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Background The aim of this study was to evaluate prognostic value of body tissue composition at the upper thigh level for 1 year mortality in elderly patients with proximal femur fracture. Methods This retrospective cohort study included consecutive elderly (aged ≥65) patients diagnosed with proximal femur fracture based on the findings of pelvic bone computed tomography (CT) performed at the emergency department of a tertiary care hospital and treated with surgery between 2010 and 2017. The cross‐sectional area of subcutaneous fat and skeletal muscle at the upper thigh level was measured using CT. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for 1 year mortality were estimated using a Cox proportional hazards model. Survival based on the SFA quartiles was assessed using nonparametric Kaplan–Meier survival analysis and compared used log‐rank tests. Results Among 876 elderly patients included in this study, the median age was 79.0 years, and 646 (73.7%) patients were female. A total of 93 (10.6%) died within 1 year after admission to the emergency department. Survivors had a significantly higher median subcutaneous fat area (SFA) than non‐survivors (170.2 vs. 133.0 cm2, P 195.0 cm2) quartiles showed significantly longer survival duration than those with SFA in the first (

Background and objectives Treatment modalities have been developed to address patient concerns with skin laxity and focal adipose excess. A previously published multicenter clinical trial reported improvement in cellulite severity after a single dermal and subcutaneous treatment on the upper thigh with a microneedle radiofrequency device. In the current study, this device was used to improve the esthetic appearance of body skin laxity and localized fat deposits above the knee, upper arms, and upper-mid back/axillary region ("bra-line"). Study design/materials and methods Subjects with cellulite, skin laxity, and/or subcutaneous adipose excess in the suprapatellar region of the anterior thigh, upper arms, and bra-line underwent a single dermal and/or subcutaneous treatment. Investigators and subjects assessed outcome at 1-, 3-, and 6-month follow-up, using 5-point Likert scales for global esthetic improvement, skin laxity improvement, and satisfaction. Results In total, 31 females (mean age 51 ± 9 years) with Fitzpatrick skin types I-IV received a single treatment on 62 treatment areas: 22 upper arms, 34 suprapatellar, and 6 bra-lines. Investigator assessments at 1, 3, and 6 months for global esthetic improvement and skin laxity for the upper arms and bra-line demonstrated improvements in 100% of subjects at all timepoints; for the suprapatellar region, these values were 69%, 92%, 65%, and 85%, 92%, 65%, respectively. Investigator satisfaction at each timepoint was satisfied or very satisfied in 80%, 100%, 90% for upper arms; 80%, 80%, 80% for bra-line; and 50%, 81%, 65% for suprapatellar region. Subject self-assessments at 1, 3, and 6 months for global esthetic improvement and skin laxity for the upper arms demonstrated improvements in 100% of subjects at all timepoints; for the bra-line, these values were 40%, 60%, 80%, and 60%, 60%, 80%, respectively; for the suprapatellar region, these values were 81%, 92%, 88%, and 69%, 85%, 88%, respectively. Subject satisfaction at each timepoint was satisfied or very satisfied in 80%, 100%, 100% for upper arms; 40%, 40%, 80% for bra-line; and 50%, 77%, 65% for suprapatellar. Treatments were well tolerated with subjects reporting transient erythema and edema associated with 69% and 46% of treatments, respectively. Mild bruising, resolving within 5 days, was reported after 32% of the treatments. Conclusion Microneedle fractional radiofrequency provides a single treatment protocol to improve the esthetic appearance of body skin laxity and localized adipose excess to the upper arms, bra-line, and suprapatellar regions. Further study is warranted to evaluate the degree of improvement and long-term effect beyond 6 months post-treatment. Lasers Surg. Med. © 2021 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.

Mantle cell lymphoma (MCL) is a relatively rare B-cell non-Hodgkin lymphoma, typically presenting with extensive lymphadenopathy, bone marrow involvement, and splenomegaly. Extranodal sites can also be involved. We discuss a 73-year-old man whose MCL presented with a 6-month history of a subdermal mass of the right upper thigh and no systemic symptoms.

Primary hydatid cyst elsewhere in the body is rare, as these cysts are always secondary to a hydatid of the liver or lungs. We report a case of 14-year-old girl presented with a swelling on medial aspect of left upper thigh which was gradually increasing in size since last 12 months. Ultrasonography diagnosed it as hydatid cyst, there was no swelling in the liver, lungs or elsewhere in the body, CT scan further reinforced the diagnosis. The swelling was removed en bloc and albendazole was given.

Pyemotes ventricosus mites are an uncommon cause of pruritic dermatitis seen most commonly in occupational exposure, prominently found in professionals such as farmers, landscapers, and factory workers who work with grains, wheat, dried beans, or grasses. The clinical description of the rash has typically been described as papular, erythematous, with a central vesicular lesion. We describe a case of Pyemotes dermatitis with an atypical clinical presentation. A 30-year-old man presented with pruritic, umbilicated papules, which involved his right lateral trunk and upper thigh leading to the submitted clinical impression of molloscum contagiosum. A biopsy of the skin was taken, and fragments of arthropod consistent with P. ventricosus were identified within umbilicated indentations of skin. The patient subsequently admitted to the onset of the rash immediately after carrying bales of straw while supporting each bale with his right side. The possibility of Pyemotes dermatitis mimicking a poxvirus-like eruption should be considered when encountering an unusual umbilicated papular eruption in the appropriate patient with occupational exposure.

We report a case of a 65-year-old male patient who presented with localized swelling and lump in the proximal third of the upper thigh. Most common upper thigh injuries involve the quadriceps muscle group associated with football injuries; however, in rare incidents certain forceful intrinsic injuries can cause intramuscular tear of the sartorius muscle. This is a rare case of spontaneous muscle rupture in an elderly patient with no history of recent sporting activity. Ultrasound provides a cost-effective, dynamic evaluation of the anterior upper thigh muscles to differentiate between chronic and acute phases of injury.

The sartorius muscle flap is a type IV (segmental blood supply) Mathes–Nahai flap. It is located in the upper thigh and is an excellent option for reconstruction of the groin. It has traditionally been used due its ease of harvesting by non-plastic surgeons (such as vascular surgeons or general surgeons) in order to cover the femoral vessels, following inguinal lymphadenectomy or debridement of an infected bypass graft. Its segmental blood supply allows a wide range of reconstructive options: a simple myoplasty involves placing the muscle under tension and moving part of the fascicles medially, enough to cover the vessels. On the other spectrum, the muscle can be transected, either distally or proximally, and rotated in order to fill the medial space and provide the necessary coverage. When distally based, the sartorius muscle can be rotated to cover small defects of the knee. The donor site morbidity is minimal.

Hemangioendothelioma is a rare tumor arising from the vascular endothelium of soft tissue, skin, bone, and viscera. The disease has an indolent course, with the potential for recurrence, and is often associated with multi-organ involvement. We present a rare case of subcutaneous tumor in the thigh, without systemic involvement in a middle-aged woman. The tumor was completely excised after ligation of the feeding vessels, and the histopathologic diagnosis was consistent with hemangioendothelioma. Regular follow-up is suggested due to the potential for recurrence.

Quantifying the wave resistance of a swimmer as a function of depth assists in identifying the optimum depth for the glide phases of competition. Previous experiments have inferred how immersed depth influences the drag acting on a swimmer [1], but have not directly quantified the magnitude of wave resistance. This research experimentally validates the use of thin-ship theory for quantifying the wave resistance of a realistic swimmer geometry. The drag and wave pattern of a female swimmer mannequin were experimentally measured over a range of depths from 0.05m to 1.00m at a speed of 2.50 m/s. Numerical simulations agree with experiment to confirm that there were negligible reductions in wave resistance below a depth of 0.40m. Larger swimming pool dimensions are shown to be significant at reducing wave resistance at speeds above 2.0 m/s and depths below 0.40m. Truncating the swimmer’s body at the upper thigh increases the wave resistance at speeds below 2.0m/s but is not significant at higher speeds, indicating that the upper body is the main contributor to the wave system. Numerical experiments indicate that rotating the shoulders towards the surface is more influential than the feet, demonstrating the impact of the upper body on wave resistance.

A 74-year-old male underwent endovascular aneurysm repair (EVAR) with Talent (Medtronic, Dublin, Ireland) graft for a large abdominal aortic aneurysm (9.8 cm) and 3.7 cm left common iliac artery aneurysm. Postoperative CTA 4 days later showed Type III endoleak from the disruption of the left iliac extension limb stent grafts; the endograft was converted to aorto-uniiliac configuration with crossover femoral-femoral graft. The femoral graft became exposed in the left groin, and the patient was treated by tunneling the crossover graft along the anterolateral aspect of left upper thigh and anastomosed to superficial femoral artery in the mid-thigh. Sartorius myoplasty resulted in satisfactory healing of the left groin.

Image digitizing has facilitated body shape evaluation gained entry in ergonomics industry, in fashion and in health. Objective: to validate the 3D image digitizer (TC 2 -18) to determine body dimensions in a fast and reliable manner. Methods: 285 adults of both sexes were studied to measure anthropometrics, plethysmography, and digitized body shape. Results: Digitizer obtained measurements highly correlated with those obtained through anthropometrics and plethysmography (R 2 ≥ 0.75). However, the TC 2 -18 gave lower values in total body volume when compared with plethysmography (CI 95%, −3.9 to −3.5 L). In contrast, the TC 2 -18 yielded higher values in mesosternal (CI 95%, 8.8–9.6 cm), neck (CI 95%, 2.6–3.0 cm), gluteus maximus (CI 95%, 3.1–3.7 cm), relaxed arm (CI 95%, 2.9–3.3 cm), and minimal waist (CI 95%, 3.1–3.7 cm) circumferences; as well as similar data for the upper thigh, calf and forearm circumference. Conclusion: TC 2 -18 3D digitizer yielded valid and reliable measures when adult persons are evaluated. Found differences occur due to movement during digitizing and by difference inherent to the used devices.

In recent years, more attention has been paid towards the study of 24-h movement behaviors (including physical activity (PA), sedentary behavior (SB) and sleep) in preschoolers instead of studying these behaviors in isolation. This study aimed to evaluate the feasibility of using wrist- vs. thigh-worn accelerometers and to report accelerometer-derived metrics of 24-h movement behaviors in preschoolers. A convenience sample of 16 preschoolers (50.0% boys, 4.35 years) and one of their parents were recruited for this study. Preschoolers had to wear the ActivPAL accelerometer (attached to the upper thigh) and Axivity accelerometer (using a wrist band) simultaneously for 7 consecutive days and for 24 h a day. Parents completed an acceptability survey. In total, 16 preschoolers (100.0%) had a minimum of 6 days of valid wrist-worn data, while only 10 preschoolers (62.5%) had a minimum of 6 days of valid thigh-worn data (p = 0.002). When looking at the acceptability, 81.3% of parents indicated that it was easy for their child to wear the Axivity for 7 consecutive days, and 93.8% of parents indicated so for the ActivPAL (p = 0.88). However, some parents stated that the wristband of the Axivity accelerometer was big, which might have affected data collection. Significant differences were found for the measurement of total volume of PA, SB and sleep across 24 h. Total PA was 464.44 min/day (±64.00) with the ActivPAL compared with 354.94 min/day (±57.46) with the Axivity (p &lt, 0.001). The volume of SB was 290.94 min/day (±55.05) with the ActivPAL compared with 440.50 min/day (±50.01) with the Axivity (p &lt, 0.001). The total volume of sleep was also significantly different between both devices (p = 0.001, ActivPAL: 684.63 min/day ± 51.96, Axivity: 645.69 min/day ± 46.78). Overall, parents perceived both devices to be feasible to use for preschoolers. However, future studies are required to validate both devices for the measurement of preschoolers’ 24-h movement behaviors since significant differences in the classification of PA, SB and sleep were found in this small sample.

This is a tinea corporis lesion in the form of a smiling face on the upper thigh of a 4 year old boy (fig 1). He presented to the clinic with itchy erythema around the …

When open-book injuries are neglected and result into a pelvic malunion or nonunion, long-term problems, such as chronic pain, gait abnormalities, sitting discomfort, neurological symptoms and urogenital symptoms can occur. In this case report, we describe the repair of a neglected pelvic disruption with the dislocation of the urinary bladder in a one-stage procedure. The clinical image with which the patient presented could be split into unique sub-problems, for which separate solutions needed to be chosen: large symphysis diastasis, instability and pain in both SI joints, malunion of the superior and inferior pubic rami fractures; and urinary bladder herniation into the upper thigh. In a single-stage procedure, the pelvic ring was reconstructed and the bladder reduced. The patient was thereafter continent for urine and could walk independently. A complex clinical problem was divided into its sub-problems, for which specific solutions were found.

WOS: 000394727100003, PubMed ID: 28137414, Despite advances in understanding of peripheral nerve injuries and regeneration and advances in surgical techniques, successful outcomes cannot be guaranteed after reconstructive surgery. Platelet-rich plasma (PRP) has been reported to have positive effects on nerve regeneration, as well as on tissue healing. The present study was designed to evaluate the effect of PRP on nerve-grafted defects. Sprague Dawley rats were divided into four surgery groups (n = 7 in each). A 1-cm long nerve defect was created in the upper thigh and then reconstructed using a nerve autograft in all groups. The wet muscle weights, electromyographic findings, and histomorphologic changes were evaluated 10 weeks later. As shown by both the electromyographic (p < 0.001) and histomorphologic findings (p < 0.001), PRP had more positive effects on nerve gap reconstruction in Group 3 then Group 4 as compared to the control groups. The present study is novel in that it evaluated the regeneration effect of PRP on a large nerve defect reconstructed with a nerve graft rather than primary repair. The results are encouraging for further experimental studies on the role of PRP in nerve healing. Copyright (C) 2016, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).

Yaemkong S, Jaipong P, Kotham P, Ngoc TN. 2019. Phenotypic and morphometric characteristics of Bangkaew dog in Phitsanulok Province, Thailand. Biodiversitas 20: 2877-2882. A research study was conducted to analyze phenotypic and morphometric characteristics of Bangkaew dogs in Mueang, Phromphirum, and Bangrakam districts, Phitsanulok Province, Thailand. In total, 54 Bangkaew dogs were randomly sampled by purposive sampling from 20 farmers between November 2018 and March 2019. The data consisted of nine phenotypic characteristics that were recorded visually and five morphometric characteristics that were obtained by using descriptive statistics and analysis of ANOVA to compare difference among means and correlation coefficients. Majority of the standard identities of Bangkaew dogs were according to the breed such as the guard coat around the face (100.00%), the guard coat around the neck or the chest coat (100.00%), the coat of belly (100.00%), the guard coat behind ears (100.00%), the lion’s leg shape (100.00%), the long coat from hip to the upper thigh (100.00%), and the plume tail (100.00%), except for the guard coat from the ruff around the shoulder (98.15%). Moreover, the coat of hair of Bangkaew dogs in this study was white-brown color (55.31%), followed by white-gray color (23.92%), white-black color (10.78%), brown color (6.44%), gray color (2.11%), and black color (1.44%), respectively. Least square means of males morphometric characteristics was significantly (p0.05), and for body length of females (55.76 ± 9.37 cm vs. 55.00 ± 7.18 cm; p>0.05) was superior to males of Bangkaew dogs. The correlations among morphometric characteristics such as body width vs. leg length, body length vs. body height, body weight vs. body height, body weight vs. body length, and body height vs. leg length, were 0.64, 0.56, 0.52, 0.34, and 0.33, respectively. These results implied that in order to conserve standard identities and improve morphometric characteristics, their typical characteristics such as structure, coat of hair and body size required by raisers should be considered in the breeding selection and mating system.

A 36-year-old woman with a history of papillary thyroid cancer underwent radioiodine remnant ablation using I. Postablation whole body I scintigraphy revealed increased activity not only in the thyroid bed but also in the right upper thigh. SPECT/CT images localized the activity to the metallic implants of the right femur, implanted 3 years earlier after the right femoral cyst resection.

Transplantation of adipose tissue is used for cosmetic as well as for reconstructive purposes. The methods of harvesting, processing, and transplantation vary in practice. Grafts are harvested almost exclusively using special extraction needles. Smaller fat particles are harvested using fine needles with small diameters of lateral openings and again transplanted using thin injection needles. There is a proven relationship between the diameter of the fat particles and that of the perforations in the extraction needle. The adipose tissue can be harvested from different regions of the body, mostly from the buttocks or the trochanter region and also possibly from the inner sides of the upper thigh or the knee region. Just a few hours postoperatively, the beginning of the neovascularization becomes evident. A certain loss in volume is generally experienced. Finally, the risks and complications of transplantation of autologous adipose tissue are discussed.

Due to the fact that meat colour represents an important aspect for sensorial evaluation of any food product,research in the field of poultry meat processing regarding efficient methods for hoarding/storage on long term ofindustrially slaughtered poultry carcasses approaches a continuous finding/optimization of certain solutions foravoiding negative consequences due to oxidation, which could include colour loss and/or its modification.The current study aimed to evaluate the effects of three storage regimes differing by temperature and time(L = -14°C, 30 days; L = -16°C, 60 days; L = -18°C, 90 days) on three anatomical cut regions (breast, upper thighand lower thigh), to characterize the colour of broiler chicken meat. Objective description of colour for frozen anddefrosted chicken meat was realised through the CIEL*a*b* Cartesian coordinate system.Overall, the preservation method determines a higher luminosity at samples gathered from L batch chickencarcasses for breast and upper thigh musculature, and L for lower thigh musculature in comparison with thecounterparts from the other experimental batches

A 39-year-old female presented to our hospital with complaints of no specific low-grade pain and tenderness of left thigh and leg with small palpable swelling within the left upper thigh. On imaging, expansile bony lesions were noted in left femur and tibia suggestive of fibrous dysplasia with two small intramuscular soft tissue swellings in the upper and mid-thigh which proved to be myxomas on histopathological examination. The association of these two findings is known as Mazabraud syndrome.

Nowadays, most Belgian patients with type 1 diabetes use flash glucose monitoring (FreeStyle Libre [FSL]; Abbott Diabetes Care, Alameda, California) to check their glucose values, but some patients find the sensor on the upper arm too visible. The aim of the present study was to compare the accuracy and precision of FSL sensors when placed on different sites. A total of 23 adults with type 1 diabetes used three FSL sensors simultaneously for 14 days on the upper arm, abdomen and upper thigh. FSL measurements were compared with capillary blood glucose (BG) measurements obtained with a built-in FSL BG meter. The aggregated mean absolute relative difference was 11.8 ± 12.0%, 18.5 ± 18.4% and 12.3 ± 13.8% for the arm, abdomen (P = .002 vs arm) and thigh (P = .5 vs arm), respectively. Results of Clarke error grid analysis for the arm and thigh were similar (zone A: 84.9% vs 84.5%; P = .6), while less accuracy was seen for the abdomen (zone A: 69.4%; P = .01). Apart from the first day, the accuracy of FSL sensors on the arm and thigh was more stable across the 14-day wear duration than accuracy of sensors on the abdomen, which deteriorated mainly during week 2 (P < .0005). The aggregated precision absolute relative difference was markedly lower for the arm/thigh (10.9 ± 11.9%) compared with the arm/abdomen (20.9 ± 22.8%; P = .002). Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly.

The aim of this study was to assess the effect of varying the maximum resting period between consecutive ambulatory bouts in community-based outcomes. Ambulation was assessed in 97 community-dwelling older adults (mean (SD) age 69.2 (7.7) years) using an accelerometer (activPAL™) worn on the upper thigh for 7 consecutive days. The volume, pattern and variability of ambulation were calculated over a range of maximum resting periods (1–30 s). Outcomes with a maximum resting period from 1 to 6 s did not vary due to device functionality. Non-linear regression (power law, r2 > 0.99) showed that increasing the maximum resting period from 6 to 30 s resulted in changes in volume (increased duration spent walking, and decreased number of bouts), variability (S2 increased) and pattern (α decreased), and a linear relationship with an increase in average bout length. With a MRP of 6s, 6% of the cohort achieved the public health guidelines of 150 min of ambulation/week accumulated in bouts ≥10 min, which increased to 40% using a maximum resting period of 30 s. Modifying the maximum resting period impacts on volume, pattern and variability measures of community based ambulation, and attainment of public health guidelines. This highlights the need for standardised algorithms to aid interpretation and explicit reporting of the maximum resting period to aid comparison between studies.

Objective To compare the efficacy of sterile preoperative skin antisepsis using either a 5-minute mechanical preparation or 5-minute non-mechanical preparation with chlorhexidine gluconate 4% solution. Study Design Matched design, ANOVA. Animals Healthy adult Thoroughbred horses (n = 30). Methods Each horse had both surgical preparation methods randomly assigned to identical sites on the left or right upper thigh. Prepared sites were sampled and cultured for bacteria after each preparation step. Results Mechanical and non-mechanical preparation techniques significantly reduced bacteria isolated from surface swab samples compared with samples taken from unprepared skin and after the preliminary rough prepared skin (P

Lipoma is a common subcutaneous tumour composed of fat tissue. It may occur as a sporadic solitary lesion or as multiple lesions. They often grow very slowly. They vary between 2 and 10 cm in size. There are rarely any subjective symptoms. Lipomas do not usually require treatment unless they are big enough to be symptomatic. We reported a 75-year-old man with a rapidly enlarging and ulcerated mass on his right upper thigh.

Recidivating pressure sores are a frequent complication in meningomyelocele patients because of their limitation in motility and their scarce ability to monitor the pressure applied on insensate areas while seated. We report the utilization of the sensate pedicled anterolateral thigh perforator flap for reconstruction of ischiatic sores in meningomyelocele patients. Between May 2011 and September 2013, five patients underwent transfer of a sensate pedicled anterolateral thigh flap, by an intermuscular passageway through the upper thigh, to reach the ischial defect. Flap was properly harvested from the thigh after assessment of the lateral cutaneous femoral nerve sensitive area with the Pressure-Specified Sensory Device. In all cases the flap reached the ischial defect harmlessly, healing was uneventful with no immediate nor late complications. Each patient showed persistence of sensitivity at the reconstructed area and no recurrent ischiatic sore was observed at mean follow-up of 26.4 months. The sensate pedicled anterolateral thigh flap is a valuable solution for coverage of recurrent ischial sores in meningomyelocele patients, in which pressure consciousness is fundamental. The intermuscular passageway allows to reduce the distance between flap's vascular pedicle origin and the ischial defect, hence to use the more reliable skin from the middle third of the anterolateral thigh. © 2014 Wiley Periodicals, Inc. Microsurgery 35:279–283, 2015.

Background: The usage of internal mammary artery perforators (IMAPs) has been described in autologous breast reconstruction although IMAPS are not yet considered standard recipient vessels. It remains unclear if these vessels can be safely used in large flaps after radiation therapy or in delayed breast reconstruction. Methods: Over a 2-year period, 515 free flaps for autologous breast reconstruction were performed on 419 patients by 2 surgeons (S1 and S2). In a retrospective analysis, time of reconstruction, ischemia time, flap weight, diameter of couplers, and complications were analyzed. All 515 flaps were compared in a subset with regard to the 2 surgeons: S1 who always used the IMA as a recipient vessel and S2 who attempted IMAP use if possible. Results: Of all 515 flaps, 424 were abdominal flaps and 91 flaps were from the upper thigh. Three hundred six cases were immediate reconstructions, and 112 were delayed reconstructions. In 97 cases, implants were converted to autologous tissue. In 112 cases, the IMAPs were used; of these, 82 were immediate and 17 were delayed reconstructions, and in 13 cases, implants were removed. Thirty-five percent of all anastomoses to IMAPs had previous radiation therapy. The flap failure rate was 1.9%. In none of these cases, the IMAPs were used. S1 never used the IMAP, and S2 used the IMAP in 37% of all of his flaps. Conclusions: IMAPs were safely used in all kinds of reconstructions and after radiation therapy, with no flap failure or negative effects on mastectomy skin flap perfusion. Using the IMAPs as recipient vessels is a further step toward simplifying microsurgical breast reconstruction.

The consequences of massive weight loss through bariatric procedures as well as diet are overall positive. However, the sequelae of massive weight loss present themselves as soft tissue redundancies in the areas of the lower abdomen, upper thigh, upper arm and breast as well as face and neck. This condition presents significant mechanical, physical and social day-to-day limitations for the quality of life of these patients. Surgical techniques are indicated for the reconstruction of the body shape and therapy of the above named problems and the coexistent psychosocial component. These surgical techniques involve dermolipectomies in different body areas and can lead to significant improvement. In view of the worldwide increase of adipositas and the increasing need for bariatric surgery, a parallel increase in demand for such reconstructive post-bariatric interventions can be foreseen. Early and precise information is crucial for the patients before engaging in weight reduction, as is the coverage of the costs of the resulting secondary reconstructive body contouring interventions by the insurance companies., Die Folgen massiver Gewichtsreduktion, sei es durch bariatrische Eingriffe oder durch diätetische Maßnahmen, sind insgesamt sehr positiv. Nichtsdestotrotz verbleiben im Bereich des Weichteilmantels bei vielen Patienten nach Erreichen des Endgewichtes ausgeprägte und behandlungsbedürftige Weichteilteilüberschüsse mit Prädilektionsstellen im unteren Abdomen, Flanken, Oberschenkel, Oberarme und Brustbereich, aber auch im Hals- und Gesichtsbereich. Diese Problemzonen stellen für die betroffenen Patienten eine entscheidende Einschränkung ihrer Lebensqualität durch mechanische wie auch pflegerische und soziale Problematiken im Alltag. Zur Wiederherstellung der Körperform und Therapie der oben genannten Probleme wie auch der psychosozialen Komponenten sind chirurgische Wiederherstellungsmaßnahmen indiziert, die durch Dermolipektomien in den verschiedenen betroffenen Körperarealen zu erheblichen Verbesserungen führen können. Mit der weltweiten Zunahme der morbiden Adipositas und dem steigenden Bedarf an bariatrischen Eingriffen ist zukünftig auch mit einem steigenden Bedarf für solche post-bariatrische wiederherstellende Eingriffe zu rechnen. Für den einzelnen Patienten ist die frühzeitige und umfassende Information noch vor Beginn der angestrebten Gewichtsreduktion sowie die Übernahme der daraus resultierenden Wiederherstellungseingriffe durch die Versicherungsträger von großer Bedeutung.

Positron emission tomography (PET) using [18F]-2-deoxy-d-glucose (FDG) diagnoses, stages, and restages many cancers and is often better than anatomic imaging alone. However, abnormalities within the orbit present a challenge in evaluation, mainly due to the subtle findings on PET/computed tomography (CT). In addition, this region is typically at the edge of the field of view for the standard base of skull to upper thigh FDG-PET/CT scans. The aim of this pictorial essay is to illustrate several subtle and apparent abnormalities within the orbit that can have a profound impact on patient management and follow-up.

In 1999, Spatz et al. reported the first 2 cases of a plexiform variant Spitz nevus. We describe another case of this variant on the upper thigh of a 10-year-old boy and dis cuss the differential diagnosis. Histologically, it comprised nodules of epithelioid cells with a plexiform arrangement distributed throughout the superficial and deep der mis. The cells had moderate eosinophilic cytoplasm with vesicular nuclei and promi nent nucleoli. Intranuclear inclusions were present focally. The tumor nodules were embedded in a myxoid stroma with intratumoral and peritumoral inflammatory cells including both lymphocytes and eosinophils. There were occasional melanin- containing spindle-shaped cells. An intraepidermal component could not be assessed, since the lesion was ulcerated. The differential diagnosis includes both melanocytic and nonmelanocytic lesions exhibiting a plexiform pattern of growth as well as myx oid lesions. Int J Surg Pathol 10(1):69-73, 2002

Context:Previous studies investigated the relationship between ultrasound-derived anatomical muscle thickness (MTH) and individual muscle cross-sectional area (CSA) and muscle volume in several limb and trunk muscles; however, the adductor muscle that contributes to hip adduction and pelvic stabilization, as well as balance ability, has not been studied.Objective:To examine the relationship between MTH of the lower, middle, and upper thigh measured by B-mode ultrasound and the muscle CSA and volume of adductor muscle obtained by magnetic resonance imaging (MRI) to confirm the possibility of predicting adductor muscle CSA/volume using ultrasound-derived MTH.Setting:University research laboratory.Subjects:10 men and 10 women (20–41 y old) volunteered to participate in this study.Main Outcome Measures:A series of continuous muscle CSAs along the thigh were measured by MRI scans (1.5-T scanner, GE Signa). In each slice, the anatomical CSA of the adductors was analyzed, and the muscle volume was calculated by multiplying muscle CSA by slice thickness. Thigh MTH was measured by B-mode ultrasound (Aloka SSD-500) at 5 sites (anterior 30%, 50%, and 70% and posterior 50% and 70% of thigh length).Results:A strong correlation was observed between anterior 30% MTH and 30% adductor CSA in men (r = .845, P < .002) and women (r = .952, P < .001) and in both groups combined (r = .922, P < .001). Anterior 30% MTH was also strongly correlated to adductor muscle volume when combined with thigh length (n = 20, r = .949, P < .001). However, there were moderate or nonsignificant correlations between anterior and posterior 50% and 70% MTH and adductor muscle CSA/volume.Conclusions:The results suggest that MTH in the upper portion of anterior thigh best reflects adductor muscle CSA or muscle volume, while the lower portions of the anterior and posterior sites are least likely to predict adductor muscle size.

Exercise to failure results in similar muscle protein synthesis responses, independent of intensity. However, low-intensity exercise likely requires more repetitions and individuals with injuries may be incapable of sustaining the mechanical stress to reach failure. The aim of this study was to determine if knee wraps provide a stimulus to decrease time to failure. Twenty healthy individuals participated in a randomized crossover study consisting of three trials. The first trial was used to determine one-repetition maximum (1-RM) on leg extension. Participants were then assigned to a blood flow restriction or control group. After trial 2, participants crossed over to the opposite trial. Knee wraps were placed around the upper thigh of each leg during blood flow restriction. Leg extensions were completed at 30% 1-RM until failure. A rating of perceived exertion was taken after exercise and whole blood samples were taken before, after, and 3 min after exercise for the determination of lactate. Repe...

This study examined changes in muscle temperature, electrically evoked muscle contractile properties, and voluntary power before and after a soccer specific active warm‐up and subsequent rest period. Ten amateur soccer players performed two experimental sessions that involved performance of a modified FIFA 11+ soccer specific warm‐up, followed by a 12.5‐min rest period where participants were required to wear either normal clothing or a passive electrical heating garment was applied to the upper thigh muscles. Assessments around the warm‐up and cool‐down included measures of maximal torque, rate of torque development, muscle temperature ( T m), and electrically evoked measures of quadriceps contractile function. T m was increased after the warm‐up by 3.2 ± 0.7°C ( P

With technological advances in magnetic resonance angiography (MRA), spatial resolution of 1-mm perforating vessels can reliably be visualized and accurately located in reference to patients' anatomic landmarks without exposing patients to ionizing radiation or iodinated contrast, resulting in optimal perforator selection, improved flap design, and increased surgical efficiency. As their experience with MRA in breast reconstruction has increased, the authors have made changes to their MRA protocol that allow imaging of the vasculature in multiple donor sites (buttock, abdomen, and upper thigh) in one study. This article provides details of this experience with multiple donor site contrast-enhanced MRA.

This study evaluated the efficacy and safety of a low-level, dual-wavelength laser energy and massage device for improving the appearance of cellulite and reducing thigh circumference.Subjects (n = 83) with mild to moderate cellulite enrolled in this IRB-approved, open-label, multicenter study. Their right or left thighs received eight treatments with a low-level, dual-wavelength laser and massage device. The untreated contralateral thigh served as a control. Circumferences of the upper, middle, and lower thighs (treated and untreated) were measured before the fifth and eighth treatments and 1 month after the final treatment.Reduction in thigh circumference of the treated areas exceeded those of the control areas for the upper, middle, and lower thigh in most subjects. The maximum reduction (-0.82 cm) occurred in the upper thigh at 1 month. The mean reduction of the upper, middle, and lower thigh circumferences was -0.64 cm for the treated thighs compared to -0.20 cm for untreated thighs. The difference was significant (p0.0001). Fifty-nine (71.1%) treatment thighs lost circumference compared to 44 (53.0%) control thighs. Resolution of adverse effects including erythema, swelling, and increased urination was seen within 30 minutes after treatment. All were resolved without sequelae and within the expected duration.The low-level, dual-wavelength laser energy and massage device safely improves the appearance of cellulite while reducing thigh circumference.

A 44-year-old man undergoing ambulatory surgery sustained a 5% total body surface first-degree burn on his lower and lateral torso and upper thigh during routine use of a new forced-air warming Bair Paws™ flex gown system. We describe the likely mechanism of injury, intraoperative events suggesting special variation in the warming process, and a brief review of adverse events associated with forced-air warming systems.

We would like to highlight an unusual clinical presentation of Kimura’s disease, a rare, benign, idiopathic condition, usually seen as swelling and lesions of the head and neck region and commonly affecting young men of Asian descent. It is rare for this disorder to present with lesions on other parts of the body, especially the lower limbs. We report a 27- year-old man who presented with a large mass located at the inguinal region and extending down to the upper thigh. Due to the large size of the mass (28 x 18 cm), our provisional diagnosis was a soft tissue sarcoma. Open biopsy showed that the lesion was benign.

Quantifying cortisol concentration in hair is a non-invasive biomarker of long-term hypothalamic-pituitary-adrenal (HPA) activation, and thus can provide important information on laboratory animal health. Marmosets (Callithrix jacchus) and capuchins (Cebus apella) are New World primates increasingly used in biomedical and neuroscience research, yet published hair cortisol concentrations for these species are limited. Review of the existing published hair cortisol values from marmosets reveals highly discrepant values and the use of variable techniques for hair collection, processing, and cortisol extraction. In this investigation we utilized a well-established, standardized protocol to extract and quantify cortisol from marmoset (n = 12) and capuchin (n = 4) hair. Shaved hair samples were collected from the upper thigh during scheduled exams and analyzed via methanol extraction and enzyme immunoassay. In marmosets, hair cortisol concentration ranged from 2,710 to 6,267 pg/mg and averaged 4,070 ± 304 pg/mg. In capuchins, hair cortisol concentration ranged from 621 to 2,089 pg/mg and averaged 1,092 ± 338 pg/mg. Hair cortisol concentration was significantly different between marmosets and capuchins, with marmosets having higher concentrations than capuchins. The incorporation of hair cortisol analysis into research protocols provides a non-invasive measure of HPA axis activity over time, which offers insight into animal health. Utilization of standard protocols across laboratories is essential to obtaining valid measurements and allowing for valuable future cross-species comparisons.

Crossbreed chicken of pelung sentul kampung broiler (PSKR) has good growth and ready to slaughter at the age of 10 weeks. So, it has potential as a local chicken for meat producers. Potential of PSKR crossbreed chicken need to know about the percentage of carcass and the physical quality of meat for holistic information. This study aimed to evaluate the carcass and the quality of the physical meat of pelung sentul kampung broiler chicken (PSKR). Material of 12 chickens PSKR 12 weeks unsexing were used and observed for the percentage of carcass in the chest, upper and lower thighs and physical quality of breast meat included pH, water-binding power, cooking impurities, and tenderness. Chickens fed 100% commercial feed for broiler chicken phase starter until age 3 weeks, then gradually added rice bran and age > 5 weeks fed 60% commercial feed plus 40% rice bran. Chicken is slaughter at 12 weeks of age. The data obtained are presented descriptively. Percentage of PSKR carcass was 68%, chest was 27.17%, upper thigh was 17.12%, lower thigh was 16.64% respectively. Physical quality of breast meat has a pH performance of 5.30,% mgH2O of 28.08%, cooking loss of 29.13%, and tenderness of 2.63 respectively. PSKR chicken had potential for meat producers based on carcass percentage with chest meat was very tender because the genetic of broiler in PSKR as much as 25%.

Introduction: Faecal diversion techniques are commonly used to avoid contamination of wounds in the perianal, gluteal, or upper thigh regions. Diversion may be achieved using operative or non-operative methods. Traditional non-operative methods may be less effective for patients with anal sphincter damage or dysfunction. Case Report: Our report discusses a novel faecal diversion technique in a 67-year old female with a gluteal abscess complicated by necrotising fasciitis, which effectively used a perianal stoma to prevent faecal contamination of her wound. Conclusion: This method was safe, inexpensive, and effective, and prevented the need of operative management. We feel this technique is valuable in preventing faecal wound contamination in individuals with anal sphincter damage or dysfunction.

Atypical fractures related to the prolonged use of bisphosphonates are caused by low energy mechanisms and are characterized by oblique and transverse lines and frequent bilateralism. We present a clinical case of a patient who we believe illustrates, both in clinical and radiological aspects, the new definition of atypical femur fracture related to treatment using bisphosphonates treated conservatively and successfully with discharge and teriparatide 20 mcg/80 mcl s.c./24h. The appearance of painful symptoms in the upper thigh, especially if bilateral, in patients treated with bisphosphonates for long periods of time, makes it necessary to dismiss bone lesions that might otherwise suggest atypical fracture. In those cases where the fracture is incomplete, restoring bone metabolism through the administration of teriparatide 20 mcg/80 mcl s.c./24h could prevent displaced fractures.

In summary, if the abdomen cannot be used for a donor site, alternative flap selection is based on individual patient anatomy and body habitus, targeting the buttocks and upper thigh. Intraoperative repositioning may be required for ease in flap harvest and donor site closure, adding time to the procedure. Flap dissection is performed in the subfascial plane to avoid injury to the perforator vessels. Deep suspension sutures may be required to maintain the gluteal fold location.

Congenital nevus spilus is rare, and the lesion is usually small. This report describes an 8-year-old girl with a giant congenital nevus spilus that involved the left side of her abdomen, perineal area, and left upper thigh. The patient also had a Mongolian spot in the lumbosacral area.

The purpose of this investigation was to measure the interface pressure exerted by lower body sports compression garments, in order to assess the effect of garment type, size and posture in athletes. Twelve national-level boxers were fitted with sports compression garments (tights and leggings), each in three different sizes (undersized, recommended size and oversized). Interface pressure was assessed across six landmarks on the lower limb (ranging from medial malleolus to upper thigh) as athletes assumed sitting, standing and supine postures. Sports compression leggings exerted a significantly higher mean pressure than sports compression tights (P < 0.001). Oversized tights applied significantly less pressure than manufacturer-recommended size or undersized tights (P < 0.001), yet no significant differences were apparent between different-sized leggings. Standing posture resulted in significantly higher mean pressure application than a seated posture for both tights and leggings (P < 0.001 and P = 0.002, respectively). Pressure was different across landmarks, with analyses revealing a pressure profile that was neither strictly graduated nor progressive in nature. The pressure applied by sports compression garments is significantly affected by garment type, size and posture assumed by the wearer.

Hip arthroscopy is increasingly used as a tool for evaluating and managing painful hip in active patients. The complex anatomy of the lower back, abdomen, pelvis, and upper thigh can make the diagnosis challenging. A thorough history and physical examination in addition to specific imaging modalities can verify the presence or absence of various intra-and extra-articular disorders of the hip. Although hip pain in athletes is often managed conservatively, specific disorders and injuries are appropriately and successfully treated with hip arthroscopy.

症例は20歳の男性で, 14歳時よりCrohn病の診断を受けていた. 19歳時, 右大腿部膿瘍を併発したが, 経皮的ドレナージで軽快したため経過観察していた. 1年6か月後, 大腿部の疼痛, 腫脹が再び出現し, 精査で回盲部後腹膜から大腿に及ぶ広範な膿瘍形成と診断し, 手術を施行した. 手術時所見では回盲部は腫大, 硬化し, 虫垂が後腹膜に穿通して後腹膜膿瘍を形成していた. 膿瘍は右腸腰筋に沿って下行し, 右大腿前面に及んでおり, 回盲部切除術, 後腹膜ドレナージ, および大腿部の膿瘍ドレナージを施行した. 術後は合併症なく経過し, 現在まで再発を認めていない. Crohn病における腸腰筋膿瘍合併の本邦報告例は少なく, 大腿前面にまで及ぶ広範な膿瘍を合併した症例はさらにまれである. 今回, 外科的治療で広範な腸腰筋膿瘍が治癒した1例を経験したので報告する.