[Splenic autotransplantation in splenic injuries].
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Biomedical subjects
Publications and source records attributed to R Farina.
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It is generally accepted that lactose intolerance is a cause of delayed recovery from malnutrition. To discriminate the true importance of this factor, the effect of dietary lactose concentration on "catch up" growth was studied on rats fed a protein free diet from weaning to 34 days of age and then refed "ad libitum" with diets providing different levels of Protein Calories (P%: 5, 11, 17 and 25%) and Lactose (L%: 0, 1, 15, 27 and 37%) for 4 days. Weight changes, daily dietary intakes and gastrointestinal disorders (GID) were recorded. The growth rate (GR) -g/100g rat/day- showed a direct correlation with P% whereas a decrease in (GR) as well as in Protein Utilization (PU) was associated with increasing L%, the higher the P%, the greater the effect of L%. The observed effect of lactose on (PU) does not correlate with (GID). Analysis of intake data -expressed as calories/day/W0.73- showed that animals ate less diet when lactose was present resulting in energy restriction (ER) from 12 to 62%. A primary effect of food intake might be proposed as a limiting factor for (GR) and (PU) in rats recovering from depletion. The influence of P% on improved lactose tolerance must also be stressed.
The authors associate the projection of the nasal tip to hypertrophy of the alar cartilages and, more specifically, of their medial branches. The heavy, blobby, or bulbous nose is caused by an increase of the columellar-alar angle of the alar cartilages, and bears no relationship to the cephalometric nasal index. Moreover, the bulbous nose usually has excess fatty tissue present in the tip of the nose. The projecting tip may be corrected by excising a rectangular or quadrangular segment from the medial branches of the alar cartilages, or by resecting the cupula of the alar cartilages, including a small or large segment of its medial branch, in order to obtain the desired effect, namely, to lower the tip and decrease the columellar-alar angle. The nasal index remains unchanged. If in addition, the tip of the nose is bulbous, the fatty tissue should be removed at the same time.
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Lateral deviations of the nose can be caused by various violent injuries or even by unsuccessful surgery (iatrogenic). Early treatment of fractures is not only bloodless but very much easier in contrast to older injuries which can only be corrected by surgery. Under these circumstances, a complete revision and repositioning of the upper and inferior lateral cartilages or alar cartilages is advisable. In both cases, the simultaneous correction of the affected septum is fundamental. The authors recommend packing of the nasal cavities for 5 days and immobilization with an aluminum splint for 7 days.
The deformities known as saddle nose and boxer's nose result from injuries or poorly planned nasal surgery. Boxer's nose may eventually be corrected using Straith's method. It is possible to correct both deformities by simply using a bone graft. Neither the use of cartilage grafts nor organic or inorganic inclusions are recommended, the former because they tend to deform, and the latter because they are not well tolerated. There are many advantages to using bone grafts taken from the tibia, including good integration and successful results. This personal method has been used by us since 1948, and is based on the principle of the first-class lever.
The authors discuss the S-shaped nasal wing that is responsible for pseudocryptocolumella. Simple excision of a spindle-shaped cutaneous wedge from the lower rim of the nasal wings corrects this imperfection. The cosmetic appearance is satisfactory and the resulting scar scarcely noticeable.
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The authors divide the techniques of reduction mammoplasty into two groups. The first one is done by the so-called classical method in which the two important pedicles--the medial (internal mammary artery) and the lateral (lateral thoracic artery)--are preserved. The second one is made through the free transplant of the areolar, chiefly in those cases of large hypertrophic breasts. Both methods give good results in experienced and skillful hands, as well as good satisfaction to the majority of our patients. On the other hand, complications may arise, as in every field of plastic surgery.
There are numerous causes of male sexual impotence: these may be classified as organic or psychic. All possible clinical options should be explored before resorting to surgery for impotence. Many techniques are available for surgical correction of impotence. The authors have used Small-Carrion's implantation of a silicone prothesis with success in a number of patients, ranging in age from 28 years to 78 years.
The fecal steroid elimination profile was studied in 7 type II hyperlipoproteinemic patients given a low-lipid diet with textured soybean proteins, in order to define the mechanism of the hypocholesterolemic activity of this new dietary regimen. Four of the patients followed a 3- + 3-week cross-over protocol, comparing the soybean diet with a reference low-lipid diet with animal proteins. In these, fecal neutral steroids and bile acids were analyzed by chromatography during the two dietary periods. In spite of the clear hypocholesterolemic effect, no significant differences in steroid output were noted between the two dietary periods. In the 3 remaining patients, a chromatographic + isotopic method (by injecting 14C-labelled cholesterol i.v. 4-6 weeks prior to the dietary study) was employed. Again, no marked changes were noted in the fecal neutral steroid and bile acid outputs and the slope of the decay curve of the plasma cholesterol-specific activity was not changed by the experimental diet, in spite of the remarkable decrease in plasma cholesterol. The reported results do not provide a definitive contribution to the mode of action of the soybean protein diet. They suggest, however, that it is not an effect mediated by undigestible dietary components. The possibility of a cholesterol redistribution from plasma to tissue pools should be considered.
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