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Biomedical subjects

W P Coleman

Publications and source records attributed to W P Coleman.

At least 19 recordsLinked to original sources

The history of liposuction and fat transplantation in America.

Dermatologists have played an important role in the development of both liposuction and fat transplantation in the United States. Dermatologists were among the earliest physicians to embrace these new procedures and have been responsible for a number of breakthroughs and refinements in these techniques. Klein's development of the tumescent technique has profoundly altered the way liposuction and fat transplantation are performed. These procedures continue to be increasingly popular among dermatologic surgeons.

Adipose Tissue

Ultrasonic-assisted liposuction. Internal and external.

UAL has not provided the promised ideal of "fat dissolution without surgery." In extremely fibrous areas and second procedure liposuction, internal UAL may be a valuable tool once it is further perfected. UAL equipment continues to evolve and as it improves we hope to see a better safety profile, a mechanism for smaller entrance sites, and greater time efficiency in the procedure.

Adipose Tissue

Fat transplantation.

Fat transplantation has been used by physicians for over 100 years; however, this technique has been refined considerably since the development of liposuction in the late 1970s. Fat transplantation can be used for augmentation of subcutaneous defects throughout the body. It continues to be the safest and most versatile form of soft tissue augmentation.

Adipocytes

Morbidity and mortality related to liposuction. Questions and answers.

Reports of fatalities following liposuction have lead to investigations by state medical boards. The risk of complications and fatalities is clearly different for liposuction under local anesthesia and intravenous sedation. Thousands of patients have been treated with true tumescent liposuction as described by dermatologist Dr. Jeffrey A. Klein, with no reports of fatalities. Patients should seek physicians who are experienced in this extremely safe method of liposuction.

Anesthesia, Intravenous

A visit to the office of Drs. Margaret and Robert Weiss.

This is one of an occasional series of articles about visitations to the offices of prominent dermatologic surgeons. There are a number of highly skilled and innovative members of our field from whom we can all learn. Unfortunately, it is impossible for everyone to visit their facilities and observe their work first hand. The purpose of this series is to provide a behind-the-scenes look at the day-to-day workings of the offices of prominent dermatologic surgeons.

Ambulatory Surgical Procedures

Ultrastructural circuitry of cardiorespiratory reflexes: there is a monosynaptic path between the nucleus of the solitary tract and vagal preganglionic motoneurons controlling atrioventricular conduction in the cat.

We have tested the hypothesis: (1) that presumptive negative dromotropic vagal preganglionic neurons in the ventrolateral nucleus ambiguus (NA-VL) can be selectively labelled from the heart, by injecting one of two fluorescent tracers into the two intracardiac ganglia which independently control sino-atrial (SA) rate or atrioventricular (AV) conduction; i.e., the SA and AV ganglia, respectively. The NA-VL was examined for the presence of single and/or double labelled cells. Over 91% of vagal preganglionic neurons in the NA-VL projecting to either intracardiac ganglion did not project to the second ganglion. Consequently, we also tested the hypothesis: (2) that there is a monosynaptic connection between neurons of the medial, and/or dorsolateral nucleus of the solitary tract (NTS), rostral to obex, and negative dromotropic neurons in the NA-VL. An anterograde tracer was injected into the NTS, and a retrograde tracer into the AV ganglion. The anterograde marker was found in both myelinated and unmyelinated axons in the NA-VL, as well as in nerve terminals. Axo-somatic and axo-dendritic synapses were detected between terminals labelled from the NTS, and retrogradely labelled negative dromotropic neurons in the NA-VL. This is the first ultrastructural demonstration of a monosynaptic pathway between neurons in the NTS and functionally associated (negative dromotropic) cardioinhibitory neurons. The data are consistent with the hypothesis that the neuroanatomical circuitry mediating the vagal baroreflex control of AV conduction may be composed of as few as four neurons in series, although interneurons may also be interposed within the NTS.

Animals

New directions in surgical therapy.

Surgical dermatology continues to evolve rapidly. The field is blessed with a number of bright and enthusiastic young surgeons who are willing to spend to necessary time investigating new techniques. The horizon has changed dramatically over the last 5 years and promises to change even more in the years to come.

Dermatology

Healthcare systems process reengineering for developing countries: a report to IMIA Working Group 9.

To discover what kinds of health informatics the developing countries need, we look first to the underlying social structures that informatics is to support. Developing countries face severe problems in their goal of assuring access to quality healthcare to their citizens. Nor is it comforting to look to the example of the developed countries, themselves uncomfortable with the tremendous commitment of resources that they use. It seems clear that if developing countries are to succeed their systems for assuring health will need to achieve radical improvements over those currently employed by the developed countries. They need to build systems that are directed to the heart of the problems; they need to make the best use of their existing human and economic resources; and they need to do this while respecting the human potential and aspirations of their people. Any such system will need to be built around planning, organizing and measuring the long-term, rather than episodic, health of citizens. In particular, health interventions need to be moved upstream where they are more effective and less expensive. The job of health informatics is to provide the fundamental enabling infrastructure that would allow individuals to cooperate in the fluid, effective ways required. We describe some of the requisites for such a system. Certainly, its construction will depend on the use of an open, standards-based distributed object software architecture.

Delivery of Health Care

Advances in chemical peeling.

Chemical peeling is traditionally discussed in terms of the depth of injury: superficial, medium, or deep. There have been a number of important advances in both superficial and medium-depth chemical peeling over the last several years. This article reviews the state of the art of these techniques and the increasing understanding of their effects on skin.

Chemexfoliation

Liposuction.

Explore the source record for details and available documents.

Humans

Infusion rates and levels of premedication in tumescent liposuction.

BACKGROUND: Tumescent liposuction has proven to be an extremely safe and effective method of liposuction. However, the infusion of tumescent anesthesia can take 1 hour or more to complete. OBJECTIVE: To document the types, dosages, and routes of administration of premedication utilized by four experienced tumescent liposuction surgeons. To determine if infusion rates for tumescent anesthesia are affected by types of premedication. METHODS: Four experienced liposuction surgeons were asked to review their most recent 100 tumescent liposuction patients with respect to types and dosages of premedication and routes of administration. Data were also provided on corresponding infusion pump settings and infusion rates. Volumes of tumescent anesthesia and corresponding volumes of fat aspirated were also collected on the same 400 patients. RESULTS: Infusion of tumescent anesthesia could be performed more rapidly in patients who were given greater amounts of premedication. Volumes of tumescent anesthesia infused were generally two or more times the volume of fat aspirated. Patients could be infused with less premedication if slow infiltration was employed. CONCLUSION: Infusion rates for tumescent anesthesia can be increased of greater amounts of premedication are given. However, this must be balanced against the safety of the premedication.

Adult

The biologic basis of ultrasonic liposuction.

The use of ultrasound to facilitate liposuction is a new and potentially exciting area of clinical and research interest. Whether or not this will result in important changes in the practice of liposuction remains to be determined.

Adipose Tissue

Combining surgical methods for skin resurfacing.

Cutaneous resurfacing with lasers is still in its infancy. As with all new techniques, its proper place will be determined in the context of established procedures. Dermabrasion and chemical peeling have been used by dermatologists for cutaneous resurfacing for over a century. In many patients, any one of these three procedures can be used to achieve excellent results. For others, a specific procedure is clearly more beneficial. For many patients, combining the use of these three techniques achieves maximum benefit. This article discusses the use of combined techniques and when they are indicated.

Chemexfoliation