simplified from the complicated ancient Daoyin art of bionic practice imitating the movements of six kinds of animal. Among them, the "xiong jing"imitates the erecting walking style of a bear so as to strengthen the waist and lower extremities; the "niao shen"follows the spreading of wings of a bird so as to extend the arms and legs, to train the shoulders and extremities; the "fu yu"imitates the movements of swimming and moving head of a wild duck so as to train the head and neck; the "yuan jue"imitates the jumping of a monkey among the tree branches so as to train the legs and waist; the "chi shi"imitates the streching neck movements of an eagle so as to strengthen the neck and improvement of vision; while the "hu gu"imitates the movement of turning head of a tiger so as to train one's nape and the buttock.

  3. Identification of a Novel Mutation in Solute Carrier Family 29, Member 3 in a Chinese Patient with H Syndrome

    Institute of Scientific and Technical Information of China (English)

    Jia-Wei Liu; Nuo Si; Lian-Qing Wang; Ti Shen; Xue-Jun Zeng; Xue Zhang; Dong-Lai Ma

    2015-01-01

    Background:H syndrome (OMIM 612391) is a recently described autosomal recessive genodermatosis characterized by indurated hyperpigmented and hypertrichotic skin,as well as other systemic manifestations.Most of the cases occurred in the Middle East areas or nearby countries such as Spain or India.The syndrome is caused by mutations in solute carrier family 29,member 3 (SLC29A3),the gene encoding equilibrative nucleoside transporter 3.The aim of this study was to identify pathogenic SLC29A 3 mutations in a Chinese patient clinically diagnosed with H syndrome.Methods:Peripheral blood samples were collected from the patient and his parents.Genomic DNA was isolated by the standard method.All six SLC29A3 exons and their flanking intronic sequences were polymerase chain reaction (PCR)-amplified and the PCR products were subjected to direct sequencing.Results:The patient,an 18-year-old man born to a nonconsanguineous Chinese couple,had more extensive cutaneous lesions,involving both buttocks and knee.In his genomic DNA,we identified a novel homozygous insertion-deletion,c.1269_1270delinsA,in SLC29A3.Both of his parents were carriers of the mutation.Conclusions:We have identified a pathogenic mutation in a Chinese patient with H syndrome.

  4. Staphylococcal scalded skin syndrome in a premature newborn caused by methicillin-resistant Staphylococcus aureus: case report

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    Andreas Hörner

    Full Text Available CONTEXT: Staphylococcal scalded skin syndrome is an exfoliative skin disease. Reports of this syndrome in newborns caused by methicillin-resistant Staphylococcus aureus are rare but, when present, rapid diagnosis and treatment is required in order to decrease morbidity and mortality. CASE REPORT: A premature newly born girl weighing 1,520 g, born with a gestational age of 29 weeks and 4 days, developed staphylococcal scalded skin syndrome on the fifth day of life. Cultures on blood samples collected on the first and fourth days were negative, but Pseudomonas aeruginosa and Enterococcus sp. (vancomycin-sensitive developed in blood cultures performed on the day of death (seventh day, and Pseudomonas aeruginosa and Serratia marcescens were identified in cultures on nasopharyngeal, buttock and abdominal secretions. In addition to these two Gram-negative bacilli, methicillin-resistant Staphylococcus aureus was isolated in a culture on the umbilical stump (seventh day. The diagnosis of staphylococcal scalded skin syndrome was based on clinical criteria.

  5. Skin changes in menopause.

    Science.gov (United States)

    Bolognia, J L; Braverman, I M; Rousseau, M E; Sarrel, P M

    1989-12-01

    Skin signs and symptoms were examined in 46 menopausal women prior to estrogen replacement therapy. Several symptoms such as pruritus, bruising, dryness and thinning were seen more frequently in sun-exposed skin emphasizing the contribution of photoaging. At the end of a 6-mth treatment period, no significant difference was observed in the prevalence or severity of the cutaneous signs and symptoms when patients receiving transdermal 17 beta-estradiol (Estraderm) were compared with controls (the only exception was cutaneous flushing). Elastic fibers from sun-protected (buttock) skin of menopausal women were studied by light and electron microscopy. In 3 women (ages 30-37) with a history of premature menopause, the elastic fibers had several degenerative changes including coalescence of cystic spaces into lacunae, peripheral fragmentation, granular degeneration and splitting of the fibers into strands. Similar age-related ultrastructural changes are normally found in individuals that are at least 20 yrs older than these patients. These findings are suggestive of a relationship between premature aging of the dermal elastic fibers and estrogen deprivation.

  6. Aging skin.

    Science.gov (United States)

    Bolognia, J L

    1995-01-16

    Aging of the skin is a composite of actinic damage, chronologic aging, and hormonal influences. The majority of changes associated with aging, such as wrinkles and solar lentigines ("liver spots"), are due to photoaging and reflect cumulative sun exposure as well as skin pigmentation. Classically, chronologic aging includes those cutaneous changes that occur in non-sun-exposed areas, such as the buttocks, and are observed in both men and women. A clinical example would be soft tissue sagging due to elastic fiber degeneration. In women, investigations into the effect of hormones on aging of the skin have concentrated on estrogens; in men, there have been a limited number of studies on the influence of testosterone. The latter have shown an age-dependent decrease in tissue androgens in pubic skin, but not scrotal or thigh skin. To date, age has not been shown to have an effect on androgen receptor binding, although a decrease in foreskin 5 alpha-reductase activity with increasing age has been described. In fibroblast cultures from foreskins, there have been conflicting results as to whether 5 alpha-reductase activity decreases in an age-dependent manner. Some of the skin changes that have been categorized as secondary to chronologic aging, such as decreased sebaceous gland activity and decreased hair growth, may actually represent a decline in the concentration of tissue androgens with increasing age. The influence of androgens on age-related changes in keratinocyte and fibroblast function remains speculative.

  7. Secular changes in body dimensions of Royal Australian Air Force aircrew (1971-2005).

    Science.gov (United States)

    Tomkinson, Grant R; Clark, Adam J; Blanchonette, Peter

    2010-08-01

    The aim of this study was to quantify the secular changes in body dimensions of Royal Australian Air Force aircrew. Following corrections for methodological differences, two samples (matched for age and overall body size) of male aircrew measured in 1971 (n = 220) and 2005 (n = 220) were compared across 13 absolute and proportional body dimensions. Changes in means were expressed as standardised effect sizes and changes in distributional characteristics were expressed as the ratio of coefficients of variation and as changes in skew. Small secular increases (standardised effects sizes >0.2) in age-matched aircrew were observed for mass, height, BMI, sitting height, buttock-knee length, waist girth, hip girth and waist:hip ratio, with a small decline observed for head girth. Changes in body dimensions were not independent of changes in overall body size (except for head girth) and were not always uniform across the distribution. These changes in body size have implications for ensuring correct human-machine and human-equipment fit. STATEMENT OF RELEVANCE: There have been small secular changes in body dimensions of RAAF aircrew between 1971 and 2005, although these secular changes have not always been uniform across the distribution. These secular changes in body dimensions have implications for ensuring correct human-machine and human-equipment fit and underscore the need for regular anthropometric surveys.

  8. Inability to predict postpartum hemorrhage: insights from Egyptian intervention data

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    Prata Ndola

    2011-11-01

    Full Text Available Abstract Background Knowledge on how well we can predict primary postpartum hemorrhage (PPH can help policy makers and health providers design current delivery protocols and PPH case management. The purpose of this paper is to identify risk factors and determine predictive probabilities of those risk factors for primary PPH among women expecting singleton vaginal deliveries in Egypt. Methods From a prospective cohort study, 2510 pregnant women were recruited over a six-month period in Egypt in 2004. PPH was defined as blood loss ≥ 500 ml. Measures of blood loss were made every 20 minutes for the first 4 hours after delivery using a calibrated under the buttocks drape. Using all variables available in the patients' charts, we divided them in ante-partum and intra-partum factors. We employed logistic regression to analyze socio-demographic, medical and past obstetric history, and labor and delivery outcomes as potential PPH risk factors. Post-model predicted probabilities were estimated using the identified risk factors. Results We found a total of 93 cases of primary PPH. In multivariate models, ante-partum hemoglobin, history of previous PPH, labor augmentation and prolonged labor were significantly associated with PPH. Post model probability estimates showed that even among women with three or more risk factors, PPH could only be predicted in 10% of the cases. Conclusions The predictive probability of ante-partum and intra-partum risk factors for PPH is very low. Prevention of PPH to all women is highly recommended.

  9. Blunt traumatic superior gluteal artery pseudoaneurysm presenting as gluteal hematoma without bony injury: A rare case report

    Institute of Scientific and Technical Information of China (English)

    Annu Babu; Amit Gupta; Pawan Sharma; Piyush Ranjan; Atin Kumar

    2016-01-01

    Blunt traumatic injuries to the superior gluteal artery are rare in clinic.A majority of injuries present as aneurysms following penetrating trauma,fracture pelvis or posterior dislocation of the hip joint.We reported a rare case of superior gluteal artery pseudoaneurysm following blunt trauma presenting as large expanding right gluteal hematoma without any bony injury.The gluteal hematoma was suspected clinically,confirmed by ultrasound and the arterial injury was diagnosed by CT angiography that revealed a large right gluteal hematoma with a focal contrast leakage forming a pseudoaneurysm within the hematoma.Pseudoaneurysm arose from the superior gluteal branch of right internal iliac artery,which was successfully angioembolized.The patient was discharged on day 4 of hospitalization with resolving gluteal hematoma.This report highlighted the importance of considering an arterial injury following blunt trauma to the buttocks with subsequent painful swelling.Acknowledgment of this rare injury pattern was necessary to facilitate rapid diagnosis and appropriate treatment.

  10. On the Aesthetics of Historic Tragedy in Mo Yan's Novels%莫言小说的历史悲剧美学

    Institute of Scientific and Technical Information of China (English)

    颜水生; 唐红卫

    2011-01-01

    In the novels of Mo Yan,history is like a huge black hole that doesn't provide mankind with the opportunity to break free,so life and survival become an unbearable weight;that is tragic nature of history expressed in Mo Yan's novles.Plump Breasts and Fat Buttocks expresses the tragic conflict between human life and wishes to survive and the harsh historical environment;Tired of Life and Death focuses on the tragic conflict between the nature pursuit of humans and the absurd historical process.%在莫言小说中,历史就像一个巨大的黑洞,不给人类提供挣脱的机会,生命与生存成为不能承受之重;这就是莫言所要表达的历史的悲剧性本质。《丰乳肥臀》集中表现了人的生命和生存愿望与残酷的历史环境之间的悲剧性冲突,《生死疲劳》侧重表现人的本质追求与荒诞的历史进程之间的悲剧性冲突。

  11. Neurofibroma paciniano: relato de um caso raro de localização intra-oral Pacinian neurofibroma: report of a rare intraoral case

    Directory of Open Access Journals (Sweden)

    Lélia B. Souza

    2003-12-01

    Full Text Available O neurofibroma paciniano é uma lesão rara encontrada predominantemente em mãos, incluindo digitais, em nádegas e pés. As lesões podem ser solitárias ou múltiplas como componente da doença de Von Recklinghausen. Na cavidade oral, o neurofibroma paciniano é um achado incomum, existindo apenas um caso relatado na literatura mundial. O objetivo deste trabalho é apresentar um caso de neurofibroma paciniano localizado em mucosa gengival, bem como descrever as suas características clínicas e histopatológicas, contribuindo, assim, para um melhor conhecimento desta entidade.PPacinian Neurofibroma is a rare lesion that has been reported predominantly on the hand, including the digits, on buttocks and feet. The lesions can be solitaries or multiples as part of the Von Recklinghausen's disease. The intraoral site is unusual and just one case has been related in the world's literature. The purpose of this report is to present one case of pacinian neurofibroma and to describe its clinical and histopathological features contributing for the best knowledge about this entity.

  12. Symptomatic sacroiliac joint disease and radiographic evidence of femoroacetabular impingement.

    Science.gov (United States)

    Morgan, Patrick M; Anderson, Anthony W; Swiontkowski, Marc F

    2013-01-01

    Symptomatic sacroiliac (SI) joint disease is poorly understood. The literature provides no clear aetiology for SI joint pathology, making evaluation and diagnosis challenging. We hypothesised that patients with documented sacroiliac pain might provide insight into the aetiology of these symptoms. Specifically, we questioned whether SI joint symptoms might be associated with abnormal hip radiographs. We reviewed the pelvic and hip radiographs of a prospectively collected cohort of 30 consecutive patients with SI joint pathology. This database included 33 hips from 30 patients. Radiographic analysis included measurements of the lateral centre edge angle, Tönnis angle, and the triangular index, of the ipsilateral hip. Evidence for retrotorsion of the hemipelvis was recorded. Hips were graded on the Tönnis grading system for hip arthrosis. In this cohort 14/33 (42%) of hips had evidence of significant osteoarthrosis indicated by Tönnis grade 2 or greater and 15/33 (45%) displayed subchondral cyst formation around the hip or head neck junction. In assessing acetabular anatomy, 21% (7/33) had retroversion, 12% (4/33) had a lateral centre edge angle >40° with 3% (1/33) >45°. Tönnis angle was arthrosis. The clinician should maintain FAI in the differential diagnosis when investigating patients with buttock pain.

  13. Multidisciplinary Management of a Giant Plexiform Neurofibroma by Double Sequential Preoperative Embolization and Surgical Resection

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    Roberto Vélez

    2013-01-01

    Full Text Available Plexiform neurofibromas are benign tumors originating from subcutaneous or visceral peripheral nerves, which are usually associated with neurofibromatosis type 1. Giant neurofibromas are very difficult to manage surgically as they are extensively infiltrative and highly vascularized. These types of lesions require complex preoperative and postoperative management strategies. This case report describes a 22-year-old female with a giant plexiform neurofibroma of the lower back and buttock who underwent pre-operative embolization and intraoperative use of a linear cutting stapler system to assist with haemostasis during the surgical resection. Minimal blood transfusion was required and the patient made a good recovery. This case describes how a multidisciplinary management of these large and challenging lesions is technically feasible and appears to be beneficial in reducing perioperative blood loss and morbidity. Giant neurofibroma is a poorly defined term used to describe a neurofibroma that has grown to a significant but undefined size. Through a literature review, we propose that the term “giant neurofibroma” be used for referring to those neurofibromas weighing 20% or more of the patient's total corporal weight.

  14. [Linear IgA bullous dermatosis: the importance of a correct differential diagnosis].

    Science.gov (United States)

    Colombo, M; Volpini, S; Orini, S; Fazi, M C; Vettore, E; Tedoldi, S; Cappellaro, E

    2008-06-01

    Linear IgA bullous dermatosis is an acquired subepidermal blistering disease which belongs to bullous autoimmune diseases, along with dermatitis herpetiformis and bullous pemphigoid. Inflammatory blisters are the main clinical characteristics and the areas of common involvement are: perioral region, abdomen, perineum, buttocks and the interior side of thighs. Essential for the diagnosis is to find by direct immunofluorescence the presence of a linear band of IgA antibodies at the level of the basement membrane. We present the case of a 5 year-old Moroccan girl which arrived at our First Aid Department for bullous dermatitis, localized mainly on the abdomen, legs and thighs. During a short stay in Morocco, a month before, the little girl was stung by an insect and developed bullous dermatitis by a residual lesion. The child was in a good state of health but blood exams showed an increase of total IgE antibodies. The girl was admitted and during her hospitalisation we made a skin biopsy which led to a diagnosis of linear IgA dermatosis. She began a steroid therapy and there was a progressive regression of the lesions. At present, she does not take medicines anymore, she feels well and is submitted to ambulatory medical follow-up.

  15. Management of pilonidal sinus by Kshar Sutra, a minimally invasive treatment.

    Science.gov (United States)

    Dwivedi, Amar P

    2010-04-01

    A Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work. It is more common in men (as they have more hair) than in women. The most commonly used surgical techniques for this disorder include excision and primary closure and excision with reconstructive flap. However, the risk of recurrence or of developing an infection of the wound after the operation is high. Also, the patient requires longer hospitalization, and the procedure is expensive. There is a similarity between Shalyaj Nadi Vran described in Sushruta Samhita and Pilonidal sinus. Sushruta has advocated a minimally invasive para-surgical treatment, viz., Kshar Sutra procedure, for nadi vran. Hence this therapy was tried in Pilonidal sinus, and is described in this case report. Kshar Sutra treatment not only minimizes complications and recurrence but also enables the patient to resume work quicker and with less discomfort, impact upon body image and self-esteem as well as reduced cost.

  16. [The sacroiliac joint dysfunction: clinical manifestations, diagnostics and manual therapy].

    Science.gov (United States)

    Grgić, Vjekoslav

    2005-01-01

    Sacroiliac joint dysfunction is one of the proved causes of sacroiliac joint syndrome. We are talking about the restricted mobility of sacrum opposite to ilium the type of "reversible blockage of movement". Main characteristics of dysfunction are as follows: restricted "joint play", referred pain, normal radiological finding, normal lab results and disappearance of clinical symptoms after deblocking of articular bodies. Pain from a blocked joint can be referred to lower back, buttocks, hip, groin, thigh, calf and lower part of abdomen. Dispersion of painful regions is a consequence of a complex and variable innervation of articular capsule. Blocked position of articular bodies and protracted tension of articular capsule causes a stimulus of nociceptors by which a capsule is protected. Nociceptive activity is manifested with referred pains in innervational region of stimulated sensitive nerves. In the article, besides the clinical manifestations, there is described a diagnostics and manual therapy of dysfunction. Springing tests by means of which a passive mobility ("joint play") is being tested, are most valuable in dysfunction diagnostics. Manual therapy (mobilization/manipulation) is indicated and efficacious with the patients suffering from dysfunction.

  17. Application of exercise transcutaneous oxygen pressure measurements for detection of proximal lower extremity arterial disease: a case report.

    Science.gov (United States)

    Mahe, Guillaume; Kalra, Manju; Abraham, Pierre; Liedl, David A; Wennberg, Paul W

    2015-06-01

    Proximal claudication is secondary to ischemia caused by peripheral artery disease (PAD), whereas proximal pseudo-claudication is secondary to other disease processes such as hip arthritis, spinal stenosis, neuropathy, and so forth. The differentiation between the two can be challenging. Exercise transcutaneous oxygen pressure measurement (exercise-TcPO2) allows noninvasive detection of flow-reducing lesions in the proximal arteries and tributaries of the lower extremity arterial tree. We present the first case report in the United States using an exercise-TcPO2 algorithm. A 71-year-old diabetic patient with proximal left-sided and right-calf claudication with indeterminate ankle-brachial indices underwent an exercise-TcPO2 study before and after endovascular intervention. Four TcPO2 probes were placed: one at chest level (reference probe), one on each buttock, and one on the symptomatic calf. The Delta from Resting Oxygen Pressure (DROP) index was calculated at each probe site using a previously validated protocol. Proximal left- and right-calf ischemia were confirmed by the initial exercise-TcPO2, and, after endovascular treatment of the left iliac artery lesion, improvements in proximal exercise-TcPO2 values were found. These data suggest that exercise-TcPO2 can be useful in PAD evaluation in patients with non-compressible arteries and/or proximal claudication.

  18. Differences from gender about the impact of Eating Behaviour Disorder on personality factors of students at secondary level

    Directory of Open Access Journals (Sweden)

    Daniel GARROTE ROJAS

    2011-09-01

    Full Text Available This paper tries to know the obsession for the thinness or incessant search of the thinness, as essential characteristic of eating Disorders, verify if significant differences exist according to the sex, to analyze the trend of students to have thoughts or to give them heavy meals –or gluttonies– uncontrollable, and verify the degree of dissatisfaction with the general form of their body or with the parts of the same one that more worried those who suffer eating Disorders (stomach, hips, thighs, buttocks, etc. For it, we have used an eclectic methodology. The samples of students who have done the test EPQ-J is 700. The students analyzed in the sample show lacks in some areas at the personal level that they exhibit to suffer an eating Disorders. There would be necessary to underline that, with regard to the «emocionalidad», 7.73% of the men and 9.63% of the women prove to be anxious, worried, with fast changes of humor, frequently depressed, they sleep badly, etc., obtaining their representation, at the age of 13. There has been verified that, 12.26% of the males and 6.85% of the women are unsatisfied with their own body.

  19. Ultrasound-Guided Injection of Botulinum Toxin Type A for Piriformis Muscle Syndrome: A Case Report and Review of the Literature.

    Science.gov (United States)

    Santamato, Andrea; Micello, Maria Francesca; Valeno, Giovanni; Beatrice, Raffaele; Cinone, Nicoletta; Baricich, Alessio; Picelli, Alessandro; Panza, Francesco; Logroscino, Giancarlo; Fiore, Pietro; Ranieri, Maurizio

    2015-08-10

    Piriformis muscle syndrome (PMS) is caused by prolonged or excessive contraction of the piriformis muscle associated with pain in the buttocks, hips, and lower limbs because of the close proximity to the sciatic nerve. Botulinum toxin type A (BoNT-A) reduces muscle hypertonia as well as muscle contracture and pain inhibiting substance P release and other inflammatory factors. BoNT-A injection technique is important considering the difficult access of the needle for deep location, the small size of the muscle, and the proximity to neurovascular structures. Ultrasound guidance is easy to use and painless and several studies describe its use during BoNT-A administration in PMS. In the present review article, we briefly updated current knowledge regarding the BoNT therapy of PMS, describing also a case report in which this syndrome was treated with an ultrasound-guided injection of incobotulinumtoxin A. Pain reduction with an increase of hip articular range of motion in this patient with PMS confirmed the effectiveness of BoNT-A injection for the management of this syndrome.

  20. Flow visualisation of downhill skiers using the lattice Boltzmann method

    Science.gov (United States)

    Asai, Takeshi; Hong, Sungchan; Ijuin, Koichi

    2017-03-01

    In downhill alpine skiing, skiers often exceed speeds of 120 km h-1, with air resistance substantially affecting the overall race times. To date, studies on air resistance in alpine skiing have used wind tunnels and actual skiers to examine the relationship between the gliding posture and magnitude of drag and for the design of skiing equipment. However, these studies have not revealed the flow velocity distribution and vortex structure around the skier. In the present study, computational fluid dynamics are employed with the lattice Boltzmann method to derive the relationship between total drag and the flow velocity around a downhill skier in the full-tuck position. Furthermore, the flow around the downhill skier is visualised, and its vortex structure is examined. The results show that the total drag force in the downhill skier model is 27.0 N at a flow velocity of 15 m s-1, increasing to 185.8 N at 40 m s-1. From analysis of the drag distribution and the flow profile, the head, upper arms, lower legs, and thighs (including buttocks) are identified as the major sources of drag on a downhill skier. Based on these results, the design of suits and equipment for reducing the drag from each location should be the focus of research and development in ski equipment. This paper describes a pilot study that introduces undergraduate students of physics or engineering into this research field. The results of this study are easy to understand for undergraduate students.

  1. A Rare Occurrence of Shagreen Patch on the Face of a Pediatric Patient with Tuberous Sclerosis

    Directory of Open Access Journals (Sweden)

    Ambey RAVI

    2012-03-01

    Full Text Available Tuberous sclerosis is a neurocutaneous syndrome characterized by a clinical spectrum varying from severe mental retardation and incapacitating seizures to normal intelligence and lack of seizures, often within the same family(1. The younger the patients present with symptoms and signs of TSC (tuberous sclerosis complex, the greater are the likelihood of mental retardation (2. Skin features are very characteristic of the disease and help in the early diagnosis of the disease. Shagreen patch is one of the major diagnostic features of the disease. It is a less common skin lesion consisting of an excess amount of fibrous tissue similar to that found in scar tissues (3. It is a section of thickened, elevated pebbly skin like an orange peel. The name is derived from the French phrase “peau chagrinee”. It is usually found on the lower back, buttock, thigh and the nape of the neck commonly. In this case report we report a characteristic skin lesion, the shagreen patch in a six-year-old child with TSC at an unusual site (the cheek never reported before with the best of our knowledge.

  2. School furniture match to students' anthropometry in the Gaza Strip.

    Science.gov (United States)

    Agha, Salah R

    2010-03-01

    This study aimed at comparing primary school students' anthropometry to the dimensions of school furniture and determining whether the furniture used matches the students' anthropometry. A sample of 600 male students, whose ages were between 6 and 11 years, from five primary schools in the Gaza Strip governorates participated in the study. Several students' body dimensions were measured. The dimensions measured included elbow-seat height, shoulder height, knee height, popliteal height and buttock-popliteal length. Measurements of the dimensions of the classroom furniture indicated that there was a considerable mismatch between the students' body dimensions and the classroom furniture. The mismatches in seat height, seat depth and desk height occurred for 99% of the students, while the mismatch for the back rest height was only 35%. Two design specifications were proposed in order to decrease the mismatch percentage based on the data obtained. The two proposed designs showed a considerable improvement in the match percentages as compared to the existing design. STATEMENT OF RELEVANCE: Having identified mismatches between the dimensions of the school furniture used in primary schools in the Gaza Strip, two new design specifications are proposed and shown to improve match with the students' anthropometric dimensions. The findings of the study are also an important addition to local knowledge on school children's anthropometry.

  3. Classroom furniture dimensions and anthropometric measures in primary school.

    Science.gov (United States)

    Panagiotopoulou, Georgia; Christoulas, Kosmas; Papanckolaou, Anthoula; Mandroukas, Konstantinos

    2004-03-01

    The purpose of this study was to compare students' dimensions to the dimension of school furniture, in primary school, and determine whether this type of furniture is well-designed and promotes good sitting posture at school by taking into account the dimensions of the children. A total of 180 (90 male and 90 female) students, from three primary schools in Thessaloniki, Greece, participated in the study. Their ages ranged from 7 to 12 years. The following human body dimensions were measured: stature, elbow height, shoulder height, upper arm length, knee height, popliteal height and buttock-popliteal length. In addition, the dimensions were measured for four different types of chairs and five types of desks prevalent in classrooms. Finally, the anthropometric measures of the students and the furniture dimensions were compared in order to identify any incompatibility between them. The data indicate a mismatch between the students' bodily dimensions and the classroom furniture available to them. The chairs are too high and too deep and desks are also too high for the pupils. This situation has negative effects on the sitting posture of the children especially when reading and writing.

  4. Match between school furniture dimensions and children's anthropometry.

    Science.gov (United States)

    Gouvali, M K; Boudolos, K

    2006-11-01

    The purpose of the study was to examine whether school furniture dimensions match children's anthropometry. Children aged 6-18 years (n=274), divided into 3 groups on the basis of the used furniture size, were subjected into anthropometric measurements (shoulder, elbow, knee and popliteal height, buttock-popliteal length and hip breadth). Combinational equations defined the acceptable furniture dimensions according to anthropometry and match percentages were computed, according to either the existing situation--where children use the size assigned for their grade--or assuming that they could use the most appropriate of the sizes available. Desk and seat height were bigger than the accepted limits for most children (81.8% and 71.5%, respectively), while seat depth was appropriate for only 38.7% of children. In conclusion, the assumption that children could use the most appropriate yet available size significantly improved the match, indicating that the limited provision of one size per cluster of grades does not accommodate the variability of anthropometry even among children of the same age.

  5. Methicillin-resistant Staphylococcus aureus infected gluteal compartment syndrome with rhabdomyolysis in a bodybuilder.

    Science.gov (United States)

    Woon, Colin Yl; Patel, Kushal R; Goldberg, Benjamin A

    2016-05-18

    Gluteal compartment syndrome (GCS) is a rare condition. We present a case of gluteal muscle strain with hematoma formation, methicillin-resistant Staphylococcus aureus (MRSA) superinfection, leading to acute GCS, rhabdomyolysis and acute kidney injury. This combination of diagnoses has not been reported in the literature. A 36-year-old Caucasian male presented with buttock pain, swelling and fever after lifting weights. Gluteal compartment pressure was markedly elevated compared with the contralateral side. Investigations revealed elevated white blood cell, erythrocyte sedimentation rate, C-reactive protein, creatine kinase, creatinine and lactic acid. Urinalysis was consistent with myoglobinuria. Magnetic resonance imaging showed increased T2 signal in the gluteus maximus and a central hematoma. Cultures taken from the emergency debridement and fasciotomy revealed MRSA. He had repeat, debridement 2 d later, and delayed primary closure 3 d after. GCS is rare and must be suspected when patients present with pain and swelling after an inciting event. They are easily diagnosed with compartment pressure monitoring. The treatment of gluteal abscess and compartment syndrome is the same and involves rapid surgical debridement.

  6. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration.

    Science.gov (United States)

    Berumen-Nafarrate, Edmundo; Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene

    2013-01-01

    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis.

  7. Male Pelvic Squamous Cell Carcinoma of Unknown Primary Origin

    Directory of Open Access Journals (Sweden)

    Lauren Chiec

    2014-01-01

    Full Text Available Pelvic squamous cell carcinoma of unknown primary origin has been described in several case reports of female patients. However, there have been no published reports describing male patients with pelvic squamous cell cancer of unknown primary origin. Our case describes a 52-year-old man who presented with right buttock pain, rectal urgency, and constipation. His physical examination demonstrated tenderness to palpation around his gluteal folds. Computed tomography scan of his abdomen and pelvis demonstrated a large mass in his retroperitoneum. The mass was determined to be squamous cell carcinoma of unknown primary origin. Additionally, the patient had small nodules in his right lower lung lobe and right hepatic lobe. The patient was treated with concomitant chemoradiation, including cisplatin and intensity-modulated radiation therapy, followed by carboplatin and paclitaxel. The patient achieved partial remission, in which he remained one year after his presentation. Our case is consistent with the literature which suggests that squamous cell carcinoma of unknown primary origin occurring outside of the head and neck region may have a more favorable prognosis than other carcinomas of unknown primary origin. Further studies are necessary to determine the most appropriate work-up, diagnosis, and optimal treatment strategies.

  8. The gluteal triangle: a clinical patho-anatomical approach to the diagnosis of gluteal pain in athletes.

    Science.gov (United States)

    Franklyn-Miller, A; Falvey, E; McCrory, P

    2009-06-01

    Gluteal pain is a common presentation in sports medicine. The aetiology of gluteal pain is varied, it may be referred from the lower back, mimic other pathology and refer to the hip or the groin. The complex anatomy of the buttock and pelvis, variability of presentation and non specific nature of signs and symptoms make the diagnostic process difficult. To date the approaches to this problem have focused on individual pathologies. The paper proposes a novel educational system based on patho-anatomic concepts. Anatomical reference points were selected to form a diagnostic triangle, which provides the discriminative power to restrict the differential diagnosis, and form the basis of ensuing investigation. This paper forms part of a series addressing the three dimensional nature of proximal lower limb pathology. The 3G approach (groin, gluteal and greater trochanter triangles) acknowledges this, permitting the clinician to move throughout the region, considering pathologies appropriately. These papers should be read in conjunction with one another in order to fully understand the conceptual approach.

  9. Delayed Presentation of Acute Gluteal Compartment Syndrome.

    Science.gov (United States)

    Tasch, James J; Misodi, Emmanuel O

    2016-07-19

    BACKGROUND Acute gluteal compartment syndrome is a rare condition that usually results from prolonged immobilization following a traumatic event, conventionally involving the presence of compounding factors such as alcohol or opioid intoxication. If delay in medical treatment is prolonged, severe rhabdomyolysis may ensue, leading to acute renal failure and potentially death. CASE REPORT We report the case of a 23-year-old male with a recent history of incarceration and recreational drug use, who presented with reports of severe right-sided buttock pain and profound right-sided neurological loss following a questionable history involving prolonged immobilization after a fall from a standing position. The patient required an emergent gluteal fasciotomy immediately upon admission and required temporary hemodialysis. After an extended hospital stay, he ultimately recovered with only mild deficits in muscular strength in the right lower extremity. CONCLUSIONS This report demonstrates the importance of early recognition of gluteal compartment syndrome to prevent morbidity and mortality. Compartment syndrome presents in many unique ways, and healthcare practitioners must have a keen diagnostic sense to allow for early surgical intervention. Proper wick catheter measurements should be utilized more frequently, instead of relying on clinical symptomatology such as loss of peripheral pulses for diagnosis of compartment syndrome.

  10. Ultrasound-Guided Injection of Botulinum Toxin Type A for Piriformis Muscle Syndrome: A Case Report and Review of the Literature

    Science.gov (United States)

    Santamato, Andrea; Micello, Maria Francesca; Valeno, Giovanni; Beatrice, Raffaele; Cinone, Nicoletta; Baricich, Alessio; Picelli, Alessandro; Panza, Francesco; Logroscino, Giancarlo; Fiore, Pietro; Ranieri, Maurizio

    2015-01-01

    Piriformis muscle syndrome (PMS) is caused by prolonged or excessive contraction of the piriformis muscle associated with pain in the buttocks, hips, and lower limbs because of the close proximity to the sciatic nerve. Botulinum toxin type A (BoNT-A) reduces muscle hypertonia as well as muscle contracture and pain inhibiting substance P release and other inflammatory factors. BoNT-A injection technique is important considering the difficult access of the needle for deep location, the small size of the muscle, and the proximity to neurovascular structures. Ultrasound guidance is easy to use and painless and several studies describe its use during BoNT-A administration in PMS. In the present review article, we briefly updated current knowledge regarding the BoNT therapy of PMS, describing also a case report in which this syndrome was treated with an ultrasound-guided injection of incobotulinumtoxin A. Pain reduction with an increase of hip articular range of motion in this patient with PMS confirmed the effectiveness of BoNT-A injection for the management of this syndrome. PMID:26266421

  11. Ultrasound-Guided Injection of Botulinum Toxin Type A for Piriformis Muscle Syndrome: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Andrea Santamato

    2015-08-01

    Full Text Available Piriformis muscle syndrome (PMS is caused by prolonged or excessive contraction of the piriformis muscle associated with pain in the buttocks, hips, and lower limbs because of the close proximity to the sciatic nerve. Botulinum toxin type A (BoNT-A reduces muscle hypertonia as well as muscle contracture and pain inhibiting substance P release and other inflammatory factors. BoNT-A injection technique is important considering the difficult access of the needle for deep location, the small size of the muscle, and the proximity to neurovascular structures. Ultrasound guidance is easy to use and painless and several studies describe its use during BoNT-A administration in PMS. In the present review article, we briefly updated current knowledge regarding the BoNT therapy of PMS, describing also a case report in which this syndrome was treated with an ultrasound-guided injection of incobotulinumtoxin A. Pain reduction with an increase of hip articular range of motion in this patient with PMS confirmed the effectiveness of BoNT-A injection for the management of this syndrome.

  12. Pr\\'evention des escarres chez les parapl\\'egiques : une nouvelle approche par \\'electrostimulation linguale

    CERN Document Server

    Moreau-Gaudry, Alexandre; Demongeot, Jacques; Payan, Yohan

    2006-01-01

    Pressure ulcers are recognized as a major health issue in individuals with spinal cord injuries and new approaches to prevent this pathology are necessary. An innovative health strategy is being developed through the use of computer and sensory substitution via the tongue in order to compensate for the sensory loss in the buttock area for individuals with paraplegia. This sensory compensation will enable individuals with spinal cord injuries to be aware of a localized excess of pressure at the skin/seat interface and, consequently, will enable them to prevent the formation of pressure ulcers by relieving the cutaneous area of suffering. This work reports an initial evaluation of this approach and the feasibility of creating an adapted behavior, with a change in pressure as a response to electro-stimulated information on the tongue. Obtained during a clinical study in 10 healthy seated subjects, the first results are encouraging, with 92% success in 100 performed tests. These results, which have to be complete...

  13. Finding the optimal setting of inflated air pressure for a multi-cell air cushion for wheelchair patients with spinal cord injury.

    Directory of Open Access Journals (Sweden)

    Hamanami K

    2004-02-01

    Full Text Available Pressure distribution patterns of the seating interface on the multi-cell air cushion (ROHO High Profile of 36 adults with spinal cord injury (SCI (Neurological level Th3 -L1 were measured at different air pressure levels by a pressure mat measurement system. Stress distribution relative to the inflated air pressure in the air cushion on the patients' wheelchairs was analyzed to determine the appropriate inflated air pressure of the cushion for patients. The maximum pressure points in all subjects were at the areas of the ischial tuberosities (82 to 347 mmHg. The optimal reduction in interface pressure at the ischial tuberosities was obtained just before bottoming out. The cushion air pressure at that point was between 17 and 42 mmHg, and correlated well to body weight (r = 0.495, P = 0.0021. In contrast, the maximum pressure levels did not correlate to body weight or the Body Mass Index (BMI. Pressure at the ischial area could be reduced, but not eliminated, by adjusting the air pressure. The maximum pressure levels seemed to be related to the shape of the buttocks, especially the amount of soft tissue, and exceeded the defined threshold for pressure ulcers (> 80 g/cm2.

  14. Familial disseminated cutaneous glomuvenous malformation: Treatment with polidocanol sclerotherapy

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    Aditi Jha

    2016-01-01

    Full Text Available Glomuvenous malformations (GVMs present as asymptomatic multiple pink-to-blue nodules or plaques. Disseminated lesions are rare, representing 10% of all the cases. Familial cases are caused by mutations in the glomulin gene. A young male presented with multiple bluish-to-dusky red-coloured nodules 10-15 in numbers over the trunk, limbs and buttocks since 12 years of age. They ranged in size from 1 to 3 cm, partially to non-compressible and tender on palpation. There was no history of any systemic complaint. His sister and mother had similar lesions but in a limited distribution. Biopsy showed multiple ectatic dilated vascular channels lined by multiple layers of glomus cells consistent with the diagnosis of GVM. The biopsy of the lesions from the mother and sister also showed similar features. Mutation analysis for glomulin gene could not be done because of the unavailability of the facility at our setting. He underwent sclerotherapy with 3% polidocanol every 2 weeks, and there was significant improvement in the lesions after six sessions of sclerotherapy. The patient is under follow-up and there is no recurrence of the lesions over treated sites after 6 months.

  15. 表现为皮肤大片瘀斑和坏死的抗磷脂抗体综合征%A case of antiphospholipid syndrome (APS) presenting with large areas of ecchymosisand necrosis on skin

    Institute of Scientific and Technical Information of China (English)

    夏济平; 许阳; 侯麦花; 张美华

    2012-01-01

    报告1例表现为皮肤大片瘀斑和坏死的抗磷脂抗体综合征.患者女性,42岁.双侧臀部及下肢大片瘀斑、坏死,血小板减少,抗核抗体、抗心磷脂抗体异常升高,补体降低.皮损组织病理示真皮血管有血栓存在.给予抗凝、血管扩张剂、糖皮质激素、免疫抑制剂和静脉注射用人免疫球蛋白等控制病情的同时,外科手术修复大片坏死皮肤.%A case of antiphospholipid syndrome (APS) presenting with large areas of ecchymosis and necrosis on skin is reported. A 42-year-old female suffered from skin ecchymosis and necrosis in buttocks and lower limbs with thrombocytope-nia, abnormal elevation of ANA and antiphospholipid antibodies (APL), and low complements. Histopathology revealed thrombosis of dermal and subcutaneous vessels. As treatment with anticoagulation, vasodilation, immunosuppressant, intravenous im-munoglobulin, the condition of the patient was changed successfully. And then the effective surgical treatment restored the large area of the necrotic skin.

  16. Optimal External Wrench Distribution During a Multi-Contact Sit-to-Stand Task.

    Science.gov (United States)

    Bonnet, Vincent; Azevedo Coste, Christine; Robert, Thomas; Fraisse, Philippe; Venture, Gentiane

    2017-03-01

    This study aims at developing and evaluating a new practical method for the real-time estimate of joint torques and external wrenches during multi-contact sit-to-stand task using kinematics data only. The proposed method allows also identifying subject specific body inertial segment parameters that are required to perform inverse dynamics. The identification phase is performed using simple and repeatable motions. Thanks to an accurately identified model the estimate of the total external wrench can be used as an input to solve an under-determined multi-con-tact problem. It is solved using a constrained quadratic optimization process minimising a hybrid human-like energetic criterion. The weights of this hybrid cost function are adjusted and a sensitivity analysis is performed in order to reproduce robustly human external wrench distribution. The results showed that the pro-posed method could successfully estimate the external wrenches under buttocks, feet and hands during sit-to stand tasks (RMS error lower than 20 N and 6 N.m). The simplicity and generalisation abilities of the proposed method allow paving the way of future diagnosis solutions and rehabilitation applications, including in-home use.

  17. Fracture of the L-4 vertebral body after use of a stand-alone interbody fusion device in degenerative spondylolisthesis for anterior L3-4 fixation.

    Science.gov (United States)

    Kwon, Yoon-Kwang; Jang, Ju-Hee; Lee, Choon-Dae; Lee, Sang-Ho

    2014-06-01

    Many studies attest to the excellent results achieved using anterior lumbar interbody fusion (ALIF) for degenerative spondylolisthesis. The purpose of this report is to document a rare instance of L-4 vertebral body fracture following use of a stand-alone interbody fusion device for L3-4 ALIF. The patient, a 55-year-old man, had suffered intractable pain of the back, right buttock, and left leg for several weeks. Initial radiographs showed Grade I degenerative spondylolisthesis, with instability in the sagittal plane (upon 15° rotation) and stenosis of central and both lateral recesses at the L3-4 level. Anterior lumbar interbody fusion of the affected vertebrae was subsequently conducted using a stand-alone cage/plate system. Postoperatively, the severity of spondylolisthesis diminished, with resolution of symptoms. However, the patient returned 2 months later with both leg weakness and back pain. Plain radiographs and CT indicated device failure due to anterior fracture of the L-4 vertebral body, and the spondylolisthesis had recurred. At this point, bilateral facetectomies were performed, with reduction/fixation of L3-4 by pedicle screws. Again, degenerative spondylolisthesis improved postsurgically and symptoms eased, with eventual healing of the vertebral body fracture. This report documents a rare instance of L-4 vertebral body fracture following use of a stand-alone device for ALIF at L3-4, likely as a consequence of angular instability in degenerative spondylolisthesis. Under such conditions, additional pedicle screw fixation is advised.

  18. Case report of subcutaneous entomophthoromycosis with retroperitoneal invasion Relato de caso de entomoftoromicose subcutânea com invasão retroperitoneal

    Directory of Open Access Journals (Sweden)

    Leonora Maciel de Souza Vianna

    2005-08-01

    Full Text Available The authors describe a case of entomophthoromycosis in a previously healthy patient, who presented with an abscess in the right buttock. After surgical drainage it evolved into a retroperitoneal tumor. The patient improved clinically after resection of the mass and ketoconazole treatment. The histopathological analysis showed the Splendore-Hoeppli phenomenon, suggesting Basidiobolus ranarum infection, a zygomycosis generally restricted to the subcutaneous tissue, with rare gastrointestinal involvement.Os autores descrevem um caso de entomoftoromicose em paciente previamente saudável, que apresentou abscesso em nádega direita, evoluindo, após drenagem cirúrgica, para tumoração retroperitoneal. Após ressecção da massa, o paciente obteve melhora clínica, em uso de cetoconazol. A análise histopatológica evidenciou fenômeno de Splendore-Hoeppli, sugerindo infecção por Basidiobolus ranarum, uma zigomicose geralmente restrita ao tecido subcutâneo, com raro comprometimento gastrintestinal.

  19. A Case of 72 Diabetic Woman with Zoster Paresis

    Directory of Open Access Journals (Sweden)

    E. Sajadi

    2009-10-01

    Full Text Available Introduction: VZV is an exclusively human pathogen. The primary infection typically occurs during childhood and causes varicella. As with other members of the herpes viruses’ family, VZV is noninfectious in its latent form but can reactivate at a later time to form intact virions in the involved sensory neurons. These virions then migrate to the skin through axons, spread from cell to cell, and penetrate the epidermis.Case Report: In this case a 72 years old woman with history of diabetes mellitus and hypertension is reported hospitalized because of urinary retention, weakness and parestesia in the right leg, complicated with vesiculoulcerative lesions in sacral area with distribution to the right buttock and vagina. L.P was done to confirm inflammatory radicopathy that showed aseptic meningitis and therapy started with acyclovir and prednisolone. Patient got well and discharged from the hospital.Conclusion: Motor weakness in noncranial nerve is one of the zoster complications known as zoster paresis. Weakness begins suddenly 2-3 weeks after rash and progresses to extremities. In this case 3 weeks after rash, nerve complications were observed. We recommend to do paresthesia examination of skin for eruption in all patients presented with paresis.

  20. Histological findings in adipocytes when cellulite is treated with a variable-emission radiofrequency system.

    Science.gov (United States)

    Trelles, Mario A; van der Lugt, Claudia; Mordon, Serge; Ribé, Adriana; Al-Zarouni, Marwan

    2010-03-01

    Cellulite is a disorder of the subcutaneous fat layer and the overlying superficial skin. Recently, radiofrequency (RF) has been proposed as an effective treatment of cellulite; however, the mechanism through which the absorbed electrical energy acts on the tissue is still not fully clear. This study reports on the histological findings from biopsies taken immediately after a single RF treatment session, on cellulite located in the buttocks, with a novel technology called automatic multi-frequency and low impedance (AMFLI) RF. Tissue samples were stained with either haematoxylin and eosin (H&E), so that we could study the morphological findings, or with oil red O, to enable us to identify lipid deposits. The histological findings observed in biopsies taken after a single RF treatment showed changes in shape, size, and lipid content, as well as in cytoplasmic and nuclear morphology. After RF treatment adipocytes were more polyhedric, with irregular, degenerated membranes, with less or no lipid content and apoptotic changes. We postulate that RF treatment on cellulite produces a decrease in lipid content of cells as well as changes in the adipocyte membrane which will lead to cell rupture and the death and extrusion of lipid content out of the cell. Further studies are needed to characterise the nature of the extra-cellular lipid material that we have demonstrated with the oil red O stain in our biopsies.

  1. Analysis of wall shear stress around a competitive swimmer using 3D Navier-Stokes equations in CFD.

    Science.gov (United States)

    Popa, C V; Zaidi, H; Arfaoui, A; Polidori, G; Taiar, R; Fohanno, S

    2011-01-01

    This paper deals with the flow dynamics around a competitive swimmer during underwater glide phases occurring at the start and at every turn. The influence of the head position, namely lifted up, aligned and lowered, on the wall shear stress and the static pressure distributions is analyzed. The problem is considered as 3D and in steady hydrodynamic state. Three velocities (1.4 m/s, 2.2 m/s and 3.1 m/s) that correspond to inter-regional, national and international swimming levels are studied. The flow around the swimmer is assumed turbulent. The Reynolds-averaged Navier-Stokes (RANS) equations are solved with the standard k-ω turbulent model by using the CFD (computational fluid dynamics) numerical method based on a volume control approach. Numerical simulations are carried out with the ANSYS FLUENT® CFD code. The results show that the wall shear stress increases with the velocity and consequently the drag force opposing the movement of the swimmer increases as well. Also, high wall shear stresses are observed in the areas where the body shape, globally rigid in form, presents complex surface geometries such as the head, shoulders, buttocks, heel and chest.

  2. 3 cases of radiation-induced sarcoma

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    Shiba, K.; Fukuma, H.; Beppu, Y.; Hirota, T. (National Cancer Center, Tokyo (Japan). Hospital); Shinohara, N.

    1982-03-01

    Criteria for the diagnosis of radiation-induced sarcoma have been previously described. All cases must have a history of irradiation and the second neoplasm must have arisen in the area of the radiation field. A latent period of several years must have elapsed after irradiation before clinical evidence of a second malignant neoplasm. Most important thing is that, all suspected cases must have been proved histologically. We have experienced 3 cases of radiation-induced sarcoma, they were 42-years-old man who developed an osteosarcoma of the lumbar spine at the field of postoperative irradiation for seminoma 7 years previously, 69-years-old woman who developed a malignant fibrous histiocytoma of the buttock at the field of radical radiation for uterine carcinoma 7 years previously and 59-years-old woman who developed an extraskeletal osteosarcoma of the abdominal wall at the field of postoperative irradiation for uterine sarcoma 7 years previously. The last case is very rare and only 8 cases of radiation-induced extraskeletal osteosarcoma have been reported. Since there has been a definite trend in the treatment of cancer toward employing radiation for more favorable cases, in addition to technical improvements in the administration of radiotherapy and more modern equipment, survival data may have been altered considerably in many malignant tumors. Accordingly, more radiation-induced tumors may be encountered in the future. The clinical presentation and histopathology of these radiation-induced sarcomas are presented with a review of the literature.

  3. Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus

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    Crésio Alves

    2008-08-01

    Full Text Available The introduction of highly active antiretroviral therapy (HAART for the treatment of acquired immunodeficiency syndrome (AIDS has resulted in greater survival of patients infected with the human immunodeficiency virus (HIV. However, the use of these drugs has been associated with lipodystrophic syndrome (LS, which is characterized by metabolic alterations (dyslipidemia, insulin resistance, diabetes, and lactic acidosis and abnormal corporal fat distribution. Clinically, LS may manifest as three different forms: lipohipertrophy (accumulation of fat in the central part of the body, lipoatrophy (loss of fat in the extremities, face and buttocks and mixed (lipohipertrophy + lipoatrophy. Although its physiopathology has not been elucidated, some mechanisms have been described, including leptin and adiponectin deficiency, mitochondrial dysfunction and use of antiretroviral drugs. The type, dose and duration of the antiretroviral treatment, as well as age and puberty are the main risk factors. LS is also associated with increased incidence of cardiovascular illnesses, atherosclerosis and diabetes mellitus. Treatment includes physical activity, cautious restriction of caloric intake, changes in antiretroviral therapy, and use of insulin-sensitizing and lipid-lowering agents. Follow up must be periodic, consisting of measurement of body fat distribution, evaluation of the lipid profile and insulin resistance.

  4. CT-guided injection of botulinic toxin for percutaneous therapy of piriformis muscle syndrome with preliminary MRI results about denervative process

    Energy Technology Data Exchange (ETDEWEB)

    Fanucci, E.; Masala, S.; Sodani, G.; Varrucciu, V.; Romagnoli, A.; Squillaci, E.; Simonetti, G. [Dept. of Radiology, Univ. of Rome (Italy)

    2001-12-01

    Piriformis muscle syndrome (PMS) is a cause of sciatica, leg or buttock pain and disability. The pain is usually increased by muscular contraction, palpation or prolonged sitting. The aim of our paper was to evaluate the feasibility of CT-guided percutaneous botulinic toxin (BTX) injection for the purpose of PMS treatment. Thirty patients suffering from PMS, suspected with clinical and electrophysiological criteria, after imaging examinations excluding other causes of sciatic pain, resulted positive at the lidocaine test and were treated by intramuscular injection of BTX type A under CT guidance. The follow-up (12 months) was performed with clinical examination in all cases and with MR 3 months after the procedure in 9 patients to evaluate the denervative process entity of the treated muscle. In 26 cases relief of symptoms was obtained after 5-7 days. In 4 patients an insufficient relief of pain justified a second percutaneous treatment which was clinically successful. No complications or side effects were recorded after BTX injection. The MR examination showed a signal intensity change of the treated muscle in 7 patients due to the denervative process of PM, whereas in the remaining 2 cases only an atrophy of the treated muscle was detected. Larger series are necessary to confirm these MRI preliminary results. The CT-guided BTX injection in the PMS is an emergent and feasible technique that obtains an excellent local therapeutic effect without risk of imprecise inoculation. (orig.)

  5. Malignant Peripheral Nerve Sheath Tumors in Children with Neurofibromatosis Type 1

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    Apostolos Pourtsidis

    2014-01-01

    Full Text Available Purpose. Malignant peripheral nerve sheath tumors (MPNSTs are rare in children and account for approximately 5–10% of all soft tissue sarcomas in adults. MPNSTs may occur independently but individuals with neurofibromatosis type 1 (NF1 have a significantly increased risk. Our aim is to present patients with MPNST treated in our department. Cases and Results. In this report we present 4 cases of MPNSTs (3 females: 13, 12, and 13 years old and 1 male: 10 years old arising in patients with NF1. All of them presented with an enlarging mass and pain at diagnosis. Tumor was located in the buttock, the spinal cord, the trunk, and the left leg proximal to the heel. Wide excision of the tumor and radiotherapy were applied to all and adjuvant chemotherapy was given to three of them after the disease was progressed. All four died 32, 18, 10, and 22 months after diagnosis with progressive disease locally and pulmonary metastases in two of them. Conclusions. In conclusion, MPNSTs arising in patients with NF1 are high grade sarcomas with short survival. Individuals with NF1 should be followed closely in order to identify early the development of MPNSTs. Aggressive surgery and complete excision significantly improves disease-free survival. The usefulness of radiation therapy in MPNSTs is not determined although all patients will receive radiation therapy at some stage of the disease. The role of chemotherapy is unclear.

  6. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the pelvis and lower extremity: Diagnosis and treatment. Part 3

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    A. E. Karateev

    2015-01-01

    Full Text Available Pain associated with rheumatic diseases of juxta-articular soft tissues (RDJAST of the pelvis and lower extremity is a frequent reason for seeking advice from general practitioners and rheumatologists. However, the true cause of painful sensations is often overlooked by a physician and the patient is long and frequently treated unsuccessfully for lumbago, coxarthrosis, or gonarthrosis.The complexities of topical diagnosis are largely associated with the fact that instrumental methods virtually always determine these or those degenerative changes in the lumbar spine and hip joint (HJ, which formally supports the presence of nonspecific low back pain and coxarthrosis. Differential diagnosis can be made between these conditions if their clinical features are considered, by discriminating symptoms, such as pains in the back or buttock, and those located predominantly in the hip and groin area.The most known forms of RDJAST of the pelvis and HJ may include trochanteritis, hip abductor and adductor syndromes, iliopectineal bursitis, and ischial tuberosity bursitis.This review briefly describes the major forms of RDJAST of the mentioned area, their clinical manifestations, and topical diagnostic techniques. It also considers main therapeutic approaches: the administration of nonsteroidal antiinflammatory drugs, local injections of glucocorticoids and plateletrich plasma, and physiotherapy.

  7. Musculoskeletal Manifestations in Inflammatory Bowel Disease

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    Giovanni Fornaciari

    2001-01-01

    Full Text Available Muscoloskeletal manifestations are the most common extraintestinal complications of inflammatory bowel disease. Wide ranges in prevalence have been reported, depending on the criteria used to define spondylarthropathy. In 1991, the European Spondylarthropathy Study Group developed classification criteria that included previously neglected cases of undifferentiated spondylarthropathies, which had been ignored in most of the oldest epidemiological studies on inflammatory bowel disease. The spectrum of muscoloskeletal manifestations in inflammatory bowel disease patients includes all of the clinical features of spondylarthropathies: peripheral arthritis, inflammatory spinal pain, dactylitis, enthesitis (Achilles tendinitis and plantar fasciitis, buttock pain and anterior chest wall pain. Radiological evidence of sacroiliitis is common but not obligatory. The articular manifestations begin either concomitantly or subsequent to the bowel disease; however, the onset of spinal disease often precedes the diagnosis of inflammatory bowel disease. The prevalence of the different muscoloskeletal manifestations is similar in ulcerative colitis and Crohn's disease. Symptoms usually disappear after proctocolectomy. The pathogenetic mechanisms that produce the muscoloskeletal manifestations in inflammatory bowel disease are unclear. Several arguments favour an important role of the intestinal mucosa in the development of spondylarthropathy. The natural history is characterized by periods of flares and remission; therefore, the efficacy of treatment is difficult to establish. Most patients respond to rest, physical therapy and nonsteroidal anti-inflammatory drugs, but these drugs may activate bowel disease. Sulphasalazine may be recommended in some patients. There is no indication for the systemic use of steroids.

  8. Necrotizing fasciitis : plain radiographic and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chang Dae; Park, Jeong Hee; Jeon, Hae Jeong; Lim, Jong Nam; Heo, Tae Haeng; Park, Dong Rib [Konkuk Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-11-01

    To evaluate the plain radiographic and CT findings of the necrotizing fasciitis. We retrospectively reviewed the radiologic findings of 4 cases with necrotizing fasciitis. Three cases were proven pathologically. We evaluated pattern and extent of the gas shadows in plain films. CT findings were analysed, with emphasis on : (a) gas pattern, (b) extent, (c) location and involved site, (d) associated focal abscess, and (e) swelling of the adjacent muscles. On plain radiographs, four cases showed streaky or mottled gas densities in the pelvis, three cases in the perineum, one case in the abdomen, and two cases in the thigh. On CT images, gas pattern was mottled and streaky appearance with swelling of the adjacent muscles. Gas shadows located in the extraperitoneal space in four cases, fascial layer in four cases, and subcutaneous layer in four cases. There were gas shadows in pelvic wall, perineum, abdominal wall, buttock, thigh, and scrotum. Focal low density lesion suggestive of focal abscess was not visualized. Plain radiography is useful for early diagnosis of the necrotizing fasciitis and CT is very useful for detection of precise location and extent of the disease. CT is also useful for differentiation of necrotizing fasciitis from focal abscess and cellulitis.

  9. Internal Iliac Artery Embolization during an Endovascular Aneurysm Repair with Detachable Interlock Microcoils

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Woo ChuL; Jeon, Yong Sun; Hong, Kee Chun; Cho, Soon Gu; Park, Jae Young [Inha University Hospital, Inha University School of Medicine, Incheon (Korea, Republic of); Kim, Jang Yong [Dept. of Vascular and Endovascular Surgery, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    The purpose of this study was to evaluate the effectiveness of detachable interlock microcoils for an embolization of the internal iliac artery during an endovascular aneurysm repair (EVAR). A retrospective review was conducted on 40 patients with aortic aneurysms, who had undergone an EVAR between January 2010 and March 2012. Among them, 16 patients were referred for embolization of the internal iliac artery for the prevention of type II endoleaks. Among 16 patients, 13 patients underwent embolization using detachable interlock microcoils during an EVAR. Computed tomographic angiographies and clinical examinations were performed during the follow-up period. Technical success, clinical outcome, and complications were reviewed. Internal iliac artery embolizations using detachable interlock microcoils were technically successful in all 13 patients, with no occurrence of procedure-related complications. Follow-up imaging was accomplished in the 13 cases. In all cases, type II endoleak was not observed with computed tomographic angiography during the median follow-up of 3 months (range, 1-27 months) and the median clinical follow-up of 12 months (range, 1-27 months). Two of 13 (15%) patients had symptoms of buttock pain, and one patient died due to underlying stomach cancer. No significant clinical symptoms such as bowel ischemia were observed. Internal iliac artery embolization during an EVAR using detachable interlock microcoils to prevent type II endoleaks appears safe and effective, although this should be further proven in a larger population.

  10. Vellus hair cysts presenting as an atypical acneiform eruption Cisto de pelo velos apresentando-se como erupção acneiforme atípica

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    Hiram Larangeira de Almeida Jr

    2011-08-01

    Full Text Available A 32-year-old male patient presented for 8 months an asymptomatic therapy-resistant acneiform eruption on his back and buttocks. Skin examination showed several inflammatory papules, which evolved to hyperpigmentation. At the same distribution non inflammatory papules, which resembled rice grains, were also observed. Light microscopy showed small keratin-filled cysts, with an epithelial multilayered wall, without granular layer. Keratin and some vellus hairs were identified inside the cyst, confirming the diagnosis of vellus hair cysts. Diagnosis of vellus hair cysts should be suspected in cases of multiple papules or therapy-resistant cases of acneiform eruptionsUm paciente de 32 anos apresentou há 8 meses uma erupção acneiforme resistente à terapêutica, localizada no dorso e nádegas. Ao exame apresentava inúmeras pápulas inflamatórias, que evoluiam para hiperpigmentação. Na mesma distribuição havia lesões não inflamatórias, lembrando grão de arroz. A microscopia óptica demonstrou cisto dérmico cuja parede era de epitélio estratificado, sem camada granular, preenchido de queratina e com pelos no interior, confirmando o diagnóstico de cisto de pelo veloso. Essa entidade deve ser suspeitada em casos de múltiplas pápulas ou erupções acneiformes resistentes à terapia

  11. Coexistence of osteopoikilosis with seronegative spondyloarthritis and spinal stenosis

    Science.gov (United States)

    Demir, Saliha Eroglu; Özaras, Nihal; Poyraz, Emine; Toprak, Hüseyin; Güler, Mustafa

    2015-01-01

    [Purpose] Osteopoikilosis is a rare hereditary bone disease that is usually asymptomatic. It is generally diagnosed incidentally on plain radiography. The coexistence of osteopoikilosis with seronegative spondyloarthritis or spinal stenosis is rarely reported. Here, we report the case of a 27-year-old male patient with osteopoikilosis, seronegative spondyloarthritis, and spinal stenosis. [Subject] A 27-year-old male patient with buttock pain and back pain radiating to the legs. [Methods] A plain anteroposterior radiograph of the pelvis revealed numerous round and oval sclerotic bone areas of varying size. Investigation of the knee joints showed similar findings, and the patient was diagnosed with osteopoikilosis. Lumbar magnetic resonance images showed spinal stenosis and degenerative changes in his lumbar facet joints. Magnetic resonance images of the sacroiliac joints showed bilateral involvement with narrowing of both sacroiliac joints, nodular multiple sclerotic foci, and contrast enhancement in both joint spaces and periarticular areas. HLA B-27 test was negative. [Results] The patient was diagnosed with osteopoikilosis, seronegative spondyloarthritis, and spinal stenosis. Treatment included asemetasin twice daily and exercise therapy. [Conclusion] Symptomatic patients with osteopoikilosis should be investigated for other possible coexisting medical conditions; this will shorten the times to diagnosis and treatment. PMID:26157277

  12. Microbiology of infected poison ivy dermatitis.

    Science.gov (United States)

    Brook, I; Frazier, E H; Yeager, J K

    2000-05-01

    We report the aerobic and anaerobic microbiology of secondarily infected poison ivy dermatitis. The study involved retrospective review of clinical and microbiology laboratory records of patients with secondarily infected poison ivy lesions. Bacterial growth was noted in 33 specimens. Aerobic or facultative anaerobic bacteria only were present in 18 (55%) patients, anaerobic bacteria only in seven (21%), and mixed anaerobic-aerobic bacteria in eight (24%). Forty-five isolates were recovered (1.4 per specimen): 27 aerobic or facultative anaerobic bacteria, and 18 strict anaerobes. The predominant aerobic and facultative anaerobic bacteria were Staphylococcus aureus (13 isolates) and group A beta-haemolytic streptococci (six). The predominant anaerobes were Peptostreptococcus spp. (seven isolates), pigmented Prevotella and Porphyromonas spp. (four) and Fusobacterium spp. (two). Single bacterial isolates were recovered in 18 (55%) patients, eight of which were S. aureus. Nineteen of the organisms isolated from 16 (48%) patients produced the enzyme beta-lactamase. Organisms that resided in the mucous membranes close to the lesions predominated in those infections. Enteric gram-negative rods and Bacteroides fragilis group predominated in leg and buttock lesions. Group A beta-haemolytic streptococci, pigmented Prevotella and Porphyromonas and Fusobacterium spp. were most frequently recovered from lesions of the finger, face and neck. The polymicrobial aetiology of secondarily infected poison ivy lesions, and the association of bacterial flora with the anatomical site of the lesions, are demonstrated.

  13. The Frequency of Diaper Dermatitis in 0-2 Years Old Children at Nursing Homes in Hamadan on 2000-2001

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    M. Emdadi

    2004-04-01

    Full Text Available Diaper dermatitis(Diaper rash is the most common cutaneous disorder of infancy and childhood. Although the etiology of this condition remains unknown, an amalgam of various causes (mechanical friction, moisture, contact with urine and feces, variation of skin pH, fungal infection bring about this common dermatitis. Because most diaper dermatitis is treated conservatively at home, the frequency is unknown, but from 7%-35% up to 50% has been reported. Therefore the frequency of diaper dermatitis and related aggravating factors in 1-2 years old children was studied at nursing home of Hamadan at year 2000-2001. The study was cross-sectional, descriptive on 385 children using randomized selection and data was collected by questionnaire and completed by direct observation. In this study 79 (20.5% subjects had diaper dermatitis, there was meaningful association with” educational level of mother, age of child and use of disposable diaper(p<0.05” . There was no meaningful relation with sex. The most prominent region of involvement was combination of perineum –genitalia-buttock-thighs. For better controlling of diaper dermatitis we should consider the proper health education for mother and nursing home instructors, and using of super absorbent diapers.

  14. Cauda equina syndrome presentation of sacral insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Muthukumar, T.; Butt, S.H.; Cassar-Pullicino, V.N.; McCall, I.W. [The Robert Jones and Agnes Hunt Orthopaedic Hospital, Department of Radiology, Oswestry, Shropshire (United Kingdom)

    2007-04-15

    Sacral insufficiency fractures are a well recognised cause for low back, buttock and groin pain in the elderly. However, over a 4 year period, four patients have presented with symptoms of cauda equina syndrome, who were found on investigation to have acute sacral insufficiency fracture without any other aetiological spinal abnormality. Four patients who presented to the spinal surgeons of our institution with symptoms of cauda equina syndrome were referred for spinal MR. Sagittal and axial T1 and T2 weighted turbo spin echo sequences of the lower thoracic and lumbar spine were performed on all patients. Subsequent studies included MR of the sacrum supplemented where appropriate by CT and technetium MDP bone scintigraphy. No evidence of a compressive lesion of the lower thoracic or lumbar spine was present in any of the four patients. Dedicated MR examination of the sacrum in these patients revealed unilateral acute insufficiency fractures involving zone 1 from S1 to S3 extending from the sacro-iliac joint to the lateral margin of the sacral foramen. There was no evidence of compression of the sacral nerve roots. The possible mechanism for the symptomatic presentation is discussed. Sacral insufficiency fractures should be excluded in elderly or osteoporotic patients presenting with cauda equina syndrome who have no evidence of compression in the thoraco-lumbar MR studies. (orig.)

  15. Colgajo póstero-medial de muslo (adductor: a propósito de un caso Postero-medial thigh flap (adductor flap: case report

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    L. Gómez-Escolar Larrañaga

    2008-12-01

    Full Text Available En pacientes con úlceras masivas o confluentes en la región glútea, puede ser necesaria la amputación de la extremidad inferior y la reconstrucción mediante colgajos totales de muslo para la cobertura del defecto. Esta técnica es muy agresiva y además de las evidentes secuelas físicas que crea puede generar importantes trastornos psíquicos para el paciente. Presentamos el caso de una paciente con una gran úlcera por decúbito en la región isquio-trocantéreosacra en la que se empleó el colgajo Adductor como alternativa a la amputación de la extremidad inferior.Amputation of the lower extremity and total thigh flaps may be necessary for coverage in patients with massive multiple or confluent sores in the buttock region. This is an aggressive technique with important physical and psychological consequences for the patient. The Adductor flap was used as an alternative of the amputation in a patient with a big ischial-trocantericsacral pressure sore.

  16. Computation of trunk muscle forces, spinal loads and stability in whole-body vibration

    Science.gov (United States)

    Bazrgari, B.; Shirazi-Adl, A.; Kasra, M.

    2008-12-01

    Whole-body vibration has been indicated as a risk factor in back disorders. Proper prevention and treatment management, however, requires a sound knowledge of associated muscle forces and loads on the spine. Previous trunk model studies have either neglected or over-simplified the trunk redundancy with time-varying unknown muscle forces. Trunk stability has neither been addressed. A novel iterative dynamic kinematics-driven approach was employed to evaluate muscle forces, spinal loads and system stability in a seated subject under a random vertical base excitation with ˜±1 g peak acceleration contents. This iterative approach satisfied equations of motion in all directions/levels while accounting for the nonlinear passive resistance of the ligamentous spine. The effect of posture, co-activity in abdominal muscles and changes in buttocks stiffness were also investigated. The computed vertical accelerations were in good agreement with measurements. The input base excitation, via inertial and muscle forces, substantially influenced spinal loads and system stability. The flexed posture in sitting increased the net moment, muscle forces and passive spinal loads while improving the trunk stability. Similarly, the introduction of low to moderate antagonistic coactivity in abdominal muscles increased the passive spinal loads and improved the spinal stability. A trade-off, hence, exists between lower muscle forces and spinal loads on one hand and more stable spine on the other. Base excitations with larger peak acceleration contents substantially increase muscle forces/spinal loads and, hence, the risk of injury.

  17. Streptococcus agalactiae mural infective endocarditis in a structurally normal heart

    Directory of Open Access Journals (Sweden)

    Nobuhiro Ariyoshi

    2016-04-01

    Full Text Available A 38-year-old Caucasian man with uncontrolled diabetes mellitus type 2 was admitted with a 1-week duration of fevers, chills, and a non-productive cough. He had a left ischiorectal abscess 1 month prior to admission. Physical examination revealed caries on a left upper molar and a well-healed scar on the left buttock, but no heart murmur or evidence of micro-emboli. Blood cultures grew Streptococcus agalactiae. A transesophageal echocardiogram revealed a mobile mass in the right ventricle that attached to chordae tendineae without valvular disease or dysfunction. A computed tomography (CT with contrast revealed the mass within the right ventricle, a left lung cavitary lesion, and a splenic infarction. He was initially treated with penicillin G for a week. Subsequently, ceftriaxone was continued for a total of 8 weeks. A follow-up CT showed no evidence of right ventricular mass 8 weeks after discharge. This is the first reported case of S. agalactiae mural infective endocarditis in a structurally normal heart.

  18. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration

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    Edmundo Berumen-Nafarrate

    2013-01-01

    Full Text Available The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis.

  19. Bilateral ureteroarterial fistula: a case report and review of literature.

    Science.gov (United States)

    Melegari, Sara; Paparella, Stefano; Follini, Matteo L; Cappellano, Francesco; Ciotti, Mariano G; Giollo, Alessandro; Marzorati, Giuliano; Airoldi, Flavio; Losa, Sergio; Verweij, Fabrizio

    2016-09-26

    Ureteral arterial fistula (UAF) is an uncommon condition characterized by a direct fistulous communication between a ureter and an iliac artery resulting in bleeding into the ureter, which can be massive and life-threatening because of hemodynamic instability, as confirmed by the high mortality rate (7-23% overall).This condition is actually increasing in frequency because of its relation to predisposing factors such as vascular pathology, previous radiation therapy, previous surgery, and necessity of ureteral stenting. Diagnosis is often challenging, as in most patients, the only symptom is hematuria and the treatment may require a multidisciplinary approach, including the expertise of the urologist, vascular surgeon, and interventional radiologist. Endovascular approach offers advantages over open surgery decreasing morbidity (reduced risk of injury to adjacent structure) and shortening hospital staying. There is no consensus regarding the safety of intentional occlusion of the hypogastric artery: proximal occlusion of a hypogastric artery typically produces little or no clinical symptoms due to well-collateralized pelvic arterial networks. On the contrary, significant complications, such as colonic ischemia, spinal cord paralysis, buttock claudication, or erectile dysfunction, are well-recognized adverse events after hypogastric artery embolization, especially in bilateral cases. We describe our experience of a bilateral UAF treated with bilateral endvascular approach.

  20. Supplementating with dietary astaxanthin combined with collagen hydrolysate improves facial elasticity and decreases matrix metalloproteinase-1 and -12 expression: a comparative study with placebo.

    Science.gov (United States)

    Yoon, Hyun-Sun; Cho, Hyun Hee; Cho, Soyun; Lee, Se-Rah; Shin, Mi-Hee; Chung, Jin Ho

    2014-07-01

    Photoaging accounts for most age-related changes in skin appearance. It has been suggested that both astaxanthin, a potent antioxidant, and collagen hydrolysate can be used as antiaging modalities in photoaged skin. However, there is no clinical study using astaxanthin combined with collagen hydrolysate. We investigated the effects of using a combination of dietary astaxanthin and collagen hydrolysate supplementation on moderately photoaged skin in humans. A total of 44 healthy subjects were recruited and treated with astaxanthin (2 mg/day) combined with collagen hydrolysate (3 g/day) or placebos, which were identical in appearance and taste to the active supplementation for 12 weeks. The elasticity and hydration properties of facial skin were evaluated using noninvasive objective devices. In addition, we also evaluated the expression of procollagen type I, fibrillin-1, matrix metalloproteinase-1 (MMP-1) and -12, and ultraviolet (UV)-induced DNA damage in artificially UV-irradiated buttock skin before and after treatment. The supplement group showed significant improvements in skin elasticity and transepidermal water loss in photoaged facial skin after 12 weeks compared with the placebo group. In the supplement group, expression of procollagen type I mRNA increased and expression of MMP-1 and -12 mRNA decreased compared with those in the placebo group. In contrast, there was no significant difference in UV-induced DNA damage between groups. These results demonstrate that dietary astaxanthin combined with collagen hydrolysate can improve elasticity and barrier integrity in photoaged human facial skin, and such treatment is well tolerated.

  1. The number and distribution of blood dendritic cells in the epidermis and dermis of healthy human subjects.

    Science.gov (United States)

    Narbutt, Joanna; Lesiak, Aleksandra; Sysa-Jedrzejowska, Anna; Smolewski, Piotr; Robak, Tadeusz; Zalewska, Anna

    2006-01-01

    Human blood dendritic cells (BDC) can be divided into three subsets: plasmacytoid DC (PDC) and two myeloid subsets--MDC1 and MDC2. Several studies revealed the presence of both MDC and PDC in blood of healthy subjects, however no precise literature data exist on the number and distribution of BDC in the skin. The aim of our study was to assess the number and distribution of BDC and their subtypes in the healthy skin. The-study included 30 healthy volunteers (age 18-51). Punch biopsies were taken from the buttock skin from each subject, and immunofluorescent staining was performed using monoclonal mouse IgG1 antibodies directed against BDCA-1, BDCA-2, BDCA-3 and BDC-4. The BDC were present both in the epidermis and dermis. PDC were detected mainly in the dermis (mean 1.2 cells per field). Myeloid subtypes were observed mainly in the middle layers of the epidermis and in the upper part of the dermis (mean 1.8 cells per field). The detection of blood dendritic cells in the skin proves their role in immune cutaneous surveillance.

  2. Low back pain: considerations for rotary-wing aircrew.

    Science.gov (United States)

    Gaydos, Steven John

    2012-09-01

    Low back pain remains a significant issue among helicopter aircrew. There is a considerable body of scientific literature devoted to the problem, including epidemiologic and experimental studies addressing prevalence, characteristics, primary etiology, and contributing factors. It is endemic and multinational, with a prevalence ranging from 50-92%. Archetypal pain begins with flight or within hours of flight, is mostly targeted in the low back/lumbar region and/or buttocks, is transient, and is commonly described as dull and achy. A minority develop chronic, persistent pain that is variously described with dissimilar characteristics. The pernicious effects of back pain or discomfort while piloting may affect flight performance and safety, including reduced operational effectiveness and lost duty time, occupational attrition, curtailed or cancelled missions, compromised emergency egress, and performance deficits during critical phases of flight. The majority of etiologic studies have focused on the pathophysical posture adopted by pilots for aircraft control and exposure to whole body vibration. With more evidence for the former, it remains likely that both, as well as other factors, may have a contributory and perhaps integrative or concerted role. Corrective and mitigation strategies have addressed lumbar support, seat and cockpit ergonomic redesign, and improved aircrew health. Flight surgeons should be familiar with this prevalent issue and future research must address longitudinal cohort studies with clear definitions, relevant and valid exposure data, dose-response detail, and control for contributing factors and confounders.

  3. Analysis of mechanical interaction between human gluteal soft tissue and body supports.

    Science.gov (United States)

    Then, C; Menger, J; Benderoth, G; Alizadeh, M; Vogl, T J; Hübner, F; Silber, G

    2008-01-01

    Pressure sores are the most common complication associated with patient immobilization. They develop through sustained localized tissue strain and stress, primarily caused by body supports. Modifying support design can reduce the risk and extent of pressure sore development with computational simulations helping to provide insight into tissue stress-strain distribution. Appropriate material parameters for human soft tissue and support material, as well as precise anatomical modelling, are indispensable in this process. A finite element (FE) model of the human gluteal region based on magnetic resonance imaging (MRI) data has been developed. In vivo human gluteal skin/fat and muscle long-term material parameters as well as open-cell polyurethane foam support long-term material parameters have been characterised. The Ogden form for slightly compressible materials was employed to describe human gluteal soft tissue behaviour. Altering support geometries and support materials, effects on human gluteal soft tissue could be quantified. FE-analysis indicated maximal tissue stress at the muscle-bone interface, not at the skin. Shear strain maxima were found in the muscle layer near the fat-muscle interface. Maximum compressive stress magnitude at the sacral bone depended strongly on the behaviour of the pelvic diaphragm musculature. We hypothesize that the compliance of the muscles forming the pelvic diaphragm govern the relative motion of the buttock tissue to the adjacent bone structure under compression, thus influencing tissue stress magnitudes.

  4. [Control measures against Serratia marcescens colonization at the neonatal intensive care unit of UOEH hospital].

    Science.gov (United States)

    Ikeno, Takako; Tanabe, Tadao; Muratani, Tetsuro; Nakano, Noriko; Kotake, Tomoko; Shirakawa, Yoshitsugu; Taniguchi, Hatsumi; Matsumoto, Tetsuro

    2003-03-01

    In September 2001, twelve neonatal intensive care unit (NICU) patients were found to be colonized with pigment-producing strains of Serratia marcescens. The UOEH Infection Control Group (ICG) committee investigated the source of this epidemic and carried out several remedial measures. Immediate investigation of both the environment and the hands of health care workers were enforced. The most likely means of transmission was thought to be from the hands contaminated with S. marcescens that was found on antiseptic cotton, kept in shared stainless steel canisters, used for wiping the patients' buttocks. Therefore, we suggested the following interventions: 1) abolish the stainless steel canisters, and prepare antiseptic cottons for each patient, 2) monitor cultures with some specimens for all patients in the NICU, 3) periodically investigate the environment, 4) enforce workers to wash and disinfect their hands before and after patient care, 5) use new gloves for each treatment, 6) re-examine and modify the caring procedures for inpatients by the nursing staff. In January 2002, this nosocomial colonization came to an end without any serious infection. One of the key points of this success was the quick response by the clinical staff and ICG committee members to the laboratory results of bacteriological examinations. Furthermore, the early investigation of reservoir and good communication between the clinical staff and ICG committee members mostly prevented this nosocomial colonization from becoming worse.

  5. Epidemiology and screening of intentional burns in children in a Dutch burn centre.

    Science.gov (United States)

    Bousema, Sara; Stas, Helene G; van de Merwe, Marjolijn H; Oen, Irma M M H; Baartmans, Martin G A; van Baar, Margriet E

    2016-09-01

    International estimates of the incidence of non-accidental burns (NAB) in children admitted to burn centres vary from 1% to 25%. Hardly any data about Dutch figures exist. The aim of this study was to evaluate the incidence, treatment and outcome of burns due to suspected child abuse in paediatric burns. We described the process of care and outcome, including the accuracy of the SPUTOVAMO screening tool and examined child, burn and treatment characteristics related to suspicions of child abuse or neglect. A retrospective study was conducted in children aged 0-17 years with a primary admission after burn injuries to the burn centre Rotterdam in the period 2009-2013. Data on patient, injury and treatment characteristics were collected, using the Dutch Burn Repository R3. In addition, medical records were reviewed. In 498 paediatric admissions, suspected child abuse or neglect was present in 43 children (9%). 442 screening questionnaires (89%) were completed. In 52 out of 442 questionnaires (12%) the completed SPUTOVAMO had one or more positive signs. Significant independent predictors for suspected child abuse were burns in the genital area or buttocks (OR=3.29; CI: 143-7.55) and a low socio-economic status (OR=2.52; 95%CI: 1.30-4.90). The incidence of suspected child abuse indicating generation of additional support in our population is comparable to studies with a similar design in other countries.

  6. Trunnion Corrosion and Early Failure in Monolithic Metal-on-Polyethylene TMZF Femoral Components: A Case Series

    Directory of Open Access Journals (Sweden)

    Peter Walker

    2016-09-01

    Full Text Available We describe four patients who were treated with primary total hip arthroplasty (THA at two tertiary academic Australian teaching hospitals that experienced premature failure of head-neck trunnions through dissociation of the head-neck taper junction. This retrospective case series have similar clinical presentations and macroscopic pathology with severe head-neck taper junction loss of material, corrosion and early catastrophic failure. It is proposed that the accelerated wear is related to use of varus offset neck in a proprietary beta titanium alloy (Ti-12Mo-6Zr-2Fe  or TMZFÒ Stryker Osteonics, Mahwah NJ, USA TMZF femoral stem, longer head-neck combination in a relatively active, older, male patient population. In this limited case series presentation was on average 80 months (range 53-92 following index procedure. In three of the four patients, a prodromal period of groin or buttock pain was reported for between 1 week and 2 months prior to acute presentation. Significant metallosis and local tissue damage including gluteal muscle insufficiency was evident. Each stem revised was well fixed. An extended trochanteric osteotomy was required in two of the four cases for stem extraction. We recommend caution and further evaluation on the relationship between TMZF metal alloy and its longevity in higher demand patients with high neck offset, varus stem geometry and large CoCr bearing heads.

  7. Animal Bites in Borujerd: An Overview of Animal Bites in Iran

    Directory of Open Access Journals (Sweden)

    Sabouri Ghannad

    2014-04-01

    Full Text Available Background Rabies has been reported as the most important endemic zoonotic disease in Iran and still remains as a major public health problem. Objectives The main objective of the current research was to study the epidemiology of animal bites in Borujerd County in Iran and to compare its prevalence to other parts of Iran from April 2006 to September 2011. Patients and Methods The data were recorded in questionnaires and analyzed by SPSS version 16. Chi-square test was performed to evaluate the relationship among variables and P value was set as 0.05. Results Dog bites were the most common (69.8%, followed by cat (17.2%, fox and wolf (1.4%, sheep and cow (2.8%, monkey and donkey (5%, mouse and squirrel (2.2% and other animals (1.6%. Leg was the most common bite site forming 46.6% of cases, followed by hands (41.8%, buttocks (4.6%, head (4% and body (2.9%. Most of the subjects belonged to the age group < 10 (175.2 per 100000 populations. The injury location was associated significantly with sex and the residential status. Conclusions This study strongly highlights a high priority goal for health authorities to develop educational programs, recommended for the general population to inform them about the benefits of continuing the medication. Vaccination of domestic dogs and also eradication of stray ones, in addition to educational programs should be prioritized by health authorities.

  8. A New Health Strategy to Prevent Pressure Ulcer Formation in Paraplegics using Computer and Sensory Substitution via the Tongue

    CERN Document Server

    Moreau-Gaudry, A; Demongeot, J; Payan, Y; Moreau-Gaudry, Alexandre; Prince, Anne; Demongeot, Jacques; Payan, Yohan

    2006-01-01

    Pressure ulcers are recognized as a major health issue in individuals with spinal cord injuries and new approaches to prevent this pathology are necessary. An innovative health strategy is being developed through the use of computer and sensory substitution via the tongue in order to compensate for the sensory loss in the buttock area for individuals with paraplegia. This sensory compensation will enable individuals with spinal cord injuries to be aware of a localized excess of pressure at the skin/seat interface and, consequently, will enable them to prevent the formation of pressure ulcers by relieving the cutaneous area of suffering. This work reports an initial evaluation of this approach and the feasibility of creating an adapted behavior, with a change in pressure as a response to electro-stimulated information on the tongue. Obtained during a clinical study in 10 healthy seated subjects, the first results are encouraging, with 92% success in 100 performed tests. These results, which have to be complete...

  9. Utilisation de la substitution sensorielle par \\'{e}lectro-stimulation linguale pour la pr\\'{e}vention des escarres chez les parapl\\'{e}giques. Etude pr\\'{e}liminaire

    CERN Document Server

    Moreau-Gaudry, A; André, P; Prince, A; Pauget, P; Demongeot, J; Payan, Y; Moreau-Gaudry, Alexandre; Robineau, Fabien; Andr\\'{e}, Pierre-Fr\\'{e}d\\'{e}ric; Prince, Anne; Pauget, Pierre; Demongeot, Jacques; Payan, Yohan

    2006-01-01

    Pressure ulcers are recognized as a major health issue in individuals with spinal cord injuries and new approaches to prevent this pathology are necessary. An innovative health strategy is being developed through the use of computer and sensory substitution via the tongue in order to compensate for the sensory loss in the buttock area for individuals with paraplegia. This sensory compensation will enable individuals with spinal cord injuries to be aware of a localized excess of pressure at the skin/seat interface and, consequently, will enable them to prevent the formation of pressure ulcers by relieving the cutaneous area of suffering. This work reports an initial evaluation of this approach and the feasibility of creating an adapted behavior, with a change in pressure as a response to electro-stimulated information on the tongue. Obtained during a clinical study in 10 healthy seated subjects, the first results are encouraging, with 92% success in 100 performed tests. These results, which have to be complete...

  10. Pseudoaneurysm Accompanied by Crowe Type IV Developmental Dysplasia of the Hip: A Case Report

    Directory of Open Access Journals (Sweden)

    Hirotake Yo

    2012-01-01

    Full Text Available We report the case of a 72-year-old woman whose pseudoaneurysm was difficult to diagnose and treat. The patient had a history of congenital dislocated hip and was undergoing anticoagulation therapy with warfarin due to the mitral valve replacement. Her chief complaint was pain and enlargement of the left buttock, and the laboratory tests revealed severe anemia. However, her elderly depression confused her chief complaint, and she was transferred to a psychiatric hospital. Two months after the onset of the symptoms, she was finally diagnosed with a pseudoaneurysm by contrast-enhanced CT and angiography. IDC coils were used for embolization. A plain CT showed hemostasis as well as a reduced hematoma at 2 months after the embolization. The possible contributing factors for the pseudoaneurysm included bleeding due to warfarin combined with an intramuscular hematoma accompanied by Crowe type IV developmental dysplasia of the hip that led to an arterial rupture by impingement between pelvis and femoral head. Since the warfarin treatment could not be halted due to the valve replacement, embolization was chosen for her treatment, and the treatment outcome was favorable.

  11. Spinal non-Hodgkin's lymphoma mimicking a flare of disease in a patient with ankylosing spondylitis treated with anti-TNF agents: case report and review of the literature.

    Science.gov (United States)

    Monti, Sara; Boffini, Nicola; Lucioni, Marco; Paulli, Marco; Montecucco, Carlomaurizio; Caporali, Roberto

    2016-01-01

    We report the case of a 52-year-old man with long-standing HLAB27-positive ankylosing spondylitis treated with anti-tumour necrosis factor (TNF) alpha therapy who was admitted to our rheumatology department complaining of increasing lumbar and buttock pain radiating to the posterior thigh, associated with numbness in the leg, gait disturbance and low-grade fever. The clinical picture was initially interpreted as a flare of disease but was not responsive to treatment. A contrast-enhanced spinal MRI was performed with evidence of a diffuse signal abnormality involving the sacroiliac joints and the spine, with evidence of spondylodiscitis of L5 and with a lesion causing L5-S1 root compression and infiltrating the iliopsoas muscle. These findings confirmed the possibility of a reactivation of disease associated with an infectious process. The most frequent causes of infectious spondylodiscitis were excluded, and a biopsy was then performed. Histological analysis revealed a high-grade B-cell non-Hodgkin's lymphoma of the spine. This case highlights how a differential diagnosis of low back pain with neurological symptoms can be particularly troublesome in ankylosing spondylitis and that continuous vigilance is warranted in patients treated with long-term immunosuppressive therapies.

  12. Female waist-to-hip ratio, body mass index and sexual attractiveness in China

    Directory of Open Access Journals (Sweden)

    B.J. DIXSON, Baoguo LI, A.F. DIXSON

    2010-04-01

    Full Text Available Men and women at Northwest University (n = 751, Xi’an, China were asked to judge the attractiveness of photographs of female patients who had undergone micrograft surgery to reduce their waist-to-hip ratios (WHR. Micrograft surgery involves harvesting adipose tissue from the waist and reshaping the buttocks to produce a low WHR and an ‘hourglass’ female figure. This gynoid distribution of female body fat has been shown to correlate with measures of fertility and health. Significantly larger numbers of subjects, of both sexes, chose post-operative photographs, with lower WHRs, as more attractive than pre-operative photographs of the same women. Some patients had gained, and some had lost weight, post-operatively, with resultant changes in body mass index (BMI. However, these changes in BMI were not related to judgments of attractiveness. These results show that the hourglass female figure is rated as attractive in China, and that WHR, rather than BMI, plays a crucial role in such attractiveness judgments [Current Zoology 56 (2: 175–181, 2010].

  13. BODY PRESSURE DISTRIBUTION OF AUTOMOBILE DRIVING HUMAN MACHINE CONTACT INTERFACE

    Institute of Scientific and Technical Information of China (English)

    CHEN Juan; HONG Jun; ZHANG E; LIANG Jian; LU Bingheng

    2007-01-01

    Aiming at the fatigue and comfort issues of human-machine contact Interface in automobile driving and based on physiological and anatomical principle, the physiological and biochemical process of muscles and nerves in the formation and development of fatigue is analyzed systematically. The fatigue-causing physiological characteristic Indexes are mapped to biomechanical Indexes like muscle stress-strain, the compression deformation of Wood vessels and nerves etc.from the perspective of formation mechanism. The geometrical model of skeleton and parenchyma is established by applying CT-scanned body data and MRI images. The general rule of comfort body pressure distribution is acquired through the analysis of anatomical structure of buttocks and femoral region. The comprehensive lest platform for sitting comfort of 3D adjustable contact Interface is constructed. The lest of body pressure distribution of human-machine contact interface and its comparison with subjective evaluation indicates that the biomechanical Indexes of automobile driving human-machine contact interface and body pressure distribution rule studied can effectively evaluate the fatigue and comfort issues of human-machine contact interface and provide theoretical basis for the optimal design of human-machine contact interface.

  14. Comparative studies of spinal celes in Switzerland, Jamaica, and Nigeria, and possible relationship with environmental pollution

    Directory of Open Access Journals (Sweden)

    M.O.N. Ibe

    2009-01-01

    Full Text Available Objective and Background:The need to sanitize our environment from elements hazardous to life on earth is hereby high-lighted, as well as a properly organized and efficiently run prenatal health care system. Clinical Methods and Materials:From 1975 to 2004,17 spinal celes (including 2 meningoceles were routinely repaired in Imo and Ebonyi States of Nigeria, and 5 in Jam aica,the West Indies; none in Easel, Switzerland. All 20 meningomyeloceles were incontinent of urine and faeces, had severe paraparesis to paraplegia, sensory loss in both lower limbs, and bilateral pedes equino-varus in 16 cases. In addition, 2 were hydrocephalic, andall meningomyeloceles were ulcerated. All celes were micllme. The meninggoceles were normal. The operations were carried out under routine general anaesthesia. Results: The pre-operation status remained the same in all 20 meningomyeloceles 60 months later, though, they were able to sit up and shift around on their buttocks. The meningoceles remain d norm al. The hydrocephalus in both cases was arrested. There were no deaths within the hospitalization period of about 14 days. Conclusion: Vigorous endeavor to sanitize our environment from obnoxious elem ents(env ironm ental pollution, hazardous waste sites, agricultural chemicals, organic solvents, water chsinfection by-products, etc., good and adequate antenatal care, with antenatal diagnosis of the malformed foetus and termination of the pregnancy, must be strived at, folic acid supplementation must begin before conception.

  15. Clinical features and epidemiology of spondyloarthritides associated with inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Carlo Salvarani; Walter Fries

    2009-01-01

    Inflammation of axial and/or peripheral joints is one of the most frequent extra-intestinal manifestations complicating the clinical course and therapeutic approach in inflammatory bowel diseases (IBD). The frequency of these complications seems to be similar for both diseases, Crohn’s disease and ulcerative colitis. Arthritis associated with IBD belongs to the category of spondyloarthropathies. Axial involvement ranges from isolated inflammatory back pain to ankylosing spondylitis, whereas peripheral arthritis is noted in pauciarticular and in polyarticular disease.Asymptomatic radiological involvement of the sacroiliac joints is reported to occur in up to 50% of patients.Other musculoskeletal manifestations such as buttock pain, dactylitis, calcaneal enthesitis, and thoracic pain are frequently underdiagnosed and, consequently,are not treated appropriately. Several diagnostic approaches and criteria have been proposed over the past 40 years in an attempt to correctly classify and diagnose such manifestations. The correct recognition of spondylarthropathies needs an integrated multidisciplinary approach in order to identify common therapeutic strategies, especially in the era of the new biologic therapies.

  16. Body image in obese children: Effects produced by physical exercise program

    Directory of Open Access Journals (Sweden)

    E. Romero

    2015-01-01

    Full Text Available Body image self-perception in obese children is important since it can encourage behaviors leading to social isolation and cause an increase in food intake. The objective of this study was to determine the changes produced in the level of body image satisfaction and the variation in anthropometric indicators of young children in the State of Sonora, Mexico after participating in a program of 40 sessions of physical exercise with an average caloric expenditure of 267 Kcal per session. 119 children were enrolled in the program; they were between the ages of 8 and 11 with a body mass index (BMI of 26.59 ± 4.2 (kg/m2. They were evaluated before and after the physical activity intervention by means of a Body Image Satisfaction (BIS Test. The results with significant changes (p ≤ 0.05 between the pre-test and post-test are in weight and height. There are also significant changes observed in self-image in 15 parts of evaluated body segments, mainly in the abdomen, chest, thighs, buttocks, waist, and hips in all children from the experimental group. The results conclude that physical exercise, in spite of not producing significant changes in BMI, can positively modify body image perception.

  17. Use of wound dressings to enhance prevention of pressure ulcers caused by medical devices.

    Science.gov (United States)

    Black, Joyce; Alves, Paulo; Brindle, Christopher Tod; Dealey, Carol; Santamaria, Nick; Call, Evan; Clark, Michael

    2015-06-01

    Medical device related pressure ulcers (MDR PUs) are defined as pressure injuries associated with the use of devices applied for diagnostic or therapeutic purposes wherein the PU that develops has the same configuration as the device. Many institutions have reduced the incidence of traditional PUs (sacral, buttock and heel) and therefore the significance of MDR PU has become more apparent. The highest risk of MDR PU has been reported to be patients with impaired sensory perception, such as neuropathy, and an impaired ability for the patient to communicate discomfort, for example, oral intubation, language barriers, unconsciousness or non-verbal state. Patients in critical care units typify the high-risk patient and they often require more devices for monitoring and therapeutic purposes. An expert panel met to review the evidence on the prevention of MDR PUs and arrived at these conclusions: (i) consider applying dressings that demonstrate pressure redistribution and absorb moisture from body areas in contact with medical devices, tubing and fixators, (ii) in addition to dressings applied beneath medical devices, continue to lift and/or move the medical device to examine the skin beneath it and reposition for pressure relief and (iii) when simple repositioning does not relieve pressure, it is important not to create more pressure by placing dressings beneath tight devices.

  18. 螯合锌对冬毛期貉生长性能、营养物质表观消化率、血清指标、毛皮品质的影响%Influences of Chelating Zinc on Growth Performance, Nutrient Apparent Digestibility, Serum Indices and Fur Quality of Raccoon Dogs during Winter-Furring Period

    Institute of Scientific and Technical Information of China (English)

    郑银伟; 刘志平; 黄卉; 王玉峰

    2015-01-01

    本文旨在研究饲粮中添加螯合锌对冬毛期貉生长性能、营养物质表观消化率、血清指标、毛皮品质的影响。选择健康冬毛期貉120只,随机分为4组,即3个试验组(Ⅰ组、Ⅱ组、Ⅲ组)与1个对照组(Ⅳ组),每组30只(公母各占1/2)。以蛋氨酸锌为螯合锌源,一水合硫酸锌(ZnSO4·H2O)为无机锌源,Ⅰ组、Ⅱ组、Ⅲ组、Ⅳ组分别饲喂基础饲粮+50 mg/kg 蛋氨酸锌+20 mg/kg ZnSO4·H2O、基础饲粮+60 mg/kg 蛋氨酸锌+10 mg/kg ZnSO4·H2O、基础饲粮+70 mg/kg蛋氨酸锌、基础饲粮+70 mg/kg ZnSO4·H2O(数据均为锌含量,基础饲粮中锌含量为42.89 mg/kg)。试验期为55 d。结果表明:1)3个试验组的终末体重和饲料转化率均显著或极显著均高于对照组(P0.05),但粗脂肪表观消化率显著高于对照组(P0.05) . However, the apparent digestibility of ether extract was significantly higher in experimental groups than that in the control group (P<0.05). 3) Serum znic content and alkaline phosphatase activity in the control group were significantly lower than those in all experimental groups ( P<0.01) . 4) Experimental groups tended to have longer guard hair, under fur and the diameter of under fur in neck, backside and buttocks compared with the control group. However, the diameter of guard hair was de-creased in experimental groups compared with the control group, and the diameter of guard hair in neck, back-side and buttocks in groupⅢwas significantly shorter than that in the control group.(P<0.05). 5) The weight of skin per unit area in three experimental groups was significantly higher than that in the control group ( P<0.01 or P<0.01) . These results suggest that adding chelating zinc to the diet can improve the body weight, av-erage daily gain, feed conversion rate, ether extract apparent digestibility and fur quality of raccoon dogs al-though, the guard hair diameter tends to become thinner. The dosage of additive chelating zinc at 70 mg

  19. Effect of Combined Interventions on Overweight and Obesity in Children%超重及肥胖儿童综合干预效果

    Institute of Scientific and Technical Information of China (English)

    汪达芳; 易维芬; 赵宏; 龚焱宏

    2011-01-01

    Objective To observe the effect of combined interventions on overweighted and obesity children based on health education,behavior modification,balanced diet,sports prescription to control the indexes of the morphology,girth and blood indexes. Methods Twenty- three overweighted and obesity pupils and secondary school students aged 8 - 14 years old were intervened for 21 d,and the changes in morphology, girth index and blood index were observed for 21 days by 10 researchers, including coach, doctor, dietitian, psychoanalyst before and affter intervention. Results Related morphological indexes including body mass index, body fat ratio, waist buttocks ratio were superior to the non- intervention individuals, and the differences were significant( Pa <0.01 ). Related girth indexes including the skinfold thickness of the upper arm, subscapular angle ,belly and the girth of the upper arm,chest, waist, buttocks were superior to the non - intervention individuals,and the differences were significant( Pa < 0.05 ) ,but the indexes of thigh had no significant difference( P >0. 100). Related blood indexes, including total cholesterol, triglyceride,high density lipoprotein and low density lipoprotein were superior to the non - intervention individuals,but the differences were not significant (Pa > 0. 100). Conclusions It's feasible to control the indexes of morphology and girth by combined systematic, effective and easy intervention on overweight and obesity in pupils and secondary school students. No obvious changes in blood index for a short time intervention, which suggests that a long - term combined intervention need to be performed to improve the physique health of overweight and obesity children basically.%目的 观察健康教育、行为矫正、膳食调整、运动处方等综合干预措施对控制超重及肥胖儿童形态指标、围度指标及血液指标的效果.方法 组织暑期夏令营,由具备研究能力的教练、医师

  20. Early diagnosis of ankylosing spondylitis: assessment the criteria for axial spondyloarthritis, proposedby the International Working Group of the Assessment of SpondyloArthritis Society (ASAS

    Directory of Open Access Journals (Sweden)

    Anna Georgiyevna Bochkova

    2010-01-01

    in 94,9 and 43,6% of the patients, respectively. The sensitivity of the first variant of the ASAS criteria was 84,6% and its specificity was 100%. These of the second variant of the ASAS criteria were 94,9 and 84,7%, respectively. With the consecutive use of the first variant of the ASAS criteria for early SPA, then their second variant, their sensitivity was as high as 100%. LB pain only was observed in 76,9% of patients with axSPA, 20% of them having wandering pains in the buttocks. In the control patients, LB pain was also predominant (71,7%. The sensitivity and specificity of the criteria proposed by M. Rudwaleit et al. and the ASAS (J. Siper et al. were 89,7 and 85,7%; 89,7 and 100%, respectively. There were no statistical differences in the sensitivity of individual criteria. The specificity of the ASAS criteria was significantly higher than that of the criteria described by A. Calin (p=0,0000; double Fisher's test. Conclusion. With the consecutive use of the first variant of the ASAS criteria for early SPA, then their second variant, their sensitivity was as high as 100%. It is more preferential to use the criteria described by М. Rudwaleit et al. or the 2009 new criteria by the ASAS working group. The valuable symptom of inflammatory pain is wandering buttock pain, the specificity of which in patients with early axSPA was 100%.

  1. The incidence of transient neurologic syndrome after spinal anesthesia with lidocaine or bupivacaine: The effects of needle type and surgical position: brief report

    Directory of Open Access Journals (Sweden)

    Etezadi F

    2011-10-01

    Full Text Available "nBurning Transient Neurologic Syndrome (TNS which was first described by Schneider et al in 1993, is defined as a transient pain and dysesthesia in waist, buttocks and the lower limbs after spinal anesthesia.1,2 The incidence of TNS after spinal anesthesia with lidocaine is reported to be as high as 10-40%.3,4 This prospective study was designed to determine the incidence of TNS with two different types of drugs, lidocaine and bupivacaine, in lithotomy or supine positions as the primary outcomes and to determine the association between two different types of needles and surgical positions with the occurrence of TNS as the secondary outcome."nThe present study was conducted on 250 patients (ASA I-II, aged 18-60 years old, who were candidates for surgery in supine or lithotomy positions. According to the needle type (Sprotte or Quincke and the local anesthetic (lidocaine or bupivacaine all patients were randomly divided into four groups. After establishing standard monitoring, spinal anesthesia was performed in all sitting patients by attending anesthesiologists at L2-L3 or L3-L4 levels. The patients were placed in supine or lithotomy position, in regards to the surgical procedure. During the first three postoperative days, patients were observed for post spinal anesthesia complications, especially TNS. Any sensation of pain, dysesthesia, paresthesia or hyperalgesia in the low back area, buttocks, the anterior or posterior thigh, knees, either foot or both feet were recorded. Moreover, duration of pain, its radiation and its relation to sleep and the patients' position were all carefully considered. Ultimately, the patients' response to opioid (pethidine for analgesia was determined."nThe incidence of TNS was higher when spinal anesthesia was induced with lidocaine (68% vs. 22%, P=0.003. TNS developed in 85% of the patients in lidocaine group and 58% in bupivacaine group after surgery in lithotomy position (P=0.002. In 77 patients pain

  2. 外用原花青素对皮肤急性光损伤日晒伤细胞及p53蛋白表达的影响%Influence of grape seed proanthocyanidin extract on sunburn cell formation and p53 protein expression induced by acute ultraviolet injury

    Institute of Scientific and Technical Information of China (English)

    袁小英; 刘玮; 胡益云; 张萍; 信许亚; 田燕; 马慧敏; 范立英

    2009-01-01

    目的 评估外用葡萄籽提取物原花青素对急性光损伤的日晒伤细胞及p53蛋白表达的影响.方法 实验设计正常皮肤组、单纯2MED照射组、基质+2MED照射组、含葡萄籽提取物原花青素样品外用+2MED照射组,连续3天相同方法处理后24 h对皮肤取材,进行HE染色和p53免疫组化染色.结果 含葡萄籽提取物原花青素样品外用+2MED照射组的日晒伤细胞数与单纯接受紫外线照射的皮肤相比.差异有统计学意义(P<0.01).含葡萄籽提取物原花青素样品外用+2MED照射组的p53蛋白阳性细胞数与单纯接受紫外线照射的皮肤相比,差异有统计学意义(P<0.05).结论 葡萄籽提取物原花青素外用对紫外线造成的急性光损伤具有较好的防护作用,可作为一种天然的防晒成分加以开发.%Objective To evaluate the influence of grape seed proanthocyanidin extract (GSPE) on sunburn cell formation and p53 protein expression induced by acute ultraviolet injury. Methods Ten volunteers were enrolled in this study. The buttock region served as the exposed region. Four areas were randomized and delineated on the buttock: one area (control area) received no exposure or product, the other 3 areas were exposed to two minimal erythema doses (MED) of simulated solar radiation (SSR) for 3 days. Of the 3 exposed areas, one area (SSR) received no product before exposure, one area (SSR + Veh) was pretreated with vehicle, the third area (SSR + GSPE) with the samples of GSPE. GSPE or vehicle was applied 30 minutes before each exposure at 2 μL/cm2. Skin biopsy was performed 24 hours after the last exposure, and skin specimens were subjected to hematoxylin eosin (HE) staining and histochemical analysis for p53 protein. Results There was a statistical difference in the number of sunburn cells per high power field (×200) between SSR sites and SSR + GSPE sites (29.8±11.1 cells vs 2.2±0.2 cells, P<0.01). A significant decrease was noticed in the account

  3. Estimating whole body intermuscular adipose tissue from single cross-sectional magnetic resonance images.

    Science.gov (United States)

    Ruan, Xiang Yan; Gallagher, Dympna; Harris, Tamara; Albu, Jeanine; Heymsfield, Steven; Kuznia, Patrick; Heshka, Stanley

    2007-02-01

    Intermuscular adipose tissue (IMAT), a novel fat depot linked with metabolic abnormalities, has been measured by whole body MRI. The cross-sectional slice location with the strongest relation to total body IMAT volume has not been established. The aim was to determine the predictive value of each slice location and which slice locations provide the best estimates of whole body IMAT. MRI quantified total adipose tissue of which IMAT, defined as adipose tissue visible within the boundary of the muscle fascia, is a subcomponent. Single-slice IMAT areas were calculated for the calf, thigh, buttock, waist, shoulders, upper arm, and forearm locations in a sample of healthy adult women, African-American [n = 39; body mass index (BMI) 28.5 +/- 5.4 kg/m2; 41.8 +/- 14.8 yr], Asian (n = 21; BMI 21.6 +/- 3.2 kg/m2; 40.9 +/- 16.3 yr), and Caucasian (n = 43; BMI 25.6 +/- 5.3 kg/m2; 43.2 +/- 15.3 yr), and Caucasian men (n = 39; BMI 27.1 +/- 3.8 kg/m2; 45.2 +/- 14.6 yr) and used to estimate total IMAT groups using multiple-regression equations. Midthigh was the best, or near best, single predictor in all groups with adjusted R2 ranging from 0.49 to 0.84. Adding a second and third slice further increased R2 and reduced the error of the estimate. Menopausal status and degree of obesity did not affect the location of the best single slice. The contributions of other slice locations varied by sex and race, but additional slices improved predictions. For group studies, it may be more cost-effective to estimate IMAT based on one or more slices than to acquire and segment for each subject the numerous images necessary to quantify whole body IMAT.

  4. Thermal Comfort While Sitting on Office Chairs – Subjective Evaluations

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    Zoran Vlaović

    2012-12-01

    Full Text Available Thermal comfort is related to human physiological reactions. In order to maintain a constant internal temperature, the human body must dissipate heat in a warm climate, and prevent heat losses in a cold climate. The overall sensation of comfort accompanies the warmest part of the body in a warm environment and the coldest one in a cold environment. Chair design and clothing may affect the difference in sensitivity between certain parts of the body, that is, they may affect thermal comfort. This research focused on subjective sensation of warmth and moisture while sitting on offi ce chairs. The subjective method of evaluating thermal discomfort is based on ISO 7730:2005 standard, according to which a questionnaire was made for this research. Six subjects took part in the research. They were sitting on five different office chairs as they performed their usual jobs in controlled conditions. From the point of view of the evaluation of the sensation of warmth, all chairs were evaluated neutrally. The sensation under the buttocks and thighs was reported to be somewhat warmer, while the sensation on the back was reported to be somewhat colder, which was affected by the design of the back of the chair. No correlation has been proven between the actual temperature and moisture measurements and subjective evaluations of thermal comfort, in spite of a number of direct links. The use of the present method offers the possibility of further research into this subject, which would prove more thoroughly a correlation between design and construction solutions of office chairs and the comfort perceived by sitting persons.

  5. a Decade of Improvement in Whole-Body Vibration and Low Back Pain for Freight Container Tractor Drivers

    Science.gov (United States)

    Nishiyama, K.; Taoda, K.; Kitahara, T.

    1998-08-01

    The authors' study in 1983 revealed that the whole-body vibration of the tractor units of freight containers was most hazardous in the back-to-chest directions (x-axis). The allowable exposure time was considerably shorter than that for heavy duty trucks. The low back pain (LBP) among the drivers seemed to be due to the long working hours and the ergonomically unsound tractor design, as well as the vibration. A preventative measure was the introduction of a tractor cab suspended by an air spring instead of a steel spring. In 1992, a follow-up field study was conducted. A personal vibration exposure meter developed by us measured the whole-body vibration on eight tractors. Eighty-nine triplets matched with the age and the years of driving tractors answered a questionnaire evaluation of the ergonomics of their tractor units.The comparison of the newest steel suspension vehicles to the old ones produced by the same motor company revealed that in thex-axis the vibration level had decreased by as much as 4 to 9 dB. Some tractors showed an increase in vibration in the buttocks-to-head direction (z-axis). However, such adverse changes seemed not to affect evaluations according to the fatigue-decreased proficiency boundary (FDP) and the exposure limit (EL) recommended in ISO 2631-1978. The present models, regardless of the type of suspension, changed the direction of the most hazardous vibration from thex-axis to thez-axis. However, the effect of the air-suspension was not so remarkable as expected. Among 40% of drivers seemed to exceed the FDP boundary during a day.The questionnaire study showed an improvement in the ergonomic evaluation of the tractors. The air suspension models seemed to induce less LBP than the steel suspension models.

  6. Effect of air conditioning and chair cushion on scrotal temperature.

    Science.gov (United States)

    Song, Gook-Sup; Kim, Wonwoo; Seo, Ju Tae

    2008-08-01

    The hypothesis of this study is that the air conditioning temperature and thickness of the chair cushion affect a man's scrotal, and consequently testicular, temperature. Ten healthy male subjects volunteered for the study (age: 23.4 +/- 2.4 years; height: 173.8 +/- 5.09 cm; weight: 71.6 +/- 9.7 kg; body fat ratio: 18.6 +/- 4.1%). The air conditioning temperature was controlled at 18 degrees C to represent the heating season, and at 26 degrees C to represent the cooling season. The thickness of the chair cushions was varied from 0 to 8 cm at 2 cm intervals. The changes in the scrotal surface temperature (SST) and buttock skin temperature were measured for 120 min. At the ambient temperatures (t(a)) of 18 and 26 degrees C, the average SST were 33.76 +/- 1.28 and 35.02 +/- 0.54 degrees C for the chair cushion thickness (C(thk)) of 0 cm, 33.87 +/- 1.07 and 34.96 +/- 0.75 degrees C for C(thk) 2 cm, 33.91 +/- 0.84 and 35.03 +/- 0.85 degrees C for C(thk) 4 cm, 34.42 +/- 0.89 and 35.02 +/- 0.63 degrees C for C(thk) 6 cm, and 34.65 +/- 1.21 and 34.99 +/- 0.62 degrees C for C(thk) 8 cm respectively. SST was significantly affected by the air conditioning temperature (p < 0.001), but was not statistically correlated with the chair cushion thickness.

  7. A STUDY OF PATTERN, SURGICAL MANAGE MENT AND OUTCOME OF BEAR MAULING AT CIMS BILASPUR

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    Santosh

    2015-07-01

    Full Text Available We studied the various injury patterns in bear mauling and outcome of management in CIMS from 2010 to 2014. A total of 20 cases evaluated which were predominantly male (95%. It is obvious that involvement of head, neck face and upper limb was in maximum cases. The age wise study shows that there was equal involvement of people from young, middle aged and older ones. It was a retrospective analysis of the reported cases. Most victims suffered from multiple injuries. Percentage wise distribution of the injuries and involvement of different body parts amongst observed cases were head neck face 75%, thorax and abdomen 40%, upper limb 75%, buttocks and genitals 30% , lower limb 50%. We observed that in 75% of cases of mutilation over h ead neck and face, it was most common site of bear mauling. Probably, it is because usually the attacks by bear is mainly on standing posture with hind limbs. All the patients were treated by a team led by surgeons including dental cum oral surgeon, otorhinolaryngologist, ophthalmologist and orthopedician. Surgical repair was done under all aseptic precaution and analgesia. Because of severe anatomical distortion of face and multiple fractures of facial bones with unstable and hanging mandible, in number of cases urgent tracheostomy was performed to restore the airways and for induction of general anesthesia. This also prevents aspiration and regurgitation. The excell ent blood supply of the face makes infection a rare occurrence with good antibiotic coverage. However, the injury may cause sufficient disfigurement and require extensive reconstruction. We also observed eye globe rupture in some cases and enucleation was inevitable. We conclude that multidisciplinary approach and follow up reduced the rate of infection and morbidity and mortality.

  8. Association of giant congenital melanocytic nevus, halo nevus and vitiligo in a 75-year-old patient Associação de nevo melanocítico congênito gigante, nevo halo e vitiligo. Relato de caso em paciente de 75 anos

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    Marina Leite da Silveira

    2012-04-01

    Full Text Available A giant congenital melanocytic nevus represents a rare condition. The halo phenomenon may be seen in congenital or acquired melanocytic nevi. In the literature, association of halo nevus and giant congenital melanocytic nevus is rare and the association of both with vitiligo even more rare. A 75-yearold woman at first consultation complained of a hyperchromic bluish-brown hairy macula on the lower back, buttocks and thighs present since birth and an achromic halo of onset three years ago. The histological features were consistent with congenital melanocytic nevus and halo nevus, respectively. After two years the patient developed achromic areas in normal skin, histologically consistent with vitiligo. The authors emphasize the rarity of this triple combination, the patient's age and the absence of malignant degeneration to date.Nevo melanocitico congênito gigante constitui uma condição rara. O fenômeno halo pode ser observado em nevos melanocíticos congênitos ou adquiridos. Na literatura a associação nevo halo e nevo melanocítico congênito gigante é rara e a associação de ambos com vitiligo ainda mais rara. Mulher de 75 anos que à primeira consulta apresentava mácula hipercrômica castanho-azulada pilosa na região lombar, nádegas e coxas desde o nascimento e halo acrômico de aparecimento há 3 anos. Os histológicos foram compatíveis com nevo melanocítico congênito e nevo halo respectivamente. Após dois anos evoluiu com áreas de acromia à distância, com histológico de vitiligo. Os autores ressaltam a raridade desta tripla associação; a idade da paciente e a ausência de degeneração maligna até o presente momento.

  9. Short- and Long-Term Quality of Life and Bowel Function in Patients With MRI-Defined, High-Risk, Locally Advanced Rectal Cancer Treated With an Intensified Neoadjuvant Strategy in the Randomized Phase 2 EXPERT-C Trial

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    Sclafani, Francesco; Peckitt, Clare [The Royal Marsden NHS Foundation Trust, London (United Kingdom); Cunningham, David, E-mail: david.cunningham@rmh.nhs.uk [The Royal Marsden NHS Foundation Trust, London (United Kingdom); Tait, Diana [The Royal Marsden NHS Foundation Trust, London (United Kingdom); Giralt, Jordi [Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Department of Medical Oncology, Barcelona (Spain); Glimelius, Bengt [University of Uppsala, Uppsala (Sweden); Keränen, Susana Roselló [Biomedical Research Institute INCLIVA, Department of Hematology and Medical Oncology, University of Valencia (Spain); Bateman, Andrew [Southampton General Hospital, Cancer Sciences Unit, University of Southampton (United Kingdom); Hickish, Tamas [Poole Hospital NHS Foundation Trust, Department of Medical Oncology, Bournemouth University (United Kingdom); Tabernero, Josep [Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Department of Medical Oncology, Barcelona (Spain); Thomas, Janet; Brown, Gina; Oates, Jacqueline; Chau, Ian [The Royal Marsden NHS Foundation Trust, London (United Kingdom)

    2015-10-01

    Objective: Intensified preoperative treatments have been increasingly investigated in locally advanced rectal cancer (LARC), but limited data are available for the impact of these regimens on quality of life (QoL) and bowel function (BF). We assessed these outcome measures in EXPERT-C, a randomized phase 2 trial of neoadjuvant capecitabine combined with oxaliplatin (CAPOX), followed by chemoradiation therapy (CRT), total mesorectal excision, and adjuvant CAPOX with or without cetuximab in magnetic resonance imaging-defined, high-risk LARC. Methods and Materials: QoL was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR29 questionnaires. Bowel incontinence was assessed using the modified Fecal Incontinence Severity Index questionnaire. Results: Compared to baseline, QoL scores during preoperative treatment were better for symptoms associated with the primary tumor in the rectum (blood and mucus in stool, constipation, diarrhea, stool frequency, buttock pain) but worse for global health status, role functioning, and symptoms related to the specific safety profile of each treatment modality. During follow-up, improved emotional functioning and lessened anxiety and insomnia were observed, but deterioration of body image, increased urinary incontinence, less sexual interest (men), and increased impotence and dyspareunia were observed. Cetuximab was associated with a deterioration of global health status during neoadjuvant chemotherapy but did not have any long-term detrimental effect. An improvement in bowel continence was observed after preoperative treatment and 3 years after sphincter-sparing surgery. Conclusions: Intensifying neoadjuvant treatment by administering induction systemic chemotherapy before chemoradiation therapy improves tumor-related symptoms and does not appear to have a significantly detrimental effect on QoL and BF, in both the short and the long term.

  10. Complications of Lower Body Lift Surgery in Postbariatric Patients

    Science.gov (United States)

    van Dijk, Martine M.; Klein, Steven; Hoogbergen, Maarten M.

    2016-01-01

    Background: There is an exponential rise of patients with massive weight loss because of bariatric surgery or lifestyle changes. The result is an increase of patients with folds of redundant skin that may cause physical and psychological problems. The lower body lift is a procedure to correct deformities in the abdomen, mons, flanks, lateral thighs, and buttocks. Complication rates are quite high and could negatively affect the positive outcomes. The purpose of this study is to assess complication rates and to identify predictors of complications to optimize outcomes for patients after lower body lift surgery. Methods: A retrospective analysis of 100 patients who underwent a lower body lift procedure was performed. The patients were reviewed for complications, demographic data, comorbidities, smoking, highest lifetime body mass index, body mass index before lower body lift surgery, percentage of excess weight loss, and amount of tissue excised. Results: The overall complication rate was 78%. Twenty-two percent of the patients had major complications and 56% had minor complications. There is a linear relationship between body mass index before lower body lift surgery and complications (P = 0.03). The percentage of excess weight loss (odds ratio [OR] 0.97; 95% confidence interval [CI] 0.92–1.00), highest lifetime body mass index (OR 1.08; 95% CI 1.01–1.15), body mass index before lower body lift surgery (OR 1.17; 95% CI 1.02–1.33), and smoking (OR 7.74; CI 0.98–61.16) are significantly associated with the development of complications. Conclusions: This study emphasizes the importance of a good weight status before surgery and cessation of smoking to minimize the risk of complications.

  11. Quantitative model of cellulite: three-dimensional skin surface topography, biophysical characterization, and relationship to human perception.

    Science.gov (United States)

    Smalls, Lola K; Lee, Caroline Y; Whitestone, Jennifer; Kitzmiller, W John; Wickett, R Randall; Visscher, Marty O

    2005-01-01

    Gynoid lipodystrophy (cellulite) is the irregular, dimpled skin surface of the thighs, abdomen, and buttocks in 85% of post-adolescent women. The distinctive surface morphology is believed to result when subcutaneous adipose tissue protrudes into the lower reticular dermis, thereby creating irregularities at the surface. The biomechanical properties of epidermal and dermal tissue may also influence severity. Cellulite-affected thigh sites were measured in 51 females with varying degrees of cellulite, in 11 non-cellulite controls, and in 10 male controls. A non-contact high-resolution three-dimensional laser surface scanner was used to quantify the skin surface morphology and determine specific roughness values. The scans were evaluated by experts and naive judges (n=62). Body composition was evaluated via dual-energy x-ray absorptiometry; dermal thickness and the dermal-subcutaneous junction were evaluated via high-resolution 3D ultrasound and surface photography under compression. Biomechanical properties were also measured. The roughness parameters Svm (mean depth of the lowest valleys) and Sdr (ratio between the roughness surface area and the area of the xy plane) were highly correlated to the expert image grades and, therefore, designated as the quantitative measures of cellulite severity. The strength of the correlations among naive grades, expert grades, and roughness values confirmed that the data quantitatively evaluate the human perception of cellulite. Cellulite severity was correlated to BMI, thigh circumference, percent thigh fat, architecture of the dermal-subcutaneous border (ultrasound surface area, red-band SD from compressed images), compliance, and stiffness (negative correlation). Cellulite severity was predicted by the percent fat and the area of the dermal-subcutaneous border. The biomechanical properties did not significantly contribute to the prediction. Comparison of the parameters for females and males further suggest that percent thigh fat

  12. In vitro and in vivo efficacy of sulfo-carrabiose, a sugar-based cosmetic ingredient with anti-cellulite properties.

    Science.gov (United States)

    Vogelgesang, B; Bonnet, I; Godard, N; Sohm, B; Perrier, E

    2011-04-01

    Most of adult women exhibit cellulite on the hips, buttock and thighs. Although extracellular matrix and lymphatic system disorders can increase its appearance, cellulite basically results from an excessive fat storage in the adipose tissue which exerts considerable pressure on the surrounding skin tissue and creates a dimpled irregular appearance. Caffeine, the most widely used anti-cellulite ingredient, favours fat break-down by inhibiting the phosphodiesterase enzyme and encouraging a high intracellular level of cAMP. A series of studies has shown that spermine and spermidine, two ubiquitous polyamines, encouraged fat storage and slowed fat break-down in the adipose tissue. Besides, it was shown that heparan sulfate glycosaminoglycans had a strong affinity for polyamines. To design a new cosmetic ingredient with anti-cellulite properties, we used molecular modelling to screen several ingredients with a structure similar to that of heparan sulfate glycosaminoglycans. This way, we identified sulfo-carrabiose as a potent molecule for trapping spermine and spermidine. These virtual results were first confirmed in tubo where sulfo-carrabiose was shown to dose-dependently inactivate spermine and spermidine. In vitro, adipocytes cultured with sulfo-carrabiose exhibited a significant reduction of lipogenesis and a significant increase of lipolysis. When sulfo-carrabiose was incorporated in a cosmetic formula, significant improvements were observed in thigh circumference, with better results than those obtained with caffeine after 28 days of use. Furthermore, a combination of caffeine and sulfo-carrabiose led to results significantly better than those obtained with caffeine alone. As measured by fringe projection, thigh volume was also significantly reduced after sulfo-carrabiose treatment. Finally, the appearance of cellulite assessed by clinical evaluation was also significantly reduced within 28 days.

  13. NEURAL MOBILIZATION A THERAPEUTIC EFFICACY IN A PIRIFORMIS SYNDROME MODEL:AN EXPERIMENTAL STUDY

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    Rahul Krishnan Kutty

    2014-06-01

    Full Text Available Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle causing pain, tingling and numbness in the buttocks and along the sciatic nerve. Traditional exercise therapy program for sciatica primarily focuses on pain relief but, neural mobilization should be viewed as another form of manual therapy similar to joint mobilization. The focus of this study is to see the effectiveness of neural mobilization on individuals with Piriformis syndrome and to assess the effectiveness over the conventional physical therapy treatment. The sample consisted of 42 subjects, from both sexes, ranging from 30 to 50-years-old. Parameters used are the Visual Analogue Scale (VAS and Goniometry measurement for diagnosis and prognosis of the condition. An experimental design was used in this study. The initial 21 participants were assigned to a group I; receive Neural Mobilization and conventional physical therapy; while a second group of 21 participants were assigned as Group II to receive only conventional physical therapy. The median (IQR of VAS pain in Experiment group is 0(0-0 whereas it is 1(0-1 in the Control group. The Median (IQR of ROM hip for the Experimental group is 40(39-45 whereas it is 35(32-38 for the Control group. Hence, VAS pain score and ROM hip score depicted statistically significant difference (p<0.001 in the average range of VAS pain score and ROM hip score in Experimental group (treated with neural mobilization and conventional physical therapy treatment than control group (treated with conventional physical therapy treatment alone. In this study it is concluded that there is a significant difference with in the Experimental group (neural mobilization and conventional physical therapy treatment Setting-1(initial treatment and setting 3(final treatment.

  14. Rapid rehabilitation programme following sacral stress fracture in a long-distance running female athlete.

    Science.gov (United States)

    Knobloch, Karsten; Schreibmueller, Louisa; Jagodzinski, Michael; Zeichen, Johannes; Krettek, Christian

    2007-11-01

    Stress fractures occur in normal bone due to mechanical overload by cyclic stress increasing the osteoclastic activity, thus facilitating weakening leading to fracture of bones. Long-distance running may lead to stress fractures of the mid- and distal tibia and of the metatarsal bones. Stress fractures to the sacrum are rare. Certain factors for stress fractures in runners have been identified, such as leg-length inequality, a high longitudinal arch of the foot, forefoot varus, and menstrual irregularities in case of female athlete triad. We report on a 22-year-old female runner (usually training 140 km/week) suffering a sacral fatigue-type fracture. The female athlete triad with eating disorders, dysmenorrhea, and osteopenia was ruled out. Sexual hormone blood samples proofed normal values. The diagnosis was performed using magnetic resonance imaging 2 weeks after the onset of buttock pain. A conservative treatment regimen was initiated with strict physical rest for the first 2 weeks, and then gradual increase of physical activity with 60-90 min of daily cycling and moderate 2 x 60 min cross-training. After another 2 weeks time, daily 60-90 min of walking, Nordic pole walking, and moderate strength training two times a week was performed. At 7 weeks running was started, gradually increased to 90 km/week without any pain. A rapid rehabilitation programme after sacral stress fractures involving low impact physical activity, such as Walking and Nordic pole walking, is applicable to female athletes after ruling out the female athlete triad.

  15. Prevalence of Malignant Soft Tissue Tumors inExtremities: An Epidemiological Study in Syria

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    Habib Reshadi

    2014-06-01

    Full Text Available Background:   Although the majority of soft tissue masses are benign, it is important to consider malignancy in differential diagnoses. Because most soft tissue sarcomas present as a painless mass, clinicians must watch for signs suggestive of malignancy, including large size, rapid growth, and site deep into the deep fascia.The purpose of this study was to determine the relative prevalence according to sex and age, site of tumor, skeletal distribution, and treatment (surgery, chemotherapy and radiotherapy before and after surgery, and ascertain the relative frequency of these tumors in specific anatomic sites and age groups based on pathological studies. Methods: A total of 308 patients, with a musculoskeletal tumor were evaluated retrospectively. All of the patients enrolled into this study were referred to the Beirouni Hospital of Damascus University with a proven diagnosis of alignant soft tissue tumors from the beginning of January 2008 until the end of 2010. The prevalence of the malignant soft tissue tumors in these patients was analyzed. For purposes of analysis, all lesions were placed in 1 of 9 categories: hand and wrist, forearm, humorous (arm, proximal limb girdle (axilla and shoulder, foot and ankle, thigh, hip and buttocks region, trunk, and other lesions. Age and sex also were recorded. Results: Malignant tumors consisted of seven diagnostic categories: malignant fibrous histiocytoma (23%, liposarcoma (22%, rhabdomyosarcoma (9%, leiomyosarcoma (8%, malignant schwannoma (5%, dermatofibrosarcoma protuberans (5%, synovial sarcoma (10%, fibrosarcoma (13%, extraskeletal chondrosarcoma (1%, and extraskeletal Ewing sarcoma (4%. Conclusions: Despite the multitude of pathologic possibilities, most malignant soft-tissue tumors are classified into a small number of diagnoses. These may be further defined when the site of the lesion and the age of the patient are considered. Knowledge of tumor prevalence will assist radiologists in

  16. Prevalence of Malignant Soft Tissue Tumors inExtremities: An Epidemiological Study in Syria

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    Habib Reshadi

    2014-06-01

    Full Text Available Background:   Although the majority of soft tissue masses are benign, it is important to consider malignancy in differential diagnoses. Because most soft tissue sarcomas present as a painless mass, clinicians must watch for signs suggestive of malignancy, including large size, rapid growth, and site deep into the deep fascia.The purpose of this study was to determine the relative prevalence according to sex and age, site of tumor, skeletal distribution, and treatment (surgery, chemotherapy and radiotherapy before and after surgery, and ascertain the relative frequency of these tumors in specific anatomic sites and age groups based on pathological studies. Methods: A total of 308 patients, with a musculoskeletal tumor were evaluated retrospectively. All of the patients enrolled into this study were referred to the Beirouni Hospital of Damascus University with a proven diagnosis of alignant soft tissue tumors from the beginning of January 2008 until the end of 2010. The prevalence of the malignant soft tissue tumors in these patients was analyzed. For purposes of analysis, all lesions were placed in 1 of 9 categories: hand and wrist, forearm, humorous (arm, proximal limb girdle (axilla and shoulder, foot and ankle, thigh, hip and buttocks region, trunk, and other lesions. Age and sex also were recorded. Results: Malignant tumors consisted of seven diagnostic categories: malignant fibrous histiocytoma (23%, liposarcoma (22%, rhabdomyosarcoma (9%, leiomyosarcoma (8%, malignant schwannoma (5%, dermatofibrosarcoma protuberans (5%, synovial sarcoma (10%, fibrosarcoma (13%, extraskeletal chondrosarcoma (1%, and extraskeletal Ewing sarcoma (4%. Conclusions: Despite the multitude of pathologic possibilities, most malignant soft-tissue tumors are classified into a small number of diagnoses. These may be further defined when the site of the lesion and the age of the patient are considered. Knowledge of tumor prevalence will assist radiologists in

  17. Erythema chronicum migrans and salmon fishing in Alaska: an enigma resolved by microbiology laboratory

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    Silvio Daffara

    2010-03-01

    Full Text Available A 50-year-old man, pentathlete and fond of salmon fishing, after returning from Alaska was referred to our Division for an erythematous and indolent lesion on the right thigh gradually enlarging from the right knee to the right rear and the buttock.The patient was clinically diagnosed with figurate erythema. Laboratory analysis demonstrated a moderate leukocytosis and hypergammaglobulinemia, accompanied by serological markers of past contact with noted EBV and CMV.A “punch” biopsy of the edge of the lesion showed a superficial and deep perivascular and interstitial infiltrate of lymphocytes, eosinophiles and a few plasma cells, consistent with a borrelial infection. Lyme serology (IFI suggested a questionable borderline positivity; subsequent investigations by ELISA and Western Blot were both positive, leading to the diagnosis of erythema chronicum migrans in course of borreliosis.The diagnosis was further confirmed by positive PCR for Borrelia burgdorferi sensu lato. The erythema resolved after a 2-week doxycycline treatment (2x100 mg die. The amplification product (16S rDNA gene obtained from skin biopsy was sequenced using standard ABI technology, and confirmed the identification of a member of B. burgdorferi sensu lato (sl complex. Since this sequence was not useful to identify the genospecies, further studies were conducted employing a nested PCR targeted on the internal transcribed spacer (ITS of B. burgdorferi, following a protocol previously described (1. The ITS sequence showed 100% identity with B. afzelii, a species not reported from North America, thus prompting us to conclude that the patient was not infected by B. afzelii during the fishing trip in Alaska.

  18. [Larva migrans].

    Science.gov (United States)

    Chabasse, D; Le Clec'h, C; de Gentile, L; Verret, J L

    1995-01-01

    Larbish, cutaneous larva migrans or creeping eruption, is a serpiginous cutaneous eruption caused by skin penetration of infective larva from various animal nematodes. Hookworms (Ancylostoma brasiliense, A. caninum) are the most common causative parasites. They live in the intestines of dogs and cats where their ova are deposited in the animal feces. In sandy and shady soil, when temperature and moisture are elevated, the ova hatch and mature into infective larva. Infection occurs when humans have contact with the infected soil. Infective larva penetrate the exposed skin of the body, commonly around the feet, hands and buttocks. In humans, the larva are not able to complete their natural cycle and remain trapped in the upper dermis of the skin. The disease is widespread in tropical or subtropical regions, especially along the coast on sandy beaches. The diagnosis is easy for the patient who is returning from a tropical or subtropical climate and gives a history of beach exposure. The characteristic skin lesion is a fissure or erythematous cord which is displaced a few millimeters each day in a serpiginous track. Scabies, the larva currens syndrome due to Strongyloides stercoralis, must be distinguished from other creeping eruptions and subcutaneous swelling lesions caused by other nematodes or myiasis. Medical treatments are justified because it shortens the duration of the natural evolution of the disease. Topical tiabendazole is safe for localized invasions, but prolonged treatment may be necessary. Oral thiabendazole treatment for three days is effective, but sometimes is associated with adverse effects. Trials using albendazole for one or four consecutive days appear more efficacious. More recent trials using ivermectine showed that a single oral dose can cure 100% of the patients; thus, this drug looks very promising as a new form of therapy. Individual prophylaxis consists of avoiding skin contact with soil which has been contaminated with dog or cat feces

  19. Subcutaneous Panniculitis-like T Cell Lymphoma: Report of A Case and Review of the Literature%皮下脂膜炎样T细胞淋巴瘤1例及文献复习

    Institute of Scientific and Technical Information of China (English)

    田华; 王晓彦; 乌日娜

    2011-01-01

    患者男,73岁.左侧臀部及右足底部出现多发性红色皮下结节及斑块,伴发热.曾被误诊为"血管炎"及"结节性脂膜炎".皮损组织病理示:肿瘤浸润皮下脂肪组织,真皮深层及皮下脂肪层小叶间隔及小叶内大量淋巴细胞及组织细胞浸润,呈团块状,见散在异型淋巴细胞.免疫组化示:CD3(+),CD45RO(+),CD30(+),CD8(+),CD20(-)和CD4(-).患者于化疗半月后因继发严重肺部感染而死亡.诊断:皮下脂膜炎样T细胞淋巴瘤.本文对本病进行相关的文献复习.%This case reported is a 73-year-old male, who had presented with multiple erythematous plaques on left buttock and right foot with fever.This patient has been misdiagnosed as vasculitis and nodular panniculitis.The histopathologic findings showed that both deep dermis and subcutaneous fat was infiltrated with lots of lymphocytes and histiocytes, in which there are interspersed atypical lymphocytes.Immunohistochemical studies showed CD3 ( + ), CD45RO ( + ), CD30 ( + ), CD8 ( + ), CD20 ( - ) and CD4 ( - ).Unfortunately,this patient died from serious lung infection after combined chemotherapy.Diagnose: Subcutaneous panniculitis-like T cell lymphoma (SPTCL).Furthermore, literatures about SPTCL were also reviewed.

  20. Stretching and joint mobilization exercises reduce call-center operators' musculoskeletal discomfort and fatigue

    Directory of Open Access Journals (Sweden)

    Denise Helena de Castro Lacaze

    2010-01-01

    Full Text Available AIM: We sought to evaluate musculoskeletal discomfort and mental and physical fatigue in the call-center workers of an airline company before and after a supervised exercise program compared with rest breaks during the work shift. INTRODUCTION: This was a longitudinal pilot study conducted in a flight-booking call-center for an airline in São Paulo, Brazil. Occupational health activities are recommended to decrease the negative effects of the call-center working conditions. In practice, exercise programs are commonly recommended for computer workers, but their effects have not been studied in call-center operators. METHODS: Sixty-four call-center operators participated in this study. Thirty-two subjects were placed into the experimental group and attended a 10-min daily exercise session for 2 months. Conversely, 32 participants were placed into the control group and took a 10-min daily rest break during the same period. Each subject was evaluated once a week by means of the Corlett-Bishop body map with a visual analog discomfort scale and the Chalder fatigue questionnaire. RESULTS: Musculoskeletal discomfort decreased in both groups, but the reduction was only statistically significant for the spine and buttocks (p=0.04 and the sum of the segments (p=0.01 in the experimental group. In addition, the experimental group showed significant differences in the level of mental fatigue, especially in questions related to memory Rienzo, #181ff and tiredness (p=0.001. CONCLUSIONS: Our preliminary results demonstrate that appropriately designed and supervised exercise programs may be more efficient than rest breaks in decreasing discomfort and fatigue levels in call-center operators.

  1. Workstation Related Anthropometric and Body Composition Parameters of Indian Women of Different Geographical Regions

    Directory of Open Access Journals (Sweden)

    Inderjeet Singh

    2015-01-01

    Full Text Available Background: Anthropometry plays an important role in industrial design, clothing design, ergonomics and architecture where statistical data about the distribution of body dimensions in the population are used to optimize products. Changes in lifestyles, nutrition, and ethnic composition of populations lead to changes in the distribution of body dimensions (e.g. the obesity epidemic, and require regular updating of anthropometric data collections. Aim and Objectives: This study analyzed the variation in anthropometric dimensions and body composition parameters of working women employees of different geographical zones. Material and Methods: The study was undertaken on nine hundred forty (940 women employees of Defence Research and Development Organization (DRDO working in seventeen different laboratories and belonged to different states of India. The age range of studied women was between 20-60 years. Fourteen body dimensions namely stature, popliteal height, knee height, buttock to popliteal length, hip breadth, waist breadth, shoulder breadth, forearm length, arm length, eye height (sitting, sitting shoulder height, hand length, hand breadth and elbow width were measured in cm using Martin anthropometers and Martin's sliding caliper. Body composition parameters like weight, percentage body fat, fat mass and fat free mass were recorded. Results: All anthropometric parameters were found significantly different (p<0.001. Body composition variables of women were also found significantly different in all three zones but fat free mass was not significantly different. Conclusion:It can be concluded that diet, environmental conditions and living style of different regions can influence the anthropometry and body composition of the individuals, however the influence of ethnic, genetic and hereditary factor are not controlled in this study.

  2. [Tumorous actinomycosis of the pelvis with in situ intrauterine device].

    Science.gov (United States)

    Bilek, K; Horn, L C; Schinagl, A

    1993-11-01

    The case is described of a 53-year old woman who had given birth three times and had undergone one abortion. After she was treated as an outpatient because of back pain in the lower waist area suppuration occurred from a fistula laterally right to the sacral bone in the area of the buttocks triangle, which persisted even after several outpatient surgical interventions. In addition, she had experienced a weight loss of 24 kg. At admission she had a temperature of 39 degrees Celsius, anemia, and leukocytosis. Sonography indicated slight hepatomegaly, hydroureter, right-sided hydronephrosis, and an right ovarian cyst of 4 cm size. Computer tomography showed a blurry structure that extended from the right kidney pole along the M. iliopsoas caudally up to the small pelvis, pressing against the organs caudally-ventrally, which also broke through dorsally between the lumbar region vertebrae and pelvis in the gluteal region percutaneously. The process was categorized as a frank paranephritis prolapsus abscess. Cessation of urine was determined. Laparotomy was carried out because of the suspicion of an inflammatory adnexal disease with parametritis. The uterus, including both adnexa as well as the conglomeration tumor, were removed. In the uterine cavity a Dana Cor IUD was found that had been inserted 13 years before and forgotten by the patient. At the site of the right adnexum there was a tumor (9 x 6 x 5 cu. cm) as well as a tube changed by inflammation (7 x 1.5 sq. cm). On the right side there was unspecific, suppurative salpingitis and in the ovary an abscess formation on the grounds of actinomycosis. On the left side there was only a suppurative inflammation of the tube without actinomycosis sediment. Immediately a high-dose antibiotic therapy (Penicillin G, 10 million IU) was started, lasting for 1 year. The kidney cessation with the back complaints rapidly disappeared. The cutaneous fistulae healed with scarring, however, a fully normal right-sided kidney function

  3. Mammary-type myofibroblastoma of soft tissue: a tumor closely related to spindle cell lipoma.

    Science.gov (United States)

    McMenamin, M E; Fletcher, C D

    2001-08-01

    Mammary myofibroblastoma is a benign breast tumor, with a reported predilection for older men. It is composed of fascicles of spindle cells having features of myofibroblasts, with intervening hyalinized collagenous stroma and a variably prominent component of adipose tissue. The spindle cells characteristically express both CD34 and desmin. Herein, we report the clinicopathologic features of nine tumors that were morphologically and immunohistochemically identical to myofibroblastoma of breast; however, they arose in subcutaneous soft tissue at extramammary sites. The study group comprised seven men and two women with an age range of 35-67 years (median 53 years). Lesions presented as either a slowly growing painless mass or were incidental findings at the time of surgery. The site distribution was as follows: inguinal/groin area (five cases) and one case each in posterior vaginal wall, buttock, anterior abdominal wall, and mid-back. Tumor size ranged from 2 to 13 cm (median 6 cm), and all lesions were well circumscribed. Eight tumors had a component of adipose tissue (ranging from 10% to 60%), within which some variation in adipocyte size was often seen. One case showed epithelioid cytomorphology and three cases showed rare atypical or multinucleated cells. Focal myxoid stromal change was seen in four cases. Tumor cells were positive for desmin (9 of 9 cases), CD34 (8 of 9 cases), and occasionally positive for smooth muscle actin (3 of 9 cases). Lesions were marginally excised with no recurrences to date, although follow-up is very limited. Lesions with morphologic and immunophenotypic features similar to myofibroblastoma of breast can arise at extramammary sites, with an apparent predilection for the inguinal area of older men. Both mammary and extramammary lesions show morphologic overlap with spindle cell lipoma and are likely closely related.

  4. Shape Maintenance Influence of Sheep Garment Leather on Wearing Comfortability%绵羊服装革保型性能对穿着舒适性的影响

    Institute of Scientific and Technical Information of China (English)

    王立新; 杜宁

    2013-01-01

    The shape maintenance of leather garments was analyzed by tests on relative indicators of leather garments ( both horizontal and vertical) . Before and after stretching the micro - structures of collagen were observed with scanning electron microscope. It shows that for sheep garment leather material, the belly department has the best softness and tensile strength, whereas the buttocks department has the weaker extensibility and lastometer deformation. The standard part of sheep garment leather has the best shape maintenance. The adoption of permanent deformation achieved by extension and paneling according to movement extension are both rational options in design and manufacture of leather garments.%通过对绵羊服装革横纵向相关指标的测试,以及拉伸变形前后胶原微结构扫描电镜图的分析比较,研究了绵羊服装革保型性能状况.结果表明:对于绵羊服装革材料来讲,柔软度以及抗张强度最好的部位是腹肷部,延伸性和顶伸性较小的部位是臀部.综合保型性各项指标,标准部位最好.因此,在皮革服装的设计制作中,可以利用拉伸产生永久性变形来满足服装造型的需要,也要根据着装运动要求合理安排皮革服装裁片.

  5. Psychophysiological adaptation of the patient with the remote effect of the III degree acute radiation syndrome

    Directory of Open Access Journals (Sweden)

    Metlyaeva N.A.

    2013-12-01

    putation of both shins at level in top / 3, late beam buttock, right hip ulcers, a beam cataract of the III degree of both eyes, stabilized. The assessment of the efficiency of psychophysiological adaptation in dynamics with 2009 indicates emergence of prevalence of hypochondriac tendencies over a demonstration with accession of high uneasiness and autistic lines at preservation of the leading role of an hypochondriac somatization of alarm with considerable decrease in an emotionality, an integration, a freedom of behavior. The changes revealed in dynamics correspond to the specific increase weight of violations of mental adaptation, characteristic for the period of adaptation exhaustion. The high intelligence, good figurative and logical thinking, well-mannered forms of behavior, high control over the emotional sphere, restraint of emotions, independence, self-sufficiency, organization, behavior taking into account environment requirements provided the patient M. firmness before a heavy illness, promoted good adaptation to an environment with confidence in myself, high social adaptability, opportunity successfully to carry out duties, hold the work account (worked 39 years after accident. Comparative assessment of operator ability of the patient M. showed good average time of common and difficult sensorimotor reactions with 2 mistakes, high time of reaction for moving object, however decrease in accuracy of reaction from 10-13% to 2% testifies to manifestation in dynamics of insufficiency of real functional reserves of nervous system. Conclusions. Efficiency of psychophysiological adaptation depends not only on a dose of radiation and weight of the transferred disease, but, mostly, on premorbid properties of the identity of the victim and his social and labor installation.

  6. The effect of human-mattress interface's temperature on perceived thermal comfort.

    Science.gov (United States)

    Califano, R; Naddeo, A; Vink, P

    2017-01-01

    In recent years, methods that allow for an objective evaluation of perceived comfort, in terms of postural, physiological, cognitive and environmental comfort, have received a great deal of attention from researchers. This paper focuses on one of the factors that influences physiological comfort perception: the temperature difference between users and the objects with which they interact. The first aim is to create a measuring system that does not affect the perceived comfort during the temperatures' acquisition. The main aim is to evaluate how the temperature at the human-mattress interface can affect the level of perceived comfort. A foam mattress has been used for testing in order to take into account the entire back part of the human body. The temperature at the interface was registered by fourteen 100 Ohm Platinum RTDs (Resistance Temperature Detectors) placed on the mattress under the trunk, the shoulders, the buttocks, the legs, the thighs, the arms and the forearms of the test subject. 29 subjects participated in a comfort test in a humidity controlled environment. The test protocol involved: dress-code, anthropometric-based positioning on mattress, environment temperature measuring and an acclimatization time before the test. At the end of each test, each of the test subject's thermal sensations and the level of comfort perception were evaluated using the ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers) scale. The data analyses concerned, in the first instance, correlations between the temperature at the interface and comfort levels of the different parts of the body. Then the same analyses were performed independently of the body parts being considered. The results demonstrated that there was no strong correlation among the studied variables and that the total increase of temperature at interface is associated with a reduction in comfort.

  7. [Treatment of Poland syndrome thorax deformity with the lipomodeling technique: about ten cases].

    Science.gov (United States)

    La Marca, S; Delay, E; Toussoun, G; Ho Quoc, C; Sinna, R

    2013-02-01

    The correct management, with the classic techniques, of the thoracic deformity in Poland's syndrome is difficult, with often insatisfactory results. The current surgical treatment involves the use of prothetic material and/or different flaps with their own complications and scares. The experience of our team with fat grafting (we named lipomodeling) in breast reconstruction helped us to propose the correction of the thoracic and mammary deformity by repeated fat transfer sessions. Fat grafting is commonly used in our team since 1998 in various indication of breast surgery. We reviewed retrospectively our ten first cases of thoracic deformity in Poland's syndrome treated with only fat grafting. Patients had repeated procedures until obtaining a satisfactory result. The fat was harvested from the thigh, buttocks, and abdomen. There were young patients with a mean age of 16years old (from 12 to 24). The mean follow-up was 51months. An average of 2.9 procedures (1 to 5) with 255cm(3) of fat injection at each procedure was needed to obtain symetry. Hundred percent of the patients were satisfied. No complication was noted. As reported, the reconstruction of the thoracic deformity and the mammary shape can be obtained by fat grafting. The absence of a flap donor site sequelae and the absence an implant allow this technique to be simple, reproductible, and without great complication. These criteria match well the surgical management of this deformity, which is mainly aesthetic. Moreover, the secondary benefit of liposuction of disgracious steatomery helps the acceptance of the procedure. Therefore in our hands, fat grafting to the breast (lipomodeling) is now our first choice treatment in thoracic Poland syndrome deformity. Given the rarity of this syndrome, we recommend a treatment by an operator who makes the learning curve of lipomodeling, and who often deals with Poland syndrome.

  8. Linear IGA bullous dermatosis in Tunisian children : 31 cases

    Directory of Open Access Journals (Sweden)

    Kharfi Monia

    2011-01-01

    Full Text Available Background: Linear IgA bullous dermatosis (LAD of children is relatively frequent in Africa. Aim: We undertook this study to evaluate the frequency of this disease among autoimmune bullous diseases (AIBDs in Tunisian children. Materials and Methods: We present a 32-year retrospective study (January 1976 to December 2007. Children with chronic acquired bullous diseases seen at the Charles Nicolle Hospital of Tunis and for who direct immunofluorescence (DIF of the perilesional skin demonstrated linear IgA immunoglobulin deposits were included in the study population. Results: Thirty-one children with LAD were selected representing 65.9% of all AIBDs of children selected in the same period, with a mean age of 5.5 years and a sex ratio (M/F of 2.4. Most of the children had generalized eruption (28/31, more profuse on the face, pelvic region, buttocks and limbs. Mucosal lesions happened in only four children (12.9%. The mean duration of the disease was 14 months. DIF demonstrated linear IgA deposits along the dermal-epidermal junction in all patients. IgG, IgM, and complement were also seen (20/31. Indirect immunofluorescence was negative in 67% of cases. Eight patients responded to dapsone; however, prednisone had to be added in seven children to control the disease and erythromycin in four others. A long-term remission period was achieved in 76.1% of patients. Conclusion: This study confirms that LAD is the most common AIBD in children in Tunisia which frequently occurs in preschool-aged males. Independently of the used drug, a long-term remission is frequently observed.

  9. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space.

    Science.gov (United States)

    Hernando, Moisés Fernández; Cerezal, Luis; Pérez-Carro, Luis; Abascal, Faustino; Canga, Ana

    2015-07-01

    Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included "piriformis syndrome," a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. The concept of fibrous bands playing a role in causing symptoms related to sciatic nerve mobility and entrapment represents a radical change in the current diagnosis of and therapeutic approach to DGS. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. A broad spectrum of known pathologies may be located nonspecifically in the subgluteal space and can therefore also trigger DGS. These can be classified as traumatic, iatrogenic, inflammatory/infectious, vascular, gynecologic and tumors/pseudo-tumors. Because of the ever-increasing use of advanced magnetic resonance neurography (MRN) techniques and the excellent outcomes of the new endoscopic treatment, radiologists must be aware of the anatomy and pathologic conditions of this space. MR imaging is the diagnostic procedure of choice for assessing DGS and may substantially influence the management of these patients. The infiltration test not only has a high diagnostic but also a therapeutic value. This article describes the subgluteal space anatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments, with emphasis on MR imaging and endoscopic correlation.

  10. Needle placement for piriformis injection using 3-D imaging.

    Science.gov (United States)

    Clendenen, Steven R; Candler, Shawn A; Osborne, Michael D; Palmer, Scott C; Duench, Stephanie; Glynn, Laura; Ghazi, Salim M

    2013-01-01

    Piriformis syndrome is a pain syndrome originating in the buttock and is attributed to 6% - 8% of patients referred for the treatment of back and leg pain. The treatment for piriformis syndrome using fluoroscopy, computed tomography (CT), electromyography (EMG), and ultrasound (US) has become standard practice. The treatment of Piriformis Syndrome has evolved to include fluoroscopy and EMG with CT guidance. We present a case study of 5 successful piriformis injections using 3-D computer-assisted electromagnet needle tracking coupled with ultrasound. A 6-degree of freedom electromagnetic position tracker was attached to the ultrasound probe that allowed the system to detect the position and orientation of the probe in the magnetic field. The tracked ultrasound probe was used to find the posterior superior iliac spine. Subsequently, 3 points were captured to register the ultrasound image with the CT or magnetic resonance image scan. Moreover, after the registration was obtained, the navigation system visualized the tracked needle relative to the CT scan in real-time using 2 orthogonal multi-planar reconstructions centered at the tracked needle tip. Conversely, a recent study revealed that fluoroscopically guided injections had 30% accuracy compared to ultrasound guided injections, which tripled the accuracy percentage. This novel technique exhibited an accurate needle guidance injection precision of 98% while advancing to the piriformis muscle and avoiding the sciatic nerve. The mean (± SD) procedure time was 19.08 (± 4.9) minutes. This technique allows for electromagnetic instrument tip tracking with real-time 3-D guidance to the selected target. As with any new technique, a learning curve is expected; however, this technique could offer an alternative, minimizing radiation exposure.

  11. Mismatch between classroom furniture and anthropometric measures in Chilean schools.

    Science.gov (United States)

    Castellucci, H I; Arezes, P M; Viviani, C A

    2010-07-01

    Children spend about five hours per day sitting down while doing their school work. Considering this as well as the potential inadequate use of school furniture, it is likely that some anatomical-functional changes and problems in the learning process may occur. The aim of this study was to compare furniture sizes within three different schools with the anthropometric characteristics of Chilean students in the Valparaíso region, in order to evaluate the potential mismatch between them. The sample consisted of 195 volunteer students (94 male, 101 female) of the 8th grade, ranging from 12.5 to 14.5 years of age from 3 different schools. Regarding the methodology, 6 anthropometric measures (Stature, Popliteal height, Buttock-popliteal length, Elbow height while sitting, Hip width, Thigh thickness and Subscapular height) were gathered, as well as 8 dimensions from the school furniture. For the evaluation of classroom furniture a match criterion equation was defined. After considering the existing classroom furniture dimensions in each match criterion equation, the anthropometric characteristics of the considered population were compared in order to determine the mismatch between them. Results indicated that seat height, which should be considered as the starting point for the design of classroom furniture, was appropriate for students' popliteal height in only 14% of the 2 out of the 3 schools, and 28% in the third. Seat to desk height was too high and mismatched 99% of the students in one school and 100% in the others. Therefore, it was possible to conclude that the classroom's furniture was inadequate in almost all the analyzed cases and subjects. It is possible that the high mismatch percentage found between furniture and students' anthropometry can be associated to the fact that the acquisition and selection of the furniture was made without any ergonomic concern or criteria.

  12. Fatigue stress injuries of the pelvic bones and proximal femur: evaluation with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kiuru, Martti J. [Department of Radiology, Helsinki University Central Hospital, P.O. Box 340, Haartmaninkatu 4, 00029 Helsinki (Finland); Research Institute of Military Medicine, Mannerheimintie 164, 00300 Helsinki (Finland); Pihlajamaki, Harri K. [Department of Surgery, Central Military Hospital, Mannerheimintie 164, 00300 Helsinki (Finland); Ahovuo, Juhani A. [Department of Radiology, Helsinki University Central Hospital, P.O. Box 340, Haartmaninkatu 4, 00029 Helsinki (Finland)

    2003-03-01

    The purpose of this study was to determine the prevalence and the distribution as well as male/female differences in patients with hip or pelvic pain based on MRI results. Three hundred forty consecutive conscripts (45 women, 295 men; age range 18-29 years; mean age 20.7 years) suffering from stress-related hip, buttock or groin pain took part in the study. All 340 patients underwent MR imaging. Radiographic data were available for 215 patients. Two radiologists interpreted the images by consensus. In MRI 174 stress injuries were diagnosed in 137 patients (32 women, 105 men). The incidence of bone stress injuries in women was significantly higher than that in men (p<0.0001). One hundred five of the injuries (60%) were related to the proximal femur, 70 (67%) to the neck, 34 (32%) to the proximal shaft, and one (1%) to the head. Sixty-nine of the 174 stress injuries (40%) concerned the pelvic bones: sacrum 28 (41%); inferior pubic ramus 34 (49%); superior pubic ramus 3 (4%); iliac bone 3 (4%); and acetabulum 1 (1%). In 31 of the 174 cases (18%) symptoms were contralateral to MR findings. Thirty-three of the 137 patients (24%) had multiple bone stress injuries, 29 had two bone stress injuries and 4 patients had three. The sensitivity of radiography was 37%, specificity 79%, accuracy 60%, positive predictive value 59% and negative predictive value 61%. The kappa value for agreement between radiography and MRI was poor (0.17, p=0.0008). Patients suffering from stress-related hip pain MRI revealed bone stress injuries in 40%; of these, 60% were located in the proximal femur and 40% in the pelvic bones. For accurate diagnosis of bone stress injuries, and to ensure appropriate treatment, the entire pelvis and both proximal femurs should be studied simultaneously by means of MRI. (orig.)

  13. A case of mycosis fungoides presenting as persistent pigmented purpuric dermatosis%以色素性紫癜性皮病为表现的蕈样肉芽肿

    Institute of Scientific and Technical Information of China (English)

    李薇薇; 杨海珍; 武玲慎; 涂平

    2012-01-01

    报告1例以持续性色素性紫癜性皮病为表现的蕈样肉芽肿.患者男,48岁.因双下肢褐色斑3年,逐渐加重偶伴瘙痒就诊.皮肤科检查可见双下肢、腰部、双臀部红褐色瘀点样的斑片,双足背、足侧面及小腿处可见深褐色斑片,轻度苔藓化,双手背、手指背侧亦可见类似皮疹.皮损组织病理示:真皮浅中层淋巴细胞灶状浸润,部分细胞可见异形性和明显的向表皮性.免疫组化检查:CD3(+),CD5(+),D4(+),CD8散在阳性,T细胞受体(TCR)β(+),CD20(-),T细胞胞质内抗原(TIA)1(+).诊断:蕈样肉芽肿.%A case of mycosis fungoides presenting as persistent pigmented purpuric dermatosis is reported. A 48-year-old male presented with eruption on his lower extremities for 3 years, the lesions gradually aggravated and with occasionally itching. Dermatological examination disclosed erythematous and red-brown petechial patches on his waist, buttocks and lower extremities, and some dark brown pigmented patches on the dorsa of feet and hands with mild lichenification. Histopathologi-cal examination showed there was focal lymphocytic infiltration in the papillary and reticular dermis, and some lymphocytes showed atypical and significant epidermotropism. Immunohistochemical investigation showed tumor cells stained positive for CD3,CD5,CD4,CD8, TCRβ, and TIA1,and negative for CD20. Thus mycosis fungoides was diagnosed.

  14. A case of Parkes-Weber syndrome accompanied by pseudo-Kaposi's sarcoma%Parkes-Weber综合征伴假性Kaposi肉瘤一例

    Institute of Scientific and Technical Information of China (English)

    唐金玲; 树叶; 陈卫坚; 罗勇奇; 汤建萍

    2014-01-01

    患者女,8岁7个月.右臀部紫红色斑8年,右下肢较左下肢逐渐增大7年余,多发性赘生物1年.皮肤科检查:右下肢较左下肢肥大且长,皮肤鲜红斑痣,皮温增高及皮肤大量赘生物伴有恶臭.X线、磁共振成像、多普勒超声提示高流速脉管畸形.皮肤病理可见血管增生,成纤维细胞增生及红细胞外溢,诊断为伴假性Kaposi肉瘤的Parkes-Weber综合征.%A girl who aged eight years and seven months presented with prunosus patches on the right buttock for 8 years,gradual unilateral enlargement of the right lower limb for more than 7 years,and multiple vegetations for 1 year.Dermatological examination showed nevus flammeus and multiple malodorous vegetations over the right lower limb with high skin temperature.The right lower limb was thicker and longer than the left lower limb.X-ray examination,magnetic resonance imaging and Doppler ultrasound examination revealed high-flow vascular malformations.Pathological examination of the vegetations showed vascular proliferation,fibroblast proliferation and erythrocyte extravasation.She was diagnosed as Parkes-Weber syndrome accompanied by pseudo-Kaposi's sarcoma.

  15. High prevalence and impact on the quality of life of facial lipoatrophy and other abnormalities in fat tissue distribution in HIV-infected patients treated with antiretroviral therapy.

    Science.gov (United States)

    Leclercq, Pascale; Goujard, Cecile; Duracinsky, Martin; Allaert, François; L'henaff, Marianne; Hellet, Maeva; Meunier, Jean Pierre; Carret, Sophie; Thevenon, Jacques; Ngo Van, Philippe; Pialoux, Gilles

    2013-05-01

    Few data report the prevalence in actual clinical settings of lipodystrophy (LD), and in particular of facial lipoatrophy (LA), in HIV-infected patients treated with long-term antiretroviral therapy (ART). A French, multicenter, cross-sectional, observational study was conducted in HIV-infected patients on continuous ART for more than 12 months. The main objective was to assess the prevalence of facial LA in this population. Additional objectives were to make the same assessments for nonfacial LA and lipohypertrophy. The presence of LD signs, type, and severity was assessed by clinicians and compared with patient self-evaluations through two questionnaires. A total of 2,131 assessable patients had a median age of 46 years and a median time on ART of 10 years. Physicians diagnosed facial LA in 54% of patients and these subjects had received ART for a longer duration than those without LA. Thymidine analog usage was associated with an increased likelihood of facial LA, but 28% of patients recently treatment-initiated (1-5 years) were also affected. At other sites, LA and lipohypertrophy were diagnosed in 59% and 57% of cases, respectively. The concordance between physician and patient assessments was good for facial and buttocks LA. In this study, facial LA affects more than half of the subjects and is frequent even among the most recently treated patients. The prevalence of facial LA significantly increases with the duration of ART, with male gender, hepatitis C virus (HCV) coinfection, and non-African origin being independent risk factors. Lipohypertrophy is frequent and appears early after ART initiation.

  16. Mycetoma in the Sudan: an update from the Mycetoma Research Centre, University of Khartoum, Sudan.

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    Ahmed Fahal

    2015-03-01

    Full Text Available This communication reports on the Mycetoma Research Centre of the University of Khartoum, Sudan experience on 6,792 patients seen during the period 1991-2014.The patients were predominately young (64% under 30 years old males (76%. The majority (68% were from the Sudan mycetoma belt and 28% were students. Madurella mycetomatis eumycetoma was the most common type (70%. In 66% of the patients the duration of the disease was less than five years, and 81% gave a history of sinuses discharging mostly black grains (78%. History of trauma at the mycetoma site was reported in 20%. Local pain was reported in 27% of the patients, and only 12% had a family history of mycetoma. The study showed that 57% of the patients had previous surgical excisions and recurrence, and only 4% received previous medical treatment for mycetoma. Other concomitant medical diseases were reported in 4% of the patients. The foot (76% and hand (8% were the most commonly affected sites. Less frequently affected sites were the leg and knee (7%, thigh (2%, buttock (2% and arm and forearm (1%. Rare sites included the chest wall, head and neck, back, abdominal wall, perineum, oral cavity, tongue and eye. Multiple sites mycetoma was recorded in 135 (2% of cases. At presentation, 37% of patients had massive lesions, 79% had sinuses, 8% had local hyper-hydrosis at the mycetoma lesion, 11% had regional lymphadenopathy, while 6% had dilated tortuous veins proximal to the mycetoma lesions. The diagnosis of mycetoma was established by combined imaging techniques and cytological, histopathological, serological tests and grain culture. Patients with actinomycetoma received a combination of antimicrobial agents, while eumycetoma patients received antifungal agents combined with various surgical excisions. Surgical excisions in the form of wide local excision, debridement or amputation were done in 807 patients, and of them 248 patients (30.7% had postoperative recurrence. Different types of

  17. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space

    Energy Technology Data Exchange (ETDEWEB)

    Hernando, Moises Fernandez; Cerezal, Luis; Perez-Carro, Luis; Abascal, Faustino; Canga, Ana [Diagnostico Medico Cantabria (DMC), Department of Radiology, Santander, Cantabria (Spain); Valdecilla University Hospital, Orthopedic Surgery Department Clinica Mompia (L.P.C.), Santander, Cantabria (Spain); Valdecilla University Hospital, Department of Radiology, Santander, Cantabria (Spain)

    2015-03-05

    Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included ''piriformis syndrome,'' a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. The concept of fibrous bands playing a role in causing symptoms related to sciatic nerve mobility and entrapment represents a radical change in the current diagnosis of and therapeutic approach to DGS. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. A broad spectrum of known pathologies may be located nonspecifically in the subgluteal space and can therefore also trigger DGS. These can be classified as traumatic, iatrogenic, inflammatory/infectious, vascular, gynecologic and tumors/pseudo-tumors. Because of the ever-increasing use of advanced magnetic resonance neurography (MRN) techniques and the excellent outcomes of the new endoscopic treatment, radiologists must be aware of the anatomy and pathologic conditions of this space. MR imaging is the diagnostic procedure of choice for assessing DGS and may substantially influence the management of these patients. The infiltration test not only has a high diagnostic but also a therapeutic value. This article describes the subgluteal space anatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments, with emphasis on MR imaging and endoscopic correlation. (orig.)

  18. Necrose adiposa do recém-nascido: a propósito de dois casos clínicos Fat necrosis of the newborn: report on two cases

    Directory of Open Access Journals (Sweden)

    Ana Cristina Santos Oliveira

    2011-08-01

    Full Text Available A necrose adiposa subcutânea do recém-nascido é uma paniculite rara do período neonatal. Surge, geralmente, em recém-nascidos de termo ou pós-termo, nas primeiras 4 semanas de vida, e em associação com trauma obstétrico. Caracteriza-se pelo aparecimento de placas ou nódulos subcutâneos duros, localizados ao tronco, nádegas ou coxas. O seu curso é, geralmente, benigno e autolimitado, embora possa acompanhar-se de hipercalcemia, o que obriga a uma vigilância periódica até à resolução das lesões cutâneas. Os autores descrevem 2 casos de necrose adiposa subcutânea do recém-nascido, um num recémnascido de termo, outro num prematuro, ambos associados a partos traumáticos e a sofrimento fetalSubcutaneous fat necrosis of the newborn is an uncommon disorder occurring during the prenatal stage. Generally occurring in full-term neonates or during the first four weeks after a traumatic delivery, the disorder is characterized by the appearance of hard subcutaneous nodules or plaques on the trunk, buttocks or thighs. It is normally a benign and transient condition, although it may be complicated by hypocalcemia, which requires close monitoring until skin lesions are cured. The authors describe two cases of subcutaneous fat necrosis of the newborn, one occurring in a full-term neonate and the other in a premature newborn, both related to traumatic delivery and fetal distress

  19. Ultrasound and MRI findings in appendicular and truncal fat necrosis

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, Philip [Leeds Teaching Hospitals, Department of Radiology, Leeds (United Kingdom); Leeds Teaching Hospitals, Musculoskeletal Centre, X-Ray Department, Chapel Allerton Hospital, Leeds (United Kingdom); Farrant, Joanna M.; McKie, Scott [Leeds Teaching Hospitals, Department of Radiology, Leeds (United Kingdom); Bourke, Grainne [Leeds Teaching Hospitals, Department of Plastic Surgery, Leeds (United Kingdom); Merchant, William [Leeds Teaching Hospitals, Department of Pathology, Leeds (United Kingdom); Horgan, Kieran J. [Leeds Teaching Hospitals, Department of Surgery, Leeds (United Kingdom)

    2008-03-15

    The objective was to evaluate ultrasound and MRI in clinical appendicular and truncal fat necrosis. Thirty-three patients (14 men, 19 women, median age 55, range 29-95) were retrospectively evaluated. Histologically, three groups were seen: Group 1 (n = 18) consisted of patients with subcutaneous masses with septal and extrinsic oedema; in Group 2 (n = 11) necrosis occurred within lipomatous tumours and little oedema; and in Group 3 (n = 4) there were large complex masses consistent with Morel-Lavallee lesions. Two experienced radiologists reviewed MR (n = 30) and ultrasound (n = 32) images with consensus agreement. MRI was performed on a 1.5T system with T1-weighted, T2-weighted fat-suppressed and T1-weighted fat-suppressed post-intravenous gadolinium sequences obtained in two orthogonal planes. Ultrasound (linear 5- to 13.5-MHz probe) was performed in the longitudinal and short axis. Anatomical position, size, shape (oval, linear, ill-defined), internal architecture (lobules, septi or stranding), intrinsic signal characteristics, presence of surrounding pseudocapsule, extrinsic linear stranding and vascularity (gadolinium enhancement or power Doppler) were recorded. Anatomical locations were buttock/thigh (n = 17), leg (n = 6), upper limb (n = 5) and thoracic/abdominal wall (n = 5) with the majority of lesions (30 out of 33) oval/linear in shape. On ultrasound and MRI most lesions showed internal fat lobules, intervening septi and a surrounding pseudocapsule. Fat necrosis can usually be identified as containing multiple fat lobules on ultrasound and MRI despite a varying degree of inflammatory change surrounding and within the mass. (orig.)

  20. Work Ergonomic Hazards for Musculoskeletal Pain among University Office Workers

    Directory of Open Access Journals (Sweden)

    Sunisa CHAIKLIENG

    2010-06-01

    Full Text Available This cross-sectional analytic study aimed to investigate ergonomic hazards in the workplace for musculoskeletal pain among university office workers. There were 142 full-time office staff from Khon Kaen University. Demographic characteristics and musculoskeletal pain were evaluated from a structured questionnaire. Ergonomic workstations, i.e. size of table, seat, work area and illuminations were measured at the workstations and anthropometric parameters were determined. Descriptive statistics were used for data analysis which were percentage, mean, and standard deviation. Inferential statistics were chi-square test and the student t-test at 95 % confidence interval. The results showed that 81.7 % of office workers were female, the mean age was 38.0 ± 10.0 years, the average work experience was 12.3 ± 10.8 years. One-month prevalence of musculoskeletal pain was 69.0 %. The onset of symptoms was during working hours and the majorly reported the cause as prolonged sitting in the same posture at work (73.3 %. From measurements, 55.8 % of all workstations had insufficient illumination being lower than the minimum standard requirement (400 lux. Most workstations (75.6 % had significantly inappropriate height (above elbow height of workers at p < 0.001. From questionnaires, the seat height was significantly associated with musculoskeletal pain (p = 0.034. Moreover, anthropometric characteristics of musculoskeletal pain cases (i.e. buttock-popliteal length, hip breadth, sitting elbow height were significantly different from healthy office workers (p < 0.05. The findings suggest that ergonomic workstations need to be improved appropriately for individual workers and improvements in working conditions following standard requirements should be considered.

  1. Atlas of Life Elements and Chemical Elements Periodic Table Atlas of Life Elements and Chemical Elements Periodic Table Atlas of Life Elements and Chemical Elements Periodic Table Atlas of Life Elements and Chemical Elements Periodic Table%生命元素图谱与化学元素周期表

    Institute of Scientific and Technical Information of China (English)

    唐志华

    2001-01-01

    A review with 12 references is given on the relation between life elements and chemical elements periodic table including the regularities of actions between trace elements in human body,the fine dynamic equilibrium of substantial exchange between human and environment and the philosphic idea of equilibrum between human life and nature.It points out that the distribution of life elemend in cherical elements pericdic table which is similar to the body form of "the animals with head and buttocks raising"hints the existence of life,and argues that we should notice not only the organic nutrition equlilbrium,but also the inorganic nutrition equlilbrium.The essay is intended to interpret the problems associated with life in chemical language.%旨在用化学语言表达与生命有关的问题。讨论了微量元素与生物体作用的规律性,人体生命元素平衡谱的构成,人与环境间精细的动态的物质交换平衡以及“天人合一”的哲学思想,指出生命元素在元素周期表中昂首翘尾的“近似动物体型”分布潜示生命的存在,提出不仅要注重有机营养平衡,更要注重无机营养平衡的观点。

  2. Analysis of Muscle Contraction on Pottery Manufacturing Process Using Electromyography (EMG)

    Science.gov (United States)

    Soewardi, Hartomo; Azka Rahmayani, Amalia

    2016-01-01

    One of the most common problems in pottery manufacturing process is musculoskeletal disorders on workers. This disorder was caused by uncomfortable posture where the workers sit on the floor with one leg was folded and another was twisted for long duration. Back, waist, buttock, and right knee frequently experience the disorders. The objective of this research is to investigate the muscle contraction at such body part of workers in manufacturing process of pottery. Electromyography is used to investigate the muscle contraction based on the median frequency signal. Focus measurements is conducted on four muscles types. They are lower interscapular muscle on the right and left side, dorsal lumbar muscle, and lateral hamstring muscle. Statistical analysis is conducted to test differences of muscle contraction between female and male. The result of this research showed that the muscle which reached the highest contraction is dorsal lumbar muscle with the average of median frequency is 51,84 Hz. Then followed by lower interscapular muscle on the left side with the average of median frequency is 31,30 hz, lower interscapular muscle on the right side average of median frequency is 31,24 Hz, and lateral hamstring muscle average of median frequency is 21,77 Hz. Based on the statistic analysis result, there were no differences between male and female on left and right lower interscapular muscle and dorsal lumbar muscle but there were differences on lateral hamstring muscle with the significance level is 5%. Besides that, there were differences for all combination muscle types with the level of significance is 5%.

  3. Analysis and performance of various classification criteria sets in a Colombian cohort of patients with spondyloarthritis.

    Science.gov (United States)

    Bautista-Molano, Wilson; Landewé, Robert B M; Londoño, John; Romero-Sanchez, Consuelo; Valle-Oñate, Rafael; van der Heijde, Désirée

    2016-07-01

    The objective of this study was to investigate the performance of classification criteria sets (Assessment of SpondyloArthritis international Society (ASAS), European Spondylarthropathy Study Group (ESSG), and Amor) for spondyloarthritis (SpA) in a clinical practice cohort in Colombia and provide insight into how rheumatologists follow the diagnostic path in patients suspected of SpA. Patients with a rheumatologist's diagnosis of SpA were retrospectively classified according to three criteria sets. Classification rate was defined as the proportion of patients fulfilling a particular criterion. Characteristics of patients fulfilling and not fulfilling each criterion were compared. The ASAS criteria classified 81 % of all patients (n = 581) as having either axial SpA (44 %) or peripheral SpA (37 %), whereas a lower proportion met ESSG criteria (74 %) and Amor criteria (53 %). There was a high degree of overlap among the different criteria, and 42 % of the patients met all three criteria. Patients fulfilling all three criteria sets were older (36 vs. 30 years), had more SpA features (3 vs. 1 features), and more frequently had a current or past history of back pain (77 vs. 43 %), inflammatory back pain (47 vs. 13 %), enthesitis (67 vs. 26 %), and buttock pain (37 vs. 13 %) vs. those not fulfilling any criteria. HLA-B27, radiographs, and MRI-SI were performed in 77, 59, and 24 % of the patients, respectively. The ASAS criteria classified more patients as having SpA in this Colombian cohort when the rheumatologist's diagnosis is used as an external standard. Although physicians do not perform HLA-B27 or imaging in all patients, they do require these tests if the clinical symptoms fall short of confirming SpA and suspicion remains.

  4. Extra nuchal-type fibroma associated with elastosis, traumatic neuroma, a rare APC gene missense mutation, and a very rare MUTYH gene polymorphism: a case report and review of the literature*.

    Science.gov (United States)

    Linos, Konstantinos; Sedivcová, Monika; Cerna, Katerina; Sima, Radek; Kazakov, Dmitry V; Nazeer, Tipu; Glazyrin, Alexey; Valerian, Brian T; Carlson, J Andrew

    2011-11-01

    We report a case of an extra nuchal-type fibroma in a 51-year-old male suspected to have attenuated familial adenomatous polyposis (Gardner's syndrome), who presented with a longstanding buttock mass excised due to enlargement and pain. Histopathologically, lobules of haphazard, hypocellular, hyalinized collagen bundles replaced the dermis and subcutis and entrapped nerve bundles, mimicking Morton neuroma. Ramifying nerve twigs found around larger nerve fascicles showed the co-existence of traumatic neuroma. Elastic tissue stain revealed elastosis characterized by large, arborizing fibers lying between and within the hyalinized collagen bundles. Modified Masson's trichrome stain showed light blue staining of collagen bundles producing the hyalinized nodules with irregular, light red staining of collagen bundles at their periphery and within tumor collagen. Compression and/or degeneration of collagen and secondary elastosis with later entrapment by tumor collagen could explain this microscopic phenotype. By immunohistochemistry, tumor spindle cells expressed nuclear β-catenin and cyclin D1, mostly within regions of fibrosis implicating activation of the adenomatous polyposis coli (APC)-Wnt pathway. Genetic analysis showed a missense mutation in APC gene (c.7504G>A, p.G2502S in exon 15) and a functional homozygous polymorphism in the MUTYH gene (c.36+325G>C, (IVS1+5G/C)). Nuchal-type fibroma has been associated with Gardner's syndrome and trauma. In this patient, genetic predisposition coupled with repetitive, localized trauma and collagen degeneration may have provided the stimulus for the development of extra nuchal-type fibroma.

  5. Mycetoma in Iran: Causative agents and geographic distribution

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    Shahindokht Bassiri-Jahromi

    2014-01-01

    Full Text Available Background: Mycetoma is a chronic granulomatous disease caused by true fungi (eumycetoma or filamentous bacteria (actinomycetoma. It usually involves the subcutaneous tissue after a traumatic inoculation of the causative organism. We reviewed retrospectively 13 patients with mycetoma. Materials and Methods: This study reports the etiologic agents and distribution of mycetoma in 35 cases from 1994 to2009 in Iran. The diagnostic of mycetoma were confirmed by histopathology and direct preparation, culture techniques, and histopathology of granules and surgical biopsies, radiological examination of the affected site. Results: Mycetoma was identified in 35 patients of 168 suspected patients (20.8%. They occurred in 22 male and 13 females. Their ages ranged from 14 to 80 years. The duration of the disease ranged from two months to 38 years. Sixteen patients had eumycetoma, and 19 patients had actinomycetoma, one of them had mix infections by eumycetoma and actinomycetoma. The majority of the patients were from central and states in south and north of Iran. The feet were most affected site (65.7% of the cases, followed by hands (25.7%, face (2.8%, and trunk (2.8%, and buttock (2.8%. Most patients (68.5% were more than 40 year-old. The male to female ratio was 5:3. The disease was abundant among housewife in urban and farmer in rural area of Iran. The most common prevalent mycetoma agents in this study were Actinomyces sp. There was a history of risk factors in 28.6% of patients in this study. Conclusion: Mycetoma occasionally occurs particularly in the South, Central, and North of Iran, and seen most often in persons, who live in hot, humid climates. If there are risk factors for invasive fungal infections traumatic inoculation with any fungus may result in rapid local spread and systemic disease, often with fatal outcome.

  6. Surya Namaskar (Sun Salutation: A Path to Good Health

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    Amit Vaibhav

    2016-07-01

    Full Text Available Surya Namaskar (Sun Salutation is an ancient and sacred yogic technique of India for expressing gratitude to the Sun. Surya Namaskar is a set of 12 Asanas (postures, It is done preferably in the morning while facing the rising sun. There are numerous health benefits of Surya Namaskar for different system of the body specially musculoskeletal, cardiovascular, gastrointestinal, nervous system, respiratory and endocrinal. The heart, liver, intestine, stomach, chest, throat, legs and backbone are main benefited organs. By practicing Surya Namaskar each and every cell of body get revitalize and regenerated, therefore it is highly recommended by all yoga experts for healthy routine life. The regular practice of Surya Namaskar improves blood circulation throughout the body, maintains health and makes the body disease-free. Regular practice of Surya Namaskar gives strength, flexibility and vitality to the body. Sun Salutation asanas help to burn extra body fat on belly, buttocks and back by modulating endocrinal system. It also helps to regulate menstrual cycles among women and also facilitate an easy childbirth. Apart from these benefits of Surya Namaskar also help to keep the mind stress free, calm and illuminated. Thus, a regular practice of Surya Namaskar is highly recommended to keep the body and mind healthy. Though the Surya Namaskar steps are very scientific and practical science ancient time but still it needs advance modern scientific justification to spread it globally, keeping this thing into the mind the present review has been framed to revalidate sacred steps of Surya Namaskar on the basis of available evidence based studies.

  7. E P I DEMIOLOGY OF PAEDIATRIC BURNS: A RETROSPECTIVE STUDY

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    Jangpreet Singh

    2015-04-01

    Full Text Available BACKGROUND: Burn injuries are a major cause of morbidity and mortality in children. These are the third most common injury causing death in children, following motor vehicle accidents and drowning accidents. AIM: To study the Epidemiological parameters for assessment of morbidity & mortality rate in pediatric burns and to form effective preventive strategy. MATERIAL AND METHODS: The study was done at the Department of Surgery, PIMS, Jalandhar. Total 50 patients (n=50 up to age of 12 years, were included in the study retrospectively. Data regarding age, sex, demographic distribution, seasonal variation, Total body surface area (TBSA involved, type and place of burn injury, parent’s occupation, family size and mortality rate were noted and analysed. RESULT S: Total 50 patients (n =50 of which 32 were males and 18 females were included in the study. Mean age of burn injuries was 3.6 years. Scalds burns were the most common cause of burns followed by thermal burns. It involved mostly upper limbs (67%, anterio r trunk (56%, lower limbs (53%, face (4%, and posterior trunk including buttocks (16% . The time lapse from injury to presentation to hospital ranged from 1 hour to 3 weeks. Total body surface area burnt was ranged from 2 – 60%. Mean hospital duration was 12 . 4 days. Complications ranged from wound sepsis in 11 patients (22%, contractures of fingers in 3 patients ( 6 % and hypertrophic scarring in 8 patients (16% . After healing of wounds, patients were advised pressure garments and oil massage and night splint age regularly for six months. CONCLUSION: Children constitute a vulnerable group of burns. Most injuries occur in the home setting where effective control measures can be adopted. Advances have also made in resuscitation, intensive care, antimicrobi als, vascular access, nutritional support, and skin banking. Splintage, physiotherapy, massage and pressure garments also help in reducing the morbidity and overall long term burden over

  8. Myiasis in Republic of Yemen (cutaneous myiasis three cases reported and genito-urinary myiasis three cases reported

    Directory of Open Access Journals (Sweden)

    Mohammed Abdul Qader Al-Malmi

    2014-01-01

    Full Text Available Myiasis is a condition resulting from the invasion of living human and animal′s tissues by larval stages of flies. study the cutaneous and genito-urinary myiasis in the Republic of Yemen. Two females and one male, Yemeni patient 12-30 years old presented with urethra-genital discharge, burning, and difficulty during micturition (dysuria. They saw whitish brownish blackish like worms passed in their urine. Three males, Yemeni patients 2 months to 30 years old had solitary and multiple furuncle like skin lesions in upper left thigh (myiasis pubis, right buttock (myiasis neonatorum and in the upper trunk. It was associated with stabbing pain (caused by creeping a foreign body subcutaneously. The duration varied from 2 days to 1 week. The larvae were detected in the urine and the skin lesions. Swab from the urethral discharge was not specific. I used the forceps accidentally and gently caught the larvae and removed them from the fruncular skin lesions. The clinical data and detection of the larvae showed the two females and one male case were genito-urinary myiasis, which caused by latrine Fannia fly larvae during defecation or sleeping and ended spontaneously. The three male patients had cutaneous myiasis, and the causative agent was the larvae of the tumbu fly, Cordylobia anthropophaga species. It penetrates the patients′ normal skin and removed by forceps or squeezing the skin lesion by the patient himself thinking that is abscess to remove the pus. Cutaneous and genito-urinary myiasis was not rare in the Republic of Yemen. Health education, hygiene, and control the flies restrict the incidence of this disease.

  9. Ultraviolet radiation after exposure to a low-fluence IPL home-use device: a randomized clinical trial.

    Science.gov (United States)

    Thaysen-Petersen, Daniel; Erlendsson, Andres M; Nash, J F; Beerwerth, Frank; Philipsen, Peter A; Wulf, Hans C; Haedersdal, Merete

    2015-11-01

    The prevailing advice is to avoid sun exposure after intense pulsed light (IPL) hair removal. However, no systematic evaluation of ultraviolet radiation (UVR) after IPL hair removal exits. Therefore, we investigated the occurrence of side effects in subjects receiving solar-simulated UVR after a low-fluence IPL treatment with a home-use device. Sixteen subjects with Fitzpatrick skin types (FST) II-V were enrolled. Three constitutive buttock blocks (4.4 × 6.4 cm) were each subdivided into four sites, randomized to one IPL exposure of 0, 7, 8, or 10 J/cm2 (spectral output 530-1100 nm). Blocks were randomized to no UVR or three standard erythema doses (SEDs) UVR either 30 min or 24 h after IPL. Follow-up visits were 48 h, 1 week, and 4 weeks after IPL. Outcome measures were (i) clinical skin reactions, (ii) reflectance measurements of erythema and pigmentation, and (iii) pain. Subjects with FST II-IV experienced no skin reactions up to 4 weeks after IPL, neither erythema, edema, blisters, crusting, textual, nor pigment changes. Reflectance confirmed no change in erythema and pigmentation (p ≥ 0.090). UVR exposure induced erythema and increased pigmentation. The combination of IPL and UVR induced skin reactions not different to responses from UVR (IPL-UVR vs. UVR, p ≥ 0.164). Pain was generally low (median 1, range 0-4) and correlated positively with fluence and pigmentation (Spearman's rho ≥ 0.394, p exposure of three SEDs either shortly or 1 day after low-fluence IPL causes no amplification of skin responses in constitutive skin of individuals with FST II-IV.

  10. Effects Related to Random Whole-Body Vibration and Posture on a Suspended Seatwith and Without Backrest

    Science.gov (United States)

    HINZ, B.; SEIDEL, H.; MENZEL, G.; BLÜTHNER, R.

    2002-05-01

    WBV-exposures are often linked with forced postures as prolonged sitting, bent forward sitting, or sitting without a backrest. No quantitative data are available to describe the exposure-effect relationships for different conditions of seating, posture, and the biological variability of workers. Experiments and subsequent predictions of forces acting within the spine during WBV can help to improve the assessment of the health risk. An experimental study was performed with 39 male subjects sitting on a suspension seat with or with no backrest contact. They were exposed to random whole-body vibration with a weighted r.m.s. value of 0·6 m/s2 at a relaxed or a forward bending posture. A two-dimensional finite element model was used for the calculation of the internal spinal load. The model simulates the human response on a suspension driver seat. Individual exposure conditions were considered by including the transfer functions between the seat cushion and the seat base as well as between the backrest and the seat base for the calculation of the vibration input to the buttocks and to the back respectively. The average peak seat transmissibility was higher for the seat with the backrest, but the peak seat-to-head transmissibility was higher for the seat without the backrest for both postures. The peak transmissibilities between the accelerations at the seat base and the compressive forces at L5/S1 were highest for the seat without the backrest during the bending posture. Various biological effects can result from identical exposures combined with different backrest contact and postures. The backrest contact and posture conditions should not be neglected in the assessment of health risk caused by whole-body vibration.

  11. 中年男性的体征参数在OSAHS诊断中的应用价值%Value of physical signs in diagnosis of obstructive sleep apnea hypopnea syndrome in middle aged men

    Institute of Scientific and Technical Information of China (English)

    李益飞; 陈琰; 薛飞; 曹爽

    2011-01-01

    Objective To study the relationship between anthropometry and polysomnography. Methods 130 middle-aged men suspected of OSAHS were examined for their height, weight, neck circumference, chest circumference, 'waist and buttocks circumference. The correlation between the results and the data of polysomnography was analyzed. Results BMI was the most important factor which affected the apnea hypopnea index (AHI), longest apnea time, lowest oxygen saturation .average oxygen' saturation. Conclusion There is a close correlation between OSAHS and BMI,therefore obesity is an important risk factor for OSAHS.%目的 研究中年男性多种体征参数与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)诊断“金标准”一多导睡眠图(PSG)监测结果之间的关系,探讨中年男性体征参数在OSAHS诊断中的应用价值.方法 对130例疑似OSAHS的中年男性患者的身高、体重、颈围、胸围、腰围、臀围进行测量,比较患者不同体征参数与PSG监测数据的相关性.结果 在受试群体的体征因素中,BMI与AHI、最长呼吸暂停时间、最低血氧饱和度和平均血氧饱和度的相关性最好.结论 BMI是预测中年男性OSAHS严重程度的最佳体征参数指标.

  12. 多发性硬下疳合并二期梅毒1例%A Case of Secondary Syphilis with Multi-chancre

    Institute of Scientific and Technical Information of China (English)

    马虎; 陈霞; 林昭春

    2012-01-01

    A 34 years men, with painless ulcers on his penis and scrotum repeatedly for six months, and with erythema on the trunk and thigh for 5 days. Examination; there were many well-demarcated, painless ulcers on the the penis and scrotum,0.5 to 1.0cm sized,which touched as cartilage-like papules. Many red round erythemas on the trunk and thigh, and no erythema and desquamation on hands and feet. Laboratory tests : TPPA ( + ) , RPR 1:128 ( + ) , HIV ( - ) ,HSV-I IgG( + ) ,HSV-II IgG( + ) ,HSV-I IgM( - ) ,HSV-II IgM ( — ). Diagnosis : secondary syphilis with multi-chancre. Benzathine penicillin G 2. 4 MU injections were given to each buttock once a week for 3 weeks, then chancres and syphilitic macules disappear.%患者男,34岁.阴茎、阴囊反复起溃疡6个月,躯干、大腿起红斑5d.查体:阴茎及阴囊可见多处浅溃疡,直径0.5 ~ 1.0cm,界清,边缘整齐,呈软骨样硬度,无触痛.躯干、大腿见广泛分布类圆形淡红斑,大小不一;双手足未见红斑和脱屑.实验室检查:TPPA(+),RPR 1:128(+),HIV抗体阴性.HSV-IIgG(+),HSV-II IgG(+),HSV-I IgM(-),HSV-II IgM(-).诊断:多发性硬下疳;二期梅毒.予苄星青霉素240万U分两侧臀部肌注,1次/周,连用3次后皮损消退.

  13. Ergonomic Analysis of Tricycle Sidecar Seats: Basis for Proposed Standard Design

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    Michael C. Godoy

    2015-12-01

    Full Text Available Ergonomics (also called human factors engineering is the study of human characteristics for the appropriate design of the living and work environment. It is applied in various industrial areas which includes transportation.Tricycle being one of the most common means of public transportation in Lipa City has various adaptations to suit the culture, and environment. The purpose of this study is to analyze the variability in design of the tricycles in Lipa City, Philippines and propose a standard ergonomically designed tricycle sidecar seat for a greater population. The study was conducted at 26 tricycle terminals with 232 tricycle samples within Lipa City proper including the public market area where 400 commuters were given questionnaires to determine the risk factors associated with the existing tricycle sidecar seat design. Anthropometric measurements of 100 males and 100 female commuters were obtained together with the sidecar dimensions of 232 tricycles to substantiate the observed variations in design. Using the design for the average and design for the extremes, it was found out that most of the tricycles in Lipa City, Philippines have inappropriate inclined seat and lowered sidecar seat pan height which can result to leg and abdominal pain; narrowed seat pan depth which caused pressure on buttocks and legs; narrowed backrest width which can cause upper and low back pain; low backrest height that can pose upper back pain; which can also result to abdominal pain; inclined backrest and limited vertical clearance which can cause upper back pain and neck pain. The researcher proposed a sidecar seat design standard which can be used by the Land Transportation Office, and Land Transportation Franchising and Regulatory Board to provide ease, comfort, and convenience to the passengers.

  14. The Usefulness of Bone Scan in Electric Burns

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    Kim, Tae Hyung; So, Yong Seon; Kweon, Ki Hyeon; Han, Sang Woong; Kim, Seok Hwan; Kim, Jong Soon; Han, Seung Soo [Hanil Hospital, Seoul (Korea, Republic of)

    1996-03-15

    Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as determining to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites and bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, scrum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.

  15. Pontomedullary lacerations and concomitant injuries: A review of possible underlying mechanisms

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    Živković Vladimir

    2013-01-01

    Full Text Available Anatomically, brainstem is constituted of medulla oblongata, pons and mesencephalon. Traumatic lesions of brainstem most commonly occur on pontomedullary junction. There are several possible mechanisms of pontomedullary lacerations. The first mechanism includes impact to the chin, with or without a skull base fracture, and most often leads to this fatal injury, due to impact force transmission through the jawbone and temporomandibular joint. The second mechanism includes lateral and posterior head impacts with subsequent hinge fractures, where occurrence of pontomedullary lacerations in these cases may depend on the energy of impact, as well as on the exact position of the fracture line, but less so on the head’s movement. The third mechanism includes frontoposterior hyperextension of the head, due to frontal impact, concomitant with fractures or dislocations of upper spine. In the fourth mechanism, there is an absence of direct impact to the head, due to the indirect force of action after feet or buttocks­first impact. Most of these cases are accompanied by ring fractures as well. In situations such as these, the impact force is transmitted up the spinal column and upper vertebrae, and telescopically intruded into the skull, causing brainstem laceration. The jawbone and other facial bones can act as shock absorbers, and their fracture could diminish the energy transfer towards the skull and protect the brain and brainstem from injury. In all the cases with pontomedullary laceration posterior neck dissection should be performed during the autopsy, since upper spine injuries are often associated with this type of injury. [Projekat Ministarstva nauke Republike Srbije, br. 45005

  16. Two Cases of Misdiagnoses of Leprosy%麻风误诊2例

    Institute of Scientific and Technical Information of China (English)

    袁华刚

    2011-01-01

    Case 1, a 57-year-old female.The disease characterized by periodic episodes of fever in her feet, and prickling-like pain sustained four years, with blistered and/or festered.She visited to a hospital half month after scabbed, with familial history of leprosy.The disease was misdiagnosed as "rheumatism", "ulcer of lower limb".Case 2, a 40-year-old male.The disease characterized by scratched all over the body lasted one year,papule or nodule on both upper extremities and buttocks, fester and scab lasted half a year.He visited to a hospital in the one month after his eyebrows shed off, without familial history of leprosy.The disease was misdiagnosed as "urticaria", "eczema".Both of two cases had skin injury, shed eyebrows, pained, hinder of temperature sensation.They were diagnosed by examined the Bacillus leprae with tissue fluid of skin inju ry and pathology.%例1女,57岁.双足反复发热,针刺样痛4年,伴水疱、溃烂,结痂半月.有麻风病家族史,曾误诊为"风湿"、"下肢溃疡".例2男,40岁.全身瘙痒1年,双上肢及臀部丘疹结节、溃烂结痂半年,双眉毛脱落1月.无麻风病家族史,曾误诊为"荨麻疹"、"湿疹".2例除皮损外,均同时伴有眉毛脱落,部分皮损区痛,温觉障碍,皮损组织液和病理组织检查发现麻风杆菌而确诊.

  17. Babinski, histologist and anatomo-pathologist.

    Science.gov (United States)

    Poirier, J

    2008-01-01

    Joseph Babinski (1857-1932), a French neurologist of Polish origin, médecin des hôpitaux de Paris, is well known for the discovery of the Sign (the toes phenomenon) which bears his name. Beyond the Sign, his semiological work in the field of neurology is also important (particularly cutaneous and osteo-tendinous reflexes, cerebellar and vestibular semiology, hysteria and pithiatism) as well as his role in the birth of the French neurosurgery. On the contrary, the implication of Babinski in pathological anatomy and histology is usually unrecognized. However, in the beginning of his career, Babinski worked as an Interne in the clinical departments of Victor Cornil (1837-1908), professor of pathological anatomy and president of the Société d'Anatomie de Paris, Alfred Vulpian (1826-1887), past professor of pathological anatomy and then professor of experimental physiology, and in the laboratory of Louis Ranvier (1835-1922), professor of general anatomy at the Collège de France. Babinski beacame préparateur at the chair of pathological anatomy, member then treasurer of the Société Anatomique, member of the Société de Biologie. He reported on several clinico-pathological observations of general pathology (liver cirrhosis, cancer of the kidney, cancer of a buttock, squamous epithelioma, tuberculosis, multiple cysts of the liver and the kidneys, bowel occlusion), of neuropathology (embolic brain softenings, hydatic cysts of the brain, multiple sclerosis, spinal cord combined sclerosis, tabetic arthropathies, adiposo-genital syndrome due to a pituitary tumor) and of human neuro-muscular histology (neuro-muscular spindles, muscular histology after nerve sectioning, diphtheria paralysis, peripheral neuritis).

  18. A 29-Year-Old Male with Borderline Lepromatous Leprosy

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    Lubna Khondker

    2013-07-01

    Full Text Available Leprosy (Hansen’s disease is a chronic granulomatous infectious disease that primarily affects the peripheral nerves, skin, upper respiratory tract mucosa, eyes and certain other tissues. It is diagnosable and curable if recognized early and treated adequately. A twenty nine-year-old male from Jessore, Bangladesh reported in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh with the complaints of multiple erythematous, large, raised and circumscribed lesions with loss of sensations on different parts of the body, especially distal portions of all four limbs for last eight months. Subsequently he developed ulcers on the anesthetic fingers due to smoking and few ulcerative lesions on both feet. Skin examination revealed multiple erythematous, large nodular lesions on both sides of the cheek and forehead, multiple erythematous, indurated, large plaques with raised margin and central clearing on the trunk, waist and all four limbs, few satellite lesions around the large plaques on the trunk, few hypopigmented patches and plaques on buttock and lower limbs, multiple painless ulcers on dorsal surface of fingers of both hands, both lateral malleoluses and right sole. On examination of peripheral nerves, left great auricular nerve, both ulnar nerves and both common peroneal nerves were moderately enlarged and tender. Slit skin smear for AFB (modified Z-N stain was done and revealed that there were large number of acid and alcohol-fast bacilli arranged in straight and curved parallel bundles with globular masses (cigar-bundle appearance, morphologically resembling Mycobacterium leprae. Skin biopsy for histopathological examination revealed extensive infiltration of macrophages in the dermis, separated from epidermis by narrow grenz zone, with destruction of skin adnexa. Few foci of poorly defined granuloma in dermis were also noted. The patient was managed with rifampicin, clofazimine, dapsone, prednisolone and omeprazole.

  19. Early excision and grafting, an alternative approach to the surgical management of large body surface area levamisole-adulterated cocaine induced skin necrosis.

    Science.gov (United States)

    Miner, Jason; Gruber, Paul; Perry, Travis L

    2015-05-01

    Levamisole-adulterated cocaine as a cause of retiform purpura progressing to full-thickness skin necrosis was first documented in 2003 and currently comprises over 200 reported cases. Whereas, its presentation, pathophysiology, and diagnostic workup have been reasonably well-defined, only one publication has significantly detailed its surgical management. For this reason there exists a relative absence of data in comparison to its reported incidence to suggest a preferred treatment strategy. In the case mentioned, treatment emphasized delayed surgical intervention while awaiting lesion demarcation and the monitoring of autoantibodies. At our institution we offer an alternative approach and present the case of a 34 year old female who presented with 49% TBSA, levamisole-induced skin necrosis managed with early surgical excision and skin grafting. The patient presented three days following cocaine exposure with painful, purpura involving the ears, nose, buttocks, and bilateral lower extremities which quickly progressed to areas of full-thickness necrosis. Lab analysis demonstrated elevated p-ANCA and c-ANCA, as well as leukopenia, decreased C4 complement, and urinalysis positive for levamisole, corroborating the diagnosis. Contrasting the most thoroughly documented case in which the patient underwent first surgical excision on hospital day 36 and underwent 18 total excisions, our patient underwent first excision on hospital day 10 and received only one primary excision prior to definitive autografting. To our knowledge, this is the largest surface area surgically treated that did not result in surgical amputation or autoamputation of limbs or appendages, respectively. We contend that early excision and grafting provides optimal surgical management of this syndrome while avoiding the morbidity seen with delayed intervention.

  20. Liposuction-assisted medial thigh lift in obese and non obese patients

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    Abdelmohsen Khalaf Aboueldahab

    2013-01-01

    Full Text Available Introduction: The abdomen, thighs and buttocks are often the areas of greatest concern to patients following massive weight loss due to bariatric surgery. The typical appearance of the patient who has lost a massive amount of weight derives from a combination of factors, including gender-dependent body morphology and a change in body mass index, which lead to skin and soft-tissue excess and poor skin tone. Thigh laxity and redundancy represents a great challenge to both patients and surgeons. Not only because of the difficulty to satisfy the patients, but also due to the higher incidence of complications especially, with those obese patients who have not undergone bariatric surgery before. The problems with such patients are due to the heavy thighs that require both debulking and tight anchorage to prevent scar migration or labial distortion. Aim of the Work: The aim of the present study is to improve the aesthetic outcome and avoid the complications of medial thigh lifting with simultaneous liposuction in obese and non-obese. Patients and Methods: A total of 25 female patients presented during the period from January 2007 to July 2011 complaining of moderate to severe thigh laxity with or without lipodystrophy. In 20 patients medial transverse thigh lift was performed, to treat medial thigh friction and laxity particularly in the upper half. Whereas, in the other five patients were suffering from upper and lower medial thigh bulkiness, vertical thigh lift was performed. Results: All patients recovered well in 2 weeks and showed improvement of thigh contour. Scar downward displacement in one patient. No skin necrosis or seroma. No labial distortion or separation encountered. Conclusion: Simultaneous liposuction and thigh lift gave good results provided proper patients selection, appropriate technique to each patient, meticulous, cautious liposuction and handling of the tissues and most importantly is the deep tight anchorage sutures to guard

  1. Lumbar extension exercises in conjunction with mechanical traction for the management of a patient with a lumbar herniated disc.

    Science.gov (United States)

    Gagne, Allison R; Hasson, Scott M

    2010-05-01

    Low back pain resulting from lumbar disc herniation is a common reason for referral for physical therapy. There is no evidence to support the management of lumbar disc herniation and derangement using mechanical traction combined with lumbar extension exercises. Therefore, the purpose of this case report was to describe and discuss the use of mechanical traction in conjunction with lumbar extension exercises for a patient with a lumbar herniated disc. The patient was a 49-year-old male referred to physical therapy with a medical diagnosis of a lumbar herniated disc at L5-S1 with compression of the L5 nerve root confirmed by MRI. The patient's chief complaint was pain over the left lumbosacral and central lumbar region with radiating pain into the left buttock accompanied by numbness and tingling in the left lower leg and foot. The patient was seen for a total of 14 visits. The first 5 days (2 weeks) of therapy consisted of lumbar extension exercises. For the following nine visits (over a 3-week period), mechanical traction was added as an adjunct to the extension exercises. Outcome measures included the Oswestry Disability Questionnaire, Back Pain Function Scale (BPFS), and the Numeric Pain Rating Scale (NPRS). Results from initial evaluation to discharge (Oswestry: 36% to 0%; BPFS: 33/60 to 57/60; NPRS: 7/10 to 0/10) demonstrated that the patient no longer experienced low back pain and improved in terms of functional status and pain-related disability. The patient no longer complained of numbness and tingling in the left lower extremity and the goals for the patient had been attained. The data from this case report suggests lumbar extension exercises in conjunction with mechanical traction facilitated the patient's improvement in pain and return to prior level of function.

  2. Compartment syndromes

    Institute of Scientific and Technical Information of China (English)

    Aly Saber

    2014-01-01

    Body compartments bound by fascia and limited by bony backgrounds are found in the extremities, buttocks, abdomen and thoracic cavity; conditions that cause intracompartmental swelling and hypertension can lead to ischemia and limb loss.Although compartment syndromes are described in all body regions from head to toe, the etiology, diagnosis, treatment, and prevention are best characterized for three key body regions: the first is extremity, the second is abdominal, and the third is thoracic compartment syndromes.Thoracic compartment syndrome usually occurs as a result of pathological accumulation of air, fluid or blood in the mediastinum and has traditionally been described in trauma.As the intracranial contents are confined within a rigid bony cage, any increase in volume within thiscompartment as a result of brain oedema or an expanding traumatic intracranial haematoma, leads to a reciprocal decrease in the volume of cerebrospinal fluid and intracranial venous blood volume.Limb compartment syndromes may present either in acute or chronic clinical forms.Intra-abdominal pressure can be measured by direct or indirect methods.While the direct methods are quite accurate, theyare impractical and not feasible for routine practice.Indirect measurement is done through inferior vena cava, gastric, rectal and urinary bladder.Indirect measurement through urinary bladder is the simplest and is considered the method of choice for intra-abdominal pressure measurement.The management of patients with intra-abdominal hypertension is based on four important principles: the first is related to the specific procedures aiming at lowering intra-abdominal pressure and the consequences of intra-abdominal hypertension and abdominal compartment syndrome; the second is for general support and medical management of the critically ill patient; while the third is surgical decompression and the fourth is optimization after surgical decompression.

  3. Effect of Acupressure on Non-stress Test (NST Results: A Randomized-Controlled Trial Study

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    Masoume Pirhadi

    2015-10-01

    Full Text Available BackgroundPregnancy and delivery are among the most stressful events in women’s life . Breech presentation is defined as a fetus in a longitudinal lie with the buttocks or feet closest to the cervix. This occurs in 3-4% of all deliveries.The risk for perinatal mortality was 1 in 300 for planned breech deliveries.Some conventional non-surgical therapies for breech presentation are available. acupoint (BL67 stimulations are commonly used for the correction of breech presentation. The present study aimed to evaluate the effect of acupressure on fetal wellbeing test results.MethodThis study is a clinical trialthat was conducted in one group and the two-steps.Participantswere pregnant women (primigravida who were 35 to 18 years that refer to Shahid Beheshti hospital in Isfahan in 2013 to receive routine prenatal care.The 32 pregnant women (32-36 weeks were randomly selected.They were stimulated immediately after the first Non stress test and before the second test.The researchers’ evaluated and analyzed variables using SPSS software version 20.FindingsMean (SD age of the subjects was 24/7±2/8 and 93/8% of them was housekeeper. The frequency of reactive Non Stress Test (NST was same before and after stimulation. The mean time of the tests’ result was decreased after stimulation significantly ( p-value=0.048. ConclusionsAlthough fetal non-stress test result wasn’t influenced by acupressure but this intervention led to shorter testing time to achieve results. In other words, after the intervention, the time it takes to reach a reactive fetal non-stress test is about 2/7 minutes less than the time without intervention.

  4. Virological investigation of hand, foot, and mouth disease in a tertiary care center in South India

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    Pavithra M Vijayaraghavan

    2012-01-01

    Full Text Available Context: Hand, foot, and mouth disease (HFMD remains a common problem in India, yet its etiology is largely unknown as diagnosis is based on clinical characteristics. There are very few laboratory-based molecular studies on HFMD outbreaks. Aim: The aim of this study was to characterize HFMD-related isolates by molecular techniques. Settings and Design: Between 2005 and 2008, during two documented HFMD outbreaks, 30 suspected HFMD cases presented at the Outpatient Unit of the Department of Dermatology, Christian Medical College (CMC, Vellore. Seventy-eight clinical specimens (swabs from throat, mouth, rectum, anus, buttocks, tongue, forearm, sole, and foot were received from these patients at the Department of Clinical Virology, CMC, for routine diagnosis of hand, foot, and mouth disease. Materials and Methods: Samples from these patients were cultured in Vero and rhabdomyosarcoma (RD cell lines. Isolates producing enterovirus-like cytopathogenic effect (CPE in cell culture were identified by a nested reverse transcription-based polymerase chain reaction (RT-PCR and sequenced. The nucleotide sequences were analyzed using the BioEdit sequence program. Homology searches were performed using the Basic Local Alignment Search Tool (BLAST algorithm. Statistical Analysis used: The statistical analysis was performed using Epi Info version 6.04b and Microsoft Excel 2002 (Microsoft Office XP. Results: Of the 30 suspected HFMD cases, only 17 (57% were laboratory confirmed and Coxsackievirus A16 (CVA16 was identified as the etiological agent in all these cases. Conclusions: Coxsackievirus A16 (CVA16 was identified as the virus that caused the HFMD outbreaks in Vellore between 2005 and 2008. Early confirmation of HFMD helps to initiate control measures to interrupt virus transmission. In the laboratory, classical diagnostic methods, culture and serological tests are being replaced by molecular techniques. Routine surveillance systems will help understand the

  5. Chronic cutaneous graft-versus-host disease: a case report and literature review%皮肤慢性移植物抗宿主病1例并文献复习

    Institute of Scientific and Technical Information of China (English)

    熊晓刚; 刘业强; 徐晓; 刘波; 雷晴; 卢军; 余泽莹; 陈方元; 涂圣安

    2012-01-01

    报告1例皮肤慢性移植物抗宿主病.患者男,25岁.全身泛发性皮损5年,主要表现为全身弥漫性色素减退伴色素加深的苔藓样斑片.面部呈现激素依赖性皮炎样表现.毛发稀疏,眉毛和腋毛脱落,睫毛及阴毛发白.手(足)指(趾)甲失去光泽,表面有纵嵴,部分缺损、萎缩.臀部皮损组织病理检查表现为苔藓样浸润模式.诊断:皮肤慢性移植物抗宿主病.给予糖皮质激素及他克莫司系统治疗,皮损改善不明显.%A 25-year-old man presented with a 5-year history of hyperpigmented and hypopigmented lichenoid skin lesions all over the body. There was steroid-dependent dermatitis-like manifestation on the face. Hair loss was evident on the scalp, eyebrows, armpit. Eyelashes and pubic hairs were white. Nail changes included brittleness, roughness, longitudinal ridges, and onychomadesis and onychatrophia. Histopathology of skin lesions on the buttocks revealed a pattern of lichenoid infiltration. The diagnosis was made as chronic cutaneous Graft-versus-host disease. The patient received daily oral corticosteroids in combination with systemic tacrolimus. No improvement had been obtained.

  6. Work-related musculoskeletal disorders among dental professionals in Saudi Arabia.

    Science.gov (United States)

    Alghadir, Ahmad; Zafar, Hamayun; Iqbal, Zaheen A

    2015-04-01

    [Purpose] Musculoskeletal disorders are common causes of work-related disability in different professions involving the frequent practice of lifting, stooping, twisting, prolonged sitting, or standing. The dental profession is one such profession. Our aim was to determine the prevalence of work-related musculoskeletal disorders among dental professionals in Saudi Arabia, the factors associated with them, and their consequences and to propose preventive measures for them. [Subjects and Methods] A self-administered online questionnaire was sent to 225 members of the Saudi Dental Association. It included questions on demographic and professional characteristics, general medical history, and history of work-related musculoskeletal disorders before and after joining the dental profession. [Results] The questionnaire was completed by 65% of the respondents. Among them 85% reported that they had developed some pain due to work after joining the dental profession, and 42% reported that they were suffering pain at the time of the survey. Besides lower back, shoulder, and neck regions, the hands, upper back, and other regions like the elbows, buttocks, thighs, leg, and feet were areas in which they pain. [Conclusion] The prevalence of work-related musculoskeletal disorders among dental professionals in Saudi Arabia is high, affecting their daily activities, sometimes even forcing them to change their work setting. Age, gender, specialty of work, work setting, number of contact hours with patients, etc., were all found to be related to their work-related pain. We need to emphasize the role of ergonomics, counseling, proper techniques of patient handling, etc., during the training of dental professionals so that they can work efficiently.

  7. Pondering Parotid Masses

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    Mark A Miller

    2001-01-01

    Full Text Available A49-year-old, human immunodeficiency virus (HIV- infected, Haitian-born woman presented with a left facial mass that she had noticed for the previous eight weeks. She was known to have been HIV-seropositive for the previous 11 years and had been on multiple antiretroviral therapies. Her past medical history was also significant for hypertension, disseminated varicella zoster virus and recurrent oral and buttock Herpes simplex episodes. She was taking the following medications at the time of her presentation with the facial mass: stavudine, lamivudine, didanosine, nelfinavir mesylate, famciclovir, hydrochlorothiazide and cotrimoxazole. She had no complaints of fever, chills, sweats, weight loss or anorexia. She denied any pain, redness or warmth at the site of the facial swelling. Her most recent CD4 lymphocyte count was 336 cells/µL, with an HIV viral load of log102.6 copies/mL. Physical examination revealed a 4 cm fluid-filled mass in the left parotid gland. There was no detectable induration, redness, warmth or tenderness, and no associated adenopathy. The rest of the examination was unremarkable. An aspirate of the mass was performed under sterile conditions and yielded 30 mL of turbid, yellow liquid. A Gram stain revealed no neutrophils, scant mononuclear cells and no visible organisms. An acid-fast stain was negative as well. Routine, mycobacterial and fungal cultures showed no growth. Cytological analysis showed scant reactive lymphocytes and no malignant cells. The patient was not given therapy and was observed for another two months. The fluid reaccumulated in the left parotid gland, and the patient?s only complaint concerned the unsightly appearance of the mass. The lesion was again aspirated for 30 mL of fluid and this time, the fluid had a turbid, brown appearance. All laboratory results were identical to the results from the first aspirate. What is your diagnosis, and how would you treat this patient?

  8. Pyogenic Arthritis, Pyoderma Gangrenosum, Acne, Suppurative Hidradenitis (PA-PASH) Syndrome: An Atypical Presentation of a Rare Syndrome

    Science.gov (United States)

    Ursani, Mohammad A.; Appleyard, Joan; Whiteru, Onome

    2016-01-01

    Patient: Male, 44 Final Diagnosis: PAPASH syndrome Symptoms: Recurrent skin ulcers • diarrhea • inflammatory arthritis Medication: Prednisone • anti-tumor necrosis factor Clinical Procedure: N/A Specialty: Rheumatology Objective: Rare disease Background: Pyogenic arthritis, pyoderma gangrenosum (PG), acne, and suppurative hidradenitis (PA-PASH) syndrome has been linked to an auto-inflammatory pathway. We report a case that is an atypical presentation of a rare syndrome, which supports literature suggesting that different phenotypes of PG-related syndromes may be a variation of the same pathogenic spectrum. Interestingly, our patient displayed a positive proteinase-3 antibody (PR-3). The clinical relevance of this is unclear. In recent literature, antineutrophil cytoplasmic autoantibodies (ANCA) positivity has been reported in various inflammatory conditions other than ANCA-associated vasculitis (AAV). Case Report: A 44-year-old African American male with history of pyogenic arthritis, acne, suppurative hidradenitis, and chronic diarrhea presented for evaluation of painful ulcers located on the bilateral lower extremities, bilateral proximal interphalangeal joints, buttocks, and scrotum, and chronic diarrhea. Infectious etiologies for the ulcers were ruled out. Biopsy of an ulcer revealed PG. Colonoscopy revealed inflammation and ulceration with biopsy consistent with ulcerative colitis (UC). After treatment with prednisone, the ulcers healed within 4 weeks, and the chronic diarrhea resolved. Conclusions: Our patient displayed a variation of PA-PASH syndrome and UC. Previously reported cases of similar phenotypes of PG-related syndromes have not presented in this fashion. Furthermore, the literature does not report cases of PG-related syndromes with an elevation in PR-3 antibody. Elevation in PR-3 has been reported in various inflammatory disorders aside from AAV. The relevance of this is currently unclear. It may be possible that the milieus of these various

  9. Ultrasonographic evaluation of lschial bursitis

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    Kim, Sung Moon; Shin, Myung Jin; Kim, Kyung Sook; Chang, Jae Suck; Lee, Soo Ho [Asan Medical Center, Ulsan Univ. College of Medicine, Seoul (Korea, Republic of); Ahn, Joong Mo [Samsung Medical Center, Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of); Cho, Kil Ho [Yeungnam Univ. College of Medicine, Kyongsan (Korea, Republic of)

    1999-06-01

    The objective of this study was to evaluate the findings of ultrasonography (US) in patients with ischial bursitis. Our study included 27 patients (mean age 62 years) who underwent US for a painful mass or tenderness in the buttock area. In six of these 27, serous fluid was obtained by needle aspiration, and in five cases, bursal excision permitted histologic confirmation. The other sixteen patients were followed up for one or two months with only NSAID medication; all showed some improvement or remission of symptoms. Using a 5-10 MHz linear array probe, US examination was performed while the patient was lying face down. US images were analyzed with regard to location and size of the lesions, thickness of cyst wall, the presence of internal septa or mural nodules, echogenicity of the cyst wall, fluid content, internal septa, compressibility by a probe, and Doppler signals within the cyst wall. In all 27 patients, ischial bursitis was located superficially to ischial tuberosity. Lesion size(maximum diameter) was 1.5-7(mean 3.8)cm, and the cyst wall was 0.2-0.8cm thick. Internal septa and mural nodules were seen in 12 cases (44%) and 13 cases (48%), respectively. The cyst wall was identifiable in 21 cases (78%), appearing as a single layer with low echogenicity (n=10) or with high echogenicity (n=1); it also appeared as two (n=6) or three (n=4) layers of different echogenicities. When internal septa were present, fluid within the cyst was low echoic in 59% of cases, high echoic in 30%, and of mixed echogenicity (so-called compartmentalization) in 15%. In all cases, the cyst became deformed, when compressed by a probe. In all patients who underwent doppler examination, some vascularity was found within the cyst wall. US helped to detect ischial bursitis; US findings were thin-walled cystic lesion located superficially to ischial tuberosity, with or without internal septa and mural nodules, and easy compressibility.

  10. Tuberculose cutânea disseminada com escrofuloderma associado à tuberculose de arco costal Disseminated cutaneous tuberculosis with scrofuloderma associated to costal arch tuberculosis

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    Elson Vidal Martins Junior

    2007-08-01

    Full Text Available Os autores relatam caso de tuberculose cutânea disseminada com escrofuloderma associado à tuberculose de arco costal. Paciente de 46 anos, do sexo feminino, há um ano com nódulos de um a 6cm em região cervical, dorso, axilas e regiões glúteas, que culminavam com fistulização e eliminação de secreção purulenta, associados a febre vespertina diária, sudorese noturna e emagrecimento de 10kg nos últimos três meses. A radiografia de tórax mostrou lesão lítica na terceira costela esquerda. A cultura de secreção do nódulo foi positiva para Mycobacterium tuberculosis. O tratamento para tuberculose resultou em melhora clínica e resolução das lesões cutâneas da paciente.The authors describe a case of disseminated cutaneous tuberculosis with scrofuloderma associated to tuberculosis in the costal arch. A 46-year-old, woman, was hospitalized with nodules measuring 1 to 6 cm in the cervical region, back, armpit and buttocks, which developed purulent discharge with elimination of caseous secretion, associated to episodes of daily evening fever, night sweats and weight loss of 10Kg over the previous three months. Thorax radiography showed an osteolytic lesion in the third left rib. Culture of the nodule secretion was positive for Mycobacterium tuberculosis. Treatment for tuberculosis resulted in pronounced clinical improvement and resolution of the patient's cutaneous lesions.

  11. The prevalence of radiographic sacroiliitis in patients affected by inflammatory bowel disease with inflammatory low back pain

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    A. Lo Nigro

    2011-09-01

    Full Text Available Inflammatory bowel diseases (IBD, are Crohn’s disease (CD or ulcerative colitis (UC, are frequently complicated by joint complaints with prevalence that varies between 10 and 28 %. The IBD related arthropathy may be expressed as peripheral arthritis or axial one frequently indistinguishable from the classical ankylosing spondylitis (AS. According to ESSG criteria for spondyloarthropathy, the presence of synovitis or the inflammatory back pain (IBP in IBD patients is diagnostic for spondyloarthropathy, but for diagnosis of as also radiological criteria must be fulfilled. There are few studies regarding the radiological prevalence of sacroiliitis in patients with IBD. We examined, by plain film radiograms of pelvis, 100 sacroiliac joints (SJ of 50 IBD patients with IBP. The New York (1984 SJ radiological score with gradation from 0 to 4 was applied. Total sacroiliac score (SJS was summarized between left and right side (from 0 to 8. Fourteen patients fulfilled New York modified criteria for AS and 8 patients had unilateral 2nd grade sacroiliitis. Only 4 of 14 AS patients (28% were HLA B27 positive. Thirty patients had localized IBP, 10 extended to buttock and 4 extended to sacrum. Sixteen patients had sciatica-like extension of back pain. A difference in SJS between left and right side were observed only in CD patients (1,3± 0,8 e 0,8± 0,9 respectively; p<0,05, but not in UC (1,5± 1,2 vs 1,5± 1,3; p=ns nor in total IBD patients (1,4± 1 vs 1,2± 1,2; p=ns. Total SJS was higher in UC respect CD, but not significantly (2,9± 2,3 vs 2,1± 1,5; p=ns. Our data confirm the importance of these symptoms in patients with IBD, who need to be carefully investigated also for these aspects.

  12. [Postural examination in daily occlusodontology].

    Science.gov (United States)

    Serviere, F

    1989-03-01

    According to the osteopathic and chiropractic concepts, facing a TMJ problem, the practitioner has to determine if the trouble observed in the stomatognatic apparatus is the cause or the effect of the structural problems present anywhere else in the body. The postural examination allows to answer this question. Tow techniques can be used. First a static and dynamic posture test proposed by Bricot. The level of the cranium, the eyes, the shoulders, the wrists, the pelvis and the ankles is analysed, from a front view; from the side, the gravity line is inspected: vertex, auditory meatus, shoulder, hip joint, anterior side of the tibia, ankle joint. The vertical posture can be studied from the front: the arms are held straight and the antero-posterior length between the fingers is measured. From the back, one notes the recoil of the buttocks on one side. An ocular convergence test is performed. Then one uses a Romberg test (oscillation of the body when the eyes are closed), and a Fukuda stepping test. The patient is then asked to bite on a compress, and the same exams are redone. If no change occurs, we are dealing with an ascending problem: the origin of the problem is not the stomatognathic system. The second technique is the Meerssemann test that needs the practice of Applied Kinesiology muscle testing. The patient is lying supine and one tests: the dental occlusion, the two TMJs, the temporal muscles, masseters, pterygoids, sterno-cleido-mastoids, upper tapezius, left and right sacro-iliac joints, psoas muscles bilaterally.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. 小学生父母对子女躯体暴力行为的现况调查%A cross-sectional study of parental self-reported physical violence against their children

    Institute of Scientific and Technical Information of China (English)

    陈晶琦; 金怡晨; 于卜一; 邱辰; 孔艳秋; 李向梅; 李景壹; 冯亚男; 赵晓侠; 张文静; 罗晓玲; 陈大光

    2015-01-01

    Objective:To investigate the prevalence of physical violence against children (PVAC)by parents and to explore possible related factors.Methods:In two primary schools in Liaoning Province,1164 parents of pupils in grade 1 to 6 were surveyed by a self-administered questionnaire anonymously to analyze situation about PVAC and related factors.PVAC was defined as having one or more following parent-to-child behaviors in the past three months:push,or shook a child;pinch,screw,or scratch a child;hit child's buttocks with hand;hit child's hand,foot,arm,leg or back with hand;hit child's buttocks with an object;hit child's face or head with hand;hit elsewhere (not buttocks)with an object;kicked a child with a foot or hit with a fist.Results:Of 1164 parents,53.1% reported that they had minor PVAC (51.0%)or/and severe PVAC (19.8%).Multivariate logistic regres-sion analysis indicated that following factors increased the risk of PVAC:child's male gender (OR =1.49),younger age of children (OR =1.38),poor school performance of children (OR =1.85 ),mother (OR =2.09),parents'childhood physical violence victimization experiences (OR =1.53),parents'supportive or tolerant attitudes towards corporal punishment (OR =3.15),parents'lower awareness of the harmfulness of physical violence against children (OR =2.31),and lower social economic status (OR =1.47).Conclusion:The PVAC by their parents may be com-mon in the present study.Parents'supportive or tolerant attitudes toward corporal punishment and low awareness of the harmfulness of physical violence is the main risk factors of PVAC.%目的:了解小学生父母对子女躯体暴力行为发生情况,探讨父母对子女躯体暴力行为的相关因素。方法:在辽宁某城市2所普通小学,对1164名1~6年级小学生父母进行了不记名自填式问卷调查,调查其在过去3个月里对子女施加躯体暴力状况,分析相关因素。躯体暴力定义为有1项或以上的下列行为者:用力推搡

  14. Cellulite and extracorporeal Shockwave therapy (CelluShock-2009 - a Randomized Trial

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    Joest Beatrice

    2010-10-01

    Full Text Available Abstract Background Cellulite is a widespread problem involving females' buttocks and thighs based on the female specific anatomy. Given the higher number of fat cells stored in female fatty tissue in contrast to males, and the aging process of connective tissue leads to an imbalance between lipogenesis and lipolysis with subsequent large fat cells bulging the skin. In addition, microcirculatory changes have been suggested, however remain largely unknown in a controlled clinical setting. We hypothesize that the combination of extracorporeal shockwave and a daily gluteal muscle strength program is superior to the gluteal muscle strength program alone in cellulite. Methods/Design Study design: Randomized-controlled trial. IRB approval was granted at Hannover Medical School, Germany on May 22, 2009. For allocation of participants, a 1:1 ratio randomization was performed using opaque envelopes for the concealment of allocation. Reporting: according to CONSORT 2010. Eligible patients were females aged 18 or over and 65 or younger with cellulite with documented cellulite 1°-4° according to the Nürnberger score. Exclusion criteria were suspected or evident pregnancy, no cellulite, no informed consent or age under 18 years or above 65 years. Patients were recruited by advertisements in local regional newspapers and via the Internet. Analysis: Intention-to-treat. Outcome parameters: a Photonumeric severity scale, b Nürnberger Score, c circumference measurements, d capillary blood flow, e tissue oxygen saturation, f postcapillary venous blood flow. Intervention group: Six sessions of extracorporeal focused shock wave for six sessions (2000 impulses, 0,25 mJ/m2 every 1-2 weeks at both gluteal and thigh regions plus a specific gluteal strength exercise training. Control group: Six sessions of sham extracorporeal focused shock wave for six sessions (2000 impulses, 0,01 mJ/m2 every 1-2 weeks at both gluteal and thigh regions plus a specific gluteal

  15. O uso de palmadas e surras como prática educativa The use of spanking and physical punishment in parenting

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    Lidia Natalia Dobrianskyj Weber

    2004-08-01

    Full Text Available Esta pesquisa identificou as práticas educativas parentais, com ênfase em castigos e punições corporais, por meio do relato de estudantes. Responderam a um questionário com 61 questões, 472 crianças e adolescentes de ambos os sexos e com idade entre oito e 16 anos. A maioria dos participantes relatou que já recebera punições corporais (88,1% e castigos (64,8%. Sobre punições corporais, 86,1% apanharam da mãe e 58,6% apanharam do pai; 36,9% dos participantes relataram que já ficaram machucados. A maioria dos participantes apanhou nas nádegas (64,7%, e os punidores utilizaram mais freqüentemente as próprias mãos (62,3%, embora cinto (43,0% e chinelo (42,3% também tenham servido para punir. A avaliação que os participantes fizeram sobre os métodos disciplinares revelou uma contradição: 75,2% concordaram que, quando fazem coisas erradas, as crianças devem apanhar, mas somente 34,5% afirmaram que utilizarão punições corporais em seus filhos, e um número considerável (27,1% afirmou estar em dúvida. As implicações do uso da punição corporal foram discutidas.The aim of this study was to identify parenting practices that included punitive interactions: physical punishment and nonphysical punishment. A 61-item survey was developed and given to 472 students (aged 8-16 years. Results of the survey showed that: the majority of the participants claimed that had received physical punishment (88,1% and nonphysical punishment (64,8%; 86,1% was spanked by mothers, and 58,9% by fathers; 36,9% reported that they had been hurt when spanked; most of the students (64,7% were hit on their buttocks; 62,3% was spanked with hands, but some objects as belt (43,0% and slippers (42,3% were also used. The evaluation made by the participants about physical punishment revealed a contradiction: while 75,2% agreed children must be spanked when they misbehave, only 34,5% said that they intend to spank their children in the future. Implications

  16. A Rare Occurrence of Shagreen Patch on the Face of a Pediatric Patient with Tuberous Sclerosis

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    Ambey RAVI

    2012-03-01

    Full Text Available How to Cite this Article: Ravi A, Veerabhadra D, Richa G, Ngangbam S. A Rare Occurrence of Shagreen Patch on the Face of aPediatric Patient with Tuberous Sclerosis. Iranian Journal of Child Neurology 2012;6(1:39-42.Tuberous sclerosis is a neurocutaneous syndrome characterized by a clinical spectrum varying from severe mental retardation and incapacitating seizures to normal intelligence and lack of seizures, often within the same family(1. The younger the patients present with symptoms and signs of TSC (tuberous sclerosis complex, the greater are the likelihood of mental retardation (2. Skin features are very characteristic of the disease and help in the early diagnosis of the disease. Shagreen patch is one of the major diagnostic features of the disease. It is a less common skin lesion consisting of an excess amount of fibrous tissue similar to that found in scar tissues (3. It is a section of thickened, elevated pebbly skin like an orange peel. The name is derived from the French phrase “peau chagrinee”. It is usually found on the lower back, buttock, thigh and the nape of the neck commonly. In this case report we report a characteristic skin lesion, the shagreen patch in a six-year-old child with TSC at an unusual site (the cheek never reported before with the best of our knowledge.References: 1. Datta AK, Mandal S, Bhattacharya S. Autism and mentalretardation with convulsion in tuberous sclerosis: a casereport. Cases J 2009;2:7061.2. Haslam RHA. Neurocutaneous syndrome. In KliegmanRM, Behrman RE, Jenson HB, Stanton BF (editors.Nelson Text book of Pediatrics,18th Edition. NewDelhi: Elsevier. 2008.P. 2485-6.3. Mallory SB (editor. Illustrated manual of pediatricdermatology, diagnosis and management, 1st Edition.UK:Taylor & Francis. 2005.P. 369-89.4. Roach ES, DiMario FJ, Kandt RS, Northrup H. TuberousSclerosis Consensus Conference: recommendationsfor diagnostic evaluation. National Tuberous SclerosisAssociation. J Child Neurol 1999 Jun;14

  17. Acoustic Wave Treatment For Cellulite—A New Approach

    Science.gov (United States)

    Russe-Wilflingseder, Katharina; Russe, Elisabeth

    2010-05-01

    Background and Objectives: Cellulite is a biological caused modification of the female connective tissue. In extracorporeal shockwave therapy (ESWT) pulses are penetrating into the tissue without causing a thermal effect or micro lesions, but leading to a stimulation of tissue metabolism and blood circulation, inducing a natural repair process with cell activation and stem cells proliferation. Recently ESWT treatment showed evidence of remodelling collagen within the dermis and of stimulating microcirculation in fatty tissue. Study Design and Methods: The study was designed to assess acoustic wave treatment for cellulite by comparison treated vs. untreated side (upper-leg and buttock). Each individual served as its own control. 11 females with a BMI less then 30 and an age over 18 years were included. 6 treatments were given weekly with radial acoustic waves. Documentation was done before and 1, 4, 12 weeks after last treatment by standardized photo documentation, relaxed and with muscle contraction, measurement of body weight and circumference of the thigh, pinch test, and evaluation of hormonal status and lifestyle. The efficacy of AWT/EPAT was evaluated before and 1, 4, 12 weeks after last treatment. Patients rated the improvement of cellulite, overall satisfaction and acceptance. The therapist assessed improvement of cellulite, side effects and photo documentation treated vs. untreated side, before vs. after treatment. The blinded investigator evaluated the results using photo documentation right vs. left leg, before vs. after treatment in a frontal, lateral and dorsal view, relaxed and with muscle contraction. Results: The improvement of cellulite at the treated side was rated by patients with 27,3% at week 4 and 12, by the therapist with 34,1% at week 4 and 31,2% at week 12 after the last treatment The blinded investigator could verify an improvement of cellulite in an increasing number of patients with increasing time interval after treatment. No side

  18. Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite

    Directory of Open Access Journals (Sweden)

    Schlaudraff KU

    2014-05-01

    Full Text Available Kai-Uwe Schlaudraff,1 Maren C Kiessling,2 Nikolaus BM Császár,2 Christoph Schmitz21Concept Clinic, Geneva, Switzerland; 2Department of Anatomy II, Ludwig-Maximilians-University of Munich, Munich, GermanyBackground: Extracorporeal shock wave therapy has been successfully introduced for the treatment of cellulite in recent years. However, it is still unknown whether the individual clinical outcome of cellulite treatment with extracorporeal shock wave therapy can be predicted by the patient's individual cellulite grade at baseline, individual patient age, body mass index (BMI, weight, and/or height.Methods: Fourteen Caucasian females with cellulite were enrolled in a prospective, single-center, randomized, open-label Phase II study. The mean (± standard error of the mean cellulite grade at baseline was 2.5±0.09 and mean BMI was 22.8±1.17. All patients were treated with radial extracorporeal shock waves using the Swiss DolorClast® device (Electro Medical Systems, S.A., Nyon, Switzerland. Patients were treated unilaterally with 2 weekly treatments for 4 weeks on a randomly selected side (left or right, totaling eight treatments on the selected side. Treatment was performed at 3.5–4.0 bar, with 15,000 impulses per session applied at 15 Hz. Impulses were homogeneously distributed over the posterior thigh and buttock area (resulting in 7,500 impulses per area. Treatment success was evaluated after the last treatment and 4 weeks later by clinical examination, photographic documentation, contact thermography, and patient satisfaction questionnaires.Results: The mean cellulite grade improved from 2.5±0.09 at baseline to 1.57±0.18 after the last treatment (ie, mean δ-1 was 0.93 cellulite grades and 1.68±0.16 at follow-up (ie, mean δ-2 was 0.82 cellulite grades. Compared with baseline, no patient's condition worsened, the treatment was well tolerated, and no unwanted side effects were observed. No statistically significant (ie, P<0

  19. A double-blinded randomized trial testing the tolerability and efficacy of a novel topical agent with and without occlusion for the treatment of cellulite: a study and review of the literature.

    Science.gov (United States)

    Rao, Jaggi; Paabo, Kristina E; Goldman, Mitchel P

    2004-01-01

    Cellulite is the unsightly dimpling and nodularity frequently found on the thighs and buttocks of post-adolescent women. The anatomy and pathophysiology of this unwanted condition is poorly understood. The paucity of research studies to date has led to a dormancy of scientifically based therapeutic options that are effective and tolerable. The purpose of this study is to evaluate the tolerability and efficacy of a novel topical agent based on a plausible pathophysiologic mechanism in the treatment of cellulite, and to compare the efficacy of this agent used in combination with an occlusive bioceramic-coated neoprene garment, to the agent used alone without occlusion. We will also review the current understanding of the etiology and nature of cellulite and summarize available treatment options. Twenty women with a moderate degree of cellulite were entered into a four-week, double-blinded, randomized trial where an anti-cellulite cream was applied to the affected sites on a nightly basis. Each subject was randomized to receive occlusion by a bioceramic-coated neoprene garment on either the right or left leg, with the contralateral side serving as a control with no occlusion. High-quality digital photography was taken before treatment and after four weeks at various angles, with tangential full-spectrum lighting. Four blinded, independent dermatologist reviewers assessed the photographs for improvement. Subjects completed questionnaire forms to assess tolerability and efficacy. Of the 17 subjects who completed the study, 76% noticed an overall improvement in their cellulite, with 54% reporting greater improvement in the thigh that received garment occlusion. The average measured decrease in thigh circumference was 1.2 cm, noting a 1.3 cm reduction with occlusion and a 1.1 cm reduction without occlusion. Upon review of the pre- and post-study photographs, the dermatologist evaluators found an improvement in 65% of treated legs with occlusion, and 59% of treated legs

  20. Comparison of 3D laser-based photonic scans and manual anthropometric measurements of body size and shape in a validation study of 123 young Swiss men

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    Nikola Koepke

    2017-02-01

    Full Text Available Background Manual anthropometric measurements are time-consuming and challenging to perform within acceptable intra- and inter-individual error margins in large studies. Three-dimensional (3D laser body scanners provide a fast and precise alternative: within a few seconds the system produces a 3D image of the body topography and calculates some 150 standardised body size measurements. Objective The aim was to enhance the small number of existing validation studies and compare scan and manual techniques based on five selected measurements. We assessed the agreement between two repeated measurements within the two methods, analysed the direct agreement between the two methods, and explored the differences between the techniques when used in regressions assessing the effect of health related determinants on body shape indices. Methods We performed two repeated body scans on 123 volunteering young men using a Vitus Smart XXL body scanner. We manually measured height, waist, hip, buttock, and chest circumferences twice for each participant according to the WHO guidelines. The participants also filled in a basic questionnaire. Results Mean differences between the two scan measurements were smaller than between the two manual measurements, and precision as well as intra-class correlation coefficients were higher. Both techniques were strongly correlated. When comparing means between both techniques we found significant differences: Height was systematically shorter by 2.1 cm, whereas waist, hip and bust circumference measurements were larger in the scans by 1.17–4.37 cm. In consequence, body shape indices also became larger and the prevalence of overweight was greater when calculated from the scans. Between 4.1% and 7.3% of the probands changed risk category from normal to overweight when classified based on the scans. However, when employing regression analyses the two measurement techniques resulted in very similar coefficients, confidence

  1. Efeito da massagem clássica estética em adiposidades localizadas: estudo piloto Effects of classic aesthetic massage on localized adiposity: a pilot study

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    Pascale Mutti Tacani

    2010-12-01

    Full Text Available Devido ao padrão de beleza imposto atualmente, tem aumentado a procura por tratamentos estéticos como a massagem clássica, porém sua suposta ação lipolítica ainda é uma questão controversa na literatura. O objetivo deste estudo foi verificar o efeito da massagem clássica estética nas adiposidades localizadas, por meio de perimetria do abdome, quadril e coxas e pela estimativa da espessura da tela subcutânea da parede abdominal (ETS por ultrassonografia. Oito voluntárias (idade 33,9±8,9 anos, peso 65,1±8,4 kg foram avaliadas quanto a MC, IMC e ETS 30 dias antes, logo antes do início da intervenção e após esta. Foram efetuadas 12 sessões de massagem clássica estética em coxas, glúteos e abdome por 30 minutos, três vezes por semana. Foi encontrada redução significativa apenas da perimetria na região do quadril (p=0,012, mas não da ETS (p=0,301. A massagem clássica estética contribuiu apenas para a redução da perimetria do quadril, e não modificou outras medidas nem a espessura da tela subcutânea da região abdominal.Due to current beauty standards, the search for aesthetic treatments, including classical massage, has increased; however, its presumed lipolytic action is still controversial in literature. The purpose of this study was to assess the effect of classical massage on localized adiposity, by means of abdomen, hip and thigh perimeter measuring, nd by estimating thickness of abdominal wall fat by ultrasonography. Eight volunteers (33.9±8.9 years old, 65.1±8.4 kg were assessed as to weight, body mass index, body perimeter measures and by abdomen ultrasonography at three moments: control (30 days before treatment, just before, and after treatment. The latter consisted of 12 thrice-weekly, 30-minute massage sessions on thighs, buttocks, and abdomen. Results showed a significant reduction at hip perimeter (p=0.012, but none of subcutaneous fat tissue thickness (p=0.301. Classical aesthetic massage hence did

  2. Sacral Insufficiency Fractures: Recognition and Treatment in Patients with Concurrent Lumbar Vertebral Compression Fractures

    Science.gov (United States)

    Granville, Michelle; Jacobson, Robert E; Berti, Aldo

    2017-01-01

    Introduction In reviewing a larger group of osteoporotic vertebral compression fractures (VCFs), we found that the overall incidence of sacral insufficiency fractures (SIFs) is higher than commonly reported values. This is especially seen in patients with previous or concurrent lumbar VCFs and also in a subgroup that had lumbar stenosis or hip arthroplasty. The altered biomechanics due to associated lumbar stenosis or hip arthroplasty lead to increased mechanical stress on already weakened and deficient sacral alae, which are more vulnerable to osteoporotic weakening than other parts of the sacrum. Materials & methods We studied an overall population of patients with VCF seen clinically and separated the patients into the following groups: patients not previously treated, patients treated with vertebroplasty or kyphoplasty at one or more levels, and patients diagnosed with sacral fractures and treated with vertebroplasty or kyphoplasty. We wanted to see if a pattern existed among the patients who had sacral symptoms, were diagnosed with sacral insufficiency fractures, and subsequently underwent sacroplasty. Results In a review of 79 consecutive patients, over a 24-month period, with VCF who underwent surgical treatment, there were 10 patients who also had sacral insufficiency fractures. Four of the patients had sacral insufficiency fractures without VCF. None of the patients with sacral insufficiency fractures were on treatment for osteoporosis at the time of diagnosis. The following symptoms indicated SIF: lower sacral pain (n = 10), buttock pain (n = 7), lateral hip pain (n = 5), and groin pain radiating to the thigh (n = 4). The average time to diagnose SIF was two months after the onset of pain. Conclusions Sacral insufficiency fractures are a frequent cause of both acute and chronic pain; however, they are often missed by the majority of physicians. The frequency of undetected sacral fractures is high. This is due to a number of potential pitfalls

  3. On Liu qin xi (Six animal frolics) in Huai nan zi (Discourses of Master Huainanzi)%论《淮南子》六禽戏

    Institute of Scientific and Technical Information of China (English)

    孙孝忠

    2014-01-01

    西汉刘安《淮南子》中记载的6种导引术式,学者们称之为“六禽戏”.六禽戏是从古代繁杂的导引术式中简化而来的,是模仿6种动物的形象而成的仿生导引.其中“熊经”是模仿熊直立摇晃行走的动作,以锻炼腰背下肢;“鸟伸”是模仿鸟伸展双臂和双腿的动作,以锻炼肩膀四肢;“凫浴”是模仿野鸭摇头游水的动作,以锻炼头颈;“蝯躩”是模仿猿在树间跳跃的动作,以锻炼腰腿;“鸱视”是模仿鸱鹰的伸颈动作,以锻炼颈项和眼睛;“虎顾”是模仿老虎扭头回视的动作,以锻炼项臀.%The six styes of the art of Daoyin recorded in Liu An's Huai nan zi (Discourses of Master Huainanzi) of the Western Han Dynasty was called the Liu qin xi which was simplified from the complicated ancient Daoyin art of bionic practice imitating the movements of six kinds of animal.Among them,the "xiong jing" imitates the erecting walking style of a bear so as to strengthen the waist and lower extremities;the "niao shen" follows the spreading of wings of a bird so as to extend the arms and legs,to train the shoulders and extremities ; the "fu yu" imitates the movements of swimming and moving head of a wild duck so as to train the head and neck; the "yuan jue"imitates the jumping of a monkey among the tree branches so as to train the legs and waist; the "chi shi" imitates the streching neck movements of an eagle so as to strengthen the neck and improvement of vision; while the "hu gu" imitates the movement of turning head of a tiger so as to train one's nape and the buttock.

  4. Ergonomics related to seating arrangements in the classroom: worst in South East Asia? The situation in Sri Lankan school children.

    Science.gov (United States)

    Jayaratne, I L K; Fernando, D N

    2009-01-01

    Sri Lanka is a resource-poor country in the South-East Asian region with good health indices. Ergonomics of children in educational environments is still novel in the region. An exploration into such issues and dissemination of the scientific evidence will stimulate policy makers in both education and health sector. An important ergonomic issue of the classroom is the seating arrangement. Essential aspects of seating include location of the chair and desk in relation to the blackboard and features of the chair and desk. Musculoskeletal pain is considered to be the most important negative effect due to mismatched ergonomics. A school-based descriptive cross sectional study was carried out in a district of Sri Lanka to ascertain the distribution of selected ergonomic factors related to seating arrangements in the classroom of school-going early adolescents and to assess their relationship to musculoskeletal pain. A sample of 1607 school children of Grade 6,7 and 8 were selected using stratified multi-stage cluster sampling method. There were 52.1% (N=838) females and 47.9% (N=769) males. Many ergonomic aspects related to classroom seating arrangements are not conducive for children. Children were seated with a mean distance of 398.04 cm (SD=132.09) to the blackboard. Nearly 23% of children had to turn more than 45~degrees to see the blackboard. A prevalence of > 80% mismatch was found between body dimensions of children and measurements of furniture. Musculoskeletal pain may have resulted from efforts to maintain stability while seated in incompatible furniture. Nearly 36% children complained of recurrent musculoskeletal pain. Musculoskeletal pain may have resulted from efforts to maintain stability while seated in incompatible furniture. Mismatched seat depth - buttock-popliteal length posed 1.59 times risk recurrent musculoskeletal pain. Despite, children perceived a good chair comfort. Use of backrest lowered the risk of recurrent pain. Results shows that

  5. Comparison of 3D laser-based photonic scans and manual anthropometric measurements of body size and shape in a validation study of 123 young Swiss men

    Science.gov (United States)

    Zwahlen, Marcel; Wells, Jonathan C.; Bender, Nicole; Henneberg, Maciej

    2017-01-01

    Background Manual anthropometric measurements are time-consuming and challenging to perform within acceptable intra- and inter-individual error margins in large studies. Three-dimensional (3D) laser body scanners provide a fast and precise alternative: within a few seconds the system produces a 3D image of the body topography and calculates some 150 standardised body size measurements. Objective The aim was to enhance the small number of existing validation studies and compare scan and manual techniques based on five selected measurements. We assessed the agreement between two repeated measurements within the two methods, analysed the direct agreement between the two methods, and explored the differences between the techniques when used in regressions assessing the effect of health related determinants on body shape indices. Methods We performed two repeated body scans on 123 volunteering young men using a Vitus Smart XXL body scanner. We manually measured height, waist, hip, buttock, and chest circumferences twice for each participant according to the WHO guidelines. The participants also filled in a basic questionnaire. Results Mean differences between the two scan measurements were smaller than between the two manual measurements, and precision as well as intra-class correlation coefficients were higher. Both techniques were strongly correlated. When comparing means between both techniques we found significant differences: Height was systematically shorter by 2.1 cm, whereas waist, hip and bust circumference measurements were larger in the scans by 1.17–4.37 cm. In consequence, body shape indices also became larger and the prevalence of overweight was greater when calculated from the scans. Between 4.1% and 7.3% of the probands changed risk category from normal to overweight when classified based on the scans. However, when employing regression analyses the two measurement techniques resulted in very similar coefficients, confidence intervals, and p

  6. Vibration transmitted to operator’s back by machines with back-pack power unit: a case study on blower and spraying machines

    Directory of Open Access Journals (Sweden)

    Roberto Deboli

    2013-09-01

    Full Text Available To correctly evaluate the vibration transmitted to the operators, it is necessary to consider each body’s point interested by the vibratory stimulus produced by machines. All the body’s part in contact to the vibration, when a portable device with internal combustion engine is used, are: hands, back and shoulders. Some information for wholebody vibration are available in the ISO 2631-1997 standard, which otherwise refers to a seated operator. ‘C’ type standards for the vibration analysis exist for some portable machines with an internal combustion engine which is comprehensive in the machine (chainsaw, brush-cutter, blower. If the engine is not inside the machine, but it is on the operator’s back, ‘C’ type standards on vibration measurements are quite incomplete. The IMAMOTER institute of CNR, the DISAFA Department (University of Turin and the Occupational Medicine Department of the University of Catania started some tests to verify the vibration levels transmitted to an operator working with backed engine devices. Two machines have been examined: a blower and a spraying machine. Two operative conditions have been considered during all the tests: idling and full load. Three operators have been involved and each test has been repeated three times. The spraying machine has been tested both with the empty tank and with 10 litres of water, to simulate the load to be caused by the presence of liquid inside the tank. In this work the comfort condition of ISO 2631-1 standard was considered, using the frequency weighting Wc curve with the weighting factor 0.8 for X axis (back-ventral direction and the Wd curve for Y and Z axis (shoulder - shoulder and buttocks - head with weighting factors 0.5 and 0.4 (respectively for Y and Z axis. Data were examined using IBM SPSS Statistics 20 software package. The statistical analysis underlined that the running condition is the main factor to condition the vibration levels transmitted to the operator

  7. 腹主动脉瘤腔内隔绝术中髂动脉的处理%Management of iliac arteries in endovascular graft exclusion of abdominal aortic aneurysm

    Institute of Scientific and Technical Information of China (English)

    何玉祥; 种振岳; 王默; 高培显; 韩宗霖; 刘洋; 金星

    2011-01-01

    Objective To summarize our experiences of management for iliac artery in endovascular graft exclusion (EVGE) of abdominal aortic aneurysm (AAA). Methods From July 2004 to November 2010, EVGE were performed in 43 patients with AAAs,including 27 cases involving unilateral and 16 cases of bilateral iliac bifurcations. Various techniques including simple coverage by stent-graft, embolization of the internal iliac artery trunk combined with stent-graft covering,ligation of common iliac artery,reconstruction of the internal iliac artery and combination of the above techniques were applied according to the different conditions of the iliac arterial system involved. Results The procedures were all technically successful in 43 patients without the occurrence of type I endoleakage. Claudication due to gluteus ischemia occurred in 6 cases(14.0%) and bloody stool in 1 case(2.3%); no patient developed buttock, perineal region, and colorectal necrosis; and no patient died. Conclusions It is important to preserve the patency of one of the internal iliac arteries and avoid occlusion of both internal iliac arteries in EVGE of AAA.%目的:总结腹主动脉瘤(AAA)行腔内隔绝术时髂动脉的处理方式.方法:2004年7月至2010年11月共对43例瘤体累及单侧或双侧髂动脉分叉的AAA行腔内隔绝术,其中单侧髂动脉分叉受累27例,双侧髂动脉分叉受累16例.根据髂动脉病变情况,分别采取髂内动脉单纯覆盖、髂内动脉栓塞后覆盖、髂动脉外环结扎、一侧髂内动脉重建等不同的处理方法.结果:所有病例均操作成功,手术结束时无I型内漏存在.术后出现臀部间歇性跛行6例(14.0%),便血1例(2.3%),无病例发生臀部或会阴部皮肤坏死、肠坏死及死亡.结论:术中避免同时封闭双侧髂内动脉,尽量保留一侧髂内动脉是很重要的.

  8. CHILD综合征的临床、病理及免疫组化特征%Clinicopathological and immunohistochemical characteristics of CHILD syndrome

    Institute of Scientific and Technical Information of China (English)

    米向斌; 郭琳琅; 邱贤文

    2013-01-01

    A 9-year-old girl was born with cutaneous erythema and plaques on the left side of the body as well as deformity of the left lower limb.Physical examination revealed limp,obvious shortening of the left lower limb,deformity of the second,third and fourth toes of the left foot.Both muscle tone and muscle strength were decreased in the left lower limb compared with the right lower limb.Cutaneous examination showed erythematous hypertrophic plaques in the left posterior neck,buttock,perineum,leg,and foot.Histopathologic examination of the skin lesions showed epidermal hyperkeratosis,a small number of foamy cells infiltrating the dermal papillae,as well as focal lymphocyte and plasma cell infiltrates in the superficial dermis.Moreover,the foamy cells in the dermal papillae stained strongly positive for CD68 and CD163,but negative for S100.A diagnosis of CHILD syndrome was made.%患者女,9岁.左侧躯体皮肤红色斑丘疹、斑块伴左下肢畸形9年就诊.体检:患者跛行左下肢较右侧明显短小,左足2、3、4趾畸形.左侧肢体肌张力下降,肌力较对侧弱.皮肤科检查:左侧后颈部、臀部、会阴部、小腿、足部明显红色肥厚性斑块.皮损组织病理检查:表皮角化过度,真皮乳头少量泡沫细胞浸润,真皮浅层灶性淋巴细胞和浆细胞浸润.免疫组化检查:真皮乳头泡沫细胞CD68、CD163强阳性,但不表达S100.诊断为CHILD综合征.

  9. 反射诱导训练与小儿大便失禁的康复%Rehabilitation of Fecal Incontinence in Children

    Institute of Scientific and Technical Information of China (English)

    郭其莲; 陈雨历; 郭其领

    1996-01-01

    为了提高小儿先天性肛门直肠畸形术后或其他外伤所致大便失禁的治疗效果,对18例2~15岁进行过括约肌重建术的患儿,行加强盆底肌的协同共济肌与毗邻肌肌力的诱导训练和反射诱导恢复排便控制反射的康复治疗.随访1~9年,结果能坚持康复训练组7例,均于半年内达到社会可接受的排便控制,而不能配合训练组11例中,仅4例在1年内恢复排便控制.反射诱导训练比生物反馈训练更经济、更易学,适合我国国情,可缩短康复时间,提高患儿日后的生活质量.%In children with fecal incontinence following congenital anorectal realformation or trauma,the rehabilitation training will achieve a fecal continence earlier.It is emphasized that the training should include all muscle activities of coaborators and adjacencies,and the introduction of bowel reflex.Eighteen children with incontinence underwent sphincter reconstruction and followed up for 1-9 years.Seven patients who had regular postoperative training,obtained an acceptable bowel movement by 6 months.In the other 11 who neglected training,4 obtained an acceptable continence in one year.A recommended training program includes a bed-lying physical exercises as following:raising the extended legs,opisthotonoid elevating the hips,sitting-ups,clapping knees and buttocks,besides,an additional digital anal stimulation and rectal balloon stimulation to induce bowel reflex,This program is easier to be popularized in China at the present time,it is much less expensive than modern biofeed back therapy.

  10. Pornô Porn

    Directory of Open Access Journals (Sweden)

    Don Kulick

    2012-06-01

    Full Text Available Este artigo analisa os enunciados sobre corpos e sexualidade presentes em uma ampla linha de produções pornô com mulheres obesas. Nessa filmografia, o foco não recai em genitais e nádegas (os quais geralmente nem chegam a ser expostos, mas nos estômagos das atrizes. A representação pornográfica consiste no ato de mostrar mulheres gordas comendo alimentos ricos em gordura. A penetração do pênis ou de outro objeto na vagina, típica do pornô mainstream, é substituída pela imagem da penetração de comida na boca dessas mulheres. O autor discute: são essas cenas realmente pornográficas? O que estaria por trás dessas cenas, conclui, seria uma outra forma de representar o prazer feminino para além da submissão a uma potência fálica. O artigo examina também os motivos pelos quais esse tipo de pornografia não inclui mulheres negras, a controvérsia ao redor da relação entre feeder/feedees, assim como os diversos tipos de transgressões levantadas pelo fat porn, uma delas seria uma transgressão que inverte os valores colocados nos corpos magros e seus prazeres.This paper analyzes statements on bodies and sexuality in a line of porn productions with obese women. In that filmography, the focus is not on genitals and buttocks (generally not exposed, but in the stomachs of the women. The pornographic representation consists in showing fat women eating fat food. Penis or any other object penetration in the vagina, typical in mainstream pornography, is substituted by the penetration of food in these women's mouths. The author asks: are these scenes really pornographic? What lies behind them? And concludes that it would be another form of presenting feminine pleasure besides submission to phallic Power. The paper also examines the reasons why this kind of pornography does not include black women, the controversial relations of feeders to feedees, as well as many kinds of transgressions presented in fat porn: one would be the

  11. Primary perineal posterior hernia: an abdominoperineal approach for mesh repair of the pelvic floor Hérnia perineal posterior primária: um acesso abdômino-perineal para o reforço do assoalho pélvico com tela

    Directory of Open Access Journals (Sweden)

    Mara R. Salum

    2005-02-01

    Full Text Available Spontaneous development of perineal hernias is a very rare condition and many techniques have been described for repairing the floor defect. The authors describe the use of a combined approach in the surgical treatment of primary perineal hernias, by reconstructing the muscle pelvic floor and restoring the rectum to its sacral position with mesh repair. The case of one patient with a huge primary perineal hernia is reported, with clinical manifestations of progressive bulging in the buttock area, obstipation and fecal incontinence. Long-term follow-up has shown no recurrence of the condition and normal bowel function. It is concluded that primary perineal hernia can be repaired by a combined surgical approach, by using prosthetic material.O desenvolvimento espontâneo de hérnia perineal representa uma condição patológica muito rara.Várias técnicas têm sido descritas para a correção da falha no assoalho muscular pélvico. Os autores descrevem um acesso cirúrgico combinado para o tratamento das hérnias perineais primárias, pela reconstrução do assoalho pélvico muscular e reposicionamento do reto com reforço utilizando-se tela. O caso de uma paciente com uma volumosa hérnia na região perineal, caracterizada como primária, é relatado, evidenciando-se manifestações clínicas de aumento progressivo do saco herniário, dificuldades para evacuar e incontinência fecal. O seguimento clínico a longo prazo, após a correção cirúrgica, demonstrou que não houve recidiva da hérnia, normalizando-se a função intestinal. Conclui-se que as hérnias perineais primárias podem ser tratadas por este acesso combinado, utilizando-se próteses.

  12. Assessment of absorbed dose and therapeutic response of tumor in repeated high-dose I-131 anti-CD20 monoclonal antibody (rituximab) radioimmunotherapy for non-Hodgkin's lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Byung Hyun; Lim, Sang Moo; Kim, Kyeong Min [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)] (and others)

    2007-07-01

    We assessed the therapeutic dose absorbed to the tumor and response in repeated RIT with I-131 rituximab for NHL. Patients with NHL (n=6) were administered a therapeutic dose of I-131 rituximab (192.527.0 mCi). The number of repeated administration was 3 for all patients. Total 12 measurable tumor regions were assessed at the time of each RIT. Whole-body (WB) planar images with anterior and posterior views were acquired sequentially at 5 min, 5hr, 24hr, 48hr, and 72hr post-injection using gamma camera. F-18-FDG PET/CT was performed before (within 7 days) and after (on Day 30) RIT. From PET/CT image acquired before RIT, maximum intensity projection (MIP) image of coronal view was acquired. Serial WB planar images were overlaid to the coronal MIP PET image, respectively, by means of registration using 4 fiducial marks (bilateral shoulder and buttock) implemented in AMIDE software. On registered MIP PET and WB planar images, both 2D-ROIs were drawn on the region of tumor and background nearby tumor. The shape of 2D-ROI of tumor was determined from the MIP PET image. The volume of tumor was measured from the CT image, the % change of tumor volume before and after RIT was used in evaluation of the therapeutic response. The values of CT-based tumor volume were 8.216.3cc. The values of absorbed dose for tumor and the % changes of tumor volume before and after RIT were 231.8603.0rad, and 55.548.7%, respectively, and did not show the linear relationship (r=0.2787). The values of absorbed dose for tumor and the % changes of tumor volume did not correlate with the number of repeated administration (p>0.05, ANOVA). Aligning PET and planar images could estimate the quantitative values of absorbed dose to tumor. The data suggest that repeated RIT with I-131 rituximab is necessary for NHL, because single-RIT is insufficient to achieve remission of disease.

  13. Local gene expression changes after UV-irradiation of human skin.

    Directory of Open Access Journals (Sweden)

    Benjamin Weinkauf

    Full Text Available UV-irradiation is a well-known translational pain model inducing local inflammation and primary hyperalgesia. The mediators and receptor proteins specifically contributing to mechanical or heat hyperalgesia are still unclear. Therefore, we irradiated buttock skin of humans (n = 16 with 5-fold MED of UV-C and assessed the time course of hyperalgesia and axon reflex erythema. In parallel, we took skin biopsies at 3, 6 and 24 h after UVC irradiation and assessed gene expression levels (RT-PCR of neurotrophins (e.g. NGF, BDNF, GDNF, ion channels (e.g. NaV1.7, TRPV1, inflammatory mediators (e.g. CCL-2, CCL-3 and enzymes (e.g. PGES, COX2. Hyperalgesia to mechanical impact (12 m/s and heat (48 °C stimuli was significant at 6 h (p<0.05 and p<0.01 and 24 h (p<0.005 and p<0.01 after irradiation. Axon reflex erythema upon mechanical and thermal stimuli was significantly increased 3 h after irradiation and particularly strong at 6 h. A significant modulation of 9 genes was found post UV-C irradiation, including NGF (3, 6, 24 h, TrkA (6, 24 h, artemin, bradykinin-1 receptor, COX-2, CCL-2 and CCL-3 (3 and 6 h each. A significant down-regulation was observed for TRPV1 and iNOS (6, 24 h. Individual one-to-one correlation analysis of hyperalgesia and gene expression revealed that changes of Nav1.7 (SCN9A mRNA levels at 6 and 24 h correlated to the intensity of mechanical hyperalgesia recorded at 24 h post UV-irradiation (Pearson r: 0.57, p<0.04 and r: 0.82, p<0.001. Expression of COX-2 and mPGES at 6 h correlated to the intensity of heat-induced erythema 24 h post UV (r: 0.57, p<0.05 for COX-2 and r: 0.83, p<0.001 for PGES. The individual correlation analyses of functional readouts (erythema and pain response with local expression changes provided evidence for a potential role of Nav1.7 in mechanical hyperalgesia.

  14. DESIGN OF ERGONOMICALLY COMPLIANT DESKS AND CHAIRS FOR PRIMARY PUPILS IN IBADAN, NIGERIA

    Directory of Open Access Journals (Sweden)

    SALAMI O. ISMAILA

    2015-01-01

    Full Text Available Selected anthropometric measures of two hundred primary school pupils in Ibadan North Local Government Area of Oyo State were used to design classroom desks and tables. The relevant anthropometric measures were popliteal height, buttock-popliteal length, elbow rest height, hip breadth, shoulder height and elbow-hand grip. The pupils with age range from 5 to 14 years (mean = 9.8 years, SD = 2.9 years were grouped into three age groups of 5-8 years, 9-12 years and 13-14 years. From the data obtained; 5th, 10th, 50th, 75th, 90th and 95th percentiles were computed. In addition, 2-Tail Paired samples T-Test was conducted for the measurements of the male and female pupils for the three- age groups at 0.05 level of significance. Based on the anthropometric data obtained, this paper proposes furniture design dimensions for seat height (32.0 cm, 37.3 cm and 40.3 cm for 5-8 years, 9 to 12 years and 13-14 years respectively. It proposes seat depth (33.0 cm, 38.0 cm and 41.0 cm for 5-8 years, 9 to 12 years and 13-14 years respectively and seat width (30.0 cm, 31.0 cm and 31.0 cm for 5-8 years, 9 to 12 years and 13-14 years respectively. Moreover, it proposes backrest height (upper (39.0 cm, 43.0 cm and 44.0 cm for 5-8 years, 9 to 12 years and 13-14 years respectively and arm rest (12.0 cm, 13.0 cm and 15.0 cm for 5-8 years, 9 to 12 years and 13-14 years respectively. It also proposes desk height (42.0 cm, 49.0 cm and 53.3 cm for 5- 8 years, 9 to 12 years and 13-14 years respectively.

  15. Manual therapy treatment of lumbar radiculopathy: A single case report

    Directory of Open Access Journals (Sweden)

    J.A. Riley

    2011-02-01

    Full Text Available Patients  with  lumbar  radiculopathy  are  often  managed with  manual therapy.  The  aim  of  this  single  case  study  was  to  describe  the outcome of manual therapy treatment of a patient with lumbar radiculopathy.  A 47-year-old female presented with acute, severe left buttock and postero-lateral thigh pain.  Symptom provocation occurred during lumbar flexion, coughing, sneezing, driving and prolonged sitting. her left straight leg raise neurodynamic test was limited and reproduced her pain, as did trigger points in the left lumbar and gluteal muscles. clinical neuro-conduction testing revealed weakness of the big and other toe extensors, as well as eversion and plantar flexion of the left ankle, and a diminished left ankle reflex. This indicated possible involvement of both the l5 and S1 nerve roots.   A  manual  therapy  treatment  approach including  lumbar rotation mobilisations (Maitland approach, massage, trigger point pressure release  and  Transversus  Abdominus muscle activation  was  used.   The  patient  was  symptom  free,  had  full pain-free  range  of  all  lumbar  movements,  a full  pain-free  left  straight leg  raise  neurodynamic  test  and  normal  neurological  conduction  six weeks  after  onset, following seven manual therapy treatments.  Although the results of this case report cannot be generalised, it describes the successful outcome of a patient with severe radicular pain and neurological deficits, whose signs and symptoms  had completely resolved following manual therapy treatment.

  16. Clinical Observation on Treatment for 30 Cases of Ankylosing Spondylitis with Self-modified Zhuangdu Wenshen Huoxue Decoction Combined with Lugua Polypeptide Injection%自拟壮督温肾活血汤联合鹿瓜多肽注射液治疗强直性脊柱炎30例临床观察

    Institute of Scientific and Technical Information of China (English)

    徐震球

    2012-01-01

    Objective: To observe the therapeutic effect of self-modified ZhuangduWenshenHuoxue decoction combined with Lugua Polypeptide Injection for patients with ankylosing spondylitis (AS) and provide theoretical foundation for developing new drugs. Methods: 30 patients with AS were treated with delf-modified ZhuangduWenshenHuoxue decoction combined with Lugua Polypeptide Injection for 1 month. Changes of main symptoms and signs were also observed before and after treatment, while the therapeutic effect and safety were evaluated after 1 month's treatment. Results: The total effective rates was 90% . Pain of lumbosacral and double-buttocks, swelling and morning stiffness of the limb joints, dysfunction of joint and lower fever improved significantly accompany with reduction of erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) after treatment of self -modified ZhuangduWenshenHuoxue decoction combined with Lugua Polypeptide Injection. Conclusion: It is obvious for the therapeutic effects of self-modified ZhuangduWenshenHuoxue decoction combined with Lugua Polypeptide Injection, which is safe and worthy of practicing.%目的:观察自拟壮督温肾活血汤联合鹿瓜多肤注射液治疗强直性脊柱炎(AS)患者的临床疗效,为新药开发作理论基础.方法:30例AS患者采用自拟壮督温肾活血汤联合鹿瓜多肤注射液治疗1个月,观察治疗前后患者主要症状、体征的变化,并评价其疗效及安全性.结果:自拟壮督温肾活血汤联合鹿瓜多肤注射液治疗AS的总有效率为90%;治疗后腰骶、双臀疼痛,肢体关节肿胀、晨僵、关节功能障碍,低热等症状均有明显改善,同时伴随ESR和CRP水平明显降低.结论:自拟壮督温肾活血汤联合鹿瓜多肤注射液治疗AS临床疗效显著,未发现明显的不良反应,值得临床推广应用.

  17. Variability of ischiofemoral space dimensions with changes in hip flexion: an MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Adam C.; Howe, Benjamin M. [Mayo Clinic College of Medicine, Department of Radiology, Rochester, MN (United States); Hollman, John H.; Finnoff, Jonathan T. [Mayo Clinic College of Medicine, Department of Physical Medicine and Rehabilitation, Rochester, MN (United States)

    2017-01-15

    supine versus prone positions. This finding has implications when evaluating for ischiofemoral impingement, an entity resulting in hip and/or buttock pain secondary to impingement of the quadratus femoris muscle within a pathologically narrowed IFS. One will need to account for patient hip flexion and supine versus prone positioning when evaluating individuals with suspected ischiofemoral impingement. (orig.)

  18. Corporal punishment: mother's disciplinary behavior and child's psychological profile in Alexandria, Egypt.

    Science.gov (United States)

    Abolfotouh, Mostafa A; El-Bourgy, Mohamed D; Seif El Din, Amira G; Mehanna, Azza A

    2009-01-01

    Although all professionals oppose abusive physical punishment, nonabusive physical punishment is still controversial. The aim of the present study was (i) to determine parents' behavior regarding the discipline of their children using corporal punishment or other alternative disciplinary methods, (ii) to identify the different associated factors for corporal punishment, and (iii) to determine the association between exposure of the child to corporal punishment and his or her psychosocial well-being. A representative sample of 400 fifth-grade primary school children and their mothers were subjected to a cross-sectional survey. Mothers were subjected to a questionnaire to assess their behavior on corporal punishment and other disciplinary methods. The children were subjected to Coopersmith Self-Esteem Inventory to assess their self-esteem, and a questionnaire to assess their relationship with others. About three-quarter of children (76.3%) were corporally punished, and about half of them (46.2%) were punished on sites other than the extremities or buttocks. In 59.3% of them the frequency of the punishment ranged from once or twice/week to more than once/day, and it left marks in about 20%. Other disciplinary methods used by mothers were yelling/insulting (43.5%), taking away a toy or privilege (39.3%), discussing/explaining (9.5%), and time out (2.8%). The significant predictors of mothers' use of corporal punishment were male gender of the child (p punishment of children and their self-esteem was not statistically significant; however, corporally punished children scored lower on their relationship with others than noncorporally punished ones (Z= 2.60, p punishment is a widespread disciplinary method in Alexandria. The use of corporal punishment could have adverse effects on the child especially on his or her relationship with others. Planning an awareness-raising educational program for current and expectant parents is recommended, to promote positive nonviolent

  19. Detailed analysis of allergic cutaneous reactions to spinal cord stimulator devices

    Directory of Open Access Journals (Sweden)

    Chaudhry ZA

    2013-08-01

    Full Text Available Zeshan Ahmed Chaudhry,1 Umer Najib,2 Zahid H Bajwa,3 W Carl Jacobs,4 Javed Sheikh,5 Thomas T Simopoulos61Department of Diagnostic and Interventional Neuroradiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA; 2Department of Neurology, Robert C Byrd Health Sciences Center of West Virginia University, Morgantown, WV, USA; 3Boston Headache Institute, Waltham, MA, USA; 4Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 5Department of Medicine, Allergy and Immunology, 6Department of Anesthesia, Beth Israel Deaconess Medical Center, Brookline, MA, USAAbstract: The use of spinal cord stimulation (SCS devices to treat chronic, refractory neuropathic pain continues to expand in application. While device-related complications have been well described, inflammatory reactions to the components of these devices remain underreported. In contrast, hypersensitivity reactions associated with other implanted therapies, such as endovascular and cardiac rhythm devices, have been detailed. The purpose of this case series is to describe the clinical presentation and course of inflammatory reactions as well as the histology of these reactions. All patients required removal of the entire device after developing inflammatory reactions over a time course of 1–3 months. Two patients developed a foreign body reaction in the lead insertion wound as well as at the implantable pulse generator site, with histology positive for giant cells. One patient developed an inflammatory dermatitis on the flank and abdomen that resolved with topical hydrocortisone. “In vivo” testing with a lead extension fragment placed in the buttock resulted in a negative reaction followed by successful reimplantation of an SCS device. Inflammatory reactions to SCS devices can manifest as contact dermatitis, granuloma formation, or foreign body reactions with giant cell formation. Tissue diagnosis is essential, and

  20. 高温强辐射下相变降温背心的热调节作用客观测评%Objective evaluation on thermal adjusting effect of PCM cooling vest under high temperature and strong radiation

    Institute of Scientific and Technical Information of China (English)

    王云仪; 赵蒙蒙

    2012-01-01

    在消防灭火、炼钢、冶金、玻璃熔制等高温强辐射环境中,作业人员易于遭受热应激的影响.研究一款用于降低热应激的降温背心的热调节性能,通过模拟炼钢高温环境(32℃高温、1000 W强辐射热),采用暖体假人对降温背心的热调节性能进行客观评价.在模拟的2轮炼钢作业中,假人各个部位的皮肤温度高低排序为:头颈、非覆盖部位、腹臀、胸背.实验结束时,假人穿着降温背心时胸背部的皮肤温度为34.0℃,比未穿着降温背心辐射30 min后低6.3℃.结果表明,在高温强辐射下,穿着相变降温背心能减小假人躯干部位的皮肤温度,减轻热应激,延长高温作业时间.%At high temperature and strong radiation environments such as firefighting, steel making, metallurgical and glass melting workshops, the operators are inclined to suffer from heat stress. This paper developed a cooling vest intended for alleviating heat stress. Thermal manikin was utilized to evaluate the thermal adjusting effect of the cooling vest in a hot environment. The environment temperature was 32 ℃ with a strong radiation of 1 000 W to simulate a steel making environment. In the simulated two working shifts, the skin temperature for each local part of the manikin had the following trend; head and neck, other parts, abdomen and buttocks, chest and back. At the end of the experiment, the skin temperature of chest and back of the manikin wearing the cooling vest was 34 ℃, which was 6. 3 ℃ lower than that without wearing the cooling vest. The experiment indicated that the cooling vest could decrease the skin temperature of manikin's torso covered with PCMs and alleviate heat stress and prolong working time in hot environment.

  1. Spine and sacroiliac joints on magnetic resonance imaging in patients with early axial spondyloarthritis: prevalence of lesions and association with clinical and disease activity indices from the Italian group of the SPACE study

    Directory of Open Access Journals (Sweden)

    M. Lorenzin

    2016-09-01

    Full Text Available Our aim was to determine the prevalence of spine and sacroiliac joint (SIJ lesions on magnetic resonance imaging (MRI in patients with early axial spondyloarthritis (axSpA and their correlation with disease activity indices. Sixty patients with low back pain (LBP (≥3 months, ≤2 years, onset ≤45 years, attending the SpA-clinic of the Unità Operativa Complessa Reumatologia of Padova [SpondyloArthritis-Caught-Early (SPACE study], were studied following a protocol including physical examination, questionnaires, laboratory tests, X-rays and spine and SIJ MRI. Positive spine and SIJ MRI and X-rays images were scored independently by 2 readers using the SPARCC method, modified Stoke ankylosing spondylitis spine score and New York criteria. The axial pain and localization of MRI-lesions were referred to 4 sites: cervical/thoracic/lumbar spine and SIJ. All patients were classified into three groups: patients with signs of radiographic sacroiliitis (r-axSpA, patients without signs of r-axSpA but with signs of sacroiliitis on MRI (nr-axSpA MRI SIJ+, patients without signs of sacroiliitis on MRI and X-rays (nr-axSpA MRI SIJ-. The median age at LBP onset was 29.05±8.38 years; 51.6% of patients showed bone marrow edema (BME in spine-MRI and 56.7% of patients in SIJ-MRI. Signs of enthesitis were found in 55% of patients in the thoracic district. Of the 55% of patients with BME on spine-MRI, 15% presented presented a negative SIJMRI. There was a significant difference between these cohorts with regard to the prevalence of radiographic sacroiliitis, active sacroiliitis on MRI and SPARCC SIJ score. The site of pain correlated statistically with BME lesions in thoracic and buttock districts. Since positive spine-MRI images were observed in absence of sacroiliitis, we can hypothesize that this finding could have a diagnostic significance in axSpA suspected axSpA.

  2. A case of epidermolysis bullosa acquisita in childhood%儿童获得性大疱性表皮松解症一例

    Institute of Scientific and Technical Information of China (English)

    姜祎群; 曾学思; 陈声利; 冯素英; 陈浩

    2011-01-01

    报道1例儿童获得性大疱性表皮松解症.患者女,12岁,因全身反复水疱、大疱和糜烂面3个月入院.患者弱智,父母非近亲结婚,无家族史.入院时表现全身大片糜烂面,包括手足、膝关节周围和股臀部,同时躯干、四肢正常或水肿性红斑基础上紧张性水疱、大疱.治疗过程中突然发生躯干、四肢大量紧张性水疱.组织病理提示,表皮下水疱,免疫荧光结果见表皮基底膜带IgG和C3线状沉积,盐裂后沉积限于真皮侧.ELISA检测BP180和BP230阴性.采用大剂量糖皮质激素联合四环素口服取得满意疗效.%A case of epidermolysis bullosa acquisita (EBA) in childhood is reported. A 12-year-old girl was hospitalized for a 3-month history of recurrent blisters, bullae and erosions on the trunk and limbs. The girl had mental retardation but no family history of similar disorders. The marriage between her parents was not consanguineous. Physical examination on admission revealed large erosions with moderate oozing on the hands and feet, around the knees and on the buttock and thighs. There were scattered tense blisters and bullae arising in normal skin or edematous erythema on the trunk and limbs. During the treatment course the patient suddenly developed a number of tense blisters over the whole integument on the trunk and limbs. Skin biopsy showed subepidermal bullae with moderate perivascular infiltration of neutrophils and eosinophils. Direct immunofluorescence (DIF) revealed linear IgG and C3 deposition along the basal membrane zone, which was on the dermal side of salt-split skin on indirect immunofluorescence (IIF). ELISA detected no serum antiBP180 or -BP230 antibodies in the patient. A diagnosis of EBA was made. The patient was successfully controlled by intravenous steroids combined with oral tetracycline.

  3. Arnebia euchroma ointment can reduce abdominal fat thickness and abdominal circumference of overweight women: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    Mansour Siavash

    2016-01-01

    Full Text Available Background: Obesity is a worldwide health problem which is associated with a lot of complications. One of these comorbidities is the metabolic syndrome that is in correlation with abdominal fat thickness and waist circumference. Various methods were used to reduce abdominal fat thickness such as liposuction. A noninvasive method is the topical agent. In this study, we investigated the effectiveness of Arnebia euchroma (AE ointment on the abdominal fat thickness. Materials and Methods: This study was a double-blind clinical trial which was done at the endocrinology clinic in Khorshid Hospital, Isfahan, Iran, in 2014. After explaining the procedure and obtaining informed consent, the candidates were randomly divided into the case and control groups. The participants of the case and control groups applied AE ointment or placebo for 6 weeks on their abdominal area. Body mass index, waist and buttock circumference, and abdominal fat thickness were measured in both case and control groups at their first visit and then at the next 2, 4, and 6 weeks. We used t-test for comparing parametric variables between groups, paired t-test for changes from baseline to final, and repeated measure ANOVA for changes at different steps. Results: Sixty female candidates participated in this study (thirty in each group. Ten patients left the study and fifty participants finished the trial. At the end of the study, participants had a significant weight loss (2.96 ± 1.6 kg, P < 0.001 that was slightly more in the case group (3.15 ± 1.5 kg vs. 2.75 ± 1.7, P = 0.375. Abdominal circumference also decreased significantly in the participants (11.3 ± 6.7 cm, P < 0.001, but the changes were more significant in the case group (13.9 vs. 6.5 cm, P = 0.004. Similarly, abdominal fat thickness decreased significantly in the participants (2.3 ± 1.1 cm, P < 0.001, although changes were not significantly different between two groups (2.53 vs. 2.04 cm, P = 0.139. Conclusion: Topical

  4. Mitochondrial toxicities of nucleoside analogue reverse transcriptase inhibitors in AIDS cases

    Directory of Open Access Journals (Sweden)

    Yogesh S Marfatia

    2014-01-01

    Full Text Available The development of antiretroviral therapy (ART has been one of the most dramatic progressions in the history of medicine. Concomitant with this momentous therapeutic advance, the mitochondrial toxicities of ART were recognized as an important clinical entity. Aim: The aim was to study the mitochondrial toxicities in terms of peripheral neuropathy (PN, lipodystrophy (LD, hepatic steatosis, lactic academia (LA, and pancreatitis developing in AIDS cases on nucleoside analog reverse transcriptase inhibitors (NRTIs based ART regimens. Materials and Methods: An observational study, which included 90 AIDS cases, receiving first line ART regimens containing two NRTIs (zidovudine [AZT]/stavudine [d4T] with lamivudine [3TC] and one nonNRTIs (nevirapine/efavirenz was conducted at Skin-VD outpatient department of a tertiary care hospital attached to a Medical College. Thorough history was taken, and clinical examination was done. Cases were subjected to measurements of abdominal girth and mid-arm circumference, liver function tests, blood sugar, lipid profile, serum lactate, and amylase levels. Results: Of 90 cases on ART, 66% were males and 34% were females. Mitochondrial toxicities developed in 26 (30% cases out of 90, which included 3 (7% out of 42 cases on AZT + 3TC and 23 (48% out of 48 cases on d4T + 3TC. Most common toxicity was PN seen in 20 (22% cases; male cases developed PN at a lower CD4 count than female cases. LD was observed in total of 13 (14.5% cases; deposition of fat in the abdomen in seven cases and at the nape of the neck (buffalo hump in one case while loss of fat from extremities was seen in seven cases and loss of buccal fat in seven cases. Women presented more with fat accumulation (breast and abdomen, while men with loss of fat (limbs and buttocks. Both PN and LD were more common in d4T based regimen. LA was reported in one case on d4T. Hepatic steatosis was seen in three cases and pancreatitis in one case receiving AZT. Conclusion

  5. 丘疹性红皮病%Papuloerythroderma

    Institute of Scientific and Technical Information of China (English)

    周乃慧; 陈爱明

    2012-01-01

    A 58-year-old woman has a 2-year history of pruritic eruption. Clinically, flat topped, red-to-brown and coalescing papules were presented on the back, buttocks and the extensor aspect of the upper limbs. The lesions spared the axillary, inguinal regions and cubital fossae and skin folds on the abdomen and sub-mammary area, resulting in the typical deck-chair' sign. The back showed a papular eruption following the Langer's line. The abnormal laboratory findings were lymphopenia and an elevated serum IgE level. The skin histopathology evidenced the hyperkeratosis and acanthosis in the epidermis, and a small number lymphocyte infiltration around the blood vessel in the upper dermis. Immunohistochemisty showed the positive staining of CD3, CD45RO, CD79a, KP-1, weakly positive staining of CD20, and negative staining of granzyme B and CD56. The diagnosis of papuloerythroderma is made.%报告1例丘疹性红皮病.患者女,58岁.因躯干、双上肢伸侧及臀部红褐色丘疹伴瘙痒2年就诊.皮肤科检查:躯干、双上肢伸侧及臀部可见较多红褐色的扁平丘疹,表面少许鳞屑,有融合趋向,呈红皮病样损害.实验室检查:外周血淋巴细胞减少,血清IgE增高.皮损组织病理学检查:角化过度,棘层肥厚,表皮突细长下延,真皮浅层血管周围少量淋巴细胞浸润.皮损免疫组化:CD3、CD45RO、CD79a及KP-1阳性,CD20弱阳性,granzyme B及CD56阴性.诊断:丘疹性红皮病.

  6. Redesign of Transjakarta Bus Driver's Cabin

    Science.gov (United States)

    Mardi Safitri, Dian; Azmi, Nora; Singh, Gurbinder; Astuti, Pudji

    2016-02-01

    Ergonomic risk at work stations with type Seated Work Control was one of the problems faced by Transjakarta bus driver. Currently “Trisakti” type bus, one type of bus that is used by Transjakarta in corridor 9, serving route Pinang Ranti - Pluit, gained many complaints from drivers. From the results of Nordic Body Map questionnaires given to 30 drivers, it was known that drivers feel pain in the neck, arms, hips, and buttocks. Allegedly this was due to the seat position and the button/panel bus has a considerable distance range (1 meter) to be achieved by drivers. In addition, preliminary results of the questionnaire using Workstation Checklist identified their complaints about uncomfortable cushion, driver's seat backrest, and the exact position of the AC is above the driver head. To reduce the risk level of ergonomics, then did research to design the cabin by using a generic approach to designing products. The risk analysis driver posture before the design was done by using Rapid Upper Limb Assessment (RULA), Rapid Entire Body Assessment (REBA), and Quick Exposure Checklist (QEC), while the calculation of the moment the body is done by using software Mannequin Pro V10.2. Furthermore, the design of generic products was done through the stages: need metric-matrix, house of quality, anthropometric data collection, classification tree concept, concept screening, scoring concept, design and manufacture of products in the form of two-dimensional. While the design after design risk analysis driver posture was done by using RULA, REBA, and calculation of moments body as well as the design visualized using software 3DMax. From the results of analysis before the draft design improvements cabin RULA obtained scores of 6, REBA 9, and the result amounted to 57.38% QEC and moment forces on the back is 247.3 LbF.inch and on the right hip is 72.9 LbF.in. While the results of the proposed improvements cabin design RULA obtained scores of 3, REBA 4, and the moment of force on

  7. 间质性蕈样肉芽肿1例并文献复习%Interstitial mycosis fungoides:a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    秦国敬; 张福仁; 陈声利; 卢宪梅

    2015-01-01

    报道1例间质性蕈样肉芽肿并对相关文献进行复习。患者,男,67岁。全身泛发浸润性红斑伴剧烈瘙痒半年。皮肤科检查:躯干、臀部及四肢见片状红斑,上覆少量白色鳞屑,边界欠清,部分皮损呈浸润性。皮损组织病理学检查示:表皮散在少量淋巴样细胞移入,部分移入细胞见核周空晕及小的Pautrier微脓肿。真皮浅层淋巴样细胞苔藓样浸润。真皮中深部胶原纤维间及血管周围单一核细胞、组织细胞及少许嗜酸粒细胞呈间质性浸润,胶原纤维束间隙增宽,并见黏液物质沉积。浸润的淋巴细胞异型不显著,但CD4、CD3、CD2和CD43均阳性表达。%A patient with interstitial mycosis fungoides was reported and the relevant literature was re-viewed. A 67-year-old male patient presented with a 6-month history of infiltrated erythematous patch with sever pruritus all over the body. Dermatological examination revealed ill-defined light pink macules with white lamellar scales located on the trunk and buttocks. Some of the lesions were infiltrated. Histopathological exami-nation revealed a small number of mononuclear cell infiltrate in the epidermis, with perinuclear halo in some cells and formation of Pautrier's microabscesses. There were lichenoid infiltrates in the superficial dermis and infiltrates consisting of numerous mononuclear cells, histiocytes and a few eosinophils between collagen fibers and around the vessels in the middle and deep dermis. The clefts between collagen fibers were broadened, where mucin deposits were seen. There was no cytologic atypia in the lymphoid cells and immunohistochemi-cally the cells were positive for CD4, CD3, CD2 and CD43 staining in the superficial and middle dermis.

  8. Stent-grafting for unfavorable abdominal aortic aneurysm:a practical challenge

    Institute of Scientific and Technical Information of China (English)

    HU Zuo-jun; CHANG Guang-qi; LI Xiao-xi; HUANG Xue-ling; YIN Heng-hui; WANG Shen-ming

    2009-01-01

    Background The endovascular treatment of abdominal aortic aneurysm (AAA) has improved greatly in the last 15 years.The present study aimed to evaluate the endografting experience for the treatment of unfavorable abdominal aortic aneurysm (uAAA).Methods During December 2001 and December 2007,41 patients with uAAA were treated with endografting using concomitant techniques.Patients were followed up for 1 to 48 months (mean 20.5 months).Results Technical success rate was 97.6% (40/41) with 1 failure converted to open surgery for an unaccessed lilac stenosis.Nine (22.5%) type Ⅰ endoleaks (5 proximal and 4 distal) were observed on the completion angiograrns and successfully corrected with aortic cuffs and iliac extensions during the procedure.Twenty-two of the planed adjunctive procedures were concomitantly performed just before endograft-implantation.There were 2 (5.0%) type Ⅰ endoleaks at 30 days;one type Ⅰ patient was treated by open conversion,another type Ⅰ patient died from a rupture before treatment in the ward,causing a 2.5% of initial mortality.The two type Ⅱ endoleaks were observed without aneurismal expansion.No buttock or leg claudication or ischemic colitis occured.During late follow-up,one additional death occurred from stroke.One new type Ⅰ endoleak was encountered from thrombocytopenia,which caused a 2.6% secondary endoleak that converted to an open surgery in the third month after a failed transabdominal banding of the aortic neck in the second month.All type Ⅱ endoleaks had disappeared in the third and sixth month.The Endografts did not present signs of material fatigue and no other type of endoleak formed.One patient presented with left limb ischemia,which underwent percutaneous transluminal angioplasty.There was no additional aneurysm rupture or any endograft imgration.Conclusion The endografting with concomitant procedures is a feasible and efficient alternative for managing unfavorable AAAs,achieving low morbidity and mortality rates

  9. Application of Vertical Uterine Incision with Hip Traction Midwifery in Cesarean Section%子宫纵切口加臀牵引助产在剖宫产术中的应用

    Institute of Scientific and Technical Information of China (English)

    李小英; 余静

    2014-01-01

    目的:探讨纵切口加臀牵引助产在剖宫产术中的应用。方法:从阿尔及利亚马斯卡拉省立医院妇产科采集,收集2010年11月~2012年11月3556例剖宫产的数据资料,并对其中采用子宫纵切口加臀牵引助产术式75例与对照组75例的临床资料进行分析比较。结果:子宫纵切口加臀牵引助产术式,从手术开始到胎儿娩出时间、手术总时间、术中出血量等明显低于对照组;两组在子宫切口延长损伤及子宫切口愈合差异比较有着显著的统计学意义(P<0.01和P<0.05)。结论:子宫纵切口加臀牵引助产娩胎儿容易,可避免子宫下段严重损伤,减少母儿并发症的发生。%Objective:To investigate the longitudinal incision hip traction midwifery in cesarean section.Methods:From the Algeria Provincial Hospital of Obstetrics and Gynecology acquisition mascara, data collected in November 3 556 cases of cesarean section in 2010 November~2012 years, and the use of uterine longitudinal incision and buttock drawing midwifery 75 cases and control group of 75 cases of clinical data were analyzed and compared.Results:The delivery time(from the beginning of surgery to fetus), total surgery time and blood loss of the cesarean section which operated with longitudinal uterine incision and hip traction midwifery style, were significantly lower than the control group, while the extended injury of uterine incision and incision healing were proved to be statistically significant (P<0.01 and P<0.05).Conclusion:Longitudinal uterine incision with hip traction midwifery make an easy childbirth, avoid serious injury of the lower uterine segment, and reduce the incidence of complications of mother and child.

  10. Analysis of musculoskeletal disorders, work load and working postures among manufacturing workers%制造业工人肌肉骨骼疾患和劳动负荷及工作姿势分析

    Institute of Scientific and Technical Information of China (English)

    余善法; 谷桂珍; 孙世义; 汪海生; 崔守明; 杨晓发; 杨叔乐; 何丽华; 王生

    2011-01-01

    Objective To analyze the distribution of the musculoskeletal disorders, work load and working postures in different factories, gender, education levels, age and working years among manufacturing workers. Methods In a cross-sectional study of 5134 manufacturing workers in 12 factories, the morbidities for musculoskeletal disorders in one year period were measured with questionnaires. Results The morbidities for musculoskeletal disorders in body sites: waist, neck, shoulder, wrist, ankle/feet, knee, hip/buttocks and elbows were 59.7%, 47.9%, 38.1%, 33.7%, 26.9%, 25.4%, 15.2%, and 14.9%, respectively in one year period.There were significant differences of morbidities for musculoskeletal symptoms in body sites of workers among different factories (P<0.05 or P<0.01 ). The morbidities of musculoskeletal symptoms in elbows, waist, wrists and ankle/feet of the workers in refractory material and chemical fiber factories were higher than those in other factories, the morbidities for musculoskeletal symptoms of workers in garments and diamond factories were lower than those in other factories. The morbidities for musculoskeletal symptoms in neck, shoulders and wrists of female workers were significantly higher than those of male workers (P<0.01). There were significant differences of the morbidities for musculoskeletal symptoms in body sites among workers with different educational levels(P<0.05 or P<0.01 ). There were significant differences of the morbidities for musculoskeletal symptoms in neck, shoulders, wrists, hip/buttocks and knee among groups with different age or different working years (P<0.01), and the morbidities for musculoskeletal symptoms increased with age and working years. The proportions of unhealthy working postures and high working load among workers in refractory material and chemical fiber factories were higher;, but those in garments and diamond factories were lower.Conclusion The morbidities for musculoskeletal symptoms in waist, neck

  11. Estudo de distribuição e morfologia dos melanócitos em pele com e sem exposição solar Melanocytes distribution and morphology analysis in skin with and without sun exposure

    Directory of Open Access Journals (Sweden)

    Daniela Mayumi Takano

    2010-02-01

    Full Text Available INTRODUÇÃO E OBJETIVOS: Acredita-se que a exposição solar possa alterar número, distribuição e morfologia dos melanócitos na pele humana, muitas vezes dificultando a interpretação de biópsias de pele, principalmente para o diagnóstico de lesões melanocíticas iniciais e para a avaliação precisa de margens de ressecção. O objetivo deste trabalho foi avaliar os melanócitos da pele humana em área exposta e não exposta ao sol. MÉTODOS: Realizada análise histológica de 60 fragmentos de biópsias de pele obtidas do antebraço (área fotoexposta e região glútea (área coberta de cadáveres do Serviço de Verificação de Óbitos de Recife-PE. A estatística foi realizada com o SPSS Windows versão 12.0. RESULTADOS: Observou-se um número bastante variável de melanócitos nos fragmentos de pele, com maior concentração destes na região do antebraço (área de maior fotoexposição (p INTRODUCTION AND OBJECTIVES: It is believed that sun exposure can change the number, distribution and morphology of melanocytes in human skin, which often hinders the interpretation of skin biopsies, mainly as to diagnosis of initial melanocytic lesions and accurate assessment of resection margins. Our objective was to evaluate melanocytes in sun-exposed and non-exposed skin. METHODS: It was conducted the histological analysis of 60 skin biopsy samples resected from cadaver forearm (sun-exposed skin and cadaver buttock (non-exposed skin from the Death Verification Service (Serviço de Verificação de Óbitos of Recife, state of Pernambuco. The statistical analysis was performed with SPSS Windows version 12.0. RESULTS: There was considerable variability in melanocyte density, with a higher concentration of these cells in sun-exposed areas (p < 0.001. There was also an irregular distribution of melanocytes along the epidermal basal layer, occasionally with cells arranged side by side. This confluence was identified with a higher frequency in sun

  12. 肠病性关节炎30例临床特征分析并文献复习%The clinical characters of 30 patients with enteropathic arthritis and literature review

    Institute of Scientific and Technical Information of China (English)

    张江林; 金京玉; 李红霞; 朱剑; 黄烽

    2010-01-01

    目的 通过分析炎性肠病伴发关节炎的临床特征,提高对其的认识,以及探讨其与HLA-B_(27)的相关性.方法 分析30例炎性肠病(溃疡性结肠炎、克罗恩病)伴发脊柱关节病变的临床表现、实验室检查及x线表现.结果 肠病性关节炎患者30例,男14例,女16例.出现肠道表现的年龄16~48(32.2 ±11.0)岁,病程1个月~20(5.9±3.4)年,出现关节炎的年龄15~52(43.4±6.8)岁,出现肠道表现与关节炎或发生腰背痛的时间间隔为0~13(4.2±4.0)年.26例患者外周关节受累,其中14例的表现极似类风湿关节炎;22例患者腰背痛,其中7例HLA-B_(27)阳性,且13例患者有影像学骶髂关节病变.关节外的表现包括:24例发热,6例肌腱端炎,4例眼炎,l例腊肠趾.9例患者HLA-B_(27)阳性.结论 炎性肠病相关的关节炎表现复杂多样,可表现为多关节对称性受累、单或寡关节和(或)中轴关节受累,肠病性关节炎骶髂关节受累与HLA-B_(27)相关.%Objective To better understand the clinical characters of enteropathic arthritis patients. Methods The clinical, laboratory and X-rays data of 30 enteropathic arthritis in-patients were analyzed. Results Among the 30 patients, 14 were male, 16 were female. Average age at onset of gastroenteric manifestations was 16-48 (32.2 ±11.0) years old. The course of disease was 1 month-20 (5.9 ±3.4) years. Average age at onset of arthritis was 15-52 (43.4±6.8) years old. The average interval between onset of diarrhea and arthritis was 0-13 (4.2±4.0) years. Peripheral arthritis was founded in 26 (87%) patients, and only 4 felt low back pain at onset. During the disease course, peripheral arthritis in 14 (54%) patients was similar to rheumatoid arthritis. The history of low back pain or buttock pain Wag recorded in 22 (73%) patients. Extra-articular features including fever occurred in 24 patients, enthesitis in 6, iritis or conjunctivitis in 4, dactulifts in l were observed. HLA-B_(27) was

  13. 臀部充气装置用于胎膜早破孕妇的临床研究%Hip inflatable devices for clinical study of pregnant women, premature rupture of membranes

    Institute of Scientific and Technical Information of China (English)

    孙芹

    2010-01-01

    Objective To investigate the clinical effect of the buttocks inflatable devices for the clinical effects of pregnant women,premature rupture of membranes.Methods 180 patients with premature rupture of membranes in pregnant women,92 cases were randomly divided into two groups,control group 88 cases,the observation group of pregnant women with elevated hip hip inflatable devices to reduce the outflow of amniotic fluid;control group was the first low-pin-high,elevation end of the bed 15°~30°,in order to reduce the outflow of amniotic fluid.Results The group of pregnant women lying in comfort,amniotic fluid volume compared with the control group was statistically significant(P<0.05),the observation group cesarean section,cis-middle class and the delivery rate compared with the control group difference was statistically significant(P<0.01),the two groups in the premature delivery,fetal distress Palace,neonatal asphyxia had a statistically significant (P<0.05),but no statistical significance in puerperal infection rates.Conclusion The hip inflatable devices for pregnant women,a significant effect of premature rupture of membranes,it is worth in obstetric clinical application.%目的 探讨臀部充气装置用于胎膜早破孕妇的临床效果.方法 将180例胎膜早破的孕妇随机分为观察组92例,对照组88例,观察组采用臀部充气装置抬高孕妇臀部,减少羊水流出;对照组采用头低脚高位,抬高床尾15°~30°,以减少羊水流出.结果 观察组孕妇卧位的舒适度、羊水流出量与对照组相比有统计学意义(P<0.05),观察组剖宫产、顺产及助产率与对照组比较差异有统计学意义(P<0.01),两组在早产、胎儿宫窘迫、新生儿窒息方面有统计学意义(P<0.05),但在产褥感染率方面无统计学意义.结论 臀部充气装置用于胎膜早破孕妇有显著效果,值得在产科临床应用.

  14. Factors related to HIV-associated lipodystrophy among patients on antiretroviral therapy%接受抗反转录病毒治疗艾滋病患者脂肪营养不良影响因素分析

    Institute of Scientific and Technical Information of China (English)

    蒋安然; 李青艳; 陈建生; 刘爱文; 陶兴永; 计国平; 李迎春

    2013-01-01

    Objective To describe the distribution and related risk factors of lipodystrophy (LD) among AIDS patients treated with antiretroviral drugs.Methods A cross-sectional study was performed on 261 AIDS patients treated with antiretroviral drugs.All the subjects were followed in the Center for Disease Control and Prevention of two counties in northern Anhui province from May 25 to 30,2012.Data related to demography,physical examination,history of antiretroviral treatment,HIV plasma viral load,and CD4 +T cell count were collected.Clinical examination was based on an assessment of changes in face,legs,arms,buttocks (peripheral sites),back,chest,neck or abdomen or change in waist size (central sites) as quoted by the clinicians.Results LD was observed in 147 (56.3%) patients.The differences of age,gender,quality of sleep,weight and time of treatment between LD and non-lipodystrophy (NLD) groups were statistically significant (P<0.05).Results from the Multivariate logistic regression analysis showed that the risk of women suffering from LD was 1.894 times ofthd males (95%CI:1.075-3.338).The risk of those with LD showed an 1.448-fold increase regarding the time of treatment for each additional year (95%CI:1.267-1.654).Patients with poor quality of sleep were prone to LD with 11.901 times more than those with good quality of sleep (95%CI:2.701-52.441).Conclusion LD was commonly observed in AIDS patients who were under antiretroviral therapy.Gender,tine of treatment and the quality of sleep appeared the main factors related to the results of observation.%目的 分析接受抗反转录病毒治疗(ART)艾滋病患者脂肪营养不良(LD)情况,探讨影响LD发生的主要因素.方法 2012年5月对261名正在接受ART的艾滋病患者进行问卷调查,收集人口学、体格测量以及ART相关临床资料,并评估身体外周部位和中心部位的脂肪变化.结果 261名艾滋病患者中147名出现LD,检出率为56.3%.LD组与非脂肪营养不

  15. Development of a Methodology to Gather Seated Anthropometry in a Microgravity Environment

    Science.gov (United States)

    Rajulu, Sudhakar; Young, Karen; Mesloh, Miranda

    2009-01-01

    restraint to eliminate any gap between the subject s gluteal surface and the seat pan and b) to document any necessary design and procedural changes needed due to the microgravity environment. The methodology and setup used during the simulated microgravity evaluations was replicable to the proposed methodology and setup for in-space missions. A flight-like Shuttle seat, pressure sensors, anthropometer, and existing hardware was used to measure seated height and contact area while experiencing microgravity. The outlying buttock and thigh surface contact areas were collected to determine if the subjects were in contact with the seat pan, while a measurer recorded their seated height with an anthropometer. The Anthropometry and Biomechanics Facility (ABF) completed data collection from three microgravity flights to assess the restraint methods and techniques to be used for the in-flight procedures performed by the crewmembers in orbit. The first flight demonstrated that the restraint system on the seat, used in a nominal configuration, did not sufficiently restrain a person in the seat. The results showed the subjects were not in full contact with the seat pan, resulting in inaccurate sitting height data. Thus, a second flight was conducted to test different restraint system options. The results showed that by 1) changing the restraint system from the nominal 3-points of the 5-point harness, which is used for crewmembers when fully suited with emergency equipment, and 2) rerouting the lap straps around the joint of the backrest, where the backrest and seat pan are joined, resulted in the optimal method to restrain a subject. This rerouting method allowed for the anchor location to change and pull the subjects back into the seat instead of being anchored at the side of the subjects thighs. The results from the third flight validated the final restraint system, which resulted in a verified methodology for collecting seated anthropometry to ultimately determine the amount of

  16. Excesso de peso e insatisfação corporal em adolescentes Obesity and body dissatisfaction amongst adolescents

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Conti

    2005-08-01

    /obese, 1.92% of the males and 3.16% of the females were underweight and the others were normal. A statistically significant association between body dissatisfaction and overweight/obesity was found for the stomach, waist and body weight in boys and the hair, buttocks, hips, thighs, legs, stomach, shoulder/back, muscle strength, body weight and overall appearance in girls. CONCLUSION: Girls who were overweight/obese were more dissatisfied with a greater number of body areas than boys. It was recommended that middle and fundamental level schools develop prophylactic activities aimed at stimulating consciousness of personal and social perception in the adolescent and of the pressures to which he is submitted.

  17. 超声在髂胫束挛缩症诊断中的应用%Application of ultrasound in diagnosis of iliotibial tract contracture

    Institute of Scientific and Technical Information of China (English)

    温建文; 龚渭冰; 梁峭嵘

    2011-01-01

    目的 探讨髂胫束挛缩症的动态高频超声表现及其临床应用价值.方法 38例经手术病理证实的髂胫束挛缩症患者,共67侧股骨大转子区域髂胫束行高频超声检查,分别观察其静态声像图特征和动态活动情况.结果 患侧髂胫束均有不同程度的增厚,约2.6~6.1 mm,平均(3.66±0.74)mm,内部正常纹理消失,呈粗条带状不均匀回声,结合部呈团块状或结节状不均匀回声.髂胫束与结合部在动态超声检查中呈挛缩状紧贴大转子滑过,滑过瞬间明显增厚.所有患者均无臀部肌肉萎缩或挛缩表现.结论 高频超声可直接、准确、清晰地显示挛缩的髂胫束和结合部,并能动态地观察挛缩组织的活动情况,是诊断髂胫束挛缩症或不典型臀肌挛缩症的重要筛查手段之一.%Objective To explore the appearance and clinical application value of dynamic high frequency ultrasound in diagnosis of iliotibial tract( ITT) contracture. Methods Sixty - seven ITT in 38 patients with ITT contracture were confirmed by surgery and pathology, then examined by dynamic high frequency ultrasound, their imaging characteristics and dynamic activities were observed. Results The thickness of abnormal ITT was 2. 6 - 6. 1 mm, mean thickness was( 3. 66 ±0. 74) mm.ITT appeared as hard strip in shape with heterogeneous echo inside. The junction of iliotihial tract and gluteus maximus muscle appeared as scleroma in shape with heterogeneous echo inside. In dynamic examination. ITT and the junction crossed the greater trochanter closely as contracture - like in shape with fast speed. The buttock muscles of all patients were normal in the imaging.Conclusion High frequency ultrasound can display the contracture of iliotibial tract and junction directly, accurately and clearly , and it can observe the contracture activities dynamically , it is an important method in diagnosis of ITT contracture.

  18. Osteossarcoma de mandíbula inicialmente mimetizando lesão do periápice dental: relato de caso Osteosarcoma of mandible initially resembling lesion of dental periapex: a case report

    Directory of Open Access Journals (Sweden)

    Rosilene C. Soares

    2005-04-01

    the dental periapex, the patient initially underwent endodontic treatment of the tooth involved. Thereafter, in a period of eleven days, a significant increase of the lesion could be observed, resulting in visible facial asymmetry. The occlusal radiographic view showed an area of bone destruction and abnormal bone formation in the region. The external cortical portion showed clear radiopacity resembling sunrays, suggesting the diagnosis of osteosarcoma. The treatment comprised partial mandibulectomy and reconstruction of the area, using bone of the rib and skin graft from the buttock for the oral mucosa involved. Eight months after surgery, there was local recurrence of the lesion and the patient died approximately one year after relapse.

  19. Effects of Duliang capsule on the expression of calcitonin gene-related peptide and cholecystokinin in the midbrain of a rat migraine model%都梁软胶囊对偏头痛模型大鼠中脑CGRP及CCK 表达的影响

    Institute of Scientific and Technical Information of China (English)

    韩喜梅; 姚刚; 满玉红; 于挺敏

    2016-01-01

    目的:研究都梁软胶囊对偏头痛模型大鼠中脑降钙素基因相关肽(CGRP)和缩胆囊肽(CCK)基因转录水平的影响,探讨其预防治疗偏头痛的作用机制。方法健康Wistar大鼠随机分4组,A为对照组,B为偏头痛组,C为都梁软胶囊对照组,D为都梁软胶囊治疗组。C、D组给予都梁软胶囊0.5g·kg -1·d-1灌胃,A、B组大鼠灌胃给予等量容积的 Tween‐80。灌胃7 d后,将B、D两组大鼠造硝酸甘油型偏头痛模型,造模2 h ,保存中脑标本。实时荧光定量PCR检测CGRP和CCK的转录水平。结果 D组大鼠中脑CGRP转录水平明显低于B组(0.64±0.35和1.61±0.51,P<0.05)。C组大鼠中脑CCK 转录水平明显低于A组(0.32±0.31和1.21±0.38,P<0.05)。结论都梁软胶囊可以干预中脑CGRP和CCK的表达,从而影响内源性痛觉调制系统的功能。%Objective To study the effects of Duliang capsule on the expression of calcitonin gene‐related peptide(CGRP) and cholecystokinin(CCK) in the midbrain of a rat migraine model ,and explored treatment effects and mechanisms of Duliang cap‐sule on rats with migraine .Methods A total of 24 rats were randomly divided into four groups :normal control groups(A) ,migraine model groups(B) ,Duliang capsule control groups(C) and Duliang capsule treatment groups(D) .C and D were intragastrically per‐fused with Duliang capsule(0 .5 g · kg -1 · d-1 ) .After 7 days ,nitroglycerin was subcutaneously injected into the buttocks of the B and D to induce migraine .Two hours after nitroglycerin injection ,the midbrain were isolated CGRP and CCK expression in midbrain were determined using SYBR Green I real‐time quantitative PCR .Results CGRP mRNA expression was significantly lower in mid‐brains of rats in the Duliang capsule treatment groups compared with migraine model groups(P<0 .05) .CCK mRNA expression was significantly lower in midbrains of rats in the

  20. Construction of experiment model of rat wound healing in pathology%病理学大鼠创伤愈合实验模型的构建

    Institute of Scientific and Technical Information of China (English)

    朱峰; 范豪; 宋雅颖; 张健; 李珊珊

    2013-01-01

    目的:构建病理学教学创伤愈合实验模型。方法:清洁级SD大鼠28只,随机分为1、3、5、7、14、28 d模型组及正常对照组。正常对照组进行正常解剖学和病理组织学观察。模型组臀背部脊柱两侧1 cm处各作长约1.5 cm切口,一侧缝合,另一侧自然愈合,对创口进行大体和组织学观察。结果:缝合伤口炎症反应较轻微,3 d可见肉芽组织,7 d肉芽组织填平创口,14 d已进入组织改建期,28 d组织结构基本恢复正常。自然愈合伤口表面哆开、炎性渗出明显,多量炎性细胞浸润,5~7 d可见多量肉芽组织,14 d开始形成瘢痕,28 d形成大量瘢痕。结论:所建立的创伤愈合实验教学模型适用于本科教学。%Aim:To establish the animal model which adapts to observe pathology wound healing process .Methods:A total of 28 SD rats in clean grade were divided into six wound groups (1, 3, 5, 7, 14, 28 d) and one normal control group at random.The control group was used to normal anatomy and histological observation .1.5 cm long wound was cut in bilateral buttocks in 1 cm apart from vertebral column , one side was sutured and another side remained nature healing . Gross and histological structure of wounds and the healing difference between the wound groups and the normal control group were observed .Results:Inflammatory response of suture wound was mild ,granulation tissue appeared in 3 d and filled the would in 7 d, then the would entered into the tissue reconstruction phase in 14 d, and finally tissue structure was recovered to the normal level in 28 d.Instead, inflammatory response of nature healing wound was severe ,its surface cracked , more exudation and inflammatory cells appeared in 1~5 d, followed up abundant granulation tissue in 5~7 d;at last, scar e-merged in 14 d and reached a peak volume in 28 d.Conclusion: The wound healing model is a good animal model for pathological teaching .

  1. Targeted fascicular biopsy of the sciatic nerve and its major branches: rationale and operative technique.

    Science.gov (United States)

    Capek, Stepan; Amrami, Kimberly K; Dyck, P James B; Spinner, Robert J

    2015-09-01

    OBJECT Nerve biopsy is typically performed in distal, noncritical sensory nerves without using imaging to target the more involved regions. The yield of these procedures rarely achieves more than 50%. In selected cases where preoperative evaluation points toward a more localized (usually a more proximal) process, targeted biopsy would likely capture the disease. Synthesis of data obtained from clinical examination, electrophysiological testing, and MRI allows biopsy of a portion of the major mixed nerves safely and efficiently. Herein, experiences with the sciatic nerve are reported and a description of the operative technique is provided. METHODS All cases of sciatic nerve biopsy performed between 2000 and 2014 were reviewed. Only cases of fascicular nerve biopsy approached from the buttock or the posterior aspect of the thigh were included. Demographic data, clinical presentation, and the presence of percussion tenderness for each patient were recorded. Reviewed studies included electrodiagnostic tests and imaging. Previous nerve and muscle biopsies were noted. All details of the procedure, final pathology, and its treatment implications were recorded. The complication rate was carefully assessed for temporary as well as permanent complications. RESULTS One hundred twelve cases (63 men and 49 women) of sciatic nerve biopsy were performed. Mean patient age was 46.4 years. Seventy-seven (68.8%) patients presented with single lower-extremity symptoms, 16 (14.3%) with bilateral lower-extremity symptoms, and 19 (17%) with generalized symptoms. No patient had normal findings on physical examination. All patients underwent electrodiagnostic studies, the findings of which were abnormal in 110 (98.2%) patients. MRI was available for all patients and was read as pathological in 111 (99.1%). The overall diagnostic yield of biopsy was 84.8% (n = 95). The pathological diagnoses included inflammatory demyelination, perineurioma, nonspecific inflammatory changes

  2. Úlceras por humedad: conocerlas mejor para poder prevenirlas Wet ulcers: understanding them better to able to prevent them

    Directory of Open Access Journals (Sweden)

    Teresa Segovia-Gómez

    2012-09-01

    Full Text Available Las lesiones en el sacro son muy a menudo clasificadas y tratadas como úlceras por presión (UPP. Sin embargo, no todas las lesiones en la zona sacra o glútea son UPP. El contacto mantenido de la piel con la humedad procedente de las heces y/o la orina genera modificaciones en la estructura y función, alterándose la barrera cutánea y ocasionando su rotura. La diferenciación entre úlcera por presión y lesión cutánea asociada a la humedad es importante porque las medidas preventivas y de cuidados a aplicar son diferentes. El paciente que presenta incontinencia fecal tiene un riesgo 22 veces superior (odds ratio = 22 de presentar una úlcera respecto al paciente que no presenta incontinencia fecal. La escala EVE (escala visual del eritema y la PAT (Perineal Assessment Tool son las dos principales escalas para valorar el riesgo de este tipo de lesiones. En la práctica habitual se han venido utilizando de manera tradicional una serie de productos comercializados tales como pañales, compresas, cremas, ácidos grasos hiperoxigenados, apósitos, colectores fecales, limpiadores (toallitas limpiadoras y de manera más reciente está disponible un dispositivo (FlexiSeal®-Sistema de Control Fecal para el manejo de la incontinencia fecal aguda con diarrea (IFAD que permite de manera eficaz y coste-efectiva aislar la piel del contacto con las heces. Es necesario realizar una mayor difusión de esta problemática entre los profesionales. Las lesiones asociadas a la humedad no son una consecuencia inevitable de la incontinencia sino que pueden ser prevenibles y ello mejorará, entre otras cosas, la dignidad del paciente.The lesions in the sacrum are often classified and treated as pressure ulcers (PUs. However, not all lesions in the sacral area or buttocks are PUs. Sustained contact of skin with moisture from the stool or urine produces changes in the structure and function, altering the skin barrier and causing breakage. The differentiation

  3. Liposuction: A Remedy From Obesity

    Directory of Open Access Journals (Sweden)

    Yatri R. Shah

    2011-03-01

    widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world. Liposuction can often provide very substantial improvements, but it must be emphasised that it is neither a weight loss technique nor a solution for obesity. It is also not an effective treatment for cellulite, a condition that gives your skin an uneven, dimpled appearance. However, liposuction is a successful procedure for spot fat reduction. Fat deposits which cannot be removed by diet or exercise usually occur in areas such as the chin, chest, stomach, sides, back and thighs. Liposuction is a fat removal procedure that aims to eliminate excess stubborn fat from these hard to shift areas. The liposuction sites may be the following: thighs, hips, knees, arms, neck, back, chin or buttocks. Liposuction should be thought of as a sculpting procedure that can change the contours of your body or face. Liposuction can be ideal for patients who have reached physical maturity, are at or near their ideal body weight, and have stubborn, localized deposits of fat they want removed. Both men and women can be excellent candidates for liposuction.

  4. Practical infant multifunctional sedan chair%实用的多功能婴幼儿健身轿椅

    Institute of Scientific and Technical Information of China (English)

    刘国林; 刘淼

    2014-01-01

    Multifunctional infant fitness sedan chair, it is mainly composed of sedan chairs, power strap with a rope, made up of rings, vibrating springs and hooks, music player can be attached, plastic toys and other infant products, sedan chairs can be made whole. This device has multiple uses, you can switch to a different coefficient of stiffness of power springs or increase or decrease the power springs and the replacement of the number of different diameters of sedan chairs, suitable for infants and young children from 3 months to 3 years old. It can be used to make infant about swinging or rotating and bouncing up and down movement in the small, can contribute to infant body balance and exercise major peripheral receptors of vestibular system function; Can contribute to the vision and brain development in infants; Infants and young children can exercise the muscles and bones of the legs, buttocks and development; While infants and young children can exercise balls, promote healthy development of body and mind; Can also let the infant through space before and after independent excretion, and infants more than usual for a longer period for 8 months of daily life and the game.%多功能婴幼儿健身轿椅,它主要由轿椅、强力吊带与吊绳、吊环、振动弹簧与挂钩组成,另外可以附加音乐播放器、塑料玩具等婴幼儿用品,轿椅也可以做成整体。本设备有多种用途,可以通过更换不同倔强系数的强力弹簧或增减强力弹簧的个数以及更换不同直径的轿椅,适宜于3个月至3岁的婴幼儿使用。它可用来让婴幼儿荡秋千或左右小范围旋转和做上下弹跳运动,可以促进和锻炼婴幼儿的人体平衡系统的主要末梢感受器官前庭的功能发育;可以促进婴幼儿视觉及大脑的发育;可以锻炼婴幼儿的腿部、臀部的肌肉和骨骼的发育;同时可以锻炼婴幼儿的胆量,促进身心的健康发展;还可以让婴幼儿通过前

  5. KEY TOPICS IN SPORTS MEDICINE

    Directory of Open Access Journals (Sweden)

    Amir Ali Narvani

    2006-12-01

    Injury, 27. Injury to the Face, Nose, Ear, 28. Dental Problems, 29. Protective Headwear and Facial Protection in Sport, 30. Spinal Injury: Functional Anatomy and General Biomechanics, 31. Cervical Spine Injuries, 32. Thoracolumbar Spine Injuries, 33. Spine Related Syndromes, 34. Chest Injuries, 35. Abdominal Injuries and Abdominal Wall Injuries, 36. Urinary Tract Injuries, 37. The Shoulder Disorders, 38. Acromioclavicular Joint Disorders, 39. The Elbow Joint, 40. The Forearm and Wrist, 41. Hand Injuries, 42. Neurological Injury Affecting the Upper Limb, 43. Buttock Pain, 44. Groin Pain, 45. Thigh Injuries. ASSESSMENT Based on graduate programme teaching practice and with an international team of contributors, this is a valuable and practical resource for all those interested in sports and exercise medicine, including sports clinicians, general practitioners, team doctors, orthopaedic surgeons, accident and emergency doctors and physiotherapists. It is concise and well organized in its presentation, creating an effective textbook. I believe, therefore, the book will serve as a first-rate teaching tool and reference for students and specialists in sports medicine and rehabilitation, athletic training, physiotherapy. Students will enjoy the format of this book

  6. Evaluation of the safety, immunogenicity, and pharmacokinetic profile of a new, highly purified, heat-treated equine rabies immunoglobulin, administered either alone or in association with a purified, Vero-cell rabies vaccine.

    Science.gov (United States)

    Lang, J; Attanath, P; Quiambao, B; Singhasivanon, V; Chanthavanich, P; Montalban, C; Lutsch, C; Pepin-Covatta, S; Le Mener, V; Miranda, M; Sabchareon, A

    1998-07-30

    A clinical evaluation of a new, purified, heat-treated equine rabies immunoglobulin (PHT-Erig), F(ab')2 preparation, was carried out in Thailand and in the Philippines-two countries where rabies is endemic. An initial prospective, randomised, controlled trial (Study 1), compared the safety and pharmacokinetics (serum concentrations of rabies antibodies) after administration either of PHT-Erig or of a commercially-available, equine rabies immune globulin (Erig PMC). A second trial (Study 2) simulated post-exposure rabies prophylaxis by using a reference cell culture vaccine, the purified Vero-cell rabies vaccine (PVRV), administered in association with either Erig PMC or PHT-Erig. In Study 1, 27 healthy, Thai adults received a 40 IU kg(-1) dose of either Erig PMC (n = 12) or PHT-Erig (n = 15) via the intramuscular (i.m.) route; half of the dose was injected into the deltoid area and the other half into the buttocks. Serum for rabies antibody determination and F(ab')2 concentration was collected at hours (H) 0, 6 and 12, and on day (D) 2, 3, 4, 6, 8, 10, 12 and 15. Both products were safe, with no serious adverse events, and in particular, no anaphylactic reactions or serum sickness was reported. A statistical comparison of the pharmacokinetic parameters did not demonstrate bioequivalence of the two products. Nonetheless, the relative bioavailability of 93% and the similar absorption rates suggest the pharmacokinetic profiles of Erig and PHT-Erig are similar. The antibody level in either group were low throughout the 15-day study period. The geometric mean titer (GMT) values ranged from group 0.027-0.117 IU ml(-1) in the Erig group and from 0.029 to 0.072 IU ml(-1) in the PHT-Erig. There was no significant difference between the evolution of GMT values for the two groups. In Study 2, 71 healthy volunteers received 40 IU kg(-1) via the intramuscular route of either Erig PMC (n = 36) or PHT-Erig (n = 35) on D0, in association with five doses of PVRV on D0, D3, D7, D14

  7. 幼年发病型脊柱关节病的临床特征%Clinical characters of juvenile onset spondyloarthropathies

    Institute of Scientific and Technical Information of China (English)

    张江林; 黄烽

    2001-01-01

    目的 提高对幼年发病型脊柱关节病(JSpA)的认识。方法 分析190例JSpA患者的临床、实验室及放射学资料,并对幼年发病关节炎的诊断、分类和鉴别进行讨论。结果 190例JSpA中,男性163例,女性27例,男女之比为6∶1,发病年龄3~16岁,平均(12±3)岁,8岁后发病175例,占92.1%;157例(82.6%)患者首先出现的是外周关节炎,23例(12.1%)以腰背痛为第一症状,病程中共有187例(98.4%)的患者出现了外周关节炎,123例(64.7%)患者有或有过腰背疼痛史,外周关节炎与腰背疼痛出现的时间间隔,从同时发生到间隔20年,平均3.2年。67例(35.3%)有肌腱端炎的表现,20例(10.5%)腊肠指(趾),9例虹膜炎。HLA-B27的阳性率为87.9%,76.0%有X线证实的骶髂关节炎。在190例患者中,106例患者确诊幼年强直性脊柱炎(JAS),此组患者平均病程6.3年,明显长于JSpA组(P<0.01)。结论 JSpA的概念有助于提高对儿童关节炎的认识,半数以上JSpA患者约在发病6.3年后发展为幼年强直性脊柱炎。%Objective To better understand the clinical characters of juvenile onset spondyloarthropa-thies (JSpA).Methods The clinical and laboratory data of 190 in-patients with JSpA were analyzed and the diagnosis,classification and differentiation of juvenile onset arthritis were discussed.Results Among these 190 patients,163 were male,with a male to female ratio 6∶1.Of them 92.1% had the disease after the age of 8.Peak of age at onset was 12 to 15 years;157(82.6%) patients had peripheral arthritis and only 23(12.1%) patients felt low back pain at onset.During the disease course, peripheral arthritis was found in 187(98.4%) patients and the history of low back pain or buttock pain was recorded in 123(64.7%).The interval between peripheral arthritis and low back pain was from 0 to 20 years,with an average of (3.2±4.5)years.Extra-articular features including enthesitis in 67

  8. Effects of rizatriptan on calcitonin gene-related peptide, proenkephalin and cholecystokinin mRNA expressions in the trigeminal ganglia of a rat migraine model%利扎曲普坦对偏头痛大鼠三叉神经节降钙素基因相关肽和脑啡肽原及缩胆囊肽基因表达的影响

    Institute of Scientific and Technical Information of China (English)

    姚刚; 郝婷婷; 于挺敏

    2014-01-01

    Objective This study assesses the influence of rizatriptan on calcitonin gene-related peptide (CGRP),proenkephalin (PENK) and cholecystokinin (CCK) mRNA expressions in the trigeminal ganglia of a rat migraine model and investigates the possible mechanisms by which triptans treat migraine.Methods A total of 24 rats were randomly divided into four groups:normal control group (A),migraine model group(B),rizatriptan control group (C) and rizatriptan treatment group(D).Groups C and D were intragastrically perfused with rizatriptan,1 mg/kg per day.After 7 days,nitroglycerin was subcutaneously injected into the buttocks of the groups B and D to induce migraine.Two hours after nitroglycerin injection,the trigeminal ganglia was isolated.CGRP,PENK and CCK mRNA expressions in the trigeminal ganglia were determined using SYBR Green Ⅰ real-time quantitative PCR.Results The copy number of CGRP mRNA (× 107) in 200 ng total RNA of each group was 0.05 ±0.01,1.30 ±0.52,0.23 ±0.12,0.43 ±0.33 ; The copy number of PENK mRNA (× 103) in 200 ng total RNA of each group was 3.30 ± 1.65,0.34 ±0.14,3.91 ± 2.44,0.71 ± 0.13.The copy number of CGRP mRNA in the trigeminal ganglia of group B was significantly higher than that of group A (q =7.854,P < 0.05) ; CGRP mRNA expressions were significantly lower in the trigeminal ganglia of rats in group D compared with group B (q =5.458,P <0.05).Compared with group A,PENK mRNA expressions in the trigeminal ganglia of rats were significantly lower in group B (q =4.478,P < 0.05).PENK mRNA expressions were significantly higher in trigeminal ganglia of rats in group C compared with group D (q =4.838,P < 0.05).CCK mRNA expression in trigeminal ganglia of rats was similar among groups.Conelusions Rizatriptan can decrease the expressions of CGRP in the trigeminal ganglia of the migraine rats and exhibits neurogenic inflammation triggered by CGRP.PENK expressions decrease in the trigeminal ganglia of the migraine rats,weaken the analgesic

  9. 利扎曲普坦对偏头痛大鼠内源性痛觉调制系统缩胆囊肽表达的影响%Rizatriptan effects on the cholecystokinin expression in endogenous pain modulatory system of a rat mi-graine model

    Institute of Scientific and Technical Information of China (English)

    姚刚; 郝婷婷; 黄倩; 于挺敏

    2014-01-01

    目的:观察利扎曲普坦对偏头痛大鼠中脑导水管周围灰质( Periaqueductal gray,PAG)缩胆囊肽( cholecystokinin,CCK)表达的影响,探讨曲普坦类药物对偏头痛发作时内源性痛觉调制系统的干预作用。方法健康Wistar大鼠随机分4组:A组:对照组,B组:偏头痛组,C组:利扎曲普坦对照组,D组:利扎曲普坦治疗组。利扎曲普坦给药组( C、D组)大鼠给予利扎曲普坦1 mg/( kg·d)灌胃。给药7 d后,B、D组大鼠制备硝酸甘油型偏头痛动物模型,造模2 h留取中脑标本。实时定量PCR及免疫组化法检测CCK的表达情况。结果 A、B、C、D组大鼠中脑每250 ng总RNA CCK mRNA拷贝数(×106)分别为:1.25±0.41、1.71±0.93、0.17±0.12、0.22±0.07。 A、B、C、D组大鼠PAG区CCK⁃8免疫反应阳性细胞个数分别为:37.17±12.62、40.17±11.09、27.33±7.71、20.67±7.66。 C组大鼠中脑CCK mRNA拷贝数明显低于A组(P<0.05),D组大鼠中脑CCK mRNA拷贝数明显低于B组(P<0.05);D组大鼠中脑PAG区CCK⁃8免疫反应阳性细胞数少于B组(P<0.05)。结论利扎曲普坦能够下调偏头痛大鼠中脑CCK基因表达,减弱CCK⁃8对内源性阿片肽镇痛效应的抑制作用,从而提高阿片肽镇痛效应,增强内源性痛觉调制系统的镇痛作用。%Objective To assess the influence of Rizatriptan on the cholecystokinin( CCK) expression in periaqueductal gray( PAG) of migraine model rat to investigate the possible mechanism by which Triptans treat mi⁃graine. Methods A total of 24 rats were randomly divided into four groups:normal control groups(A),migraine model groups(B),Rizatriptan control groups(C) and Rizatriptan treatment groups(D).C and D groups were intra⁃gastrically perfused with Rizatriptan,1 mg/kg per day. After 7 days,nitroglycerin was subcutaneously injected into the buttocks of the B and D group to

  10. The aging changes of the plasma retinol-binding protein 4 levels in elderly essential hypertension patients%老年高血压患者血浆视黄醇结合蛋白的增龄变化

    Institute of Scientific and Technical Information of China (English)

    曹萍; 李睿; 沈丹; 钟亚

    2011-01-01

    Objective To explore the aging changes of the plasma retinol-binding protein 4(RBP4)levels in elderly essential hypertension patients and to evaluate the influential factors. Methods 275 essential hypertension patients were divided into two groups according to whether complicated by type 2 diabetes mellitus. Fifty healthy persons served as normal control group. Plasma RBP4 levels were determined in the three groups. The relationships of plasma RBP4 levels with the blood pressure,the plasma lipids levels and body mass index were analyzed. The effect of aging in the 275 patients on the plasma RBP4 levels was explored. Results The plasma RBP4 levels were significantly increased both in the pure hypertension group and in the hypertension complicated by type 2 diabetes mellitus group compared with the control group (P<0.01), but there was no statistical difference between the pure hypertension group and the hypertension complicated by type 2 diabetes mellitus group. The level of plasma RBP4 was positively correlated with plasma triglyceride and low density lipoprotein-cholesterol (r = 0. 347, r = 0. 229, P < 0.01). However, the level of plasma RBP4 gradually decreased with age in all essential hypertension patients. The age was negatively correlated with the level of plasma RBP4, buttock circumference, body weight, body mass index, diastolic pressure,average arterial pressure, triglyceride and low density lipoprotein cholesterol (P < 0.01). Conclusion There is a phenomenon of insulin resistance which correlates with plasma RBP4 increase in the patients with essential hypertension. The level of plasma RBP4 gradually decreases with age in all essential hypertension patients. It is inferred that the insulin resistance plays a more important part in essential hypertension in young patients than in elderly patients.%目的 探讨老年高血压患者血浆视黄醇结合蛋白(retionl binding protein 4,RBP4)水平的增龄变化及其影响因素.方法 将275例高

  11. CT and MRI Features of Extra-abdominal Desmoid-type Fibromatoses%腹外型韧带样纤维瘤病的CT、MRI表现

    Institute of Scientific and Technical Information of China (English)

    郝光宇; 张静; 姚沉非; 胡粟; 朱默; 王希明; 胡春洪

    2016-01-01

    relation to the following: location, size, morphology, margin, CT density, MRI signal and enchancement pattern.Results Masses were located in limbs (14 cases), chest wall (4 cases), cervical part (2 cases)and buttocks (2 cases), sphenoid sinus (1 cases), paravertebral gutter(1 cases). Lesions were 1.9~11.2cm in size, including oval round masses in 6 cases and lobular masses in 18 cases, the majority (19/24) of lesions demonstrated ill defined circumscribed border. Neurovascular involvement was detected in 14 tumors (58.3%), periosteal adhesion was seen in 16 tumors (66.7%) and bone distruction was detected in 3 cases (12.5%).10 cases performed CT examinations , without necrosis and calcification, were slightly low density, 2 cases demonstrating moderate enhancement. Compared with the muscle signal, the lesions showed slightly low signal on T1WI and showed high and low mixed signal on T2 WI. After contrast enhancement, the lesions showed moderate enhancement. The stripe and patchy non-enhanced structures with low signal intensity on both T1WI and T2W1 were seen in 13 cases (65%). Conclusion Extra-abdominal desmoid-type fibromatoses is a rare intermediate soft tissue tumor. With the CT and MRI findings of lesions specific, CT and MRI examinations have important value in diagnosis and monitor after operation.

  12. Correlation of polymorphism of adiponectin promoter with diabetes type 2 and its complications%脂联素启动子基因多态性与2型糖尿病及并发症的相关性研究

    Institute of Scientific and Technical Information of China (English)

    贾玫; 冯秀玲; 张正; 乔博明; 秦效英; 孙媛媛

    2008-01-01

    objective To explore the correlation of single nucleotide polymorphism (SNP) frequency of adiponectin(APN)in patients with type Ⅱ diabetes(T2DM)and its complications,investigate whether the SNP is a risk factor of inheritance of T2DM,and to set up a highly efficient.accurate, economical and practical screening assay to detect the mutation of APN in clinical practice.Methods According to the diagnostic criteria of T2DM,patients with coronary heart disease(CHD),hypertension (HP),and diabetic nephropathy(NE)were recruited into this study.In simple,12DM group,T2DM-HP, T2DM-CHD.T2DM-NE and the control group.serum biochemistry items are measured.The technique of denaturing high-performance liquid chromatography(DHPLC)was used to detect SNPs of ANP gene.Results After all fragments amplified in the reglen of promoter of APN gene were compared with APN GeneID:9370 sequence recorded in GenBank,point mutation has been identified(-11377G/C).The frequency of genotypes of GG,GC,and CC are 5.16%,42.25%,52.58%and 3.4%.32.75%,63.85%,respectively in the groups of T2DM and control.The frequency of G allele was related to the incidence of T2DM,and is a risk factor of T2DM.The relative risk of GC to CC in developing T2DM is much high than that in the control group (OR=0.55).By comparing the clinical data of different groups of genotype in T2DM,it was observed that the genotype affected systolic blood pressure,BMI,abdominal circumference, and waist-buttock ratio(P=0.015).After optimizing the experimental conditions.it was found column temperature 6 0℃ was the best when using DHPLC technology to estimate SNP of APN gene.Conclusion SNP (-11377G/C) of APN gene G allele has a definite correlation with complications of hypertension in T2DM patients,and may contribute to the genetic risk for type 2 diabetes.%目的 观察脂联素(APN)启动子基因单核苷酸多态性(SNP)频率与2型糖尿病(T2DM)及其合并症间的相关性,探讨脂联素基因(aPM1)突变是否是T2DM遗传的

  13. 电针百会、风府穴对脑I/R损伤大鼠海马区CPG15表达影响的实验研究%Effects of Eiectroacupuncture Bai Hui, Feng Fu on CPG15 Expression of Hippocampus in Rats with Cerebral Ischemic Reperfusion

    Institute of Scientific and Technical Information of China (English)

    唐晓敏; 秦正玉; 何宗宝; 王家琳; 吴生兵; 汪克明

    2011-01-01

    (GV16) in electroacupuncture on meridian acupoints group. Electroacupuncture was applied on non - meridian acupoints of buttock in electroacupuncture on non - meridian acupoints group. Electroacupuncture was applied on meridian acupoints and non - meridian acupoints for 30 minutes with frequency 2Hz,electric current 3 mA to 5 mA.once each day for 2 weeks. Nimodiping 20 mg/(kg · d) was used by intra-gastric administration in medicine treatment group. Neurologic impairment score were studied. CPG15 expression of hippocampus in rats with cerebral ischemic reperfusion was studied by immunol photochemistry. Results Neurologic impairment score and CPG15 expression of hippocampus in normal group were notable less than that in I/R modec group (P<0. 01). CPG15 expression of hippocampus in electroacupuncture on meridian acupoints group and Nimodiping treatment group were notable higher than that in I/R model group (P<0. 01). Conclusion Electroacupuncture on Bai Hui(GV20) and Feng Fu (GV16) could reduce neurologic impairment score and enhance the CPG15 expression of hippocampus in rats with cerebral ischemic reperfusion and improve the neuroplasticity of impaired cerebral cells.

  14. 单侧骶棘韧带固定术治疗盆腔器官脱垂%Unilateral sacrospinous ligament fixation in treatment of pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    周宁; 赵恩峰; 张云

    2014-01-01

    blood loss was 83 ml, the average hospital stay time was 6.2 days, the urinary catheter indwelling time was 2.5 days, and the postoperative morbidity was 17.5%. Hematoma was found in the right pelvic of 11 patients (15.7%), vaginal vault prolapse in 2 patients (2.8%), stress incontinence in 6 patients (8.6%), urgent incontinence in 2 patients (2.8%), and vaginal suture exposure in 5 patients(7.1%). The Aa, Ba, Ap, Bp and D of POP-Q were significantly different before and after operation (P<0.01). Conclusion Unilateral SSLF is a safe and effective procedure for POP, especially for stages 1-3 POP. Its main complications are lumbosacral, buttock and inguinal pain and stress incontinence.

  15. Rabdomiólise por síndrome compartimental glútea após cirurgia bariátrica: relato de caso Rabdomiolisis por síndrome compartimental glúteo después de cirugía bariátrica: relato de caso Rhabdomyolysis secondary to gluteal compartment syndrome after bariatric surgery: case report

    Directory of Open Access Journals (Sweden)

    Márcio Luiz Benevides

    2006-08-01

    a cirugía bariátrica tipo duodenal switch, bajo anestesia general asociada a la anestesia peridural. El procedimiento se dio sin incidencias. El tiempo anestésico quirúrgico fue de 3 horas y 30 minutos. El primer día del postoperatorio el paciente presentó dolor en la región lombosacral y en las nalgas, además de parestesia en los miembros inferiores en la distribución del nervio ciático. Durante el examen, las nalgas presentaban una discreta palidez, tensas, con edemas, dolían cuando eran tocadas y cuando se movían. Fue diagnosticado el síndrome compartimental glúteo que evolucionó con rabdomiolisis e insuficiencia renal aguda. Hubo una recuperación de la función renal y ninguna secuela motora o sensitiva se detectó. CONCLUSIONES: Los pacientes obesos mórbidos sometidos a la cirugía bariátrica pueden presentar síndrome compartimental glúteo. Cuando no se diagnostica y se trata precozmente, puede evolucionar con rabdomiolisis e insuficiencia renal aguda representando una seria amenaza para la vida.BACKGROUND AND OBJECTIVES: Bariatric surgery has become a common procedure and several complications have been reported. The objective of this report is to present a case of gluteal compartment syndrome that evolved to acute renal failure after bariatric surgery and to discuss the diagnosis, and the prophylactic and therapeutic measures. CASE REPORT: A 42 years old male patient, white, with a body mass index (BMI of 43, physical status ASA II, who underwent bariatric surgery of the duodenal switch type, under general anesthesia associated with epidural anesthesia. There were no complications during the procedure. The anesthetic-surgical procedure lasted 3 hours and 30 minutes. On postoperative day one the patient developed lumbosacral and gluteal pain, besides paresthesia in the lower limbs in the distribution of the sciatic nerve. On physical exam, the buttocks were slightly pale, tight, swollen, and painful to palpation and to movement. A diagnosis

  16. Estudio PET/TC en patología inflamatoria-infecciosa PET/CT in infectious and inflammatory pathology

    Directory of Open Access Journals (Sweden)

    Cecilia Carrera

    2012-06-01

    utilidad para el diagnóstico y seguimiento de pacientes con FOD. Cambia la conducta en la vasculitis sin necesidad de realizar una biopsia y es considerado el método Gold Standard. Además, es útil en el monitoreo del tratamiento y seguimiento en la sarcoidosis.Objective. To demonstrate the utility of PET/CT in infectious and inflammatory diseases. Materials and Methods. We evaluated retrospectively five patients with infectious and inflammatory pathology, by PET/CT scan (hybrid SIEMENS-BIOGRAPH 16, Siemens, Erlangen, Germany in the period between january 2009 and may 2011. Results. Case 1: a 68-year-old woman presented with a 6- months duration fever, fatigue, and weight loss. The rheumatologic examination showed a decrease in both radial pulses with no other associated symptoms. She underwent a temporal artery biopsy, which confirmed temporal arteritis. A PET/CT scan showed significant uptake in the thoracic aorta and major branches. Case 2: An 85-year-old patient with fever of unknown origin (FUO was studied suspecting osteomyelitis of the hip, but on the contrary, PET/CT demonstrated an avid enhancement indicative of gluteal cellulitis and pneumonia, ruling out bone infection. Case 3: a 35-year-old woman with evening fever. PET/CT scan showed enlarged multiple FDG-avid mediastinal, axillary and retroperitoneal lymph nodes, as well as diffuse involvement of the spleen with multiple calcifications. Diagnosis of cytomegalovirus infection was confirmed by positive immunoglobulin G and M. Case 4: a 39-year-old patient with HIV-infection presented with hypercalcemia. PET/CT scan showed buttocks silicone implants with associated avid inflammatory process, confirmed by biopsy. Case 5: a 45-year-old female with previous history of breast cancer under follow-up presented in recent CT scans enlarged mediastinal and supraclavicular lymph nodes, as well as diffuse multifocal splenic involvement, all of them avid on PET / CT examination. Sarcoidosis was confirmed by a

  17. 利扎曲普坦对硝酸甘油型偏头痛模型大鼠行为学和外周血中疼痛相关因子水平的影响%Effects of rizatriptan on behavior and pain-related cytokines in peripheral blood of rat models with nitroglycerin-type migraine

    Institute of Scientific and Technical Information of China (English)

    姚刚; 郝婷婷; 罗翔丹; 于挺敏

    2014-01-01

    Objective To observe the influence of rizatriptan on the behavior and pain-related cytokines in peripheral blood of the migraine model rats, and to investigate the theraputic effect of rizatriptan on migraine.Methods A total of 24 rats were randomly divided into:control group,migraine group,rizatriptan control group and rizatriptan treatment group.The rats in rizatriptan control and rizatriptan treatment groups were intragastrically perfused with rizatriptan,1 mg·kg-1 per day (according to the adult daily dose),and the rats in control and migraine groups were perfused with normal saline,1 mL per day. After 7 d, nitroglycerin was subcutaneously inj ected into the buttocks of the rats in rizatriptan treatment and migraine groups to induce migraine.Normal saline was injected into the rats in control and rizatriptan control groups.At 60-90 min following nitroglycerin injection,the total number of behavioral symptoms was measured.The serum calcitonin gene-related peptide(CGRP),5-hydroxytryptamine (5-HT ), interleukin-1β(IL-1β), and tumor necrosis factor-α(TNF-α) levels were determined using ELISA. Results Compared with migraine group, the behavioral score of the rats in rizatriptan treatment group was significantly decreased (P0.05 );the serum 5-HT level in rizatriptan control group was significantly increased(P0.05).Conclusion Rizatriptan can relieve the behavior symptoms in nitroglycerin-induced migraine model rats, increase the serum 5-HT level, improve the vasomotor disturbance,and relieve the angiectasis.%目的:观察利扎曲普坦对偏头痛模型大鼠行为学和外周血中疼痛相关因子的影响,探讨曲普坦类药物对偏头痛的治疗作用。方法:24只健康 Wistar大鼠随机分为空白对照组、偏头痛组、利扎曲普坦对照组和利扎曲普坦治疗组,每组6只。利扎曲普坦对照组和利扎曲普坦治疗组大鼠给予利扎曲普坦灌胃,剂量为1 mg· kg-1· d-1(药物剂量根据成人常规每日口

  18. Vesicular Contact Reaction May Progress into Erythema Multiforme.

    Science.gov (United States)

    Czarnecka-Operacz, Magdalena; Jenerowicz, Dorota; Szulczyńska-Gabor, Joanna; Teresiak-Mikołajczak, Ewa; Szyfter-Harris, Joanna; Bowszyc-Dmochowska, Monika

    2016-12-01

    Dear Editor, Erythema multiforme is considered an acute skin condition, characterized by a self-limiting and sometimes recurrent course. It is regarded as a type IV hypersensitivity reaction associated with certain infections, medications, and other various triggers. Allergic contact dermatitis is in turn a delayed type of induced allergy as a result of cutaneous contact with a specific allergen to which the patient develops specific sensitivity. This type of cutaneous reaction is associated with inflammation manifesting with erythema, edema, and vesicles. A 27-year old female patient presented with a 3-day history of erythematous and vesicular lesions which developed 24 hours after cesarean section. Initially the lesions were localized in the area of surgery (mainly the abdomen and upper thighs) and on the next day progressed to the buttocks and lumbar area. The patient was referred to the Outpatient Clinic and was treated with antihistamines, but her dermatological state deteriorated rapidly. At the day of admission to the Department of Dermatology, numerous erythematous and vesicular lesions were present on the skin of the abdomen, thighs, and back (Figure 1, a), but the skin of the neck, chest, and extremities was also covered with erythematous and edematous patches. On the second day of hospitalization, we observed the evolution of lesions localized within the chest and extremities into an erythema multiforme-like targetoid eruption (Figure 1, b). Initially the patient was treated with intravenous injections of dexamethasone and ceftriaxone and orally with second-generation antihistamines (in four-fold doses), followed by intravenous metyloprednisolone pulse-therapy (total dose of 3 g). As the new vesicobullous lesions started to appear on the face and arms, we introduced cyclosporine A orally 400 mg daily. We could then observe gradual remission, but on the seventh day of hospitalization the patient developed a massive labial herpes simplex infection and had

  19. 母婴床旁护理对新生儿早期发育及产妇抑郁焦虑、泌乳量的影响%Maternal bedside care on early development of newborn and maternal depression and anxiety,lactation

    Institute of Scientific and Technical Information of China (English)

    罗隽; 郑加永

    2016-01-01

    observation group,60 cases in each group.The two groups of newborns and mothers were given routine care,including care and neonatal umbilical buttocks care,maternity care,including genital or abdominal incision dressing,newborns were routinely vaccinated.In the control group,the newborns were taken to a public bath chamber concentrated bath. The observation group was implemented maternal and child care bedside manner Based on this,at the bedside of the newborn bathing and massage,swimming daily with newborns.Anxiety score (SAS)and depression scale score (SDS)for depression and anxiety were evaluated before and after the two groups of mothers nursing,and maternal milk yield variation were observed at different time,measured neonatal neurological assessment score (NBNA)and height,body mass index,head circumference growth.Results After treatment,the SAS and SDS scores of mothers of the two groups were decreased compared with before treatment,which in the observation group decreased more significantly, the differences were statistically significant (t =3.46,4.21,all P <0.05).After care,the maternal milk productions of the two groups started to grow,which of the observation group were always increased better than the control group, the differences were statistically significant (χ2 =9.34,4.53,6.79,all P <0.05).The newborn NBNA scores,head circumference,height,improvement in the quality index of growth in the observer group were better than the control group,the differences were statistically significant (t =1.98,1.65,2.73,3.63,all P <0.05).Conclusion Maternal and child bedside care can significantly improve maternal depression and anxiety scores,increase maternal lactation, and has a certain role in promoting early neonatal development,it is worth clinical application.

  20. 带翼型髋臼加强杯在重建髋臼肿瘤切除后骨缺损中的应用%UTILIZATION OF REINFORCED ACETABULAR CAGES WITH CAUDAL FLANGE IN RECONSTRUCTING PELVIC DEFECT AFTER ACETABULAR TUMOR RESECTION

    Institute of Scientific and Technical Information of China (English)

    李大森; 郭卫; 杨荣利; 汤小东; 曲华毅

    2011-01-01

    Objective To evaluate the surgical procedure of reinforced acetabular cage with caudal flange in reconstruction of pelvic defect after acetabular tumor resection. Methods Between June 2003 and December 2009, 25 patients with Harrington class III pelvic defect underwent reconstruction with a reinforced acetabular cage with caudal flange and total hip arthroplasty (THA). There were 13 males and 12 females with an average age of 51.2 years (range, 13-73 years). The main clinical manifestations included hip pain and buttock pain, with a median disease duration of 6 months (range, 1-96 months). Pathological findings showed 18 cases of metastasis, 3 cases of multiple myeloma, 1 case of non-Hodgkin's lymphoma, 1 case of grade I chondrosarcoma, 1 case of giant cell tumor, and 1 case of chondroblastoma. For the patient with chondroblastoma, THA with LINK RIBBED system was used. An artificial total hip system made in China was used in 6 patients and LINK SP II system was used in the other 18 patients. Results No patients died perioperatively. Deep infection and hip dislocations occurred inI and 2 patients, respectively. At last follow-up, 8 of 18 patients with metastasis died of cancer and the average survival time wasII months. The other 10 who were alive were followed up 15 months on average. One patient with multiple myeloma died of pulmonary infection at 21 months after operation and the other 2 with multiple myeloma and 1 with lymphoma were alive with an average follow-up of 17 months. The patient with grade I chondrosarcoma and patient with chondroblastoma were followed up 58 and 12 months, respectively, without recurrence. Recurrence occurred in the patient with giant cell tumor at 19 months after operation. Loosening of implant occurred in 3 patients because of local tumor recurrence. For the 23 patients at 6 months after operation, the mean Musculoskeletal Tumor Society (MSTS) 93 score was 81% (range, 57%-93%). Conclusion Reinforced acetabular cage with caudal