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Biomedical subjects

M B Constantian

Publications and source records attributed to M B Constantian.

At least 37 records · Page 2Linked to original sources
PubMed1989

An alternate strategy for reducing the large nasal base.

The position of the dorsum directly influences the apparent size of the nasal base: the higher the bridge, the smaller the nasal base seems. This powerful optical illusion provides the surgeon with an alternate strategy for creating harmony in the nose with a low, straight dorsum and a disproportionately large nasal base. Instead of reducing the lower nose, the surgeon can augment the upper nose (and make whatever nasal base changes are independently necessary). This alternate strategy limits the amount of nasal skeletal reduction necessary, thereby limiting the potential for postoperative change and soft-tissue distortion and directly increasing the surgeon's control over the result.

Adult↗
PubMed1989

An algorithm for correcting the asymmetrical nose.

Correction of the twisted nose forms the watershed of aesthetic and reconstructive rhinoplasty, combining and requiring elements of each. Faced with this formidable task, surgeons have fashioned a great number of techniques, many of which rely for their cardinal step on cutting, fracturing, or scoring the dorsal septal strut. While highly satisfactory results have been achieved with these methods, the constant problem of loss of dorsal support remains. It is possible in many cases to align the crooked nose while leaving intact osteocartilaginous dorsal support. The key determination to be made is the preoperative aesthetic balance, itself a product of bridge height and nasal base size. Once nasal aesthetics have been established, the algorithm proceeds as follows: First, resect the dorsum in the area of the deviation until the dorsal septal edge is sufficiently close to the midline to allow camouflage of the remaining asymmetry. Second, perform the septal resection necessary for the airway, preserving a continuous dorsal strut. Third, augment according to (a) the support needed for the dorsum, middle vault, columella, and tip and (b) the aesthetic balance that must be restored.

Adult↗
PubMed1987

A model for planning rhinoplasty.

A rhinoplasty model is detailed in which nasal shape is conceived as a dynamic system, the result of powerful expansive and contractile forces, of a skin sleeve in equilibrium with a dynamic skeleton, in which the alar cartilages are external to the remaining skeleton and support a large area of lower nasal skin. In this system, changes in one region have "global" effects. Consequently, one powerful way to control nasal shape is to maintain skin sleeve size and thus maintain the preoperative nasal equilibrium. The surgeon who controls the postoperative equilibrium controls the postoperative result.

Female↗
PubMed1987

Interactive computer graphics: a new technology to improve judgment in rhinoplasty.

A teaching system has been developed that employs interactive computer graphics to simulate the surgical experience of rhinoplasty, allowing the surgeon to experiment within a model of nasal behavior. The ability to experiment without risk and to safely learn the laws governing nasal behavior should augment the development of surgical judgment in rhinoplasty.

Computer Graphics↗
PubMed1987

The expert teaching system: a new method for learning rhinoplasty using interactive computer graphics.

We have developed software that employs interactive computer graphics to simulate the surgical experience of rhinoplasty by allowing the surgeon to experiment within a model of nasal behavior. For any of three preoperative noses, the surgeon can choose and see the effects of dorsal resection, modification of nasal spine or caudal septum, alar cartilage resection, osteotomy, alar wedge resection, and a variety of nasal grafts. The available choices and views total nearly 3000 images, or approximately 200 different surgical solutions. The surgeon can get textual analysis at any time or see accelerated healing to the projected nasal appearance at 1 year. We believe that the ability to experiment without risk, to safely learn the biological laws governing nasal behavior, should augment the development of surgical judgement in rhinoplasty.

Computer Graphics↗
PubMed1985

Grafting the projecting nasal tip.

Cartilage grafting in some projecting nasal tips can enhance the result obtainable by modifying the alar cartilages alone: where there is a sizeable discrepancy between skin sleeve and skeletal volumes, or where a small tip requires a change in configuration. These principles are defined and illustrated in primary rhinoplasty.

Cartilage↗
PubMed1984

Toward refinement in rhinoplasty.

Three interrelated principles can help to achieve nasal refinement: creation of nasal planes, attention to lateral light reflexes, and maintenance of skin sleeve size. These principles are detailed and illustrated in primary and secondary rhinoplasty patients.

Esthetics↗
PubMed1979

The dorsal ganglion with anomalous muscles.

Either an anomalous extensor indicis proprius muscle or an extensor digitorum brevis manus may coexist with a dorsal wrist ganglion. To assure relief of symptoms, treatment must include division of the fourth dorsal extensor compartment in the case of the former muscle, and excision in the case of the latter.

Adult↗
PubMed1978

Association of sepsis with an immunosuppressive polypeptide in the serum of burn patients.

One hundred ninety serum samples from 51 burned patients were tested for immunosuppressive activity which might explain decreased host immune competence following thermal injury. The serum from a variable but significant percentage of these patients suppressed the response of normal human peripheral blood lymphocytes to phytohemagglutinin. The occurrence of immunosuppressive activity paralleled the severity of the injury. Ten of ten severely burned patients (severity index greater than 40), but only 20 of 30 patients with index 10--39.9, and three of 11 patients with Index 0--9.9 developed suppressive serum. Differences between these groups were significant (p less than .05). In all 19 patients who became septic, immunosuppressive serum activity immediately preceded or coincided with the septic episode. In contrast to the effect on lymphocytes, burn sera stimulated fibroblast proliferation. Immunosuppressive activity did not correlate with serum cortisol levels, blood transfusion, protein-calorie malnutrition, or anesthesia. Suppressive sera were not cytotoxic. A majority of the active serum factor(s) was contained in a low molecular weight (less than 10,000 daltons) polypeptide subfraction.

Adolescent↗
PubMed1977

Association of a circulating immunosuppressive polypeptide with operative and accidental trauma.

The serum from 109 traumatized patients was examined for immunosuppressive activity which might explain diminished host immune responsiveness following operative or accidental injury. Twenty-eight fo 31 (90%) severely tralmatized patients, 25 of 60 (42%) moderately traumatized patients, and 0 of 18 minimally traumatized patients developed serum which suppressed the response of normal human lymphocytes to phytohemagglutinin. The degree and duration of serum immunosuppressive activity paralleled the severity of the clinical course but did not correlate with serum cortisol or barbiturate levels. Suppressive sera were not cytotoxic. The immunosuppressive factor(s) was contained in a low molecular weight (less than 10,000 daltons) peptide fraction and was present in 5--10 times the amount recoverable from normal serum. By size and activity the trauma serum factor resembled immunoregulatory alpha globulin, a naturally-occurring serum inhibitor of T-lymphocyte reactions. Thus, depressed immunoreactivity following trauma may be due in part to high concentrations of an endogenous immunosuppressive polypeptide.

Adolescent↗
PubMed1977

Anti-immunoglobulin as an adjunct in producing long-term antigen-specific allograft survival. Organ localization of immune complexes.

Heterologous anti-immunoglobulin is a potent immunosuppressive agent that prolongs H-2- and H-3-incompatible skin graft survival. In conjunction with antithymocyte serum, anti-immunoglobulin promotes greater graft life than either antiserum used alone, without evidence of toxicity to recipient animals. Combination treatment with anti-immunoglobulin, antithymocyte serum, and donor spleen cells produces long-term allograft survival to the lifetime of the host and can result in antigen-specific immune unresponsiveness of sufficient strength to permit acceptance of a second-set graft. Anti-immunoglobulin complexes formed in treated mice appear to be localized primarily in the lymphatic reticuloendothelial system.

Animals↗