bluuebunny/crossref_metadata_2025_split huggingface dataset:
Male Breast Liposuction Today: Hypertumescent Power Liposculpting—A 700-Case Retrospective Study
Authors: Schafer Jeffry B. , Shane Ron 
Published: January 2017

Introduction: Many men (∼36–40%) have some form of breast enlargement or swelling, called gynecomastia. The condition may make these men self-conscious about the feminine appearance of their chests in public. Classic removal, with direct excision of the glandular tissue and fat, has been the treatment for gynecomastia in the past. The purpose of this retrospective surgical review and discussion is to compare various treatment modalities for gynecomastia that have been used in our practice over time, and then to present a protocol for the procedure that is the most successful in terms of highest patient satisfaction and lowest revision rate. Materials and Methods: A retrospective surgical review of 700 gynecomastia liposuction treatment regimes, including open and closed techniques employing liposuction with manual, ultrasonic, power, and rotary cannulas is presented. Results: Comparisons of various treatment modalities used by the authors in over 700 cases demonstrate the advantage of hypertumescent infiltration of the dense tissue of the male breast before liposculpture. The aesthetic result is more satisfactory for several reasons: (1) scarring is minimal, (2) neurovascular damage to the delicate areola or surrounding tissue is avoided, (3) the surgeon is allowed to sculpt the tissue rather than just remove it, and (4) a more “normal” looking chest without the periareolar scar is created. Discussion: Many men with gynecomastia need diet, exercise, and counseling. We have found that many of these men have high levels of free estrogen accompanied by total testosterone under 300 ng/dL. This endocrine pathological scenario is exacerbated by obesity. If the patients continue to be overweight after treatment, their upper torsos will gradually become feminized again. Thus, our patients are encouraged to follow a high-protein and low-fat diet with caloric restriction and to vigorously exercise so that their results will last. Conclusions: Surgical treatment can successfully treat gynecomastia in male patients and leave very little scarring. Postoperative diet and exercise will also dramatically improve patients' appearance and self-esteem.
Comparison of Autologous Platelet-Rich Plasma with Bone Dust versus Platelet-Rich Plasma Alone and Bone Dust Alone in a Rabbit Model
Authors: Williams Troy C. , Kelly Christopher , Bello Gustavo , Silberberg Boris , Moreira Andrea , Bradford Melinda 
Published: January 2017

Introduction: When reconstructing bony defects created secondary to tumor excision or remodeling, there exists a need to increase the rate of bone graft acceptance and the degree of development. In our study we intend to show that platelet-rich plasma can be used in craniofacial defects to increase graft densities. Methods and Materials: Twenty-seven New Zealand white rabbits were used as specimens in which cranial osteotomies were performed to create a critical size defect that was then repaired with several combinations of substances. Either the bone dust from the defect, bone dust plus autologous platelet-rich plasma, or autologous plateletrich plasma alone was placed into the graft site. Each specimen was evaluated by DEXA Scan as well as histologic examination. Results: All 27 specimens survived and remained infection free. Thus, the results showed that the combination of platelet-rich plasma and bone dust allowed for superior bone mineral density and prevention of bone reabsorption.
Radiesse for Aesthetic Soft Tissue Augmentation
Authors: Cuevas Silvia , Rivas Maria Patricia , Amini Sadegh , Weiss Eduardo 
Published: January 2017

Introduction: Calcium hydroxyapatite (CaHa; also spelled “hydroxylapatite”) is the main mineral component of bone, calcified cartilage, and teeth. It has been used since the 1970s in many specialties, including orthopedics, urology, otolaryngology, maxillofacial surgery, and radiology, as a bioactive implant that promotes chemical attachment of the soft tissue to its surface. In 2001, Radiance FN (now Radiesse) was introduced as a CaHa-based product and approved by the US Food and Drug Administration (FDA) as a radiographic tissue marker, for soft tissue vocal fold augmentation, and for implants in maxillofacial defects. Currently, it is also used outside the United States and off-label in the United States for facial soft tissue augmentation. Microspheres of CaHa are suspended in a mixture of water, glycerin, and carboxymethylcellulose gel that provides a scaffold for tissue infiltration. Once injected, the gel is degraded and the CaHa infiltrates the surrounding cells. CaHa is nonirritating, and the carrier gel components are classified as safe by the FDA. Although a great variety of fillers are currently on the market, CaHa (Radiesse) has demonstrated the longest duration in tissue without any reports of antigenicity, migration, or granuloma formation. In this study, we report our experience with CaHa (Radiesse) for aesthetic soft tissue augmentation. Materials and Methods: A total of 139 patients were treated over an 18-month period at 2 private offices in Argentina and the United States. Exclusion criteria included previous use of permanent tissue fillers in the treatment area. Patients with previous use of hyaluronic acid fillers in the treatment area (up to 1 year prior to the study) were allowed to participate in the study. Radiesse was injected from 1-mL prefilled syringes with 27½-gauge needles in different areas such as nasolabial folds, lips, marionettes lines, cheeks, and cellulite dimples. Patient satisfaction and adverse effects were assessed by both physicians and patients during the procedure and during follow-up visits up to 1 year later. Results: Minimal pain, erythema, edema, and bruising were noted during and immediately after the procedure. All of the patients treated were satisfied with their results after one visit. There were no long-term adverse effects during the study period or on follow-up visits. Evaluation of 75% of the patients 1 year after treatment revealed persistence of filling effects. Discussion: CaHa used for aesthetic soft tissue augmentation yields immediate clinical results with high patient satisfaction.
Evaluation and Result of Reduction Labioplasty
Authors: Rezai Allen , Jansson Per-Erik 
Published: January 2017

Introduction: Hypertrophy and variation in the size of labia minora has long been recognized as a problem that can be bothersome for aesthetic, functional and psychosocial reasons. In the past labia minora reduction was usually performed by simple and straight resection of the protuberant segment and oversewing the edge. This paper presents a comparison of our results with each procedure. Materials and Methods: From March 1997 to February 2005, 100 women from 17 to 45 years old underwent reduction labioplasty. We performed w-shaped resections with interdigitated suturing in 50 cases and de-epithelialized reduction labioplasty in 50 cases. Results: Patients in both groups had minimal discomfort postoperatively and at 6 months reported improvement of their original problems with chronic irritation, inadequate hygiene, and sexual intercourse. Twenty-three patients underwent treatment of hypertrophic labia minora with excellent results and minimal postoperative discomfort. Three patients suffered from postoperative infection but were successfully treated with antibiotics. In group A, 5 patients were not satisfied with the appearance of the edge of the labia minora, and in 8 patients, it took up to 2 years for sensation to be restored to the labia minor. Conclusion: The deepithelialized reduction labioplasty gives the patient more satisfaction both in the appearance of the edge of the labia minora and the neurovascular preservations of the labia.
An Innovative Device for Fractional CO2 Laser Resurfacing: A Preliminary Clinical Study
Authors: Cassuto Daniel A. , Sadick Neil S. , Scrimali Luca , Siragò Paolo 
Published: January 2017

Background and Objective: Use of CO2 laser resurfacing is a powerful tool for the treatment of several skin conditions, such as fine and coarse wrinkles, scars of various origin, uneven pigmentation, and dilated pores. Some major drawbacks have progressively limited its use: the need for effective anesthesia, the downtime associated with treatment, the risk of hyperpigmentation and scarring, the need for intensive postoperative care, the long-lasting erythema, and the need to avoid sun exposure for extended periods. Fractional laser resurfacing with a 1540-nm laser can avoid some of these disadvantages, but pain and cost still serve as barriers. A new CO2 laser system with a fractional modality added to a traditional though potentially very rapid scanner was tested as a tool for skin rejuvenation. It can perform traditional and fractional resurfacing at depths ranging from 20 to 500 μm and treating 20%, 40%, or 100% of the scanned area. Materials and Methods: A series of 24 consecutive patients (Fitzpatrick skin types II–IV) were treated with one pass of the aforementioned fractional CO2 laser (18 faces, 2 necks, 8 hands). No anesthesia was used. The power used was between 8 and 15 W, with SX index values of 4 to 8, according to patient tolerance. SX index indicates pulse width: the shorter the pulse the higher the SX index value. Postoperative management included a thermal water-based cream and makeup provided free of charge. Digital clinical macrophotography was used to assess the results and a subjective pain and satisfaction evaluation was also done. Results: All patients showed improvement in skin texture and color after one treatment. Undesired postoperative effects were immediate erythema, and swelling that subsided within 24 hours. Fine pinpoint microcrusting occurred in all cases, but it resolved within 1 week on the face and 10 days on the other body areas. The treatment was well tolerated. With makeup it looked like a tan. No long-term side effects were observed after 6 months of follow-up. Conclusions: The evaluated system is an effective and safe tool for skin rejuvenation by fractional laser resurfacing.
Novel Management of Wound Dehiscence: Case Study
Authors: Michelson David N. 
Published: January 2017

Introduction: Wound healing is a long and complex process, and can be affected by many different preexisting health conditions and complications. Postoperative surgical wound dehiscence is a serious complication wherein a surgical wound does not close or heal properly. The decision was made to take a novel approach to treating a patient who presented with this complication by pursuing a course of PRO QR Powder, a topical powder wound dressing (Biolife, LLC, Sarasota, Fla) and 10% acetic acid solution. Materials and Methods: A 28-year-old woman suffering from postsurgical wound dehiscence in her axilla was treated with PRO QR Powder, an alternative treatment method. The treatment duration was 10 weeks, with the patient returning at 2-week intervals for assessment. Results: Over a 10-week period, the wound showed progress and was completely healed at the end of treatment with no further complications. Conclusions: This case showed that a treatment approach using PRO QR Powder was safe and effective when treating this type of wound.
The Umbilical Locator: Bringing Simplicity to Surgery
Authors: Forouzanpour Fardad , Karmali Hasni 
Published: January 2017

Introduction: The purpose of this article is to introduce the Umbilical Locator and demonstrate how it simplifies umbilical transposition in abdominal surgeries in both the cosmetic and reconstructive fields. Materials and Methods: The Umbilical Locator is a new device that was designed and patented by one of the authors (F.F.) to help surgeons who are performing umbilical translocation during abdominal surgeries. The Umbilical Locator is safe, disposable, sterilizable, made of a nonlatex plastic, and can be used with any surgical method preferred by the surgeon. It was designed specifically for use in abdominoplasties. It was developed, manufactured, and marketed for sale by Innovative Med Inc, Irvine, California. Results: To date, the Umbilical Locator has been used exclusively by one of the authors (F.F.), with excellent results. He has used this innovative device in 20 recent abdominoplasties, with no resultant umbilical slough or ischemia. Furthermore, there have been no complications noted with positioning, anchoring, or removal of the device. Discussion: In abdominoplasty, an aesthetic and natural appearance of the umbilicus is a key factor to the end result. The Umbilical Locator can be used with any surgical method to create the umbilicus. The purpose of the product is only to help locate the position of the umbilicus on the skin. The surgeon is allowed to use the incision or surgical method of his or her choice on top of the umbilicus after the skin has been redraped prior to excision to precisely locate the umbilicus. Conclusions: These preliminary data provide promising evidence for the continued and future use of the Umbilical Locator as a more reliable and accurate method of umbilical localization in abdominoplasty than prior techniques, such as the use of a spinal needle to pinpoint the location of the umbilicus. The Umbilical Locator has the potential to decrease the incidence of deformities, wound tension, and resulting ischemia, and to reduce umbilical hypertrophic scarring. What has been to date a technically imprecise, unsophisticated phase of an abdominoplasty has now been simplified and refined using the Umbilical Locator.
The Use of Integra Artificial Dermis for Keloid Scars
Authors: Leventhal Douglas D. , Pribitkin Edmund A. 
Published: January 2017

Introduction: Keloid scars are notoriously difficult lesions to treat, and at the present time, there is no universally effective therapy. Numerous theories have been put forth regarding keloid formation, but the pathophysiologic mechanism remains a mystery. One hypothesis is that keloids are formed as a result of underlying skin tension. Numerous grafts have been used to decrease skin tension after keloid excision, but recurrence rates typically remain high. Materials and Methods: This prospective, nonrandomized clinical intervention study examined the results of Integra artificial dermis grafting in preventing keloid recurrence in patients who presented to an academic otolaryngology/facial plastic surgery office. Results: Two patients underwent the procedure, but because of the high recurrence rate and the poor cosmetic outcome, the study was terminated early. All patients had signs of recurrence by the 3-month follow-up visit. One patient served as her own control and had earlier and more severe recurrence at the site where the Integra was used. Discussion: Integra artificial dermis grafting fails to prevent keloid recurrence following excision. This study suggests that increased skin tension may not play an integral role in keloid formation.
The Tumescent Technique for Lipo-Suction Surgery
Authors: Klein Jeffrey A. 
Published: January 2017

The tumescent technique of lipo-suction is a modification of the wet technique. A large volume of very dilute epinephrine is infiltrated into a targeted fat compartment prior to lipo-suction, producing a swelling and firmness. This tumescence of fat permits an increased accuracy in lipo-suction and minimizes postsurgical irregularities or rippling of the skin. Epinephrine-induced vasoconstriction minimizes blood loss, bruising, and postoperative soreness. Safe, rapid infiltration of large volumes of solution is achieved using a closed sterile system featuring a newly designed blunt-tipped, 30-cm-long, 4.7-mm-diameter needle having a hollow handle that accommodates a 60-cc syringe. Attached to a liter bottle of anesthetic solution by an intravenous line, the needle is inserted via the same incision and deposits the solution along the same path as that intended for the lipo-suction cannula. Thus, the solution is infiltrated exactly where it is needed for hemostasis or local anesthesia. Used in conjunction with general anesthesia, the tumescent technique saves time in achieving maximal vasoconstriction of the targeted fat compartment. If dilute lidocaine (0.1%) is added to the solution, the technique permits lipo-suction of more than 2 liters of fat totally by local anesthesia. Twenty-six patients, having received a mean lidocaine dose of 1250 mg (18.4 mg/kg or 8.5 mg/kg/hr) infiltrated into subcutaneous fat, had a mean serum lidocaine level of less than 0.36 μg/ml 1 hour after completion of the infiltration.
Use of the KTP Laser in Cosmetic Surgery
Authors: Keller Gregory S. 
Published: January 2017

The KTP is a versatile laser system when used for cosmetic surgery. When combined with a hexascanner or small spot size handpiece, it is equivalent to a continuous-wave yellow dye laser or copper vapor laser in the treatment of vascular lesions. The KTP laser wavelength (532 nm) is near the peak of a hemoglobin absorption curve as is the wavelength of the continuous-wave yellow dye or copper vapor laser. The KTP laser is also excellent for use in the treatment of Lentigines. The solar lentigines of the hand, arm, and leg are particularly treatable. The hexascanner delivery system makes the KTP laser particularly time-efficient when used to treat the multiple lesions that usually occur with this condition. The KTP laser can also be combined with special quartz contact probes and used for incisional cosmetic surgery such as blepharoplasty, rhytidectomy, forehead lifting, and new “endolaser” small-incision cosmetic surgery. The contact probes focus and defocus the laser quickly allowing the precision use of the laser deep under a flap with a spot size of 0.1 mm. The coagulative abilities of the laser allow an almost bloodless dissection. The Laserlift™ produces less swelling and bruising for the patient and allows the surgeon to complete complicated surgery with excellent visualization in a bloodless field.
Reduction Malarplasty
Authors: Burres Steven 
Published: January 2017

Although many societies consider prominent cheekbones attractive, when the midface roundness reaches an excessive proportion this distinction may become undesirable. Besides the issue of hypertrophy, malar asymmetry in any individual may also require correction. Reduction malarplasty is performed through a vertical incision in the canine fossa. After the zygomaticus muscles are bluntly divided and retracted, the periosteal cover is elevated from the cortex. With a high-speed cutting burr, the malar eminence is then drilled until the desired height is achieved. The wound is irrigated and closed. We have performed this procedure successfully in eight patients with up to eighteen months follow-up. Transient loss of zygomaticus muscle function and numbness from traction on the infraorbital nerve occurred in two patients. All patients were completely satisfied with the improvement in their frontal profile. This operation requires a detailed understanding of the mid-face anatomy and the surgical boundaries of the malar bone but will result in a more sculptured front-face outline.
JCAHO Nutrition Care Standards Adopted For Home Care
Authors: Mirtallo Jay M. 
Published: January 2017

Like the 1995 JCAHO Standards for hospitals, the Accreditation Manual for Home Care (AMHC) emphasizes nutrition.The JCAHO is focusing accreditation on the actual performance of governance, managerial, clinical, and support functions within organizations that directly and significantly affect the quality of patient care. This Agenda for Change consists of three sets of interlinked initiatives: reformulation of JCAHO standards, redesign of the survey process, and development of performance measures that will lead to the use of an interactive indicator data base. The reformulation of the standards is initially being achieved through reorganization of the AMHC into chapters that represent “important functions”—those that influence patient care outcomes the most.The 1995 AMHC consists of two sections, with chapters related to direct (Section 1) and indirect (Section 2) care. Each chapter has a preamble that includes goals and essential processes that make up the function. The standards are accompanied by expanded intent and scoring guidelines to provide a clearer picture of how to comply. The intent statement and scoring guidelines for these standards relate to each type of service being provided. Further, how‐to examples are being used more extensively in the scoring guidelines. Thus the AMHC appears considerably different from previous editions.
Pharmacological and Nonpharmacological Treatment for Apathy in Alzheimer Disease
Authors: Theleritis Christos , Siarkos Kostas , Katirtzoglou Everina , Politis Antonios 
Published: January 2017

Objective: Apathy is one of the most frequent neuropsychiatric symptoms encountered in Alzheimer disease (AD). Early diagnosis and timely treatment of apathy in AD seem to be of great importance, since apathy has been associated with poor disease outcome, reduced daily functioning, and caregiver distress. Design: Within this context, we conducted an extensive electronic search from the databases included in the National Library of Medicine as well as PsychInfo and Google Scholar for studies that have investigated the effect of pharmacological and nonpharmacological treatments of apathy in AD. Results: Acetylcholinesterase inhibitors, gingko biloba, methylphenidate, and a variety of nonpharmacological interventions were found to be successful in reducing apathy in patients with AD. Methodological heterogeneity of the studies and the small amount of studies where apathy was a primary outcome measure are limiting factors to evaluate for group effects. Conclusion: Treatment of apathy in AD is a complicated and an underexplored field. Standardized and systematic efforts primarily focused on the study of apathy in AD may establish a benefit from individualized treatment for specific disease groups that would stem from a combination of both pharmacological and nonpharmacological interventions.
Regulation of Proto-Oncogenes and Salivary Gland Cell Proliferation
Authors: Kousvelari E. , Yeh C.-K. , Mertz P.M. , Chinchetru M. 
Published: January 2017

The proto-oncogenes c-fos and c-jun express proteins targeted into the nucleus. The fos and jun proteins form a heterodimeric complex that binds to regulatory elements in the promoter region of specific genes to influence their transcription. Through such a mechanism, the fos and jun proteins have been suggested to link extracellular stimuli to short- and long-term functional changes in cells. Recently we have shown that β-adrenergic receptor stimulation of rat parotid acinar cells in vitro or addition of 8-BrcAMP in a rat submandibular cell line (RSMT-A5) increases the expression of the c-fos gene in a time-dependent manner. Maximal responses were found at 60 min. The expression of the c-fos gene did not correlate with DNA synthesis in either cell type, and c-fos transcripts were undetectable in the glands of animals treated for eight days with isoproterenol. The new data presented here extended our observations to c-jun gene expression in both salivary cell types where a similar pattern of expression for this proto-oncogene was seen. Conversely, treatment of rats with isoproterenol for nine days resulted in the appearance of two c-abl mRNAs of unique size, in addition to the known 5.3-kb c-abl transcripts. The data suggest that β-adrenergic receptor stimulation or exposure to 8-BrcAMP induces the early expression of the "nuclear proto-oncogenes" c-fos and c-jun before changes are noted in salivary epithelial cell proliferation. Differences in c-abl mRNA size, occurring later, may be associated with the morphological and biochemical changes known to occur in rat parotid glands after chronic β-adrenoreceptor stimulation.