SEARCH · PubMed Health

Results for “Subcutaneous”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources

PubMed1992

Comparison of subcutaneous and intravenous recombinant human erythropoietin for anemia in hemodialysis patients with significant comorbid disease.

While recombinant human erythropoietin (rHuEPO) is an effective therapy for anemia in renal failure, most published studies concern benefits in relatively healthy hemodialysis patients. The present study compares intravenous and subcutaneous administration of rHuEPO in an unselected group of 128 hemodialysis patients who were randomized to receive rHuEPO in an initial dose of 150 U/kg/week in three divided doses by subcutaneous or intravenous injection. Following a 4-week placebo run-in period, patients received rHuEPO until their hemoglobin was stable between 105 and 125 g/l for 4 weeks and then followed for a further 24 weeks. Eighty-three patients completed the study, 45 in the subcutaneous and 38 in the intravenous group. There was no difference in mean hemoglobin at any stage between subcutaneous and intravenous patients. Mean rHuEPO dose at the time of stabilization was significantly lower in the subcutaneous group compared to the intravenous (205.9 +/- 135.4 vs. 274.1 +/- 142.4 U/kg/week; p = 0.019), mean time to hemoglobin target was 9.9 +/- 4.5 weeks for the subcutaneous group and 11.9 +/- 4.9 weeks for the intravenous group (p = 0.037). Time to stabilization was 14.9 +/- 4.7 weeks for the subcutaneous compared to 17.3 +/- 3.9 weeks for the intravenous group (p = 0.006). Diabetic patients had higher dose requirements for rHuEPO at all time points and required a longer time to reach stabilization than nondiabetics (18.6 +/- 4.6 vs. 15.6 +/- 4.3 weeks; p = 0.016). Quality of life estimated by a disease-specific Kidney Disease Questionnaire improved significantly during rHuEPO therapy in both groups. There was no significant change in dialysis prescription throughout the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2004

Absolute bioavailability and pharmacokinetics of treprostinil sodium administered by acute subcutaneous infusion.

The objective of this study was to evaluate the absolute bioavailability and acute pharmacokinetics of treprostinil sodium administered by continuous, short-term subcutaneous infusion in normal subjects. Fifteen healthy volunteers received treprostinil via an intravenous infusion at 15 ng/kg/min over 150 minutes, followed by a 5- to 7-day washout and a subcutaneous infusion at the same rate administered over 150 minutes. Serial plasma samples were collected predosing, during dosing, and postdosing, and plasma treprostinil concentration levels were measured by a validated liquid chromatography atmospheric pressure ionization tandem mass spectrometry (LC/MS/MS) method with a lower limit of quantitation (LLOQ) of 25 pg/mL. Acute administration of treprostinil administered by subcutaneous infusion at a rate of 15 ng/kg/min for 150 minutes achieved a mean Cmax of 1.47 ng/mL. Mean AUC infinity values for intravenous and subcutaneous dosing were 3.52 and 3.97 ng.h/mL, respectively, resulting in a mean apparent absolute bioavailability of 113% for subcutaneous administration. It was possible that the area under of the curve for the intravenous administration was underestimated because most of the terminal elimination phase could not be documented due to the LLOQ of the assay. The mean apparent elimination half-life of treprostinil following subcutaneous administration was 1.38 hours, compared to 0.87 hours following intravenous administration. It was concluded that treprostinil administered by subcutaneous administration is completely absorbed, with a slightly longer half-life compared to intravenously administered treprostinil.

Adult↗

PubMedDate not supplied

Insuflon versus subcutaneous injection for cytokine administration in children and adolescents: a randomized crossover study.

Pain is a frequent complication of subcutaneous cytokine injections in children. A randomized crossover trial was conducted to determine the least painful and preferred method of cytokine administration for children and young people. The current standard practice of subcutaneous injection was compared with the use of Insuflon (Maersk Medical, Roskilde, Denmark), a subcutaneous indwelling catheter. Children aged between 1 month-and 18 years undergoing treatment within the oncology/hematology unit of a single tertiary hospital and receiving cytokines were eligible for the study. Twenty children participated in the study, each child receiving both administration methods in random order during sequential cytokine treatment courses. There was a trend toward higher pain scores when using subcutaneous injections for drug administration compared to Insuflon. Seventy-five percent (n = 15) of the children who completed the trial and their families preferred using insuflon for subcutaneous drug administration. Consideration needs to be given, however, to those who refused to enter the study, withdrew, or continued because of a preference for subcutaneous injections. Current practice at the Women's and Children's Hospital is to allow the child and parents to choose their preferred treatment modality for subcutaneous drug administration.

Adolescent↗

PubMed2000

Subcutaneous administration of amifostine during fractionated radiotherapy: a randomized phase II study.

PURPOSE: Amifostine (WR-2721) is an important cytoprotective agent. Although intravenous administration is the standard route, pharmacokinetic studies have shown acceptable plasma levels of the active metabolite of amifostine (WR-1605) after subcutaneous administration. The subcutaneous route, due to its simplicity, presents multiple advantages over the intravenous route when amifostine is used during fractionated radiotherapy. PATIENTS AND METHODS: Sixty patients with thoracic, 40 with head and neck, and 40 with pelvic tumors who were undergoing radical radiotherapy were enrolled onto a randomized phase II trial to assess the feasibility, tolerance, and cytoprotective efficacy of amifostine administered subcutaneously. A flat dose of amifostine 500 mg, diluted in 2.5 mL of normal saline, was injected subcutaneously 20 minutes before each radiotherapy fraction. RESULTS: The subcutaneous amifostine regimen was well tolerated by 85% of patients. In approximately 5% of patients, amifostine therapy was interrupted due to cumulative asthenia, and in 10%, due to a fever/rash reaction. Hypotension was never noted, whereas nausea was frequent. A significant reduction of pharyngeal, esophageal, and rectal mucositis was noted in the amifostine arm (P <.04). The delays in radiotherapy because of grade 3 mucositis were significantly longer in the group of patients treated with radiotherapy alone (P <.04). Amifostine significantly reduced the incidence of acute perineal skin and bladder toxicity (P <.0006). CONCLUSION: Subcutaneous administration of amifostine is well tolerated, effectively reduces radiotherapy's early toxicity, and prevents delays in radiotherapy. The subcutaneous route is much simpler and saves time compared with the intravenous route of administration and can be safely and effectively applied in the daily, busy radiotherapy practice.

Abdominal Neoplasms↗

PubMed2004

Inhalation of insulin in dogs: assessment of insulin levels and comparison to subcutaneous injection.

Pulmonary insulin delivery is being developed as a more acceptable alternative to conventional subcutaneous administration. In 15 healthy Beagle dogs (average weight 9.3 kg), we compared insulin distribution in arterial, deep venous, and hepatic portal circulation. Dogs received 0.36 units/kg s.c. regular human insulin (n = 6) or 1 mg (2.8 units/kg) or 2 mg (5.6 units/kg) dry-powder human inhaled insulin (n = 3 and 6, respectively). Postinhalation of inhaled insulin (1 or 2 mg), arterial insulin levels quickly rose to a maximum of 55 +/- 6 or 92 +/- 9 microU/ml, respectively, declining to typical fasting levels by 3 h. Portal levels were lower than arterial levels at both doses, while deep venous levels were intermediate to arterial and portal levels. In contrast, subcutaneous insulin was associated with a delayed and lower peak arterial concentration (55 +/- 8 microU/ml at 64 min), requiring 6 h to return to baseline. Peak portal levels for subcutaneous insulin were comparable to those for 1 mg and significantly less than those for 2 mg inhaled insulin, although portal area under the curve (AUC) was comparable for the subcutaneous and 2-mg groups. The highest insulin levels with subcutaneous administration were seen in the deep venous circulation. Interestingly, the amount of glucose required for maintaining euglycemia was highest with 2 mg inhaled insulin. We conclude that plasma insulin AUC for the arterial insulin level (muscle) and hepatic sinusoidal insulin level (liver) is comparable for 2 mg inhaled insulin and 0.36 units/kg subcutaneous insulin. In addition, arterial peak concentration following insulin inhalation is two times greater than subcutaneous injection; however, the insulin is present in the circulation for half the time.

Administration, Inhalation↗

PubMed2006

Effect of controlled volumetric tissue heating with radiofrequency on cellulite and the subcutaneous tissue of the buttocks and thighs.

BACKGROUND: Regardless of diet and exercise, genetics plays an important part in creating puckering skin or dimples, which are difficult to hide at any age. The demand for a nonsurgical, noninvasive treatment of cellulite has inspired some manufacturers to invest in a new age of sophisticated devices and treatment therapies to repair the skin and improve contours. Although many of these new choices have demonstrated a smoothing effect (following a multitude of treatments), the objective documentation has in most cases been limited to biopsies, circumference measurements, and photographic evidence. HYPOTHESIS: We believe that the application of noninvasive high-energy radiofrequency (RF) to the skin of the thigh and buttocks heats the subcutaneous adipose tissue, causing collagen fibers to contract. The resulting impact to the subcutaneous tissue and collagen is expected to improve the skin's external architecture. Given that the subcutaneous tissue and adipose tissue are difficult to evaluate through histological methods, this investigation seeks to demonstrate the changes that occur when applying 2 treatments of high-energy RF on the subcutaneous tissue of thighs and buttocks utilizing real-time ultrasound image scanning. MATERIALS AND METHODS: Twenty-six healthy female patients (ages 18 to 50) with visible bilateral cellulite (grade 1 to 3) on either the buttocks and/or thighs received 2 treatment sessions (15 days apart) of unipolar RF using the Accent RF System (Alma Lasers Inc). The system utilizes a unipolar RF applicator that is electrically cooled to aid in patient comfort during the treatment. Appropriate energy was set and the treatment was delivered in 3 passes of 30 seconds each. Evaluation of the thickness of the subcutaneous tissue on buttocks and thighs took place before the first treatment, second treatment, and 15 days following the second treatment with a with real-time scanning image ultrasound (Philips Medical Systems). Clinical improvement was objectively evaluated through comparative pre- and post-treatment measurements of the distance between the stratum corneum to the Camper's fascia and from the stratum corneum to the muscle. The study also evaluated the structure and changes of the collagen (thickening and realignment of septae) resulting from 2 treatments of RE Photography was used to document contour and superficial changes. RESULTS: From the measurements of the distance between the stratum corneum to the Camper's fascia and from the stratum corneum to the muscle we were able to demonstrate that 68% of the patients presented a contraction of the volume of approximately 20%. CONCLUSIONS: Based on the demonstrated results with real-time ultrasound scanning, we have observed that 2 RF treatments on the subcutaneous tissue of the buttocks and thighs provide a volumetric contraction effect in the majority of patients. This validates the primary hypothesis of our protocol and establishes that the RF energy works on the connective tissue of the subcutaneous adipose tissue. This effect should be the same on any other body part.

Adolescent↗

PubMed1991

Subcutaneous absorption of insulin in insulin-dependent diabetic patients. Influence of species, physico-chemical properties of insulin and physiological factors.

One major problem encountered when treating diabetic patients with insulin is the very large inter- and intra-individual variability in subcutaneous insulin absorption, a major contributory factor in the variability of the blood glucose level. Thus, to optimize insulin treatment the factors influencing the absorption have to be known and possibly utilized. The different types of insulin ("short-acting", "intermediate-acting" and "long-acting") have different times of action. "Short-acting" and "intermediate-acting" human insulin are probably absorbed slightly faster than porcine (and bovine) insulin. "Long-acting" human insulin is absorbed significantly faster than bovine insulin. More concentrated "short-acting" insulin (100 IU/ml) is absorbed slightly slower than less concentrated insulins (40 IU/ml). The absorption of "intermediate-acting" and "long-acting" insulin is dose-dependent, with a decreasing absorption rate with increasing dose of insulin. Insulin is administered subcutaneously either by injection or by using an infusion pump. The injection technique influences the absorption rate. Giving a continuous subcutaneous insulin infusion as a basal rate infusion, a depot is built-up. The building-up and the size of the depot, as well as the blood glucose and plasma insulin levels during steady-state conditions, are independent of the pulse-rate interval of the pump used (5 min vs 1 h). The size of the steady-state depot is constant during constant conditions but inversely correlated to the local subcutaneous blood flow and directly correlated to the infusion rate. An increase or decrease in the infusion rate during a basal rate infusion will after a delay of 2-3 h induce corresponding changes in the insulin absorption rate from the depot. After termination of the infusion, the insulin depot will still provide some insulin supply for 2-3 h. During the continuous infusion, the pharmacokinetics of the superimposed preprandial boluses will resemble injections of soluble insulin. The inter- and intra-individual variability in the insulin absorption, even when giving the same type, species, concentration and dose of insulin, is presumably primarily due to different and changing diffusion conditions in the subcutaneous tissue. Some factors which influence the diffusion conditions include exercise, local massage and, especially, local subcutaneous blood flow. Alterations in the blood flow induce, with a hyperbolic relationship, changes in the same direction in the absorption rate of injected and infused "short-acting" insulin and of injected "intermediate-acting" insulin. Several factors have been shown to influence both subcutaneous blood flow and insulin absorption, e.g. injection site, skinfold thickness, smoking, orthostatic changes, ketosis and ambient temperature.(ABSTRACT TRUNCATED AT 400 WORDS)

Absorption↗

PubMed1989

Responses of ewes to B. melitensis Rev1 vaccine administered by subcutaneous or conjunctival routes at different stages of pregnancy.

An experiment to determine the innocuousness and the humoral immune response of B. melitensis Rev1 vaccine was carried out in pregnant ewes. Thirty-three ewes were vaccinated on day 55 of pregnancy: 9 ewes received 2 X 10(9) Rev1 of French origin by the subcutaneous route, 9 ewes were conjunctivally vaccinated with 5 X 10(8) of the same strain, 7 ewes were subcutaneously vaccinated with 10(9) Rev1 of Spanish origin and 8 ewes received 1.8 X 10(9) Spanish strain Rev1 by conjunctival route. Another group (8 animals) were subcutaneously vaccinated with a reduced dose (10(6) of the French strain between days 90 and 120 of pregnancy. Finally, 20 ewes were vaccinated on day 120 of pregnancy with the French strain of which 11 received 10(9) Rev1 by the subcutaneous route and 9 were conjunctivally vaccinated with the same dose. Rev1 strain was isolated from the vaginal discharge of a significantly higher number of ewes vaccinated subcutaneously than in conjunctivally vaccinated ewes (24/35 versus 9/26 respectively; P less than 0.001). No difference between the two vaccine strains was recorded in the number of ewes excreting Rev1. Ewes subcutaneously vaccinated on day 55 of pregnancy aborted more frequently than conjunctivally vaccinated ewes (11/16 versus 2/17, respectively), hence a significantly reduced (P less than 0.001) length of pregnancy. Although 10 of the 11 animals subcutaneously vaccinated on day 120 of pregnancy excreted Rev1 strain, only one aborted. There was no significant effect of the time of vaccination on both abortions and length of pregnancy in ewes conjunctivally vaccinated with the French strain.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1985

Subcutaneous versus intramuscular growth hormone therapy: growth and acute somatomedin response.

To determine the optimal route of growth hormone administration, a comparison was made of the acute somatomedin response and chronic growth response to either intramuscular or subcutaneous growth hormone in 20 children with growth hormone deficiency. None of the children had received growth hormone for at least 2 weeks prior to their random selection to receive growth hormone by either the subcutaneous (N = 11) or intramuscular (N = 9) route. Plasma samples for determination of levels of insulin-like growth factors I and II (IGF-I and IGF-II) were obtained prior to therapy and 20 hours after the first and fourth of four daily injections of growth hormone. Growth rate and growth hormone antibody levels were determined before and after 6 months of therapy. IGF-I levels tripled in both treatment groups after four days of growth hormone injections, whereas IGF-II levels nearly doubled, with no significant difference between the intramuscular or subcutaneous group. After 6 months of therapy, there was no significant difference in growth rate and only two patients had developed growth hormone antibodies. Both patients and parents expressed a preference for the subcutaneous method. The identical rises in the IGF-I and IGF-II levels following a brief course of either subcutaneous or intramuscular injections of growth hormone, the similar growth rates, the low incidence of antibody development, and the preference for the subcutaneous route all suggest that the subcutaneous route is the method of choice for chronic growth hormone therapy.

Adolescent↗

PubMed1994

Subcutaneous morphine for postoperative analgesia.

OBJECTIVE: a. To confirm the efficacy of subcutaneous morphine infusion for postoperative analgesia and compare this effect with three-hourly subcutaneous bolus injections of morphine. b. To evaluate the suitability of a simple micro-infusion set to deliver subcutaneous infusion, as conventional infusion pumps are expensive and not readily available. SETTING: Double blind, prospective controlled clinical trial. PATIENTS: 21 patients belonging to the American Society of Anaesthesiologists' (ASA) classes I or II, who underwent major elective abdominal surgery were studied in an intensive care unit. INTERVENTION: All patients were given loading doses of morphine intravenously (iv) followed by subcutaneous (sc) infusion in two groups and three-hourly sc bolus injections in the third group. The doses were titrated on an individual basis. The infusion was delivered by a power driven pump in one group and by a microinfusion set in the other. Those with significant pain during this regime were given morphine supplements intravenously. MEASUREMENT: Pain scoring was done hourly using a modified verbal rating scale. The percentage of patients who required intravenous supplements in each group was compared to draw statistical conclusions. RESULTS: 1. Subcutaneous infusion provided adequate analgesia in 86% of the patients studied. 2. There was no significant difference between the groups in terms of additional iv supplement requirement. 3. The microinfusion set required frequent readjustments to maintain constant flow. CONCLUSIONS: Intermittent subcutaneous bolus injections of morphine given through an indwelling butterfly needle is a simple, safe, and effective method for postoperative analgesia after major abdominal surgery. Simple infusion sets are not suitable to deliver subcutaneous infusions, and the need for infusion pumps makes the infusion technique unsuitable for routine use in wards.

Abdomen↗

PubMed2000

Magnetic resonance imaging detection of occult skin and subcutaneous abnormalities in juvenile dermatomyositis. Implications for diagnosis and therapy.

OBJECTIVE: To assess the utility of magnetic resonance imaging (MRI) of skin, subcutaneous tissue, and fascia in evaluating disease activity in juvenile dermatomyositis (DM). METHODS: Short tau inversion recovery (STIR) MRI of the proximal thighs and buttocks, cutaneous assessment, and other measures of disease activity were prospectively obtained in 26 children meeting criteria for probable or definite juvenile DM. Also undergoing STIR MRI assessment were 8 subjects who were being evaluated for muscle disorders and who were not diagnosed as having juvenile DM. RESULTS: Skin, subcutaneous, or fascial edema of the thighs and buttocks were seen on STIR MRI in up to 85% of juvenile DM patients at baseline evaluation compared with no more than 38% of the comparison group without juvenile DM. In juvenile DM, STIR MRI skin and subcutaneous edema scores correlated (r(s) = 0.51, P = 0.008), as did fascial and muscle edema scores (r(s) = 0.58, P = 0.002). Skin global disease activity scores correlated with MRI skin edema scores (r(s) = 0.41, P = 0.04), and serum aldolase levels correlated with both MRI skin and subcutaneous edema scores (r = 0.44 and 0.40, P = 0.03 and 0.05 respectively). The extent and severity of STIR MRI changes in the skin, subcutaneous tissue, and fascia were not predicted by most other measures of juvenile DM disease activity. Five juvenile DM patients with thigh MRI subcutaneous edema developed clinically apparent calcinosis at the same location within 9 months. CONCLUSION: Edema or inflammation in the skin, subcutaneous tissue, and fascia, found on STIR MRI, is common in juvenile DM patients and is often undetected by standard assessments. These MRI changes can precede the development of calcinosis. STIR MRI may be a useful adjunct for assessing disease activity and guiding the treatment of juvenile DM.

Adolescent↗

PubMed1997

Relationship of anterior and posterior subcutaneous abdominal fat to insulin sensitivity in nondiabetic men.

Recent studies from our reveal that adipose tissue (AT) in the subcutaneous abdominal region is the most important determinant of peripheral and hepatic insulin sensitivity. Because of different anatomic and physiologic characteristics of anterior and posterior subcutaneous abdominal AT, we investigated the relationship of the masses of each compartment, as determined by magnetic resonance imaging, to insulin sensitivity (using euglycemic hyperinsulinemic glucose clamp technique), and other anthropometric variables. Thirty-four healthy men with varying ranges of obesity were recruited for the study. The mass of posterior subcutaneous abdominal AT was approximately 1.6 times more than that of the anterior compartment, and these masses accounted for 12.9% and 8.2% of the total body fat mass, respectively. All anthropometric variables, including body mass index (BMI), waist-to-hip circumference ratio (WHR), skin-fold thicknesses, and intraperitoneal AT mass were more significantly related to the posterior than the anterior subcutaneous abdominal AT mass. Compared to the anterior compartment mass, the posterior compartment mass displayed stronger relationship with insulin-mediated glucose disposal (Rd) (r = -0.44, p = 0.009, and r = -0.76, p = 0.0001, respectively) as well as with residual hepatic glucose output during the 40 mU.m-2.min-1 insulin infusion (r = 0.39, p = 0.02, and r = 0.53, p = 0.001, respectively). After adjusting for total body fat, the Rd values showed a significant partial correlation with the posterior subcutaneous abdominal AT mass (r = 0.52, p = 0.002). To conclude, posterior subcutaneous abdominal AT mass is more important determinant of peripheral and hepatic insulin sensitivity than the anterior subcutaneous abdominal AT.

Adipose Tissue↗

PubMed1983

Pharmacokinetics of continuous subcutaneous insulin infusion.

One of the reasons for the variability of blood glucose regulation in Type 1 (insulin-dependent) diabetic patients is the huge variation in subcutaneous absorption of intermediate-acting insulin. We have investigated the variation in insulin absorption during continuous subcutaneous insulin infusion in eight such patients. The content of insulin in the subcutaneous tissue was measured using 125I-labelled insulin. The concentration of free serum insulin and blood glucose was followed from 1 h before and from 7 h after breakfast on two consecutive days. The amount of insulin absorbed during 24 h differed in all cases by less than 3% from the daily insulin dose given by the pumps. Mean insulin absorption rates and mean free insulin concentration showed peak values 30-90 min after meal bolus injections; this was sufficient to maintain near-normal blood glucose. Mean free serum insulin correlated strongly with disappearance of insulin from the subcutaneous tissue (r = 0.98). From the insulin absorption rates and free insulin concentrations during basal constant insulin infusion, the half-time of serum insulin was calculated as 6 min. Compared with the known large variability in the absorption of intermediate-acting insulin, continuous subcutaneous insulin infusion offers a precise and reproducible way of insulin administration resulting in post-prandial serum insulin peaks sufficient to maintain near-normal blood glucose levels. The half-time of serum insulin during subcutaneous infusion corresponds to values for intravenous infusion given in the literature, indicating that local degradation of insulin in subcutaneous tissue is of minor importance.

Adult↗

PubMed1992

Chronic fissure-in-ano: a randomized study comparing open and subcutaneous lateral internal sphincterotomy.

A prospective study comparing open and subcutaneous lateral internal sphincterotomy for chronic anal fissure was conducted. One hundred twelve patients were randomized to open (n = 54) or subcutaneous (n = 58) sphincterotomy. There was no significant difference in acute complications between the subcutaneous (8.6 percent) and open (7.4 percent) groups. Postoperative length of stay was significantly shorter for the subcutaneous group (1.7 +/- 0.2 days) than for the open group (2.3 +/- 0.1 days; P less than 0.001). Although the response rate to a pain questionnaire was less than 50 percent, the data suggest a lower level of postoperative pain in the subcutaneous group. Fissure healing was similar between the subcutaneous (96.6 percent) and open (94.4 percent) groups. We conclude that subcutaneous lateral internal sphincterotomy for chronic fissure-in-ano is effective and may result in significantly less postoperative discomfort, shorter postoperative lengths of stay, and a comparable rate of complications compared with the open technique.

Adult↗

PubMed1998

Subcutaneous granuloma annulare: radiologic appearance.

OBJECTIVE: Granuloma annulare is an uncommon benign inflammatory dermatosis characterized by the formation of dermal papules with a tendency to form rings. There are several clinically distinct forms. The subcutaneous form is the most frequently encountered by radiologists, with the lesion presenting as a superficial mass. There are only a few scattered reports of the imaging appearance of this entity in the literature. We report the radiologic appearance of five cases of subcutaneous granuloma annulare. DESIGN AND PATIENTS: The radiologic images of five patients (three male, two female) with subcutaneous granuloma annulare were retrospectively studied. Mean patient age was 6.4 years (range, 2-13 years). The lesions occurred in the lower leg (two), foot, forearm, and hand. MR images were available for all lesions, gadolinium-enhanced imaging in three cases, radiographs in four, and bone scintigraphy in one. RESULTS: Radiographs showed unmineralized nodular masses localized to the subcutaneous adipose tissue. The size range, in greatest dimension on imaging studies, was 1-4 cm. MR images show a mass with relatively decreased signal intensity on all pulse sequences, with variable but generally relatively well defined margins. There was extensive diffuse enhancement following gadolinium administration. CONCLUSION: The radiologic appearance of subcutaneous granuloma annulare is characteristic, typically demonstrating a nodular soft-tissue mass involving the subcutaneous adipose tissue. MR images show a mass with relatively decreased signal intensity on all pulse sequences and variable but generally well defined margins. There is extensive diffuse enhancement following gadolinium administration. Radiographs show a soft-tissue mass or soft-tissue swelling without evidence of bone involvement or mineralization. This radiologic appearance in a young individual is highly suggestive of subcutaneous granuloma annulare.

Adipose Tissue↗

PubMed2004

Influences of age and sex on abdominal muscle and subcutaneous fat thickness.

This study aimed to investigate the influences of age and sex on the thickness of the rectus abdominis muscle and subcutaneous fat at the abdomen. The two tissue thickness values were determined using ultrasonography in a total of 194 young (20-29 years) and elderly (70-79 years) persons of both genders. In both sexes, the elderly groups showed significantly thinner muscle and thicker fat than the younger groups. The percentage of the mean value of subcutaneous fat thickness in the elderly group compared to that in the younger group was higher in the women (176%) than in the men (128%), but the corresponding value of muscle thickness was similar between men (68%) and women (65%). In both generations, the women had significantly thinner muscle and thicker fat than the men. The percentage of the mean value of subcutaneous fat thickness in the women compared to that in the men was higher in the elderly group (169%) than in the younger group (123%), but the corresponding value of muscle thickness was similar between the younger (80%) and elderly (77%) groups. In every group, subcutaneous fat thickness significantly correlated with waist circumference, but muscle thickness did not. The findings here indicated that: (1). aging was associated with a decrease of muscle thickness and an increase of subcutaneous fat at the abdomen in men and women, with a similar relative loss of muscle thickness in both genders and a greater increase of subcutaneous fat thickness in women than in men, and (2). subcutaneous fat rather than muscle thickness reflected waist circumference, regardless of age and gender.

Abdominal Muscles↗

PubMed2000

Effect of pressure and gas type on intraabdominal, subcutaneous, and blood pH in laparoscopy.

BACKGROUND: According to the literature, the number of port-site metastases in laparoscopic surgery varies considerably depending on the type of gas used for the pneumoperitoneum. In order to investigate this observation we studied the changes in blood, subcutaneous, and intra-abdominal pH during laparoscopy with helium, CO(2) and room air in a rat model. In addition, we looked at the influence of intra-abdominal pressure and duration of pneumoperitoneum on the pH during the laparoscopy. METHODS: pH was measured by tonometry, intra-abdominally and subcutaneously. A pH electrode was additionally placed into the subcutaneous tissue and the results compared to those measured by tonometry. Blood samples were taken from a catheter in the carotid artery. The intra-abdominal pressure was 0, 3, 6, 9 mm Hg for 30 min in each case. We investigated the effect of pneumoperitoneum with CO(2), helium and air in randomized groups of 5 rats. In an additional series the pressure was held constant at 3 mm Hg and the pH was measured every 30 min. RESULTS: Due to the different absorption capacity of the peritoneum, laparoscopy with CO(2) decreases the subcutaneous pH from 7.35 to 6.81. Blood pH is reduced from 7.37 to 7.17 and the intra-abdominal pH from 7.35 to 6.24. Other, less absorbable gases induce smaller changes of blood and subcutaneous pH (only 10% of CO(2)). In a variance analysis the p value is less than 0.001. The influence of duration of laparoscopy (30 min vs. 90 min) on the subcutaneous pH is less compared to the influence of intra-abdominal pressure (0, 3, 6, 9 mm Hg). CONCLUSIONS: Depending on the type of gas (CO(2), air, helium) used for laparoscopy blood, subcutaneous and intra-abdominal pH are influenced differently. Because lower pH is known to impair local defense mechanisms, these results may be one explanation for the higher incidence of port-site metastasis in laparoscopy with CO(2) than with other gases, as reported in the literature.

Abdomen↗

PubMed1995

Subcutaneous tissue approximation in relation to wound disruption after cesarean delivery in obese women.

OBJECTIVE: To test the hypothesis that closure of the subcutaneous fat decreases the incidence of wound disruption after cesarean delivery. METHODS: Two hundred forty-five women with at least 2 cm of subcutaneous fat were randomized to closure of the Camper fascia or no closure with cesarean delivery. RESULTS: Complications leading to disruption or opening of the incision were classified as wound seromas in 28 women (11.4%) and as wound infections in 17 (7.0%). The relative risk (RR) of seroma formation in the subcutaneous closure group was 0.3 with a 95% confidence interval (CI) of 0.1-0.7 (5.1 versus 17.2%), a statistically significant difference. There was no significant difference in the incidence of wound infections in the two study groups. Overall, there was a significant difference in the incidence of wound disruption from all causes between the two groups: 14.5% in the subcutaneous closure group compared with 26.6% when the subcutaneous tissues were not reapproximated (RR 0.5, 95% CI = 0.3-0.9). CONCLUSION: Closure of the subcutaneous tissue can significantly reduce the rate of postoperative wound disruption in women with at least 2 cm of subcutaneous adipose tissue.

Adult↗