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Leiomyosarcoma of the skin and subcutaneous tissue.

Leiomyosarcomas arising in the skin and subcutaneous tissue are rare tumors, and diagnosis usually is made by microscopic examination of the lesion. These lesions typically appear as a single, smooth nodule in the skin but may also occur as multiple nodules with varying surface changes. After local excision, these lesions recur in a large proportion of patients. However, metastatic spread that leads to death seems to occur only in patients with the subcutaneous variety of the tumor. Three patients had varied clinical appearances of leiomyosarcomas. In one case, which was available for long-term evaluation, no recurrence was noted six years after surgical excision of a single lesion.

Aged↗

Subcutaneous tissue involvement of CD30-positive large cell lymphoma.

There are several types of T-cell lymphoma presenting with subcutaneous tissue involvement showing different clinical features and prognoses. The entity of subcutaneous involvement of T-cell lymphoma should be differentiated. We report a case of CD30-positive large cell lymphoma which initially presented with subcutaneous tissue involvement only, but progressed to systemic dissemination.

Adult↗

[Late effects of mammary radiotherapy on skin and subcutaneous tissues].

Late damages to the skin and subcutaneous tissues are almost inescapable because of the high skin doses required in the irradiation of breast tumours. While the clinical and histological descriptions date back to the first decades of the therapeutic use of ionising radiation, the recent advances in cellular and molecular biology have significantly contributed to the increased understanding of late skin injury mechanisms. In particular, sub-cutaneous fibrosis appears to be the partly reversible results of a continuous and self-maintained local process, possibly sensitive to therapeutic intervention. A second very active research avenue is the development of biologic assays potentially able to predict the probability of increased normal tissue injury after irradiation in individual patients. Such a test would allow the adaptation of the treatment modalities to the radiobiological behaviour of normal tissues. To date, these expectations have not been met. The quality of the irradiation and its modalities (total dose, fractionation, inter fraction interval) remain the main ways to achieve an optimal functional and cosmetic outcome.

Breast Neoplasms↗

Histologic study of the regeneration of axillary hair after removal with subcutaneous tissue shaver.

It was observed that after subcutaneous tissue shaving for the radical therapy of hircismus and hyperhidrosis axillary hair often regrew. Histologic study of this phenomenon showed that hair bulb and most of the follicle up to a level near the sebaceous duct opening had been removed. Hair regrows from remnant outer root sheath, but only when sebaceous glands are preserved, that is when the upper portion of the follicular isthmus is intact. One or several solid epithelial pegs grow downward from the cut end of the trichilemma, and inner root sheath and new young hair are formed in its center. In hair peg stage, the lower tip of the hair follicle descends while new hair is growing in its center through the mitotic activity is growing in its center through the mitotic activity of hair germ cells and is prevented from pushing toward the skin surface by interlocking fusion between hair cuticula and sheath cuticula. Eventually, the epithelial cells wrap around a mass of mesenchymal cells and form a new bulb from which the terminal hair grows upward. The new matrix acquires a new complement of functioning melanocytes.

Adult↗

Interstitial fluid oncotic pressures in rabbit subcutaneous tissue.

Interstitial fluid oncotic pressures in rabbit subcutaneous tissues were measured by chronically implanted membrane osmometers. Pairs of osmometers were used, one using a membrane permeable and one impermeable to plasma proteins. Measurements from the small-pore membranes averaged 10.2 mmHg while pressures measured from the large-pore membrane osmometers averaged -1.2 mmHg, indicating that the measured pressures were osmotic rather than hydrostatic in nature. These values are in agreement with previously published values from this laboratory on oncotic pressures of excised rabbit skin and with a computer-simulation study of capillary fluid balance. The oncotic pressures described in this study are of the s-me general magnitude as those of lymph from most organs in the body.

Animals↗

A flow injection microdialysis sampling chemiluminescence system for in vivo on-line monitoring of glucose in intravenous and subcutaneous tissue fluid microdialysates.

A novel flow injection on-line microdialysis system for in vivo monitoring of glucose in subcutaneous tissue fluid and blood is described. An implantable loop-type microdialysis probe was used for subcutaneous sampling, and a flow-through microdialyzer was used for intravenous sampling by pumping of the blood from the tested rabbit through the microdialyzer located outside the living system at a flow rate of 10 microL/min. The perfusion rate of the dialysate was 20 microL/min. The glucose in the dialysate was detected on-line with a flow injection chemiluminescence system after passing through an immobilized glucose oxidase reactor. The calibration of the detector system (including reactor) and monitoring of baseline drifts were performed simultaneously to improve the reliability of the monitoring process. The dialysate sample volume was 20 microL, and the sample throughout was 28 h-1. The variation of glucose level in subcutaneous tissue fluid and blood of the rabbits was monitored after the administration of glucose or insulin to demonstrate the favorable resolution and reliability of the system for in vivo on-line monitoring.

Animals↗

Effect of dental adhesives on the exudative phase of the inflammatory process in subcutaneous tissue of rats.

The vascular changes in the subcutaneous connective tissue of rats induced by dentin bonding systems (one step) was studied and compared to those induced by saline solution (negative control) and Furacin (positive control), during the exudative phase of the inflammatory process. Twenty mg/kg of Evan's blue were injected intravenously in the vein of the rats' penises; 0.1 ml of each substance tested was inoculated in the subcutaneous tissue. After a 3 hour period the animals were sacrificed and their skins were excised and punched out with a standard steel 2.5 cm in diameter. The specimens were immediately immersed in 8 ml of formamide and taken to a double boiler for 72 hours at 37 C, to remove the dye. The liquid containing the overflowed dye was filtered, analyzed in the spectrophotometer (620 nm) and classified according to the criteria established by Nagem-Filho, Pereira (1976). After statistical analysis, the irritative potential of the substances was ranked as follows: Furacin (severe) > Single Bond and Bond 1 (moderate - no significant differences between the dentin bonding systems tested) > saline solution (not significant as regards the irritation degree).

Animals↗

Extramedullary plasmacytoma of maxillary sinus with later involvement of the gall bladder and subcutaneous tissues.

We recently encountered a patient with extramedullary plasmacytoma (EMP) originating in the maxillary air sinus, who developed subcutaneous tissue and gall bladder involvement 2 years after initial local radiotherapy. Treatment with melphalan, prednisone and interferon led to a rapid and sustained regression of the gall bladder tumour. Complete remission was obtained by subsequent regional radiotherapy to the subcutaneous tumours in the extremities. Progression of plasmacytoma to the hepatobiliary system and subcutaneous tissues is quite rare and the effects of chemo- and radiotherapy on these lesions have not been fully elucidated. This study demonstrated that EMP can be well controlled and complete remission obtained by various therapeutic strategies, even though this tumour develops widespread dissemination.

Gallbladder Neoplasms↗

Inhibition of Salmonella enteritidis ingested in mononuclear phagocytes from liver and subcutaneous tissue of mice immunized with live vaccine.

Sato, Ichiei (School of Medicine, Gunma University, Maebashi, Japan), Tokumitsu Tanaka, Kazuko Saito, and Susumu Mitsuhashi. Inhibition of Salmonella enteritidis ingested in mononuclear phagocytes from liver and subcutaneous tissue of mice immunized with live vaccine. J. Bacteriol. 83:1306-1312. 1962.-In our earlier studies it was shown that mice hyperimmunized with live vaccine of Salmonella enteritidis resisted intravenous challenge with 1,000 MLD of virulent strain 116-54 of S. enteritidis. Survivors of this challenge completely resisted additional intravenous challenge with 10,000 MLD of the same organism. Mononuclear phagocytes obtained from the abdominal cavity of mice immunized with live vaccine of S. enteritidis inhibited intracellular multiplication of virulent strain 116-54, regardless of the presence of antibody in the cell-culture medium. In the present study, mononuclear phagocytes were obtained in a nearly pure state from liver or subcutaneous tissue of mice and were maintained in vitro in good condition. These cells also resisted cellular degeneration caused by intracellular existence of virulent strain 116-54, regardless of the presence of antibody in the cell-culture medium. In contrast, cells obtained from normal mice or mice immunized with dead vaccine were subject to degeneration.

Animals↗

Collagen deposition in the subcutaneous tissue during wound healing in humans: a model evaluation.

Wound healing encompasses coagulation, inflammation, angiogenesis, fibroplasia, contraction, epithelialisation and remodeling. A granulation tissue is produced following incision of tissue such as skin, abdominal wall or the gastrointestinal tract, and the strength of the wound is determined primarily by the collagen content early in the healing course. Few models are available to study wound healing in man. The percutaneous insertion of expanded poly-tetrafluoroethylene tubes (ePTFE) into the subcutaneous tissue has been an established model for 20 years. The procedure is performed using a local anesthesia. The model has a diameter of 2.5 mm, a length of 5-10 cm and a pore size of 90-120 microns which is substantially more than that of vascular grafts. The polymer accumulates granulation tissue, the architecture of which resembles that of a normal surgical wound. Previous studies on the use of the ePTFE model in wound healing research are summarized in detail. Histological and immunohistochemical analyses of the granulation tissue deposited in the model were undertaken. The content of amino acids following hydrolysis of the granulation tissue was determined applying spectrophotometric or HPLC assays. Collagen amounts accumulated in the model are expressed as hydroxyproline per length of ePTFE or per total protein. Following a study in rats we examined 85 healthy volunteers and 158 surgical patients in the studies. Higher contents of hydroxyproline were found 10 days after implantation as compared to 5 days with considerable inter-person variation. Regarding median values there was a 25% difference between two measurements performed on two distinct ePTFE tubes from the same person, and a 12% difference between values obtained from two different pieces of the same ePTFE. Higher accumulation levels of hydroxyproline did not result in higher variability. Deposition of proline in the model correlated closely to total protein content. The ePTFE and a modified PVA model were compared in surgical patients. No reproducible measurements of hydroxyproline deposition were obtained with the PVA model as opposed to the ePTFE model. It is concluded that the modified PVA model is inadequate for determination of collagen deposition in subcutaneous granulation tissue. We found no correlation between collagen deposition levels obtained with placement of the ePTFE model in the subcutaneous tissue of the arm and in an uncomplicated surgical wound of the groin in the same patient, respectively. Significantly higher collagen deposition levels in the model were found in the surgical wound. Conversely, there was a significant correlation between protein deposition levels obtained at the two sites. Patients undergoing minor surgery (groin hernia repair) did not differ from healthy non-traumatized volunteers as regards deposition of collagen in subcutaneous tissue of the arm, whereas patients subjected to major general surgery demonstrated a significant decline during the postoperative phase compared to a preoperative evaluation. This decline was enhanced in patients who had infectious complications. Non-smoking volunteers were found to specifically accumulate more collagen (median value 82%) than smokers matched for age and gender. Irrespective of the smoking status women accumulated significantly more collagen in the model than men. These findings were re-tested in a prospective series leading to the same conclusion. Matrix metalloproteinases (MMP-2 and MMP-9) were determined in wound fluid obtained from the subcutaneous cavities of herniotomy wounds 24 and 48 h after operation. A significant and inverse correlation was demonstrated between MMP-9 after 24 h and accumulation levels of collagen in the ePTFE tube 10 days after implantation in the wound. Finally, it was demonstrated that local application of granulocyte-macrophage colony-stimulating factor into the ePTFE model during implantation specifically and dose-dependently reduced the number of fibroblasts and deposition of collagen. The doses chosen for the experiments resulted in both a local and a systemic effect. It is concluded that the minimally invasive ePTFE model, despite a certain level of variability, presently provides one of the best possibilities of evaluation of the wound healing potential in both volunteers and patients under various conditions. We found the model convenient for the assessment of both matrix deposition during wound healing and the influence of several factors including demographic characteristics, trauma, tobacco smoking, drugs and tissue degrading components of the wound.

Animals↗

[An animal experimental study on the retention rate of polycyclic aromatic hydrocarbons in the lung and in the subcutaneous tissue (author's transl)].

The retention rate of five polyaromatic hydrocarbons (PAH) (benzo(a)pyrene, dibenz(ah)anthracene, chrysene, pyrene, benz(a) anthracene) was studied after intratracheal instillation into syrian hamsters and subcutanous injection into mice. For subcutanous injection the PAH were solved in 0.5 ml tricaprylin, for intratracheal instillation a suspension in NaCl was used. The results were the following: 1. With respect to the retention rate of the five PAH the largest difference was found comparing the application modes. The ratio of the averaged half-time-values for the intratracheal test to the subcutanous test is about 1:35. 2. The retention rates for each polycyclic hydrocarbon differs significantly. An interrelation of PAH after application of a PAH-mixture was not detectable. 3. The retention rates determined in the lung and in the subcutanous tissue do not give a constant ratio concerning each PAH. Thus DBahA is retained in the lung as well as in the subcutanous tissue definitely longer than BaP. Chrysene and benz(a)anthracene behave - respecting the retention rate - in the subcutanous test like BaP. In lung tissue, however, the different behaviour becomes obvious: while benz(a)anthracene is eliminated most rapidly, chrysene can be detected for a relative long time.

Animals↗

[Thermal reaction of subcutaneous tissue to food intake in patients with obesity].

Investigating the temperature of deep layers of skin and in the main of subcutaneous tissue in patients with obesity we found the close connection between changes of this temperature and food intake. In patients who are in postabsorptive period the intake of the small portion of test food (220 kcal) induces in 3-4 min a marked increase of the subcutaneous tissue temperature (often by 1.0-1.5 degrees C in comparison with the initial level). Further the temperature still rises some what and then keeps at increased level for 30-45 min. At the end of the treatment course of patients in the clinic (and the body weight loss by 10-14 kg) these changes of the temperature become much less intensive or do not quite manifest. The above thermic reaction is developed apparently as a result of the dilatation of blood vessels of the skin and filling the venous plexus with the arterial blood. Probably in depends upon the regulatory activity of hypothalamus which is directed on an increase of heat loss into environment.

Body Temperature↗

Distribution of intramuscularly administered erythromycin into subcutaneous tissue chambers before and after inoculation with Pasteurella haemolytica.

Distribution of erythromycin into subcutaneous tissue chambers was characterised pharmacokinetically and the effect of Pasteurella haemolytica infection on the extent of penetration was studied. Thermoplastic tissue chambers were implanted subcutaneously in the paralumbar fossae of six calves. Thirty-five days after implantation, the tissue chamber distribution of intramuscularly administered erythromycin (30 mg kg-1) was studied. Chambers were then inoculated with P haemolytica and the tissue chamber pharmacokinetics of erythromycin were again studied. Diffusion of erythromycin into tissue chambers was best described using a two-compartment model with tissue chambers representing a relatively inaccessible compartment. Despite changes in chamber fluid pH, the extent of erythromycin penetration into chambers was not affected by P haemolytica inoculation. Comparison of computer simulated concentration-time curves resulting from different routes of administration revealed that penetration of erythromycin into less accessible sites was more likely to be higher after intravenous administration than after intramuscular administration.

Animals↗

Determination of the subcutaneous tissue to blood partition coefficient in patients with severe leg ischaemia by a double isotope washout technique.

Knowledge of the tissue to blood partition coefficient (lambda) is essential for calculation of the perfusion coefficient in a single tissue based on measurements of the washout of locally injected isotopes. No measurements of lambda for Xenon in subcutaneous tissue in the leg have been done in patients with occlusive arterial disease. In 12 patients with occlusive arterial disease in the legs lambda for Xenon was determined in subcutaneous tissue in the calf region and foot as the ratio between the washout rate constant of 131I-Antipyrine and 133Xe. A mixture of the two indicators was injected subcutaneously laterally on the calf and in the first interosseous space on the foot. The time until the curves followed a monoexponential course varied between 15 and 45 min in the calf and 5 and 45 min in the foot. The calculated lambda for Xe showed a great variance between individuals in calf as well as foot. Mean value was 3.7 ml X g-1 (range: 1 X 7-10 X 7) in the calf and 2 X 7 ml X g-1 (range: 1 X 2-4 X 9) in the foot. It is concluded that lambda measurements are necessary for determination of subcutaneous blood flow from 133Xe washout curves in these patients. Determination of lambda is especially important when comparisons are made between individuals.

Aged↗

Repair of incomplete simple syndactyly by a web flap on a subcutaneous tissue pedicle.

A new web flap on a subcutaneous tissue pedicle was developed to repair incomplete simple syndactyly. It was isolated from the top skin in syndactyly and transferred down into the depth of the web space to create a web commissure. With use of this technique, aesthetic appearance of the web and well-functioning fingers were gained. Moreover, this technique made full use of the original skin of the syndactyly, and a skin graft was not needed. We report here the operative technique, which presents another alternative for repair of incomplete simple syndactyly.

Adolescent↗

Kinetics of glucose delivery to subcutaneous tissue in rats measured with 0.3-mm amperometric microsensors.

The time between intravenous injection of a glucose bolus and the time the glucose concentration peaked in the subcutaneous tissue was measured in pentobarbital-anesthetized rats with implanted 290-microns-diameter amperometric sensors. Boluses of 100, 200, and 400 mg/kg body wt were injected. The glucose concentration in the jugular vein was monitored by frequent withdrawal and analysis of samples. The glucose concentration in the subcutaneous tissue was continuously monitored with the sensors. The times required for the subcutaneously implanted sensor to reach its maximum current, corrected for sensor response times, were 7.5 +/- 3.9, 9.8 +/- 5.5, and 10.0 +/- 4.4 min for the smallest to the largest dose, respectively. The shorter delay in response to the smallest dose was statistically significant (P < 0.03). The results were consistent with dilution of the bolus in the cardiovascular system and transport of glucose by both diffusion and facilitated transport via a saturable mediator. An understanding of the differences in the dynamics of venous vs. subcutaneous response to a glucose dose is important in developing algorithms for the control of blood glucose based on a subcutaneous measurement.

Animals↗

Cytotoxicity analysis of alendronate on cultured endothelial cells and subcutaneous tissue. a pilot study.

The use of alendronate, a bisphosphonate which is able to inhibit bone resorption, in order to prevent dental root resorption after tooth replantation would be of clinical relevance. However, this drug must be biocompatible to the periapical tissues. The aim of this study was to analyze the effect of an alendronate paste in polyethyleneglycol (2 g ml(-1)) on endothelial cells in culture (in vitro) and on rat subcutaneous tissue (in vivo). For the in vitro study the paste was applied on round glass coverslips that were immersed into confluent cell cultures (clone Cips). The cell viability percentages of these cultures were obtained 0, 6 and 12 h after contact with the substance. As control, cultures that received plain coverslips were used. This analysis was carried out in triplicate using the Trypan blue dye exclusion assay. For the in vivo study the paste was introduced into polyethylene tubes that were placed into the rat subcutaneous tissue. The rats were killed 7 and 14 days later; then, the tissue sections stained with hematoxylin-eosin were analyzed. In vitro, the alendronate caused a significant decrease in the cell viability in 6 h (P < 0.05) and 12 h (P < 0.01), when compared with the control cultures. In vivo the tissue response was exuberant and similar at the two experimental times. There was a necrosis in a comprehensive area in contact with the open end of the tube. Presence of micro-abscesses and intense inflammatory infiltrate in the hypoderm permeating the muscle fibers and fat lobules were observed. In conclusion, the alendronate paste in polyethylene glycol as used showed to be highly cytotoxic in vitro as well as in vivo.

Alendronate↗

Transcapillary forces in subcutaneous tissue of lower limbs with deep venous thrombosis.

Starling forces (interstitial fluid pressure, plasma- and interstitial fluid colloid osmotic pressures) were measured in the subcutaneous tissue of legs in 22 patients with deep venous thrombosis (DVT). For comparison, measurements were obtained in the contralateral leg and in healthy controls as well. Interstitial fluid pressure (Pif) was measured with the 'wick-in-needle' technique and we found a significantly higher pressure in limbs with DVT compared to contralateral limbs and controls. Interstitial fluid was collected from subcutaneous tissue with the 'wick technique'. Colloid osmotic pressure was measured in wick interstitial fluid (COPif) and plasma (COPpl) with an osmometer. A significant reduction of COPif was found in limbs with DVT compared to the contralateral side and controls. The COPpl was also significantly reduced in patients compared to controls. Saphenous vein pressure (Pv) measured at the ankle was significantly increased in the thrombosed limb compared to the contralateral. We conclude that the main cause of subcutaneous oedema in DVT of the lower limbs is increased transcapillary filtration caused by a rise in Pv. This leads to a fall in COPif and rise in Pif which act as oedema-preventing mechanisms.

Aged↗