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At least 739 records · Page 41Linked to original sources
PubMed2000

Measurement feasability of advanced glycated end-products from skin samples after antioxidant vitamin supplementation in patients with type 2 diabetes.

PURPOSE: To determine the feasibility of measuring advanced glycated end-products (AGEs)from skin samples and to evaluate the effects of a combination of vitamins E and C on measures of glycemic control and AGEs in patients with type 2 diabetes mellitus. METHODS: Twenty-two patients with type 2 diabetes from a Family Medicine clinic were randomly assigned to receive a daily dietary supplement containing either a combination of 400 mg of vitamin E and 500 mg of vitamin C or matching placebo for a period of one year. AGEs were measured from skin samples taken from the buttock. RESULTS: Nineteen subjects completed this one-year pilot study. There were no major problems found in measuring AGEs from skin samples taken from the butttock. Neither the treatment or placebo group had significant changes in glycemic control, protein glycosylation or AGEs. DISCUSSION: Skin samples taken from the buttock area may be an appropriate site for the determination of AGE levels as this procedure appeared to be well-tolerated. Daily vitamin E and C supplementation did not improve measures of glycemic control or AGE levels in this small sample of patients with type 2 diabetes. Because antioxidant vitamins are inexpensive and free of side effects, additional research using a variety of antioxidant vitamin combinations and dosing regimens is needed.

Adult↗
PubMed2001

[Experimental study on closing the firearm injured soft tissue defect by skin stretch].

OBJECTIVE: To investigate the availability and effect of skin stretch in closing the firearm injured soft tissue defect. METHODS: Eight white pigs with firearm injured soft tissue defect were divided into 3 groups. Each group I and group II had 3 pigs which were performed skin stretch. The control group had 2 pigs without stretch. The average diameter of the defect in three groups was (7.3 +/- 0.2) cm, (9.1 +/- 0.3) cm, (7.3 +/- 0.2) cm respectively, and the site of defect was on the lateral thigh and buttock. RESULTS: Skin stretch could make a visible reduction of the wound. It was possible to close the wound by direct traction when the diameter of the buttock wound was less than 7 cm, and when the diameter of the lateral thigh wound was less than the radius of thigh. The skin stretch should not last more than 7 days and the best effect appeared in 4 to 5 days after performing the skin stretch. CONCLUSION: The skin stretch can be applied in the repair of the firearm injured soft tissue defect. It has many advantage compared with the tradtional treatment.

Animals↗
PubMed2002

Clinical manifestation and management of hemangiomas of infancy.

A retrospective study of hemangioma seen at the Pediatric Dermatology Clinic, Department of Pediatrics, Faculty of Medicine King Chulalongkorn Memorial Hospital from June 1991 to June 2000 was conducted. A total of 197 patients with 221 hemangiomas were followed-up from 6 months to 9 years. There were 134 girls and 63 boys (2.1:1), ranging in age from 6 months to 9 years. Twenty-two patients (11%) were premature neonates. Hemangiomas were presented at birth in 114 patients (58%), within the first month in 65 patients (33%), and after the age of 1 month in 18 patients (9%). Among the 197 patients, 18 patients (9%) had multiple locations. Types of hemangiomas were recorded as superficial, deep and combined in 84 (43%), 31 (16%) and 82 (41%), respectively. Head and neck were the most common sites of hemangiomas (65%), with 36 lesions (18%) on the trunk, 22 lesions (11%) on upper extremities, 22 lesions (11%) on lower extremities and 15 lesions (8%) on the perineum and buttock. Complications were found in 63 patients (32%) with 93 complications. Perineum and buttock had the highest rate of complication (60%), followed by the eyelid region (41%). Superficial hemangioma had the highest rate of complication (64%), followed by combined type (46%). Ulceration was the most common complication in the superficial and combined type. Obstruction was the most common complication in deep hemangioma. Management of hemangioma included observation, prednisolone, flashlamp-pumped pulsed-dye laser, topical therapy and excision in 68 per cent, 8.6 per cent, 10.7 per cent, 9.6 per cent, and 2.5 per cent, respectively. In conclusion, complications of hemangiomas are common. Close observation with regular follow-up will give better recognition and treatment of complications and associations.

Child↗
PubMed2004

Reproducibility of proximal and distal transcutaneous oxygen pressure measurements during exercise in stage 2 arterial claudication.

AIM: Although transcutaneous oxygen pressure measurements (tcpO2) are largely used in the investigation of vascular patients, its reproducibility is still debated. Indeed an unpredictable gradient exists between arterial and transcutaneous oxygen pressure. We hypothesised that indices taking into account changes over time and independent of absolute starting values would be more reproducible than other indices. METHODS EXPERIMENTAL DESIGN: comparative test-retest procedure (1 to 13 days between tests). SETTINGS: institutional practice, ambulatory care. PATIENTS AND PARTICIPANTS: 15 subjects with stage 2 claudication. INTERVENTIONS: tcpO2 recordings at rest and at exercise during the 2 treadmill tests. MEASURES: calculation of the Delta-from-rest of oxygen pressure index (limb tcpO2 changes minus chest tcpO2 changes), of the resting - or minimal values attained during exercise - of absolute tcpO2 and of the regional perfusion index (regional perfusion index: ration of limb to chest). RESULTS: Both absolute tcpO2 and regional perfusion index at rest showed low reproducibility. During exercise the best reproducibility was attained through Delta-from-rest of oxygen pressure index calculation. Equations from the linear regression analysis (test 2 versus test 1) were 0.88 x -4.2 (r(2)=0.82) at the buttock level and 0.82 x -3.8 (r(2)=0.80) at the calf level. CONCLUSION: TcpO2 measurement on the calf or buttock during exercise, is a reproducible measurement in patients with vascular claudication, specifically when corrected for exercise-induced systemic pO2 changes trough Delta-from-rest of oxygen pressure calculation.

Aged↗
PubMed2004

[Surgery for extraperitoneal pelvic neoplasms].

OBJECTIVE: To evaluate the methods of surgery for extraperitoneal pelvic neoplasms. METHODS: Clinical data related to surgery of 84 cases of extraperitoneal pelvic neoplasms were extracted and retrospectively analyzed. RESULTS: All 84 patients underwent operations, including one of them who received 4 operations within 6 months for resection of a single tumor. 58 abdominal, 16 buttock and 10 combined incisions were made in the series. Pelvic organs and structures were co-resected in 35 cases, including total pelvic exenteration in 2 cases and anterior pelvic exenteration in 2 cases. Common and/or external iliac vessels were resected and transplantations of artificial vessel were carried in 5 cases. Internal iliac arteries were ligated in 10 cases. The mean blood lose was 2 385 ml in our series and the largest was 15 000 ml. The complete resection rate of tumor was 81% for 84 operations and the largest resected tumor was 30 cm x 30 cm x 25 cm. There was no hospitalized death, and postoperative complication rate was 7% (6/84) in our series. Only 1 death were seen during the mean period of postoperative follow-up of 54 months, 22 operations were carried for 21 cases of recurrence, including 7 operations for 7 recurrences in a case within 12 years. CONCLUSIONS: Making adequate abdominal or/and buttock incisions, exenterations of involved pelvic organs and structures, total pelvic exenteration if necessary, appropriate management of iliac vessels, planned re-operation for one tumor, and re-operation for recurrences are important methods for the treatment of extraperitoneal pelvic neoplasms.

Adolescent↗
PubMed2005

Pruritic urticarial papules and plaques of pregnancy presenting in the postpartum period: a case report.

BACKGROUND: Pruritic urticarial papules and plaques of pregnancy (PUPPP), also known as polymorphic eruption of pregnancy, is the most common dermatosis of pregnancy. It usually evolves in the third trimester and resolves rapidly postpartum. CASE: A 25-year-old woman complained of an intensely pruritic rash for 2 days. The rash began 10 days postpartum. It began on her abdomen and spread to her buttocks, legs and upper arms. On examination, erythematous papules and urticarial plaques were present in the striae of the abdomen and buttocks and involved the legs, arms and back. No excoriations, vesicles or pustules were present, and there was sparing of the face, palms and soles. The patient was treated with fexofenadine, hydroxyzine, oatmeal baths and cool compresses. Follow-up 2 days later revealed a worsening rash and persistence of severe pruritus. At that time the patient was placed on prednisone, which led to relief of her symptoms and clearing of the rash. DISCUSSION: PUPPP is reported to develop in 0.5% of pregnancies. MEDLINE searches of the literature from 1966 to 2003 using the keywords pruritic urticarial papules and plaques of pregnancy or polymorphic eruption of pregnancy and postpartum revealed only 2 other cases of PUPPP developing in the postpartum period. Although the clinical presentation of this patient was typical of that of PUPPP, it demonstrates an unusual time course with its postpartum presentation. CONCLUSION: Dermatoses of pregnancy should remain in the differential diagnosis of rash even weeks after a woman delivers.

Adult↗
PubMed1992

Cyclophosphamide-induced neutropenia: effect on postischemic skin-flap survival.

In a blinded study, 24 pigs were randomized to a 5-day preoperative treatment regimen of cyclophosphamide (n = 12) or placebo (n = 12). At operation, buttock cutaneous and latissimus dorsi myocutaneous flaps were created and then subjected to 6 hours of global ischemia. After 24 hours of reperfusion, flap skin and muscle survivals were determined. All cyclophosphamide-treated animals were rendered neutropenic (less than 500 neutrophils/mm3 of peripheral blood). The results show that neutropenia had no effect on postischemic buttock cutaneous flap survival. In contrast, cyclophosphamide-induced neutropenia demonstrated a significant protective effect on postischemic latissimus dorsi myocutaneous flap survival. This study further implicates the neutrophil as a significant factor in the mediation of ischemia/reperfusion injury of myocutaneous flaps.

Analysis of Variance↗
PubMedDate not supplied

Desmoplastic hairless hypopigmented nevus (DHHN). A distinct variant of giant melanocytic nevus.

Desmoplastic hairless hypopigmented nevus (DHHN) is the name Ruiz-Maldonado et al. gave to a new variant of giant congenital melanocytic nevus characterized clinically by a hard ligneous consistency, absence of hair and progressive loss of pigment. Histologically, dermal fibrosis consistent with desmoplasia is a predominant feature. We describe a 6-year-old boy with a hard hairless pigmented congenital nevus involving the lumbosacral area, buttocks, perineum and scrotum. During the first years of life, the nevus showed a progressive reduction in colour, size and consistency. These changes continued until the age of four when a well-demarcated tumour appeared, within the nevus, on the right buttock. Resection of this outgrowth was performed. Histologically, nevus cells of normal appearance between thick collagen bundles were present. Immunostaining revealed S100 +, Vim +, HMB45--results. The nevus has continued to involute to date. An immune response against the melanocytes of the nevus may explain this type of evolution.

Child↗
PubMed2005

Non-pigmented fixed drug eruption induced by eprazinone hydrochloride.

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.

Aged↗
PubMed2006

[Morel-Lavallee syndrome after crush injury].

Closed internal degloving is a significant soft tissue injury associated with pelvic trauma in which the subcutaneous tissue is torn away from the underlying fascia, creating a cavity filled with hematoma and liquefied fat. It commonly occurs over the greater trochanter, but may also occur in the flank, buttock and lumbodorsal region, and it is known as a Morel-Lavallee lesion. The diagnosis of closed degloving injuries is based on physical and ultrasonographic examinations. The presence of a soft fluctuant area is the hallmark physical finding. Decreased cutaneous sensation is often associated with the skin over the area of degloving. Local contusion or other signs of injuries such as tire marks may also be present. In two separate cases, a 26-year-old woman and a 67-year-old man were injured in low velocity automobile accidents. During hospitalization, subcutaneous swellings were diagnosed as internal degloving injuries, and were drained several times by a plastic surgeon. A follow-up one year later revealed that the woman still suffered from swelling in the buttocks and thigh, though liposuction was successfully conducted; the man recovered completely from his injury after the conservative treatment. In most cases of degloving injuries, there is bruising of the skin or superficial hematoma, which resorbs spontaneously. However, in some cases, injury to the subcutaneous fatty tissue can result in the formation of a pseudocyst due to lymphatic extravasation. When hematoma or fluid collection does occur, puncture drainage and pressure therapy is usually considered to be sufficient treatment. Otherwise, surgical intervention must be proposed.

Accidents↗
PubMed1992

Conservative management of piriformis syndrome.

Piriformis syndrome is a questionable clinical entity that has been cited as a cause of buttock pain and sciatica. The intimate relationship between the piriformis and the sciatic nerve has been suspected as being the source of the signs and symptoms that often appear following minor trauma to the pelvic or buttock region. Muscle function is an important consideration in the evaluation and treatment of the athlete with suspected piriformis syndrome. The action of the piriformis muscle on the hip varies as the hip moves from a neutral to a flexed position. While in a flexed position, the piriformis internally rotates and abducts the hip; however, in a neutral position, the piriformis acts as an external rotator of the hip. A comprehensive evaluation provides the information necessary to design a treatment plan specific to the involved structures, while meeting the functional needs of the individual athlete. This paper describes the anatomy, pathomechanics, physical examination, and treatment options relevant to the piriformis syndrome. Treatment protocols stressing exercises that promote strength, flexibility, and functional activities are believed to be essential in restoring the athlete's ability to return to pain-free competition.

Journal Article↗
PubMed2006

A 47-year-old man with eruptions on his trunk.

A 47-year-old white male came to the hospital emergency department complaining of chest pain. At admission, it was noted that the patient had numerous lesions on his buttocks, abdomen, back, and all extremities. These lesions had been there for approximately 5 months--they developed after he discontinued his cholesterol medication due to lapsed insurance coverage. He had a similar eruption when he went off cholesterol medication on another occasion. The patient's medical history included type 2 diabetes mellitus, hypertension, coronary artery disease, and hyperlipidemia. He has had multiple heart catheterizations with stent placement, most recently 2 years ago. His mother also had diabetes mellitus, and she died at age 58 from a myocardial infarction. On examination, his lesions were painless and nonpruritic. He had numerous yellow papules on his buttocks, abdomen, back, and upper and lower extremities. He had no lesions on his face. The rest of the physical exam showed no abnormal results. What is your diagnosis? What laboratory tests should be done to help make the diagnosis?

Diagnosis, Differential↗
PubMed1991

Melanocytic naevi, melanoma and sun exposure.

The naevus profile was examined in 379 randomly selected Swedes (30-50 years) and in 121 melanoma patients in the same age-range selected from the Regional Cancer Register. The total body count of common naevi (CN) greater than or equal to 2 mm in the population was high (mean 67, range 1-300). Even so, the melanoma patients had almost twice as many CN as the controls (mean 113, range 13-347). The prevalence of clinical dysplastic naevi (DN) was 18% in the population and 56% in the patients. The corresponding figures for histologically diagnosed DN were 8% and 40% respectively. Subjects with dysplastic naevi had a significantly larger number of CN than those without DN. Subjects with a sun-sensitive skin, greater than or equal to 150 naevi and presence of DN had a 50 times higher melanoma risk than those without these characteristics. For identifying subjects at risk of developing cutaneous malignant melanoma (CMM), clinically diagnosed DN was as good a discriminator as histologically diagnosed DN. The numbers of naevi in different skin areas were tested for their power in predicting the total body naevus count. The strongest correlations were found between total counts and counts on the anterior surface of the thighs and the lateral aspect of the arms. Counts from either of these areas will provide a practical and satisfactory estimate of the total number of naevi. To study the possible link between sun exposure, naevus formation and melanoma development, the distribution of CN, DN and CMM over the body surface was studied in the 121 melanoma patients and in 310 consecutive controls. The number of naevi was four times as high in a sun-exposed area on the lower back compared with in an adjacent sun-protected area on the buttocks, indicating that sunlight plays a role in naevus development. Both CN and CMM were found to have a general distribution pattern over the body surface consistent with the idea that sun exposure is important for their formation. The number of CN and CMM per unit body surface area was significantly higher in intermittently sun-exposed than in rarely or chronically exposed skin. The distribution pattern of DN was quite different from that of CN, with few DN on the sun-exposed upper chest and face and many DN in protected areas such as the buttocks and lower abdomen, indicating that DN may develop independently of sun exposure.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMedDate not supplied

The sensitivity and specificity of seven lumbo-pelvic orthopedic tests and the arm-fossa test.

Twenty-nine lumbosacral asymptomatic and 39 symptomatic patients who attended a chiropractic clinic were examined by a practitioner who was blinded to their symptoms. Seven lumbosacral orthopedic tests, along with the arm-fossa test were scrutinized for sensitivity, specificity and diagnostic competency values. Only the arm-fossa test and heel-buttock tests had a significantly higher percentage of positive findings in symptomatic than asymptomatic cases. These same tests were the only ones which could be considered to have an acceptable diagnostic value, when both the sensitivity and specificity were taken into consideration by Youden's index. The number of positive tests was unrelated to the presence of lumbosacral symptoms. Orthopedic tests which appeared to strain several adjacent anatomical structures were most commonly positive. No particular combination of tests could predict if the patient was symptomatic or asymptomatic. Only the heel-buttock test had some predictive value. It appears that these tests were of limited value in differentiating between the symptomatic and asymptomatic subjects who attended the study clinic.

Chiropractic↗
PubMed1990

[Clinical aspects of persistent sciatic artery. Description of 2 cases with angiographic demonstration].

We report 2 additional cases with angiographic demonstration. The embryology and radiological findings are discussed. This anomaly should be kept in mind in the clinical assessment of a patient with unexplained sciatic or buttock pain or a pulsatile buttock mass with or without symptoms of peripheral vascular disease. It also represents a potential hazard during renal transplant surgery.

Angiography↗
PubMed1989

Antibiotic prophylaxis for surgery in morbidly obese patients.

The rate of wound infections in morbidly obese patients who underwent gastroplasty surgery at our institution was 16.5% compared with a rate of 2.5% in normal-weight patients who underwent clean-contaminated surgery. Both groups received 1 gm of cefazolin intramuscularly before surgery was performed. We hypothesized that this regimen of prophylaxis did not provide adequate tissue levels in the morbidly obese. Morbidly obese patients who were undergoing gastroplasty were randomly selected to receive 1 gm cefazolin in the buttock fat, buttock muscle, or by intravenous injection. A fourth group of morbidly obese patients received 2 gm of cefazolin intravenously. Normal-weight patients who were undergoing upper abdominal surgery received 1 gm of cefazolin intravenously. At incision and closure, both blood and tissue levels of cefazolin were significantly (p less than 0.001) lower for all morbidly obese patients who received 1 gm cefazolin when compared with the blood and tissue levels of the drug found in normal-weight patients. The cefazolin levels obtained were below the minimal inhibitory concentrations of greater than 2 micrograms/ml for gram-positive cocci and of greater than 4 micrograms/ml for gram-negative rods. Only when the morbidly obese patient received 2 gm cefazolin were both the serum and adipose tissue levels adequate. For a 4-month period, all morbidly obese patients received 2 gm cefazolin prophylaxis, and the wound infection rate dropped to 5.6% compared with the previous rate of 16.5% (p less than 0.03). We conclude that antibiotic prophylaxis must be specially tailored to the needs of these obese patients.

Adipose Tissue↗
PubMed1988

Cutaneous malakoplakia. Report of a case.

A case of cutaneous malakoplakia in a 44-year-old women under immunosuppressive therapy after renal transplantation for nephrosclerosis is reported. A nodular lesion with inflammatory signs appeared on her right buttock. Histopathology showed a dermal infiltrate with histiocytes containing Michaelis-Gutmann bodies. Electron microscopy showed Michaelis-Gutmann bodies with concentric laminar structure ('target' appearance). Tissue culture revealed Escherichia coli growth. Lesions recurred on surrounding skin and left buttock after excision. Clofazimine treatment resulted in total remission.

Adult↗
PubMed1988

Hip pain.

Hip pain can be categorized as either anterior groin pain, lateral trochanteric pain, or posterior buttock pain. Reproduction of the pain during passive and active range of motion of the hip against resistance provides the most accurate localization. The very important intra-articular diagnoses with poorer prognoses and more urgent requirement for treatment, such as a septic joint and hip fracture, often present with anterior groin pain. Trochanteric bursitis is the most common cause of lateral pain next to osteoarthritis. Buttock pain occasionally represents a radiation from lumbar disc or facet joint disease but more commonly is muscular in origin. Management of osteoarthritis of the hip successively challenges the primary care physician to provide effective patient education regarding NSAIDs, assistive devices for walking, and optimal timing of total hip arthroplasty.

Diagnosis, Differential↗