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Changes in cellular composition of subcutaneous connective tissue were studied on the film-like preparations immediately or some time after single and repeated general overheating. It is suggested that the discovered changes in fibroblasts, histiocytes and mast cells reflect the connective tissue reaction directed at the maintenance of the metabolic homeostasis.
Mast cells of the rat subcutaneous connective tissue were studied in experimental hypertension. An increase was discovered in the degranulation of the cells in rats with spontaneous and adrenal-regenerative hypertension. These animals demonstrated a rise in the number of immature cells with a relatively low content of serotonin. The changes described are believed to be linked with arterial pressure elevation.
The new optical device Lipometer allows noninvasive, quick, and safe determination of the thickness of subcutaneous adipose tissue (SAT) layers (in mm) at any site of the human body. The specification of 15 evenly distributed body sites enables the precise measurement of subcutaneous body fat distribution, so-called subcutaneous adipose tissue topography (SAT-Top). SAT-Top was measured in 980 children aged 7-19 years. In this paper we describe the degree to which SAT-Top body sites are intercorrelated. We consider whether a meaningful reduction of data is possible using factor analysis, which factors can be extracted, and how SAT-Top data of children can be added to a factor value plot, depicting the essential results of age-dependent subcutaneous fat development. SAT layers situated on the same body area provide correlation coefficients up to +r = 0.91. Two factors are extracted: factor 1, containing all upper body sites (from neck to hip); and factor 2, consisting of all leg body sites. When all 980 children are divided into three age groups in a factor value plot, the first age group (7-11 years) shows almost equal SAT-Top development in boys and girls. Afterwards, for the consecutive age groups 2 (11-15 years) and 3 (15-19 years), the age-dependent subcutaneous fat development of boys and girls progresses into nearly orthogonal directions.
In sepsis and endotoxemia, metabolism is characterized by accelerated catabolism. In the present study, lipolytic responsiveness of subcutaneous and mesenteric adipose tissue to the sub-lethal dose of endotoxin injection (5 mg/kg) was evaluated using microdialysis techniques in rats. All rats were urethane-anesthetized and implanted with microdialysis probes in their subcutaneous and mesenteric adipose tissue. Lipolysis in each adipose tissue was assessed by measuring the glycerol concentration (an index of lipolysis) in the dialysate from the microdialysis probe. Lipolysis was continuously monitored for 7-hours, prior to and following the injection of endotoxin. The control animals were injected with only saline. Lipolysis in subcutaneous adipose tissue began to increase by 1-hours after endotoxin injection, and reached a peak 60% higher than the basal level by 2-hours after injection. This activated lipolysis after endotoxin was markedly greater than that in the control animals and maintained for 5 hours. In mesenteric adipose tissue, lipolysis after endotoxin injection was greater than in the control animals, but not significant. The endotoxin-induced lipolysis in the subcutaneous adipose tissue was significantly greater than that in the mesenteric adipose tissue. We conclude that the sub-lethal dose of endotoxin injection cause active lipolysis in adipose tissues, and that the lipolytic responsiveness to endotoxin in subcutaneous adipose tissue is greater than in mesenteric adipose tissue.
Specimens of the rabbit V2 carcinoma were maintained in organ culture to study the secretion of proteinases. Elastase-like, chymotrypsin-like, plasminogen activator-like, cathepsin B-like and collagenase activities were assayed with sensitive fluorimetric techniques. Of these enzymes, the only activities that were secreted in considerable amounts in primary cultures of tumor tissue were collagenase and a cysteine proteinase resembling cathepsin B. Co-cultures of intraperitoneally grown tumor and normal subcutaneous tissue of the rabbit resulted in significantly higher production of the cysteine proteinase and collagenase compared to the sum of the activities of the separate tissues. Explants of subcutaneous tissue of tumor-bearing rabbits secreted significantly more cysteine proteinase and collagenase than explants from normal animals. Explants from normal subcutaneous tissue stimulated with tumor-conditioned culture medium secreted both enzymes in higher amounts compared to the controls. The cysteine proteinase was similar in some properties to rabbit liver cathepsin B, but the enzyme from the tumor-host system showed a remarkable stability to a moderately alkaline pH. We suggest that a diffusible factor, derived from the tumor or immigrated cells, promotes an increased synthesis and secretion of collagenase and cysteine proteinase in the host, and that both enzymes may play cooperative roles during invasion of the surrounding tissues by the V2 carcinoma.
The possibility of continuously monitoring the absolute glucose concentration in subcutaneous adipose tissue, using microdialysis of the extracellular water space, was investigated in six Type 1 (insulin-dependent) diabetic patients. By using a large microdialysis probe (30 x 0.62 mm), and by perfusing with a low flow rate (0.5 microliters/min), complete recovery of glucose was attained in vitro. In the patients the dialysis probe was implanted subcutaneously, perfused by a wearable microinfusion pump, and dialysate samples were collected in 60-min fractions over 10 h. The absolute glucose concentration in the tissue dialysate was the same or almost the same as the blood glucose concentration (range 87-101% of the blood glucose value). The changes in blood glucose were closely paralleled by the variations in adipose tissue glucose (r = 0.93, p < 0.01), and the recovery of glucose in the microdialysate remained constant during the 10-h study period. In conclusion, it is possible, using microdialysis, to directly determine the absolute glucose concentration in subcutaneous adipose tissue. Hence, this technique may be used for continuous glucose monitoring in diabetic patients.
Several types of musculocutaneous flaps, including that the pectoralis major, have been used for reconstruction following resection of malignant tumors in the head and neck region. Although several clinical studies have investigated the vascularity of such musculocutaneous flaps, the findings have been inconsistent. The present study examined the distribution of arteries in the pectoralis major muscle and surrounding subcutaneous tissue by macroscopic dissection and angiography. Based on the results of this examination, muscle layer and surrounding subcutaneous tissue appear to be supplied by different arteries and show different distribution patterns. However, evidence of penetrating branches from the muscle layer to the subcutaneous tissue layer suggests the existence of blood flow from the muscle layer to the subcutaneous tissue layer. Such arterial branches should be considered when raising the pectoralis major flap in order to prevent necrosis and improve the viability of the flap.
OBJECTIVE: This study determined if the magnetic resonance imaging (MRI) protocol used alters the estimation of change in abdominal fat with weight loss in obese type 2 diabetic women. This study also examined if there is a uniform fat loss across the abdomen. METHODS AND PROCEDURES: Thirty-three obese postmenopausal women with type 2 diabetes (age 50-70 years, body mass index>30 kg/m(2)) had a total abdominal MRI scan pre- and post weight loss intervention. Three different MRI analysis protocols were used and compared: a single slice at L(2)-L(3) vs five slices (centered at L(4)-L(5)) vs all abdominal slices. In addition, the total abdominal scan was divided into four regions (four slices each) with region 3 (critical region) including the traditionally studied L(2)-L(3), and regions 1 and 2 superior and region 4 inferior to critical region 3. Analysis of variance (ANOVA) with repeated measures was used to compare the influence of weight loss on abdominal fat measured both regionally and using the varying number of MR slices. RESULTS: At baseline, the ratio of visceral adipose tissue:subcutaneous adipose tissue (VAT:SAT) was significantly lower using the single-slice method compared to five slices and the total abdomen (P<0.01). Using the single-slice method, a lower %VAT was found than with the other methods (P<0.01). In regions 1, 2, 3, and 4, the absolute change in total fat was 122+/-50, 182+/-48, 182+/-55, and 155+/-40 cm(3), respectively. The regional difference in abdominal fat patterning revealed that the critical region (region 3) had a smaller VAT:SAT ratio than regions 1 and 2 (P<0.05), and the ratio at region 4 was smaller than region 3 (P<0.05). Weight loss resulted in a decrease in the VAT:SAT ratio (P<0.05) for regions 3 and 4 but not for regions 1 and 2. CONCLUSIONS: The number of MR slices analyzed yields differential result in relative VAT distribution. Regional differences in abdominal fat loss occur with a greater relative VAT loss in the critical region, thus if only the critical region is analyzed the overall VAT loss induced by weight loss intervention may be overestimated.
In the present work we study the binding of insulin to its receptors in adipocytes from subcutaneous adipose tissue of left hypochondria extracted during an adrenalectomy carried out in a patient with Conn's Syndrome (left adrenal adenoma), comparing it to insulin binding to its receptors in adipocytes from subcutaneous adipose tissue of right hypochondria, obtained during a cholecystectomy because of cholelithiasis (controls). According to our results, there is an evident decrease in insulin binding to its receptors in adipocytes of the patient with Conn's Syndrome in relation to control group. This decrease in binding would be based both in a decrease in insulin receptor number as in an affinity loss of these receptors for the hormone. These facts at the receptor level could be originating a decrease in tissue response to insulin and be the base for glucose intolerance observed in patients with this pathology.
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We report three cases of amniocentesis in which mosaicism for trisomy 12 was detected in two or more independent cultures. The parents elected to terminate the pregnancy in all three cases. Follow-up studies in two of the cases confirmed the mosaicism in fetal tissues (in subcutaneous tissue in one case; in fetal lung in the other), but not in blood. No fetal anomalies were evident by ultrasound or at autopsy. These results along with other reported cases demonstrate the difficulty in counselling for mosaic trisomy 12.
The purpose of this study was to investigate changes in muscle hardness after eccentric exercise of the elbow flexors muscles that produce muscle shortening and swelling. To assess muscle hardness, a pressure method was used in which the force required to deform the tissue (skin, subcutaneous tissue, muscle) was recorded. Eleven healthy male students performed 24 maximal eccentric actions of the elbow flexor muscles with their non-dominant arms. Muscle hardness, maximal isometric force (MIF), muscle soreness, plasma creatine kinase (CK) activity, relaxed elbow joint angle (RANG), upper-arm circumference (CIR) and B-mode ultrasound transverse images were measured before, immediately after, and 1-5 days after exercise. A long-lasting decrease in MIF, muscle swelling shown by increases in CIR and muscle thickness, large increases in plasma CK activity, and development of muscle soreness indicated that damage occurred to the elbow flexor muscles. The RANG had decreased by approximately 20 degrees at 1-3 days after exercise and showed a gradual recovery thereafter. The CIR increased gradually after exercise and peaked on day 5 post-exercise, the mean amount of increase in CIR being 18 mm. Muscle hardness measured at the relaxed elbow position did not change until 3 days after exercise, but increased significantly (P < 0.01) on days 4 and 5 post-exercise. On the other hand, muscle hardness measured when forcibly extending the shortened elbow joint increased significantly (P < 0.01) with time and peaked at 3 days after exercise. Muscle hardness assessed by the pressure method seems to reflect changes in muscle stiffness and swelling.
Vermilion notching or 'whistle deformity' is a common secondary deformity of the vermilion in patients with cleft lip. The free border of the lip is a composite structure consisting of the orbicularis oris and the overlying tissues, namely subcutaneous fat, vermilion and mucosa. A deficiency of all or one of these structures is responsible for the vermilion notch. An absolute shortage of the muscle or subcutaneous tissue necessitates the use of tissue from another source to correct the deformity. Dermis fat grafts have been used to augment the free border of the lip and correct this deformity. The technique is simple and reliable. The tissue is available in plenty, easy to harvest and could be repeated if necessary, i.e. in case of resorption. From June 1996 until January 2000 the technique was used in 10 patients. Of these 10, one was a bilateral cleft and nine were unilateral cleft lip deformities. A degree of graft resorption was seen in one patient, one had a partial graft loss due to ulceration and exposure. The first patient had a further augmentation.
Biodynamic responses of the finger-hand-arm system, such as apparent mass and mechanical impedance, characterize the relationship between the motion of the finger-hand-arm system and the dynamic force acting on the driving point, and they are useful for vibration exposure assessment. In the present study, a two-dimensional finite element (FE) model has been proposed to simulate the biodynamic responses of the fingerpad in vibration tests. The fingernail was supported by the rigid ground while the fingerpad was activated by a vibration probe. The fingertip model is composed of skin, subcutaneous tissue, bone, and nail. The soft tissues (i.e., skin and subcutaneous tissues) were assumed to be non-linearly elastic and linearly viscoelastic. The FE model was applied to predict the effects of pre-indentation of the vibration probe onto the fingerpad, the damping of the soft tissues, and probe mass on the magnitude and phase angle of the mechanical impedance and the apparent mass, as measured in the vibration tests. The model predictions showed that the probe mass has non-negligible effects on the measured biodynamic responses in the vibration tests. In order to determine "true" biodynamic responses of the finger-hand-arm system, the mass effects have to be cancelled using an appropriate approach. The present analysis provided a theoretical explanation, from a biomechanical point-of-view, for the inconsistencies in the published experimental data for the biodynamic responses of fingerpad.
Ependymomas of the sacrococcygeal region almost always arise on the posterior aspect of the sacrum in the soft tissues and subcutaneous tissues of this region. The predominant histologic type of ependymoma in the sacrococcygeal area is myxopapillary. We report a case of myxopapillary ependymoma arising in the presacral area and presenting clinically as an abdominal mass. Ependymomas arising on the ventral aspect of the sacrum are exceedingly rare, and only 24 previous cases have been reported in the English literature. While dorsal myxopapillary ependymomas occasionally metastasize, there have been no reports of metastasis in the presacral tumors of this type.
A dangerous and little-discussed group of soft tissue (skin, subcutaneous tissue, fascia, and skeletal muscle) infections are characterized by the presence of extensive gangrene and/or discernible tissue gas. The identifying characteristics of these infections, as well as diagnostic measures and therapy, are reviewed.
BACKGROUND: The provision of ambulatory dermatologic procedural care is not well characterized. OBJECTIVE: Our purpose was to determine the frequency that different cutaneous procedures are performed by different physician specialties and the diagnoses corresponding to these procedures. METHODS: Outpatient dermatologic procedures recorded in the 1993 and 1994 National Ambulatory Medical Care Survey were analyzed. To define dermatologic procedures and diagnoses, the International Classification of Diseases diagnosis and procedure codes were identified that related to the skin and subcutaneous tissues. Sampling weights were applied to achieve the nationally representative estimates. RESULTS: During 1993 and 1994, an estimated 37 million dermatologic procedures were performed. Most were performed by dermatologists (69%) and by family and general practice physicians (15%). A single procedure, "Other local excision or destruction of lesion or tissue of skin and subcutaneous tissue," constituted 65% of all of the dermatologic procedures. UV light treatments, ambulatory microscopic examination of skin specimens, and acne surgical procedures were performed almost exclusively by dermatologists. Most skin biopsies (82%) and excision/destruction procedures (71%) were performed by dermatologists. Actinic keratoses and viral warts accounted for 25% of all cutaneous dermatologic diagnoses treated. CONCLUSION: Dermatologists have far more experience performing skin biopsies and excision/destruction procedures than other physicians. Cost containment efforts that deny coverage for treatment of actinic keratoses and viral warts would affect a significant portion of cutaneous procedures.
Transvaginal images, under matched conditions, are in general superior in quality to transabdominal sonograms. The difference is, however, not dramatic and instances frequently occur when the same quality and even inferior images are obtained on transvaginal examinations. The dominant factor is the amount of overlying tissues. For the same thickness, subcutaneous tissues have greater degrading characteristics. Subcutaneous tissues also mar the quality of images by giving rise to strong multiple reflection artifacts. The major factors for image degradation are associated with a moderate increase in the width of the ultrasonic beam and a large increase in the side lobes. The dramatic superiority of transvaginal imaging described in previous comparison studies is due principally to the use of higher frequencies, more strongly focused beams and closer positioning of tissues to the transducer.