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At least 433 records · Page 24Linked to original sources
PubMed1984

Treatment of Class II deep bite by orthodontic and surgical means.

Conventional orthodontic correction of the Class II deep-bite deformity with a decreased lower anterior facial height tendency can be mechanically difficult, inefficient and, in many instances, impossible. Orthodontic treatment alone of either adults or adolescents with such deformities frequently can neither increase lower anterior facial height sufficiently to achieve ideal facial proportions nor achieve long-term occlusal stability. Despite the need for surgical intervention to achieve satisfactory occlusal and esthetic results, many patients with such deformities are still being treated in clinical practice by traditional orthodontic procedures, with less than ideal esthetic and/or occlusal results. The challenge to achieve efficient and stable treatment of this deformity has been met by the use of various surgical techniques in combination with orthodontic treatment. This combined surgical-orthodontic approach can provide increased treatment efficiency, long-term stability, and optimal esthetic results. The proper sequencing and correct selection of orthodontic mechanotherapy are essential to ensure the desired results. This article purposes to detail basic problems involved in diagnosis and treatment planning for the combined surgical-orthodontic approach to patients exhibiting Class II deep bite and decreased lower facial height. Orthodontic and surgical treatment objectives are explained, and representative case reports are presented and discussed to illustrate this method of treatment. Extraction patterns, control of the transverse dimension, arch wire selection, auxiliary wires, elastics, and extraoral appliance use are described. Surgically, the dentofacial disharmony associated with this deformity may defy treatment by surgical advancement of the mandible only. Genioplasty, Le Fort I osteotomy, symphyseal osteotomy, anterior or total mandibular subapical osteotomy, body osteotomy, submental lipectomy, and rhinoplasty are adjunctive procedures that are described and may be used in concert with mandibular advancement surgery.

Adult↗
PubMedDate not supplied

The versatile superficial inferior epigastric artery free flap.

A series of 27 successful Superficial Inferior Epigastric Artery free flaps were analysed for a number of clinical and surgical variables. The anatomy and surgical technique of the flap are detailed and its advantages and disadvantages relative to other free flaps used for soft tissue contour are considered. Analysis of the variety of recipient sites of this flap is presented, as are details of the vascular pedicle and our experience with its constancy. It has been found to be a safe flap in experienced hands, with an aesthetic donor site scar, no functional loss and it lends itself to subsequent recontouring with suction assisted lipectomy or open techniques.

Abdomen↗
PubMed1984

Estrogen-induced effects on food intake and body weight in ovariectomized, partially lipectomized rats.

Following ovariectomy, rats were either partially lipectomized (10-15% of total body lipid was removed) or left intact, and were treated with either sesame oil vehicle or estradiol benzoate (EB; 4 micrograms/day) for 2 weeks. Although lipectomy resulted in a change in carcass adiposity, robust behavioral and metabolic effects of EB were observed in all animals. EB treatment induced changes in all carcass components examined, including lipid, protein and water. Lipid:protein ratios were not altered by EB treatment.

Animals↗
PubMed2005

What should be the treatment modality in giant cutaneous lipomas? Review of the literature and report of 4 cases.

We present three females (20, 39 and 58 years old) and one male patient (47 years old), admitted to our clinic with 3-20 years history of giant lipomas on periscapular (n = 2), posterior cervical (n = 1) and abdominal areas (n = 1), respectively. The sizes of the tumours ranged from 15 x 14 cm(2) to 35 x 25 cm(2) weighing 1900-12 350 g. In all cases, the diagnosis of the lesions was by physical examination and confirmed with computed tomography, magnetic resonance imaging and ultrasonography. Incisional biopsy or aspiration cytology were used to exclude liposarcoma. Three lesions with surrounding capsule formation and lipofibromatous changes underwent open surgery. In one case, as the capsule formation was not evident, suction assisted lipectomy was attempted. However, no aspirate could be evacuated possibly due to the fibrotic nature of the lesion and open surgery was performed. The follow-up period was 14 months to 5 years and no recurrence was noted.

Adult↗
PubMed2005

Augmentation phalloplasty surgery for penile dysmorphophobia in young adults: considerations regarding patient selection, outcome evaluation and techniques applied.

OBJECTIVES: To report on the efficacy and safety of augmentation phalloplasty procedures in physically normal young men, to introduce a patient selection and outcome evaluation questionnaire as well as, to propose a surgical technique modification. METHODS: Eleven (11) out of 28 psychosomatically normal men (25-35 years) who presented complaining of penile dysmorphophobia (subjective perception of small penis), were subjected to: (a) penile lengthening (suprapubic skin advancement--ligamentolysis): n=5, (b) penile lengthening and shaft thickening (free dermal-fat graft shaft coverage): n=3 and (c) panniculectomy--suprapubic lipectomy and penile lengthening: n=2. A self administered questionnaire was employed in order to facilitate selection of the patients qualifying for the operation as well as to evaluate the outcome. In addition, a technical modification regarding dermal-fat graft handling was applied. RESULTS: The postoperative course was uneventful with minor complications. The mean penile length gain (flaccid--stretched penis) was 1.6 cm (1-2.3 cm) [p=0.0014], the mean circumference gain was 2.3 cm [p=0.003] at the base and 2.6 cm [p=0.0012] subcoronaly. Significant (20%-53%) [p<0.0001] sexual self-esteem and functioning improvement was reported by the majority (91%) of patients. CONCLUSIONS: Although penile size alteration was not spectacular or satisfying the patients' "great" expectations, the substantially uneventful clinical course coupled with the significant improvement in sexual self-esteem and function and the highly accepted outcome by the patients, render augmentation phalloplasty reasonable treatment modality for the management of strictly selected and thoroughly informed young adults who suffer from penile dysmorphophobia.

Adult↗
PubMed2006

Human mesenchymal stem cells from adipose tissue: Differentiation into hepatic lineage.

Adipose tissue represents an accessible source of mesenchymal stem cells (ADSCs), with similar characteristics to bone marrow-derived stem cells. The aim of this work was to investigate the transdifferentiation of ADSCs into hepatic lineage cells in vitro. ADSCs were obtained from human adipose tissue from lipectomy. Cells were grown in medium containing 15% AB human serum. Cultures were serum deprived for two days and exposed to a two-step protocol with two different media using growth factors and cytokines. Hepatic differentiation was assessed by RT-PCR of liver-marker genes. ADSCs exhibited a fibroblastic morphology that changed to a cuboidal shape when cells differentiated. Expression of liver genes increased when using one of the two studied media consisting of DMEM supplemented with HGF, bFGF and nicotinamide for 14 days. The results indicate that, under certain specific inducing conditions, ADSCs can be induced to differentiate into hepatic lineage in vitro. Adipose tissue may be an ideal source of high amounts of autologous stem cells.

Adipose Tissue↗
PubMedDate not supplied

Submandibular tissue obstruction of tracheostomy tube: reversal with "chin sling".

We report on a 55-year-old woman with a tracheostomy who had unexplained respiratory failure from acute nocturnal shortness of death. During the second day of admission, the patient noticed that her "second chin" folded over the tracheostomy on neck flexion, occluding her artificial way. The patient jury-rigged a strap to retain the submental tissue from occluding the opening of the tracheostomy tube. She was subsequently free from obstructive symptoms with good oxygen saturation even with neck flexion. She was consequently discharged with a presumptive diagnosis of acute upper airway obstruction. We believe that this unusual complication of the tracheostomy tube may be more common than appreciated. Accordingly, patients with a tracheostomy should be evaluated through a full range of body and neck positions. Increases in body fat and tissue relaxation should be suspected as possible causes occlusion of tracheostomy tubes. The application of a "chin sling" can reverse this unusual upper airway obstruction until definitive correction by surgical lipectomy is performed.

Adipose Tissue↗
PubMed1988

Multiple symmetric lipomatosis: treatment with liposuction.

Multiple symmetric lipomatosis is a fascinating disease of uncertain etiology that manifests as massive lipomatous deposits in specific areas of the body. The clinical syndrome and possible pathogenesis are discussed. Classic surgical lipectomy has been the only treatment thus far reported; we report a patient successfully treated with liposuction.

Adipose Tissue↗
PubMed1983

The versatility of genioplasty using a broad pedicle.

The biologic and clinical foundation for using a broad soft-tissue pedicle genioplasty technique is described. This technique is versatile and stable and produces more predictable soft-tissue changes than previously reported methods of altering chin contour with alloplastic implants. The broad pedicle genioplasty technique has clear advantages over other techniques for procedures such as secondary genioplasty using local anesthesia, concomitant genioplasty and anterior subapical osteotomy, simultaneous genioplasty and submental lipectomy, and segmentalization of the chin to facilitate narrowing or widening.

Adolescent↗
PubMed1999

A case of multiple symmetrical lipomatosis (Madelung's disease).

Multiple symmetrical lipomatosis (Madelung's disease) is a rare disease with multiple symmetrical unencapsulated fatty accumulation diffusely involving the neck, the shoulders and the upper extremities (Kohan et al. Otolaryngol. Head Neck Surg. 1993;108:156-159). We describe a 48-year-old Japanese man with a history of alcoholism and liver cirrhosis who reported gradually enlarging masses in his cervical region for 4 years. MRI revealed large masses suggesting lipomas in the neck. The patient underwent a two-stage lipectomy. This patient is the 13th case reported in Japan since 1978, though over 200 cases have been reported since 1846 in Europe, most of them from the Mediterranean (Kitano et al. ORL 1994;56:177 180; Kaku et al. Endocrinol. Diabetol. 1997;4:103-106).

Adipose Tissue↗
PubMed1994

Therapy for obesity--today and tomorrow.

Obesity poses a serious health hazard and its treatment is often disappointing. Besides conservative methods, the place of pharmacotherapy, very-low-calorie diets, and even, in selected cases, mechanical means or surgery can be considered. Effective drug treatment for obesity must reduce energy intake, or increase energy expenditure, or increase energy losses in faeces. All these possibilities have potential activities but also serious limitations. Current pharmacotherapy essentially uses anorectic drugs and the other approaches, although promising, are still under investigation. Of the anorectic compounds currently available, serotoninergic agents, like dexfenfluramine and fluoxetine, appear to have the most suitable pharmacological profile. Very-low-calorie diets could help in the short-term but should be associated with other approaches to increase the rate of long-term success. They must be well-balanced as macronutrients and micronutrients are concerned, be prescribed in well-selected patients under careful medical supervision, and not be followed longer than a few weeks. Surgery can provide palliation for severe obesity when all medical approaches have failed. It may consist in decreasing food intake (gastric procedures), affecting calorie absorption (intestinal shunting, biliopancreatic bypass), or removing localized excess fat (lipectomy, liposuction). Gastric reduction operations are safe and effective provided they are performed by experienced surgeons in well-selected patients. They can be considered now as the best option for a minority of patients with morbid and refractory obesity. Finally, in very selected patients, mechanical means (such as the waist cord) may also help losing weight and/or avoiding weight regain. Even if all these therapeutic approaches can be helpful, at least in some obese individuals, they also have important limitations so that prevention remains up to now the 'treatment' of choice for obesity.

Appetite Depressants↗
PubMed1992

Surgical treatment of exophthalmos and exorbitism: a modified technique.

A modified surgical technique for the treatment of exophthalmos caused by Graves' disease or meningioma is presented. It is based on the orbital expansion as presented by Tessier (1969). It consisted of a lateral marginotomy with extension to the superior and inferior orbital rim and removal of the great wing of the sphenoid bone. The osteotomised orbital rim segment was advanced and stabilised by interposition of a calvarial bone graft. Concomitant lipectomy was carried out when indicated. Seven patients were operated on. No major complications occurred. The advantages of the method are discussed.

Adult↗
PubMed2001

Penoplasty for buried penis in children: report of 50 cases.

PURPOSE: The authors report their experience with a large number of children with buried penis and describe their surgical technique. METHODS: Fifty consecutive cases of buried penis that occurred between 1993 and 1999 were analyzed by chart review. Age at the time of surgery was 11 months to 13 years. Each patient underwent elective surgical repair utilizing a surgical technique not described previously. The authors' technique avoids a circumferential incision at the base of the penis, decreasing postoperative edema. The authors also utilize a unique through and through vertical mattress suture at the base of the penis that firmly attaches the shaft skin to the underlying corpora. RESULTS: All patients had a good to excellent outcome with a low postoperative complication rate. One patient fell during the postoperative period and developed a wound dehiscence. Early in the series 3 patients underwent additional procedures for recurrent retraction (6%). All patients experienced some postoperative discomfort as expected. Edema, when present, was mild and resolved within an acceptable period of time. All patients had a good cosmetic result with increased visualization of the penile shaft. CONCLUSIONS: A surgical approach to the buried penis is warranted in most circumstances. There are psychological benefits to both the patients and the parents. Although the authors perform the procedure as early as 11 months, it can be performed safely at 3 months. The procedure reported here provides immediate excellent cosmetic results with a low complication rate. The authors do not recommend suprapubic lipectomy either alone or in combination with the buried penis procedure. Circumcision should be avoided in an infant with a definite diagnosis of buried penis.

Adolescent↗
PubMed1986

Liposuction for debulking free flaps.

Suction-assisted lipectomy is a useful adjunct technique that allows the microsurgeon to debulk composite tissue transfers safely, without fear of compromising flap viability. The functional and aesthetic results of free flaps can often be enhanced in a single stage, which may not be possible using other conventional procedures.

Adipose Tissue↗
PubMed1986

Fat ablation and food restriction influence reproductive development and hibernation in ground squirrels.

The role of white adipose tissue in development of the reproductive apparatus of male golden-mantled ground squirrels was assessed by surgical removal of fat (lipectomy) immediately prior to onset of hibernation or by manipulation of fat levels through food restriction for 5 wk preceding hibernation. Animals then were maintained without food at 6 degrees C, and they hibernated from November 1983 until April 1984. At that time, blood plasma was assayed for hormone levels, and body mass, body composition, and masses of the testes and seminal vesicle-prostate complex were determined. At autopsy, testes and sexual accessory organs were heavier in Control squirrels than in Food-Restricted or Lipectomized (LIPX) animals. Paired-testes mass was positively correlated with body mass. Testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels were uniformly low in animals sampled during torpor, but were elevated in 2 animals that had regained the euthermic state. The Food-Restricted animals spent more time in torpor than did the other two groups, and the percentage of decrease in body mass over the hibernation season was less for Food-Restricted than for LIPX or Control animals. Adequate lipid stores may be essential for the normal development of the reproductive apparatus of male ground squirrels. In the field, animals with insufficient fat stores may forego reproduction and thereby conserve energy for survival.

Adipose Tissue↗
PubMed1978

Panniculectomy and the difficult ileostomy for urinary diversion.

This paper describes a helpful operation for revision of the difficult ileal stoma for urinary diversion. By using the standard technique of panniculectomy or abdominal lipectomy, the ileal loop can be left in the same position on the abdominal wall and healthy, viable tissue can be mobilized and repositioned to enable the urological surgeon to perform the cutaneous portion of the procedure again and to refashion the ileal loop. This saves the patient an operation of greater magnitude and risk.

Abdominal Muscles↗
PubMed1983

The vascular supply to the skin: an anatomical and physiological reappraisal--Part II.

The subcutaneous vascular system demonstrated in the first part of this study augments skin flap survival when included within human abdominal flaps. Flaps with larger subcutaneous vessels will survive to a greater length than flaps supplied solely by the subdermal plexus. Knowledge of the subcutaneous vascular system is applicable to breast reduction, subcutaneous mastectomy, and abdominal lipectomy.

Abdominal Muscles↗
PubMed1985

Refined liposuction unit.

I present two innovations that may be helpful to anyone who is designing or purchasing a unit for suction lipectomy: dual use of the unit as an ordinary operating room sucker, and cannulas with hand control.

Adipose Tissue↗