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At least 307 records · Page 17Linked to original sources
PubMed2004

[Functional neuronal plasticity].

INTRODUCTION: Thanks to the contributions made by neuroscientific research and the clinical evidence regarding the functional recovery of the central nervous system in the different motor, cognitive, linguistic and sensory spheres, we now know more about how the brain is built and its modifications. This recovery is possible due to the plasticity of the brain, its capacity to reorganise itself and to modify functions in order to adapt to both external and internal changes. This capacity is inherent to brain cells and allows cortical circuits to be repaired, integrates other cortical areas to carry out modified functions and responds to different disorders. It depends on genetic, neuronal and neurochemical factors and its limits can be manipulated through clinical and pharmacological intervention. DEVELOPMENT: The brain's capacity to adapt itself to changes is crucial in the development of the nervous system and has important repercussions on learning. The neuroanatomical, neurochemical and functional changes that take place during the reorganisation made possible by plasticity will facilitate the recovery acquisition of the functions involved (adaptive plasticity) and may hinder the development of others (maladaptive plasticity). This variability of the possible responses is related to the chronology of the lesion, the site that is affected, the state of the substrata that can take on the function and the type of function that is altered. The mechanisms responsible for facilitating this plasticity are different at any given time (fast and late plasticity), depending on the function that is altered, with expansion of the somatotopic representations in the motor cortex adjacent to the damage, interhemispherical transfer of language or crossed plasticity in the auditory or visual function. The neuropsychological pathology can appear linked to the lesion or secondary to a maladaptive plasticity. CONCLUSIONS: Advancing in our knowledge of the intrinsic mechanisms of brain plasticity and synaptic regulation will lead us to understand the recovery of damaged or lost functions in the brains of children with special needs, and thus allow us to implement favourable clinical and pharmacological interventions.

Central Nervous System↗
PubMed1988

DRGs, costs, and outcome for plastic surgical patients.

The purpose of this study was to analyze hospital cost, resource utilization, and outcome by age for a large group of hospitalized plastic surgical patients using the DRG format. Hospital cost per patient for all plastic surgical admissions (both inpatient and potentially ambulatory patients) treated (N = 1632) at an academic medical center increased with age and peaked for plastic surgical patients 75 to 80 years of age ($11,585 per patient). Although DRG payment would have produced an aggregate profit of $2,404,854, older plastic surgical patients (65 years of age and above) generally produced losses. Older plastic surgical patients demonstrated a longer hospital length of stay, a greater severity of illness, a higher percent of outliers, and a greater mortality than younger plastic surgical patients. In addition, older plastic surgical patients had higher clinical resource utilization based on a number of clinical parameters such as emergency admission, SICU utilization, need for blood transfusions, and need for plasma product infusions. This study suggests that the current DRG reimbursement methodology may be inequitable vis-à-vis the older plastic surgical patient. As additional pressures encourage the performance of more ambulatory procedures (previously performed as inpatients), our profit margins may decline and possibly affect our ability to provide quality plastic surgical care.

Adult↗
PubMedDate not supplied

Factors affecting light transmission of single-use, plastic light-curing tips.

Recently, manufacturers introduced presterilized, single-use, plastic light-curing tips to be used either routinely or on patients with known or questionable communicable health concerns. The purpose of this study was to examine the effect of these single-use tips on light transmission compared to conventional fiber-optic bundles in a variety of commercial light-curing units. Also, the effects of surface contact with the plastic tips (human tissues, reflective or opaque media, and barrier films) were evaluated. Where applicable, single-use tips from two sources (Caulk/Dentsply and Demetron) were placed in commercial curing units (Optilux 150 and 500, MAX 100, Spectrum Curing Light, and 3M XL-3000), and the intensity was compared to that of the conventional glass curing tip used with that specific curing unit. Intensity readings were also made for 6 continuous minutes using plastic tips in a high-intensity curing unit to simulate veneer bonding. If the sides of the plastic tip came in contact with the operator's fingers or the patient's tongue and/or cheek during a clinical procedure, a lowering of transmitted light intensity resulted. The glow emitted from the sides of the tip when in use may be annoying to the operator. To prevent this glare, the operator may be tempted to treat the sides of the tip by painting, applying a thin polymer barrier, abrasion, or wrapping in an opaque reflective material (aluminum foil). A significant decrease in light intensity can result if plastic curing tips contact oral tissues or bare hands. Application of thin polymer barriers was found to significantly reduce light transmission value. Also, surface modification (coating with paint or surface scratches) was found to greatly reduce light intensity levels, while wrapping the tip in aluminum foil produced a very small increase. Results indicated that transmitted light intensity with use of plastic tips was dependent upon both the brand of plastic tip tested and the different photocuring units. Either a slight increase or a slight decrease in intensity was noted. Plastic tips did not degrade in transmitted intensity when exposed to the heat produced during a simulated veneering scenario. In summary, use of plastic, single-use light-curing tips can provide adequate intensity for photoactivated restorative techniques; however, the clinician must be aware of specific, clinically relevant limitations with their use. Clinicians must also note that these tips are not designed for re-use.

Analysis of Variance↗
PubMed2005

Plastic versus glass support for an immunoassay on metal-coated surfaces in optically dense samples utilizing directional surface plasmon-coupled emission.

We compared plastic (polycarbonate) and high-quality glass support materials for gold-coated slides, when performing a model immunoassay against rabbit IgG using fluorescently labeled (AlexaFluor-647) anti-rabbit IgG, and detecting surface plasmon-coupled emission (SPCE) signals. Both, glass and plastic slides were simultaneously coated with a 48-nm layer of gold and protected with a 10-nm layer of silica. The maximum SPCE signal of AlexaFluor-647 was only two- to three-fold smaller on plastic slides than on glass slides. A small difference in the SPCE angles on glass (theta (F) = 55 degrees ) and plastic (theta (F) = 52.5 degrees ) slides was observed and can be explained with a slightly smaller refractive index of the plastic. We have not found any difference in the angle distribution (sharpness of the fluorescence signal at optimal SPCE angle) for the plastic slide compared to the glass slide. The kinetics of binding was monitored on the plastic slide as well as on the glass slide. Optically dense samples, a 4% red blood cell suspension and a 15% hemoglobin solution, are causing a reduction in the immunoassay SPCE signal by approximately 15% and three times, respectively, and the percentage of the reduction is the same for plastic and for glass slides. We believe that plastic substrates can be readily used in any SPCE assay, with only marginally lower total signal compared to high-quality glass slides.

Animals↗
PubMed2006

Strain-induced disorder, phase transformations, and transformation-induced plasticity in hexagonal boron nitride under compression and shear in a rotational diamond anvil cell: in situ x-ray diffraction study and modeling.

Plastic shear significantly reduces the phase transformation (PT) pressure when compared to hydrostatic conditions. Here, a paradoxical result was obtained: PT of graphitelike hexagonal boron nitride (hBN) to superhard wurtzitic boron nitride under pressure and shear started at about the same pressure ( approximately 10 GPa) as under hydrostatic conditions. In situ x-ray diffraction measurement and modeling of the turbostratic stacking fault concentration (degree of disorder) and PT in hBN were performed. Under hydrostatic pressure, changes in the disorder were negligible. Under a complex compression and shear loading program, a strain-induced disorder was observed and quantitatively characterized. It is found that the strain-induced disorder suppresses PT which compensates the promotion effect of plastic shear. The existence of transformation-induced plasticity (TRIP) was also proved during strain-induced PT. The degree of disorder is proposed to be used as a physical measure of plastic straining. This allows us to quantitatively separate the conventional plasticity and transformation-induced plasticity. Surprisingly, it is found that TRIP exceeds the conventional plasticity by a factor of 20. The cascade structural changes were revealed, defined as the reoccurrence of interacting processes including PTs, disordering, conventional plasticity, and TRIP. In comparison with hydrostatic loading, for the same degree of disorder, plastic shear indeed reduces the PT pressure (by a factor of 3-4) while causing a complete irreversible PT. The analytical results based on coupled strain-controlled kinetic equations for disorder and PT confirm our conclusions.

Journal Article↗
PubMed2006

The loss of adaptive plasticity during long periods of environmental stasis.

Adaptive plasticity allows populations to adjust rapidly to environmental change. If this is useful only rarely, plasticity may undergo mutational degradation and be lost from a population. We consider a population of constant size N undergoing loss of plasticity at functional mutation rate m and with selective advantage s associated with loss. Environmental change events occur at rate theta per generation, killing all individuals that lack plasticity. The expected time until loss of plasticity in a fluctuating environment is always at least tau, the expected time until loss of plasticity in a static environment. When mN > 1 and N theta >> 1, we find that plasticity will be maintained for an average of at least 10(8) generations in a single population, provided tau > 18/theta. In a metapopulation, plasticity is retained under the more lenient condition tau > 1.3/theta, irrespective of mN, for a modest number of demes. We calculate both exact and approximate solutions for tau and find that it is linearly dependent only on the logarithm of N, and so, surprisingly, both the population size and the number of demes in the metapopulation make little difference to the retention of plasticity. Instead, tau is dominated by the term 1/(m+s/2).

Adaptation, Biological↗
PubMed2002

Genetic architecture of plastic methyl jasmonate responses in Arabidopsis thaliana.

The ability of a single genotype to generate different phenotypes in disparate environments is termed phenotypic plasticity, which reflects the interaction of genotype and environment on developmental processes. However, there is controversy over the definition of plasticity genes. The gene regulation model states that plasticity loci influence trait changes between environments without altering the means within a given environment. Alternatively, the allelic sensitivity model argues that plasticity evolves due to selection of phenotypic values expressed within particular environments; hence plasticity must be controlled by loci expressed within these environments. To identify genetic loci controlling phenotypic plasticity and address this controversy, we analyzed the plasticity of glucosinolate accumulation under methyl jasmonate (MeJa) treatment in Arabidopsis thaliana. We found genetic variation influencing multiple MeJa signal transduction pathways. Analysis of MeJa responses in the Landsberg erecta x Columbia recombinant inbred lines identified a number of quantitative trait loci (QTL) that regulate plastic MeJa responses. All significant plasticity QTL also impacted the mean trait value in at least one of the two "control" or "MeJa" environments, supporting the allelic sensitivity model. Additionally, we present an analysis of MeJa and salicylic acid cross-talk in glucosinolate regulation and describe the implications for glucosinolate physiology and functional understanding of Arabidopsis MeJa signal transduction.

Acetates↗
PubMed2005

Indirect consequences of artificial selection on plasticity to light quality in Arabidopsis thaliana.

Covariation between light quality- and photoperiod-mediated phenotypic plasticity was investigated using Arabidopsis thaliana. Three episodes of artificial selection were imposed on an index that quantified the plastic response to reduced red to far-red ratios (R:FR), with higher index values indicating greater plasticity. Relative to control lines, two high plasticity (HP) lines showed 1.6- and 2.4-fold increases in the index; low plasticity (LP) lines showed 1.4- and 1.1-fold decreases. A factorial experiment combining high and low R:FR conditions with long and short photoperiods assessed indirect consequences of selection on plasticity. Despite divergent R:FR-mediated plasticities in HP vs. LP lines, all four lines showed increases in photoperiod-mediated responses and decreases in mean leaf number. Complex relationships among trait means, plasticities and underlying mechanisms caution against generalizing about the genetic architecture of plastic traits. Partially independent developmental and evolutionary responses to R:FR and photoperiod are somewhat unsurprising, given this species' cosmopolitan nature.

Arabidopsis↗
PubMed1992

Parallel induction by glucose of adherence and a polysaccharide antigen specific for plastic-adherent Staphylococcus epidermidis: evidence for functional relation to intercellular adhesion.

The initial attachment and the accumulation of Staphylococcus epidermidis on polymer surfaces in multilayered cell clusters embedded in amorphous slime, which together lead to the plastic-adherent phenotype detected by the adherence assay used in this study, have been proposed to be major virulence factors of these bacteria. An antigen specific for plastic-adherent S. epidermidis strains was detected by an indirect immunofluorescence test using absorbed antiserum raised against the strongly plastic-adherent S. epidermidis 1457. A coagglutination assay was established, which allowed the quantitation of the antigen in bacterial extracts under different physiologic growth conditions. Expression of the antigen and of plastic adherence depended significantly on the presence of glucose in the growth medium. Parallel to increased plastic adherence, a 32- to 64-fold increase in the amount of the antigen was detected in bacterial extracts of cells grown in tryptone soya broth (TSB) compared with that in extracts of cells grown in TSB lacking glucose. A parallel time-dependent increase of plastic adherence and expression of the antigen was observed after stimulation by glucose of stationary-phase cultures of plastic-adherent S. epidermidis strains grown in TSB lacking glucose. The antigen consisted most probably of polysaccharide, because its immunologic reactivity was completely abolished by periodate oxidation but was resistant to protease digestion. A significant proportion of cells of plastic-adherent as compared with nonadherent S. epidermidis strains grown in TSB were located in large cell clusters exceeding 50 cells, which completely disintegrated after periodate oxidation of the cell preparations. Periodate oxidation of adherent bacterial films in situ led to release of the adherent cells from the plastic surface. These results strongly indicate a functional relation of the antigen to adherence of S. epidermidis to polymer surfaces, most probably by mediating intercellular adhesion of cells leading to accumulation in multilayered cell clusters.

Agglutination↗
PubMed1997

Source of error on A-aDO2 calculated from blood stored in plastic and glass syringes.

We studied the effects of time delay on blood gases, pH, and base excess in blood stored in glass and plastic syringes on ice and the effects of resulting errors on calculated alveolar-to-arterial PO2 difference (A-aDO2). Matched samples of dog whole blood were tonometered with gas mixtures of 5% CO2-12% )2-83% N2 (mixture A), 10% CO2-5% O2-85% N2 (mixture B), and 2.88% CO2-4% O2-93.12% N2 (mixture C). Tonometered blood samples were transferred to 5-ml glass (5G), 5-ml plastic (5P), and 3-ml plastic (3P) syringes and stored on ice. Blood gases were measured every 1 h up to 6 h. In 5G, PO2 progressively decreased in blood tonometered with mixture A but rose in blood tonometered with mixtures B and C. O2 saturation progressively fell in all cases. In 5G, blood PCO2 progressively rose regardless of which gas mixture was used, and pH as well as base excess progressively fell. The rise in PO2 was faster in plastic than in glass syringes, and O2 saturation always rose in plastic syringes. Differences between storage in plastic and glass syringes on PO2 change were greatest when initial blood PO2 was highest (mixture A). At the highest PO2, O2 exchange was faster in 3P than in 5P. The rise of PCo2 was just as fast in plastic as in glass syringes, but in both the rise in PCO2 was faster at a higher initial PCO2 (mixture B) than in lower initial PCO2 (mixtures B and C). Rates of PO2 and PCO2 change in matched samples were significantly faster in 3P than in 5P. Errors due to rises in PCO2 and PO2 cause additive errors in calculated A-aDO2, and when blood is stored in plastic syringes for > 1 h significant errors result. Errors are greater in normoxic blood, in which estimated A-aDO2 decreased by > 10 Torr after 6 h on ice in plastic syringes, than in hypoxic blood.

Animals↗
PubMed1990

Lesions of nonvisual inputs affect plasticity, norepinephrine content, and acetylcholine content of visual cortex.

1. The depletion of both norepinephrine (NE) and acetylcholine (ACh) in the visual cortex can decrease plasticity. This decrease in plasticity, although dramatic under some circumstances, fails to occur under others. 2. We depleted cortical NE and ACh in 35- to 42-day-old kittens by making a lesion of the white matter behind the cingulate gyrus. One eye was sutured on the day of the lesion. We recorded from the visual cortex 7 days or 2-3 mo later and used the influence of the deprived eye on the cortical cells as a measure of plasticity. 3. We measured NE content by high-pressure liquid chromatography (HPLC) and inferred ACh depletion from depletion of choline acetyltransferase (ChAT) activity. NE depletion averaged 60% in the successfully depleted animals. Depletion of ChAT activity was consistent with NE depletion. 4. When recording occurred 7 days after the lesion and the sutured eye was contralateral to the lesion, plasticity was decreased on the side with the lesion; 70% of the cells were driven by the deprived eye. On the control, uninjured side only 15% of the cells were driven by the deprived eye. 5. In two circumstances the lesion did not cause a decrease in plasticity. In animals with suture ipsilateral to the lesion, the cortex remained plastic. In these animals only 26% of the cells in the hemisphere with the lesion were driven by the deprived eye. The cortex also retained its plasticity if the contralateral eye remained sutured for several months after the lesion, even though there was no recovery from NE and ACh depletion. 6. We conclude that depletion of NE and ACh does decrease plasticity; that is, it protects the deprived eye from losing its ability to drive cortical cells, at least for a short period of time. Depletion protects only the normally dominant contralateral pathway; the ipsilateral visual pathway remains plastic. 7. Perhaps the importance of the side of the deprived eye can be explained by assuming that depletion of NE and ACh removes facilitatory input. This would decrease the ability of cortical cells on the side with lesion to potentiate the input from the nondeprived eye relative to the deprived eye; that is, it would decrease the molecular deprivation (MD) effect. A removal of facilitation would also increase the visual input required to drive cells.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetylcholine↗
PubMed2006

Phenotypic plasticity and experimental evolution.

Natural or artificial selection that favors higher values of a particular trait within a given population should engender an evolutionary response that increases the mean value of the trait. For this prediction to hold, the phenotypic variance of the trait must be caused in part by additive effects of alleles segregating in the population, and also the trait must not be too strongly genetically correlated with other traits that are under selection. Another prediction, rarely discussed in the literature, is that directional selection should favor alleles that increase phenotypic plasticity in the direction of selection, where phenotypic plasticity is defined as the ability of one genotype to produce more than one phenotype when exposed to different environments. This prediction has received relatively little empirical attention. Nonetheless, many laboratory experiments impose selection regimes that could allow for the evolution of enhanced plasticity (e.g. desiccation trials with Drosophila that last for several hours or days). We review one example that involved culturing of Drosophila on lemon for multiple generations and then tested for enhanced plasticity of detoxifying enzymes. We also review an example with vertebrates that involves selective breeding for high voluntary activity levels in house mice, targeting wheel-running behavior on days 5+6 of a 6-day wheel exposure. This selection regime allows for the possibility of wheel running itself or subordinate traits that support such running to increase in plasticity over days 1-4 of wheel access. Indeed, some traits, such as the concentration of the glucose transporter GLUT4 in gastrocnemius muscle, do show enhanced plasticity in the selected lines over a 5-6 day period. In several experiments we have housed mice from both the Selected (S) and Control (C) lines with or without wheel access for several weeks to test for differences in plasticity (training effects). A variety of patterns were observed, including no training effects in either S or C mice, similar changes in both the S and C lines, greater changes in the S lines but in the same direction in the C lines, and even opposite directions of change in the S and C lines. For some of the traits that show a greater training effect in the S lines, but in the same direction as in C lines, the greater effect can be explained statistically by the greater wheel running exhibited by S lines ('more pain, more gain'). For others, however, the differences seem to reflect inherently greater plasticity in the S lines (i.e. for a given amount of stimulus, such as wheel running/day, individuals in the S lines show a greater response as compared with individuals in the C lines). We suggest that any selection experiment in which the selective event is more than instantaneous should explore whether plasticity in the appropriate (adaptive) direction has increased as a component of the response to selection.

Adaptation, Physiological↗
PubMedDate not supplied

[Position test: an instrument for measuring the cognitive plasticity in the elderly with mild cognitive impairment].

INTRODUCTION: The search for variables that mediate in the shift from mild cognitive impairment (MCI) to dementia is currently a very active field of research. In this area, the term cognitive plasticity or modifiability can be of great interest. Proof of the existence of plasticity in the elderly with MCI and its possible value as an indicator of the shift from this condition to dementia have aroused an interest in investigating evaluation tools that enable the evaluation of plasticity in old age. AIMS. In this study we assess the validity of the position test (PT) as a measure of cognitive plasticity in the elderly and we examine its existence in people with MCI. PATIENTS AND METHODS: A total of 117 elderly subjects were evaluated with the Spanish version of the MMSE (Minimental State Examination) as a screening test for cognitive impairment, the AVLT LP (Auditory Verbal Learning Test Learning Potential), a test that is frequently used to evaluate plasticity, and the PT. RESULTS: Findings show that the PT evaluates cognitive plasticity in the elderly suffering from MCI, that it is possible to shorten the test without losing its evaluative properties and that performance in the test is not affected by educational level. Furthermore, it also reveals the fact that some elderly people with MCI show plasticity. CONCLUSION: The data obtained allow us to state that the PT is ideal for evaluating plasticity in the elderly, and we also recommend further research into plasticity and its possible relation with the cognitive progress of people with MCI.

Aged↗
PubMed2004

Molecular mechanisms of brain plasticity: neurophysiologic and neuroimaging studies in the developing patients.

The term plasticity, derived from the Greek word "plaistikos" meaning "to form" refers to the brain's ability to learn, remember and forget as well as its capacity to reorganize and recover from injury. There are four major types of plasticity: adaptive plasticity, impaired plasticity, excessive plasticity, and the 'Achilles heel' of the developing brain. Mechanisms of plasticity include: a change in the balance of excitation and inhibition; a long-term potentiation (LTP) or long-term depression (LTD); a change in neuronal membrane excitability; the anatomical changes-formation of new axon terminals and new synapses. Mechanisms for plasticity include activity-dependent refinement of neuronal connections and synaptic plasticity as a substrate for learning and memory. The molecular mechanisms for these processes were described in view of the current investigations. Authors presented: the role of calcium ions, calcium channels, NMDA receptors, free radicals, lipid peroxides and neurotrophins in the plasticity of developing brain. The utility of the neurophysiologic and MRI techniques were described in the determination of brain reorganization and repair in patients with cerebral palsy. Authors discussed their results on quantitative EEG and spectroscopy MRI studies in children with cerebral palsy. They have shown the existence of two processes in brain: brain damage and recovery.

Brain↗
PubMedDate not supplied

"Green" nanocomposites from cellulose acetate bioplastic and clay: effect of eco-friendly triethyl citrate plasticizer.

"Green" nanocomposites have been successfully fabricated from cellulose acetate (CA) powder, eco-friendly triethyl citrate (TEC) plasticizer and organically modified clay. The effect of the amount of plasticizer varying from 15 to 40 wt % on the performance of the nanocomposites has been evaluated. The morphologies of these nanocomposites were evaluated through X-ray diffraction (XRD), atomic force microscopy (AFM), and transmission electron microscopy (TEM) studies. The mechanical properties of nanocomposites are correlated with the XRD and TEM observations. Cellulosic plastic-based nanocomposites with 20 wt % TEC plasticizer and 5 wt % organoclay showed better intercalation and an exfoliated structure than the counterpart having 30/40 wt % plasticizers. The tensile strength, modulus and thermal stability of cellulosic plastic reinforced with organoclay showed a decreasing trend with an increase of plasticizer content from 20 to 40 wt %. The nano-reinforcement at the lower volume fractions (phi < or = 0.02) reduced the water vapor permeability of cellulosic plastic by 2 times and the relative permeability better fits with larger platelet aspect ratios (alpha = 150).

Aluminum Silicates↗
PubMed2006

Effect of the Veterans Affairs Medical System on plastic surgery residency training.

BACKGROUND: Teaching hospitals within the Veterans Affairs Health System perform the majority of complex and high-risk surgical procedures in the veteran patient population. Residency positions in the Veterans Affairs Medical System are usually part of a rotational educational system within a university-based residency, and plastic surgeons in training are a major work force and health care provider. The purpose of this study was to evaluate the current effect of the Veterans Affairs Medical System on plastic surgery residency training. METHODS: A 6-year (January of 1998 to December of 2003) review was performed of procedures completed at the Durham Veterans Affairs Medical Center, Section of Plastic Surgery. Procedures were divided into the following categories: extremities and trunk; breast and cosmetic; head and neck, including excision of skin lesions; hand surgery; craniomaxillofacial surgery; and other. Only procedures performed in the main operating room were reviewed and analyzed. In addition, a detailed review was performed of major head and neck reconstructions with free tissue transfer. RESULTS: A total of 1655 operative procedures were performed in 1290 patients. The ratio of men to women was 6:1 (1112 men and 178 women). Patients ranged in age from 26 to 97 years (average age, 62.7 years). Procedures in the extremities and trunk (n = 193, 11.7 percent), breast and cosmetic (n = 228, 13.8 percent), hand surgery (n = 155, 9.4 percent), and other (n = 275, 16.6 percent) categories were comparably distributed. Although the head and neck category accounted for the highest number of procedures (n = 766, 46.3 percent), the majority of these procedures were simple excisions of skin tumors (n = 612). There were significantly fewer major craniomaxillofacial cases (n = 38, 2.3 percent). CONCLUSIONS: Data from the retrospective analysis reveal that a broad spectrum of plastic surgical procedures is performed within the Veterans Affairs Health System, serving as a tremendous resource for resident training. The fact that approximately 260 procedures per year are performed demonstrates an active service. Craniomaxillofacial surgery is currently underrepresented compared with other categories at the authors' particular institution. By their definition, nonspecific plastic surgical procedures ("other") account for 275 (16.6 percent) of all 1655 procedures performed. This demonstrates that plastic surgery "overlaps" with other specialties, such as dermatology. The Veterans Affairs Health System will continue to play a significant role in the future training of plastic surgeons. Now, more than ever, a strong Veterans Affairs surgical service, including plastic surgery and its modern techniques, will be needed.

Adult↗
PubMed2007

Dynamics of hospital-based plastic surgery.

BACKGROUND: Legislative regulations, decreasing reimbursements for office procedures, and malpractice premiums have transformed plastic surgery from an office-based specialty into a hospital-based one. Simultaneously, hospital economics has altered, wherein the "business model" has all but subsumed the old "medical care" model. Integration between plastic surgeons and the new hospital structure has been difficult for both. Limited understanding of the financial dynamics of hospital-based practices, unfamiliarity with the administrative processes, and resistance to accept and assimilate changes by both sides pose hurdles, in some situations even forcing plastic surgeons out of hospital settings. METHODS: Using well-defined financial terminology, changing national development in health care policy, and hospital-based administrative strategies as a backdrop, this study finds common ground for the plastic surgery specialty to coapt with the hospital. RESULTS: Key missing elements in the interaction between plastic surgeons and hospital administrations and ways of integrating these components are identified. To do so effectively, plastic surgeons must first understand the basic tenets of management that drive hospital administrators, participate at every level they can in guiding these processes, and assume leadership roles that will ultimately dictate the way they work and conduct their professional lives. CONCLUSIONS: It is critical that plastic surgeons engage in important processes that govern the economics of hospital-based health care delivery. This commitment will also ensure that all three groups (the patients, physicians, and hospital administrators) achieve a degree of satisfaction. The message to plastic surgeons is clear: be proactive and lead a campaign of change.

Financial Management, Hospital↗
PubMed2006

[Development in the field of plastic surgery].

OBJECTIVE: To summarize the recent development in the plastic and reconstructive surgery. METHODS: The related literature was reviewed and the main achievements in the field of plastic surgery were summarized. RESULTS: Plastic and reconstructive surgery was one of the quickly-developed fields in the world medicine, especially aesthetic plastic surgery. Reconstructive plastic surgery and aesthetic plastic surgery would be bind in the future. The unaesthetic hand surgery" was a very important branch of the hand surgery, so not only the function recovery of the hand deformities but also the aesthetic sculpture for the deformed hand should be emphasized. Evaluation on measurement of the facial paralysis reconstruction was a main part of the facial examination. The allotransplantation of the face became more developed. The anatomical research on the cutaneous perforator arteries, vascularisation of the biceps femorismuscle, and the gracilis perforator flap was well performed by the plastic surgeons. CONCLUSION: The quick development has happened in the reparative and reconstuctive surgery and the aesthetic plastic surgery. We must not only pay attention to the organ defect reconstruction and tissue deformity repair but also to the aesthetic sculpture for the deformed parts of the body.

Plastic Surgery Procedures↗