摘要:

The present study was conducted to determine if 200 patients with silicone-gel implants demonstrated elevated levels of autoantibodies, compared with a similar group of 100 age-matched control subjects without breast implants. These results were then compared with 29 patients who had demonstrated implant rupture. Differences in the frequency of autoantibody levels were determined by the chi-squared test. Differences in autoantibody titers were determined by Wilcoxon's signed rank test. Differences were considered significant with p > 0.05. The prevalence of a positive antinuclear antibody (ANA) test (dilution 1:100) in the 200 patients with breast implants was 26.5% compared with 28% in the 100 control subjects. In 29 patients with implant rupture, only 17.2% tested ANA positive. These values were not significantly different. In addition, there were no significant differences between the ANA titers of positive patients in each group. In each of the three groups, all patients who tested ANA positive were analyzed to assess the frequency and titer of other autoantibodies, including anti-DNA, anti‐cardiolipin, anti-SSA, anti-SSB, anti-SM, anti-RNP, and anti-Scl-70. There were no significant differences between the frequency or titer of any of these autoantibody levels in each of the three groups of patients. These studies strengthen the concept that there is no conclusive evidence that silicone-gel implants are related to the development of connective tissue disease.

ISSN:0148-7043    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The surgical anatomy of the fascial layers and vascularization of the scalp was studied by means of 11 bilateral cadaver dissections. This article is organized as follows: first, a description of the layers and fasciae of the scalp and their relationships with the main vascular structures, and then a description of the histological structure of the subgaleal fascia (composed of multiple connective vascularized sheets that glide over one another) and of its blood supply. In our dissections, we found the constant topographic distribution of the major perforant vessels to the subgaleal tissues as follows: in the temporal region, perforant vessels from the superficial temporal artery near and 10 to 14 cm above the zygomatic arch, where the superficial temporal artery leaves the surface of the galea to enter the superficial subcutaneous tissue, and in the frontoparietoccipital region, many small perforant vessels evenly entering the subgaleal plane every 5 to 10 mm. These findings could lead to greater use of fascial or' composite flaps from the scalp region.

ISSN:0148-7043    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The factors influencing cleft repair are multiple and complex. A compromise must be achieved between facial growth, scarring, speech and language development, and psychological factors. However, one question remains unanswered. When is it safest in relation to the maturity of the respiratory control mechanisms? It was the aim of this pilot study to identify any problems with respiratory function after primary surgery. Of 39 patients, 42% were seen to have episodes of repeated hypoxemia of <92% saturation associated with bradycardia beyond 48 hours postoperatively. The implication of the findings and future directions for research are discussed.

ISSN:0148-7043    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The nasal bones and pyriform apertures of 20 skulls were measured for length and width. There were 6 skulls from the Ashanti tribe in West Africa, 5 black American skulls, 5 skulls from Austria in northern Europe, and 4 American Indian skulls. The nasal bones were measured for length and width at the narrowest and widest portions and the pyriform apertures were measured for height and for width at the base, the mid section, and near the apex at the nasomaxillary suture line. The Ashanti nasal bones were the shortest with a length of 2.18 cm. They were the narrowest with mean widths of 0.47 and 0.83 cm. The Austrian nasal bones were the longest (mean, 3.02 cm). The mean widths were 0.68 and 1.11 cm. The Indian nasal bones had a mean height of 3.0 cm and were the widest with mean widths of 0.61 and 1.28 cm. The measurements of the American black nasal bones fell between the Ashanti on the one hand, and the Austrian and Indian on the other, with a mean height of 2.79 cm and mean widths of 0.49 and 1.03 cm, reflecting the triethnic origin. The pyriform aperture in the Ashanti was oval whereas the white and Indian pyriform apertures were triangular. The black American pyriform apertures varied from oval to triangular, also reflecting the triethnic origin. The clinical implication of these differences in black rhinoplasty are discussed.

ISSN:0148-7043    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

In 1989 we began to treat soft-tissue defects around the olecranon process with local fasciocutaneous flaps as our preferred method of treatment. These soft-tissue defects are complications of bursitis, degenerative joint disease, and burns. They may also result from pressure necrosis over the olecranon in patients with impaired sensation. Because of the difficulty in treating these wounds a variety of local muscle, musculocutaneous, fasciocutaneous, distant, and free flaps have been described. Fasciocutaneous flaps have the advantage of using regional tissue in a single stage. Fasciocutaneous flaps around the elbow can be categorized as proximally or distally based. Proximally based flaps include the radial and ulnar forearm flaps as well as the posterior interosseous flap. Distally based flaps are based on upper elbow collaterals including the radial collateral artery, the middle collateral artery, and the anterior and posterior ulnar recurrent arteries. Eleven fasciocutaneous flaps were used in 10 patients with a follow-up of 1 to 3 years. All flaps survived and provided primary wound closure. Complications included 1 patient with recurrent ulceration after being healed for 6 months and 1 patient with a transient neurapraxia of the posterior interosseous nerve that resolved after 2 weeks. These flaps provide long-term stable coverage of olecranon wounds by using regional tissue with an acceptable donor site morbidity.

ISSN:0148-7043    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The ideal material for reconstruction of a breast is fat and skin. Most current methods of autogenous reconstruction use myocutaneous flaps. We investigated the feasibility of transfer of skin and fat from the lower abdomen without muscle sacrifice. The flap is based on one, two, or three perforators of the deep inferior epigastric vessels. The study will demonstrate both experimentally and clinically this original technique for breast reconstruction. Fifteen breasts have been successfully reconstructed with this technique. This technique has all of the advantages of the free transverse rectus abdominis myocutaneous flap with decreased possibility of ventral hernia or muscle weakness.

ISSN:0148-7043    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We discuss our experience with antineoplastic drug extravasation. Between December 1988 and December 1990, 40 patients with cytostatic extravasation with lesions of varying seriousness were observed. In these patients, whenever possible, depending on the amount of time that elapsed since the accident and on the severity of the lesion, conservative therapy was done. The procedure consisted of local injection of a considerable amount of saline solution (20–90 ml, depending on the site of extravasation) and topical occlusive applications of corticosteroids locally. In all patients this was sufficient to avoid tissue necrosis. Treatment of a few patients deviated from these procedures because surgery was performed that ranged from the simple excision of infiltrated tissue to a more complex procedure of free flaps. On the basis of our experience, we discuss the role of early surgery when preventive measures and drug therapy are insufficient because of drug effects at the tissue level. In this series we did not perform early surgery.

ISSN:0148-7043    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The regeneration of anastomosed aortas after radiotherapy and chemotherapy was studied by light, scanning, and transmission electron microscopy in a rat model. At the ultrastructural level, it was observed that sublethal doses of these methods of cancer treatment did not severely block endothelial proliferation in the region of the microanastomosis. Based on the experimental results, myocutaneous free flap transfers were completed in patients with malignant tumors who had been undergoing radiotherapy and chemotherapy to cover defects resulting from their excision.

ISSN:0148-7043    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Of 57 patients who underwent microvascular free flap reconstruction of the plantar surface, 21 developed recurrent trophic ulcerations. Clinical and roentgenographic examination demonstrated that the recurrences were primarily traumatic in origin, resulting either from exogenous factors such as footwear or from endogenous factors such as osteophytes. A new method of surgically reconstructing the plantar aponeurosis was found to be effective in reducing the rate of recurrence.

ISSN:0148-7043    

出版商:OVID    

年代:1994

数据来源: OVID