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Journal of Ultrasound Sep 2022The present work is aimed studying the visibility and position of the vasto-adductor membrane with ultrasonography and demonstrating that injection performed under this... (Review)
Review
The present work is aimed studying the visibility and position of the vasto-adductor membrane with ultrasonography and demonstrating that injection performed under this membrane allows to infiltrate the saphenous nerve. It was analyzed with ultrasonography in four cadaveric subjects and in 13 volunteers. This membrane was clearly visible and methylene blue was located underneath it after injection in all cadaveric subjects. This study demonstrates that it can be used as a reliable anatomic landmark when performing an injection for both regional anesthesia and in the treatment of saphenous nerve tunnel syndrome.
Topics: Cadaver; Humans; Nerve Block; Thigh; Ultrasonography; Ultrasonography, Interventional
PubMed: 34195927
DOI: 10.1007/s40477-021-00604-9 -
Human Vaccines & Immunotherapeutics 2020The anatomical safety of intramuscular injections at the deltoid and ventrogluteal sites has been investigated; however, the anatomical relationship between...
The anatomical safety of intramuscular injections at the deltoid and ventrogluteal sites has been investigated; however, the anatomical relationship between intramuscular injection sites in the thigh and major blood vessels and nerves remains unclear. We aimed to compare intramuscular injection sites in the rectus femoris and vastus lateralis with those at the deltoid and ventrogluteal sites and identify safe intramuscular injection sites in the thigh. Twenty-seven young adult volunteers were recruited, and the thicknesses of subcutaneous tissue and muscle as well as the number of blood vessels present were evaluated at two sites on the deltoid, ventrogluteal, and thigh using ultrasound equipment. The right thighs of 24 cadavers were used, and the thickness of muscle, number of blood vessels or nerves present, and the distance between each examined site and major blood vessels or nerves were evaluated in the rectus femoris and vastus lateralis. A major blood vessel was observed in the middle of the rectus femoris in young adults. In cadavers, the descending branch of the lateral circumflex femoral artery and muscle branch of the femoral nerves to the vastus lateralis were observed at the middle point, distal two-thirds point, and middle point between the middle and distal two-thirds points of the rectus femoris, but not at the middle of the vastus lateralis. The middle of the vastus lateralis is an appropriate site for intramuscular injections because of the low risk of vascular or nerve damage. The present results support good practices for site selection for intramuscular injections.
Topics: Adult; Aged; Aged, 80 and over; Blood Vessels; Cadaver; Cross-Sectional Studies; Female; Healthy Volunteers; Humans; Injections, Intramuscular; Japan; Male; Middle Aged; Muscle, Skeletal; Thigh; Young Adult
PubMed: 31403356
DOI: 10.1080/21645515.2019.1646576 -
BMC Surgery Jun 2020Leiomyosarcoma (LMS) is an uncommon mesenchymal neoplasm, which infrequently metastasizes to pancreas and thigh. Clinical presentation and imaging findings of metastatic...
BACKGROUND
Leiomyosarcoma (LMS) is an uncommon mesenchymal neoplasm, which infrequently metastasizes to pancreas and thigh. Clinical presentation and imaging findings of metastatic broad ligament LMS are often nonspecific. Complete excision plays an important role in treatment of patients with localized LMS.
CASE PRESENTATION
Here, we report a case of a 33-year-old woman with recurrent broad ligament LMS metastasizing to pancreas and thigh. Previously, she was diagnosed with broad ligament LMS and underwent hysterectomy, bilateral salpingo-oophorectomy. The disease-free interval was 2.5 years until metastases were found. Computerized tomography (CT) of abdomen and thighs, magnetic resonance imaging (MRI) of thighs and whole-body 18-fluorodeoxyglucose positron emission tomography - computed tomography (PET-CT) performed, revealed pancreatic and thigh metastasis. Ultrasonography-guided biopsy and histological examinations confirmed LMS at both the sites. Pancreatic metastasis was completely resected first. Then the patient underwent surgical resection of thigh metastasis when both chemotherapy and radiotherapy failed. She recovered well and remained free of disease recurrence in the 2 years follow-up.
CONCLUSIONS
Though imaging lacks specificity, it is a valuable asset in assessing the burden of disease and characterizing lesions while histological examination with immunohistochemistry is helpful for the diagnosis of LMS. Complete surgical resection of all metastatic sites where-ever feasible should be strongly considered in a treated case of broad ligament LMS with a durable disease-free interval.
Topics: Adult; Antineoplastic Agents; Broad Ligament; Combined Modality Therapy; Female; Follow-Up Studies; Genital Neoplasms, Female; Humans; Hysterectomy; Leiomyosarcoma; Pancreatectomy; Pancreatic Neoplasms; Radiotherapy, Adjuvant; Salpingo-oophorectomy; Thigh; Treatment Outcome
PubMed: 32600468
DOI: 10.1186/s12893-020-00804-w -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =...The polyfoliate anterolateral thigh perforator flap needs to dissect two or more perforators, which is an ideal choice for repairing wide and irregular wounds. However,...
OBJECTIVES
The polyfoliate anterolateral thigh perforator flap needs to dissect two or more perforators, which is an ideal choice for repairing wide and irregular wounds. However, the uncertainty of perforating vessels restricts the development of this operation. This study discusses the feasibility and clinical efficacy of the polyfoliate anterolateral thigh perforator flap with single-perforator.
METHODS
Fifteen patients with skin and soft tissue defects in extremities, were treated with polyfoliate anterolateral thigh perforator flap with single-perforator. Based on the perforator detected by Doppler ultrasound or color Doppler ultrasonography before operation, a polyfoliate anterolateral thigh perforator flap with single-perforator was designed. The perforating point of perforator was near the boundary of the skin paddle. Following the perforating vessels and vascular pedicles free, the vessels in the deep layer of the superficial fascia were meticulously free under the microscope. After obtaining the appropriate length, the skinpaddles were separated and recombined. After confirming the blood supply of flap, the vascular pedicle was ligated and transplanted to the recipient area.
RESULTS
In 15 cases, the area of the flap was 8.0 cm×5.0 cm+6.0 cm×5.5 cm to 16.0 cm× 9.5 cm+24.0 cm×9.0 cm. All flaps survived well without necrosis and had a satisfactory appearance. The donor area was closed directly. The patients were followed up for 3 to 12 months, with an average of 6 months. The skin flaps were normal in color and good in texture.
CONCLUSIONS
It's a better method to repair the skin and soft tissue defects in extremities by the polyfoliate anterolateral thigh perforator flap with single-perforator because only one perforator needs to be dissected, a group of blood vessels need to be anastomosed, and only one donor area needs to be sacrificed.
Topics: Humans; Perforator Flap; Plastic Surgery Procedures; Skin Transplantation; Soft Tissue Injuries; Thigh; Treatment Outcome
PubMed: 34707008
DOI: 10.11817/j.issn.1672-7347.2021.200051 -
BMJ Case Reports Jul 2021Primary soft-tissue sarcomas (STSs) of the chest wall are uncommon. Complete surgical resection remains the mainstay of treatment being sternal resection ocassionally...
Primary soft-tissue sarcomas (STSs) of the chest wall are uncommon. Complete surgical resection remains the mainstay of treatment being sternal resection ocassionally required. We present a 25-year-old man with an anterior chest wall STS. The patient underwent complete oncological resection with reconstruction using titanium bars combined with a free vascularised anterolateral thigh flap. STSs of the chest wall are very rare and they comprise a surgical challenge for both resection and reconstruction.
Topics: Adult; Humans; Male; Plastic Surgery Procedures; Sarcoma; Thigh; Thoracic Wall; Titanium
PubMed: 34266816
DOI: 10.1136/bcr-2021-241603 -
British Journal of Anaesthesia Nov 2016
Topics: Anesthesia, Local; Anesthetics, Local; Nerve Block; Thigh; Tourniquets
PubMed: 27799183
DOI: 10.1093/bja/aew322 -
Nature Communications Nov 2020Limb motion capture is essential in human motion-recognition, motor-function assessment and dexterous human-robot interaction for assistive robots. Due to highly dynamic...
Limb motion capture is essential in human motion-recognition, motor-function assessment and dexterous human-robot interaction for assistive robots. Due to highly dynamic nature of limb activities, conventional inertial methods of limb motion capture suffer from serious drift and instability problems. Here, a motion capture method with integral-free velocity detection is proposed and a wearable device is developed by incorporating micro tri-axis flow sensors with micro tri-axis inertial sensors. The device allows accurate measurement of three-dimensional motion velocity, acceleration, and attitude angle of human limbs in daily activities, strenuous, and prolonged exercises. Additionally, we verify an intra-limb coordination relationship exists between thigh and shank in human walking and running, and establish a neural network model for it. Using the intra-limb coordination model, dynamic motion capture of human lower limbs including thigh and shank is tactfully implemented by a single shank-worn device, which simplifies the capture device and reduces cost. Experiments in strenuous activities and long-time running validate excellent performance and robustness of the wearable device in dynamic motion recognition and reconstruction of human limbs.
Topics: Biomechanical Phenomena; Equipment Design; Extremities; Humans; Leg; Monitoring, Physiologic; Motion; Neural Networks, Computer; Reproducibility of Results; Thigh; Wearable Electronic Devices
PubMed: 33154381
DOI: 10.1038/s41467-020-19424-2 -
Dermatology Online Journal Dec 2014Eccrine chromhidrosis, or colored eccrine sweating, may be caused by contamination of sweat by dyes, pigmentation from microorganisms, or more rarely,... (Review)
Review
BACKGROUND
Eccrine chromhidrosis, or colored eccrine sweating, may be caused by contamination of sweat by dyes, pigmentation from microorganisms, or more rarely, hyperbilirubinemia. Pigment usually affects the palms and soles, where abundant sweat glands are found.Purpose, Material and Methods: We report a unique case of eccrine chromhidrosis in the setting of hyperbilirubinemia and review the current literature available on PubMed of previously reported cases.
RESULTS
Six patients with chromhidrosis have been previously reported in the setting of significant hyperbilirubinemia, in association with fever and thickened stratum corneum.
CONCLUSIONS
Eccrine chromhidrosis secondary to hyperbilirubinemia is very rare, but can be diagnosed on the basis of classic clinical findings, dermoscopic examination, and negative tissue cultures.
Topics: Fingers; Humans; Hyperbilirubinemia; Male; Middle Aged; Skin; Sweat Gland Diseases; Thigh
PubMed: 25780969
DOI: No ID Found -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Aug 2021To evaluate the effectiveness of free anterolateral thigh flap in repairing hand twist trauma combined with forearm main vascular injury.
OBJECTIVE
To evaluate the effectiveness of free anterolateral thigh flap in repairing hand twist trauma combined with forearm main vascular injury.
METHODS
Between February 2016 and March 2020, 14 patients with hand twist trauma combined with forearm main vascular injury were admitted. There were 10 males and 4 females. The mean age was 36.3 years (range, 22-53 years). There were 5 cases with left hand and 9 cases with right hand. The degloving injury of hand was rated as type ⅢA in 2 cases, type ⅢB in 9 cases, and type Ⅳ in 3 cases. The size of soft tissue defects range from 8.0 cm×4.5 cm to 13.5 cm×8.0 cm. Of all patients, 11 cases were ulnar artery injury and 3 cases were radial artery injury. Time from injury to operation was 2-16 hours (mean, 7.1 hours). The free anterolateral thigh flaps with the size of 10.0 cm×5.5 cm to 15.0 cm×9.5 cm were used to repair the soft tissue defects with the "T" shape anastomosis of blood vessel in 8 cases or direct anastomosis of blood vessel in 6 cases. The donor sites were directly sutured in 9 cases and repaired with free skin graft in 5 cases.
RESULTS
All patients were followed up 6-12 months (mean, 10.5 months). The vascular crisis occurred in 1 case and the flap survived with symptomatic treatment after operation. Other flaps survived and the wounds healed by first intention. All donor sites healed by first intention and the skin grafts survived. Three cases underwent the fat-free trimming at 4-5 months after operation. According to the evaluation standard of the upper limb part of the Chinese Medical Association, the hand function was evaluated as excellent in 4 cases, good in 7 cases, and fair in 3 cases, with an excellent and good rate of 78.6% at last follow-up.
CONCLUSION
Because the diameter of the descending branch of the lateral femoral circumflex artery is similar to that of the ulnar artery and radial artery, the use of free anterolateral thigh flap can not only repair the wound and obtain a good hand shape, but also repair blood vessels and promote recovery of hand function.
Topics: Adult; Female; Forearm; Free Tissue Flaps; Humans; Male; Perforator Flap; Plastic Surgery Procedures; Skin Transplantation; Soft Tissue Injuries; Thigh; Treatment Outcome; Vascular System Injuries
PubMed: 34387434
DOI: 10.7507/1002-1892.202103049 -
JPMA. the Journal of the Pakistan... Nov 2022Sebaceous carcinoma is an uncommon malignant tumour of the sebaceous glands. This lesion typically occurs as painless and slow growing nodule in the eyelid region. In...
Sebaceous carcinoma is an uncommon malignant tumour of the sebaceous glands. This lesion typically occurs as painless and slow growing nodule in the eyelid region. In rarity, it can develop on buccal mucosa, head and neck, and other regions of the body in people in their 60s and 70s. Sebaceous carcinoma is locally aggressive and carries the potential of regional and distant spread. We present the case of a 15-year-old male who was diagnosed with sebaceous carcinoma over the forehead. After discussing the case in the board meeting, surgery was performed to remove the tumour with 1 cm margin. Outer table of the frontal bone was also removed and intraoperative frozen section was done for margin clearance. After the excision, soft tissue coverage was done with free Anterolateral thigh flap and the patient received six cycles of post-operative radiation therapy.
Topics: Male; Humans; Adolescent; Forehead; Free Tissue Flaps; Thigh; Carcinoma
PubMed: 37013316
DOI: 10.47391/JPMA.4899