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131.
Tarek A. Amer Tarek F. Elwakil Mahmoud S. Elbasiouny 《European journal of plastic surgery》2007,30(2):67-73
Haemangiomas are the most common tumours of infancy. They typically proliferate then involute with considerable variation
as regards to their rates of proliferation and involution. Haemangioma of the nasal tip is a lesion of special characteristics.
During proliferation, it expands, contracts and deviates the nasal cartilages. Particularly, it regresses slowly and frequently
involutes incompletely. That is why excision of the lesion is frequently suggested. The present study was conducted to evaluate
open rhinoplasty after initial non-excision treatment modalities namely, intra-lesional corticosteroid injections and laser
treatment, as a protocol of treatment for nasal tip haemangiomas. Twelve patients with nasal tip haemangiomas were included
in the present study. Patients of both sexes, of different ages, with deep and mixed haemangiomas were studied. Disfigurement
was the constant presenting symptom. Initial non-excision treatment reported different responses as denoted by the regression
of the lesions’ size. Haemangiomas constantly extended between the medial crura of the alar cartilages as noted by the constant
widening of the columella pre-operatively and the obvious separation of the nasal cartilages intra-operatively. This separation
was constantly found to require approximation by sutures. The results of the present study concluded that whenever an early
presentation with nasal tip haemangioma could be established, initial non-excision treatment followed by open rhinoplasty
could be a useful protocol of treatment. Within the limitations of the present study, this protocol could achieve an early,
safe and effective treatment for nasal tip haemangiomas with provisionally acceptable cosmetic outcomes so far. 相似文献
132.
This study investigates whether tissue recoil or patient intrinsic factors influence the final position of the nipple areola
complex (NAC) after reduction mammoplasty.
The age, pre-operative ptosis, BMI and weight of the tissue resected were recorded as patient intrinsic factors in 37 patients
undergoing reduction mammoplasty. The “spring-back” value was defined as the distance from the sternal notch to a nipple landmark
on the breast meridian with the patient sitting up, minus the same measurement repeated with the patient recumbent to eliminate
the pull of gravity on the breast. Spring back was measured pre-operatively for the nipple and nipple mark then post-operative
for the nipple. The difference in centimeters between the final post-operative distance from the sternal notch to the nipple
and the level intended by the pre-operative nipple mark was termed the “judgment error.” The final position of the post-operative
nipple and the judgment error was compared to the spring-back values and patient intrinsic factors.
Pre-operative ptosis was statistically related to increasing patient BMI and mass of tissue resected per breast. Pre-operative
spring-back values for the nipple increased with increasing ptosis, BMI and decreasing age. Spring-back values were greater
in the lower pole of the breast than in the upper pole. The final position of the nipple was higher than the pre-operative
mark in 65% of cases, lower in 8% and as marked in 27% of cases. The post-operative NAC was, on average, 0.6 cm higher than
planned pre-operatively. The post-operative distance from the sternal notch to the nipple increased with increasing pre-operative
ptosis, mass of breast tissue resected per breast and all three spring-back values. The difference between the level of the
pre-operative mark and the final nipple position showed a weak correlation with post-operative spring-back values.
The parameters of ptosis, BMI, weight of tissue resected per breast and pre-operative nipple spring back reflect body habitus
and breast size. Spring-back values vary between the upper and lower pole of the breast. The final NAC position was higher
than that intended at pre-operative marking in the majority of cases. The surgeon instinctively marks the nipple lower in
patients with greater pre-operative ptosis and in whom a larger resection is anticipated. Judgment error did not relate to
intrinsic factors nor to pre-operative spring-back values; hence, these parameters cannot be applied as predictive tools for
more accurate pre-operative marking of the nipple position. This study suggests that the pre-operative nipple mark should
be placed, with the patient sitting up, at least 23 cm from the sternal notch and 0.6 cm lower than the final position estimated
using the inframammary crease as a landmark.
An invited commentary on this paper is available at . 相似文献
133.
Marlene S. See M. R. Foxton N. A. Miedzianowski-Sinclair C. E. Roberts C. Nduka 《European journal of plastic surgery》2007,29(8):387-393
The nasolabial fold is a significant facial landmark. Its size, shape, and symmetry are important in facial reanimation surgery,
while effacement is an important goal in rejuvenation surgery. However, quantitative data for the nasolabial fold volume (NLFV)
and depth is still unavailable. We present a new method of measurement using 3D color speckle stereophotogrammetry and its
application in the assessment of NLFV. The VECTRA-3D system was validated to determine its minimum resolution and accuracy.
Normal volunteers aged 13–84 years (n = 87) were imaged in repose. Mother–daughter pairs (n = 15, aged 13–61) were imaged in the upright and supine positions. All data were processed using custom software and analyzed
by linear regression and nonparametric tests as appropriate. NLFV varied from 0.0026 to 0.2306 ml. There was significant correlation
between NLFV and age (r = 0.7269, p < 0.0001). Men had significantly higher NLFV than women across all ages. There was no significant difference between the
left and right NLFV. NLFV altered significantly from upright to supine in all subjects (p = 0.0012). However, the mothers increased their NLFV by 32% from supine to upright postures, which was a greater change than
observed in their daughters. We have demonstrated a rapid, objective, and non-invasive assessment tool for facial reanimation
and rejuvenation surgery. We have quantified the effects of age and posture on NLFV, and the efficacy and longevity of rejuvenation
procedures are currently under investigation. 相似文献
134.
135.
136.
Jamshid Shirani Jagat Narula William C. Eckelman Navneet Narula Vasken Dilsizian 《Journal of nuclear cardiology》2007,14(1):100-110
Conclusions Noninvasive imaging of neurohumoral upregulation in remodeled myocardium suggests that an imaging strategy can be developed
for predicting the rate of remodeling and likelihood of HF development. This should allow a more judicious use of neurohumoral
antagonists especially in subjects who do not have manifest HF.74 In others specific targeted imaging may allow timely selection of individualized treatment strategies and ensure optimization
of therapeutic intervention. Similar to ACE and AII receptors, multiple other targets in the hormonal cascades can identify
the likelihood of adverse and favorable remodeling.74 相似文献
137.
Yuji Takeda Naoki Minato Yuji Katayama Tomoki Shimokawa 《General thoracic and cardiovascular surgery》2005,53(1):42-45
Two successful cases of the surgical treatment for coronary artery aneurysm (non-Kawasaki disease) were reported. The first
case had a saccular aneurysm on the left circumflex coronary artery (LCx) #14. Resection of the LCx aneurysm was performed
subsequent to single vessel coronary artery bypass grafting (CABG) to the distal portion of LCx#14 under the cardioplegic
cardiac arrest. The second case had aneurysms on both the left anterior descending artery (LAD) #7 (fusiform) and the LCx#11
(saccular). After double vessel CABG to LAD#7 and LCx#11, ligation or resection of two aneurysms was performed successfully.
Postoperative courses have been uneventful with good angiographic results achieved. Since these surgical procedures demonstrated
safety, the patients are expected to achieve a good long-term prognosis. 相似文献
138.
Kimihiro Shimizu Yoshimi Otani Takashi Ibe Osamu Kawashima Mituhiro Kamiyoshihara Yasuo Morishita 《General thoracic and cardiovascular surgery》2005,53(1):39-41
Late-onset chylothorax occurred 49 days after right lower lobectomy for lung cancer in a 76-year-old man. Chylothorax was successfully managed by conservative treatment with chest tube drainage and an enteral low-fat diet. Chylothorax may occur in the late period after pulmonary resection and systematic mediastinal lymph node dissection for lung cancer, for which conservative management is the treatment of choice. 相似文献
139.
Michael J. Bernas Robert L. Askew Jane M. Armer Janice N. Cormier 《Current breast cancer reports》2010,2(1):53-58
Lymphedema is an under-recognized, progressive, life-long condition estimated to impact 2-3 million people in the United States.
The incidence of breast cancer related lymphedema varies greatly in the literature largely due to different measurement techniques,
competing thresholds for defining lymphedema, and variation in length of follow-up. Multiple imaging techniques have become
useful for diagnosis. Lymphoscintigraphy is one of the most commonly used, as it can identify pathways of lymphatic drainage,
quantify extent of dermal backflow, and help determine functional and morphologic changes in the lymphatic system. Early detection
and intervention hold the greatest promise of reducing the incidence of lymphedema. Health care providers involved with cancer
patients need to become more educated about lymphedema, aware of current risk-reduction practices, and familiar with methods
of diagnosis and assessment, so that patients with early swelling can be referred to lymphedema treatment specialists at a
time when treatment is more effective. 相似文献
140.