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PubMed1984

[Unusual variations of the large arteries of the thigh].

Three rare variations of the large arteries of the thigh are known: Hypoplasia or aplasia of the superficial femoral artery in combination with persistent sciatic artery which normally is present during embryogenesis for a few days only. Typical finding is a large dorsal artery in the thigh accompanied with a hypoplastic superficial femoral artery. For the first time angiography of this vascular situation is shown in two projections. Complications of persistent sciatic artery include aneurysm (25%) and occlusion (embolic or thrombotic). Duplication of the superficial femoral artery. Absence or duplication of the deep femoral artery caused by separately originating branches. Knowledge of embryogenesis of the vessels helps to understand these artery variations.

Adult↗
PubMed2004

Distribution of alpha-tocopherol stereoisomers in liver and thigh of chickens.

The effect of supplementation with different levels of all-rac-alpha-tocopheryl acetate and the inclusion of different dietary contents of PUFA on the deposition of alpha-tocopherol stereoisomers in liver and thigh of chickens was evaluated. Ninety-six 1-d-old Ross female broiler chickens were randomly distributed into eight experimental treatments (three replicates each) resulting from four levels of alpha-tocopheryl acetate without supplementation and supplemented with 100, 200 and 400 mg alpha-tocopheryl acetate/kg and two levels of dietary PUFA (15 and 61 g/kg). The feeds supplemented with alpha-tocopheryl acetate contained a similar proportion of each stereoisomer. The diets without alpha-tocopheryl acetate had the following alpha-tocopherol stereoisomers (%): RRR 35.1, RRS 24.5, RSR 25.3, RSS 13.9 and total 2S forms 1.3. Consumption of different levels of alpha-tocopheryl acetate did not lead to statistical differences in alpha-tocopherol stereoisomer proportion in the liver and thigh. In general, the stereoisomer profiles in the tissues studied were similar, responding to the stereoisomer profile of the diet. Both tissues preferentially accumulated 2R stereoisomer (69-100 %). However, when alpha-tocopheryl acetate was used the discrimination was not specific for the RRR alpha-tocopherol form. Furthermore, the 2R:2S ratio had a tendency to increase as the polyunsaturation level of the diet increased.

Animals↗
PubMed1998

Controversial issues in diagnosis of liposarcomas of the thigh. A report of 18 cases.

Liposarcoma is a common soft tissue neoplasm mainly found in the thigh. Early diagnosis and appropriate treatment are essential for survival, but clinical diagnosis may not be easy, and the importance of imaging is controversial as it often fails to indicate the presence of liposarcoma so that treatment is delayed. We report our experience of 18 cases of liposarcoma (16 of which in the thigh). This experience has led us to revise our opinions about imaging, clinical, and histopathological diagnosis, and the surgical and medical treatment. We now suggest that any hard, subfascial mass in an adult should be considered as a soft tissue neoplasm. Of these neoplasms, liposarcoma is the most common type, after malignant fibrous histiocytoma. Diagnosis by imaging techniques is rarely possible, so that integration with clinical data is essential. Among the various imaging techniques, computed tomography and ultrasound seem to be most useful.

Adult↗
PubMedDate not supplied

Influence of age, sex, and BMI on waist-to-thigh circumference ratio in children.

In adults the distribution of body fat towards the central region seems a good predictor of disease and mortality. Central fat deposition tends to increase with age; sex and obesity further influence this trend. In children the distribution of adiposity to the central region is not well known. Recently, using circumferences of waist and thigh, we computed the percentile curves of the waist to thigh circumference ratio (WTR) from 2858 subjects (1440 males, 1418 females), 6-14-years-old (Zannolli, R., Chiarelli, F., and Morgese, G., 1993, International Journal of Obesity, 17 (Supplement 2), 60). In the present study, using the same sample of data, we showed that in lean, average or fat subjects, WTR is only weakly (< 5% of variance) explained by age, sex and body-mass index (in spite of the 'statistical significance' of sex and body-mass index in some groups). Hence, some subjects, among the lean, average and fat groups, could have a high (i.e. > 2 SD over the mean) WTR, independent of age, sex or weight. We therefore propose that the values of WTR should be checked against appropriate standards. Those with a WTR value greater than 2 SD from the mean, independent of age, sex or weight, should be studied more carefully, using anthropometry, so as to give early warning of those who are more prone to degenerative disease.

Abdomen↗
PubMed2002

Localized thigh swelling mimicking a neoplastic process: involvement of coxsackie virus type A21.

UNLABELLED: A 4-y-old girl was admitted because of a left leg limp with an isolated swollen upper thigh and normal muscle enzymes. A radioisotope scan showed increased uptake especially in the bone and soft tissue of the left thigh, while magnetic resonance imaging of that region demonstrated widespread oedema in striated muscle. On muscle biopsy perivascular infiltrates were demonstrated but muscle fibres were not shown to be affected. Sequence analysis of reverse transcription-polymerase chain reaction amplified fragments from the 5'-non-coding region of human enteroviruses identified a local strain of coxsackie virus A21 in the muscle. Clinical symptomatology subsided with oral steroids. CONCLUSION: Local swelling mimicking a neoplasm may be related to infestation of coxsackie virus in muscle tissue.

Base Sequence↗
PubMed1991

Skull, patella and thigh cryptococcosis after a crashing injury of the temporal bone.

An unusual case of triple location (skull, patella and thigh) Cryptococcus neoformans is described. The peculiarity of the case is based on the probability of direct post-traumatic bone inoculation, subsequent seeding from skull to patella, thigh and cerebral spinal fluid (CSF), patella involvement, lack of evidence of lung involvement and lack of predisposing underlying disease. The response to surgery and a combination of amphotericin B and 5-flucytosine administration was favorable without relapse at follow-up after 7-year discontinuation of therapy.

Bone Diseases↗
PubMed1988

In vivo postantibiotic effect in a thigh infection in neutropenic mice.

The postantibiotic effect (PAE) is the suppression of bacterial growth that persists after limited exposure of organisms to antimicrobial agents. We demonstrated and standardized the in vivo PAE in a thigh infection model in neutropenic mice. Inhibitors of protein and nucleic acid synthesis induced PAEs of 1.4-7.5 h against aerobic gram-negative bacilli, whereas beta-lactam antibiotics did not induce significant PAEs. Against aerobic gram-positive cocci, cell wall-active agents and inhibitors of protein and nucleic acid synthesis induced PAEs of 1.2-7.1 h, except for penicillins, which did not induce PAEs against streptococci. With few exceptions the in vivo PAE correlated well with the PAE reported in prior in vitro studies. Residual drug in thigh tissue did not cause the PAE. Theoretically, the presence of a PAE may allow antimicrobial agents to be given more intermittently without organism regrowth after drug levels fall below the minimal inhibitory concentration.

Agranulocytosis↗
PubMed1988

Electrically elicited co-contraction of thigh musculature after anterior cruciate ligament surgery. A description and single-case experiment.

The purpose of this article is to describe a method for strengthening the quadriceps femoris muscle in a patient after anterior cruciate ligament (ACL) surgery. The method incorporates electrically elicited co-contraction of the quadriceps femoris and hamstring muscles. A single-case experimental design based on a split-middle (ABAB) technique was used to assess the effects of the systematic administration and withdrawal of electrical stimulation with respect to changes in knee isometric extension and flexion torque and circumferential measurements of the thigh in a patient six weeks after ACL reconstruction. Results show increases in extension and flexion torque and thigh circumferential measurements that are associated with both stimulation (treatment) phases in addition to a maintenance effect demonstrated during the withdrawal phase. In this patient, the technique appears to be effective in increasing muscle strength and circumferential measurements, particularly quadriceps femoris muscle torque. Implications and suggestions for future research are included.

Adult↗
PubMed1986

Aesthetic surgery of the medial thigh.

Aesthetic surgery of the medial thigh is indicated in three instances: excess of skin, localized steatomery, and diffuse obesity after loss of weight. In the first two cases it is possible to limit scarring to the gluteal fold. In obese patients the functional benefits of a combination excision-suction lipectomy outweigh the disadvantages of the scarring over the medial thigh.

Dermatologic Surgical Procedures↗
PubMed1987

Squamous cell carcinoma of the perineum: management with Mohs' surgical excision and gluteal thigh flap.

Two patients with squamous cell carcinoma of the perineum are presented. The carcinomas were treated by wide local excision using Mohs' fresh-tissue technique for control of the surgical margins. The wounds were closed using a gluteal thigh flap. In 1 patient the flap was extended across the midline for coverage of a contralateral perineal site. Healing was complete in each case. The combination of Mohs' fresh-tissue methods and the posterior thigh flap provided accurate identification and removal of the perineal tumor with stable wound coverage.

Buttocks↗
PubMed1990

Scrotal reconstruction following Fournier's gangrene using the medial thigh fasciocutaneous flap.

Scrotal reconstruction with adequate protection of the testicles remains the challenge following Fournier's gangrene. Early single-staged sensate flap coverage is ideal. This is readily accomplished using the medial thigh fasciocutaneous flap based on the longitudinal axiallty of the anteromedial thigh suprafascial plexus. Only a single lower extremity need be violated, and the ipsilateral gracilis muscle may be simultaneously independently elevated for closure of larger defects. Primary donor site closure obviates the need for skin grafts.

Aged↗
PubMed1990

Experience with the island inferior gluteal thigh flap compared with other local flaps for the reconstruction of the pelvic area.

The pelvic area can be one of the most difficult areas in the body to reconstruct. We divide pelvic wounds into three functional categories: spinal cord injury with no sensation or motor function, spinal cord injury with partial sensorimotor function, and miscellaneous injury, such as that resulting from congenital causes, trauma, or tumor resection. We have found the posterior thigh, particularly the island inferior gluteal thigh flap, to be an excellent choice for all three types of wounds, with the added advantages of sensate coverage and sparing of ambulation musculature in patients for whom such aspects are important. We have found that designing flaps based on the vascular territories of major blood vessels--the angiosome approach described by Taylor and Palmer--provides an excellent and reliable flap for most wounds in the pelvic area. In most patients, the major source vessel is the inferior gluteal artery and the flap is taken as an island flap. When this is not possible or when the island flap does not offer an advantage, we have chosen other local flaps. Our report covers our experience with 36 such procedures in 31 patients, with follow-up ranging from 3 months to 2 years.

Adolescent↗
PubMed1991

Simultaneous transposition of anterior thigh muscle and fascia flaps: an introduction to the chimera flap principle.

A compound flap implies that more than a single tissue structure has been linked together to achieve a common purpose. In this sense then, a composite flap is the simplest form of a compound flap because by definition it incorporates multiple tissue types, but the latter are restricted in that the vascularization of all contained parts are interdependent and inseparable if total viability of the unit is to be maintained. More complex compound flaps may have components with separate vascular sources but remain physically attached, or may be fabricated by joining disparate flaps together using microsurgical methods. The chimeric flap, as still another type of compound flap, differs in that its tissue components may be independently maneuvered, remaining ultimately attached together only by some common regional source vessel or plexus. Concurrent, independent local transposition of the anterior thigh fasciocutaneous flap and rectus femoris muscle flap is used to demonstrate the chimera principle where these disparate flaps have been harvested from the same anterior thigh region.

Accidents, Occupational↗
PubMed1993

Experience with U-shaped gluteal thigh flap for reconstruction of radionecrosis in the sacral region.

The gluteal thigh flap first reported by Hurwitz in 1980 can provide a large reliable flap for coverage of the sacrogluteal and perineal regions. This flap can be extended quite some way along its axial inferior gluteal vessels, but its width is limited to approximately 10 cm if direct approximation of the donor site defect is required. In this article, we report a U-shaped modification of the gluteal thigh flap for efficient use of the flap in covering a large defect in the sacrogluteal region.

Aged↗
PubMed2002

Versatility of the free anterolateral thigh flap for reconstruction of soft-tissue defects: review of 140 cases.

From August 1995 to June 1999, 140 free anterolateral thigh (ALT) flaps were transferred to reconstruct a variety of soft-tissue defects. The size of ALT flap ranged from 10 to 33 cm in length and 4 to 14 cm in width. Based on the anatomic variations of the perforators, the blood supply to the skin island came from the septocutaneous perforators only in 19 patients (13.6%), arising from the descending or transverse branch of the lateral circumflex femoral artery (LCFA), or originating directly from LCFA. The other flaps were supplied by musculocutaneous perforators that were elevated as a true perforator flap via intramuscular dissection (N = 34, 24.3%), or used a cuff of vastus lateralis muscle for added bulk (N = 87, 62.1%). The overall success rate was 92% (129 of 140). After a 2-year follow-up, all flaps have healed unevenffully and donor thigh morbidity is minimal. Anatomic variations must be considered if the ALT flap is to be used safely and reliably.

Adult↗
PubMed2002

Intraoperative lymphatic mapping to treat groin lymphorrhea complicating an elective medial thigh lift.

Groin lymphoceles and lymphorrhea are a rare complication of medial thigh lift procedures. The author describes a case in which a very thin patient developed groin lymphorrhea after an uncomplicated medial thigh lift procedure. Initial treatment interventions, including edema control and the placement of a drain with surgical exploration, failed to control the lymphatic leak. Additionally, the onset of an infection and abscess formation complicated the treatment efforts. Using techniques well established in treating cutaneous malignancies, the lymphocele was treated successfully by identifying three separately damaged lymphatic channels with the use of intraoperative lymphatic mapping with blue dye. No drains were needed and the immediate cessation of lymph flow was noted. Using this novel adaptation of a well-known technique, the groin lymphocele was able to be repaired quickly and effectively with minimal morbidity and no evidence of recurrence to date.

Female↗
PubMed1998

Evaluation of the effects of high dose irradiation on canine thigh muscle by follow-up magnetic resonance imaging and phosphorus-31 magnetic resonance spectroscopy.

RATIONALE AND OBJECTIVES: The authors investigate alterations of proton T1 and T2 relaxation times and phosphorus metabolites of canine thigh muscle tissue after high dose x-ray irradiation by follow-up magnetic resonance imaging (MRI) and phosphorus-31 (31P) magnetic resonance spectroscopy (MRS). METHODS: A group of 20 dogs was used for MRI and in vivo 31P MRS. Single doses of 5,000 and 10,000 cGy were delivered to the right thigh muscle of groups of 10 dogs each. All MRI and 31P MRS examinations were performed before irradiation and 1, 7, 14, 28, 42, and 56 days after irradiation. For measurement of T1, repetition time (TR) was measured at 300, 500, 1000, 1500, 2000 msec and echo time (TE) was fixed at 12 msec. Also, for measurement of T2, TE was measured at 20, 40, 60, and 80 msec and TR was fixed at 2000 msec. Image selected in vivo spectroscopy (ISIS) pulse sequence was used to obtain 31P MR spectra. Peak areas for each phosphorus metabolite were measured using a Marquart algorithm. RESULTS: Magnetic resonance imaging signal began to change at 28 days after a single dose of 10,000 cGy, whereas there was no significant MRI signal change until 56 days after a single dose of 5,000 cGy. Also, extensive MRI signal changes were observed at 42 days after a single dose of 10,000 cGy. Significant correlation was established between T2 and a lapse of time although there was no correlation between T1 and a lapse of time. T2 value increased substantially corresponding to the time period after x-ray irradiation. Although MR spectral change was not observed until 42 days after a single dose of 5,000 cGy, it began at 14 days after a single dose of 10,000 cGy. And, significant MR spectral changes were observed at 28 and 42 days. Inorganic phosphate and phosphodiesters signal intensities increased while phosphocreatine signal intensity decreased. The pH value was 7.22 +/- 0.05 at control, and 6.98 +/- 0.04 at 42 days after a single dose of 10,000 cGy. CONCLUSIONS: The postirradiation follow-up MRI and 31P MRS studies demonstrated that morphologic and metabolic changes were dependent upon the x-ray dose and a lapse of time.

Animals↗
PubMed1987

Acute anterior compartmental syndrome of the thigh following contusion. A case report and review of the literature.

Contusion is a rare cause of acute compartmental syndrome in the thigh. To date, no case report has described blunt trauma precipitating this limb-threatening condition. The patient in this case report developed rapidly progressive signs and symptoms which required emergency fasciotomy. Delayed primary closure was possible and recovery was complete. The etiologies, diagnosis and management of thigh compartmental syndrome are reviewed.

Adult↗