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At least 343 records · Page 19Linked to original sources

PubMed1998

Local radiant heating increases subcutaneous oxygen tension.

BACKGROUND: We evaluated a novel bandage that incorporates a thermostatically controlled radiant heater. We first determined optimal bandage temperature, based on increases in subcutaneous oxygen tension, a measure correlating well with resistance to infection and wound strength. We then tested the hypothesis that prolonged radiant heating would increase collagen deposition in experimental thigh wounds. METHODS: The experimental bandages were positioned on the anterior thigh of 8 volunteers, and heated for 2 hours at 38 degrees C, 42 degrees C, or 46 degrees C, in a random order. Subcutaneous oxygen tension under the bandage was recorded from an electrode positioned within a subcutaneous tonometer. We studied 10 volunteers in the second protocol. For 1 week, the experimental bandage was continuously applied to one thigh, and heated to 38 degrees C using a 2-hour on/off cycle. On the alternate week, a standard gauze bandage was applied to the contralateral thigh. Treatment order was randomly assigned. Wound collagen deposition under each bandage was evaluated with subcutaneous polytetrafluoroethylene tubes, which were removed and assayed for hydroxyproline on the eighth day. Data are presented as means +/- SDs. RESULTS: Skin temperature during heating ranged from 36 degrees C to 37.5 degrees C. Oxygen tension increased approximately 50% during heating, but the increase was comparable at the three tested temperatures. Even after heating was discontinued, subcutaneous oxygen tension remained elevated for the remaining 3 study hours. Collagen deposition after 1 week of active heating was 3.4 +/- 1.0 microg/ cm. After 1 week of control treatment, collagen deposition was 3.2 +/- 1.1 microg/cm (P = not significant). CONCLUSIONS: Our data suggest that radiant heating at 38 degrees C significantly increases subcutaneous oxygen tension, and presumably resistance to infection. However, prolonged heating at this temperature does not increase wound collagen deposition.

Adult↗

PubMed1999

Relationship of visceral adipose tissue to metabolic risk factors for coronary heart disease: is there a contribution of subcutaneous fat cell hypertrophy?

Visceral adipose tissue (VAT) accumulation is an important correlate of the metabolic complications found in obese patients. The aim of this study was to evaluate the respective contribution of VAT deposition versus subcutaneous abdominal or femoral fat cell hypertrophy as correlates of the metabolic risk profile in 69 men and 65 premenopausal women (aged 35+/-5 years) with a wide range of fatness (body mass index, 18 to 57 kg/m2). In both genders, VAT accumulation was positively correlated with fasting plasma insulin, triglyceride (TG), and low-density lipoprotein (LDL)-apolipoprotein B (apo B) levels and the cholesterol (CHOL)/high-density lipoprotein (HDL)-CHOL ratio (.24 < or = r < or = .71, P < .05). A similar pattern of positive relationships was found between subcutaneous abdominal fat cell weight and metabolic risk variables in men and women (.33 < or = r < or = .60, P < .01). Positive associations were also observed in women between femoral fat cell weight and fasting plasma insulin, TG, and CHOL levels and the CHOL/HDL-CHOL ratio (.29 < or = r < or = .42, P < .05). However, only plasma TG concentrations and the CHOL/HDL-CHOL ratio were positively correlated with femoral fat cell weight in men (r = .30, P < .05). To better investigate the relationships between the metabolic risk profile and hypertrophic subcutaneous obesity, individuals with small versus large subcutaneous abdominal adipocytes were matched according to VAT accumulation. Men with large abdominal fat cells displayed higher plasma TG and LDL-apo B levels compared with men characterized by small abdominal adipocytes (P < .05). Stepwise multiple regression analyses showed that subcutaneous abdominal fat cell weight was the best independent variable predicting plasma TG and LDL-apo B levels in men. No significant difference was found in the metabolic profile of subjects displaying small versus large femoral adipocytes. Taken together, these results suggest that for a given VAT deposition, the presence of hypertrophied subcutaneous abdominal adipocytes in men appears to be associated with further deterioration in the metabolic risk profile. On the other hand, the hypertrophy of femoral adipocytes does not further alter the metabolic complications generally related to obesity in both men and women.

Adipocytes↗

PubMed1999

Subcutaneous fat in the fetal abdomen as a predictor of growth restriction.

OBJECTIVE: To determine if measuring fetal abdominal fat antenatally using ultrasound can predict fetal growth restriction (FGR). METHODS: One hundred thirty-seven unselected women with singleton pregnancies had serial ultrasound scans at 20, 26, 31, and 38 weeks' gestation. Subcutaneous fat in the fetal abdomen was measured using the same section as the abdominal circumference (AC). Outcome measures were birth weight, neonatal morbidity, and ponderal index. RESULTS: Infants with subcutaneous fat less than 5 mm at 38 weeks (n = 51) were almost five times more likely to have a birth weight below the 10th centile than those with subcutaneous fat of 5 mm or more (n = 75). The incidence of neonatal morbidity was significantly higher in infants with subcutaneous fat less than 5 mm, compared with those with subcutaneous fat of 5 mm or more (20% versus 8%, P < .05). Decreased subcutaneous fat was also associated with a high prevalence of low ponderal index, regardless of birth weight category. CONCLUSION: Measurement of fat in the abdominal wall is a simple technique with a sensitivity for predicting low birth weight similar to that of conventional sonography and might potentially predict FGR irrespective of fetal weight.

Abdomen↗

PubMed1976

Subcutaneous infusion and intramuscular injection of desferrioxamine in patients with transfusional iron overload.

The effects of intramuscular injection and subcutaneous infusion of desferrioxamine (D.F.) on urinary iron excretion were compared in eleven patients with thalassaemia major and one with congenital sideroblastic anaemia who were being maintained on regular blood-transfusions. Total (48-hour) urinary iron excretion ranged from 3-3 to 40-3 mg (mean 16-3 mg) in nine patients who received 750 mg D.F. intramuscularly before transfusion and from 3-9 to 32-3 mg (mean 11-9 mg) in ten patients who received D.F. by the same route after transfusion. In all 9 patients studied before transfusion, continuous subcutaneous infusion of 750 mg D.F. over 24 hours increased iron excretion by 61-5 to 135-8% (mean 101+/-25-4 S.D.%) compared with intramuscular injection of a similar dose. In the 10 patients studied after transfusion, the iron excretion produced by continuous subcutaneous infusion was from 18-9 to 213% (mean 128+/-74-3%) more than that produced by a single intramuscular injection of D.F. When the subcutaneous dose over 24 hours was increased to 1500 mg in six patients, 48-hour iron excretion ranged from 29-2 to 81-2 mg (mean 52-4 mg) and was increased by 80-2--794% (mean 429%) compared with the excretion when 750 mg was given by intramuscular injection. It is concluded that continuous subcutaneous infusion of D.F. produces more iron excretion in patients with iron overload than intramuscular injection. Providing a suitable portable pump can be carried by the patients, continuous subcutaneous infusion of desferrioxamine may prove a valuable means of preventing or treating iron overload in anaemic patients maintained on regular transfusions.

Adolescent↗

PubMed2000

Ultrasonic assessment of variations in thickness of subcutaneous fat during the normal menstrual cycle.

OBJECTIVE: To verify the occurrence of natural variations in thigh and abdominal subcutaneous fat thickness related to the phases of the menstrual cycle, to assess the value of ultrasonography as a reliable method for monitoring subcutaneous fat thickness changes and to evaluate their amplitudes. METHODS: This study included 10 women (19-39 years) who menstruated regularly. None had used oral contraceptives or slimming products during the 3 months prior to the study. At cycle day 2 (CD2), CD6, CD14, CD22, CD27 and CD30 days (CD0: beginning of menstruation), the subjects were submitted to: (1) measurement of weight and thigh perimeters, (2) measurements of thigh and abdomen subcutaneous fatty tissue thickness on B-mode images acquired at 10 MHz. A protocol was designed to guarantee a reproducible repositioning during the whole time course of the study and ultrasound examinations (US) were always performed by the same trained person to avoid inter-examiner variability. RESULTS: Subcutaneous fat thicknesses decreased during the first half of the cycle and reached their lowest values at day 22 (-2.0% for the thighs; -3.3% for the abdominal region). Both thigh and abdomen subcutaneous fat reached their maximum thicknesses during menstruation with respective increases of +2.2 and +4.0%. The observed cyclic amplitude variations in the subcutaneous adipose tissue thickness accounted for 7.3% for the abdominal region and 4.1% for the thighs. CONCLUSION: Variations in adipose tissue thickness during the menstrual cycle could be quantified and monitored by US. The thickness of the thigh and abdominal hypodermis was more important during menstruation and decreased in mid-cycle with a minimum occurring 1 week after ovulation.

Abdominal Muscles↗

PubMed1998

Osteoinduction capability of recombinant human bone morphogenetic protein-2 in intramuscular and subcutaneous sites: an experimental study.

The osteoinduction capability of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the muscle and in the subcutaneous tissue in Wistar rats (n = 20) was evaluated, using atelopeptide type-I collagen as a carrier. The alkaline phosphatase (ALP) activity and calcium (Ca) content were quantitatively analyzed 1, 3, 7 and 21 days after the implantation of 5 micrograms of rhBMP-2. At 3 days, the ALP activity began to increase gradually. The Ca content showed a slow increase until 7 days and was markedly elevated at 21 days. There was no significant difference observed between the intramuscular and subcutaneous sites until 3 days. However, at 7 days, both the ALP activity and Ca content were significantly higher intramuscularly than subcutaneously. Also, at 21 days they were higher in the muscle than in the subcutaneous tissue. These results suggest that the difference in osteoinduction could be related to the partial pressure of oxygen or the blood supply in the intramuscular and subcutaneous sites, and that immature mesenchymal cells in the muscle could more easily differentiate into osteoblasts, leading to osteoinduction. This study clearly demonstrated that even a small amount (5 micrograms) or rhBMP-2 induces new bone in the subcutaneous tissue, which has a lesser blood flow than the muscle.

Alkaline Phosphatase↗

PubMed1998

Home subcutaneous metochlopramide therapy for hyperemesis gravidarum.

Objective: To evaluate the efficacy, safety, and economics of home subcutaneous metochlopramide (Reglan) therapy for hyperemesis gravidarum.Methods: All charts of patients who underwent home therapy via a standard protocol utilizing a pump to administer metochlopramide subcutaneously between January 1994 and December 1995 were reviewed. Data were collected on the resolution of symptoms, reason for discontinuance of therapy, additional antiemetic therapy before, during, and after subcutaneous metochlopramide therapy, and side effects.Results: A total of 301 patients received home subcutaneous therapy with metochlopramide: 195 (64.8%) patients had complete resolution of symptoms, 32 (10.6%) patients discontinued therapy because of side effects, and 43 (14.3%) discontinued therapy because of worsening symptoms. A total of 16 (5.2%) patients discontinued therapy for other/nonspecific reasons. Two hundred twenty-two (73.8%) patients received one or more antiemetics prior to subcutaneous metochlopramide therapy. This number decreased to 6 (3%) of the group successfully treated who required any maintenance antiemetic after therapy was completed. One hundred sixty-four (54.5%) patients experienced some side effects. The vast majority of these were mild and did not require discontinuation of therapy. Eleven patients experienced extra pyramidal symptoms, 9 of which were discontinued therapy. The average daily costs for each home therapy patient was $265.00/day. This compares to the average daily costs of $1,370.00 for inpatient therapy for the same Diagnosis Related Group (DRG) in a Midwest five-hospital system.Conclusion: Home subcutaneous metochlopramide therapy appears to be a safe and effective treatment for hyperemesis gravidarum. The home setting results in decreased costs compared to inpatient hospitalization and may constitute a therapeutic, less stressful environment.

Journal Article↗

PubMed2004

Degree of anticoagulation after one subcutaneous and one subsequent intravenous booster dose of enoxaparin: implications for patients with acute coronary syndromes undergoing early percutaneous coronary intervention.

BACKGROUND: Many cardiologists continue to be reluctant to utilize low-molecular-weight heparin in the treatment of patients with non-ST-segment-elevation acute coronary syndrome because they are concerned about how to manage such patients if they have received only one dose of subcutaneous enoxaparin and are then taken within hours of such treatment to the cardiac catheterization laboratory for percutaneous coronary intervention (PCI). Although we and others have recommended that such patients who have received only one subcutaneous enoxaparin dose receive an intravenous 0.3 mg/kg enoxaparin "booster" dose immediately prior to PCI, there are little actual data to support this recommendation. METHODS: 20 middle-aged subjects were treated with 1 mg/kg subcutaneously-administered enoxaparin and then 6 hours later with a "booster" dose of 0.3 mg/kg intravenously-administered enoxaparin. Anti-Xa levels, as well as ENOX Times, were assessed at baseline, at 2, 4 and 6 hours after the initial SC dose, and at 5 min, 1 and 2 hours after the IV booster dose. RESULTS: At 2 and 6 hours after the initial subcutaneous enoxaparin dose, thirty-five percent of patients had anti-Xa levels below 0.6 IU/mL; twenty percent and ten percent had anti-Xa levels below 0.5 IU/mL at 2 and 6 hours after the initial subcutaneous dose, respectively. After the IV booster dose, all patients had anti-Xa levels in the therapeutic range during the 5 minutes to 2 hours during which blood samples were obtained. There was no significant "overshoot" with this booster dose above what is considered to be the upper therapeutic range. ENOX times showed an overall moderate correlation with anti-Xa levels. CONCLUSIONS: A strategy of administering a 0.3 mg/kg IV booster dose to patients who have received only one subcutaneous dose of enoxaparin and then undergo PCI within the first 2-6 hours of such treatment reliably leads to anti-Xa levels in the therapeutic range.

Acute Disease↗

PubMed2000

[Harvesting the vena saphena magna for aortocoronary bypass operations--is the subcutaneous suture necessary?].

BACKGROUND: The need for stitching the subcutaneous layers after saphenous vein graft harvest for coronary artery bypass is discussed controversially. METHODS: We conducted a prospective study to determine whether subcutaneous stitches reduce the incidence of hematoma, infection and wound dehiscence after saphenous vein graft harvest in patients undergoing coronary artery bypass grafting. Patients were randomized either to group 1 (n = 100, subcutaneous suture) or group 2 (n = 46, without subcutaneous suture). Leg wounds were examined for hematoma, wound dehiscence, necrosis or secretion preoperatively and on day 2 and 5 after surgery. Furthermore, leg circumferences were measured at distinct areas. RESULTS: There were no significant differences in the incidence of wound complications. Especially, leg circumferences and incidence of hematomas (group 1: 36% versus group 2: 39%) as well as the length of hospital stay (group 1: 6.8 days versus group 2: 6.2 days) did not differ significantly. CONCLUSIONS: The subcutaneous suture following saphenectomy is unnecessary. A deterimental effect of an additional subcutaneous suture could not be demonstrated.

Aged↗

PubMed2002

The effect of obesity on the ratio of type 3 17beta-hydroxysteroid dehydrogenase mRNA to cytochrome P450 aromatase mRNA in subcutaneous abdominal and intra-abdominal adipose tissue of women.

OBJECTIVES: To investigate (1) whether type 3 17beta-hydroxysteroid dehydrogenase (17beta-HSD), the enzyme which catalyzes the conversion of androstenedione to testosterone in the testis, is co-expressed with P450aromatase in the preadipocytes of women, and (2) whether the relative expression of type 3 17beta-HSD and aromatase varies in subcutaneous abdominal vs intra-abdominal adipose tissue of women. SUBJECTS: Subcutaneous abdominal and intra-abdominal adipose tissue was obtained from women undergoing elective abdominal surgery (age 22-78 y, body mass index (BMI) 22.4-52.9 kg/m(2)). MEASUREMENTS: Expression of type 3 17beta-HSD in adipose cell fractions was determined using RT-PCR. Preadipocyte steroidogenesis was investigated in primary cultures using androstenedione as substrate. Messenger RNA levels for type 3 17beta-HSD and aromatase were measured in adipose tissue from the subcutaneous abdominal and intra-abdominal depots using a quantitative multiplex competitive RT-PCR assay. RESULTS: Type 3 17beta-HSD is co-expressed with aromatase in the abdominal preadipocytes of women. Cultured preadipocytes from both subcutaneous abdominal (n=5) and intra-abdominal (n=5) sites converted androstenedione to testosterone, and there was minimal conversion of androstenedione to estrone. Consistent with this, the levels of type 3 17beta-HSD mRNA were significantly higher than aromatase mRNA at both sites (P<0.05; n=8 subcutaneous abdominal, n=12 intra-abdominal adipose tissue). The ratio of levels of 17beta-HSD mRNA to aromatase mRNA in intra-abdominal adipose tissue was positively correlated with BMI (n=11, r=0.61, P<0.05) and waist circumference (n=10, r=0.65, P<0.05). The converse was found in subcutaneous abdominal adipose tissue. CONCLUSION: The intra-abdominal adipose tissue of women may be substantially androgenic, increasingly so with increasing obesity, particularly central obesity. While androgen production by this adipose tissue deposit may not contribute to circulating testosterone levels due to hepatic clearance, it may have hitherto unrecognised local effects in the intra-abdominal adipose tissue and also on the liver via the hepatic portal system. These studies suggest a mechanism linking central obesity with insulin resistance and dyslipidaemia.

17-Hydroxysteroid Dehydrogenases↗

PubMedDate not supplied

A comparison of gestational days gained with oral terbutaline versus continuous subcutaneous terbutaline in women with twin gestations.

OBJECTIVE: To compare gestational days gained with oral versus subcutaneous terbutaline for maintenance tocolysis. STUDY DESIGN: In retrospective fashion 386 women enrolled in an outpatient preterm labor identification program met the following criteria: twin gestation, development of threatened preterm labor resulting in treatment with oral terbutaline, and subsequent recurrence of threatened preterm labor resulting in treatment with continuous subcutaneous terbutaline. The primary outcome was gestational days gained with oral terbutaline versus gain with continuous subcutaneous terbutaline. RESULTS: There were significantly more days gained during subcutaneous treatment than during oral treatment (34.0 +/- 19.8 versus 19.3 +/- 15.3 days). Thirty-three percent of desired prolongation was achieved with oral terbutaline, whereas 79% of desired prolongation was achieved with subcutaneous terbutaline (p < 0.001). Patients gained a mean of 53.4 +/- 21.4 days overall with outpatient tocolysis. The mean gestational age at delivery was 35.2 +/- 1.9 weeks. CONCLUSION: Continuous subcutaneous terbutaline was superior to oral terbutaline in prolonging gestation in women with twin gestations.

Administration, Oral↗

PubMedDate not supplied

Clinical and cost-effectiveness of continuous subcutaneous terbutaline versus oral tocolytics for treatment of recurrent preterm labor in twin gestations.

OBJECTIVE: To compare the clinical and cost-effectiveness of treating recurrent preterm labor with continuous subcutaneous terbutaline versus oral tocolytics in twin gestations. STUDY DESIGN: In a retrospective, matched-cohort design, twin pregnancies treated as outpatients with continuous subcutaneous terbutaline were identified from a perinatal database, then matched 1:1 by gestational age at recurrent preterm labor to those receiving oral tocolytics. There were 353 patients per treatment group. A cost model was used to compare antepartum hospital, nursery, and outpatient charges. RESULTS: Infants of the subcutaneous terbutaline group had greater gestational age at delivery, higher birth weights, and less frequent neonatal intensive care unit admission. Charges for antepartum hospitalization and nursery were significantly less in the subcutaneous terbutaline group, while charges for outpatient services were less for the oral group. Mean total estimated charges were US$17,109 less for those receiving subcutaneous terbutaline. CONCLUSION: Improved clinical outcomes and decreased nursery utilization suggest cost-effectiveness of outpatient continuous subcutaneous terbutaline versus oral tocolytics for the treatment of recurrent preterm labor.

Administration, Oral↗

PubMed2001

Subcutaneous curettage vs. injection of botulinum toxin A for treatment of axillary hyperhidrosis.

BACKGROUND: Axillary hyperhidrosis is a functional non-inflammatory abnormality of the eccrine sweat glands. The cause of genuine hyperhidrosis is unknown and, therefore, no specific corrective therapy is available and conservative treatment often fails. Subcutaneous sweat gland curettage of the axillae is one of the proven surgical modalities. Local injection of botulinum toxin A (BT-A) is a promising new conservative approach. OBJECTIVE: The purpose of this study was to compare the efficacy of subcutaneous curettage vs. injection of BT-A in axillary hyperhidrosis. METHODS: A total of 113 patients (36.3% males, 63.7% females) suffering from genuine axillary hyperhidrosis were treated by either subcutaneous curettage (n = 90) or local injection of BT-A (n = 23). Median follow-up period was 23.5 months. Questionnaires were handed out to patients for a subjective assessment of symptoms before treatment, 6 months after the procedure, and at the time of last follow-up. The patients were asked to rate the amount of axillary sweating based on a score ranging from 1 (no axillary secretion) to 6 (maximum axillary secretion). The subjective scores of sweating at rest, at high temperatures, under physical stress, under emotional stress and after spicy meals were assessed. RESULTS: The patients' subjective assessments of the overall outcome after subcutaneous curettage were 'very good' in 36.4%, 'good' in 29.9% and 'satisfactory' in 16.9%. The subjective score of axillary sweating at rest was reduced to 40.0% after 6 months, and finally to 45.7% at the end of follow-up (median: 28.2 months). Patients treated by BT-A injection assessed outcome as 'very good' in 39.1%, 'good' in 21.7% and 'satisfactory' in 8.7%. Sweating at rest was reduced to 48.5% after 6 months, and finally to 68.8% at the end of follow-up (median: 16.1 months). The mean duration of the antiperspiration effect of BT-A was 7.6 months (median: 7 months), but there were two cases of long durations, i.e. 14 and 18 months. CONCLUSIONS: Subcutaneous curettage and injection of BT-A both present major advantages compared with earlier methods. Subcutaneous curettage offers the same permanent efficacy but far fewer side-effects than sympathectomy, and less scarring than local excisional procedures, respectively. Of the conservative approaches BT-A is by far the most efficacious. Patients should be informed of the advantages and disadvantages of both methods.

Adult↗

PubMed1999

Subcutaneous leiomyosarcoma on the face.

BACKGROUND: Cutaneous leiomyosarcoma is a rare soft tissue sarcoma with a predilection for the lower extremities. Leiomyosarcoma of the face is very rare. Subcutaneous leiomyosarcoma has a higher likelihood of recurrence and metastases than that of the superficial dermal type. OBJECTIVE: The dermatologic surgeon and pathologist should be familiar with the characters of subcutaneous leiomyosarcoma. METHODS: We report a case of subcutaneous leiomyosarcoma on the face with the results of histologic examination and immunohistochemical studies. RESULTS: Leiomyosarcoma of the face is exceedingly rare. The deep subcutaneous type is thought to arise from the smooth muscle of the vascular wall. The neoplasm we report here has deep tumor invasion, high malignancy grade (3B), and large tumor size. Wide excision and postoperative radiotherapy were performed. CONCLUSION: Subcutaneous leiomyosarcoma has a higher likelihood of recurrence and metastases than that of the superficial dermal type. The most effective treatment is wide excision with 3-5 cm lateral margins and a depth that includes subcutaneous tissue and fascia.

Facial Neoplasms↗

PubMed2001

Contributions of total body fat, abdominal subcutaneous adipose tissue compartments, and visceral adipose tissue to the metabolic complications of obesity.

Obesity is related to the risk for developing non-insulin-dependent diabetes mellitus (NIDDM), hypertension, and cardiovascular disease. Visceral adipose tissue (VAT) has been proposed to mediate these relationships. Abdominal subcutaneous adipose tissue (SAT) is divided into 2 layers by a fascia, the fascia superficialis. Little is known about the radiologic anatomy or metabolic correlates of these depots. The objective of this study was to relate the amounts of VAT, SAT, deep subcutaneous abdominal adipose tissue (DSAT), and superficial subcutaneous abdominal adipose tissue (SSAT) to gender and the metabolic complications of obesity after adjusting for total body fat and to discuss the implications of these findings on the measurement of adipose tissue mass and adipose tissue function. The design was a cross-sectional database study set in a nutrition research center. Subjects included 199 volunteers participating in nutrition research protocols who also had computed tomography (CT) and dual energy x-ray absorptiometry (DEXA) measurement of body fat. The amount of DSAT was sexually dimorphic, with women having 51% of the subcutaneous abdominal fat in the deep layer versus 66% for men (P <.05). Abdominal fat compartments were compared with metabolic variables before and after adjusting for body fat measured by DEXA using 2 separate methods. The unadjusted correlation coefficients between the body fat measures, R(2), were largest for fasting insulin and triglyceride and smaller for high-density lipoprotein (HDL) cholesterol and blood pressure. A large portion of the variance of fasting insulin levels in both men and women was explained by total body fat. In both men and women, the addition of VAT and subcutaneous abdominal adipose tissue depots only slightly increased the R(2). In men, when body fat compartments were considered independently, DSAT explained a greater portion of the variance (R(2) =.528) in fasting insulin than VAT (R(2) =.374) or non-VAT, non-DSAT subcutaneous adipose tissue (R(2) =.375). These data suggest that total body fat is a major contributor to the metabolic sequelae of obesity, with specific fat depots, VAT, and DSAT also making significant contributions.

Abdomen↗

PubMed1998

[Subcutaneous manifestations of a centrocytic non-Hodgkin lymphoma at the injection site of a mistletoe preparation].

HISTORY AND CLINICAL FINDINGS: A 73-year-old man, first diagnosed as having centrocytic Non-Hodgkin lymphoma 5 years previously, presented with subcutaneous nodes of the abdominal wall at precisely the sites of previous regular injections of a mistletoe preparation. These nodes had first appeared 5 weeks after the first injection. Injections were stopped and he reported to the out-patient clinic. Except for the visible and easily nodes in the anterior wall no other subcutaneous nodes were palpated. Prominent cervical lymphomas and swelling of the epicranial aponeurosis and lower lip had, according to the patient, been present for some time. INVESTIGATIONS: There was a T-lymphocytopenia, lactate dehydrogenase activity was raised to 255 U/l. The subcutaneous nodes in the anterior abdominal wall were also demonstrated by ultrasound. Computed tomography showed them as having the density of connective tissue and being up to 5 cm in diameter. The excised nodes histologically revealed to be infiltrations by the centrocytic lymphoma. TREATMENT AND COURSE: Once the mistletoe injections had been discontinued no further subcutaneous infiltrates were seen despite the progression of the lymphoma. Six weeks later the patient died of bilateral pneumonia. CONCLUSION: There are pointers that high concentrations of mistletoe preparations subcutaneously injected can have a growth-promoting action on cells of a centrocytic lymphoma. As part of a leukaemic "wash-out", these cells reach the subcutaneous tissue. This proliferative stimulus may have been mediated by a high local concentration of interleukin-6 liberated from the skin by mistletoe lectins.

Abdominal Muscles↗

PubMed1996

Difference in leptin mRNA levels between omental and subcutaneous abdominal adipose tissue from obese humans.

Differences in fat cell size and function among adipose tissue depots are well known and may be important in the pathophysiology of the metabolic and cardiovascular complications of obesity. Since the newly discovered adipocyte hormone leptin is thought to be a central factor in the regulation of energy homeostasis, it may be interesting to know if there are regional differences in leptin production. The aim of this study was to compare the level of leptin expression in the omental and subcutaneous abdominal adipose tissue from obese humans. Adipose tissue samples were collected from 25 severely obese adults (mean BMI: 48.9 +/- 9.7 kg/m2) undergoing vertical gastric banding. Semi-quantitative determination of leptin mRNA by the RT-PCR technique showed significantly lower leptin expression in omental compared to subcutaneous abdominal adipose tissue (leptin/Sp1 ratio in omental vs. subcutaneous fat: 1.53 +/- 0.89 vs. 3.02 +/- 1.58, p < 0.01). Identical results were obtained when Northern blotting was applied in a subgroup. Leptin expression increased with age in omental adipose tissue (r = 0.42, p < 0.05), but not in subcutaneous tissue. No correlation was found between BMI or waist/hip ratio (WHR) and leptin expression in omental or subcutaneous adipose tissue. The regional difference in leptin expression was similar in the patients with impaired glucose tolerance/type-2 diabetes and those with normal glucose tolerance. In conclusion, the results of this study indicate that leptin expression is lower in omental than subcutaneous adipose tissue, possibly due to differences in fat cell size and/or sympathetic innervation.

Abdomen↗

PubMed2001

Reduction of subcutaneous mass, but not lean mass, in normal fetuses in Denver, Colorado.

OBJECTIVE: To test the hypothesis that reduced birth weight in normal fetuses born at moderately high altitude (Denver), compared with the birth weight in normal fetuses born at sea level (Milan), is caused by a reduction in both lean mass and subcutaneous fat mass. STUDY DESIGN: Ninety-four normal singleton pregnancies (46 in Denver, 48 in Milan) had serial ultrasonographic axial images obtained to assess subcutaneous tissues of fetuses as a measure of body fat. The abdominal wall thickness and mid upper arm and mid thigh were examined. The equation was: Subcutaneous tissue equals total cross-sectional area minus bone and muscle area. Lean mass included the area of muscle and bone, head circumference, and femur length. RESULTS: Gestational age at delivery was similar between groups. Birth weight was less at Denver's altitude (2991 +/- 79 g versus 3247 +/- 96 g; P =.04). Abdominal wall thickness, mid upper arm, and mid thigh subcutaneous tissues measurements were significantly reduced at Denver's altitude and increased further in significance with advancing gestational age. Lean mass measurements were similar between groups. CONCLUSIONS: The reduced birth weight of the newborns in Denver was the result of a reduction in fetal subcutaneous fat tissue and not lean mass. Ultrasonography can be used to follow subcutaneous measurements longitudinally and to detect differences, and potentially disease processes, in study populations.

Adipose Tissue↗