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At least 1,135 records · Page 63Linked to original sources
PubMed1990

Case report 589: Use of Ostamer in fusion of lumbar spine, postoperative appearance.

In the late 1950s and early 1960s there was intense orthopedic interest in a plastic polyurethane foam (Ostamer) that could be used in the fixation of fractures, performance of arthrodesis, and in spinal fusions. It saw limited success at that time but eventually fell from favor. A patient presenting with a draining sinus in the buttock, back pain, and a history of lumbar spinal fusion with Ostamer was recently scanned in our department. The CT appearance of Ostamer and a brief review of the literature are reported.

Bone Cements↗
PubMed1995

[Fournier gangrene].

Fournier's gangrene is a relatively rare, mixed aerobic and anaerobic soft tissue infection in the perineoscrotal area. Although it is convenient to give it a separate name, it is really either necrotizing fasciitis or nonclostridial myonecrosis of the scrotal and perineal areas. The condition frequently develops from perineal diseases, including perianal abscess, and fistulas, inflamed haemorrhoids and indwelling urethral catheter. In patients with Fournier's gangrene morbidity is extreme and mortality high. This article is based on a retrospective study of 15 cases of Fournier's gangrene, 13 in male and 2 in female patients. A combination of surgery and antibiotics was used to treat 9 patients. The last 6 cases were treated with a combination of surgery, antibiotics and hyperbaric oxygen. In 13 cases, the diagnosis was made on the basis of the fulminating progression of the infection to a scrotal gangrene, identification of multiple underlying pathogenic organisms and toxaemia. In the 2 female patients, a similar infection developed in the labia majora and perineum and extended to the buttocks and the anterior abdominal wall.

Adult↗
PubMed1981

Reflexes evoked in leg muscles from arm afferents: a propriospinal pathway in man?

Long-loop reflexes from arm afferents onto motoneurones of leg muscles were investigated in 57 healthy subjects by means of H reflex testing and tonic EMG testing. In various tonically activated leg muscles, brachial nerve stimulation exerted stereotyped reflex responses which regularly consisted of an initial depression phase (mean onset latency: 60 ms) and a subsequent facilitatory phase (mean onset latency: 80 ms). H reflex studies, in contrast, only revealed the later facilitation. Except for this difference, both methods led to similar results: fibres responsible for the response were identified as low-threshold skin afferents with a conduction velocity of about 40 m/s. Noxious stimulation reinforced the effects of innocuous stimulation. The receptive field for the reflex response was not restricted to the ipsi- and contralateral arm regions but included the face and the rostral part of the trunk above the buttock. Percutaneous stimulation of dorsal roots C4 and T9, respectively, resulted in a shortening of the onset latencies of both depression and facilitation, with T9 stimulation. It is therefore suggested that the reflexes described are mediated via a directly descending, long spinal pathway.

Adolescent↗
PubMed1983

Effects and biotransformation of 4-dimethylaminophenol in man and dog.

The cyanide antidote 4-dimethylaminophenol . HCl (DMAP) was administered orally, i.v., or i.m. to man and dog. Ferrihemoglobin formation and changes of several parameters in human blood were investigated to obtain information on damage to liver, kidney, muscle, and red blood cells; in addition, the metabolism of DMAP was studied. In dogs, the initial rate of ferrihemoglobin production (DMAP, 3.25 mg/kg i.v. or i.m., 15 mg/kg orally) amounted to 28%, 3.5%, and 2% of the total hemoglobin per min; the corresponding values for man were 9%, 2%, and 2% per min. The dogs behaved normally while CPK increased after i.m. injection. In man, only i.m. injection of DMAP (3.25 mg/kg) was followed by increases in LDH, GOT, and CPK of 110, 260, and 490%, resp.; while total bilirubin, conjugated bilirubin, and iron concentration rose by 270, 120, and 50%, respectively. Bilirubin and iron concentration increased also after DMAP i.v. (3.25 mg/kg) or when it was taken orally (600 or 900 mg). The lactate concentration was not influenced while the pyruvate concentration increased by 50%. DMAP produced hemolysis in vitro. Generally, the values determined in vivo approached the starting level within 1 week. Intramuscular injection of DMAP induced reversible subjective and objective symptoms, e.g., local pain, swollen buttock, fever reaction. The urine showed no pathological changes. About 54% of DMAP taken orally was excreted as metabolites in the urine, 41% as glucuronide, 7% as sulfate, and 6% as thioethers. After i.v. administration the total of metabolites was somewhat higher, and the thioether proportion was 15%. The results indicate that DMAP is readily absorbed after oral administration but undergoes significant first pass effect in the liver. Therefore, the 4-fold i.v. dose must be administered orally to achieve the same ferrihemoglobin formation.

Administration, Oral↗
PubMed1992

Rheumatic manifestations of infective endocarditis.

Rheumatic manifestations are common and varied in infective endocarditis. We performed a retrospective case analysis on 87 patients with 93 episodes of infective endocarditis admitted to Flinders Medical Centre over an 11 year period (1980-1990). Disabling musculoskeletal symptoms and signs were documented in 22 (25%) of the patients. Thirteen patients developed severe or moderately severe low back pain during their illness, two with radiological evidence of a septic discitis or vertebral osteomyelitis. Two patients developed polyarthralgia/arthritis, four had septic arthritis (all with acute Staphylococcus aureus endocarditis), three developed severe loin pain, two acute gout, two had severe buttock pain and sacroiliac joint tenderness and two each developed disabling jaw/facial pain, neck/scapular pain and flank pain respectively. Five patients presented initially to the orthopaedic or rheumatological unit for management of their musculoskeletal symptoms. Four of seven patients with Streptococcus bovis endocarditis demonstrated prominent low back pain supporting a previously noted association between this organism and back symptoms. Furthermore, in one patient who had three separate episodes of endocarditis involving three different organisms, florid back symptoms were only seen in the infective episode involving Streptococcus bovis.

Aged↗
PubMed1995

Radiographic diagnosis and surgical repair of a sciatic hernia: report of a case.

We report the case of a 44-year-old woman who presented with a reducible painless swelling in her left buttock. The mass was preoperatively diagnosed as a sciatic hernia by herniography, which showed the peritoneal sac through the sciatic foramen, and by enterography, intravenous pyelography, and cystography, which demonstrated that the small intestine and urinary bladder had herniated into the sac. The diagnosis and management of this patient are described, followed by a review of the literature on sciatic hernias.

Adult↗
PubMed1984

A semiquantitative light and electron microscopic analysis of histopathologic changes in photochemotherapy-induced freckles.

Photochemotherapy(PUVA)-induced freckles were found in 25 patients (41%) who had received more than 1,000 J/cm2 of PUVA. The patients had been treated with PUVA for more than 2 years, with more than 150 exposures before PUVA lentigines appeared on the thighs, the upper arm, the mid-lower arm, the waist, and the buttocks. The histopathology of these freckles was analyzed by light and electron microscopy. Light microscopy showed an increased amount of pigment and melanophages and increased numbers and size of melanocytes. The keratinocytes often displayed atypical features such as enlarged nuclei, giant size, or fibrillar degeneration. Homogenization of the papillary dermis was observed in 11 patients. The activation of melanocytes was confirmed electron microscopically, and pathological features such as large amounts of lipid droplets and lysosome-melanosome complexes within the melanocytes were seen. The Langerhans cells were mostly normal, whereas the keratinocytes showed cytolytic changes, fibrillar degeneration, and vacuolization. A close follow-up of patients with prolonged PUVA treatment is recommended.

Epidermis↗
PubMed1992

The pelvic compartment syndrome.

In the pelvic region three major compartments (gluteus medius-minimus compartment, gluteus maximus compartment, and iliopsoas compartment) can be distinguished from the smaller compartment of the tensor fasciae latae muscle. Pelvic compartment syndromes are rare. A clear history of trauma is often lacking. Association with drug and alcohol abuse is common, as is the association with the widespread use of anticoagulant therapy. From 1982 to 1990 six patients with acute buttock compartment syndrome were treated in the Department of Trauma Surgery of Hannover Medical School. In five patients fasciotomy of the gluteal compartment was performed. Two patients with a compartment syndrome secondary to necrotizing fasciitis died of septic multiple organ failure. The mean follow-up of the four other patients was 29 months (7-48 months). Three of these four patients revealed a decrease of gluteal muscle volume. Ergometric tests showed a decrease in gluteal muscle force in all patients.

Adolescent↗
PubMed1991

Sporotrichosis presenting as pyoderma gangrenosum.

A 56-year-old female with an eight-year history of corticosteroid therapy for rheumatoid arthritis presented with large, deep, painful ulcers on the left buttock and thigh. The lesions appeared typical of pyoderma gangrenosum. Nine separate cultures of the exudate grew Sporothrix schenckii. During the course of iodide therapy, the patient expired due to Escherichia coli pneumonia. This is the third case report of sporotrichosis presenting as pyoderma gangrenosum and the first report from China. Sporotrichosis presenting as pyoderma gangrenosum is a special form of this disease. It develops quickly and must be treated promptly. Only two cases have been reported in the world literature. This is the first case reported from China.

Biopsy↗
PubMed1985

[Pityriasis versicolor due to Malassezia ovalis].

In a randomly collected series of 175 cases of pityriasis versicolor in residents of the central-northern part of Venezuela, 13% of the patients were infected with ovoid unicellular units of the causal fungus (Malassezia ovalis) and 87% with globous unicellular units in the scales (M. furfur). Only globous unicellular units (Pityrosporum orbiculare) were seen outside the active lesions and in these, after the successful treatment with ketoconazole. The median age of 40 'ovalis' patients was 37.5 years; the same in 40 'furfur' patients was 24.5 years. The median age at the moment of discovering the first lesions among 'ovalis' patients was 31; among 'furfur' patients this was 20 years. There were 16 male patients among the 'ovalis' and 24 among the 'furfur' groups of 40. The topographic distribution of the lesions varied according to the type of the invader. M. ovalis prevailed on the trunk below the waist-line and on the limbs, mainly on buttocks and upper legs. M. furfur prevailed on the chest, neck, face and upper limbs. The hypothesis is offered that the ovoid agent of pityriasis versicolor preferentially occupies the less sweating and sebum-producing parts of the body in older (and drier) persons than the globous type does.

Adolescent↗
PubMed1987

Disseminated bilateral hyperkeratotic variant of porokeratosis Mibelli.

Clinical, histopathological, and ultrastructural features of a new clinical variant of porokeratosis Mibelli (PM) are presented. We report a solitary case of a patient, male aged 62, who developed disseminated verrucous nodules on the buttocks and the lower extremities 3 years before diagnosis. Histopathologically, all specific signs of the keratinization disorder of PM were demonstrable; in addition, however, multiple cornoid lamellae were found at the margin as well as in the center of the lesions, which only in part showed relationships to the epidermal appendages. In the papillary dermis, numerous ectatic capillaries were conspicuous. Using electron microscopy the same specific abnormalities of the keratinization process as known from classical cases of PM could be demonstrated: autophagocytic cells that revealed perinuclear edematization and vacuolization, accumulation of autophagic vacuoles and heterolysosomes, and dyskeratotic corps ronds-like cells that become transformed to fibrillar or Civatte bodies. Problems of the classification, differential diagnosis, and pathomorphogenesis are discussed.

Age Factors↗
PubMed1987

Influence of isaxonine on reinnervation of the rat gastrocnemius muscle.

Isaxonine is reported to have a favourable effect on nerve regeneration. The histological and histochemical changes were compared in the gastrocnemius muscles of 20 rats, in which the left sciatic nerve was frozen-crushed for 10 s at the level of the buttock. The animals received a daily dose of intraperitoneal isaxonine and ten others the solvent only. After 8 weeks small type grouping was seen in rats receiving solvent only and large type grouping in rats treated with isaxonine. After 10 weeks a checkerboard pattern of the fibre types was observed in the muscles of animals receiving solvent only but fibre type grouping was present in those treated with isaxonine. This experiment indicates that isaxonine prevents synaptic remodelling by suppression of the redundant nerve endings from additional axons, which have regenerated more slowly, in making contact with motor endplates.

Animals↗
PubMed1990

A new method for measuring power output in a single leg extension: feasibility, reliability and validity.

A method is described for measuring the explosive power of the leg in extension which has been found safe and acceptable for all age groups and levels of physical capability. The extension movement takes 0.25-0.40 s in a push through 0.165 m against a flat pedal. At the end of the push the leg is fully extended. The movement is made seated so that the forces are contained between the buttocks and the foot. The seat position is adjusted for leg length and the push is transmitted by a lever and chain to spin a flywheel. The gearing is such that resistance to the movement remains velocity of the flywheel is measured by an optoswitch and used to calculated the average leg extensor power (LEP) in the push. The reliability of the power measurement was evaluated in 46 subjects ranging in age from 20 to 86 years; they included medical students and geriatric day patients. They were tested on two occasions separated by a week. The maximal values on the first occasion (best of at least five trials) ranged from 30 to 300 W (mean +/- 1 SD = 154 +/- 88 W). There was no significant difference on re-test and the coefficient of variation was 9.4%. In a subgroup of 9 non-naive subjects who were measured by an experienced observer it was 6.3%. As expected, power was lower in women than in men and declined sharply with age. The sex difference was less when the values were expressed as power per body mass; a sharp age-related decline remained.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1976

Biofeedback use of common objects: the bathroom scale in physical therapy.

Many common devices can be used as biofeedback devices. The feedback use of the bathroom scale in rehabilitation medicine (physical therapy) has been explored with stroke patients. These patients used two scales, one under each foot, to relearn their sense of weight distribution. In addition, the scale was used to teach patients to shift their weight distribution from their knees to their hands as they learned to crawl, and from their feet to their buttocks and the chair as they learned to sit down.

Biofeedback, Psychology↗
PubMed1984

[Gunshot injuries in peacetime and their therapy].

Between 1976 and 1982 46 patients with gunshot injuries (43 m., 3 f.) were seen at the University of Heidelberg Department of Surgery. Frequent causes of injury in 42 adults (40 m., 2 f.) and 4 children (3 m., 1 f.) were suicide attempts (19) and carelessness in the handling of shotguns (11). Criminal offence was related to nine injuries; no retrospective classification of the event causing the injury was possible in further seven cases. Affected in descending order of frequency were brain and lung (10 each), soft tissue of thigh (9), intraabdominal organs (5), heart (4), liver and bone (3 each), blood vessels (2) and facial skull, penis, buttock, neck and mediastinum (1 each). Six patients suffered from combined injuries, in three cases a combined abdomino-thoracic injury was seen. Whilst suicidal injuries of the skull are related to poor prognosis, other peacetime gunshot wounds are less problematic when compared to military gunshot wounds due to the lower speed of the projectiles. Therapeutic procedures follow the general rules of open treatment of injuries including prophylaxis against tetanus and botulism as well as systemic antibiotic therapy. In general abdominal and abdomino-thoracic gunshot wounds as well as vascular injuries require immediate surgical procedure. In isolated thoracic injuries a conservative approach may be justified depending on the situation. The same rule applies to fractures caused by gunshots.

Abdominal Injuries↗
PubMed1988

Experience of injected fat grafting.

Eighteen months' experience with the injected fat grafting technique used in 208 patients to correct various problems such as buttocks (augmentation and reshaping), trochanteric depressions, breast augmentation, scar depressions, thighs and legs (calf and ankle augmentation), small wrinkles and depressions of the face (Romberg's disease), nasolabial fold, upper outer breast quadrant, liposuction sequela, fingers and hands is presented. This method shows major advantages with few complications. Some technical details and recommendations for successful fat grafting are also presented.

Abdomen↗
PubMed1982

Anterior periosteal dermal suspension with suction curettage for lateral thigh lipectomy.

The standard excisional approach to lipectomy has now been expanded by the use of suction curettage either as an adjunct or a primary procedure. In severe cases of steatomeria (a term used to designate trochanteric obesity and eliminate the misuse of the term lipodystrophy), curettage serves to prepare and shape the flaps, while excision and "periosteal dermal suspension" are sometimes necessary to achieve adequate contour and lift. Periosteal anchoring ensures adequate permanent suspension and a tension-free closure. Achievement of lateral thigh contouring by an anterior approach is facilitated by the use of the suction curette. Undermining of the superior flap and contouring with suction, as well as overlapping the closure with buried dermal-fat suspension flaps, eliminates bulging above or below the incision. Periosteal dermal suspension decreases the possibility of scar widening and eventual ptosis, provides a fixation technique that permits more lift, and eliminates scarring from the lateral thigh. Lateral thigh suction lipectomy with periosteal dermal suspension has been done alone or in conjunction with buttock reduction or with medial thigh or abdominal lipectomy in 14 patients. The operating time was short, and the results were good with minimal morbidity.

Adipose Tissue↗