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At least 811 records · Page 45Linked to original sources
PubMed2003

Treatment of long-standing extensive perianal hidradenitis suppurativa using double rotation plasty, V-Y plasty and free grafts.

BACKGROUND: Perianal hidradenitis suppurativa is a chronic recurrent inflammatory, suppurating, and fistulizing disease of apocrine glands, adjacent anal canal skin, and soft tissues. The standard treatment used for extensive cases is a staged surgical procedure allowing the wound to heal by secondary intention or the delayed use of skin grafts. CASE PRESENTATION: A long-standing case, disabling for the patient, with extensive involvement of the buttock region, treated in one stage, which for reconstruction required the use of sliding plasties and free skin grafts, is reported. RESULTS: The outcome was satisfactory. Primary closure after wide excision using plastic-surgery techniques may help us resolve complex situations and obtain good results and a rapid recovery. CONCLUSION: The method of closure with a combination of skin flaps and skin graft in one stage can be considered a valid surgical option for a group of patients with extensive perianal hidradenitis.

Buttocks↗
PubMed2001

Glomangiopericytoma causing oncogenic osteomalacia. A case report with immunohistochemical analysis.

A 47-year-old woman suffered from gait disturbance due to back pain and muscle weakness. Laboratory data showed serum hypophosphatemia, elevated alkaline phosphatase, and a normal level of ionized calcium. Radiological examinations revealed multiple pathologic fractures in the ribs and pubic rami. She had had no episode of familial or any other notable disorder, and so she was initially treated with medication for adult-onset osteomalacia. However, 19 years later (when she was 66 years old), she noticed a soft-tissue tumor in her buttock. The tumor was excised. The histological features were those of glomangiopericytoma characterized by both glomus tumor-like and hemangiopericytoma-like structures. After removal of the tumor, her symptoms disappeared immediately. Laboratory data normalized 8 months later. To our knowledge, this is the first report of oncogenic osteomalacia caused by glomangiopericytoma.

Aged↗
PubMed2005

Endovascular stent graft repair of a persistent sciatic artery aneurysm.

An 88-year-old female presented with a large, painful, pulsatile buttock mass. Computed tomographic angiogram with three-dimensional reconstruction and lower extremity arteriogram revealed a 5 cm sciatic artery aneurysm. We report a case of successful repair of a sciatic artery aneurysm with endovascular stent graft.

Aged↗
PubMed1975

Orthodontics and dentistry for the hemophilic patient.

In this presentation we have contrasted the normal blood-clotting mechanism with the failure to form blood clots in hemophiliacs due to the absence of protein factors necessary for conversion of prothrombin to thrombin. The statistics, hereditary basis, and long-term disabling consequences of hemophilia to the severely ffected patient are described. The systemic means of minimizing severe joint disabilities and serious internal bleeding hazards by employing concentrates of antihemophilic factors to reverse the bleeding defects are discussed. Availability and advantages of the types of concentrates are explained. The fatalistic attitude of hemophiliacs toward hepatitis is discussed, along with admonitions to avoid the use of aspirin, alcohol, and buttock injections. Alternative medications for pain are recommended; and injection sites for pediatric patients are suggested. The details of simplified oral surgical management of hemophilic patients without hospitalization are described, including local anesthetic injection technique, method of performing extractions, general anesthesia techniques when indicated, materials for packing of extraction sockets, regimen and precautions in use of Amicar administration for clot maintenance, postoperative diet, and postsurgical activity guidelines. Also noted is the self-administration of intravenous concentrate infusions at home in the event of hemorrhagin, so that bleeding is on the way to bein controlled even before the patient reaches the hospital. We avoided orthodontic treatment of hemophilic patients in the past; however, recently developed bracket-fixation techniques and auxiliary aids; along with an enlightened understanding that gingival bleeding is ot to be feared, have changed our attitude, and we now treat hemophilic patients in much the same manner as otherwise normal orthodontic patients...

Anesthesia, Dental↗
PubMed1983

Variants of hemipelvectomy.

Anterior flap hemipelvectomy is used for large, fixed tumors in the area of the buttock. The anterior flap consists of skin, subcutaneous fat, fascia lata, and the mobilized femoral vessels attached to the flap. It is accomplished by dividing the profunda femoris vessels. In routine posterior flap hemipelvectomy, a long flap can be constructed, if necessary, reaching to the level of the umbilicus. The viability of the posterior flap is assured by leaving the gluteus maximus muscle attached to it.

Amputation, Surgical↗
PubMed1993

Posttraumatic osseous tunnel formation causing sciatic nerve entrapment.

Sciatic nerve entrapment in an osseous tunnel has only been reported twice previously. We describe a 19-year-old man evaluated for left lower limb pain and weakness that began one and one half years after sustaining stab wounds to the left buttock and midline back near the T11 vertebrae. The patient had sciatica and demonstrated motor and sensory deficits on physical exam. Electrodiagnostic studies demonstrated a localized injury to the sciatic nerve in the proximal thigh. Radiographic studies of the left pelvis and femur showed an 8 to 10cm linear opacification overshadowing the left femoral head and anatomic neck. An arteriogram of the left leg demonstrated a 3 x 4cm lobulated aneurysm arising from the distal portion of the inferior gluteal artery. Surgical exploration revealed the sciatic nerve to be encased in cylindrical bone. The ectopic bone was removed and the sciatic nerve released. The patient had gradual improvement with a nearly complete neurological recovery by three months after surgery.

Adult↗
PubMed1980

Ectopic xanthomas in familial (type II) hypercholesterolemia.

Xanthomas ordinarily occur in the skin and tendons of patients with severe hyperlipidemia. These xanthomas include xanthelasma, tuberous xanthoma, tendon xanthoma and eruptive xanthoma. Two patients with hypercholesterolemia are now described with xanthomas found in other locations, one deep in the mediastinum and one in the muscles of the buttock. These masses simulated the occurrence of neoplastic tumors but on pathological and chemical examination proved to be typical xanthomata. Ectopic xanthomas should be considered in the differential diagnosis of masses in patients with familial hypercholesterolemia.

Aged↗
PubMed1990

Regional changes in adrenergic receptor status during hypocaloric intake do not predict changes in adipocyte size or body shape.

The anatomic distribution of fat is related to the risk for obesity-associated morbidity. Among individuals with equal degrees of relative adiposity, those with an upper-body preponderance of fat distribution (android) have higher rates of diabetes, stroke, ischemic heart disease, and early death than those with preferential deposition of adipose tissue in lower portions of the body (hips, thighs, buttocks; gynecoid. There are well-documented anatomic site-related differences in the relative activities of the adrenergic receptors (beta 1----lipolysis; alpha 2----antilipolysis) that control lipolysis. We assessed modifications of the status of alpha 2- and beta 1-adrenergic receptor and subreceptor function in small fragments of adipose tissue obtained by needle biopsy from the gluteal and abdominal subcutaneous regions of five android, seven gynecoid, and six uniformly obese women during a period of weight maintenance (4 weeks) (T1), and after 15% weight loss on an 840 kcal/d diet (T2). Measurements of body shape and adipocyte size were made and related to changes in the metabolism of these adipocytes. The waist-to-hip ratio (WHR) was used to define these three types of regional distribution of fat in these obese subjects: android = WHR greater than 0.86; gynecoid = WHR less than or equal to 0.76; uniform = WHR greater than 0.76 less than or equal to 0.86. WHR was not significantly altered by weight loss in any of the three groups. Although significant effects of time and/or anatomic site on in vitro responses to isoproterenol, norepinephrine, clonidine, forskolin, and dibutyryl cAMP were found, these did not correlate with intra-individual changes in anthropometry or adipocyte size.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1990

Clear cell carcinoma arising in extraovarian endometriosis: report of three cases and review of the literature.

The literature on malignancy arising in extraovarian endometriosis comprises only three cases of clear cell carcinoma. We wish to report the clinical features and pathologic findings of an additional three cases. The first concerns a 39-year-old oriental pregnant woman who presented with a large intraluminal obstructing lesion of the sigmoid colon, the second case deals with an abdominal wall mass that appeared in a cesarean section scar of a 45-year-old black woman, and the third case describes an ulcerating lesion of the perineum and the buttock in a 43-year-old white woman with a long history of endometriosis in an episiotomy scar. Our observations support the notion that clear cell carcinoma arising in extraovarian endometriosis behaves differently from its counterpart in ovarian endometriosis, but more in line with clear cell carcinoma of the endometrium.

Abdominal Neoplasms↗
PubMed1987

Merkel cell carcinoma.

Merkel cell carcinoma is a rare malignant neoplasm of the skin which is locally invasive and frequently metastasizes to lymph nodes, liver, lungs, bone, and brain. Computed tomographic and pathologic findings in an elderly woman with Merkel cell carcinoma of the buttock and regional nodal metastasis are reported. The presence of calcitonin and neuron-specific enolase within the tumor supports the theory that Merkel cell carcinoma is a neuroendocrine tumor derived from the APUD (amine precursor uptake and decarboxylase) system.

Aged↗
PubMedDate not supplied

P15 in tibial nerve SEPs as an example of the junctional potential.

Tibial nerve stimulation at the ankle elicited a stationary, dipolar potential P15/N15 over the buttock with a reference electrode at the contralateral greater trochanter (GTc). P15 was distributed in the rostral and contralateral region and N15 in the caudal and ipsilateral region. The derivation from the contralateral iliac crest to the ipsilateral greater trochanter (ICc-GTi) registered a large P15 (= P15-N15) potential which was well free from artifacts. The Cz'-contralateral knee lead, which had been employed in previous studies, registered a smaller P15 of poor quality. Sequential bipolar recording along the course of the sciatic nerve indicated that P15 was generated around the greater sciatic foramen. Comparison with a simulation study suggested that P15 is a junctional potential which is generated when the sciatic nerve enters the bone at the greater sciatic foramen. P15 is expected to be a useful tool to evaluate the proximal segment of the tibial nerve.

Adult↗
PubMed1991

Giant neuroendocrine (Merkel cell) carcinoma of the skin.

An 82-year-old woman had a dark red to purple tumor on the left buttock that had gradually enlarged during the last 5 years. Although routine histologic examination was not sufficient for diagnosis, neuroendocrine carcinoma was diagnosed by immunohistochemical and ultrastructural studies. Immunohistochemical-positive reactions to neurofilament, cytokeratin, neuron-specific enolase, and epithelial membrane antigen were noted. Electron microscopically, membrane-bound, dense core granules that yielded a positive uranaffin reaction and intermediate filaments in the perinuclear area were observed in the cytoplasm of most tumor cells. Desmosome-like structure between them was also found. Approximately 6 months after local excision, metastatic lesions developed in the regional lymph nodes and liver.

Actins↗
PubMedDate not supplied

Large epidermal cyst involving the ischiorectal fossa: MR demonstration.

A large subcutaneous mass was noted in the buttock of a 79-year-old man. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a thin-walled cystic mass that involved the ischiorectal fossa. The content appeared hyperintense on T1-weighted images. T2-weighted images demonstrated a considerable amount of debris. At surgery an epidermal cyst with markedly keratinized squamous epithelium was found. It contained much keratin and cholesterin.

Aged↗
PubMed1996

Preservation of the pelvic circulation during infrarenal aortic surgery.

Paraplegia, ischemia of the colon, and gluteal necrosis are uncommon but devastating sequelae of surgery of the infrarenal aorta. These complications are ischemic in nature, secondary to the following technical maneuvers, individually or in combination: bilateral occlusion of the hypogastric arteries; division of a patent inferior mesenteric artery; or proximal end-to-end aortic to common femoral artery bypass grafting accompanied by stenosis of the external iliac arteries. The etiology of paraplegia after infrarenal aortic surgery is of particular interest since it now appears that it is more likely due to interruption of flow to lumbosacral branches of the hypogastric arteries supplying the conus of the spinal cord and/or to division of a low-lying 'conus medullaris artery' rather than to occlusion of the higher-lying great radicularis artery of Adamkiewicz. Knowledge of the pelvic circulation to the colon, buttocks, and terminal spinal cord allows the surgeon prophylactically to avoid or reconstruct critical branches during operations on the infrarenal aorta. While rare, severe complications cannot be completely eliminated; hopefully their incidence can be reduced by an understanding of their etiology.

Anastomosis, Surgical↗
PubMed1995

The detection of cyclobutane thymine dimers, (6-4) photolesions and the Dewar photoisomers in sections of UV-irradiated human skin using specific antibodies, and the demonstration of depth penetration effects.

Ultraviolet irradiation of skin induces various DNA photolesions. Here we demonstrate that irradiation of human buttock skin with 300 nm UVR in situ induces thymine dimers and 6-4 photoproducts. Irradiation with 260 nm immediately followed by UVA (320 nm) induces the Dewar photoisomers of the 6-4 lesions. All three lesions can be detected in methanol-fixed paraffin sections using specific monoclonal antibodies. The sections have been analysed in an automated image analysis system (Discovery) and the level of immuno-DAB-peroxidase measured in individual epidermal cell nuclei as absorption at 460 nm (integrated optical density). The staining patterns with the antibodies showed no detectable change with epidermal depth by eye after 300 nm irradiation, however, the machine detected a fall off with depth of about 2.5% per cell layer. Following irradiation with a shorter wavelength (260 nm) there was a rapid fall off in staining with depth easily detectable by eye and machine (39% per cell layer).

Antibodies, Monoclonal↗
PubMed2006

Ultrasound-guided piriformis injection: technique description and verification.

Piriformis injections are commonly used in the evaluation and treatment of patients presenting with buttock pain syndromes. Because of its small size, deep location, and relation to adjacent neurovascular structures, the piriformis is traditionally injected by using electromyographic, fluoroscopic, computed tomographic, or magnetic resonance imaging guidance. This report describes and verifies a technique for performing ultrasound-guided piriformis injections. Ultrasound offers several advantages over traditional imaging approaches, including accessibility, compact size, lack of ionizing radiation exposure, and direct visualization of neurovascular structures. With appropriate training and experience, interested physiatrists can consider implementing ultrasound-guided piriformis injections into their clinical practices.

Buttocks↗
PubMed2004

Maximizing aesthetics in lateral-tension abdominoplasty and body lifts.

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

Abdominal Wall↗