bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of VLT/X-shooter OH and O2 rotational temperatures with consideration of TIMED/SABER emission and temperature profiles
Authors: Noll S. , Kausch W. , Kimeswenger S. , Unterguggenberger S. , Jones A. M.
Published: November 2015

Abstract. Rotational temperatures Trot derived from lines of the same OH band are an important method to study the dynamics and long-term trends in the mesopause region near 87 km. To measure realistic temperatures, a corresponding Boltzmann distribution of the rotational level populations has to be achieved. However, this might not be fulfilled, especially at high emission altitudes. In order to quantify possible non-local thermodynamic equilibrium (non-LTE) contributions to the OH Trot as a function of the upper vibrational level v', we studied a sample of 343 echelle spectra taken with the X-shooter spectrograph at the Very Large Telescope at Cerro Paranal in Chile. These data allowed us to analyse 25 OH bands in each spectrum. Moreover, we could measure lines of O2b(0-1), which peaks at about 94 to 95 km, and O2a(0-0) with an emission peak at about 90 km. The latter altitude is reached in the second half of the night after a rise of several km because of the decay of a daytime population of excited O2. Since the radiative lifetimes for the upper levels of the two O2 bands are relatively long, the derived Trot are not significantly affected by non-LTE contributions. These bands are well suited for a comparison with OH if the differences in the emission profiles are corrected. For different sample averages, we made these corrections by using OH emission, O2a(0-0) emission, and CO2-based temperature profile data from the multi-channel radiometer SABER on the TIMED satellite. The procedure relies on differences of profile-weighted SABER temperatures. For an O2a(0-0)-based reference profile at 90 km, we found a good agreement of the O2 with the SABER-related temperatures, whereas the OH temperatures, especially for the high and even v', showed significant excesses with a maximum of more than 10 K for v' = 8. The exact value depends on the selected lines and molecular parameters. We could also find a nocturnal trend towards higher non-LTE effects, particularly for high v'. The amplitude of these variations can be about 2 K or less, which tends to be significantly smaller than the total amount of the non-LTE contributions. The found variations can be critical for dynamical studies based on Trot derived from OH bands with high v'.
Inscribir el declive en el tiempo. Detroit: Auge y crisis de la ciudad industrial
Authors: Fernández Águeda Beatriz
Published: November 2015

A comienzos del siglo XX, Detroit era una ciudad dinámica en pleno desarrollo. Pronto se convirtió en la cuarta ciudad de Estados Unidos, la capital de la naciente industria automovilística. El crecimiento se prolongó hasta finales de los años 50, cuando, a pesar del auge económico de Estados Unidos y de su área metropolitana, Detroit comenzó a mostrar los primeros signos de estancamiento. La crisis se ha prolongado hasta hoy, cuando Detroit constituye el paradigma de la ciudad industrial en declive. Estas dos imágenes contrapuestas, el auge y la crisis, no parecen explicar por sí mismas las causas de la intensidad y persistencia del declive de Detroit. Analizar las interacciones entre crecimiento económico, políticas públicas locales y desarrollo urbano a lo largo del tiempo permitirá subrayar las continuidades y comprender en qué medida el declive de Detroit ancla sus raíces en el modelo planteado durante la etapa de auge.
Mecanismos culturales para mantener la identidad entre los indios monimboseños de Nicaragua
Authors: García Bresó Javier
Published: November 2015

No hay culturas puras ni mezcladas, sino culturas. Cada cultura genera identidades particulares que pueden haber incorporado elementos culturales ajenos. Estos elementos forman parte del patrimonio cultural de la humanidad, pertenecen a todos los seres humanos. La etnicidad de Monimbó (Nicaragua) se fundamentó en el estigma y la marginación consecuente de su identidad india y en haber mantenido algunas tradiciones de clara influencia colonial, cuando ya en la sociedad nacional habían desaparecido. Estas incorporaciones históricamente “impuestas” constituyen ahora su base cultural más importante, una vez que sólo los indios las mantienen. Se trata de tradiciones que por supuesto han sufrido las variaciones lógicas causadas por la readaptación y el paso del tiempo, cambios impuestos que fueron apropiados, asimilados o encapsulados a través de un contacto prolongado. El fenómeno o la paradoja es: ¿Quién iba a decir que las “imposiciones culturales” contribuirían a la continuidad cultural?
Teacher’s and Students’ Beliefs on English for General Academic Purposes: The Case of Iranian University Students
Authors: Kojour Masoud Kermani , Heirati Javad Kia
Published: November 2015

This study was framed in the sociocultural theory to look into the evolution of L2 learners’ beliefs about the general English course during a term. One hundred ninety-eight male and female university students and their general English course teacher were randomly selected as the participants of the study. Data were gathered through the administration of Horwitz’s (1988) BALLI questionnaire. Among the participants, 38 students were invited to take part in semi-structured interview sessions and fill in an open-ended questionnaire at the beginning and end of the term. Descriptive statics were applied to precisely analyze the quantitative data based on the questionnaire. In order to qualitatively analyze the data, the grounded theory methodology was utilized to code the data and find the main categories in line with the research questions of the study. Findings concluded that all the learners changed their simplistic beliefs about the general English course highlighting the attention to grammar and vocabulary. In fact, the teacher believed in teaching strategies to pave the way for the learners to comprehend the text better and apply the strategies while reading. The teacher’s meditational activity assisted the learners to evolve their simplistic beliefs and be able to benefit from reading strategies for better comprehension. Awareness-raising activities should be done in terms of teachers’ and students’ beliefs about EGAP (English for general academic purposes) to equip L2 learners with better educational environments resulting in their enjoyment of the learning process.
The Role of the Auditor in Planning and Reduce the Risk of IT Environment in Commercial Jordanian Banks
Authors: Hamdan Mohammed Naser , Hosban Atallah
Published: November 2015

This study aimed to identify the role of the auditor’s judgment in dealing with the risks of the IT environment, so I studied the process of IT risk planning , and study how the auditor to reduce the risk of information technology. The study on designing a questionnaire covering the variables and hypotheses of the study , the questionnaire consists of 14 paragraphs, were used methods of statistics such as averages and standard deviations, and percentages and frequencies , and the study sample consisted of auditors (52) (external Auditors )for commercial banks in Jordan , most results are: Auditor determine the output of the likelihood of recurrence of the threat event (incidence of threat), and is expressed in a year ,Auditor Identify risks that cause weakness and imbalance core activities of the company, and monetary loss resulting from it , and Auditor prepare Prioritize risks according to their importance. Study recommendations are: its important to care that  the members of the team in charge of identifying risks with a statement of clarification and details in favor of it, based on the knowledge that they own about those risks. And Auditor evaluate on an ongoing basis and on a periodic basis, and this determines the important information should be focused information security on them.
Firm’s Financial Flexibility: Driving Factors, Flexibility Degree and Economic Results: A Comparison of America and China
Authors: Ma Chun-ai , Jin Yanbo , Chang Heng-Yu
Published: November 2015

Our paper establishes the causal links among the driving factor, flexibility degree and performance of a firm and tests these links based on two samples made of American and Chinese listed companies in manufacturing industry respectively from 2009 to 2012. Our results show the financial flexibilities of American and Chinese firms are mainly driven by strengthening risk management and chasing investment opportunities respectively, the degree of financial flexibility has positively impact on firm performance, and the effect of financial flexibility driven by chasing investment opportunities on performance is more statistically significant than financial flexibility driven by strengthening risk management. Our results suggest that a firm can improve its performance if it retains a high flexibility degree driven by chasing investment opportunities.
Comparative Relationship of Fiber Strength and Yarn Tenacity in Four Cotton Cultivars
Authors: Liu Yongliang , Campbell B. Todd , Delhom Chris , Martin Vikki
Published: November 2015

High volume instrumentation (HVITM) measurement is a primary and routine tool of providing fiber properties to cotton researchers. There have been considerable studies designed to derive yarn quality from acquired fiber quality data by various means, including HVI. There is also of desired information about the comparison of yarn quality within a cotton cultivar or among the cultivars, as such knowledge could be informative in attempts to understand the selection of cotton cultivars. The purpose of this preliminary study was to characterize the fiber HVI strength and yarn skein tenacity of four cotton cultivar harvested from three locations in different crop years. Instead of developing linear regression models from acquired fiber property parameters to predict yarn tenacity, this study applied a simple ratio method (i.e., correct fiber strength or yarn tenacity with fiber micronaire component) to relate fiber strength with yarn tenacity. The results indicate that three cultivars (DP 393, Phytogen 72, and FM 958) show stronger correlation between micronaire corrected yarn tenacity and micronaire corrected fiber HVI strength. It implies the feasibility of utilizing HVI fiber micronaire and strength property data, as a semi-quantitative and fast tool, to compare the yarn tenacity performance within a cotton cultivar or between cultivars.
Autoriteit in beeld
Authors: Schillemans Thomas , Jacobs Sandra
Published: November 2015

Autoriteit in beeld. Over toezichthouders en medialogica in het nieuws

Publieke organisaties staan van oudsher bekend als nieuwsmijdende organisaties. Ze voeren belangrijke publieke taken uit met een soms grote invloed op de samenleving, maar ze opereren relatief onzichtbaar achter gekozen politici die voor hen het woord voeren en op grond van bureaucratische routines en wettelijke regelingen.

De analyse in dit artikel is erop gericht om aan de hand van voorlopige inzichten uit empirisch onderzoek te bekijken in welke mate de zorgen over de rol van de media in bestuur en toezicht gerechtvaardigd zijn en om kansen voor toezichthouders door medialogica te identificeren.

Als men de conclusies op zich beziet, valt op dat de analyse op één cruciaal punt na, meer redenen voor geruststelling dan bezorgdheid biedt. Medialogica werkt, uitgaande van de sombere verwachtingen in een deel van de literatuur, vaker positief dan negatief uit voor toezichthouders.
Towards Governance-Based Regulation?
Authors: Zeitlin Jonathan
Published: November 2015

Towards Governance-Based Regulation? The WRR Report on Toezien op publieke belangen in European and International Perspective

Until quite recently, the Netherlands had an outstanding reputation at home and abroad for administrative regulation and supervision (‘toezicht’) of markets and public services. Over the past decade, however, that reputation has been tarnished, both internally and externally, by a series of regulatory failures and scandals across a wide range of policy domains. In this article the author gives us the international perspective.
Onrustige onafhankelijkheid
Authors: Aelen Margot , Biezeveld Gustaaf
Published: November 2015

Onrustige onafhankelijkheid

In deze bijdrage wordt voortgebouwd op het idee dat onafhankelijkheid een kernwaarde is van toezicht. De auteurs gaan in op de voornaamste redenen voor onafhankelijkheid en de oorzaken van de ‘onrust’. Tot slot schetsen zij de contouren van een structurele oplossing voor de spanning tussen de politiek en toezichthouders.
Surgeon-Delivered Sedation for Outpatient Cosmetic Surgery
Authors: Davis Craig
Published: November 2015

Introduction:

Sedation is a valuable anesthetic technique used in settings ranging from hospitals to physicians' offices. This article describes more than 200 sedations given under the direct supervision of the operating surgeon. The main objectives are to evaluate the effectiveness and safety of this technique and to determine whether individualized sedation results in significant differences in medications given. In addition, pre-sedation evaluation, paying particular attention to upper airway assessment, is discussed.

Materials and Methods:

A retrospective chart review was completed on 150 patient records from a private cosmetic surgery practice.

Results:

For the period studied, 218 surgeon-supervised sedations provided adequate and safe anesthesia for outpatient facial and body cosmetic surgical procedures. Breast surgeries required significantly higher doses of ketamine and propofol compared with the other procedures. The lowest amounts of ketamine and propofol were used during facial surgeries.

Conclusions:

In select patients, surgeon-supervised sedations are safe and effective for outpatient cosmetic surgical procedures. Less intense sedation is required for facial surgeries than for other procedures. A pre-sedation evaluation, paying particular attention to upper airway assessment, should be completed by the surgeon.
Buttock Augmentation with Implants and Fat Grafting: A Comparative Study
Authors: Chugay Paul N. , Chugay Nikolas V.
Published: November 2015

Introduction:

We sought to compare our experience in the 2 primary techniques for buttock augmentation and determine if one is clearly superior to the other from the standpoints of complications, postoperative pain, and patient satisfaction.

Materials and Methods:

A retrospective search of patient records was performed for the period 2008–2011. A total of 129 patients were identified as having undergone buttock augmentation, 33 via fat transfer with stem cell therapy and 96 by way of silicone prosthesis. Complications were tabulated. Medcalc version 12.1 was used for analysis.

Results:

Over a 4-year period, we found that a total of 96 implant augmentations had been performed versus 33 fat-grafting augmentations. The overall satisfaction of the patients receiving buttock augmentation was 76.0% (73/96) for augmentation with implants and 69.7% (23/33) for augmentation with fat, which was statistically significant ( P < .001; 95% confidence interval [CI], 67.93–71.47). Seroma formation was more prevalent in the implant group (3.0% versus 17.7%; P = .02; 95% CI, 0.070–15.7). Lumps or dents were more prevalent in the fat-grafting group (33.3% versus 2.1%; P < .0001; 95% CI, 17.9–51.8). Complications isolated to those undergoing implant augmentation included dehiscence (14.6%) and contracture (13.5%).

Conclusions:

Although fat grafting for buttock augmentation is rising in popularity among surgeons, its results are not as consistent as those seen with buttock implant augmentation. This consistency of results is offset by the risk of capsular contracture and dehiscence, which are seen in implant surgery. Cosmetic surgeons should be aware of both techniques in buttock augmentation and their respective risks and benefits.
Retrospective Analysis of Type II Psillakis-like Mini-Abdominoplasties in a Single Cosmetic Surgery Practice: A Pilot Study
Authors: Peterson Jennifer D. , Palm Melanie D. , Goldman Mitchel P.
Published: November 2015

Introduction:

Mini-abdominoplasty is a surgical procedure available to patients with mild skin laxity and no underlying structural deficits including hernias or diastasis recti. This procedure can be performed safely with local anesthesia and minimal recovery time.

Materials and Methods:

All patients at a single private practice undergoing mini-abdominoplasties between 2005 and 2009 were identified. All procedures were performed using intravenous sedation, tumescent anesthesia, limited undermining, and without rectus plication or umbilical stalk resection. Identified patients were asked to complete a postprocedure questionnaire regarding postoperative complications and patient satisfaction.

Results:

Eight patients underwent mini-abdominoplasties, 7 of whom had concomitant liposuction. All patients were contacted and completed the questionnaire. No major postoperative complications were reported. Patient-reported pain, bruising, and edema following the procedure were mild in nature. Patient-evaluated overall improvement in the appearance of their abdomen was 78.13%.

Conclusions:

Type II Psillakis-like mini-abdominoplasty performed with tumescent anesthesia and intravenous sedation offers a safe and effective management of redundant abdominal skin tissue with high patient-reported improvement.
Abdominoplasty Seroma Prevention with Fibrin Sealant
Authors: Perez Jorge A. , Thau Mathew
Published: November 2015

Abdominoplasty is among the most commonly performed procedures in plastic surgery. Complications reported after abdominoplasty include pulmonary embolism and seromas. The abdominoplasty paradox is that postoperative patient and flap immobilization may diminish seroma formation but may also predispose the patient to embolism. Early mobilization may prevent the latter but increase the risk of seroma. Commercially available fibrin sealants can create flap adherence, reducing the risk of seroma formation, while at the same time allowing early ambulation. In this article we retrospectively review 55 consecutive ambulatory abdominoplasty procedures using intraoperative aerosolized commercial fibrin sealant for flap adhesion. Minimum follow-up was 24 days. No postoperative seromas occurred. Results indicate that fibrin sealants can help prevent postoperative seroma formation in abdominoplasty surgery. No complications or untoward side effects are reported. The application of sealant product requires proper in-service and technique.
The Latest Advance in Hair Regeneration Therapy Using Proteins Secreted by Adipose-Derived Stem Cells
Authors: Fukuoka Hirotaro , Suga Hirotaka , Narita Keigo , Watanabe Rei , Shintani Satoru
Published: November 2015

Introduction:

Adipose-derived stem cells (ADSCs) that can be harvested from fat cells are one of the latest breakthroughs in the aesthetic field. In addition, basic studies have reported that ADSC conditioned medium (ADSC-CM) promotes skin and hair regeneration. We validate our novel approach, known as hair regenerative therapy, for hair growth treatment using ADSC-CM.

Materials and Methods:

ADSCs were cultured and expanded in hypoxic culture conditions, and ADSC-CM was collected. ADSC-CM includes various cytokines and growth factors that influence hair regrowth, to which we added buflomedyl, cysteine, coenzyme Q10, and vitamins. Protein solution from ADSC-CM was applied 4 to 6 times every 3 to 5 weeks by mesotherapy techniques such as nappage and papule injections. Satisfactory results of hair regenerative therapy in 12 women and 13 men were determined with a visual analog scale.

Results:

All patients experienced increased hair growth from the treatments with ADSC-CM. Four treatment sessions performed within 3 to 4 months provided especially good results. Scores on the visual analog scale increased with treatment frequency. Statistical significance was determined by Friedman's 2-way analysis of variance (P < .01) and Wilcoxon's signed rank test (P < .01).

Discussion:

ADSCs secrete cytokines, such as keratinocyte growth factor, vascular endotheliatl growth factor, platelet-derived growth factor, hepatocyte growth factor. Those cytokines and growth factor are very important for hair growth. Our new therapy with ADSC-CM does not require specialized facilities, such as a cell-processing center, and can be a valuable treatment.
High-Pressure Injection and Suction Curettage: A Novel Treatment for Lipoma
Authors: Boeni Roland
Published: November 2015

Introduction:

Lipomas present as soft, mobile subcutaneous benign tumors. Liposuction is performed on medium to large lipomas, but extraction of the whole capsule through a slit incision is often difficult. This study aims to evaluate a novel approach in the treatment of lipoma.

Materials and Methods:

Twelve encapsulated lipomas (range, 4–16 cm) were treated using a high-pressure injection technique with an injection pump, followed by suction curettage. The capsule's remnants were not extracted. Patients were followed up after 2 years.

Results:

High-pressure injection facilitated identification and handling during suction curettage. There were no recurrences after 2 years.

Conclusions:

Lipoaspiration is limited to medium to large lipomas. This novel approach allows for the treatment of lipomas without extracting the capsule. Intralesional pressure not only facilitates suction curettage but might also be a contributing factor to the capsule's breakdown.
Pulmonary Synovial Sarcoma: Lip Presentation Was More Than Met the Eye
Authors: Gollard Russell P. , Turner J. Francis
Published: November 2015

Synovial sarcomas are rare tumors. Most occur in a joint but they can occur in any tissue where mesenchymal cells are present. We report an extremely rare case of a lip presentation of a primary synovial sarcoma of the lung. Although uncommon, a variety of soft-tissue sarcomas can occur primary to the lung. The prognosis is generally poor.
Review of Facial Fillers and Injectable Neurotoxins
Authors: Ferneini Elie , Boynton Tyler , Almunajed Husam , Dimitrov Kroum , Banki Mohammad
Published: November 2015

Introduction:

Noninvasive cosmetic techniques continue to increase in popularity. In particular, dermal fillers and botulinum toxin injectables have consistently shown a rise in demand. Pharmaceutical companies have spent millions of dollars to develop these products to produce more achievable, predictable, and long-lasting results. As a result, multiple products were developed that differ in their physical and chemical properties. By understanding these characteristics, the cosmetic surgeon will achieve more safe and reliable results.

Materials and Methods:

A literature search on dermal fillers and botulinum toxin injectable treatments was completed from 2005 to 2013.

Results:

Injectables are a great resource for clinicians to improve a patient's appearance in a short time with relatively little discomfort to the patient. With a rise in the number of patients requesting these treatments, it is crucial that the surgeon and patient are aware of all of the risks and benefits of treatment. As the quest for the youthful image continues in our society, anti-aging therapies will continue to improve.

Conclusions:

Patients and cosmetic surgeons will continue to work with these and more advanced products as they are approved. With proper training and experience, the surgeon should be able to provide treatments that consistently benefit their patients. It is the purpose of the paper to provide the cosmetic surgeon with a description of the current products available as well as the complications that can arise when using these materials.
Melanin Light Absorption as the Necessary but Not Sufficient Condition for Photoepilation: Intra-Anagen Variability of Hair Follicle Light Sensitivity
Authors: Kruglikov Ilja L.
Published: November 2015

Several well-known, contradictive photoepilation phenomena cannot be reliably explained within the framework of traditional theory. Counted among are the contradiction between the total number of anagen hairs and the number of light sensitive hairs as well as the paradoxical, regional variations in the light sensitivity of anatomically similar hairs. These and some other phenomena can, however, be explained by intra-anagen variability of the hair follicle (HF) sensitivity to light. Melanin content in the hair matrix is important for the initial temperature increase at the distal portion of the growing HF, where strong epithelial and mesenchymal remodeling processes take place, thus being the necessary condition for photoepilation. This condition is, however, not sufficient for effective hair removal. We discuss the variation of intra-anagen light sensitivity and its possible correlation with sonic hedgehog activity, which is strongly responsible for the remodeling processes at the distal end of the growing HF. It is concluded that the theory needs much modification, along with revision of the optimal treatment strategy.
The Physics of Liposuction: From Poiseuille to Starling
Authors: Sanniec Kyle , Gellis Michael
Published: November 2015

Liposuction has become a field all to itself. There are dedicated fellowships in body contouring, and large research groups around the world are investigating new techniques and methods. The science of lipoplasty has grown exponentially in the last several decades. Similarly, with the advent of new techniques, more and more patients are requesting liposuction procedures. It has become the most sought after cosmetic surgery procedure in the United States. Furthermore, there is no indication that this increased demand will stop in the near future. In order to accommodate this increased demand, the liposculptor must become efficient with the liposuction techniques. Knowledge of the physics behind effective liposuction has several advantages. Knowing how the Starling forces act on the adipose tissue can help the liposculptor manipulate these forces and can improve efficiency. Similarly, knowing the effect of the Law of Poiseuille can help the liposculptor choose the proper cannula dimensions for the desired area. Additionally, a better understanding of the basic science behind liposuction can lead to further research contributions related to this technique.
Multimodal Treatment of Hypertrophic and Keloidal Scars
Authors: Lack Edward B.
Published: November 2015

Introduction:

Hypertrophic and keloidal scars are unwanted sequelae of wound healing. As multiple pathologic progenitors and mediators are responsible for these abnormal scars, single modality therapy is only intermittently successful. Multiple empiric therapies are now available which can be applied concomitantly or sequentially to address these uncomfortable and unsightly conditions.

Materials and Methods:

A 76-year-old woman underwent a rhytidectomy and blepharoplasty followed by perioral ablative laser resurfacing. During the ensuing 4 months, she developed circumferential perioral hypertrophic scars with foci of keloidal scar formation plus secondary evolution of microstomia.

Results:

Over an 18-month period, the patient received a single course of imiquimod cream, multiple injections of 5-fluorouracil and triamcinolone, multiple intense pulsed light treatments, and multiple nonablative fractional laser resurfacing treatments. At the conclusion of therapy, the patient achieved more than 90% resolution of hypertrophic and keloidal scarring.

Conclusions:

While knowledge of the pathogenesis of hypertrophic and keloidal scarring is evolving, at tempts at its resolution are empirical. Not surprisingly, the processes by which various therapies are effective continue to be argued. Nonetheless, administering multimodal therapy in an artful sequence can ameliorate many if not most hypertrophic and keloidal scars when treated at a relatively early stage.
Suture Granuloma following Ventral Herniorrhaphy
Authors: Bonni Aram
Published: November 2015

Skillful wound closure requires proper knowledge of the physical characteristics of the wound; knowledge of surgical technique; and familiarity with different types of needles, sutures, and instruments to use for a specific condition. Better randomized, double-blind, and controlled studies are needed to confirm that long-lasting absorbable monofilament sutures reduce the risk of suture erosion without increasing surgical failure. There seems to be enough evidence for surgeons to use long-lasting monofilament absorbable sutures instead of permanent sutures with their potential unfavorable consequences. This should help prevent repeated surgeries, and in the case described here could have potentially avoided three extra surgeries with significant reduction of morbidity.
Zigzag Genioplasty; Patients Evaluation, Technique Modifications and Review of the Literature
Authors: Keyhan Seied Omid , Khiabani Kazem , Raisian Shahrokh , Bohlouli Behnam , Feizbakhsh Masoud , Hemmat Seifollah , Mehmandoost Meghdad Khanian , Varedi Payam , Shirafkan Saeed , Hoseini Elham
Published: November 2015

Introduction:

The purpose of our study was to evaluate patients and technique and complete a review of the literature related to Zigzag genioplasty.

Materials and Methods:

To address the research purpose, the investigators designed and implemented a prospective clinical trial study. Seven osteotomy types (I–VII) are proposed for genioplasty that will permit one to decrease the 3-dimensions of the chin. These osteotomy designs are based on the displacement of bone fragments on the slopes of an inclined plane with a superior-medial direction.

Results:

All of the patients were satisfied with the esthetic results of their osteotomy. Based on presurgical and post-surgical facial analysis and clinical evaluations, no patients who received a Zigzag osteotomy suffered from permanent neurosensory deficiency, infection, hardware failure, severe pain, asymmetry, necrosis, massive hematoma, relapse, or suprahyoid muscle dysfunction.

Conclusions:

As a result, on the basis of our experience with 23 patients and after at least 1 year of follow-up with each one, the authors concluded that this technique is simple and easy to implement.
Photodynamic Therapy (PDT) Utilizing Multiple Light Sources Significantly Improves Clinical Efficacy and Subject Satisfaction with a Review of PDT Mechanisms of Action
Authors: Thornfeldt Carl
Published: November 2015

Introduction:

Many topically applied devices and medicaments have been developed to give hope to people who want to reduce the signs of visible aging. All modalities have benefits and risks, and no single modality produces complete resolution of photoaging. Although approved by the US Food and Drug Administration for treatment of epithelial neoplasia, photodynamic therapy (PDT) is also reported to produce significant benefits in reducing photoaging. The goal of this study was to determine if clinical response and subject satisfaction can be improved for PDT while reducing downtime and increasing activation of the photosensitizer.

Materials and Methods:

In a regimen administered monthly for 3 treatments, 14 subjects participated in a prospective intervention pilot trial using an 830 nm light-emitting diode (LED), a 540 nm advanced fluorescence technology laser, a 570 nm advanced fluorescence technology laser, and a 633 nm LED. The photoactivation phase was initiated with the 830 nm LED 10 minutes after application of 20% 5-aminolevulinic acid, followed by each modality in listed order. Baseline global extrinsic aging scores were compared with scores 1 month after the final treatment. Subject satisfaction scores were also obtained 1 month after the final treatment.

Results:

Twelve subjects completed this trial. The global extrinsic aging score improved from a baseline of 3.3 to 1.0. Of these 12 subjects, 10 (84%) indicated that they were satisfied or very satisfied with the results 1 month after completion of the treatment.

Conclusions:

This photodynamic therapy regimen is very effective while being better tolerated and involving less downtime. The treatment can also be completed in a shorter time than regimens requiring a longer incubation time.
Umbilical Hernia Repair with Abdominoplasty
Authors: Shiffman Melvin A.
Published: November 2015

Repair of umbilical hernia at the time an abdominoplasty is performed is complicated by the possibility of umbilical necrosis. Understanding the vascular anatomy of the umbilicus is the most important aspect of being able to perform a successful herniorrhaphy without resulting in umbilical stalk necrosis. The vascular anatomy of the umbilicus is discussed, and a method of performing umbilical herniorrhaphy during abdominoplasty without damaging the vascular supply to the umbilicus is described.
2012 American Academy of Cosmetic Surgery Review of Anesthesia Safety for the Cosmetic Surgeon
Authors: Haiavy Jacob , Petro Jane A. , Edds Gerald G. , Elias Husam , Fisher Richard D. , Forouzanpour Fardad , Mandell-Brown Mark , Pancholi Samir , Schmid Peter M.
Published: November 2015

Safety guidelines from many different medical specialties have been developed and are frequently used to establish a standard of care. The American Academy of Cosmetic Surgery appointed a committee to produce a review of anesthesia safety for cosmetic surgeons. This document is not intended to represent a standard of care, but reflects what the committee considers to be key elements of practice that benefit patient safety when anesthesia is being used as part of the practice of cosmetic surgery.
Quadriceps Implant: Cosmetic Improvement to the Anterior Thigh Region in a Patient Suffering from HIV Muscle Wasting
Authors: Chugay Nikolas V. , Chugay Paul N.
Published: November 2015

Introduction:

Muscle wasting is a known complication of HIV and the highly active antiretroviral therapy (HAART) therapy employed to treat HIV/AIDS. To date, there has been no good solution for patients suffering from muscle wasting in the anterior thigh region. We have developed a custom silicone prosthesis to help those who suffer from inadequacy of the anterior thigh/quadriceps.

Materials and Methods:

A custom-designed silicone prosthesis was placed via an incision in the anterior thigh beneath the fascia of the quadriceps muscle to augment the anterior thigh.

Results:

A single patient underwent quadriceps augmentation with a semisolid silicone prosthesis and has had an excellent cosmetic result 3 months postoperatively.

Conclusions:

Because of HIV or HAART therapy, a patient may suffer from wasting in the legs, and placement of a silicone prosthesis may help to restore a patient's confidence and improve the cosmetic appearance of the anterior thigh/quadriceps region. This procedure may have application in the realm of non-HIV patients seeking cosmetic augmentation of the anterior thigh, and further research is warranted.
Hypersensitivity Reaction to Facial Augmentation with a Hyaluronic Acid Filler
Authors: Ferneini Elie M. , Banki Mohammad , Ferneini Christina M. , Castiglione Charles
Published: November 2015

For cosmetic surgeons, facial augmentation with hyaluronic acid (HA) fillers is a standard and safe technique. We report the case of an unusual allergic reaction to a nasolabial fold augmentation with Restylane-L (a popular HA filler) and review the literature.
Successful Management of Delayed-Onset Complications from a Dermal Filler of Unknown Provenance
Authors: Munro Drew , Ehrlich Michael , Woodward Julie
Published: November 2015

Introduction:

A 52-year-old woman presented with delayed-onset nodules in the malar and glabellar regions approximately 16 months after undergoing facial augmentation via injection of an unknown substance in China. Medical records for the procedure were not available. The authors performed an investigative review of fillers used abroad to determine possible treatment options for the patient. After discussion with general plastic surgeons in China, a treatment plan was initiated.

Materials and Methods:

Computed tomography of the head with 3-dimensional reformatting was performed to characterize the nature and extent of the interventions performed. The study revealed significant amounts of a subdermal substance in the malar and glabellar regions.

Results:

A cycle of treatment was performed involving the injection of lidocaine, triamcinolone, and fluorouracil into the affected areas accompanied by interspersed daily massage. The regimen proved effective, and there was clear reduction in the size and inflammation of the nodules.

Conclusions:

The modern age of facial rejuvenation features an increasing array of soft tissue fillers available to physicians performing facial augmentation. The expansion of available filling agents and the rising costs of domestic health care have resulted in an increase in the number of patients seeking elective cosmetic procedures abroad, and patients presenting with complications from cosmetic tourism are increasingly a part of the modern aesthetic practice. Maintaining a solid awareness of current usage trends of injectable filling agents and a thorough understanding of the management options for delayed-onset nodules are essential for mitigating complications from soft tissue fillers of unknown provenance.
A Review of New Facial Filler Techniques for Facial Rejuvenation
Authors: Ferneini Elie , Jackson Terri , Ferneini Christina , Banki Mohammad
Published: November 2015

Introduction:

Over the recent years, the use of facial fillers for rejuvenation of the aging face has continued to increase in popularity. As the demand for noninvasive cosmetic enhancements increases, so does the need for new cosmetic techniques that will increase patient satisfaction while decreasing complications. In the past, facial fillers were mostly used for lip augmentation, nasolabial folds, and marionette lines. However, because of advances in cosmetic techniques and types of dermal fillers, cosmetic surgeons today are able to correct lines, wrinkles, and volume loss seen in crow's feet, around the eyes, chin, and cheeks.

Materials and Methods:

A literature search was performed from 2006 to 2013 to determine new cosmetic techniques used for facial rejuvenation of the aging face.

Results:

Advances in facial rejuvenation are helping to give cosmetic surgeons better results with little discomfort when using dermal fillers around the eyes, cheeks, and chin to improve the overall look of wrinkles and volume loss.

Conclusions:

The development of new techniques and injectable dermal fillers will continue to advance with the increasing demand for a youthful appearance. Up until recently, facial fillers were used mainly to improve the effects of aging seen around the lips, nasolabial folds, and marionette lines. Today, because of advances in the type of facial filler and used techniques, facial fillers can be used to improve volume loss, lines, and wrinkles around the eyes, cheeks, and chin.
Nasal Tip Reconstruction with Replacement of Lower Lateral Cartilage during Revision Rhinoplasty
Authors: Moina Daniel G. , Moina Gabriel , Ripetta Luis Maria
Published: November 2015

Introduction:

Nasal tip revision remains one of the most challenging procedures for plastic surgeons. Performing 3-dimensional anatomic nasal tip reconstruction by complete replacement of alar cartilages with ear cartilage allows optimal nasal tip correction in patients with severe alar distortion. We aim to describe this reconstructive surgical technique and report our experience with this procedure.

Materials and Methods:

We performed a retrospective analysis of patients who underwent complete replacement of alar cartilages as part of a revision rhinoplasty.

Results:

From January 2010 to December 2014, 569 patients underwent revisions, 20 (3.5%) of them with complete alar replacement. Additional grafts used were as follows: 8 columellar struts, 6 onlay grafts, and 3 spreader grafts. There were no in-hospital complications. At follow-up (mean 24 months), all patients reported satisfaction with the esthetic outcome and improvement in functional symptoms. No patient underwent further augmentation or repeat revision.

Conclusions:

Complete replacement of alar cartilages is an efficient surgical alternative for nasal tip reconstruction during revision rhinoplasty. This technique recreates the severely injured alar cartilage structure and returns the original nasal tip appearance.
Desmoid Tumor in the Late Postoperative Period of PIP Implant Replacement
Authors: Blugerman Guillermo , Schavelzon Diego , Martínez Estela , Siguen María , Wexler Gabriel
Published: November 2015

Fibromatosis is an infrequent lesion of connective tissue of unknown etiology, characterized by differentiated fibro-blast proliferation without the characteristics of malignancy. Fibromatosis represents 0.2% of breast tumors. Diagnosis can be confirmed only by histologic study, with the elective treatment being surgical removal. The objective of this article is to present our experience with this unusual tumor that was diagnosed in a patient during the postoperative period of an implant exchange surgery. As fibromatosis is rare but important to consider in the differential diagnoses of breast-implant–associated tumors, a literature review was carried out. In our case, the patient underwent polyimplant prothesis (PIP) replacement and returned 5 months postoperatively with complaints of breast asymmetry caused by a tumor-like lesion arising from the right submammary fold. After a physical examination and complementary studies, an ultrasound-guided needle biopsy was performed, resulting in the presumptive cytologic diagnosis of a neurofibroma. The patient subsequently underwent surgical management with a complete resection of the tumor, preserving the new implants. The final pathological diagnosis of the resected mass was a desmoid tumor. To date, the patient has remained 20 months disease-free. In conclusion, desmoid tumors of the breast are rare, are difficult to diagnose, and require a multidisciplinary approach for surgical management. Additional studies are needed to assure a cause-and-effect relationship between this tumor and the industrial filler used in PIP implants.
Case of Cutaneous Infection with Mycobacterium Fortuitum following Abdominal Liposuction and Abdominoplasty Complicated by Involvement of a Laparoscopic Gastric Band
Authors: Watkins Brenda , Puryear Angel S. , Peterson Jennifer D. , Hall Jason J. , Price Todd M. , Sturgeon Ashley
Published: November 2015

Mycobacterium fortuitum is an ubiquitous, rapidly growing nontuberculous mycobacteria that has been known to contaminate water supplies and surgical equipment leading to postoperative skin and soft tissue infections. This report describes a case of cutaneous infection with M fortuitum following abdominal liposuction and abdominoplasty complicated by involvement of a laparoscopic adjustable gastric band. This case demonstrates how early microbiologic diagnosis, appropriate antimicrobial treatment, and prompt surgical intervention are very important in postcosmetic surgery wound and soft tissue infections. Furthermore, infections involving atypical mycobacterium can be particularly difficult to identify making the study of cases such as this all the more important.
Surgical Correction of Facial Skeletal Deformity of Patients with Thalessemia
Authors: Badri Amir Ali , Keyhan Seied Omid , Jalalian Faranak , Fallahi Hamid Reza , Asayesh Mohammad Ali , Khiabani Kazem
Published: November 2015

Introduction:

Our primary intention is to review the literature that has been published in this field and to report some cases of surgical correction of facial and skeletal deformities in patients with thalassemia. Thalassemia is widespread, and about 5% of the world population is affected. Management of facial and skeletal deformity is a major concern in patients with thalassemia, and numerous surgical approaches have been advocated to correct facial deformities, although the type of treatment remains in dispute.

Materials and Methods:

We report the cases of 3 specific patients who were treated with uncommon surgical procedures after the hematologic condition was corrected.

Results:

No signs of relapse or maxillary bony overgrowth have occurred in these patients. No massive bleeding occurred during the procedures, and the patients tolerated the surgical approach very well. Complicated surgical procedures, such as bimaxillary segmental osteotomies with 2 or more pieces have been done in patients who had proper systemic conditions without any complications.

Conclusions:

Maintaining a hemoglobin level of approximately 10 g/dL decreases the risk of preoperative hemorrhage and complications of anesthesia. A complicated surgical approach and more instability during surgery is expected in patients with higher degree of systemic problems. We found that preoperative facial analysis was important in guiding our surgical planning and would benefit the cosmetic outcome as well. Attention to cardiac dysfunction, osteoporosis, vitamin D deficiency, and type of hemoglobin deficiency must be kept in mind, though more surgical cases must be treated before reaching a definitive conclusion.
A New Horizon in Facial Plastic Surgery: Skin Tissue-Engineering and Stem Cell Therapy—Reality or Dream?
Authors: Keyhan Seied Omid , Hemmat Seifollah , Asayesh Mohammad Ali , Mehriar Peyman , Khojasteh Arash
Published: November 2015

Facial skin replacement after burns or other injuries has proved to be a challenging task in wound healing. The application of laboratory-based tissue-expansion techniques is a potential solution to the problem of surface area cover. Considerable progress has been made in approaches to these techniques, including allograft and autograft skin transplantation to replace skin temporarily or permanently. Methods for handling skin wounds, such as transplantation, tissue engineering, and, more recently, stem cell therapies, have advanced in the past few decades. Issues with these techniques still remain, though. Development of new treatments for facial burn or wound victims is still a problem in cultured skin grafts. Hair follicles, sweat glands, and other features of normal skin are absent in cultured skin. Scientists believe stem cells with unique characteristics, including self-renewal and differentiation potential offer a possible way for reconstructing some structures within a wound. Enhanced understanding of these new approaches may help researchers develop novel therapies to overcome the problems in facial wound healing.
Staged Treatment of a Traumatic Cheek and Jowl Avulsion: Using a Purse-String Technique, Rhombic Flap, and Rhytidectomy
Authors: Hanna Todd C. , Waite Peter D.
Published: November 2015

Introduction:

This article describes a 3-stage treatment modality for a traumatic cheek and jowl avulsion consisting of a purse-string technique, rhombic flap, and face-lift. This approach has not been previously published.

Materials and Methods:

This case report and literature review discusses the management of a complex left cheek wound consisting of a 6-cm-diameter avulsion and a 5-cm-linear extension. Primary closure was not possible, and a staged treatment modality was selected. The avulsed portion was reduced with a purse-string suture. Primary closure was achieved 3 weeks later with a rhombic flap. Asymmetry was addressed at 6 months postinjury with bilateral rhytidectomy and liposculpture. Successful outcome was determined through patient satisfaction, clinical examination, and comparison of perioperative photographs.

Results:

The initial defect was reduced in size by more than one-half, from 6 cm to 2.5 cm in diameter, with the purse string. Primary repair was achieved with a smaller local flap, preserved facial landmarks and central oval, and a satisfactory scar. Jowl and nasolabial fold symmetry was effectively restored with bilateral rhytidectomy. No major complications occurred, including flap necrosis, infection, or facial nerve injury.

Conclusions:

For facial soft-tissue avulsions that are not amenable to primary closure, a purse-string technique allows for circumferential tissue recruitment, creep, and expansion. This creates a smaller defect and potentiates a more conservative definitive closure. Residual nasolabial and jowl asymmetry may be improved with bilateral rhytidectomy. Patients must be fully informed of the complexities of staged treatment including multiple surgeries, increased wound care and appointments, and delayed results.