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At least 883 records · Page 49Linked to original sources
PubMed1997

Dietary modulation of omega-3/omega-6 polyunsaturated fatty acid ratios in patients with breast cancer.

BACKGROUND: Polyunsaturated fatty acids of the omega-6 (omega-6) class, as found in corn and safflower oils, can act as precursors for intermediates involved in the growth of mammary tumors when fed to animals, whereas polyunsaturated fatty acids of the omega-3 (omega-3) class, as found in fish oil, can inhibit these effects. The effects of dietary intervention on the ratios of these fatty acids in breast and other adipose tissues have not previously been prospectively studied. PURPOSE: The present investigation was conducted to study the impact on the ratio of omega-3 and omega-6 polyunsaturated fatty acid in plasma and in adipose tissue of the breast and buttocks when women with breast cancer consume a low-fat diet and fish oil supplements. METHODS: Twenty-five women with high-risk localized breast cancer were enrolled in a dietary intervention program that required them to eat a low-fat diet and take a daily fish oil supplement throughout a 3-month period. Breast and gluteal fat biopsy specimens were obtained from each woman before and after dietary intervention. The fatty acid compositions of specimens of plasma, breast fat, and gluteal fat were determined by gas-liquid chromatography. Statistical analysis involved use of a two-sided paired t test. RESULTS: After dietary intervention, a reduction in the level of total omega-6 polyunsaturated fatty acids in the plasma was observed (P<.0003); moreover, total omega-3 polyunsaturated fatty acids increased approximately three-fold (P<.0001) and the omega-3/omega-6 polyunsaturated fatty acids ratio increased approximately fourfold (i.e., mean values increased from 0.09 to 0.41; P = .0001). An increase in total omega-3 polyunsaturated fatty acids in breast adipose tissue was observed following dietary intervention (P = .04); the omega-3/omega-6 polyunsaturated fatty acid ratio increased from a mean value of 0.05 to 0.07 (P = .0001). An increase in total omega-3 polyunsaturated fatty acids was observed in gluteal adipose tissue following the intervention (P = .05); however, the ratio of omega-3 to omega-6 polyunsaturated fatty acids (mean ratio values of 0.036-0.045; P = .06) was unchanged. CONCLUSION: Short-term dietary intervention can lead to statistically significant increases in omega-3/omega-6 polyunsaturated fatty acid ratios in plasma and breast adipose tissue. Breast adipose tissue changed more rapidly than gluteal adipose tissue in response to the dietary modification tested in this study. Therefore, gluteal adipose tissue may not be a useful surrogate to study the effect of diet on breast adipose tissue.

Adipose Tissue↗
PubMed1985

Neuroectodermal neoplasms arising in congenital nevi.

Congenital giant nevi of neuroectodermal origin are composed predominantly of melanocytes and occasional neural elements. Neoplasms arising in such nevi may be morphologically heterogeneous with variable clinical behavior. We report the case of a female infant born with multiple pigmented nevi, including a giant hairy nevus of bathing trunk distribution in which arose a large pedunculated mass involving the sacral region, buttocks, perineum, and left thigh. Within this neoplasm, mixtures of neural crest-derived tissues having both melanocytic (nevus) cell and neural supportive (neuroid of Schwannian) cell differentiation were identified. The neural differentiation, which was seen in the dermis and subcutaneous tissue, had a neurofibromatous appearance and demonstrated multiple pseudomeissnerian corpuscles. In addition, at 16 months of age the child developed a malignant melanoma in the flank region of this congenital giant nevus. The morphologic pluripotentiality of the primitive neural crest derivatives in congenital nevi has only recently been elucidated. These lesions should be regarded as neuroectodermal neoplasms and subclassified according to their differentiating histologic characteristics because prognosis and management are influenced by morphologic determinants.

Buttocks↗
PubMed1988

Small pustules in Kawasaki disease. A clinicopathological study of four patients.

We report the clinical and histological changes of small pustules that developed in four patients with Kawasaki disease (KD). The small pustules were superimposed on the urticarial erythema and symmetrically arranged on the genital area, buttocks, axillae, and extensor surface of the extremities. These lesions showed spongiform pustules histologically and were different from miliarial pustules. Reviewing previous reports, the clinical and histological characteristics of pustules in KD are summarized herein. This study indicates that small pustules underwent the consecutive changes related to the generalized polymorphous exanthem in KD.

Adult↗
PubMed1994

Condyloma acuminatum associated with syringocystadenoma papilliferum.

A 70-year-old man presented with a keratotic lesion of the right buttock. Histologic examination revealed an endophytic cystic and papillary lesion of the dermis. The papillae were lined by two layers of cuboidal epithelial cells with a dense plasmacytic infiltrate of the stroma, consistent with syringocystadenoma papilliferum (SCAP). The overlying epidermis showed acanthosis, papillomatosis, and hyperkeratosis. There were multiple foci of prominent koilocytotic atypia. In situ DNA probes for HPV type 6/11 were positive in many epidermal nuclei. The concurrent occurrence of SCAP and CA may be coincidental; however, the occurrence of CA may be related to the environment at the surface of the SCAP. Syringocystadenoma papilliferum often occurs in association with nevus sebaceus (NS), but it has also been reported from most body sites. When it is not seen in association with NS, the epidermis overlying SCAP may be hyperkeratotic or verrucous. The verrucous changes in our case had features of condyloma acuminatum (CA), which were confirmed by in situ DNA probes.

Adenoma, Sweat Gland↗
PubMed1996

Dabska tumor developing within a preexisting vascular malformation.

Malignant endovascular papillary angioendothelioma, first described by Dabska in 1969, is a rare vascular tumor that primarily affects children and is characterized by papillary proliferations of endothelial cells into vessel lumens. We report a case of this rare neoplasm in a boy with angiomatosis who developed Kasabach-Merritt syndrome. The tumor evolved as an ulcerated lesion superficially within a previous vascular malformation on his buttock. A review of the literature is presented.

Adolescent↗
PubMed1984

Subcutaneous pseudosarcomatous polyvinylpyrrolidone granuloma.

A 77-year-old man developed an induration of the buttock following repeated injections of an antihypertensive remedy containing polyvinylpyrrolidone (PVP). The excised tumor had a cellular, pseudosarcomatous appearance with abundant extracellular material, and resembled a myxoid liposarcoma. All of the staining reactions and infra-red spectrophotometry of the deposition indicated the presence of PVP. The awareness of such a cellular PVP granuloma is important for surgical pathologists so as to avoid the diagnosis of sarcoma.

Aged↗
PubMed1990

Cytoskeletal heterogeneity of an epithelioid sarcoma with expression of vimentin, cytokeratins, and neurofilaments.

We studied an unusual sarcoma with morphologic features diagnostic of epithelioid sarcoma by conventional light microscopy, transmission electron microscopy, and immunohistochemistry. The primary tumor, which was located in the deep soft tissues of the buttock of a 32-year-old woman, and its metastases to lymph nodes, liver, and lung were available for investigation. The histomorphological and ultrastructural appearance of the primary tumor and its metastatic deposits were typical of epithelioid sarcoma. Immunohistochemistry revealed a strong and uniform reactivity for vimentin in both the primary tumor and its metastases. In contrast, a marked cytoskeletal heterogeneity became evident for cytokeratins and neurofilaments, which were observed exclusively in lymph node metastasis. To our knowledge, the observation of neurofilaments in epithelioid sarcoma has not previously been reported.

Adult↗
PubMed1995

Solitary fibrous tumors of soft tissue. A clinicopathologic and immunohistochemical study of 12 cases.

We describe 12 cases of primary soft tissue neoplasms that showed the histologic and immunohistochemical features of solitary fibrous tumors of serosal surfaces (solitary fibrous mesothelioma, submesothelial fibroma). Nine patients were women and three were men whose ages ranged from 28 to 83 years. Seven lesions were located in the head and neck region, and the remainder were located in the back, buttock, perineum, and groin. The lesions measured from 1 to 6 cm in greatest diameter and presented grossly as well-circumscribed, unencapsulated, soft to rubbery tissue masses. Histologically they were characterized by a proliferation of spindle cells exhibiting a variety of growth patterns, including storiform, herringbone, neural with wavy nuclei, and hemangiopericytic admixed with areas of sclerosis. In two cases the lesions showed areas of increased cellularity with occasionally scattered mitotic figures. Three cases were located adjacent to a major salivary gland; in one, entrapment of normal salivary gland acini and ducts could be observed at the edges of the lesion. Immunohistochemical studies showed positive staining of the spindle cells with CD34 (anti-HPCA-1) and vimentin antibodies and negative staining with keratin, actin, desmin, S-100 protein, collagen type IV, and factor VIII related antigen. Follow-up from 6 months to 12 years has shown no evidence of recurrence or metastasis in any of our patients. Solitary fibrous tumors appear to represent ubiquitous mesenchymal neoplasms that may not be necessarily restricted to serosal surfaces. Identification of these lesions is of importance to avoid misdiagnosis with other more aggressive conditions in soft tissue locations.

Adult↗
PubMed2003

Piriformis syndrome: anatomic considerations, a new injection technique, and a review of the literature.

BACKGROUND: Piriformis syndrome can be caused by anatomic abnormalities. The treatments of piriformis syndrome include the injection of steroid into the piriformis muscle and near the area of the sciatic nerve. These techniques use either fluoroscopy and muscle electromyography to identify the piriformis muscle or a nerve stimulator to stimulate the sciatic nerve. METHODS: The authors performed a cadaver study and noted anatomic variations of the piriformis muscle and sciatic nerve. To standardize their technique of injection, they also noted the distance from the lower border of the sacroiliac joint (SIJ) to the sciatic nerve. They retrospectively reviewed the charts of 19 patients who had received piriformis muscle injections, noting the site of needle insertion in terms of the distance from the lower border of the SIJ and the depth of needle insertion at which the motor response of the foot was elicited. The authors tabulated the response of the patients to the injection, any associated diagnoses, and previous treatments that these patients had before the injection. Finally, they reviewed the literature on piriformis syndrome, a rare cause of buttock pain and sciatica. RESULTS: In the cadavers, the distance from the lower border of the SIJ to the sciatic nerve was 2.9 +/- 0.6 (1.8-3.7) cm laterally and 0.7 +/- 0.7 (0.0-2.5) cm caudally. In 65 specimens, the sciatic nerve passed anterior and inferior to the piriformis. In one specimen, the muscle was bipartite and the two components of the sciatic nerve were separate, with the tibial nerve passing below the piriformis and the peroneal nerve passing between the two components of the muscle. In the patients who received the injections, the site of needle insertion was 1.5 +/- 0.8 (0.4-3.0) cm lateral and 1.2 +/- 0.6 (0.5-2.0) cm caudal to the lower border of the SIJ as seen on fluoroscopy. The needle was inserted at a depth of 9.2 +/- 1.5 (7.5-13.0) cm to stimulate the sciatic nerve. Patients had comorbid etiologies including herniated disc, failed back surgery syndrome, spinal stenosis, facet syndrome, SIJ dysfunction, and complex regional pain syndrome. Sixteen of the 19 patients responded to the injection, their improvements ranged from a few hours to 3 months. CONCLUSIONS: Anatomic abnormalities causing piriformis syndrome are rare. The technique used in the current study was successful in injecting the medications near the area of the sciatic nerve and into the piriformis muscle.

Adult↗
PubMed1985

Surgical management of massive perianal hidradenitis suppurativa.

Hidradenitis suppurativa of the perineum and buttocks is a devastating disease often causing patients years of pain, discomfort, and eventual social isolation. The chronic form of the disease results from a lack of aggressive surgical intervention when the patient is first seen. It is characterized by a malodorous drainage from multiple sinus tracts encased in marked scarred and fibrotic tissue. In contrast to axillary involvement, the perianal form of hidradenitis suppurativa is associated with an increased frequency of anemia, fistulous communications with bowel and urinary tract, and the development of carcinomas. Several cases illustrating the debilitating nature of the disease and its optimal management are presented. This report illustrates that (1) a well-planned preoperative and postoperative bowel regimen can eliminate the need for a diverting colostomy, even in the most extensive forms of perianal disease, (2) radical excision is expedited and blood loss is minimized by the use of a Shaw hot knife (Oximetrix, Mountain View, CA), (3) the quilted application of meshed split-thickness skin grafts as a primary procedure provides rapid closure of the surgical defect and minimizes patient discomfort, and (4) aggressive surgical intervention in severe cases provides a chance for a rapid recovery from this crippling disease.

Adult↗
PubMed1991

Synchronous eruption of cotton-induced granulomas 45 years after exposure: report of an unusual case.

A 58-year-old woman developed multiple, recurrent abscesses and subcutaneous nodules over both buttocks during a 12-year period. Microbiological studies of surgical biopsy specimens were inconclusive for a specific infectious cause, but histochemical preparations on several separate occasions revealed an exuberant foreign body reaction to raw cotton fibers. Interestingly, the patient gave a detailed history of sliding down piles of cotton hulls during her childhood, some 45 years earlier. With a probable cause-and-effect relationship established, we postulate a dramatically delayed foreign body granulomatous reaction to cotton fibers.

Buttocks↗
PubMed1993

Use of tissue expanders in reconstruction after excision of multiple large silicone granulomas.

We present a case rare for its extensive nature with symptomatic silicone granulomas and for the various extensive reconstructive techniques using tissue expansion in several areas. Although the course of surgical rehabilitation was extensive and prolonged, it was initiated and tenaciously pursued by the woman and her husband who initially requested surgery only for relief of pain in the areas of the buttocks and groin. The eventual results achieved were gratifying to the woman.

Adult↗
PubMed1997

Circumferential torsoplasty.

The abdominal deformities remaining after massive weight loss of 30% or more body weight often are not satisfactorily corrected by standard abdominoplasty techniques. Redundant lateral flank and hip rolls may in fact be accentuated by the operation. Accordingly, a circumferential torso excision was designed by the senior author and utilized for 7 patients during the past two years. This technique dramatically reduces the lateral flank and posterior tissue rolls to improve the operative results. Contour improvement of the buttocks and lateral thighs is produced as well. We employ a four blade propeller pattern of fascial plication centered on the umbilicus which tightens the abdominal fascia in both vertical and horizontal dimensions. Details of patient selection, operative technique, post-operative management and results are presented. Complications have been minimal and satisfaction of both patients and surgeons significantly enhanced.

Abdominal Muscles↗
PubMed2002

Botulinum toxin type A use in piriformis muscle syndrome: a pilot study.

OBJECTIVE: This study was undertaken to test the hypothesis that intramuscular botulinum toxin type A decreases chronic pain attributed to piriformis muscle syndrome to a greater extent than a similar injection with vehicle (saline) alone. DESIGN: This double-blind, single group, crossover study was performed at an outpatient university clinic. Nine women with chronic buttock, hip, and lower limb pain without evidence of lumbar disk herniation or nerve root impingement on imaging studies participated in the study. The analgesic efficacy of a fluoroscopic/electromyographically guided unilateral intramuscular piriformis injection with 100 units botulinum toxin type A was compared with a similar injection of vehicle alone. Visual analog pain scales (VASs) were used to measure pain intensity, distress, spasm, and interference with activities. RESULTS: No differences in mean VASs were detected between groups at baseline or after injection with vehicle. However, decreases were observed between baseline and post-botulinum toxin type A injection mean VASs, but only in one of four categories (interference with activities). VASs from every time point (days) were also compared with the average baseline VASs. After injection with vehicle, decreases were detected, but only in one of the four categories (distress). In comparison, after injection with botulinum toxin type A, decreases were observed under all VAS categories. CONCLUSIONS: VAS data suggest that intramuscular piriformis injection with 100 units of botulinum toxin type A can reduce pain to a greater extent than similar injections with vehicle alone.

Activities of Daily Living↗
PubMed1996

Radioisotope bone scanning in chronic osseous sarcoidosis.

Sarcoidosis is rarely recognized as an osseous manifestations alone. Patients with osseous involvement usually have a chronic multivisceral form of the disease. The authors report a case of osseous sarcoidosis without other visceral involvement. A bone scan was requested to evaluate the extent of the bone involvement and explore buttocks pain.

Arthralgia↗
PubMed1975

Ipsilateral lower extremity flaps in children.

A technique utilizing an ipsilateral thigh or buttock flap in children is described. Its advantages are the ease with which the patients ambulate and the extremely good tolerance of this position, as well as the placement of the donor scar sufficiently high to enable it to be hidden under most clothing.

Buttocks↗
PubMed1977

Superior gluteal artery aneurysm.

Aneurysms of the gluteal arteries are an uncommon complication of trauma to the gluteal region. A case report is presented following a gunshot wound to the buttock in a 36-year-old female. Diagnosis and management are discussed, with a review of the recent surgical literature.

Adult↗
PubMed1997

Pseudoaneurysm of the superior gluteal arterial system: an unusual cause of pain after a pelvic fracture.

This case report describes a complication after treatment of a rotationally unstable pelvic fracture: a pseudoaneurysm of the superior gluteal arterial system. The patient sustained an anterior-posterior compression pelvic fracture that was stabilized with anterior symphyseal plating and percutaneous iliosacral screw insertion. The etiology of the pseudoaneurysm was likely multifactorial, including the injury (anterior-posterior compression pelvic fracture), prolonged coagulation parameters during administration of warfarin, and the percutaneous insertion of an iliosacral lag screw. A pseudoaneurysm of the superior gluteal arterial system should be included in the differential diagnosis of unexplained pelvic or buttock pain after a pelvic fracture.

Adult↗