Effect of skin concavity on subcutaneous tissue fluid pressure

1991 ◽  
Vol 261 (2) ◽  
pp. H349-H353 ◽  
Author(s):  
T. H. Adair ◽  
G. A. Vance ◽  
J. P. Montani ◽  
A. C. Guyton
Keyword(s):  
Linear Regression ◽  
Entire Range ◽  
Lymphatic System ◽  
Subcutaneous Tissue ◽  
Fluid Pressure ◽  
Tissue Fluid ◽  
Average Depth ◽  
Factors Associated ◽  
Mechanical Factors ◽  
Fascial Plane

We tested the hypothesis that mechanical factors associated, with a skin concavity can cause the local tissue fluid pressure to become more negative. Perforated Teflon collars, 26 mm in diameter and having various heights (5, 10, 13, and 16 mm), were implanted into the fascial plane of the inguinal and abdominal areas of six sheep. After several weeks, visible signs of edema were no longer apparent, and the skin formed a concavity within the center of each collar. The depth of each concavity was measured using an electronic micrometer, and the tissue fluid pressure beneath the concavity was measured using a needle method. Over the entire range of collar heights, the average depth of the concavities ranged from 1.1 to 4.7 mm in the abdominal tissues and from 1.8 to 5.5 mm in the inguinal tissues. The respective values of tissue fluid pressure averaged -4.6 to -13.0 and -5.7 to -12.8 mmHg. The results therefore indicate that implanting deeper collars leads to the formation of deeper concavities in the skin and also to greater negativity in the free tissue fluid pressure beneath the skin. Linear regression extrapolation to a collar height of 0 mm corresponded to a tissue fluid pressure of -1.0 mmHg in the abdominal tissue and -2.4 mmHg in the inguinal tissues. A model based on excessive pumping of the lymphatic system in the vicinity of a concavity is provided to explain this newly described phenomenon. We conclude that mechanical factors associated with the formation of a skin concavity cause or permit the tissue fluid pressure to reach levels of negativity far greater than those that exist in the absence of a concavity.

Chubby Infant – Should One Worry? An Infant with Primary lymphedema – Mini Review and Case Report

2020 ◽  
Author(s):  
Joanna Magdalena Kaczmarek ◽  
Karolina Anna Graczykowska ◽  
Iwona Szymkuć-Bukowska ◽  
Ewa Łoś-Rycharska ◽  
Aneta Krogulska
Keyword(s):  
Case Report ◽  
Lymphatic System ◽  
Subcutaneous Tissue ◽  
Pediatric Population ◽  
Tissue Fluid ◽  
Fat Tissue ◽  
Primary Lymphedema ◽  
Progressive Accumulation ◽  
Secondary Causes ◽  
Localized Form

AbstractLymphedema is a localized form of tissue swelling, characterized by a progressive accumulation of a tissue fluid in the interstitial compartment as a result of the lymphatic system dysfunction. It is a rare disease in the pediatric population and in the majority of cases it is a consequence of an abnormal formation of the lymphatic system, which is called primary lymphedema. Although its epidemiology is not precise, it is assumed that 1:100 000 children suffer from primary lymphedema. The diagnosis can be made by a proper clinical examination after ruling out secondary causes of lymphedema, particularly in cases with a more asymmetric swelling of the extremities. In this very article we present a case report of an 8-months-old infant with primary lymphedema, who had presented swelling of the extremities from birth and yet no pathology was suspected before. The purpose of this article is to draw attention to the fact that a baby with excessive subcutaneous tissue is not always a healthy, chubby infant with considerable amount of fat tissue.

Interspecific comparison of subcutaneous tissue fluid pressure in the bat wing

1985 ◽  
Vol 30 (1) ◽  
pp. 75-79 ◽  
Author(s):  
John E. Bassett ◽  
Curt A. Wiederhielm ◽  
Robert D. Hogan
Keyword(s):  
Subcutaneous Tissue ◽  
Fluid Pressure ◽  
Tissue Fluid ◽  
Interspecific Comparison ◽  
Bat Wing

Measurement of subcutaneous tissue fluid pressure using a skin-cup method

1985 ◽  
Vol 58 (5) ◽  
pp. 1528-1535 ◽  
Author(s):  
T. H. Adair ◽  
A. C. Guyton
Keyword(s):  
Steady State ◽  
Subcutaneous Tissue ◽  
Fluid Pressure ◽  
Recording System ◽  
Servo Control ◽  
Free Fluid ◽  
Tissue Fluid ◽  
Dynamic Changes ◽  
Servo Control System ◽  
Small Needle

We developed a new method for measuring tissue fluid pressure in subcutaneous tissue. Porous Teflon cylinders were permanently implanted subcutaneously into the inguinal area of 10 dogs, and after several weeks a skin concavity formed in the center of each of the cylinders. A small needle attached to a recording system was inserted into the free tissue fluid lining the concavity, and the tissue fluid pressure averaged -8.8 +/- 2.7 (SD) mmHg. Next, a hollow Plexiglas cup was placed over the concavity and glued to the skin. The air pressure in the skin cup was continually adjusted (using an electromechanical servo-control system) to pull the skin upward and to hold it perfectly flat across the upper ridge of the Teflon cylinder. The simultaneously recorded needle and cup pressures averaged -9.1 +/- 2.4 and -8.6 +/- 2.6 mmHg, respectively, during steady-state conditions with the skin in a flat position. Both pressures also responded appropriately to dynamic changes in tissue fluid pressure caused by increasing and decreasing the volume of the free tissue fluid. Because the skin was flat, the equivalences of pressures above and below the skin is consistent with the hypothesis that the skin was not tethered significantly to the underlying tissues and that cup pressure accurately estimates the tissue free fluid pressure.

Characteristics and Factors Associated With Spontaneous Regression of Extruded Lumbar Disc Herniation: A Retrospective Analysis of 31 Cases

2021 ◽  
Author(s):  
Qing-Guang Qin ◽  
Jia Liu ◽  
Li-Jing Zhao ◽  
Shuai Yuan ◽  
Fang Feng ◽  
...  
Keyword(s):  
Linear Regression ◽  
Multiple Linear Regression ◽  
Acute Phase ◽  
Lumbar Disc Herniation ◽  
Spontaneous Regression ◽  
Lumbar Disc ◽  
Bed Rest ◽  
Factors Associated ◽  
Herniated Discs ◽  
Rehabilitation Exercise

Abstract BackgroundLumbar disc herniation (LDH) is a common condition leading to high individual, social, and economic impacts. Reported rates of spontaneous resorption of LDH vary from 35% to 100%; however, it remains unclear how spontaneous absorption, rather than re-protrusion, can be maximized.Purpose The main objective of this study was to determine the characteristics and factors enabling for spontaneous regression of extruded LDH. DesignA retrospective single center case series. Patient sampleInpatients (n = 33) with LDH who experienced spontaneous regression between September 2015 and June 2020. Outcome measuresQuestionnaire responses and magnetic resonance imaging (MRI)-determined hernia regression.MethodsA questionnaire was distributed to patients to assess factors associated with hernia resorption, the volume of herniated intervertebral discs evaluated by MRI, and the absorption ratio calculated. Multiple linear regression was used to explore factors enabling spontaneous herniated disc regression. ResultsA total of 31 patients received a mean of 5.90 conservative treatments during hospitalization, and 1.91 during rehabilitation. Of patients, 90.32% underwent bed-rest during the acute phase of the disease, and 61.29% did so during rehabilitation. Rehabilitation exercise was undertaken by 93.55% of patients, with a mean of 2.42 exercise methods per patient. Waist lumbosacral orthosis devices were worn by 80.65% of patients. Multiple linear regression showed that bed-rest days in the acute phase (X1), herniation type (X2), time wearing lumbosacral orthosis (X3), onset-treatment duration (X4), and days of bed-rest days in rehabilitation (X5) had significant effects on the spontaneous regression ratio (y) of herniated discs (all P < 0.05). The optimal linear regression equation was y = 0.616 + 0.497X1 – 0.478X2 + 0.384X3 – 0.343X4 – 0.241X5. Conclusions Our findings support that patients with extruded or sequestered LDH should receive comprehensive treatment. Early treatment, early bed-rest, and lumbosacral orthosis protection promote the spontaneous regression of herniated discs; however, bed-rest during rehabilitation is a poor prognostic factor. Adherence to rehabilitation exercise will be beneficial to the recovery of patients with LDH.

scholarly journals Platelets Disseminate Extracellular Vesicles in Lymph in Rheumatoid Arthritis

2020 ◽  
Vol 40 (4) ◽  
pp. 929-942 ◽  
Author(s):  
Nicolas Tessandier ◽  
Imene Melki ◽  
Nathalie Cloutier ◽  
Isabelle Allaeys ◽  
Adam Miszta ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Extracellular Vesicles ◽  
Lymphatic System ◽  
Circulatory System ◽  
Donor Cell ◽  
Vascular Leakage ◽  
In Vivo Model ◽  
Interstitial Tissue ◽  
Tissue Fluid

Objective: The lymphatic system is a circulatory system that unidirectionally drains the interstitial tissue fluid back to blood circulation. Although lymph is utilized by leukocytes for immune surveillance, it remains inaccessible to platelets and erythrocytes. Activated cells release submicron extracellular vesicles (EV) that transport molecules from the donor cell. In rheumatoid arthritis, EV accumulate in the joint where they can interact with numerous cellular lineages. However, whether EV can exit the inflamed tissue to recirculate is unknown. Here, we investigated whether vascular leakage that occurs during inflammation could favor EV access to the lymphatic system. Approach and Results: Using an in vivo model of autoimmune inflammatory arthritis, we show that there is an influx of platelet EV, but not EV from erythrocytes or leukocytes, in joint-draining lymph. In contrast to blood platelet EV, lymph platelet EV lacked mitochondrial organelles and failed to promote coagulation. Platelet EV influx in lymph was consistent with joint vascular leakage and implicated the fibrinogen receptor α2bβ 3 and platelet-derived serotonin. Conclusions: These findings show that platelets can disseminate their EV in fluid that is inaccessible to platelets and beyond the joint in this disease.

scholarly journals Review on the Lymphatic Vessels in the Dental Pulp

Biology ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1257
Author(s):  
Kamila Wiśniewska ◽  
Zbigniew Rybak ◽  
Maria Szymonowicz ◽  
Piotr Kuropka ◽  
Maciej Dobrzyński
Keyword(s):  
Dental Pulp ◽  
Lymphatic System ◽  
Light And Electron Microscopy ◽  
Fluid Pressure ◽  
Lymphatic Vessels ◽  
Main Role ◽  
Reaction Products ◽  
Dental Tissues ◽  
Optical Electron ◽  
Antigen Antibody

Despite many studies, opinions on the lymphatic system of the teeth are still incompatible. Studies using light and electron microscopy and directly using methods such as a radioisotope (radionuclide) scan and interstitial fluid pressure measurement reported incomplete results. Immunohistochemistry (IHC) plays the main role in investigating presence of the lymphatic system in dental tissues. This method uses labeled antibodies against antigens typical of lymphatic vessels. The use of appropriate staining enables the detection of antigen-antibody reaction products using a light (optical), electron or fluorescence microscope. However, these studies do not show the system of vessels, their histologic structure under physiological conditions and inflammation as well as the lymphangiogenesis process in the dental pulp. Unfortunately, there is a lack of studies associating the presence of lymphatic vessels in the dental pulp with local lymphatic nodes or large vessels outside the tooth. In the scientific and research environment, the evaluation of the lymphatic system of the teeth is problematic because it is quite difficult to clearly distinguish lymphatic vessels from small blood vessels. Despite many indications of the presence of lymphatic vessels in the pulp chamber, this problem remains open and needs further research.

scholarly journals Analysis of risk factors associated with caesarean section surgical site infections: a case control study

2020 ◽  
Vol 9 (12) ◽  
pp. 5075
Author(s):  
Riya Rano ◽  
Purvi K. Patel
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Subcutaneous Tissue ◽  
White Blood Cells ◽  
Significant Risk ◽  
Surgical Site Infections ◽  
Patient Characteristics ◽  
Factors Associated ◽  
Operative Care ◽  
Duration Of Surgery

Background: Surgical site infection (SSI) is defined as infection occurring within 30 days after a surgical procedure and affecting either the incision or deep tissues at the operation site. SSIs are the most common nosocomial infections, accounting for 38% of hospital-acquired infections. Despite the advances in SSI control practices, SSIs remain common causes of morbidity and mortality among hospitalized patients. This study was undertaken with an objective to determine and analyze the risk factors associated with cesarean section SSIs.Methods: The study was carried out at Medical College and SSG Hospital, Baroda. After obtaining informed consent to be a part of the study, 140 subjects having cesarean section SSI as per the definition, were included as cases in the study. The controls (140) were also selected from the hospital subjects. The primary post-operative care was similar for the cases as well as controls. For patients who had SSI, samples of discharge from the cesarean section wound were collected and transported for culture. Antibiotics were given accordingly. Details about patient characteristics and outcomes were collected in the proforma for cases and controls and data analyzed.Results: The cesarean section SSI rate was 4.78%. Of the parameters studied, maternal age, parity, gestational age, HIV status, meconium stained amniotic fluid, amount of blood loss, previous surgery, duration of surgery were not associated with cesarean section SSI.Conclusions: Number of antenatal care (ANC) visits, haemoglobin, total white blood cells (WBC) count, pre eclampsia, premature rupture of membranes (PROM), non-progression in 2nd stage and subcutaneous tissue thickness were the independent significant risk factors associated with post-cesarean SSI.

Fluid exchanges across the parietal peritoneal and pleural mesothelia

1993 ◽  
Vol 74 (4) ◽  
pp. 1779-1784 ◽  
Author(s):  
D. Negrini ◽  
M. del Fabbro ◽  
D. Venturoli
Keyword(s):  
Protein Concentration ◽  
Fluid Pressure ◽  
Colloid Osmotic Pressure ◽  
Small Samples ◽  
Tissue Fluid ◽  
Liquid Pressure ◽  
Null System ◽  
Net Pressure ◽  
Linear Regressions

In 31 anesthetized rabbits, after removal of superficial tissues, glass micropipettes filled with 0.5 M NaCl solution and connected to an electrohydraulic servo-null system were used to measure extraperitoneal interstitial fluid pressure (Pi,per) and peritoneal liquid pressure (Pliq,per) at various heights. Linear regressions relating pressure to recording height (H) were Pi,per = 1.07 – 0.27H and Pliq,per = 0.9 – 0.64H, respectively. Protein concentration (Cp;g/dl) and colloid osmotic pressure (II; cmH2O) of plasma and of peritoneal and pleural liquids were 5.48 +/- 0.38 and 24.61 +/- 3.23, 3.07 +/- 0.5 and 13.29 +/- 1.87, and 1.76 +/- 0.42 and 8.45 +/- 2, respectively. The equation relating II to Cp was II = 4.64Cp + 0.0027Cp2. Tissue fluid samples were collected with saline-soaked wicks implanted in vivo or dry wicks inserted postmortem in extraperitoneal and extrapleural interstitial spaces. After 60 and 15 min, respectively, wicks were withdrawn and centrifuged; wick fluid was analyzed in colloid osmometer for small samples. Average extraperitoneal and extrapleural II values were 14.2 +/- 2.49 and 11.94 +/- 1.52 cmH2O, corresponding to Cp of 3.07 and 2.57 g/dl, respectively. The average net pressure gradient, assuming reflection coefficient and hydraulic conductivity (Negrini et al. J. Appl. Physiol. 69: 625–630, 1990; 71: 2543–2547, 1991), was 1.18 and 0.98 cmH2O for parietal peritoneal and pleural mesothelia, respectively, favoring filtration from the extraserosal interstitia into the serosal cavities. Total parietal peritoneal filtration was 1.49 ml.kg-1.h-1, approximately 15-fold higher than that for pleural mesothelium.

scholarly journals Factors Associated With Cost of 30-Day and 90-Day Readmissions Following Anterior Cervical Discectomy and Fusion: Insights From the Nationwide Readmissions Database

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Anshit Goyal ◽  
Archis Bhandarkar ◽  
Mohammed A Alvi ◽  
Mohamad Bydon
Keyword(s):  
Health Policy ◽  
Linear Regression ◽  
Economic Burden ◽  
Medical Diagnosis ◽  
Cervical Spondylosis ◽  
National Database ◽  
Policy Makers ◽  
Medical Diagnoses ◽  
Factors Associated ◽  
Symptom Recurrence

Abstract INTRODUCTION The rising cost of spine surgery and the resultant economic burden has attracted the attention of health policy makers. Readmissions constitute a significant economic burden to the healthcare system. METHODS We queried the Healthcare Cost and Utilization Project (HCUP) Nationwide Readmissions Database (NRD) for patients undergoing elective ACDF during 2012 to 2015Q3. Multivariable linear regression was performed to establish the factors associated with cost of each 30/90-d readmission episode (REC). We also determined the procedure-related and medical diagnosis at readmission associated with higher cost of hospitalization. RESULTS A total of 4792 30-d readmissions from 4512 patients and 8156 90-d readmissions from 7198 patients were included. The average 30-d REC was $11,843 (95% CI: $11,390–$12,297) and the average 90-d REC was $14,353 (95% CI: $13,962–$14,744). Number of procedures at index admission (IA), length of stay at IA, and days since IA that the readmission occurred were the top predictors of readmission cost. Other important predictors (P < .001) included a diagnosis of cervical spondylosis with myelopathy at IA and weekend IAs. Cervical myelopathy and aspiration pneumonia emerged as the procedure and medical-related readmission diagnoses associated with the highest 30-d readmission costs respectively. Device-related mechanical complications and symptom recurrence were the diagnoses associated with the highest cost of 90-d RECs respectively. CONCLUSION In this analysis from a national database, we determined the factors associated with cost of readmissions following elective ACDF. Our results indicate that a significant economic burden of readmissions is due to medical diagnoses, apart from procedure related complications.

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