Mega-Liposuction: Analysis of 1520 Patients

Fifteen hundred and twenty cases of liposuction/liposculpture were performed at Dr. M. Erfan & Bagedo Hospitals and King Abdulaziz University Hospital in Jeddah from January 1983 to December 1994. These cases were mostly females. The age group was from 16–65 years. Multiple procedures were performed in 11.68% of these cases. The change in hemoglobin and the hematocrit ratio pre- and post-operatively, and the incidence of complications, were studied. The percentage of surface area operated upon rather than the amount of fat removed was the most important relevant factor.     

Comparison of ultrasound transmission velocity with computed metacarpal radiogrammetry and dual-photon absorptiometry

The aim of our study was to evaluate the validity of a quantitative US technique for measuring the bone density of the proximal phalanges of the nondominant hand compared with computed metacarpal radiogrammetry and dual-photon absorptiometry (DPA) of the lumbar spine. Mean US bone velocity (UBV) correlated with mean metacarpal cortical index (MCI), with mean metacarpal bone density (MBD) and with bone mineral density (BMD) of the lumbar spine, whereas it was correlated negatively with age and menopause duration. The average UBV was significantly higher in premenopausal women than in postmenopausal women, and higher in normal lumbar DPA patients than in reduced lumbar DPA patients. We conclude that the US evaluation of the nondominant hand proximal phalanges may be a new alternative way for measuring bone mass in screening of osteoporosis. Correspondence to: A. Sili Scavalli     

Therapeutic Megalipoextraction or Megaliposculpture

Background: For a long time, surgeons hesitated to extract more than 2.5 liters of adipose tissue from a patient. Through the years, liposuction has advanced, now allowing megaliposculptures to be performed so that more than 10 liters can be extracted without posing any greater risk to the patient than a conventional esthetic liposculpture. Methods: This article traces the progressive evolution of the technique, discussing complications and the concept of megaliposculpturing. Results: The syringe-assisted extraction of large quantities of adipose tissue without transfusion, hypovolemic shock, or any major complication opens new horizons in the symptomatic treatment of certain types of osteoarthritis of the lower extremities and the potential complications of obesity. Conclusions: Large quantities of adipose tissue may safely, quickly and efficiently be extracted. Numerous investigations in various pathological domains can now begin after this first step (megalipotherapy). Therapeutic megalipoextraction can be done either as a preliminary indication or as a treatment of the residual adiposities that occur after bariatric operations.     

Spatio-temporal progression of the AEP P300 component using the cortical imaging technique

Summary The cortical imaging technique (CIT), a mathematical method for simulating the potential fields on the surface of the brain, was used to analyze the spatio-temporal progression of the AEP P300 component (as well as the preceding and subsequent N2a and N3 components) from thirty normal adult subjects recorded in a standard oddball paradigm. Comparisons were made between the progressions of the endogenous event-related cognitive potentials and the exogenous stimulus-dependent potentials (Nl component). Cortical imaging results suggest that different and multiple generator sites are involved in the production of exogenous and endogenous evoked responses. We particularly note the asymmetric development of the P300 component and the apparent anterior generator sites for the N2a component. This last result is interesting because the N2a precedes the P300 component and supports an earlier frontal contribution.     

Intra-anal intussusception: diagnosis by posteroanterior stress proctography

Intra-anal intussusception was diagnosed in eight of 39 patients on evacuation proctography. Posteroanterior views revealed prolapse of the infolded rectum into the anal canal on straining in seven of eight patients, associated with splaying open of the anal canal and sudden distal movement of the fold during prolapse. Similar changes were seen in four of 31 patients in whom intussusception had not been diagnosed on lateral evacuation proctography. The pattern of the collapsed rectum was assessed for fold length, thickness, and angulation in relation to the midline of the rectum. Infoldings that prolapsed were closer to the anorectal junction on stress (mean 14.6 42.4 mm, p < 0.0001) showed greater change in height between rest and strain (28.8 14.6 mm, p < 0.05) and became more acutely angled during straining (41.9 5.3°, p < 0.01). Intra-anal intussusception may be missed in 33% (four of 12 patients) on routine evacuation proctography. Posteroanterior stress proctography is a simple supplementary examination to validate intussusception.     

Production of 5–15 µm Diameter Alginate-Polylysine Microcapsules by an Air-Atomization Technique

A novel method of preparing small-sized microcapsules using a Turbotak air-atomizer is reported. Alginate-polylysine microcapsules containing Bacillus Calmette Guérin vaccine have been prepared by an adaptation of the method of Lim (1) which allows the manufacture of small-sized microcapsules. A Turbotak is used to spray sodium alginate solution into calcium chloride solution to form temporary calcium alginate microgel capsules. These temporary microgel droplets are subsequently cross-linked with polylysine to form permanent membranes. Microcapules in the size range of 5–15 µm have been produced which can be compared to an average diameter of 300 µm obtained by the method reported by Lim. The microcapsule size is dependent on the conditions of operation of the Turbotak and the concentration of the sodium alginate solution. Particles within the size range 5–15 µm can be reproducibly manufactured using the conditions of operation reported here. Other size ranges below the minimum of 300 µm reported by Lim are also feasible using this technique.     

Cat Distal Forelimb Joints and Locomotion: An X-ray Study

The complex construction of the joint apparatus of the cat distal forelimb, which allows the paw three degrees of freedom, poses special requirements on the neural signals controlling the paw position. To understand the electromyography (emg) signals of the distal forelimb muscles during locomotion, it is necessary to know the kinematics of the forelimb joints in detail. As no such information is available, we used the pulsed X-ray technique in trained cats during treadmill locomotion to analyse the angular excursions of the wrist, the metacarpophalangeal (MCP) and the proximal interphalangeal (PIP) joints. X-ray illuminations were done in either the parasagittal or the frontal plane. At the beginning of the stance phase the wrist (WR) and the MCP joints extended slowly, and the PIP joints flexed. Whereas the WR and the PIP joints maintained a constant angular position of approximately 200 degrees and 60 degrees, respectively, throughout the stance phase, extension continued in the MCP joints from 240 degrees at touch-down to 300 degrees at the end of the stance phase. Slightly before lift-off (100 ms) the WR and the MCP joints flexed rapidly. This flexion changed approximately 150 ms after lift-off into a slow extension. The PIP joints extended rapidly at the beginning and at the end of the swing phase, during the interposed period of the swing phase they displayed a slow flexion. Rotatory movements of the forelimb in the radioulnar joints were present during the swing and stance phases. During the swing phase the limb first supinated (starting 100 ms after lift-off); pronation occurred immediately before ground contact. During the stance phase the supination angle was kept constant until 100 ms before lift-off, when a short pronation was found. The paw was kept in an ulnar deviated position throughout the complete step cycle. Ulnar deviation decreased at the end of the swing and stance phases. The results of this study increase our understanding of how the body weight is transmitted on to the ground. They suggest four main functions for the skeletomotor apparatus and the underlying neural commands to secure the forward movement of the animal during the stance phase: (i) preparation and stabilization of a force-transmitting platform; (ii) stabilization of the wrist and the carpal/metacarpal joints; (iii) stabilization of the supination angle; (iv) antigravity control of the extension in the MCP.     

The ONG capsular lens,report of 100 implantations

This Capsular Lens (ONG, type IV, to be called O.C.L.) has been developed for routinely performed extracapsular cataract extraction with lens implantation. The fundamental surgical procedure was based on continuing experience with the bimanual aspiration-irrigation technique and system developed by the author in 1971. The biomechanical properties of the asymmetric partly flexible, haptic loops are designed to give tensionfree fixation in two capsular pockets. The plano-anterior position of the lens ensures well-defined irido-lenticular clearance and proper alignment of the convex side with the posterior capsule. Consequently no iridectomy or iridotomy is needed for proper aqueous flow.