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At least 595 records · Page 33Linked to original sources
PubMed1990

Paraplegic pressure sore frequency versus circulation measurements.

Paraplegic subjects (N = 34) were examined to determine the association of pressure sore history with respect to ankle pressure ratio and buttocks cutaneous plethysmographic harmonic persistence. No relationship was found between pressure sore history and ankle pressure ratio. No significant difference in ankle pressure ratios exists for those who have a pressure sore history as compared to those who have not experienced a pressure sore in 5 years. Those subjects with a diminished buttocks circulation harmonic persistence are more likely to have experienced one or more pressure sores than those subjects with normal circulation characteristics. A Poisson distribution analysis of multiple pressure sore occurrence suggests that repeated pressure sores are unlikely to arise as the result of chance.

Ankle↗
PubMed1990

Reduction of sitting pressures with custom contoured cushions.

Previous research indicated that matching a cushion to the shape of the buttocks results in less tissue distortion and lower interface pressures. A system was developed to measure body contours and fabricate a cushion to match the measured contour. This project fabricated contoured foam cushions for 11 persons with spinal cord lesions (C5-L3). Mean pressures were compared on two flat and two contoured foams with different degrees of stiffness. Deflection characteristics on flat foam were compared to deflection on contoured foam in order to analyze loading differences. Material studies were determined by examining the load-deflection curves for flat foams of 1-, 2-, and 3-inch thicknesses. It was found that sitting on contoured foam resulted in a lower pressure distribution than sitting on flat foam (p less than 0.05), and sitting on a soft foam (ILD = 45) resulted in a lower pressure distribution than sitting on a stiffer foam (ILD = 55) (p less than 0.05). Results of the deflection measurements and compression tests were used to explain the loading differences at the seat interface of flat and contoured cushions. Loaded contoured foam demonstrated increased enveloping of the buttocks, decreased foam compression, and a more uniform pressure distribution. These attributes are typical of a safer sitting surface and may indicate less tissue distortion.

Biomechanical Phenomena↗
PubMed1998

Management and results of sciatic nerve injuries: a 24-year experience.

OBJECT: The purpose of this retrospective clinical study was to present results and provide management guidelines for various types of sciatic injuries. METHODS: Over a 24-year period, 380 patients with sciatic nerve injuries were managed. In 230 patients (60%), the injury was at the buttock level, with injection injuries comprising more than half of these cases. Thigh-level sciatic injury was evaluated in 150 cases (40%) and was usually secondary to one of four main causes: 1) gunshot wound; 2) femur fracture; 3) laceration; or 4) contusion. Patients with partial deficits uncomplicated by severe pain or with significant spontaneous recovery or late referral were managed medically. Surgical exploration was not indicated in 23% of injuries at the thigh level and almost 50% of those at the buttock level. Most of these patients achieved partial but good spontaneous recovery, especially in the tibial division distribution. Surgical intervention was required for more complete and persistent deficits in either the tibial or peroneal distribution. Divisions of the sciatic nerve were split apart and evaluated independently. Management was guided by nerve action potential (NAP) recordings, which indicated whether neurolysis or resection of the lesion was required. Repair was then made by using sutures or more frequently by graft placement. In most cases in which neurolysis was performed because a positive NAP was recorded distal to the lesion, useful function was found in the peroneal distribution. Unfortunately, significant recovery occurred in only 36% of patients who received suture or graft repairs of the peroneal division. Good-to-excellent outcome was common for the tibial division, even in cases in which repair was proximal and required lengthy grafts. The relatively favorable recovery of tibial as opposed to peroneal divisions of the sciatic nerve occurred regardless of the level or mechanism of injury. CONCLUSIONS: Surgical exploration and, when necessary, repair of sciatic nerve injuries is worthwhile in selected cases.

Action Potentials↗
PubMed1999

Exclusion of internal iliac arterial aneurysm concomitant with abdominal aortic aneurysm repair.

BACKGROUND: To study the long-term outcomes after exclusion of internal iliac arterial aneurysm performed concomitantly with abdominal aortic aneurysm repair in patients with ruptured aortic aneurysm or other high-risk conditions. METHODS: The 31 patients who participated in this study underwent emergency (N = 9) or elective surgery (N = 22). The abdominal aortic aneurysm and the common iliac artery were excluded together with the internal iliac aneurysm in 7 patients. Forty-three (12 bilateral and 19 unilateral) internal iliac aneurysms were excluded: 35 by proximal ligation only, 5 by proximal and distal ligation, and 3 by partial resection of the proximal part of the aneurysm. The platelet count and fibrinogen level were evaluated pre- and postoperatively. Pelvic organ ischemia, classed as ischemic colitis, buttock claudication and sexual dysfunction, was examined. RESULTS: The inferior mesenteric artery was reimplanted in 21 patients. The platelet count dropped significantly postoperatively, but the fibrinogen level increased and no bleeding tendency was noted. Ischemic colitis occurred in 7 patients, resulting in colonic infarction in 2 patients. The operative mortality was 16%, and the postoperative observation periods ranged from 4 days to 217 months (mean, 60 months). The incidence of buttock claudication and sexual dysfunction was 12% and 39%, respectively. The excluded aneurysms were all thrombosed at discharge, and no late rupture was noted. The 5- and 10-year survival rate after surgery was 56% and 51%, respectively. CONCLUSIONS: Exclusion of the internal iliac aneurysm concomitant with abdominal aortic aneurysm repair shows acceptable outcome when performed in patients with high-risk conditions.

Aged↗
PubMed2000

Squamous cell carcinoma arising in a cutaneous epidermal cyst--a case report.

INTRODUCTION: Cutaneous epidermal cysts are common lesions, but fortunately, malignant transformation of their epithelium is rare. There are only a few cases mentioned in recent literature, mostly occurring in epidermal cysts in the head and neck region. CLINICAL PICTURE: We present a case of malignant transformation in a long-standing buttock epidermal cyst, presenting a month after trauma to the cyst. TREATMENT: An excision biopsy and rotation flap was done. When the pathology was confirmed, a second resection was carried out and the defect covered with a free latissimus dorsi flap, a buttock rotation flap and a posterior thigh rotation flap. CONCLUSION: Although malignant transformation is rare, this case illustrates the importance of routine histology in excision of epidermal cysts.

Biopsy↗
PubMed2001

Atypical presentations in children with post-neonatal tetanus in Ibadan, Nigeria.

In a retrospective review of 73 children with post-neonatal tetanus seen over an 11-year period at University College Hospital, Ibadan, Nigeria, atypical portals of entry of the causative agent were recorded in nine and five developed unusual complications during the course of treatment for tetanus. Localized tetanus was encountered in seven children; this involved the cephalic region in one and one lower limb in each of the remaining six. Among these six children, the portal of entry of the organism included intramuscular injections into the buttock in five and an infected insect bite on the buttock in one case. Another unusual portal of entry, observed in two children, was through an impacted foreign body in the ear in the absence of otitis media. Arthritis of large joints was encountered in three children and two had episodes of severe bronchospasm which responded to bronchodilator treatment. The findings in this study significantly widen the reported spectrum of presentations and complications of tetanus in third-world children.

Buttocks↗
PubMed2001

Fatty acid analysis of transplanted adipose tissue.

OBJECTIVE: To determine whether autologously transferred human adipose tissue maintains viability in vivo for prolonged periods. DESIGN: Six healthy female patients (mean age, 61.5 years; mean body mass index, 23.4 kg/m2) received autologous fat transplants from the gluteus to the nasolabial folds. Subcutaneous fat was sampled from facial and gluteal sites 4 times in 1 year. SETTING: Private practice, basic science research center. INTERVENTION: After local anesthesia, 10 g of subcutaneous adipose tissue was harvested from the right buttock of each patient. Ten milligrams of adipose tissue was aspirated from the right nasolabial fold. Five grams of gluteal fat was then injected into each nasolabial fold using a uniform monolayer threading technique with no overcorrection. As controls, 10 mg of adipose tissue was obtained from the opposite left buttock and left cheek. Adipose tissue from the transplanted and control facial and gluteal sites was sampled at 4, 6, and 12 months after transplantation. MAIN OUTCOME MEASUREMENTS: Gluteal fat has more monounsaturated fatty acids and less saturated fatty acids than facial fat. This unique site-specific fatty acid pattern was used to assess the course of the survival of transplanted adipose tissue in the nasolabial region. In all fat samples, the percent area (weight percentage) was obtained for each fatty acid (C12:0 to C22:6 omega-3) using capillary gas chromatography. Clinical results were also analyzed by macrophotographs. RESULTS: As expected, gluteal fat had significantly more monounsaturated fatty acids and less saturated fatty acids than facial fat. In 5 of 6 patients, at 4, 6, and 12 months after transplantation, the fatty acid pattern at the transplanted recipient site was similar to the pattern of the control facial site. However, at 4 months, 1 patient had a fatty acid pattern in the transplant recipient site that was similar to the pattern of her gluteal fat. This pattern persisted for 1 year. Fat retention at the transplant site was corroborated by photographic assessment. CONCLUSIONS: Long-term adipocyte survival is an achievable goal following fat transfer. The importance of harvesting and injection techniques as well as adipose tissue characteristics require further study.

Adipocytes↗
PubMed1975

[Gluteal fistulo-gummatous syndrome (malignant dysembryoma)].

The authors present the case of a 61 years old patient with fistulo-gummutous lesions with ulcer formation and pus formation in the right buttock, loss of weight and asthenia. The lesions appeared six months after a violent blow on the right buttock. General examination of the ano-rectal region, including sigmoidoscopy and fistulography, together with histo-pathological examination, revealed the existence of a perirectal muciparous carcinoma developing on embryonic glanduilform remains, situated in the right perinee-rectal region. The special interest of this case resides in its rareness and the unusual clinical appearance of gummatous fistula.

Buttocks↗
PubMed1975

Thermographical investigation of decubitus ulcers.

1. Posterior body reference thermograms indicate that in general a similar thermal body pattern of humans does exist. 2. The buttocks, hips, and thighs of a nude subject are thermally cool regions, possibly indicating poor vascular circulation and/or large fat concentrations. 3. Thermograms of the same anatomical area on the same subject under controlled environmental conditions are thermally similar. 4. The scapular region is from 1 to 2 deg F hotter than the sacral region for subjects reclining on Mylar. 5. The 1 deg temperature differential thermograms and the reference thermogram while the subject is on Mylar, in many ways, denote the geometrical shape of the underlying bone structure, especially the bones of the scapulae and sacrum. 6. On the degree temperatue differential thermograms, the anatomical regions most accused of being decubitus ulcer prone are the regions of highest temperatures: the scapulae, sacrum, elbows, and calves. 7. During reactive hyperemia, the visible red flare over the sacrum and coccyx becomes very intense in the first few minutes and then gradually diminishes. The thermal flare persists longer than the visible flare. The extended duration of the thermal flare over the visible red flare is attributed to a continued local elevated metabolic tissue rate caused by the previous engorgement of blood. 8. The thermal mottling seen in the first minute after releasing the load is believed to have been caused by the rapid infusion of blood and the dilation of affected vessels responsible for making up the blood flow debt which occurred during the period of ischemia. 9. A posterior body heating effect noticed immediately after the subject left the Mylar film has been attributed to the insulative qualities of the film. The cooling effect is more difficult to explain, but it is thought that the higher than average room temperature caused an increased evaporative cooling rate response of the two subjects either before getting off the film or immediately after getting off and therefore reduced the temperature of the skin. 10. The maximum reactive hyperemic temperature difference, the difference between the initial standing reference thermogram and the maximum flare temperature observed during tissue hyperemia, may be as high as 12 deg F. 11. Males on the average have larger flare patterns than females, 5.7 in.2 and 4.7 in.2, respectively. The flare areas were computed from thermograms taken 2 to 3 minutes after off-loading of tissue. 12. With the average distance from the buttock's fold to the highest and lowest thermal flare indication being lower for females (3.2 and 5.9) than for males (3.8 and 6.4), a relationship between the site or decubitus ulcer formation and the pelvic bone structure of the sexes may well exist. 13. No two thermal flare patterns are similar either in size or in shape. Thermal flare patterns occur along the centerline of the body at the sacrum and coccyx level. 14...

Adolescent↗
PubMed2006

Bilateral localized lipoatrophy secondary to a single intramuscular corticosteroid injection.

A 15-year-old boy developed two, almost symmetric, asymptomatic, depressed plaques, localized to both buttocks after receiving a single intramuscular corticosteroid injection in his right buttock for treatment of lumbar pain. He suffered from asthma since early childhood, and had been repeatedly treated with corticosteroid injections for many years as a young child. A skin biopsy from both lesions was performed, showing a decrease in the number and size of adipocytes. We describe a case of acquired localized lipoatrophy with a particular bilateral distribution secondary to a single intramuscular corticosteroid injection.

Adolescent↗
PubMed2006

[Distal perforator-based gluteus maximus muscle V-Y flap for treatment of sacral ulcers].

OBJECTIVE: To explore the method of the distal perforator-based gluteus maximus muscle V-Y flap to treat the sacral ulcer and to simplify the operative procedures. METHODS: From March 2002 to March 2005, 11 cases of sacral ulcer were repaired by distal perforator-based gluteus maximus muscle flaps. The area of sacral ulcer ranged from 13 cmX 11 cm to 18 cmX 14 cm. Of 11 cases, 7 were female and 4 were male, whose age ranged from 21 to 69 years, and the disease course was 8 months to 3 years. A triangular flap was designed to create a V-Y advancement flap. The length of the base was made almost equal to the diameter of the defect. The apex of the triangle was located near the great trochanter. The medial part of the flap was elevated as a fasciocutaneous flap by dissecting the layer between the fascia and the muscle. The distal part of the flap was elevated by dissecting the layer between the gluteus maximus muscle and the fascia of the deeper muscle group. The flap was advanced to the defect. RESULTS: All the flaps survived. After a follow-up of 5 months to 3 years, the bilateral buttocks were symmetry and whose appearance was satisfactory. Except for 1 case dying of other disease, no recurrence of ulcer was observed. All the flaps survived. CONCLUSION: The distal perforator-based fasciocutaneous V-Y flap for treatment of sacral ulcers is a simple and reliable technique, which has several advantages over the conventional V-Y flap technique,such as excellent excursion, viable coverage.with the fasciocutaneous component, high flap reliability, preservation of the contralateral buttock, and preservation of the gluteus maximus muscle function.

Adult↗
PubMed1991

[Application of liposuction and its clinical significance].

300 liposuction patients involving 444 anatomical areas are reported in this paper. The clinical significance of the applied anatomy and the comparison between groups are analyzed. 1. The distribution of the liposuction areas. 2. The distribution of blood vessels in the abdominal wall, buttocks and thighs and its relation to the volume of fat removed as well as blood loss. The blood vessels are so abundant in the abdominal wall that the blood loss is larger than that in the buttocks and thighs in the operation. According to the anatomical characteristics of distribution of the blood vessels, the authors pointed out a few "relatively forbidden areas". In group 2 we intentionally avoided doing liposuction in these areas. The results showed that the blood loss was less than that in group 1 and that the volume of fat removed could obviously be increased. 3. The characteristics of liposuction in severe obesity or in patients over 90kg body weight: The aspirate volume is big; the blood versus fat ratio is low. So it is possible to increase the aspirate volume. The elasticity of skin of the abdominal wall is very high. It is not necessary to remove skin in very obese patients with abdominal dermatochalasis.

Abdominal Muscles↗
PubMed1988

[Piriformis syndrome. A contribution to the differential diagnosis of lumbago and coccygodynia].

The piriformis syndrome is characterized by pain in the buttock radiating to the leg and to the coccydeal region. It is an isthmus syndrome of the N. ischiadicus and/or N. cutaneous femoris posterior. The most frequent causes are blunt traumas of the buttocks and spasms of the N. piriformis. More often than not the piriformis syndrome is the cause of a "postlaminectomy syndrome" or of a coccygodynia. The diagnosis can be established by a clinical examination with sufficient reliability.

Back Pain↗
PubMed1984

Body sculpturing.

Body contouring surgery is a routine procedure used to improve the aesthetic aspect of the trunk and may be performed in one or more surgical stages. It may involve the abdomen, breasts, flanks, lumbar area, buttocks, trochanter, upper arms, and upper-inner thigh. The author discusses suction lipectomy, augmentation mammoplasty, breast reduction and mastopexy, abdominoplasty, surgery of the trochanter and buttocks, surgery of the thigh, brachioplasty, and combined procedures.

Abdomen↗
PubMed1983

[An unusual cause of sciatica: soft tissue desmoid tumor. Apropos of 2 cases].

The authors report 2 cases of sciatica resulting from nervous compression by a desmoid tumour in women aged 33 and 27 years. In each case, careful exeresis did not prevent recurrence as shown by tomodensitometry. Eight other well-documented cases were found in the literature. The desmoid tumour penetrates the buttock and thigh muscles and presses the sciatic nerve. The patients often suffer from previous and persistent sciatica which can combine with hip restriction. The responsible tumour made up of abundant bundles of collagenous fibers, a small number of fusiform cells without mitosis or atypics and on the periphery degenerative and dissociated muscle fibers is usually discovered late. Tomodensitometry is the best means of detection, evaluation of the extent, adhesions and recurrence during the observation period. Treatment is usually surgical and success depends on the quality of the exeresis. Other methods, corticoid, anti-oestrogen and radiotherapy, sometimes effective in desmoid tumours of the abdominal wall, do not prevent recurrence in the buttocks or thighs which are of sciatic derivation.

Adult↗
PubMed1982

Electromyographic evidence of inferior gluteal nerve compromise: an early representation of recurrent colorectal carcinoma.

Lumbosacral or primary buttock pain and cutaneous anesthesia in the distribution of the posterior femoral cutaneous nerve were the initial symptoms in 5 patients later proven to have extensions of previously resected colorectal malignancy. The initial electromyographic impression of an inferior gluteal nerve mononeuropathy associated with recurrent neoplasia was confirmed by a positive colon biopsy in 1 case and widespread pelvic metastasis demonstrated at laparotomy in the 4 remaining cases. Four of the 5 patients also had increased levels of carcinoembryonic antigen. Roentgenographs and other laboratory data were otherwise normal in all 5 cases. Entrapment of the inferior gluteal nerve and the accompanying posterior femoral cutaneous nerves is facilitated by its medial, intrapelvic fixation at its origin from the sciatic nerve and the crowding effect of the piriformis muscle above, the dorsal rim of the sciatic notch behind and the inferior gluteal vessels and nodes below. The demonstration of hypestesia over the inferior lateral buttock and a concomitant history of colorectal malignancy should alter the examiner to the possible presence of an inferior gluteal nerve neuropathy.

Adult↗
PubMedDate not supplied

Measurements of interface pressure between body sites and the surfaces of four specialised air mattresses.

Four specialised air mattresses had interface pressure measured under six body sites prone to pressure sores in 10 subjects, supine and sitting. The mattresses were the Clinirest (SSI) and FirstStep (KCI) continuous airflow mattress overlays, and Airwave (Pegasus) and Nimbus (Huntleigh) alternating pressure air mattresses. On the mattress overlays, average supine interface pressures were 2.33 kPa (scapula), 4.15 kPa (elbow), 1.94 kPa (sacrum) and 2.79 kPa (buttock), although they were higher at the occiput (7.97 kPa) and heel (11.7 kPa). The alternating pressure air mattresses had an average minimum interface pressure close to zero for three sites, rising to 4.28 kPa under the heel. Average maximum interface pressures were 8.61 kPa (occiput), 5.21 kPa (scapula), 4.90 (elbow), 4.85 kPa (sacrum), 4.61 kPa (buttock) and 13.2 kPa (heel). No accepted scientific method exists for comparing the two types of mattress. Our data suggest a clinical benefit at the occiput and heel (supine) in using an alternating pressure air mattress and a benefit in using a continuous airflow mattress overlay at other sites.

Air Pressure↗
PubMed1994

Functional compartmental resection for soft tissue sarcomas.

The necessary extent of surgical resection in soft tissue sarcomas of the extremities remains controversial. In the absence of effective adjuvant therapy to prevent metastatic disease the aim of treatment is to minimize local recurrence and to preserve function. Intracompartmental soft tissue sarcomas arising entirely within a muscle compartment may be treated by a resection which preserves some innervated muscle within that compartment rather than by total compartmental resection. The functional outcome of patients with quadriceps and buttock sarcomas treated by such functional compartmental resection is reported. Thirty-seven patients whose tumours were entirely intra-compartmental, were identified from a consecutive series of 179 patients with soft tissue sarcomas of the pelvic girdle and lower limb seen at the Royal Marsden Hospital between October 1989 and April 1993. Twenty-four were still alive for assessment of range of movement, muscle strength and functional ability. Although objective limitation of movement and muscle power were identified in the majority, the level of function was either normal or only mildly impaired in the entire group. All walk independently and of those undergoing functional compartmental resection of quadriceps or buttock, eight of the nine patients employed at the time of diagnosis have returned to their previous employment. Sporting activities were more commonly affected but the majority were able to continue previous activities with minor modification such as wearing a knee support. Functional compartmental resection is associated with a satisfactory functional outcome, is not associated with an increased risk of local recurrence and patients can be reassured that they should be able to return to their previous level of activity.

Adolescent↗