[Tissue accommodation of skin and subcutaneous tissue in plastic reconstruction of upper digestive tract].
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Esophagus↗
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Inoculation of Lacazia loboi into the subcutaneous tissue of the hamster cheek pouch.
The subcutaneous tissue of the hamster cheek pouch, a site of immunologic privilege, has been used to investigate the potential infectivity of different types of parasites. It has been demonstrated that the implantation of fragments of lesions induced by the fungus Lacazia loboi, the etiologic agent of Jorge Lobo's disease, into the subcutaneous tissue of the hamster cheek pouch resulted in parasite multiplication and dissemination to satellite lymph nodes16. Here we describe the evolution of lesions induced by the inoculation of the isolated fungus into this immunologically privileged site. The morphology of the inflammatory response and fungal viability and proliferation were evaluated. Inoculation of the fungus into the cheek pouch induced histiocytic granulomas with rare lymphocytes. Although fungal cells were detected for a period of up to 180 days in these lesions, the fungi lost viability after the first day of inoculation. In contrast, when the parasite was inoculated into the footpad, non-organized histiocytic lesions were observed. Langhan's giant cells, lymphocytes and fungal particles were observed in these lesions. Fungal viability was observed up to 60 days after inoculation and non-viable parasites were present in the persistent lesions up to 180 days post-inoculation. These data indicate that the subcutaneous tissue of the hamster cheek pouch is not a suitable site for the proliferation of Lacazia loboi when the fungus isolated from human tissues is tested.
Animals↗
Dermatofibroma extending into the subcutaneous tissue. Differential diagnosis from dermatofibrosarcoma protuberans.
When dermatofibromas are composed predominantly of fibroblasts and extend into the subcutaneous tissue, it may be difficult to distinguish them from dermatofibrosarcoma protuberans. Because the patterns of extension of dermatofibroma have not been well characterized, we studied 185 cases of the fibrous variant of dermatofibroma with extension into the subcutaneous tissue and 40 cases of dermatofibrosarcoma protuberans. Dermatofibromas had two main patterns of extension into subcutaneous tissue. One pattern, seen in 133 of 185 cases (72%), consisted of irregular extension into the subcutaneous tissue in a vertical or radial fashion, predominantly along the septa, which appeared wedge-shaped. The other pattern, seen in 52 of 185 cases (28%), showed a smooth and well-demarcated deep margin that bulged into the subcutaneous tissue. Dermatofibrosarcoma protuberans also had two main patterns of extension into the subcutaneous tissue. In one pattern, seen in 12 of 40 cases (30%), slender spindle-shaped cells extended along septa and between fat cells in a classic honeycomb or lacelike pattern. The other pattern observed in 24 of 40 cases (60%) exhibited a distinct multilayered pattern in which the bundles of slender spindle-shaped cells showed a predominantly parallel orientation to the skin surface. In four cases (10%), a mixture of both patterns was present. We conclude that the patterns of extension of dermatofibroma into the subcutaneous tissue are different from the patterns of dermatofibrosarcoma protuberans.
Diagnosis, Differential↗
Wound infection after cesarean: effect of subcutaneous tissue thickness.
OBJECTIVE: To estimate the effect of the thickness of subcutaneous tissue at the surgery site on abdominal wound infection after cesarean delivery. METHODS: We measured the maximum vertical depths of subcutaneous incisions of women who had cesarean deliveries. The surgical technique for closure was standardized and drains were not used. Abdominal wound infection was defined by standard criteria and limited to the first 6 postoperative weeks. Additional demographic, intrapartum, and perioperative data previously associated with wound infection also were collected. Data were analyzed by Student t test, chi(2) test, and multiple logistic regression. RESULTS: Wound infection occurred in 11 of 140 women (7.8%) who delivered by cesarean. Risk factors identified as significantly associated with wound infection by univariate analysis were thickness of subcutaneous tissue, maternal weight, and body mass index. Multiple logistic regression analysis confirmed subcutaneous tissue thickness as the only significant risk factor for wound infection, with a relative risk of 2.8 (95% confidence interval 1.3, 5.9). There were no significant differences between women who developed wound infections and those without infections in terms of selected demographics, duration of ruptured membranes, number of vaginal examinations, chorioamnionitis, type of skin incision, or duration of surgery. CONCLUSION: Thickness of subcutaneous tissue appears to be the only significant risk factor associated with abdominal wound infection after cesarean delivery.
Abdomen↗
Wound infection after abdominal hysterectomy: effect of the depth of subcutaneous tissue.
OBJECTIVE: Our purpose was to determine the effect of the depth of the subcutaneous tissue at the operative site on abdominal wound infection after hysterectomy. STUDY DESIGN: A prospective study was performed of women undergoing abdominal hysterectomy and not receiving antibiotic prophylaxis who underwent maximum vertical measurement of their subcutaneous incisions before the abdominal cavity was surgically entered. Additional demographic and perioperative data previously associated with wound infection were collected and analyzed. Surgical technique was standardized among the three attending surgeons involved. RESULTS: Wound infection occurred in 17 of 150 (11.3%) women undergoing abdominal hysterectomy. Univariate analysis identified the following risk factors as being significantly associated with wound infection: depth of subcutaneous tissue (p = 0.0004), preoperative serum albumin (0.0015), weight (p = 0.0029), and body mass index (p = 0.0032). Logistic regression analysis confirmed the thickness of the subcutaneous tissue as the only significant risk factor for wound infection (p = 0.04) (odds ratio 1.37, 95% confidence interval 1.01 to 1.86). No patients with a maximum depth of subcutaneous tissue < 3 cm had a wound infection. CONCLUSION: We conclude that the depth of subcutaneous tissue is the most significant risk factor associated with abdominal wound infection after hysterectomy.
Abdomen↗
Characterization by microdialysis of intracellular glucose level in subcutaneous tissue in humans.
The subcutaneous intercellular glucose concentration was measured with a microdialysis method in 14 healthy volunteers and compared with that in venous blood. Under steady-state fasting conditions the intercellular glucose concentration was similar to that in the blood. During an oral glucose tolerance test the absorption phase was slightly delayed (approximately 2 min) in the intercellular space compared with the blood. However, the kinetics for the decline in glucose was similar in the two compartments. The interstitial glucose concentration was similar to that in venous blood during both a eu- and a hyperglycemic clamp. However, a rapid change from euglycemia to hyperglycemia was associated with a significant delay (approximately 8 min) in the intercellular glucose. The data demonstrate that the subcutaneous tissue glucose concentration under non-steady-state conditions closely resembles that in venous blood.
Adult↗
Differential expression of the murine and rat renin genes in peripheral subcutaneous tissue.
We have previously identified peripheral subcutaneous tissue as a bonafide site of primary renin expression in the mouse fetus by virtue of oncogene mediated tumorigenesis in transgenic mice. In this report we demonstrate that the murine renin genes are differentially expressed in this tissue. Through selective breeding and differential primer extension we demonstrate that Ren-1d and Ren-1c transcripts were several fold more abundant than Ren-2. Renin transcripts were also identified in fetal subcutaneous tissues of Spontaneously Hypertensive (SHR) and Wistar Kyoto (WKY) rats. We conclude from these studies that expression of renin during fetal development may be widespread in rodents with its temporal and spatial localization consistent with a role in fetal development.
Animals↗
Fate of porcine and human insulin at the subcutaneous injection site. II. In vitro degradation of insulins in the subcutaneous tissue of the rat.
We compared the in vitro degradation of porcine and human insulin in the subcutaneous tissue of rat. The insulin degrading activity was largely confined to the 160000 X g supernatant fraction of subcutaneous tissue. The degradation of human insulin was approximately half that of porcine insulin in the supernatant fraction. The degradation of porcine insulin in subcutaneous tissue was inhibited by bacitracin, leupeptin, phosphoramidon, and Z-Gly-Pro-Leu-Gly, though the human insulin degradation was not. The degradation of both insulins was accelerated by glutathione. While the proteolytic enzyme activities of cathepsin-B and collagenase-like peptidase were detectable in subcutaneous tissue, chymotrypsin, elastase, kallikrein, alpha-thrombin, and trypsin activities were almost negligible. These in vitro studies suggest that human insulin is comparatively stable against proteolytic enzymes, probably collagenase-like peptidase or cathepsin-B, in the subcutaneous tissue, which support the in vivo evidence.
Animals↗
Comparative analysis of tissue reactions to anesthetic solutions: histological analysis in subcutaneous tissue of rats.
Postanesthetic pain is a relatively common complication after local anesthesia. This complication may be caused by the anesthetic technique or by the anesthetic solution used. Tissue reactions induced by the anesthetic solutions may be one of the factors resulting in pain after anesthesia. The objective of this study was to comparatively analyze tissue reactions induced by different anesthetic solutions in the subcutaneous tissue of rats. The following solutions were utilized: 2% lidocaine without vasoconstrictor; a 0.5% bupivacaine solution with 1:200,000 adrenaline; a 4% articaine solution and 2% mepivacaine, both with 1:100,000 adrenaline; and a 0.9% sodium chloride solution as a control. Sterilized absorbent paper cones packed inside polyethylene tubes were soaked in the solutions and implanted in the subcutaneous region. The sacrifice periods were 1, 2, 5, and 10 days after surgery. The specimens were prepared and stained with hematoxylin and eosin for histological analysis. The results showed that there is a difference in tissue irritability produced by the local anesthetic solutions. The results also showed that there is no relation between the concentration of the drug and the inflammatory intensity, that the mepivacaine and articaine solutions promoted less inflammatory reaction than the bupivacaine, and that the lidocaine solution produced the least intense inflammation.
Anesthetics, Local↗
Subcutaneous tissue thickness in children with type 1 diabetes.
AIM: This paper reports a study to measure the thickness of subcutaneous tissue at three major injection sites and to identify frequently used injection sites and injection methods. BACKGROUND: Glycaemic control is the key factor in the management of children with type 1 diabetes, and subcutaneous injection of insulin plays a major role in glycaemic control. However, only limited studies have examined the thickness of subcutaneous tissue at various injection sites. METHODS: The subcutaneous thickness in a convenience sample of 65 children aged 8-16 years attending a diabetes camp in 2002 was measured once per child at the outer arm, anterior thigh, and abdomen by one investigator using a Lange caliper. Injection sites and the method of injection were observed daily for four days by a trained investigator using a checklist. RESULTS: Median values of subcutaneous thicknesses at the outer arm, anterior thigh, and anterior abdomen for girls were respectively 18.00, 18.00 and 19.75 mm, and for boys were 17.00, 12.50 and 17.00 mm. In 40% of participants, the thickness of the subcutaneous tissue of the abdomen was <12.5 mm. Boys over 14 years old had statistically significantly thinner subcutaneous tissue at all injection sites than that of age-matched girls. The anterior abdomen was the most common injection site in boys, and the anterior thigh in girls. Perpendicular injection without skin-folding was the most frequently used injection method. Body Mass Index was statistically significantly correlated with subcutaneous tissue thickness at all sites. CONCLUSION: A needle shorter than a 12.5-mm needle should be used, particularly for boys. Injection with skin-folding may decrease the possibility of intramuscular injection.
Adolescent↗
Development of a miniaturized glucose monitoring system by combining a needle-type glucose sensor with microdialysis sampling method. Long-term subcutaneous tissue glucose monitoring in ambulatory diabetic patients.
OBJECTIVE: To develop a reliable and practical glucose monitoring system by combining a needle-type glucose sensor with a microdialysis sampling technique for long-term subcutaneous tissue glucose measurements. RESEARCH DESIGN AND METHODS: A microdialysis Cuprophan hollow-fiber probe (inner diameter, 0.20 mm; length, 15 mm) was perfused with isotonic saline solution (120 microliters/h) and glucose concentrations in the dialysate were measured by a needle-type glucose sensor extracorporeally. This system was tested both in vitro and in vivo. Subcutaneous tissue glucose concentrations were then monitored continuously in 5 healthy and 8 diabetic volunteers for 7 to 8 days. A hollow-fiber probe was inserted into the abdominal subcutaneous tissue. RESULTS: This monitoring system achieved excellent results in vitro. Subcutaneous tissue glucose concentrations were measured in a wide range from 1.7 to > 27.8 mM glucose, with a time delay of 6.9 +/- 1.2 min associated with a rise in glucose and 8.8 +/- 1.6 min with a fall in the glucose level (means +/- SE). The overall correlation between subcutaneous tissue (Y) and blood (X) glucose concentration was Y = 1.08X + 0.19 (r = 0.99). The subcutaneous tissue glucose concentration could be monitored precisely for 4 days without any in vivo calibrations and for 7 days by introducing in vivo calibrations. CONCLUSIONS: Glycemic excursions could be monitored precisely in the subcutaneous tissue by this microdialysis sampling method with a needle-type glucose sensor in ambulatory diabetic patients.
Adult↗
Distribution of [3H]dexamethasone in rat subcutaneous tissue after delivery from osmotic pumps.
Inflammation surrounding implantable glucose sensors may be controlled through local release of dexamethasone at the site of implantation. In the present study, we evaluated the distribution of dexamethasone in rat subcutaneous tissue during the first 2.5 days after local release. Osmotic pumps containing [3H]dexamethasone were implanted into the subcutaneous tissue of rats. Digital autoradiography was used to measure the distribution of the [3H]dexamethasone within the subcutaneous tissue at 6, 24, and 60 h after implantation. Measured concentration profiles, near the catheter tip through which the agent was released, were compared to mathematical models of drug diffusion and elimination. The results demonstrate that the majority of the [3H]dexamethasone delivered into the subcutaneous tissue was found within a 3 mm region surrounding the catheter tip. There was good agreement between the experimental data and the mathematical model. The diffusion coefficient for dexamethasone in subcutaneous tissue was found to be D = 4.11 +/- 1.77 x 10(-10) m2/s, and the elimination rate constant was found to be k = 3.65 +/- 2.24 x 10(-5) s(-1). The diffusion coefficient and elimination rate constants for dexamethasone in subcutaneous tissue have not been previously reported. The use of a mathematical model may be useful in predicting the effectiveness of local delivery of dexamethasone around implantable glucose sensors.
Animals↗
[Celiprolol increases the microcirculation in subcutaneous tissue and calf muscles in essential hypertension].
The microcirculation of the subcutaneous tissue and muscles of the extremities is changed already in the early stage of essential hypertension. Insight into the effect of celiprolol, a beta blocker of the third generation, on tissue microcirculation is of both pathogenetic and therapeutic value. On using the method of Na131I tissue clearance, the effect of celiprolol on the microcirculation of subcutaneous tissue and muscles of the extremities was studied in 21 patients with essential hypertension. Celiprolol was administered orally in the daily dose of 300 mg. After one-week administration celiprolol significantly reduced mean arterial pressure and significantly increased the microcirculation in the subcutaneous tissue of the hand and crus as well as in the calf muscle. Celiprolol was thus found to increase the microcirculation in those tissues of the extremities in which its decrease was recorded before onset of the treatment. The obtained results may be of therapeutic value particularly in patients suffering from ischemia of the lower extremities. (Fig. 2, Ref. 19.).
Adult↗
A percutaneous device to study glucose kinetics in subcutaneous tissue fluid.
In the current study subcutaneous glucose kinetics were investigated in tissue fluid collected with a percutaneous device (PD). PDs containing a subcutaneous tissue chamber were implanted subcutaneously in New Zealand white rabbits. Sintered titanium fiber mesh sheets were used for subcutaneous anchorage of the PD. The bottom of the subcutaneous tissue chamber was either covered with a titanium fiber mesh sheet, a cellulose acetate membrane, or left uncovered. Subcutaneous glucose kinetics were determined after injection of octreotide and glucagon. The tissue reaction to the implants was evaluated histologically. No dynamic relationship was observed between glycaemia and subcutaneous tissue fluid glucose for all membrane covered devices. Histological evaluation showed that the presence of a seroma cavity in combination with obstruction of the membrane prevented adjustment of the subcutaneous glucose concentration in response to changes in glycaemia. In the uncovered devices, on the other hand, changes in glycaemia were reflected in subcutaneous tissue fluid. Our results prove that it is possible to measure changes in the glucose concentration in subcutaneous tissue fluid collected with a percutaneous device. Therefore, we conclude that a percutaneous device has an application as model to study the in vivo performance of implantable glucose sensors. The use of porous membranes in such devices has to be avoided.
Journal Article↗
Distensibility of the vascular bed in subcutaneous tissue in generalized scleroderma.
Passive distensibility of resistance vessels in subcutaneous tissue of hand and leg was examined in 6 normals and 8 patients suffering from generalized scleroderma of the acrosclerosis type. Local paralysis of smooth muscle was obtained by injection of papaverine and increase in transmural pressure by lowering the limb. Blood flow was estimated by the local 133Xenon wash-out method. Distensibility of blood vessels in subcutaneous tissue in generalized scleroderma was not decreased to a significant degree, whereas, both in patients and normals, the blood vessels of the leg exhibited diminished distensibility compared to blood vessels of the hand. The findings suggest that the morphologic changes of vascular and extravascular tissue observed in sclerodermic skin do not affect distensibility of the vascular bed in subcutaneous tissue.
Adult↗
Regeneration of axillary hair and related phenomena after removal of deep dermal and subcutaneous tissue by a special "shaving" technique.
A subcutaneous tissue "shaver" was used in the treatment of axillary bromhidrosis. Regeneration of axillary hair was observed postoperatively even if subcutaneous tissue and dermis were removed almost up to the level of sebaceous ducts. Hair regenerated more often in male patients whose sebaceous glands and follicular isthmus were designedly left intact than in female patients whose sebaceous glands were designedly removed completely. Some function of apocrine and eccrine glands tends to return over a two-year period.
Axilla↗
Comparison of closure of subcutaneous tissue versus non-closure in relation to wound disruption after abdominal hysterectomy in obese patients.
AIMS: To evaluate the role of subcutaneous tissue closure in relation to wound disruption after abdominal hysterectomy in obese patients. MATERIAL AND METHODS: In a prospective study at a tertiary referral centre in Mumbai, India, 60 obese patients with subcutaneous fat more than 2.5 cms were included in the study. In 30 patients, subcutaneous tissue was closed using synthetic suture (dexon) while in 30 control patients subcutaneous tissue was not closed. Average weight in the study and control groups were 69 -/+ 9.2 kg and 63.3 -/+ 11.2 kg respectively. RESULTS: The wound disruption occurred in 5 patients in non-closure group as compared to only one in the closure group. Incidence of seroma, haematoma formation and other wound complications were higher in the non-closure group. CONCLUSIONS: Closure of the subcutaneous tissue after abdominal hysterectomy of women with at least 2.5 cms of subcutaneous tissue lowers the overall rate of complications leading to disruption of the incision.
Adult↗
Subcutaneous tissue mechanical behavior is linear and viscoelastic under uniaxial tension.
Subcutaneous tissue is part of a bodywide network of "loose" connective tissue including interstitial connective tissues separating muscles and surrounding all nerves and blood vessels. Despite its ubiquitous presence in the body and its potential importance in a variety of therapies utilizing mechanical stretch, as well as normal movement and exercise, very little is known about loose connective tissue's biomechanical behavior. This study aimed to determine elastic and viscoelastic mechanical properties of ex-vivo rat subcutaneous tissue in uniaxial tension with incremental stress relaxation experiments. The elastic response of the tissue was linear, with instantaneous and equilibrium tensile moduli of 4.77 kPa and 2.75 kPa, respectively. Using a 5 parameter Maxwell solid model, material parameters micro(1) = 0.95 +/- 0.24 Ns/m and micro(2) = 8.49 +/- 2.42 Ns/m defined coefficients of viscosity related to time constants tau(1M) = 3.83 +/- 0.15 sec and tau(2M) = 30.15 +/- 3.16 sec, respectively. Using a continuous relaxation function, parameters C = 0.25 +/- 0.12, tau(1C) = 1.86 +/- 0.34 sec, and tau(2C) = 110.40 +/- 25.59 sec defined the magnitude and frequency limits of the relaxation spectrum. This study provides baseline information for the stress-strain behaviors of subcutaneous connective tissue. Our results underscore the differences in mechanical behaviors between loose and high-load bearing connective tissues and suggest that loose connective tissues may function to transmit mechanical signals to and from the abundant fibroblasts, immune, vascular, and neural cells present within these tissues.
Animals↗