ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Thirty consecutive cases were scheduled for submuscular breast augmentation under continuous thoracic epidural anesthesia. The epidural tube was placed into the intervertebral space between the third and fourth thoracic vertebrae. An average of 15 ml of 2% lidocaine with 1:80,000 epinephrine was used as a primary anesthetic agent. There were no significant changes in respiratory function; only a transient elevation of blood pressure and increased heart rate were noted. All cases were successfully anesthetized, except one case (3%) who had a partial analgesic effect and needed to combine general anesthesia. One patient needed a single dose of ephedrine, 20 mg, to treat hypotension. Perioperative complications included transient shivering (33%), stuffy nose (20%), nausea (7%), and shortness of breath (13%). These symptoms were alleviated after reassurance or light sedation and oxygen inhalation. Immediate postoperative pain of the operative site was effectively controlled by injection of local anesthetics through the epidural tube. This study revealed that thoracic epidural anesthesia was feasible, effective, and even better than conventional alternative anesthetic techniques for breast augmentation.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The velopharyngeal dimensions and velopharyngeal functions of 58 patients having a cleft lip and palate were compared with those of 30 normal noncleft subjects. The patient group received perceptual speech assessment, nasopharyngoscopic examination, and lateral cephalogram, and was classified accordingly into three categories: velopharyngeal competency, borderline velopharyngeal competency, and velopharyngeal incompetency. The results indicated that (1) the need ratio differs significantly among the three cleft palate patient groups and (2) when compared to the control group, the velopharyngeal incompetency group has an excessive need ratio, narrower posterior pharyngeal wall, narrower linear dimensions in pharyngeal depth, and shorter velar and hard-palate length. The clinical implication and application of the findings are discussed.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Lipomas were extracted with an ultrasonic suction scalpel, assisted by an endoscope, with good results. The combined surgical technique is described in this paper. Preoperative clinical findings and diagnostic imaging of the patients provided a preoperative diagnosis of lipomas. For the procedure, the endoscope was inserted through a small incision immediately above the tumor. The tumor was endoscopically confirmed and then extracted with an ultrasonic scalpel. Complete lipoma extraction was achieved in all patients without recurrence. The patients had good cosmetic results with only minimal postoperative scarring. The endoscopic extraction of lipomas with an ultrasonic scalpel is proven to be highly useful, especially for large tumors, and permits a less invasive and more reliable surgical operation.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Forty-three women, in a series of 150, participated in a prospective study that examined their chest walls for deformities 3 months after maximal tissue expansion for single-breast reconstruction. Computed tomography imaging was used for this purpose. Twenty-one patients underwent immediate breast reconstruction and the other 22 patients underwent delayed reconstruction. Fifty-three percent had some chest wall abnormality. In the delayed group, chest wall deformities were more statistically significant (p< 0.001). Our findings suggest that chest wall deformity is a common occurrence after maximal tissue expansion for breast reconstruction.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Since April 1986, implantation of a vascular bundle containing the ramus carpeus dorsalis of the interosseal anterior artery and vein into the lunate has been undertaken for aseptic necrosis of the lunate bone. A series of 11 cases were performed in East- South Hospital with satisfactory results. The average follow-up period was 36 months. A series of follow-up roentgenograms reveal that necrosis of the lunate bone is being continuously repaired. Fourteen months postoperative, the following results are obtained: (1) the sclerosis of the lunate bone has completely disappeared on the roentgenograms, (2) the architecture and density of the lunate bone have returned to normal on the roentgenograms, (3) technically colorized X-ray films show that lunate bone density decreases after the operation (the decreasing range is 20 to 44 Gray scale [mean, 30.3 ± 2.4 Gray scale]) and that the cyst formations on the lunate bone have completely disappeared postoperatively, and (4) pain in the affected wrists disappeared and patients have returned to their former work, including manual labor. The necrotized lunate bones are healed. Anatomic study shows that the presence of the ramus carpeus dorsalis of the interosseal anterior artery and vein on the wrist is 100%, and the structure as well as location of the ramus carpeus dorsalis has little anatomic variation and is long enough to be transplanted into the lunate bone.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The bipennate soleus muscle has properly become entrenched as the muscle flap of choice for coverage of the middle third of the leg. Yet its potential versatility in fulfilling many other indications has been understated. With minor alterations in the methodology for transfer, often the reach of the muscle can be extended to more proximal or even distal defects in lieu of more complex solutions. Function preservation with hemisoleus flaps, the possibility of a cutaneous version, and use as a dynamic muscle demonstrate the diversity of additional alternatives. The merit of several techniques for augmenting circulation to the unreliable “reversed” soleus flap further prove the limitations of this option. Recognizing that we can often “get more” from the soleus muscle than traditionally considered deserves reemphasis.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The traditional treatment of high-flow vascular malformations consists of selective embolization, surgical removal, or a combination of both. Recurrence of the lesion and bleeding control are still the main problems, and the result of treatment is sometimes disappointing. We suggest treatment of these lesions with surgical ligation of the distal major feeding arteries followed by intravascular injection of a sclerosing agent (3% tetradecyl sulfate), and surgical excision and reconstruction when indicated. We have found this to be an effective treatment regimen. We present 14 cases of high-flow vascular malformations of the head and neck area treated with this approach, of which 4 cases developed skin necrosis. Three of these 4 cases of skin necrosis were later treated with skin grafting and, in 1 case, an upper arm skin tube flap was used for nasal tip reconstruction. Three cases underwent delayed reconstruction using tissue expanders. From a symptomatic and aesthetic point of view, preliminary satisfactory results were obtained. We feel that this approach is a good option for treating difficult, high-flow vascular malformations.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A patient with Buerger's disease is described in whom reconstruction of a gangrenous forefoot with a free flap has been successfully performed. In order to limit the amputation level, a more aggressive approach toward reconstruction in young patients seems appropriate. To our knowledge, this is the first described case of free flap reconstruction of a gangrenous defect in a Buerger patient.

ISSN:0148-7043    

出版商:OVID    

年代:1996

数据来源: OVID